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This paper studies the real effects of foreign real estate capital inflows. Using transaction-level data, we document (i) a "China shock" in the U.S. housing market characterized by surging foreign Chinese housing purchases after 2008, and (ii) "home bias" in these purchases, as they concentrate in neighborhoods historically populated by ethnic Chinese. Exploiting their temporal and spatial variation, we find that these capital inflows raise local employment, with the effect transmitted through a housing net worth channel. However, they displace local lower-income residents. Our results show that real estate capital inflows can both stimulate the real economy and induce gentrification. [ABSTRACT FROM AUTHOR]

The present study investigated whether the presence of another person in a visuospatial perspective taking (VSPT) paradigm would influence the performance of non-autistic and autistic children. Experiment 1 tested non-autistic children aged 5–7 (N = 82, 42 girls) in a self-condition (pure spatial updating of self-mental rotation) and an other-condition (taking another agent’s perspective). Experiment 2 compared 18 autistic children (3 girls, aged 7.17–14.33 years old) and 22 mental ability-matched non-autistic peers (10 girls, Mage = 6.82). Both experiments were conducted in mainland China with Chinese participants. Non-autistic children below 7 years of age and autistic children performed better in the self-condition than in the other-condition, especially when angular disparities were greater than 90°, while no such differences were observed in 7-year-old non-autistic children. The interaction between perspective and angular disparity indicated the interference of another agent’s presence in typical VSPT tasks from a developmental perspective. The results were discussed with regard to the nonsynchronous development of spatial and social ability involved in the VSPT paradigm and its implications for the purity of VSPT as a measure of spatial ability. [ABSTRACT FROM AUTHOR]

Background: Ethnically Chinese adults in Canada and the United States face multiple barriers in accessing equitable, culturally respectful care at the end-of-life. Palliative care (PC) is committed to supporting patients and families in achieving goal-concordant, high-quality serious illness care. Yet, current PC delivery may be culturally misaligned. Therefore, understanding ethnically Chinese patients' use of palliative care may uncover modifiable factors to sustained inequities at the end-of-life. Objective: To compare the use and delivery of PC in the last year of life between ethnically Chinese and non-Chinese adults. Design: Population-based cohort study. Participants: All Ontario adults who died between January 1st, 2012, and October 31st, 2022, in Ontario, Canada. Exposures: Chinese ethnicity. Main Measures: Elements of physician-delivered PC, including model of care (generalist; specialist; mixed), timing and location of initiation, and type of palliative care physician at initial consultation. Key Results: The final study cohort included 527,700 non-Chinese (50.8% female, 77.9 ± 13.0 mean age, 13.0% rural residence) and 13,587 ethnically Chinese (50.8% female, 79.2 ± 13.6 mean age, 0.6% rural residence) adults. Chinese ethnicity was associated with higher likelihoods of using specialist (adjusted odds ratio [aOR] 1.53, 95%CI 1.46–1.60) and mixed (aOR 1.32, 95%CI 1.26–1.38) over generalist models of PC, compared to non-Chinese patients. Chinese ethnicity was also associated with a higher likelihood of PC initiation in the last 30 days of life (aOR 1.07, 95%CI 1.03–1.11), in the hospital setting (aOR 1.24, 95%CI 1.18–1.30), and by specialist PC physicians (aOR 1.33, 95%CI 1.28–1.38). Conclusions: Chinese ethnicity was associated with a higher likelihood of mixed and specialist models of PC delivery in the last year of life compared to adults who were non-Chinese. These observed differences may be due to later initiation of PC in hospital settings, and potential differences in unmeasured needs that suggest opportunities to initiate early, community-based PC to support ethnically Chinese patients with serious illness. [ABSTRACT FROM AUTHOR]

Background: Effect of education attainment and nutritional status on the development of cognitive impairment in Chinese elderly has not been reported. Objective: To investigate the role of education and nutrition in preventing cognitive impairment in the hospitalized Chinese elderly. Methods: Cognitive function was examined using the scoring system of Mini-Mental State Examination (MMSE) domains performed under instruction of Physicians of Geriatrics. Generalized linear mixed-effect regression was used for analyzing the association of demographic factors (age and gender), socioeconomic factors (education attainment and monthly income), as well as health-related factors (nutritional status, comorbidity, anxiety, and depression) and MMSE scores. Results: Total 246 hospitalized Chinese elders were enrolled into this study. Of them, 96 participants were 60–70 years old, 65 participants were 71–80 years old, and 85 of them were 81 years or older. Of the examined factors, we found that age, education attainment, and nutritional status were significantly associated with the outcome of MMSE scores, while monthly income and health condition (comorbidity, anxiety, and depression) were not significantly associated with MMSE score. Furthermore, education attainment was significantly associated with majority of the MMSE domains, including orientation, registration, attention and calculation, recall, and most of language sub-domains. Conclusion: Education attainment and nutritional status were significantly associated with MMSE scores in the hospitalized Chinese elderly. Higher education and better nutritional status are protective factors for the development of cognitive impairment in the hospitalized elderly Chinese population. [ABSTRACT FROM AUTHOR]

To estimate the prevalence of lifetime e-cigarette use and explore the association between lifetime conventional and electronic cigarette use with suicidality among Chinese adolescents, focusing on sex and school-type differences. A total of 22,509 students from 432 classes in 80 schools were recruited in Guangdong Province using a multistage, stratified cluster, random sampling method in 2021. Self-report questionnaires were used to collect information. Multivariable logistic regression models were performed and stratification analysis was conducted. All analyses were weighted and adjusted for the complex survey design. The weighted prevalence of lifetime e-cigarette use among adolescents in Guangdong Province was 8.7 % (4.3 % were dual users and 4.4 % were e-cigarette-only users) and 2.6 % were conventional-cigarette-only users. Lifetime e-cigarette-only users (AOR [Adjusted OR] =1.46, 95 % CI = 1.21–1.76), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.58–2.46) and dual users (AOR = 1.67, 95 % CI = 1.38–2.02) were at a higher risk of suicidal ideation than non-users. Lifetime e-cigarette-only users (AOR = 2.03, 95 % CI = 1.53–2.70), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.42–2.73), and dual users (AOR = 2.76, 95 % CI = 2.10–3.61) had a significantly higher risk of suicide attempts than non-users. After further analysis stratified by sex and school type, the associations of lifetime cigarette use patterns with suicidality slightly varied. The cross-sectional study design and self-report information. The prevalence of e-cigarettes among Chinese adolescents is concerning. Lifetime conventional and e-cigarette use were associated with suicidality among Chinese adolescents, with sex and school type moderating these associations. Targeted measures to restrict cigarette use, including new tobacco product (e-cigarette) use, among adolescents are warranted. • A large cross-sectional study of cigarette patterns and suicidality in China • E-cigarettes were associated with suicidality in Chinese adolescents. • Dual users had the highest risk of suicide attempts among cigarette users. • The association of cigarette use with suicidality varied by sex and school type. [ABSTRACT FROM AUTHOR]

With the number of internet users booming, problematic internet use (PIU) has become a public health threat. This study aims to figure out the inter-relationships between PIU symptoms and personality traits with network-based analysis among young people and to discuss the gender difference in the above networks. Based on a national cross-sectional study in 2022, 4655 Chinese adolescents and young adults aged 14 to 25 were included. We adopted the 6-item Short-Form Problematic Internet Use Questionnaire (PIUQ-SF-6) and the 10-item version of the Big Five Inventory (BFI-10) to measure PIU and personality traits, respectively. Network analysis was used to identify influential nodes and edges and compare the network models between male and female participants. The mean age of 4655 participants was 19.84, and 52.1 % (2424) of them were females. There are differences in age and gender between participants with and without PIU (P < 0.05). The network of personality and PIU showed that 22 out of the 28 edges were estimated to be nonzero, and "obsession-neuroticism" was the strongest positive edge between the two communities. Central symptoms (i.e., "obsession" and "control disorder") and bridge symptoms (i.e., "obsession" and "neuroticism") have been identified. Gender differences existed in network global strength: female = 3.71, male = 3.18 (p < 0.001). The cross-sectional study needs more evidence to build causal inference. The results of PIU-personality networks may contribute to the personalized prevention and treatment of PIU. The gender difference in PIU-personality networks also requires more attention and discussion. • "Obsession-neuroticism" was the strongest edge between PIU and personality groups. • "Obsession" has the highest strength and bridge strength in the whole network. • Females have a denser PIU-personality network structure than males. [ABSTRACT FROM AUTHOR]

Background: Gallbladder cancer is a major health concern in China, and awareness of the associated incidence and mortality rates is particularly important given the aging population. Objective: To determine trends in gallbladder cancer incidence and mortality rates over 12 years and quantitatively analyze the influence of demographic factors on these rates in China. Methods: We performed a retrospective study of 98,860 Chinese citizens using the Chinese Cancer Registry, a national database. Gallbladder cancer incidence and mortality data pertaining to patients treated between 2005 and 2017 were collected. Joinpoint regression models were used to estimate the annual percentage change (APC) and average APC (AAPC). We used age-period-cohort analyses and decomposition methods to investigate differing trends in incidence and mortality. Results: The age-standardized gallbladder cancer incidence and mortality rates in China trended downward between 2005 and 2017, with AAPCs of -2.023% and -1.603%, respectively. Coefficients of age effect for incidence rate increased with age up to 70 years and peaked at 70–79 years, while coefficients of age effect for the mortality rate showed a consistent increase with age. Both coefficients of period for incidence and mortality rates increased in more recent periods; in terms of the cohort effect, coefficients of cohort for rates generally decreased in later birth years but showed a partial rise between 1982 and 1996. The crude incidence rates of gallbladder cancer according to demographic and non-demographic factors were 626.09% and -526.09% respectively (366.23% and -266.23% among men, and 6068.93% and -5968.93% among women, respectively). The rates were 543.01% and -443.01%, respectively, in urban areas and were 68.22% and 31.78%, respectively, in rural areas. The mortality rates according to demographic and non-demographic factors were -495.93% and 595.93%, respectively (-1763.10% and -1863.10% for men and -270.56% and -370.56% for women, respectively). These rates were -930.33% and 1030.33%, respectively, in urban areas and were 101.48% and -1.48%, respectively, in rural areas. Conclusions: The overall standardized gallbladder cancer incidence and mortality rates in China are trending downward, but not sufficiently so. Proper living and eating habits should be encouraged while exploring the establishment of long-term, standardized gallbladder cancer screening programs. [ABSTRACT FROM AUTHOR]

ABSTRACT We evaluated the diagnostic accuracy of various international guideline criteria for identifying HBeAg‐positive chronic HBV infection patients with no significant liver disease. A total of 1108 HBeAg‐positive CHB patients were retrospectively enrolled. The guidelines assessed included those from the European Association for the Study of the Liver (EASL) 2017, the American Association for the Study of the Liver Disease (AASLD) 2018, the Asian Pacific Association for the Study of the Liver (APASL) 2015 and the Chinese Society of Hepatology (CSH) 2022. The CSH criteria demonstrated a higher proportion of patients with G0‐1 and S0‐1 (82.9%) compared to the EASL (75.9%), AASLD (75.3%) and APASL groups (58.8%). Additionally, the CSH criteria exhibited a significantly higher predictive value (AUC 0.782, 95% CI 0.754–0.809) than the EASL (AUC 0.765, 95% CI 0.737–0.793), AASLD (AUC 0.749, 95% CI 0.720–0.778) and APASL (AUC 0.720, 95% CI 0.690–0.750) criteria for identifying G0‐1 and S0‐1. Adding quantitative HBsAg levels (> 104 IU/mL) to the EASL, AASLD and APASL criteria improved diagnostic performance. Consequently, the CSH guideline thresholds showed higher accuracy in identifying Chinese HBeAg‐positive patients with no significant liver disease compared to EASL, AASLD and APASL criteria, emphasising the importance of considering quantitative HBsAg in the evaluation of HBeAg‐positive chronic HBV infection. [ABSTRACT FROM AUTHOR]

Pediatric obesity is a serious global health challenge. In East Asia, rapid socioeconomic changes have increased obesity rates. This study examines weight distribution and obesity trends in East Asian children using WHO criteria. Data from the Non-Communicable Disease Risk Factor Collaboration was used to analyze weight categories (thinness, normal weight, overweight, and obesity) among children aged 5 to 19 in China, Japan, South Korea, and Taiwan. Data were collected through probabilistic sampling and national surveys and classified using WHO BMI standards. Age standardized prevalence rate enabled cross-country comparisons for boys and girls from 2010 to 2022. Statistical methods included arithmetic statistics, linear regression, and time series analysis using the ARIMA model, with SAS 9.4 and SPSS for analysis. Significant trends were found (p for trend < 0.05). Taiwan and South Korea showed increased thinness, while China and Japan showed decreases. Normal weight prevalence declined, notably among South Korean boys. Overweight and obesity rates rose, especially among South Korean boys and Chinese girls. Japan's rates remained stable, while Taiwan showed minor fluctuations. Boys had higher overweight and obesity rates than girls in all countries. The highest rates were among children aged 10 to 11 years. East Asia, particularly South Korea and China, has seen rising obesity rates. Increasing thinness in South Korea and Taiwan also requires attention. The decline in healthy-weight children is concerning. Interventions should target children before ages 10 to 11. Urgent, tailored public health interventions are needed. [ABSTRACT FROM AUTHOR]

Objective Methods Results Interpretation We established a prospective cohort study to investigate the differences in motor and non‐motor symptoms between idiopathic Parkinson's disease (IPD) and Parkinson's disease in carriers of leucine‐rich repeat kinase 2 (LRRK2) gene risk variants (LRRK2‐PD).The study included 1407 individuals with IPD and 649 individuals with LRRK2‐PD (comprising 304 with LRRK2‐G2385R, 220 with LRRK2‐R1628P, and 105 with LRRK2‐A419V). Differences in symptoms between LRRK2‐PD and IPD were analyzed using LCMM modeling and Cox regression analysis.The LRRK2‐G2385R variant showed slower progression in tremor symptoms and excessive daytime sleepiness compared with IPD. In contrast, symptoms associated with LRRK2‐R1628P and LRRK2‐A419V were more similar to those of IPD. Survival analysis revealed that LRRK2‐PD does not affect life expectancy compared with IPD.Our extended longitudinal follow‐up of LRRK2‐PD in the Chinese population provided valuable insights, further confirming the clinical characteristics of the three LRRK2 variants. [ABSTRACT FROM AUTHOR]

Background Objective Method Results Conclusion Implications The past few decades have witnessed drastic changes in family structures and the provision of care within the family in China.The current study investigated how familial caregivers of children (N = 30, Mage = 41.67, SD = 11.32) living in one of the largest urban centers in China learned and taught how to care within the family.Nine focus groups were conducted to collect data, and thematic analysis was adopted to analyze the data.Two main themes were found: (a) learning to care on one's own and (b) the importance of encouraging one to want to care. The findings indicate that Chinese caregivers received limited direct instruction in learning how to care and were often faced with the challenge of having to self‐teach care. Meanwhile, when teaching care, caregivers focused on the motivation to care (e.g., filial piety) as an important element for learning to practice care.These findings highlight considerations of motivation of care often not mentioned in the Western literature while also indicating the need of society to support teaching and learning the practice of care within the family.This study highlights the importance of cultural considerations when designing intervention programs to help individuals to develop the ability to care and provides insights exploring how school‐family partnership promotes children's ability to be caring. [ABSTRACT FROM AUTHOR]

Objective: The study aims to evaluate personality characteristics, self-efficacy, and medication adherence in Chinese patients with hypertension, while also investigating how self-efficacy mediates the relationship between personality traits and medication adherence. Methods: This investigation included 787 Chinese patients diagnosed with hypertension, as reported in the "2021 China Family Health Index Survey Report." The study employed several assessment tools such as a General Information Questionnaire, the Brief Big Five Inventory (BFI-10), the New General Self-Efficacy Scale (NGSES), and the Medication Adherence Rating Scale (MARS). Statistical analyses encompassed the Mann–Whitney U test, chi-square test, multiple logistic regression, Spearman's rank correlation, standardized regression coefficients, and Bootstrap techniques. Results: (1) Individuals with debt, who also possess high levels of self-efficacy, tend to adhere more consistently to their medication regimens. (2) An analysis of personality traits indicated that Extroversion,Conscientiousness and Openness positively influences self-efficacy,while Agreeableness and Neuroticism negatively impacts it. (3) Self-efficacy plays a mediating role in the indirect relationship between personality traits such as Extroversion and neuroticism and medication adherence. Conclusion: In the context of Chinese adults, both self-efficacy and Extroversion positively influence medication adherence, whereas high levels of neuroticism adversely impact it. Furthermore, self-efficacy serves as a mediating factor in the linkage between personality traits and medication adherence. [ABSTRACT FROM AUTHOR]

This study examines the role of root-seeking summer camps in enhancing Chinese cultural identity among the new ethnic Chinese generation (ECNG) amidst the challenges of globalization. Semi-structured interviews with thirty campers revealed that ECNG often lack clear ethnic consciousness, experience conflict in community relationships, and have limited opportunities for traditional cultural experiences. The study found that summer camps exert both intrinsic and extrinsic influences on campers. Intrinsically, they facilitate the internalization of leisure motivation, foster a deepened leisure experience, and promote strengthened leisure interactions. Extrinsically, they provide opportunities for leisure education and cultural immersion. Through this synergy, summer camps enhance the cultural identification of ECNG. However, the study also noted that course enjoyment and teaching staff behavior could influence perceptions of the camp. This study contributes to understanding the relationship between leisure and identity, explaining how summer camp activities enhance ECNG's cultural identity, and offering insights for governments and agencies. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by diverse clinical features. EEG biomarkers such as spectral power and functional connectivity have emerged as potential tools for enhancing early diagnosis and understanding of the neural processes underlying ASD. However, existing studies yield conflicting results, necessitating a comprehensive, data-driven analysis. We conducted a retrospective cross-sectional study involving 246 children with ASD and 42 control children. EEG was collected, and diverse EEG features, including spectral power and spectral coherence were extracted. Statistical inference methods, coupled with machine learning models, were employed to identify differences in EEG features between ASD and control groups and develop classification models for diagnostic purposes. Our analysis revealed statistically significant differences in spectral coherence, particularly in gamma and beta frequency bands, indicating elevated long range functional connectivity between frontal and parietal regions in the ASD group. Machine learning models achieved modest classification performance of ROC-AUC at 0.65. While machine learning approaches offer some discriminative power classifying individuals with ASD from controls, they also indicate the need for further refinement. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer-related lymphedema (BCRL) is a common complication among breast cancer survivors. Most BCRL studies have focused on patients receiving adjuvant chemotherapy, with relatively little attention paid to BCRL in patients undergoing neoadjuvant chemotherapy (NAC). This study aimed to investigate the risk factors associated with BCRL in Chinese women undergoing NAC and axillary lymph node dissection (ALND). Methods: At our institution, this cohort study collected data from 336 women with breast cancer and documented axillary nodal metastasis at diagnosis, who received NAC and ALND surgery between 2015 and 2020. BCRL was assessed through both objective limb circumference measurements and subjective self-reported symptoms. Multivariate logistic regression was employed to identify risk factors for BCRL, considering clinical, demographic, and lifestyle-related characteristics. Results: The cumulative incidence of BCRL within 2.5 years was 43.75%. Factors independently associated with BCRL included radiotherapy (versus no radiotherapy; hazard ratio (HR) = 1.611; P = 0.020), NAC duration of 105 days or shorter (versus 105-143 days; HR = 0.471; P = 0.020), removal of more than 15 lymph nodes (versus 15 or fewer lymph nodes; HR = 1.593; P = 0.036), drainage duration of 20-29 days (versus 10-19 days; HR = 1.568; P = 0.028), and sleeping biased toward the affected arm (versus sleeping biased toward the healthy arm; HR = 2.033; P = 0.019). Conclusion: This study identified several risk factors for BCRL in breast cancer patients following NAC and ALND. Patients presenting with one or more of these factors should be monitored closely for early detection and intervention. Further research is warranted to explore the impact of drainage duration and sleep position on the development of BCRL. [ABSTRACT FROM AUTHOR]

Background: Biomarkers can be used to assess the severity of spinal muscular atrophy (5q SMA; SMA). Despite their potential, the relationship between biomarkers and clinical outcomes in SMA remains underexplored. This study aimed to assess the association among biomarkers, phenotypes, and motor milestones in Chinese patients diagnosed with SMA. Methods: We collected retrospective clinical and follow-up data of disease-modifying therapy (DMT)-naïve patients with SMA at our center from 2019 to 2021. Four biomarkers were included: survival motor neuron 2 (SMN2) copies, neuronal apoptosis inhibitory protein (NAIP) copies, full-length SMN2 (fl -SMN2), and F-actin bundling protein plastin 3 (PLS3) transcript levels. Data were analyzed and stratified according to SMA subtype. Results: Of the 123 patients, 30 were diagnosed with Type 1 (24.3%), 56 with Type 2 (45.5%), and 37 with Type 3 (30.1%). The mortality rate for Type 1 was 50%, with median survival times of 2 and 8 months for types 1a and 1b, respectively. All four biomarkers were correlated with disease severity. Notably, fl -SMN2 transcript levels increased with SMN2 copies and were higher in Type 2b than those in Type 2a (p = 0.028). Motor milestone deterioration was correlated with SMN2 copies, NAIP copies, and fl -SMN2 levels, while PLS3 levels were correlated with standing and walking function. Discussion: Our findings suggest that SMN2 copies contribute to survival and that fl -SMN2 may serve as a valuable biomarker for phenotypic variability in SMA Type 2 subtypes. These insights can guide future research and clinical management of SMA. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionTo investigate the longitudinal relationship between myopia and retinal shape in Chinese children.A total of 2471 seven-year-old Chinese children were measured for axial length, anterior corneal radius of curvature, anterior chamber depth, lens thickness, central spherical equivalent, and peripheral refractions along the horizontal meridian (±15°, ±30°) under cycloplegia. Retinal shape was fitted using vertex radius of curvature, asphericity, and an offset. The areas under the horizontal retinal curve, the nasal side of areas under the horizontal retinal curve and the temporal side of areas under the horizontal retinal curve, were calculated. Children were tested annually for 5 years from year 0 to 4, with 1123 newly developed myopes divided into eight subgroups based on relative time to myopia onset.In follow-up subgroups, vertex radius of curvature showed positive correlations with central spherical equivalent from years 1 to 4. Smaller temporal side of areas under the horizontal retinal curve was associated with negative central spherical equivalent each year. Myopic shift (Δcentral spherical equivalent) was negatively correlated with baseline central spherical equivalent and with greater change in areas under the horizontal retinal curve from year 0 to 4. The absolute change in temporal side of areas under the horizontal retinal curve (0.39 ± 1.15 mm2) was significantly larger than the absolute change in nasal side of areas under the horizontal retinal curve (0.05 ± 1.11 mm2) over the 4 years. In myopia onset subgroups, temporal side of areas under the horizontal retinal curve was significantly smaller than nasal side of areas under the horizontal retinal curve. The ratio of temporal side of areas under the horizontal retinal curve/nasal side of areas under the horizontal retinal curve was closest to 1 in the year before myopia onset and decreased as myopia developed. Vertex radius of curvature, areas under the horizontal retinal curve, and temporal side of areas under the horizontal retinal curve decreased linearly as myopia progressed.A progressive steepening of the horizontal posterior retina was associated with myopia progression. Myopia shift was negatively correlated with baseline central spherical equivalent and with greater change in posterior retinal shape. As myopia progressed, the horizontal retina shape displayed increased asymmetry. [ABSTRACT FROM AUTHOR]

Objective: Small dense low-density lipoprotein cholesterol (sdLDL-C), as an emerging atherogenic factor of cardiovascular diseases, requires additional tests. We aimed to establish a sdLDL-C equation using standard lipid profile and evaluate its capacity of identifying the residual cardiovascular risk beyond LDL-C and apolipoprotein B (ApoB). Methods: This cross-sectional study included 25 435 participants from Health Management Cohort and 11 628 participants from China Health and Retirement Longitudinal Study (CHARLS) to construct and evaluate the sdLDL-C equation by least-squares regression model. The equation for sdLDL-C depended on low-density lipoprotein cholesterol (LDL-C) and an interaction term between LDL-C and the natural log of triglycerides (TG). Results: The modified equation (sdLDL-C = 0.14*ln(TG)*LDL-C − 0.45*LDL-C + 10.88) was more accurate than the original equation in validation set (slope = 0.783 vs. 0.776, MAD = 5.228 vs. 5.396). Using the 80th percentile (50 mg/dL) as a risk-enhancer rule for sdLDL-C, accuracy of the modified equation was higher than the original equation in validation set (90.47% vs. 89.73%). The estimated sdLDL-C identified an additional proportion of high-risk individuals in BHMC (4.93%) and CHARLS (1.84%). Conclusion: The newly developed equation in our study provided an accurate tool for estimating sdLDL-C level among the Chinese population as a potential cardiovascular risk-enhancer. [ABSTRACT FROM AUTHOR]

Borayflo Haemostatic matrix is a new absorbable hemostatic gelatin matrix which can be used for intraoperative assisted hemostasis. In a prospective, multicenter, non-inferiority, randomized controlled trial, a total of 354 subjects were recruited from the departments of hepatobiliary surgery, obstetrics and gynaecology and orthopaedics of 4 hospitals and randomly allocated to test group (Borayflo Haemostatic matrix) or control group (Surgiflo Haemostatic matrix) in a 1:1 ratio. In the modified intention-to-treat population, 163 (93.14%) of 175 subjects in the test group versus 167 (94.89%) of 176 subjects in the control group successfully achieved hemostasis within 5 min (P > 0.05). Non-inferiority for effective rates of hemostasis at 5 min to Surgiflo Haemostatic matrix was shown in the study (treatment difference: -1.74% [95%CI, -6.70–3.22%] for modified intention-to-treat population). In terms of efficacy and safety, the new hemostatic gelatin matrix (Borayflo Haemostatic matrix) is equivalent to Surgiflo Haemostatic matrix. There was no significant difference in the incidence of AEs or SAEs between the test and control groups(P > 0.05). In addition, Borayflo Haemostatic matrix is a domestically produced haemostatic gelatin product, an advantage that will reduce the cost of surgical haemostasis for Chinese patients. [ABSTRACT FROM AUTHOR]

AbstractZNF384 gene rearrangements are a distinct subtype of adult B cell acute lymphoblastic leukemia (B-ALL). We screened 46 B-other ALL patients for ZNF384 fusions using fluorescent in situ hybridization (FISH) and reverse transcription-polymerase chain reaction (RT-PCR). Clinical data, treatment response, and minimal residual disease (MRD) status were analyzed. Ten (21.7%) patients were ZNF384-r positive (nine by FISH, nine by RT-PCR, eight by both). FISH showed atypical signals, including 3’ signal gain and 5’ signal deletion. EP300 was the main fusion partner (n = 5). TAF15::ZNF384, SYNRG::ZNF384, CREBBP::ZNF384, and TCF3::ZNF384 fusions were found in one patient each; one case’s partner gene is unknown. One patient was MRD-negative at the end of the first induction, lower than in patients without ZNF384-r. ZNF384-r incidence matched B-other ALL incidence in Chinese patients. Combined FISH and RT-PCR improved detection. ALL with ZNF384-r has unique features, and lower MRD-negative response may indicate a negative impact on traditional treatments. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionThis study aimed to evaluate the effects of an anti-inflammatory diet (AID) combined with Infliximab (IFX) therapy on maternal and neonatal health outcomes in pregnant Chinese patients with inflammatory bowel disease (IBD).IBD patients treated with steady IFX maintenance therapy at the time of conception were randomly assigned to either the IBD-AID group (n = 49), which received an anti-inflammatory diet intervention during the third trimester, or the habitual diet group (n = 49). Primary outcomes included assessments of disease activity, inflammatory markers, and neonatal health. Secondary outcomes included health-related quality of life (HRQoL) in patients and functional gastrointestinal disorders (FGIDs) in infants.The IBD-AID intervention significantly reduced disease activity scores in IBD patients at 4 weeks post-intervention and 1 month postpartum compared to the habitual diet group, and also improved HRQoL. Serum C-reactive protein (CRP) and fecal calprotectin (FC) levels were significantly lower in the IBD-AID group at these times, with a trend towards lower levels at 6 months postpartum. Birth weight and Apgar scores were higher in the IBD-AID group but did not reach statistical significance. The incidence of at least one FGID in infants was significantly lower in the IBD-AID group (24.5%) compared to the habitual diet group (46.9%, p = 0.034).The IBD-AID intervention combined with IFX therapy significantly improved disease activity, inflammatory markers, and QoL in maternal IBD patients, and was associated with a lower incidence of FGIDs in infants, indicating benefits for both maternal and neonatal health. [ABSTRACT FROM AUTHOR]

ABSTRACT This article explores how women's postgraduate education becomes entangled with heteronormative gender regimes enacted in public discourses that caution against women becoming too educated in China. The cultural capital of the PhD is obliterated by the loss of cultural capital resulting from gender non‐conformity. Two powerful discourses—‘leftover women’ and women with PhDs as a ‘third sex’ operate in tandem, we argue, to make the decision to study at postgraduate level challenging for women in China. Theoretically informed by neotraditionalist familialism, heteronormativity, chrononormativity and the potent affective ecology of shame, this research makes a significant contribution to scholarship on gender and higher education internationally by analysing the lived experiences of 15 Chinese postgraduate female students. The article suggests that by analysing gender and higher education in temporal terms, or culturally loaded age and gender‐appropriate decision‐making processes in China, chrononormativity effectively undoes the graduate premium and cultural capital of those Chinese women who do not marry or reproduce. We argue, however, that Chinese women are not powerless victims of patriarchal culture. Many are choosing to study for their PhDs (42% of PhDs in Mainland China in 2020 were gained by women), and in doing so are opening up options and lifestyles which disrupt, add value to or query the traditional gendered social order. [ABSTRACT FROM AUTHOR]

Reasons for the increased incidence of depression in Chinese children remain poorly understood. Therefore, this study explored the influence of paternal companionship and peer relationships on depression in children based on OLS method using data reported by 2498 children from China (children Mage 10.7; 52.1% girls). We found that both variables could alleviate depression among children, but the effect of peer relationships was significantly greater than that of paternal companionship. This conclusion remains robust after considering gender, age and family structure. Heterogeneity studies have found that paternal companionship significantly impact boys, while peer relationships significantly impact girls. Mechanism analysis demonstrated that both factors can indirectly alleviate depression in children by regulating anxiety. Our research results emphasize the importance of increasing paternal companionship and peer relationships to alleviate depression in children. [ABSTRACT FROM AUTHOR]

Revealing the spatial distribution and regional differences of red blood cell distribution width (RDW) reference values in the healthy Chinese population is important for the monitoring, diagnosis and prevention of the top chronic diseases in the disease spectrum in China. Medical indicator data were matched with geographical data and environmental pollution data to predict RDW reference values for the whole region of China using ridge regression analysis, support vector machine and BP neural network. Taylor diagrams and assignment methods were used to select the optimal model, and the spatial distribution was mapped according to the prediction results of the optimal model, and the intervals of RDW reference values for different age groups of healthy people in China were redefined. It was suggested that the reference values of RDW in the young and middle-aged groups in China were divided into low-value areas in the north (12.31,12.80) and high-value areas in the south (12.80,13.18); the reference values of RDW in the elderly group were divided into low-value areas in the north (11.28,12.60) and high-value areas in the south (12.60,13.91).In turn, it can provide a more accurate reference basis in the monitoring, diagnosis and prevention of chronic diseases at the top of the disease spectrum. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depressive disorders, characterized by high incidence and functional impairments, are emotional disorders with shared etiological and maintenance mechanisms. Dialectical behavior therapy (DBT) is a promising approach for the transdiagnostic treatment of emotional disorders. Developing a brief DBT intervention can facilitate the adoption of evidence-based therapy. Methods: This protocol is for a 3-year single-blinded, two-arm randomized controlled trial. Individuals with depressive or anxiety disorder will be randomly allocated to a modified DBT–informed transdiagnostic psychotherapy group or a treatment-as-usual group. The intervention group will receive DBT individual therapy for 15 weeks. Power analyses revealed that the cohort should include a minimum of 250 participants. Preintervention, postintervention, and follow-up (after 3 months) assessments will be conducted. Primary outcomes will be severities of depression and anxiety rated by blind assessors. Intent-to-treat and per-protocol analyses will be conducted using the hierarchical linear model. Effect sizes will be estimated using Cohen's d. Result: To the best of our knowledge, the proposed study will be the first randomized controlled trial to evaluate the efficacy of a modified DBT intervention in managing transdiagnostic emotional disorders in Chinese individuals. Conclusion: This intervention is expected to improve clinical outcomes, daily functioning, and quality of life. The trial will enrich the empirical evidence for transdiagnostic interventions, facilitating the implementation of evidence-based therapy and reducing the high prevalence and challenges (e.g., disability) of emotional disorders in the Chinese population. Trial registration number: NCT05989451 [ABSTRACT FROM AUTHOR]

Background: Shared decision-making is recommended for stroke rehabilitation. However, the complexity of the rehabilitation modalities exposes patients to decision-making conflicts, exacerbates their disabilities, and diminishes their quality of life. This study aimed to explore the experiences and needs of older patients with stroke in China during rehabilitation decision-making, providing a reference for developing decision-support strategies. Methods: A qualitative phenomenological design was used to explore the experiences and needs of older patients with stroke in China. Purposive sampling was used to recruit 31 older Chinese patients with stroke. The participants participated in face-to-face, semi-structured, and in-depth interviews. Data were analyzed using inductive thematic analysis. Results: The key themes identified include (1) mixed feelings in shared decision-making, (2) multiple barriers hinder the possibility of participating in shared decision-making, (3) Delegating rehabilitation decisions to surrogates, (4) gaps between reality and expectation, and (5) decision fatigue from lack of continuity in the rehabilitation health care system. Conclusions: Older patients with stroke in China have complex rehabilitation decision-making experiences and needs and face multiple obstacles when participating in shared decision-making. They lack an effective shared decision-making support system to assist them. Providing patients with comprehensive support (such as emotional and informational), strengthening the construction of a continuous rehabilitation system, alleviating economic pressure, and promoting patient participation in rehabilitation decision-making are necessary. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia and frailty are common among elderly individuals and present substantial health hazards. Exploring their relationship is essential for optimizing geriatric healthcare, particularly within the context of China. Methods: A population-based cross-sectional design was employed using data from the China Health and Retirement Longitudinal Study (CHARLS). The study enrolled 5,714 participants aged ≥60 years who underwent assessment for sarcopenia following the criteria established by the Asia Working Group for Sarcopenia (AWGS 2019) in 2019. Frailty status was determined using a frailty index that categorized participants into robustness, pre-frailty, and frailty stages. Multivariable logistic regression models were employed to examine the relationship between sarcopenia and frailty and pre-frailty conditions. Subgroup and interaction analyses were performed to explore the robustness of the associations between sarcopenia and frailty across different subgroups. Results: Among the participants, 1,028 (18.0%) were identified as frailty, 2,987 (52.3%) as pre-frailty, and 645 (11.3%) had sarcopenia. Sarcopenia demonstrated an independent association with higher risks of frailty (OR = 2.13, 95% CI: 1.52–2.99) and pre-frailty (OR = 1.42, 95% CI: 1.20–1.81) in the multivariable logistic analysis. Subgroup and interaction analyses consistently demonstrated significant associations across nearly all demographic and health-related subgroups. Conclusions: This study highlights that sarcopenia is significantly and independently associated with frailty and pre-frailty among older adults in China. Early detection and targeted interventions for sarcopenia are crucial to mitigate frailty and its adverse health outcomes in aging populations, emphasizing the need for tailored healthcare strategies to promote healthy aging. [ABSTRACT FROM AUTHOR]

Since cyberloafing has become prevalent across organizations, scholars have increasingly focused on exploring its antecedents. Based on ego depletion theory, we explore how and when interest incongruence, a particular type of person‐environment misfit, influences employee cyberloafing behaviours. Using three‐wave survey data of a sample from 443 Chinese employees, we found that interest incongruence is associated with ego depletion, leading to employee cyberloafing. Furthermore, our results demonstrated the moderating roles of trait self‐control and moral identity internalization in the interest incongruence‐ego depletion‐cyberloafing link at different stages. Specifically, trait self‐control mitigated the effect of interest incongruence on ego depletion and the indirect effect of interest incongruence on cyberloafing via ego depletion. Moral identity internalization mitigated the effect of ego depletion on cyberloafing and the indirect effect of interest incongruence on cyberloafing via ego depletion. These findings suggest that employee cyberloafing is not only an immoral issue but also a behaviour affected by employees' self‐regulatory resources. [ABSTRACT FROM AUTHOR]

Family socioeconomic status (SES) is one of the key indicators of academic achievement, including language achievement. Further investigation of SES's mechanisms of influence and potential mediators is essential due to the concern regarding the disparities caused by SES in language achievement. This study examines the relation between SES and Chinese adolescents' English achievement, emphasizing the role of parenting as a conduit for socioeconomic impacts on children and adolescents. The mechanism through which SES influences English achievement was examined in a sample of 1634 junior secondary school students in an urban city in mainland China. A unified model with solid fit indices, comprising both SES and parenting components, was identified through structural equation modeling. As expected, socio-economic disparities appeared to be largely associated with students' English achievement, and this connection was partially mediated by parental emotional support. Parental emotional support, however, had varied mediating effects that affected the developmental course and shaped achievement outcomes across different SES groups. This study offers valuable insights into the joint contribution of distal SES factors and proximal interactions to achievement outcomes. Intervention efforts and future research implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have indicated an obesity paradox in observational research on aging health, where being normal weight or underweight adversely affects cognitive function, while moderate obesity may offer protective benefits. This study aims to investigate the association between body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), abdominal volume index (AVI), and the joint effect of BMI and HC on cognitive impairment in older Chinese people. Methods: A total of 10,579 participants aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included in this cross-sectional study. BMI, WC, HC, WHtR, WHR, and AVI were calculated from height, weight, WC, and HC measurements, where weight, WC, and HC were obtained by direct measurement. Mini-Mental State Examination was used to assess cognitive impairment. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using binary logistic regression. Non-linear correlations were investigated using restricted cubic spline curves. Results: In multivariate logistic regression models fully adjusted for confounding variables, our analyses showed significant negative associations of WC [OR 0.93 (95%CI 0.88–0.98), P =.012], HC [OR 0.92 (95%CI 0.87–0.97), P =.004], lower WHR (Q2) [OR 0.85 (95%CI 0.72-1.00), P =.044], and AVI [OR 0.93 (95%CI 0.88–0.98), P =.011] with cognitive impairment. Nonlinear curve analysis showed that the risk of cognitive impairment was lowest when the BMI was about 25.5 kg/m², suggesting that the optimal BMI for older Chinese people to maintain good cognitive ability may be in the overweight range. In addition, there was a non-linear "N" shaped relationship between HC and cognitive impairment, with HC having the highest risk of cognitive impairment at about 82 cm and the lowest risk at about 101 cm. The joint effects analysis indicated that the lowest risk was observed among those with normal or higher BMI but higher HC compared with participants with normal BMI levels and lower HC levels. Conclusion: In older Chinese people, a low-waisted and high-hip circumference body figure is favorable for cognitive function in older people. It also found a significant association between AVI and cognitive impairment. The joint analysis of BMI and HC suggests that maintaining a normal or higher BMI with a higher HC may be more conducive to maintaining good cognitive function. [ABSTRACT FROM AUTHOR]

Methods: We recruited 58 MA-dependent young adult females from a compulsory isolation drug rehabilitation center in Sichuan Province and randomly divided them into an MBRP group (n = 29) and a control group (n = 29) according to their degree of psychological craving. The MBRP group received 2 hours of MBRP training twice a week for 4 weeks, alongside routine treatment at the drug rehabilitation center. Meanwhile, the control group solely received routine treatment at the drug rehabilitation center without any additional interventions. The assessment was conducted before and immediately after the intervention, with the Compulsive Drug Use Scale (OCDUS) used to assess craving and the Five-Factor Mindfulness Scale (FFMQ) used to assess trait mindfulness. Also, a "mental feedback monitoring balance" instrument was used to assess concentration and relaxation during some training sessions. This randomized trial was conducted to evaluate the effectiveness of decreasing psychological craving and increasing trait mindfulness. Results: At baseline, there were no significant differences in total or dimension scores for FFMQ or OCDUS between the two groups (all P > 0.05). After the intervention, the repeated measures ANOVA showed a significant time main effect on changes in observing, non-judging, and non-reacting scores (all P < 0.05), and a significant interaction effect between time and group on both FFMQ total score and OCDUS score (P < 0.01 or P < 0.05). Mental feedback monitoring indicated significant improvement in concentration and relaxation after breath meditation exercises (P < 0.05 or P < 0.001). Additionally, the MBRP group showed improved relaxation during the body scan exercise (P < 0.01). Conclusion: MBRP training can improve the trait mindfulness of MA addicts and reduce psychological cravings effectively. [ABSTRACT FROM AUTHOR]

Purpose: Lefamulin is the first pleuromutilin antibiotic approved for the treatment of community-acquired bacterial pneumonia (CABP). However, the pharmacokinetic/pharmacodynamic (PK/PD) characteristics in Chinese CABP patients are not fully understood. This study aimed to evaluate its microbiological efficacy against Streptococcus pneumoniae and Staphylococcus aureus via PK/PD analysis. Methods: The population PK (PopPK) model, established with foreign data was validated using data from Chinese CABP patients. PK/PD analysis was conducted for the intravenous administration of 150 mg q12 h for 1-h, 1.5-h and extended 2-h infusion. Oral administrations of 600 mg q12 h were assessed, considering original and higher plasma protein binding. Results: Lefamulin displayed similar PK characteristics in both Chinese and Western populations. The PopPK model effectively predicted lefamulin concentrations in Chinese CABP patients. Under the dosage regimen of 150 mg q12 h via intravenous infusion for 1/1.5/2 h, the probability of target attainments reached 98% at the minimum inhibitory concentration for both 90% S. pneumoniae and S. aureus, considering both original and higher protein binding rates. It is advisable to extend the infusion duration from 1/1.5 h–2 h to minimize the risk of adverse effects at the infusion site. Regardless of fasted or fed conditions, the PTAs for 600 mg q12 h lefamulin via oral administration proved comparable to those for intravenous administration. Conclusion: This study proved that intravenous and oral administrations of lefamulin can reach preclinical PK/PD targets of S. pneumoniae and S. aureus. These findings support the optimal use of lefamulin for the safe and effective treatment of Chinese CABP patients. [ABSTRACT FROM AUTHOR]

In a volatile, uncertain, complex, and ambiguous (VUCA) world, the question of how to effectively harness employee role behaviour, such as proficiency, adaptability, and proactivity, is inciting heated discussion among academic societies, and it is a vital practical issue to address. Employing self-determination theory, this study examines the mechanisms by which supervisors' developmental feedback influences employees' work role performance. The two-wave survey data from 497 respondents obtained via hierarchical regression analyses reveal that supervisors' developmental feedback positively impacts employee work role performance, that thriving at work plays a mediating role in the relationship, and that this mediating relationship has conditional effects on the moderator variable of trait mindfulness. These findings could enrich the understanding of the effects of supervisors' developmental feedback on employees' work role performance and provide insight about how to facilitate this process. [ABSTRACT FROM AUTHOR]

Background: With the rapid ageing of the global population, the number of older adults with physical frailty has been gradually increasing, making ageing at home a key strategy for coping with this demographic change. The opinions of older adults regarding their willingness to age at home deserve to be considered respectfully. As a result, this study aimed to investigate willingness to age at home and any associated underlying mechanisms involving physical frailty among older Chinese adults. Methods: This study was a national cross-sectional survey. Stratified random and quota sampling were used before and after the individual level respectively. Willingness to age at home was compared between older adults with different characteristics using the Mann–Whitney U test and Kruskal–Wallis H test. A Spearman rank test was conducted to explore the correlations among physical frailty, loneliness, family health, and willingness to age at home. The path hypothesis that loneliness and family health influence the relationship between physical frailty and willingness to age at home among older adults was further tested through sequential multiple mediation analysis. Results: A total of 3,837 older adults were included in this study. They returned a median score of 78 in terms of willingness to age at home. Physical frailty (β = − 0.044, P < 0.01) and loneliness (β = − 0.070, P < 0.001) were negatively associated, and family health (β = 0.275, P < 0.001) was positively associated with a willingness to age at home among older Chinese adults. Loneliness and family health played sequential multiple mediating role (β = − 0.018, Boot SE = 0.002, 95% CI = [–0.022, − 0.014]) between physical frailty and willingness to age at home. Conclusions: Reducing physical frailty in older adults, reducing their sense of loneliness, and enhancing their family health is essential, as it can increase their levels of confidence with regard to ageing at home. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prognostic value of visible hematuria in T1a renal cell carcinoma (RCC). Materials and methods: In the RCC database of the Chinese People's Liberation Army General Hospital Department of Urology, we assembled the records of patients with unilateral RCC over 18 years of age diagnosed between 2008 and 2019. The clinical stage was cT1, and the tumors ranged in size from 0 to 7 cm. The primary treatments were partial nephrectomy (PN) or radical nephrectomy (RN). Logistic regression analysis, Cox regression, interaction analysis, and Kaplan-Meier survival analysis were used to study the correlation between visible hematuria and progression-free survival (PFS), and cancer-specific survival (CSS). Results: A total of 7,610 patients with cT1 RCC comprised the study population, including 505 RCC patients with visible hematuria. The average follow-up time was 64.6 months (range: 12–144 months). Visible hematuria was significantly associated with the prognosis (PFS, hazard ratio [HR] = 2.7, P < 0.001; CSS, HR = 4.2, P < 0.001) of T1a RCC, but was more significant for CSS in cases of a tumor size ≤ 2 cm (HR = 26.8, P = 0.026). This effect was not significant in T1b RCC (PFS, HR = 0.7, P = 0.153; CSS, HR = 1.1, P = 0.862). The interaction between visible hematuria and tumor size was significant (P = 0.001). Conclusions: This study showed that visible hematuria was an independent risk factor for PFS and CSS in T1a RCC. The predictive value of visible hematuria for CSS was more significant in RCCs ≤ 2 cm, but did not reach statistical significance in T1b RCC. T1a RCC patients with visible hematuria should be intensively monitored during follow-up. [ABSTRACT FROM AUTHOR]

Introduction: This research aimed to explore the determinants of cervical HPV infection and evaluate how cervical cancer screening outcomes influence sexual functioning and anxiety among women across three provinces in China. Methods: Study participants were categorized into HPV-positive or HPV-negative groups, after which they completed the General Characteristics Questionnaire and the SAS Anxiety Scale. The HPV-positive cohort was further divided into four subgroups: Subgroup 1 consisted of individuals with HPV types 16 or 18 but no cytological abnormalities. Subgroup 2 included those with cytological abnormalities and infections with HPV types 16 or 18. Subgroup 3 included participants infected with high-risk HPV types other than 16 and 18, who did not show cytological abnormalities, while Subgroup 4 encompassed individuals with both cytological abnormalities and infections with high-risk HPV types other than 16 and 18. All participants were assessed using the Female Sexual Function Index Scale (FSFI), which measures sexual function across these subgroups. Results: A total of 531 questionnaires were analyzed. Logistic regression identified several risk factors for HPV infection, including manual labor, service occupations, other occupations, low- and middle-income groups, and cervical columnar epithelial ectasia, as well as an increase in the number of previous sexual partners. Conversely, protective factors included condom use during sexual activity and mutual genital hygiene prior to intercourse. The incidence of lower genital tract infections was significantly higher in the HPV-positive group compared to the HPV-negative group, with rates of chlamydia (13.3% versus 4.6%, P<0.001), gonococcal infections (5.2% versus 0.4%, P<0.001), and mycobacterial diseases (38.9% versus 23.4%, P<0.001). Additionally, anxiety levels were significantly higher in the HPVpositive group compared to the HPV-negative group (p<0.005). Anxiety levels and cytological outcomes were significantly correlated across the four HPV-positive subgroups (p<0.05), with type 16/18 infections being associated with notably lower FSFI scores compared to other high-risk HPV types (p<0.05). Conclusions: The findings suggest that infections with HPV type 16/18, especially when accompanied by abnormal cytological findings,significantly elevate anxiety and distress in women and are associated with reduced FSFI scores. These results highlight the complex impact of HPV infection on women's sexual health and psychological well-being with HPV type 16/. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) has become a common health care burden worldwide. The high heterogeneity of NAFLD remains elusive and impairs outcomes of clinical diagnosis and pharmacotherapy. Several NAFLD classifications have been proposed on the basis of clinical, genetic, alcoholic, or serum metabolic analyses. Yet, accurately predicting the progression of NAFLD to cirrhosis or hepatocellular carcinoma (HCC) in patients remains a challenge. Here, on the basis of a Chinese cohort of patients, we classified NAFLD into three distinct molecular subtypes (NAFLD-mSI, NAFLD-mSII, and NAFLD-mSIII) using integrative multiomics including whole-genome sequencing (WGS), proteomics, phosphoproteomics, lipidomics, and metabolomics across a broad range of liver, blood, and urine specimens. We found that NAFLD-mSI had higher expression of CYP1A2 and CYP3A4, which alleviate hepatic steatosis through mediating free fatty acid/bile acid–mTOR–FXR/PPARα signaling. NAFLD-mSII displayed an elevated risk of liver cirrhosis along with increased hepatic infiltration of M1 and M2 macrophages because of lipid-triggered hepatic CCL2 and CRP production. NAFLD-mSIII exhibited a potential risk for HCC development by increased transcription of CEBPB- and ERCC3-regulated oncogenes because of activation of the EGF-EGFR/CHKA/PI3K-PDK1-AKT cascade. Next, we validated the existence of these three NAFLD molecular subtypes in an external cohort comprising 92 patients with NAFLD across three different Chinese hospitals. These findings may aid in understanding the molecular features underlying NAFLD heterogeneity, thereby facilitating clinical diagnosis and treatment strategies with the aim of preventing the development of liver cirrhosis and HCC. Editor's summary: Nonalcoholic fatty liver disease (NAFLD) is part of a disease spectrum and can progress to cirrhosis (scarring) or hepatocellular carcinoma. However, existing NAFLD classifications are unable to identify patients who are at risk of progressing. Using multiomic profiling, Ding et al. found that two independent cohorts of Chinese patients with NAFLD could be divided into three molecular subtypes broadly characterized by reduced liver steatosis, increased hepatic macrophage infiltration and risk of cirrhosis, or increased risk of hepatocellular carcinoma. Further work will need to determine whether these subtypes could be applied to benefit individual patients in a clinical setting. —Catherine Charneski [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR) is linked to an increased risk of neurological impairment following a stroke and may contribute to poor neurological prognosis in affected patients. The metabolic score for the insulin resistance index, shortened as the METS-IR, generally serves as a surrogate index for IR. However, its association with the severity of neurological impairment in patients with severe cerebral infarction (CI) in neurological intensive care units (ICU) has not been fully established. Methods: Patients with a diagnosis of CI, admitted to the neurological ICUs of Yangzhou University's Affiliated Hospital and Xuzhou Medical University's Affiliated Hospital, were included in the study. A multivariate logistic regression model and restricted cubic splines (RCS) were employed to explore the relationship between the METS-IR index and the severity of neurological impairment in these patients. The predictive capabilities of the METS-IR index and the triglyceride-glucose (TyG) index for outcome measures were compared through the ROC curve. Furthermore, a decision curve analysis was executed, and the integrated discrimination improvement (IDI) index was computed to evaluate the enhancements in predictive performance and clinical utility of various scoring systems with the inclusion of the METS-IR index. Subgroup analysis was conducted regarding age, BMI, and smoking status. Results: The study ultimately included 504 participants. Adjusted logistic regression and RCS results showed that as the METS-IR index increases, the risk of neurological impairment in patients with severe CI consistently grows (P for overall = 0.0146, P -nonlinear: 0.0689). The METS-IR index's predictive capability for neurological impairment (AUC = 0.669) was superior to that of the TyG index (AUC = 0.519). Conclusion: From the study results, the METS-IR index can serve as an important predictor for neurological impairment in ICU patients with severe CI. It can aid in the identification and early intervention of neurological impairment in these patients. [ABSTRACT FROM AUTHOR]

AbstractThis study aimed to analyze the clinical phenotype of the HBA2: c.95G>A mutation in the Chinese population and to provide guidance for clinical diagnosis and genetic counseling. Peripheral blood samples were collected from 16 patients, including 6 newborns, 2 children, and 8 adults. Hematological parameters and hemoglobin electrophoresis were analyzed, and genotypes were identified using methods such as PCR combined with reverse dot blot (RDB), nested PCR, gap polymerase chain reaction (Gap-PCR), and DNA sequencing. The results showed that 10 patients had mild anemia, 2 had moderate anemia, and 12 exhibited microcytic hypochromic features with MCV values ranging from 53 to 74.7 fl and MCH values from 16.2 to 25.4 pg. Additionally, 3 cases displayed obvious HbH + HbBarts bands (>15%). Among the 16 cases, various combinations of the HBA2: c.95G>A mutation were observed: one case had –α3.7 combined with HBA2: c.95G>A, another had –α4.2 combined with HBA2: c.95G>A, and five had –SEA combined with HBA2: c.95G>A, while the remaining cases were HBA2: c.95G>A heterozygotes. The study concludes that the HBA2: c.95G>A mutation in the α2 globin gene causes α+ thalassemia. When this mutation is combined with the Southeast Asian deletion (–SEA), it results in HbH disease, characterized by moderate microcytic hypochromic anemia and the presence of HbH + HbBarts bands. [ABSTRACT FROM AUTHOR]

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy‐specific liver disease and the second most frequent cause of jaundice in pregnancy, but the etiology of it is poorly understood. By collecting blood and fecal samples from 12 healthy pregnant women (CON group) and 32 ICP patients (ICP group) in China, we performed 16s rRNA gene sequencing and analyzed microbial diversity. The results showed a decrease in species richness of the ICP group compared to that in the CON group, with a significant difference in species diversity between the two groups. Differential analysis revealed the following biomarkers: s__unclassified__Megamonas, g__Megamonas, f__Selenomonadaceae, c__Bacilli, and o__Lactobacillales. Importantly, we found a decrease in species richness of Selenomonadaceae at the family level and decreased bacilli at the class level in ICP patients. Correlation network analysis and functional gene prediction were performed accordingly. Our data provided new information linking microbiota and ICP, and are possibly helpful for further exploration of the disease. [ABSTRACT FROM AUTHOR]

Reserving existing customers is significantly more meaningful than acquiring new customers, particularly for logistics service providers. This long-standing view emphasizes the importance of customer retention for maintaining favorable relationships between logistics service providers and their clients. Drawing on the framework of the stimulus-organism-response model, this study proposes a model that integrates entertainment, interaction, trendiness, customization, and electronic word-of-mouth to examine how social media marketing activities and trust affect brand equity and reuse intentions for logistics services, both directly and indirectly. Empirical evidence was obtained from an online survey using WeChat and QQ, which administered a structured questionnaire to individuals with prior experience in logistics services at least once a week. We collected the data using a purposive sampling method from 932 participants, who represented the demographic of adult Chinese consumers. By applying partial least squares structural equation modeling, this study shows that interaction, trendiness, customization, electronic word-of-mouth, and trust positively affect the brand equity of logistics services, while the effect of entertainment on brand equity is not significant. In addition, the brand equity of logistics services positively affects the logistics service reuse intention. Furthermore, the result of the mediation analysis revealed that brand equity mediates the connection between interaction, trendiness, customization, electronic word-of-mouth, trust, and logistics service reuse intention. This study's uniqueness lies in its thorough analysis of logistics service providers' social media marketing efforts, trust, and their combined impact on brand equity and reuse intention. This study offers valuable perspectives on the significance of brand equity within the logistics sector, emphasizing the importance of prioritizing brand equity enhancement to improve performance and competitive edge. [ABSTRACT FROM AUTHOR]

Background: The triglyceride–glucose (TyG) index has garnered recognition as a surrogate marker for insulin resistance, a pivotal factor in the pathogenesis of various metabolic disorders. Despite its emerging role, the empirical evidence delineating its association with prediabetes mellitus (Pre-DM) remains scant. This research aims to clarify the link between the TyG index and the likelihood of Pre-DM development within a Chinese demographic. Methods: This investigation was structured as a retrospective cohort analysis, encompassing a sample of 179,177 Chinese adults. These individuals underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. To ascertain the relationship between the TyG index and the incidence of Pre-DM, this study employed Cox regression analysis complemented by sensitivity and subgroup assessments. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore the existence of any non-linear connection within this association. Results: Upon adjusting for a comprehensive array of confounding variables, a statistically significant positive correlation between the TyG index and the risk of Pre-DM was identified (HR: 1.60, 95%CI 1.56–1.65, P < 0.001). The analysis illuminated a non-linear relationship, with an inflection point at a TyG index value of 8.78. For TyG index values below and above this inflection point, the HR was calculated to be 1.94 (95%CI 1.86–2.03) and 1.26 (95%CI 1.20–1.33), respectively. Sensitivity analyses further fortified the reliability of these findings. Conclusions: This comprehensive examination delineated a significantly positive, non-linear correlation between the TyG index and the risk of Pre-DM within a Chinese population. Individuals with TyG index values below 8.78 have a significantly increased risk of developing prediabetes. These findings underscore the TyG index's potential efficacy as a predictive tool for assessing Pre-DM risk in clinical practice. [ABSTRACT FROM AUTHOR]

Social–emotional skills (e.g., emotion regulation) influence a variety of academic outcomes among children. This study examined the relations of coping strategies and cognitive emotion regulation (CER) to academic achievement goals and academic performance among Chinese children (N = 401, age M = 10.52 years). Full Structural Equation Modeling (SEM) analysis showed that children's use of active coping strategies was positively associated with their endorsement of performance approach and mastery avoidance goals. Avoidant and support-seeking coping strategies were not associated with any outcome variables. Maladaptive CER was positively associated with performance approach, performance avoidance, and mastery avoidance goals and negatively associated with academic performance; adaptive CER was positively associated with mastery approach goals but not associated with other outcome variables. The current study provided some preliminary evidence to indicate that active coping strategies, maladaptive CER, and adaptive CER were associated with academic achievement goals and academic performance among Chinese children. Although maladaptive CER was not used as often as adaptive CER by Chinese children, the more they used maladaptive CER, the more likely they were to have academic achievement goals that focused on things other than learning itself, whereas the more Chinese children used adaptive CER, the more likely they were to set an achievement goal to master the knowledge. Therefore, in teaching practices or intervention planning, decreasing maladaptive CER strategies may be as important as cultivating adaptive CER strategies to facilitate academic success among Chinese children. [ABSTRACT FROM AUTHOR]

As population aging increased globally, this study aimed to examine the relationship between leisure activity participation and cognitive function in the older Chinese population and the gender and age differences in this relationship. A total of 12526 individuals aged 60 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey were obtained for this study. Multiple linear regression analysis was used to explore the relationship. This study found productive, physical, intellectual, recreational and social activities were associated with cognitive function. Males enjoyed extra benefits from recreational activities compared with females. Females enjoyed extra benefits from productive activities and social activities compared with males. Older age enjoyed extra benefits from productive activities, physical activities, intellectual activities, recreational activities, social activities in comparison with younger age. Thus, Chinese older adults need to make efforts to increase the time and variety of leisure activities, especially for the oldest old. Compared with other types of leisure activities, it's more important for old men to participate in recreational activities, and for old women to participate in productive activities and social activities. [ABSTRACT FROM AUTHOR]

Background: Enfortumab vedotin, a fully human monoclonal antibody–drug conjugate (ADC) directed to Nectin‐4, prolonged overall survival (OS) versus standard chemotherapy in patients with previously treated locally advanced or metastatic urothelial carcinoma (mUC) previously receiving a programmed cell death protein 1/ligand 1 (PD‐1/L1) inhibitor and platinum‐based chemotherapy in the pivotal, phase 3 EV‐301 clinical trial, supporting global approvals of enfortumab vedotin monotherapy. This bridging study was the first to evaluate enfortumab vedotin monotherapy in previously treated Chinese patients with locally advanced or mUC. Methods: EV‐203 was a multicenter, open‐label, phase 2 study (NCT04995419) assessing efficacy, safety/tolerability, pharmacokinetics (PK), and immunogenicity of enfortumab vedotin in 40 Chinese patients (PK analysis set, n = 13) with previously treated locally advanced or mUC. Patients received enfortumab vedotin 1.25 mg/kg (Days 1, 8, and 15). Primary endpoints included confirmed objective response rate (ORR) by the independent review committee (IRC) and PK parameters of ADC, total antibody (TAb), and free monomethyl auristatin E (MMAE). Secondary endpoints included investigator‐assessed confirmed ORR; investigator‐/IRC‐assessed duration of response (DOR), disease control rate (DCR), and progression‐free survival (PFS); OS; immunogenicity; and safety/tolerability. Results: As of May 13, 2022, the median follow‐up was 6.5 months. Confirmed ORR was 37.5% (n/N = 15/40; 95% CI: 22.7%–54.2%) by IRC and 42.5% (n/N = 17/40; 95% CI: 27.0%–59.1%) by investigator assessment. By IRC, DCR was 72.5% (n = 29), median DOR was not reached, and median PFS was 4.7 months. Median OS was not reached. Endpoints assessed by investigators were consistent with IRC assessments. Two patients discontinued treatment for treatment‐related adverse events. No new safety signals were identified. ADC, TAb, and free MMAE were characterized in Chinese patients and consistent with previously characterized populations. The incidence of positive antitherapeutic antibodies postbaseline was 0%. Conclusion: Enfortumab vedotin demonstrated meaningful clinical activity with a manageable safety profile in Chinese patients with previously treated locally advanced or mUC. Trial Registration: ClinicalTrials.gov identifier: NCT04995419 [ABSTRACT FROM AUTHOR]

This study examines the acceptance of young Chinese consumers for different "Fuji" apples, focusing on their sensory characteristics and physicochemical foundations. The sensory attributes of the samples were evaluated using a combination of static descriptive analysis (DA) and temporal check‐all‐that‐apply fading (TCATA‐fading) methods. Furthermore, the volatile compounds, soluble sugars, organic acids, and textural parameters of the samples were analyzed. The findings revealed that participants favored apples that were perceived as "sweet," "crunchy," "juicy," and "aromatic." The results from the DA indicated that certain sensory attributes, such as "sweet," "vanilla," "honey," and "pear" positively influenced acceptance, while attributes like "sour," "hard," and "grass" had a negative impact. The findings from both the DA and TCATA‐fading methods were consistent with each other. In terms of dynamic evaluation, sweetness, and sourness were the initial perceptions, followed by a range of other flavors. Notably, our data suggested that sweetness perception could be enhanced by attributes such as "honey" and "banana." Additionally, the sugar‐acid ratio and specific volatile compounds, including hexanal, (E)‐2‐hexenal, β‐damascenone, butyl acetate, and propyl 2‐methylbutyrate, were found to influence the perception of sweetness in apples. Practical Application: This study helps to understand the effect of different origins on the acceptance of "Fuji" apples and to know the sensory and material basis for the emergence of such differences. It is beneficial for growers and marketers to improve 'Fuji' apples. [ABSTRACT FROM AUTHOR]

Understanding consumers' sensory preferences for dairy products is essential. This study employed sensory analysis and instrumental techniques to analyze the flavor of pasteurized milk and UHT milk. There were 6 milk samples with similar fat content (4.0–4.6 g/100 mL) and protein content (3.2–3.8 g/100 mL). Sensory data from consumer tests was collected using check-all-that-apply (n = 100) and 9-point hedonic preferences. Research showed that Chinese consumers could distinguish the flavor of the 2 types of milk, and UHT milk showed a higher preference score, which may be due to the more pronounced milky flavor and sweet taste of UHT milk. A total of 48 aroma-active compounds were sniffed through 2-dimensional gas chromatography olfactometry time-of-flight MS, among which 11 were determined as key aroma-active compounds. Correlation analysis showed that milky odor, sweetness, and aftertaste-milky were positively correlated with γ-dodecalactone and γ-nonanolactone. Cooked and oxidized taste were positively correlated with 1-octen-3-ol and E-2-octenal. This study is important for developing Chinese dairy products and exporting dairy products to China by multinational companies. The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: This study was to investigate the differences between young older adults with and without vision impairment on neuropsychological and psychiatric outcomes following falls during the past year and to identify predictors of cognitive decline or mental distress. Methods: A secondary analysis of 668 young older Chinese adults aged 65 ∼ 79 years old with a history of falls was conducted from the cross-sectional survey data in the 2018 wave of the Chinese Longitudinal Health Longevity Survey (CLHLS). Results: Participants with vision impairment scored significantly higher on anxiety and depression and lower on cognitive function and SWB than those without vision impairment. And vision impairment was a significant predictor of adverse outcomes for all four neuropsychological and psychiatric measures. Conclusion: Neurocognitive deficits, psychological problems, and decreased self-sufficiency are quite common among community-dwelling older adults with visual impairment who have a history of falls within a year. [ABSTRACT FROM AUTHOR]

Objective To determine if the cardiac function and "endocrinium" of Chinese patients are associated with dopamine D2 (DRD2) (rs6276) and DRD3 (rs6280, rs963468) genetic polymorphisms when treated with amisulpride. Methods This study enrolled 148 patients with schizophrenia who took amisulpride orally for 8 weeks. DRD2 (rs6276) and DRD3 (rs6280, rs963468) genetic polymorphisms were detected with TaqMan-MGB allelic discrimination. Results Analysis by multivariate covariance analysis (MANCOVA) showed that after adjusting for age, gender, and the baseline level, the increase in the level of aspartate aminotransferase (AST) and creatine kinase (CK) in the rs6276 AG group was higher than that in the AA and GG groups. Similarly, the changed estradiol (E2) level in rs6276 GG and rs963468 GG groups was higher than that in the other two groups. Adjusting for covariates, the increased triglyceride (TG) level in rs6276 GG and rs963468 GG groups was the highest among their different genotype groups. The increase in the level of "AST" in the rs6280 TT group was higher than that in the CC and CT groups upon adjusting for covariates. Similarly, MANCOVA showed that the increase in the level of "CK" in the rs6280 CT group was higher than that in the CC and CT groups. Besides, the increased level of "PRL" in the rs6280 CC group and rs963468 GG group was higher than that in their other two genotypes groups. ConclusionDRD2 (rs6276) and DRD3 (rs6280, rs963468) polymorphisms can affect amisulpride tolerability since they are associated with the observed adverse reactions, including cardiac dysfunction and endocrine disorders in Chinese patients with schizophrenia. [ABSTRACT FROM AUTHOR]

The extant empirical evidence indicates that multicultural experiences (MCEs) are linked to numerous positive outcomes, including increased trust, reduced intergroup bias, and the promotion of large‐scale cooperation. These beneficial effects partly depend on the fact that increased MCEs enhance cultural sensitivity, which may enable individuals to better empathize with others. Therefore, we explored the beneficial effects of MCEs on empathy, along with the potential mechanisms. A sample of 1480 Chinese young adults (M = 21.40, SD = 1.86) were employed to complete anonymous questionnaires on their MCEs, positive emotions, critical thinking, empathy, and multicultural breadth. By controlling for gender and family socioeconomic status, parallel mediation analysis revealed that MCEs can independently influence individuals' levels of empathy through both positive emotions and critical thinking. Thereafter, multicultural breadth was determined as a moderator influencing this model. The results highlighted the role of MCEs in increasing empathy through their relationship with cognitive and emotional processes. This study is significant in expanding our understanding of the consequences of MCEs and has practical value in promoting more interpersonal harmony and social tolerance through enhanced empathy. [ABSTRACT FROM AUTHOR]