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HPV vaccine hesitancy in Asia is unique compared to western countries. Concerning whether social media promotion about HPV vaccine will be related with parental support for Chinese adolescent girls, we investigated the correlation among social media promotion, risk perception of HPV vaccine and parental support. Through the theoretical lens of Health Action Process Approach model (HAPA), we found that social media promotion could reduce the risk perception of HPV vaccine and promoted parental supportive decision, and risk perception played a mediation role between social media information exposure to vaccine and parental support. Consideration of future consequences has been found to play a moderating role between social media promotion and risk perception, and parents' sexual attitudes moderated the effect of social media promotion on parental support. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

This study analyzed the content, visual features, and audience engagement data of Instagram posts from two mental health organizations over one year (N = 725). For content features, mental health literacy and communicative strategies were examined. Posts that promoted knowledge of mental disorders and treatments, used information and community strategy were more likely to receive higher audience engagement. Visual features of demographic segments, visual composition, and visual framing topics were analyzed. Images that covered an unspecific population, used illustrated images, and focused on anti-stigma topical frames obtained more engagement. Theoretical contributions and practical applications regarding visual message design and management on social media to promote mental health are also offered. [ABSTRACT FROM AUTHOR]

Few studies have been conducted to explore medication non-adherence in persons with schizophrenia (PWS) and its influencing factors in rural China. This study aimed to investigate the medication non-adherence and its influencing factors among PWS in rural China. A total of 269 PWS and their family caregivers in Xinjin district, Chengdu, China were investigated on medication adherence and related factors. Logistic regression was employed to identify the influencing factors. The results showed that 37.6% of PWS had medication non-adherence. PWS living with family caregivers had significantly lower rate of medication non-adherence (34.7%) than those not living with family caregivers (60.0%) (p < 0.01). Family caregivers' affiliate stigma of mental illness, knowledge of mental illness and self-esteem were significantly related to patients' medication non-adherence (p < 0.05). PWS' employment status, living with family caregiver, present mental status and social support were significantly related to medication adherence. This study shows medication non-adherence is severe among PWS in rural China. Both patient- and family-related factors affect patients' medication adherence seriously. Except improving patients' treatment and mental status, development of family caregiving, social support network and intervention on reducing stigma of mental illness should be crucial for enhancing PWS' medication adherence. [ABSTRACT FROM AUTHOR]

Objective. Brief, reliable, and cost-effective methods to assess parenting are critical for advancing parenting research. Design. We adapted the Three Bags task and Parent Child Interaction Rating System (PCIRS) for rating online visits with 219 parent–child dyads (White, n = 104 [47.5%], Black, n = 115 [52.5%]) and combined the video data with survey data collected during pregnancy and when children were aged 1. Results. The PCIRS codes of positive regard, stimulation of child cognitive development, and sensitivity showed high reliability across the three parent–child interaction tasks. A latent positive parenting factor combining ratings across codes and tasks showed good model fit, which was similar regardless of parent self-identified race or ethnicity, age, socioeconomic disadvantage, marital/partnered status, and parity, as well as methodological factors relevant to the online video assessment method (e.g., phone vs. laptop/tablet). In support of construct validity, observed positive parenting was related to parent-reported positive parenting and child socioemotional development. Finally, parent reports of supportive relationships in pregnancy but not neighborhood safety or pandemic worries, were prospectively related to higher positive parenting observed at age 1. With the exception of older parental age and married/partnered status, no other parent, child, sociodemographic, or methodological variables were related to higher overall video exclusions across tasks. Conclusions. PCIRS may provide a reliable approach to rate positive parenting at age 1, providing future avenues for developing more ecologically valid assessments and implementing interventions through online encounters that may be more acceptable, accessible, or preferred among parents of young children. [ABSTRACT FROM AUTHOR]

Purpose: To assess the relationship between anticoagulant use and rehabilitation outcomes in post-acute hip fracture patients. Methods: A retrospective study (1/2017 to 5/2019) of 299 hip fractured patients. Outcome measures: Functional Independence Measure (FIM) and the motor FIM's effectiveness. Results: Patients treated with anticoagulation drugs exhibited a significant longer latency time from fracture to surgery (U?-4.37, p<0.001) and from surgery to rehabilitation (U=-2.27, p=0.023), and a significantly higher rate of cardiovascular diseases (χ²=0.15, p= 0.023) compared with untreated patients. No significant differences between the two patient groups were found regarding the rate of blood transfusions, perioperative complications (infections, reoperation), or functional outcome measures. Conclusions: Oral anticoagulants are not associated with rehabilitation outcomes of hip fracture patients. [ABSTRACT FROM AUTHOR]

The researchers' aim to quantitatively study the impacts of education, health expenditure, Internet, mobile phone, and open-access articles in medical science on women's health in China. We found that there are very strong significant negative correlations between the data of women's mortality rates and female school enrollment (p≪0.01), whereas there are strong significant negative correlations for open-access papers in eight disciplines of medical science, individuals using the Internet, and mobile cellular subscriptions (p≪0.01). The first principal component explains 96.8%, 96.6%, and 99.6% of the variation in the mortality rate of female infants (p = 0.002 < 0.01), females under-5 (p = 0.003 < 0.01), and female adults (p = 0.002 < 0.01), respectively. There is a similar relationship between open-access medical papers and women's health. The above results could be helpful to interdisciplinary audiences (patients, practitioners, and policymakers) to develop strategies for the effective implementation of knowledge on women's health (how to disseminate knowledge more effectively in the whole society). [ABSTRACT FROM AUTHOR]

This study analyzed tweets posted over 1 year from three mental-health organizations in the United States, along with audience engagement data of comments, retweets, and likes. The results revealed that tweets focused on mental illnesses or mental health received more engagement than those that emphasized event promotion or relationship building. In addition, there were more gain-framed than loss-framed messages, although the latter triggered more public engagement. Thematic framing was used more frequently than episodic framing and related to higher levels of engagement. Call-to-action (CTA), other audience engaging methods and multimedia strategies were used in various frequencies in these tweets; and the use of CTA, other engaging methods, photos/pictures, and external links, but not videos, were positively related to public engagement. Theoretical contributions and practical implications regarding using social media for mental health promotion were offered. [ABSTRACT FROM AUTHOR]

This study aimed to estimate temporal trends in physical fitness (PF) by regions, age groups and nutritional status among Chinese children and adolescents and to longitudinally examine PF determinants based on social-ecological model. Participants (n = 68,265) aged 7–18 were from five successive national surveys (2000 to 2019). Six tested items of PF were calculated as PF indicator (PFI), which was used to divide participants into two categories: low vs. moderate/high. One-way analysis of variance was used to compare difference and change trend of PFI. Linear regression evaluated relationship between PFI and body mass index (BMI), and logistic regression assessed association between PFI and factors of behaviours and lifestyles on individual-, family- and school-level based on the social-ecological model. PFI declined sharply from 2000 to 2010, increased slightly from 2010 to 2014 and then edged down in 2019. Students with moderate BMI and students in urban areas tended to have higher PFI, and larger increase of PFI was found in students aged 7–9 and 13–15 after 2010. Several determinants on individual-, family- and school-level related to PFI. Efforts to develop PF mainly include increasing PA and reducing sedentary behaviours by facilitating home-school collaboration and emphasizing age-, region- and BMI-specific actions. [ABSTRACT FROM AUTHOR]

Previous studies have investigated the prognostic value of the advanced lung cancer inflammation index (ALI) in gastrointestinal (GI) cancers; however, the results are controversial. This meta-analysis aimed to evaluate the prognostic and clinicopathological role of ALI in patients with GI cancers. A systematic search of electronic databases was conducted to evaluate the prognostic and clinicopathological value of ALI in GI cancers. Nine studies comprising 3,750 patients were included in this meta-analysis. The pooled results showed that a low ALI was significantly associated with worse overall survival (OS, hazard ratio [HR] = 1.95, 95% confidence interval [CI] = 1.53–2.47, P < 0.001, I2 = 63.9%) and disease-free survival/relapse-free survival (DFS/RFS, HR = 1.49, 95% CI = 1.28–1.73, P < 0.001, I2 = 0%) in patients with GI cancers. In addition, decreased ALI correlated with the depth of tumor invasion and presence of distant metastasis and tended to be associated with male sex, high carcinoembryonic antigen levels, lymph node metastasis, and right-sided colon cancer. Low ALI was associated with adverse OS and DFS/RFS in patients with GI cancer. In addition, decreased ALI also correlated with clinicopathological factors, indicating higher stage of the malignancy. [ABSTRACT FROM AUTHOR]

Two new withaphysalin-type withanolides (18-O-ethylwithaphysalin R and 5-O-ethylphysaminimin C, 1 and 2), along with twelve known withanolides (3–14), were purified and identified from Physalis peruviana L. The chemical structures of these new isolates were elucidated through analyzing spectroscopic and HRESIMS data. All the obtained metabolites were appraised for their potential antiproliferative activity against the human breast cancer cell line MCF-7. Compound 7 was discovered to exhibit potent activity with an IC50 value of 3.51 µM and compounds 2, 6 and 14 showed weak cytotoxic effect. [ABSTRACT FROM AUTHOR]

Farmers in tropical countries have been impacted by slow-onset heat stress. By comparing the nature of farming activities performed by conventional farmworkers and agroecological farmers, this study examined the changes in physiological health in responses to heat exposure through a six-month longitudinal study. Throughout the six-month follow-up period, the heat stress index (HSI), physiological strain indices (PSI), and physiological health parameters (BMI, blood glucose level, blood cholesterol level, uric acid level) were measured and repeated every two-month. Physiological parameters were recorded twice daily, before and during their first lunch break. This study found that slow-onset heat stress affects farmers differently. The health of agroecological farmers is more resistant to slow-onset extreme temperatures. Pre-existing metabolic health effects from pesticide exposure make conventional farmers more susceptible to extreme temperatures, delaying their bodies' adaptation to rising temperatures. [ABSTRACT FROM AUTHOR]

Whether ambulance transport patterns are optimized to match children to high-readiness emergency departments (EDs) and the resulting effect on survival are unknown. We quantified the number of children transported by 9-1-1 emergency medical services (EMS) to high-readiness EDs, additional children within 30 minutes of a high-readiness ED, and the estimated effect on survival. This was a cross-sectional study using data from the National EMS Information System for 5,461 EMS agencies in 28 states from 1/1/2012 through 12/31/2019, matched to the 2013 National Pediatric Readiness Project assessment of ED pediatric readiness. We performed a geospatial analysis of children 0 to 17 years requiring 9-1-1 EMS transport to acute care hospitals, including day-, time-, and traffic-adjusted estimates for driving times to all EDs within 30 minutes of the scene. We categorized receiving hospitals by quartile of ED pediatric readiness using the weighted Pediatric Readiness Score (wPRS, range 0-100) and defined a high-risk subgroup of children as a proxy for admission. We used published estimates for the survival benefit of high readiness EDs to estimate the number of lives saved. There were 808,536 children transported by EMS, of whom 253,541 (31.4%) were high-risk. Among the 2,261 receiving hospitals, the median wPRS was 70 (IQR 57-85, range 26-100) and the median number of receiving hospitals within 30 minutes was 4 per child (IQR 2-11, range 1 to 53). Among all children, 411,685 (50.9%) were taken to EDs in the highest quartile of pediatric readiness, and 180,547 (22.3%) children transported to lower readiness EDs were within 30 minutes of a high readiness ED. Findings were similar among high-risk children. Based on high-risk children, we estimated that 3,050 pediatric lives were saved by transport to high-readiness EDs and an additional 1,719 lives could have been saved by shifting transports to high readiness EDs within 30 minutes. Approximately half of children transported by EMS were taken to high-readiness EDs and an additional one quarter could have been transported to such an ED, with measurable effect on survival. [ABSTRACT FROM AUTHOR]

Poverty, lack of education and gender inequality make unemployed and out-of-school young women extremely vulnerable to HIV infection. Promotive social protection programmes aim to increase livelihood and capabilities and could empower this priority population to act on HIV prevention choices. In Botswana, they rarely benefit from such programmes. A modified Policy Delphi engaged a panel of 22 unemployed and out-of-school young women and eight frontline service providers to consider alternative policy and practice options, and tailor available programmes to their own needs and social situation. The panel assessed the desirability and feasibility of improvement proposals and, in a second round, ranked them for relative importance. Nearly all 40 improvement proposals were considered very desirable and definitely, or possibly, feasible, and panellists prioritised a wide range of proposals. Frontline service providers stressed foundational skills, like life skills and second chance education. Young women preferred options with more immediate benefits. Overall, panellists perceived positive role models for programme delivery, access to land and water, job skills training, and stipends as most important to empower HIV-vulnerable young women. Results suggest ample policy space to make existing social protection programmes in Botswana more inclusive of unemployed and out-of-school young women, hence more HIV-sensitive. [ABSTRACT FROM AUTHOR]

To report on serum 25-hydroxyvitamin D (25(OH)D) levels in post-acute hip fractured patients, revealed the associations between serum 25(OH)D levels and hip fractured patients' baseline characteristics and rehabilitation outcomes. A retrospective study (9/2017-9/2020) of 493 hip fractured patients. 25(OH)D levels were recorded following the patient's baseline characteristics and outcome measures, including the functional independence measure and motor functional independence measure effectiveness. The sample was divided into three groups: deficient (<30 nmol/l), insufficient (30–75 nmol/l) and sufficient (>75 nmol/l) 25(OH)D levels. ANOVA and chi-square test tests compared the groups. Multiple linear analysis assessed the associations between the 25(OH)D and discharge functional independence measure score. 25(OH)D deficiency was found in 20.3% of the patients. The only baseline characteristic significantly associated with serum 25(OH)D levels was dementia. The group with deficient levels of 25(OH)D exhibited a significantly higher rate of low education, low admission albumin levels and a reduced handgrip strength compared to the insufficient/sufficient groups. All functional measure scores were significantly lower in the deficient (25(OH)D) group compared with the insufficient/sufficient patient groups. 25(OH)D levels were found to be significantly associated with the discharge functional independence measure score. Routine screening for 25(OH)D levels is mandatory in post-acute hip fracture patients as it may affect rehabilitation outcomes. 25-hydroxyvitamin D 25(OH)D levels are associated with rehabilitation outcomes in post-acute hip fractured patients. A routine screening for 25(OH)D levels and standardized supplementation protocol during the acute and post-acute rehabilitation setting is recommended as it may improve the quality of care. [ABSTRACT FROM AUTHOR]

Township health centers play a cornerstone role in the primary healthcare in China while it's development is largely limited by the brain drain. Job satisfaction is closely related to brain drain, investigating the relevant factors of job satisfaction can provide strategies to reduce brain drain. This research was conducted in Huangpi, China. Convenience sampling methods and self-administereded questionnaires were used. We collected 1370 valid samples, with an effective rate of 97.72%. Descriptive statistics are used to describe sociodemographic information. The Pearson Chi-square statistical was used to test the binary association between job satisfaction and another categorical variable. All the sociodemographic information was applied to the binary logistic regression model using the stepwise selection method. The mean age was 36.98 (SD = 9.84), factors that affect job satisfaction include educational background (x2 = 7.99, p< 0.05), marital status (x2 = 8.96, p< 0.05, monthly income (x2 = 51.43, p< 0.01), hire form (x2 = 7.64, p< 0.05), hours worked per week (x2 = 33.48, p< 0.01), parent had a stable job (x2 = 10.65, p< 0.01). Government and management should consider the impact of current policies on job satisfaction. Increasing the welfare of healthcare staff and promoting equity are potential strategies for improving low levels of job satisfaction. [ABSTRACT FROM AUTHOR]

To determine the association between fish intake and dietary polyunsaturated fatty acids (PUFA) and incidence of lung cancer. We systematically reviewed and meta-analyzed all available studies to quantify the associations of fish and PUFA consumption with risk of lung cancer. Relative risk (RR) with 95% confidence interval (CI) was calculated. 13 population-based prospective cohort studies involving 1,785,000 participants and two randomized control trials were included. Our study demonstrated that dietary PUFA significant reduced risk of lung cancer for men (RR 0.99, 95%CI 0.98 to 1.00) and the U.S. population (RR 0.99, 95%CI 0.98 to 1.00). Dose-response analysis indicated that a 5 g/day increment of dietary PUFA was associated with 5% lower risk of lung cancer (RR 0.95, 95%CI 0.91 to 0.99). In addition, PUFA supplementation is significant improved overall survival in patients with lung cancer (RR 1.98, 95%CI 1.09 to 3.59). Our study showed an inverse association between dietary PUFA and risk of lung cancer in males and among the U.S. population. Although smoking cessation is the single biggest factor associated with lung cancer risk reduction, this study adds to a growing body of evidence that diet may have a role in modestly reducing lung cancer risk. [ABSTRACT FROM AUTHOR]

This study describes the conditions under which Israeli social workers in hospital settings operated s during the COVID-19 pandemic, and assesses their perceived support (informal and organizational support) and preparedness for the next pandemic. It further assesses correlates for perceived support and associations between perceived support and preparedness. The participants were 163 social workers from four hospitals who completed an on-line survey. The findings revealed that the level of exposure to COVID-19 and fear of contracting COVID-19 were unrelated to perceived informal and organizational support. Age and having children who are minors living at home moderated the relationship between fear of contracting COVID-19 and both types of perceived support. Each type of perceived support was significantly associated with preparedness beyond age, having minors at home, exposure to COVID-19, and fear of contracting COVID-19. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the practice patterns used by Malaysian speech-language pathologists (SLPs) with patients with dysarthria, identified challenges perceived by SLPs and explored strategies to address perceived barriers for improving dysarthria management. Method: Two studies were conducted. Study 1 disseminated a 30-item survey questionnaire electronically via google link to SLPs in the Malaysian Speech-Language-Hearing Association through e-mail lists. Responses were analysed using descriptive statistics. In Study 2, semi-structured interviews of twelve SLPs who managed patients with dysarthria were conducted. Data were transcribed verbatim and analysed using the thematic analysis method. Result: Three major themes and ten sub-themes emerged from the interviews, including "assessment and treatment practices", "challenges", and "overcoming challenges". SLPs' practice of assessment and treatment of dysarthria were predominantly impairment-based. Respondents (64%) who never used standardised assessment tools valued textbooks more as sources of evidence and had a lower level of confidence in their knowledge about dysarthria compared to those who used standardised tools. Conclusion: Focus now needs to be on the education needs of our SLPs, on both the university training and continuing education levels, for direction of the development of professional training courses. Ongoing research and public awareness are required to guide clinical management decisions. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the protective action and mechanisms of quercetin on the blood-brain barrier (BBB) in rats subjected to transient middle cerebral artery occlusion (tMCAO) and reperfusion. Quercetin (10, 30, 50mg/kg) was intraperitoneally administered at the onset of reperfusion. The results showed that quercetin significantly reduced cerebral infarct volume, neurological deficit, BBB permeability and ROS generation via Sirt1/Nrf2/HO-1 signaling pathway. Moreover, EX527, a selective inhibitor of Sirt1, reversed these neuroprotective effects. Our findings indicate that quercetin has neuroprotective effects against cerebral ischemia-reperfusion injury by protecting BBB through Sirt1 signaling pathway in MCAO rats. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate whether the single nucleotide polymorphism (SNP) rs1801552 C/T in CDH1 gene is correlated with the risk of esophageal squamous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA), as a preliminary study. The rs1801552 C/T polymorphism was genotyped by the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 1316 cancer patients (810 ESCC and 506 GCA) and 1966 controls in north China. We performed two case–control studies, each of which included a population-based set and a hospital-based set. The data showed that the rs1801552 C/T polymorphism was associated with the risk of ESCC. Allelotype and genotype distributions of the rs1801552 C/T polymorphism in ESCC patients of high-incidence region and hospital were significantly different from that in their respective controls (p < 0.05). Compared with C/C genotype, T/T genotype increased the risk of ESCC in high-incidence region and hospital (age, sex, smoking status and family history of UGIC adjusted odds ratio (OR) = 1.79 and 2.10, 95% confidence interval (CI) = 1.23–2.60 and 1.10–4.04, respectively). Allelotype and genotype distributions of the rs1801552 C/T polymorphism in GCA patients were not significantly different from that in their controls, respectively (p > 0.05). The findings in the present pilot study suggest that the rs1801552 C/T polymorphism was associated with the risk of ESCC, but was not associated with the risk of GCA in high-incidence region and hospital. [ABSTRACT FROM AUTHOR]

Self-substitution is the conscious switch from one drug to another for reasons such as price, availability, desired effect, or perceived benefit of the substitute drug. Purpose/Objectives: This study aimed to describe drug use patterns and motivations associated with substitution. We examined correlates of lifetime substitution among individuals with substance use disorder. Methods: A cross-sectional study of 771 treatment-enrolled individuals. We used self-report for determining the lifetime prevalence, correlates, and motivations for substitution. Results: Of the 771 respondents, 570 (73.9%) reported ever substituting their preferred substance. The main incentives for substitution were availability (23.7%) and curiosity (20.2%). Among heroin or cannabis preferers, improved effects or less adverse effects of the substitute drug, self-medication, and managing withdrawal symptoms were significant substitution incentives. Increased odds for substitution were observed for past 12 months use of cannabis (OR = 1.51, CI = 1.06-4.52), prescription opioids (OR = 2.86, CI = 1.81-4.52), novel psychoactive substances (OR = 2.68, CI = 1.64-4.36), and repeated admission (OR = 1.50, CI = 1.05-2.14). Older age at onset-of-use was negatively associated with substitution (OR = 0.95, CI = 0.93-0.98). Conclusions: Self-substitution of one substance for another is a highly prevalent behavior among treatment-enrolled patients with substance use disorder. Clinicians caring for substance use disorder patients should be aware of substitution patterns involving the use of highly potent substances, which constitutes a risk to patients. Results underscore the benefit of substitution patterns analyses, as they reveal important information on the characteristics of persons who use drugs and their motivations. [ABSTRACT FROM AUTHOR]

Bonebridge is an suitable option for conductive hearing loss, however, the traditional approach cannot accomplished a satisfying implantation for patients with congenital malformation or radical mastoidectomy. To evaluate the clinical application of retrosigmoid sinus approach in Bonebridge implantation and postoperative evaluation. 11 patients who underwent retrosigmoid sinus approach Bonebridge implantation from March 2016 to September 2019 were retrospectively analyzed, including 6 males and 5 females, aged 12–54 years old (30.6 in average). Among them, 4 cases had undergone bilateral radical mastoidectomy, 6 cases had bilateral congenital aural atresia or stenosis, and 1 case had unilateral congenital aural atresia. All patients underwent Bonebridge implantation through retrosigmoid sinus approach according to the preoperative image reconstruction and plan. There was no surgical injury of sigmoid sinus or cerebrospinal fluid leakage during the operation. The aided threshold obtained an increase of 32.32 dB HL; the speech recognition rates of bisyllabic words, monosyllabic words and sentence were 79.6%, 67.8% and 75.0%, respectively. After 11–53 months of follow-up, the hearing effect was stable and no long-term complications occurred. The retrosigmoid sinus approach is an effective surgical approach for patients with congenital ear deformities or radical cavity after mastoidectomy. [ABSTRACT FROM AUTHOR]

This study identified changes in blood pressure, blood glucose, and cholesterol levels in frail elderly adults who received home health care nursing over 8 years in Korea. Secondary data extracted from nursing records (2010–2018) of a public health center were analyzed using a mixed model of repeated measure. Study participants were elderly people (n = 499) with a mean age of 81.9 ± 5.56 years. Systolic and diastolic blood pressure decreased by 8.97 and 15.78 mmHg, and by 2.92 and 5.01 mmHg, respectively, at 4-year and 8-year monitoring. This demonstrates that home health care nursing is effective and has both short- and long-term benefits. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to compare the efficacy and complications between cesarean hysterectomy and uterine artery embolization (UAE) in the management of postpartum bleeding. Material and methods: We analyzed the outcomes of 48 patients who underwent cesarean hysterectomy from October 2007 to January 2017, and 333 patients who underwent UAE for postpartum bleeding which was unresponsive to conservative management. We reviewed all medical records retrospectively, and assessed the length of hospital stay, amount of blood transfused, operative time, and all procedural-related complications. Results: There was a significant difference between the two groups in the mean hospital stay between the cesarean hysterectomy group and the UAE group (12.88 ± 15.37 days vs. 7.37 ± 15.92 days, respectively). The number of transfusions received by those in the cesarean hysterectomy group was larger than that in the UAE group, and this difference was also statistically significant (16.81 ± 11.23 pints vs. 5.59 ± 7.02 pints). The mean operative time of the UAE procedure was significantly shorter than the cesarean hysterectomy procedure (83 min vs. 179 min, respectively). We also closely compared complications during and after the procedures. Conclusion: We concluded that UAE is safer and more effective than cesarean hysterectomy for the management of postpartum hemorrhage unresponsive to conservative management. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence rates of depression anxiety and suicidal ideation among Chinese general hospital inpatients and to identify the potential associations with sociodemographics. Method: A cross-sectional survey was applied in a Chinese general hospital. A questionnaire set, including sociodemographic variables, Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7), was completed by the participants. Clinically significant depression (CSD) and clinically significant anxiety (CSA) were defined as a score above 10 on the two scales. CSD and CSA are proxy measures but not specific diagnoses of mental disorders. Results: Data from 1329 patients were included in the final analysis. 422 (31.8%) reported clinically significant depressive symptoms, 83 (6.3%) reported frequent suicidal ideation, and 204 (15.3%) reported clinically significant anxiety. Household income was negatively associated with CSD. Inpatients with lower household incomes and educational levels had higher rates of CSA. Middle-aged inpatients were more prone to suicidal ideation, and stable marital status was related to less suicidal ideation. Conclusion: Depression, anxiety, and suicidal ideation were determined to be common psychological problems in Chinese inpatients. Chinese medical personnel must pay attention to the mental health conditions of inpatients, particularly inpatients with lower income, educational levels, and poor marital status. This is one of the first studies focusing on the prevalence of depression and anxiety in Chinese hospitalized inpatients in non-psychiatric departments of a general hospital. The PHQ-9 and GAD-7 were determined to be potential screening tools to aid Chinese medical workers in recognizing depression and anxiety in nonpsychiatric departments. The prevalence of depression, anxiety and suicidal ideation was observed to be relatively high in inpatients, which requires more attention from Chinese clinicians. [ABSTRACT FROM AUTHOR]

A change in homeostasis between food intake and energy expenditure is the hallmark of obesity. Many plant-based weight-management products are available in dietary supplement markets with no direct efficacy comparison. In this in vivo acute feed intake study in rats, the appetite suppression efficacy of well-known natural ingredients in the weight-loss market were evaluated. We tested pure caffeine, potato skin extract, Cissus quadrangularis extract, Garcinia cambogia extract, Crocus sativus extract, raspberry ketone isolated from Rubus idaeus, one commercial product (Appetrex), and one novel composition (UP601). Rats treated with potato skin extract, Crocus sativus bulb extract, and Cissus quadrangularis extracts showed statistically significant reduction in food consumption only at the 2-hour timepoint with 44.9%, 34.1%, and 44.3% reductions, respectively, after food provision at an equivalent human dosage of 2 g, 10 g, and 10 g, respectively. Garcinia cambogia fruit extract and raspberry ketone from Rubus idaeus showed statistically significant reduction in food consumption only at the 1-hour timepoint with 33.7% and 79.4% reductions, respectively, after food provision at an equivalent human dosage of 8 g and 5 g, respectively. UP601 and Appetrex were compared at 230 mg/kg. While 88.5%, 73.8%, and 63.1% reductions in food intake were observed for the UP601 treatment group, 64.2%, 27.5%, and 34.7% reductions in food intake were observed for rats treated with Appetrex at 1 h, 2 h, and 4 h after food provision. The composition UP601 demonstrated superior activity in food intake compared to any of the dietary supplements marketed for appetite suppression tested in this study. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the vasorelaxant effect of quercetin on cerebral basilar artery in vitro and provide a preliminary discussion concerning the underlying mechanisms. Using a DMT-isolated micro vessel system, quercetin was found to exhibit a vasodilatory effect on basilar arteries contracted by potassium chloride (KCl), endothelin-1 (ET-1), and 5-hydroxytryptamine (5-HT). The vasorelaxant effect of quercetin was partially attenuated when endothelium cells were removed. L-NAME, indomethacin, and ODQ treatment also decreased the potency of quercetin. In endothelium-denuded rings, the vasorelaxant effect of quercetin was not influenced by K+ channel inhibitors. However, quercetin inhibited KCl induced extracellular calcium influx and ET-1 induced transient intracellular calcium release in a Ca2+-free solution. In conclusion, quercetin induced relaxation of the basilar artery in vitro is partially dependent on endothelium, which is mainly related to NO and COX pathways. It also induces relaxation through blockage of calcium channels. [ABSTRACT FROM AUTHOR]

Background: It is unclear about the change and risk factors of depression among adolescent survivors after earthquake. Aims: This study aimed to explore the change of depression, and identify the predictive factors of depression among adolescent survivors after the 2008 Wenchuan earthquake in China. Methods: The depression among high school students at 6, 12 and 18 months after the Wenchuan earthquake were investigated. The Beck Depression Inventory (BDI) was used in this study to assess the severity of depression. Results: Subjects included 548 student survivors in an affected high school. The rates of depression among the adolescent survivors at 6-, 12- and 18-month after the earthquake were 27.3%, 42.9% and 33.3%, respectively, for males, and 42.9%, 61.9% and 53.4%, respectively, for females. Depression symptoms, trauma-related self-injury, suicidal ideation and PTSD symptoms at the 6-month follow-up were significant predictive factors for depression at the 18-month time interval following the earthquake. Conclusions: This study highlights the need for considering disaster-related psychological sequela and risk factors of depression symptoms in the planning and implementation of mental health services. Long-term mental and psychological supports for victims of natural disasters are imperative. [ABSTRACT FROM AUTHOR]

Conclusion: This study demonstrated that the common immunological mechanism, which involves aberration of immunoglobulin and T-cell distribution in histologically distinctive tonsils, may be associated with the pathogenesis of tonsillar focal infection. Objectives: Tonsillar focal infection comprises a group of relatively common diseases combined with chronic tonsillar infection, is associated with unusual immune responses in tonsils, and may cause lesions in another distant target organ. This study aimed to investigate the distribution of inflammatory T cells and T-cell regulatory elements, such as programmed cell death-1 (PD-1) and Fork head box protein 3 (Foxp3), immunoglobulin production, and histological characteristics in tonsils from patients with tonsillar focal infection. Methods: Immunohistochemistry and reverse transcription-polymerase chain reaction (PCR) were used to compare the expression of CD8+ T cells, immunoglobulins, and cytokines associated with immunoglobulin production in the tonsils of patients with IgA nephropathy (IgAN), palmoplantar pustulosis (PPP), rheumatoid arthritis (RA), and chronic tonsillitis. Results: The overexpression of CD8+ T cells combined with decreased expression of Foxp3 and PD-1 and the aberration of immunoglobulin production, which may be due to the elevated expression of activation-induced deaminase (AID), B-cell-activating factor of the TNF family (BAFF), supporting isotype switching, and B-cell survival in the histologically distinctive tonsils. [ABSTRACT FROM AUTHOR]

Eight tetranortriterpenoids (1–8) and two sesquiterpenoids (9 and 10) including two new compounds, cineracipadesin G (1) and 1β-hydroperoxy-6α-hydroxy-eudesm-4(15)-ene (9), were isolated from the EtOAc extract of branches of Cipadessa cinerascens. The structures of two new compounds were elucidated by 1D and 2D NMR and MS spectroscopic analyses. The anti-feedant activity of two tetranortriterpenoids (1 and 7) was tested and obvious anti-feedant effects were detected. [ABSTRACT FROM AUTHOR]

Objective:An unusual side effect of hallucinogen use is the appearance of hallucinogen persisting perception disorder (HPPD). Despite high rates of prior hallucinogen use among individuals with schizophrenia, there are insufficient data on the clinical characteristics of individuals with co-occurring schizophrenia and HPPD.Methods:Twenty-six hospitalized patients with schizophrenia and prior LSD use (12 with HPPD and 14 without HPPD) were recruited. Participants were clinically assessed using validated tools, and details regarding hospitalizations were retrieved from their medical records. Those patients who also had HPPD completed a questionnaire addressing HPPD-associated perceptual disturbances.Results:Participants were mostly male (n= 22, 84.6%) and had an average age of 32.3 (SD= 7.67). Nearly half (n= 12, 46.2%) met criteria for HPPD. No significant differences were found in sociodemographic and clinical characteristics (including response to antipsychotic medications and adverse effects) between the groups. Nine individuals (75%) in the schizophrenia and HPPD group reported the ability to identify specific precursory cues for the appearance of the HPPD-associated perceptual distortions, and 8 (67%) reported the ability to distinguish HPPD perceptual disturbances from those associated with their psychotic disorder.Conclusions:Very little is known about the co-occurrence of schizophrenia and HPPD or the associated clinical implications. Further research is needed to understand the clinical impact of this comorbidity. [ABSTRACT FROM AUTHOR]

Two new alkaloids, lycosprenine (1) and 2α-methoxy-6-O-methyllycorenine (2), along with 22 known alkaloids (3–23b), were isolated from the bulb of Lycoris sprengeri. Their structures were elucidated on the basis of spectral analysis and by comparison of the spectroscopic data with those of known compounds. Selected compounds (1–3 and 6–9) were tested for their neuroprotective activities against H2O2-, CoCl2- and Aβ25–35-induced SH-SY5Y cell injury, most of which exhibited neuroprotective effects of different degrees. [ABSTRACT FROM AUTHOR]

Conclusion: Our findings suggest that migrainous vertigo (MV) has a substantial vestibulo-spinal abnormality that can be uncovered by posturography. Patients with MV also showed a difficulty in using multisystem information, especially somatosensory information. Caloric and sensory organization tests (SOTs) have complementary roles in assessing vestibulo-ocular and vestibulo-spinal function, particularly for Meniere's disease (MD) and MV. Objectives: To compare vestibular dysfunction through caloric testing and posturography in patients with MV, MD, and acute vestibular neuritis (VN). Methods: Caloric tests and SOTs were performed in 31 patients with MV, 23 with MD, and 37 with VN. The abnormal results in caloric test, SOT conditions, and somatosensory, visual, and vestibular ratios were analyzed. Results: Abnormal canal paresis was found in 7 patients with MV (23%), 11 with MD (48%), and 37 with VN (100%). An abnormal vestibular ratio in SOT was found in 14 patients with MV (45%), 6 with MD (26%), and 23 with VN (62%). In MV, an abnormal vestibular ratio was more common than canal paresis and an abnormal vestibular ratio was more common than in MD. An abnormal somatosensory ratio (19%) in MV was significantly more common than in VN and MD (3% and 0%). For condition 2, MV showed a significantly higher abnormal rate than VN. An abnormal visual ratio in MV was more common than in VN and MD but this was not significant. [ABSTRACT FROM AUTHOR]

The cytotoxic activity of 36 saponins isolated from roots ofPulsatilla chinensis(Bunge) Regel against the human cancer cell lines (A549, SGC-7901) and the human hepatic cell line (HL-7702) was tested by 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay. Saponins1–14showed considerable cytotoxic activity, whereas saponins15–36showed no significant activity, which suggested that a free carboxylic group located at C-28 of aglycon is essential for their cytotoxic activity. Moreover, the analysis of structure–activity relationships also suggested that the oleanane-type saponins showed better cytotoxic activity than lupane-type saponins, and the length and linkage of glycolic chain attached to C-3 of aglycon displayed an important effect to the potent cytotoxicity. In conclusion, oleanolic acid 3-O-α-l-rhamnopyranosyl-(1 → 2)-[β-d-glucopyranosyl-(1 → 4)]-α-l-arabinopyranoside (5) exhibited the most significant cytotoxic activity. [ABSTRACT FROM PUBLISHER]

The cytotoxic activity of 36 saponins isolated from roots of Pulsatilla chinensis (Bunge) Regel against the human cancer cell lines (A549, SGC-7901) and the human hepatic cell line (HL-7702) was tested by 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay. Saponins 1-14 showed considerable cytotoxic activity, whereas saponins 15-36 showed no significant activity, which suggested that a free carboxylic group located at C-28 of aglycon is essential for their cytotoxic activity. Moreover, the analysis of structure-activity relationships also suggested that the oleanane-type saponins showed better cytotoxic activity than lupane-type saponins, and the length and linkage of glycotic chain attached to C-3 of aglycon displayed an important effect to the potent cytotoxicity. In conclusion, oleanolic acid 3-O-α-L- rhamnopyranosyl-(1 → 2)-[βD-glucopyranosyl-(1 → 4)]-β-L-arabinopyranoside (5) exhibited the most significant cytotoxic activity. [ABSTRACT FROM AUTHOR]

Background: Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. We conducted a multicentre case-control study to determine the risk factors for SSI in patients undergoing gastric surgery and to establish strategies to reduce the risk of SSI. Methods: Between January 2007 and December 2008, 121 patients who developed an SSI after gastric surgery were matched with controls who had undergone surgery on the dates closest to those of the cases, at 13 centres in Korea. Results: The results of multivariate analyses showed that the independent risk factors for SSI after gastric surgery were older age ( p = 0.016), higher body mass index (BMI) ( p = 0.033), male gender ( p = 0.047), and longer duration of prophylactic antibiotic use ( p < 0.001). Conclusion: Older age, higher BMI, male gender, and longer duration of prophylactic antibiotic use were independently associated with significant increases in the risk of SSI. Additional prospective randomized studies are required to confirm these results. [ABSTRACT FROM AUTHOR]

The leaf extract of guava (Psidium cattleianum Sabine) has traditionally been used for the treatment of diarrhea and diabetes in East Asia and other countries. Recently, the leaf extract has been employed in the therapy of cancer, bacterial infections, and inflammation in experimental models. However, the exact mechanisms of how guava leaf extract inhibits tumor metastasis and invasion are still unknown. In the present study, we investigated in detail the molecular mechanism(s) responsible for the potential antimetastatic and antiinvasive effects of the butanol fraction of guava leaf extract (GBF). Interestingly, we observed for the first time that GBF suppressed both matrix metalloproteinases (MMP)-9 and MMP-2 expression and activity in part through the downregulation of the ERK1/2 activation in lung cancer cells. Also, importantly, the major components of the GBF were identified as d-glucuronic acid, quercetin 3-glucuronide, loganin, and xanthyletin by LC-ESI-MS/MS. Collectively, our data indicate that the guava leaf could reduce the metastasis of lung cancer cells and therefore suggest that it could be advantageously used to control the metastatic process. [ABSTRACT FROM AUTHOR]

In response to the rapidly increasing application and abuse of psychological tests in China, the Psychometrics Division of the Chinese Psychological Society published the 2008 revisions of the Chinese Code of Ethical Use of Psychological Tests. We investigated the implementation status of the code 2½ years after its promulgation. Sample included 284 psychological professionals and psychology graduate students. The average accuracy rate for the appropriate use of psychological tests was 67.1% (range = 25.5–97.5%), with 10 items having accuracy rates below 45%. Participants remained uncertain about the clients' rights to information about the purpose, psychometric properties, and scores of the tests. The most frequent violations involved “using psychological tests without psychometric information for entertainment purposes” and “using SCL-90 to measure mental health of normal people.” [ABSTRACT FROM PUBLISHER]