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Abstract The objective of this study was to investigate self-medication behavior among Chinese adolescents aged 12–18 years and explore the factors associated with whether adolescents prioritize drug efficacy or safety when engaging in self-medication behavior. In 2021, a questionnaire investigation was conducted in the Chinese mainland using a multi-stage sampling approach. After a statistical description, logistic regression was used to analyze the factors associated with considering drug efficacy and safety. The self-medication rate among Chinese adolescents aged 12–18 years was 96.61%. Of these, 65.84% considered drug safety to be essential, while 58.72% prioritized drug efficacy. Regression analysis showed that individuals with better healthcare were more likely to consider drug efficacy an important factor. Additionally, those with a healthier family lifestyle were more likely to prioritize efficacy. When individuals engage in self-medication, those residing in urban areas and possessing advanced preventive health literacy and ample family health resources tend to prioritize drug safety to a greater extent. Conversely, those with higher monthly household incomes and only children exhibit a decreased inclination towards prioritizing safety during self-medication. Self-medication is a frequently observed practice among Chinese adolescents aged 12–18. Several factors, such as demographic and sociological characteristics, health literacy, and family health status, have been found to be associated with the extent to which adolescents prioritize medication safety and efficacy when engaging in self-medication practices. Higher levels of health literacy and better family health status were positively correlated with considering both the efficacy and safety of drugs as important factors when self-medicating.

PurposeThis study aims to explore and compare Chinese university students’ preferences for various physical activity motivation programs.Patients and methodsA cross-sectional study was conducted in China from February 25 to March 25, 2022. Participants anonymously completed an online questionnaire based on a DCE. A total of 1,358 university students participated in the survey. The conditional logit model (CLM), willingness to accept (WTA), and propensity score matching (PSM) were used to assess college students’ preferences for different attributes and levels of physical activity incentive programs.ResultsRespondents identified the number of bonus, exercise time, and academic rewards as the three most significant attributes of the athletic incentive program. The importance of each attribute varied based on individual characteristics such as gender and BMI. In CLM, college students displayed a preference for a “¥4” bonus amount (OR: 2.04, 95% CI 1.95–2.13), “20 min” of exercise time (OR: 1.85, 95% CI 1.79–1.92), and “bonus points for comprehensive test scores” as academic rewards (OR: 1.33, 95% CI 1.28–1.37). According to the WTA results, college students were willing to accept the highest cost to obtain academic rewards tied to composite test scores.ConclusionThe number of bonus, exercise time, and academic rewards emerge as the three most crucial attributes of physical activity incentive programs. Furthermore, college students with different characteristics exhibit heterogeneity in their preferences for such programs. These findings can guide the development of programs and policies aimed at motivating college students to engage in physical activities.

Abstract Objective To explore the mechanism of infectious disease prevention behavior on quality of life, and to investigate the mediating role of self‐efficacy and the moderating role of family structure. Methods A total of 3015 subjects were selected by multistage stratified cluster sampling. Results Infectious disease prevention behavior had a significant positive predictive effect on the quality of life (β = 0.08, p

Background and objectiveCOVID-19 has imposed burdens on public health systems globally. Owing to the urgency of vaccination, this study aimed at comparing the differences in preference and willingness to pay of COVID-19 vaccine among Chinese and American middle-aged and elderly adults.MethodsA cross-sectional survey containing demographic questions, rating their acceptance of COVID-19 vaccination with and without recommendations from friends, family members or employers (the social cues referred to in our study), and a discrete choice experiment understanding COVID-19 vaccine preference and willingness to pay was conducted to collect data. Propensity score matching was utilized to adjust confounding factors of baseline characteristics and the relative importance of respondents' preference for each attribute and its level was estimated using a conditional logit model. Then, willingness to pay was calculated.ResultsIn total, 3,494 (2,311 and 1,183 from China and the United States, respectively) completed the questionnaire, among which 3,444 questionnaires were effective. After propensity score matching, 1,604 respondents with 802 from the US and 802 from China were included. Under the influence of the social cues, Chinese respondents' vaccine acceptance decreased from 71.70 to 70.70%, while American respondents' vaccine acceptance increased from 74.69 to 75.81%. The discrete choice experiment showed that American respondents regarded the efficacy of COVID-19 vaccine as the most important attribute, whereas Chinese respondents attached the highest importance to the cost of vaccination. But overall, the COVID-19 vaccine with the higher efficacy, the milder adverse effect, the lower cost, and the longer duration will promote the preference of the public in both countries. Additionally, the public were willing to spend the most money for a reduction in COVID-19 vaccine adverse effect from moderate to very mild (37.476USD for the United States, 140.503USD for China), followed by paying for the 1% improvement in its efficacy and paying for the one-month extension of its duration.ConclusionGiven the impact of social cues on vaccine acceptance, Chinese government should promote reasonable vaccine-related information to improve national vaccination acceptance. Meanwhile, considering the influence of COVID-19 attributes on public preference and willingness to pay, regulating the vaccine pricing, improving the efficacy of the vaccine, reducing its adverse effect, and prolonging the duration of the vaccine works will contribute to vaccine uptake.

BackgroundHome first-aid kits can play an important role when residents are injured, suddenly become seriously ill or suffer from disasters.PurposeTo explore the home first-aid kit preparedness of Chinese residents and the relationship between demographic sociological characteristics, self-efficacy, Big Five personality, health literacy and home first-aid kit preparation behavior.MethodsA cross-sectional study was conducted. Information was collected through a self-designed questionnaire consisting of sociological characteristics, the New General Self-Efficacy Scale (NGSES), the Health Literacy Scale Short-Form (HLS-SF12), and the 10-item short version of Big Five Inventory (BFI-10). Rank sum test, Chi-square test, and logistic regression were used to explore the relationship between independent variables and home first-aid kit preparation behavior.ResultsA total of 9,344 respondents were included, and 2,156 (23.07%) prepared home first-aid kits. Among the respondents who had prepared their home first-aid kits, disinfection supplies (85.20%), medical masks (84.51%), commonly used drugs (82.79%) were the most frequently available. The respondents whose geographic area was Central and Western China, permanent residence in the urban area, secondary education or above, monthly income of 3,000 RMB or above, health care cost-bearing method mainly resident health insurance, high subgroup of self-efficacy, high subgroup of health care dimension in health literacy, and whose openness and conscientiousness was high subgroup were more likely to prepare home first-aid kits (P < 0.05).ConclusionThe preparation rate for home first-aid kits in China is less than a quarter. The public's home first-aid kit preparation behavior is related to demographic characteristics, self-efficacy, health literacy, and the openness of the Big Five personality. A multi-level linked national emergency literacy education system should be established to enhance the residents' attention to home first-aid kits and improve the residents' ability to prevent emergencies.

Background: This study aims to investigate the needs of child caregivers for popular science about safe medication for children, to deeply explore the characteristics of child caregivers’ demand for safe medication and the shortcomings of current popular science work, and then to seek better coping strategies to ensure children’s safe medication.Methods: A questionnaire was designed based on Lasswell’s “5W” communication model to investigate the needs of child caregivers in terms of content, channels, and forms of popular healthcare science on the safe usage of children’s medication.Results: The primary ways caregivers receive popular healthcare science education concerning safe medication usage knowledge are through medical institutions, notification by medical staff, and personal media. The caregivers of children have a high demand for the presentation of text, pictures, and videos in three forms of popular healthcare science content. Caregivers placed significant importance on the popularization of safe medication usage for children. The survey results showed that the top 3 ways for caregivers to think that the quality of popular healthcare science content was “very good” came from medical institutions, medical staff notifications, and personal media, effectively increasing popular healthcare information accuracy. The intelligibility and pertinence of content expression are urgently needed within the caregiver population.Conclusion: Caregivers are very concerned about the popular science of safe medication for children, and are willing to learn about relevant content. Guided by the demand, we should actively disseminate accurate and easy-to-understand popular science about safe medication for children to caregivers through online or offline channels so as to promote safe medication for children.

(1) Background: research on vaccines has received extensive attention during epidemics. However, few studies have focused on the impact of media use on vaccination behavior and the factors influencing vaccination in groups with different media use degrees; (2) Method: Based on seven items related to media use, a total of 11,031 respondents were categorized by the frequency of media use by using latent profile analysis (LPA). Binary regression analysis was used to study the factors that influence the vaccination behaviors of people with different media use frequencies; (3) Results: All respondents were classified into the following three groups: media use low frequency (9.7%), media use general (67.1%), and media use high frequency (23.2%). Media use low frequency (β = −0.608, p < 0.001) was negatively associated with COVID-19 vaccination behavior. In the media use low frequency, analysis showed that “aged 41 years or older” β = 1.784, p < 0.001), had religious belief (β = 0.075, p < 0.05), were ethnic minorities (β = 0.936, p < 0.01) and had friends support (β = 0.923, p < 0.05) were associated with a preference to accept the COVID-19 vaccine. In the media use general, those who aged 41 years old and older (β = 1.682, p < 0.001), had major depression (β = 0.951, p < 0.05), had friends support (β = 0.048, p < 0.001) would be more likely to receive COVID-19 vaccination. However, respondents who live in towns (β = −0.300, p < 0.01) had lower behaviors to receive vaccination for COVID-19. In the media use high frequency, the respondents who aged 41 or older (β = 1.010, p < 0.001), were ethnic minorities (β = 0.741, p < 0.001), had moderate depression (β = 1.003, p < 0.05) would receive the vaccination for COVID-19 positively; (4) Conclusions: The more occluded the media use is, the less likely the respondents are to get vaccinated against COVID-19. Vaccination behavior is influenced by different factors in groups with different frequencies of media use. Therefore, the government and appropriate departments should make individualized and targeted strategies about COVID-19 vaccination and disseminate the vaccination information to different media use groups.

Abstract Background Due to the high drug resistance of hepatocellular carcinoma (HCC), sorafenib has limited efficacy in the treatment of advanced HCC. Cancer-associated fibroblasts (CAFs) play an important regulatory role in the induction of chemoresistance. This study aimed to clarify the mechanism underlying CAF-mediated resistance to sorafenib in HCC. Methods Immunohistochemistry and immunofluorescence showed that the activation of CAFs was enhanced in HCC tissues. CAFs and paracancerous normal fibroblasts (NFs) were isolated from the cancer and paracancerous tissues of HCC, respectively. Cell cloning assays, ELISAs, and flow cytometry were used to detect whether CAFs induced sorafenib resistance in HCC cells via CXCL12. Western blotting and qPCR showed that CXCL12 induces sorafenib resistance in HCC cells by upregulating FOLR1. We investigated whether FOLR1 was the target molecule of CAFs regulating sorafenib resistance in HCC cells by querying gene expression data for human HCC specimens from the GEO database. Results High levels of activated CAFs were present in HCC tissues but not in paracancerous tissues. CAFs decreased the sensitivity of HCC cells to sorafenib. We found that CAFs secrete CXCL12, which upregulates FOLR1 in HCC cells to induce sorafenib resistance. Conclusions CAFs induce sorafenib resistance in HCC cells through CXCL12/FOLR1.

Background: More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains unclear if solitary HCC (SHCC) patients particularly those without high-risk recurrence factors should also receive PA-TACE. This study aimed to analyze the efficacy of PA-TACE in them. Methods: Retrospectively, we enrolled 123 SHCC patients who either received radical hepatectomy alone (No TACE group, n = 39) or followed by PA-TACE (PA-TACE group, n = 84) in our institution. Prognostic risk factors, disease-free survival (DFS), and overall survival (OS) were analyzed using the Cox proportional hazard regression model, the Kaplan-Meier method, and the log-rank test. Results: Liver cirrhosis was the only independent risk factor for SHCC patients. Overall, the PA-TACE group had no improved OS (P = 0.977) but worse DFS compared with the No TACE group (P = 0.045). Consistently, in subgroup analysis, SHCC patients with negative microvascular invasion (MVI), tumor size ≤ 5 cm and preoperative alpha-fetoprotein (AFP) < 400 ng/ml had similar OS (P = 0.466, P = 0.864, P = 0.488, respectively) but even worse DFS (P = 0.035, P = 0.040, P = 0.019, respectively) than those in the No TACE group. Besides, there was no significant difference in DFS and OS between the two groups of SHCC patients with liver cirrhosis (P = 0.342, P = 0.941, respectively). Conclusions: PA-TACE may not improve the long-term survival of SHCC patients, but may even potentially promote their postoperative tumor recurrence, especially for those with MVI-negative, tumor size ≤ 5 cm, and preoperative AFP < 400 ng/ml.

Egg yolks are rich in lipids that are easily altered during processing and storage. In this study, a liquid chromatography-tandem mass spectrometry strategy was used for quantitative lipidomics analysis of egg yolk after spray-drying processing and accelerated storage. Spray-drying treatment caused lipid oxidation (especially the oxidation of free fatty acids), potential hydrolysis of phospholipids, and alteration of the form of certain polyunsaturated fatty acids (docosahexaenoic acid, eicosapentaenoic acid, linolenic acid, and eicosatetraenoic acid) in egg yolk. These lipid alterations caused by the spray-drying process were further aggravated by the accelerated storage process. In detail, following storage, the abundance of free fatty acids, phosphatidic acid and phosphatidylethanolamine decreased further; and the abundance of polyunsaturated fatty acids in the form of triglycerides increased significantly. These results provide new insight into the mechanism underlying egg yolk property changes during spray-drying and storage, and offer valuable reference data for egg yolk powder promotion and application in food processing.

Aim: Chromosome 14 open reading frame 166 (C14orf166) acts as a transcriptional repressor and is correlated with centrosome architecture manipulation. Nevertheless, the function of C14orf166 in hepatocellular carcinoma (HCC) progression remains unclear. We aimed to investigate the role C14orf166 plays in HCC and further compared the prognostic value of C14orf166 with that of clinicopathological features. Methods: C14orf166 expression was evaluated in a human liver cell line, HCC cell lines, HCC tissues and adjacent noncancerous liver tissues with qRT-PCR, western blot and immunohistochemistry. Patients were divided into two different groups according to C14orf166 level. The relationship between C14orf166 expression and clinicopathological features was assessed by Pearson chi-squared test and receiver operating characteristic curves. Cumulative disease-free survival (DFS) and overall survival (OS) curves were evaluated using the Kaplan–Meier method. Results: C14orf166 mRNA and protein expression is upregulated in HCC cell lines and tissues. The level of C14orf166 was correlated with serum alpha-fetoprotein level, lymph node metastasis, tumor size and recurrence, with high C14orf166 expression correlating with high HCC recurrence risk. The poor OS and DFS of HCC patients are partly due to the persistently high HCC recurrence risk. When combined with serum alpha-fetoprotein level, the predictive accuracy of C14orf166 for HCC recurrence was enhanced (AUC = 0.712, 95% CI 0.603–0.821; p = 0.001). Conclusions: This study demonstrated that C14orf166 is a high-risk biomarker and predictive factor for HCC recurrence, providing information for the selection of appropriate treatment strategies.

Abstract Background Hepatocellular carcinoma (HCC) is a common malignant tumor in China. Advanced treatment like transcatheter hepatic arterial chemoembolization (TACE) has prolonged the lives of many HCC patients. However, the prognosis of most HCC patients remains unsatisfactory. Recently, circular RNAs (circRNAs) have been gradually unveiled to exert considerable functions in cancer. Promising circRNAs in HCC remains to be further elucidated. Methods Gene expression was assessed by qRT-PCR and western blot. The function of circ-DENND4C in HCC was estimated by both in vitro and in vivo experiments. The location of circ-DENND4C in HCC cells was determined by subcellular fractionation and FISH assays. The association among molecules were analyzed through RNA pull down, RIP and luciferase reporter assays. Results circ-DENND4C (DENN domain containing 4C), an oncogene identified in breast cancer, was overexpressed in HCC cells. Also, circ-DENND4C exerted pro-tumor functions in HCC through activating Wnt/β-catenin pathway. Importantly, circ-DENND4C could augment transcription factor 4 (TCF4) expression to activate Wnt/β-catenin signaling via sequestering miR-195-5p. Moreover, following rescue assays disclosed that circ-DENND4C mediated malignant phenotypes in HCC cells via up-regulating TCF4 through sponging miR-195-5p. Conclusion circ-DENND4C boosted TCF4 expression to modulate malignant behaviors of HCC cells via activating Wnt/β-catenin pathway, which might offer a promising target for HCC treatment.

Abstract Background Hepatic clonorchiasis is one of the most prevalent food-borne parasitic diseases worldwide. Clonorchis sinensis, the pathogen, is the major parasitic trigger contributing to cholangitis, cholelithiasis, and even cholangiocarcinoma. Unfortunately, unspecific clinical manifestations of patients with hepatic clonorchiasis tend to mislead clinicians to neglect or misdiagnose them, following ignorance of appropriate therapy. Our case report may shed light on definite diagnosis of clonorchiasis with concomitant cholelithiasis, methodology for surgical drainage of the parasites, and postoperative anthelmintic therapy. Case presentation Two patients with habit of eating infected raw or undercooked freshwater fish were hospitalized due to right upper quadrant pain and jaundice. Magnetic resonance cholangiopancreatography (MRCP)/computed tomography (CT) detection indicated cholangiolithiasis and cholangiolithiasis with concurrent cholecystolithiasis, respectively. Fecal examinations were both negative for adult worms or eggs of parasites. However, adults of Clonrochis sinensis were detected within hepatobiliary tracts during laparoscopic cholecystectomy. Postoperative drainage and anthelmintic therapy contributed to complete recovery with good prognosis. Conclusions Clonorchiasis provokes cholangiolithiasis and cholecystolithiasis. Standardized treatments for these gallstone patients with concomitant clonorchiasis include surgical removal of the calculus, postoperative T tubule drainage and anthelmintic therapy. Serological test or polymerase chain reaction (PCR)-based approaches might be helpful for diagnosis of clonorchiasis when no eggs are found by stool microscopy. Public health promotion on ceasing to eat raw freshwater fish is essential for prevention and control of clonorchiasis.