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In order to fully exploit the relationship between temporal features in photovoltaic power generation data and improve the prediction accuracy of photovoltaic power generation, a photovoltaic power generation forecasting method is proposed based on a hybrid model of the convolutional neural network (CNN) and extreme gradient boost (XGBoost). Taking the historical data of China's photovoltaic power plants as a sample, the high-dimensional mapping relationship of photovoltaic power generation variables is extracted based on the convolutional layer and pooling layer of the CNN network to construct a high-dimensional time-series feature vector, which is an input for the XGBoost. A photovoltaic power generation prediction model is established based on CNNXGBoost by training CNN and XGBoost parameters. Since it is difficult for a single model to achieve optimal prediction accuracy under different weather conditions, the k-means clustering algorithm is used to group the power datasets and train independent models to improve prediction accuracy. Through the actual data verification of photovoltaic power plants, the proposed photovoltaic power generation prediction model can accurately predict the power, which shows high prediction accuracy and generalization ability compared with other methods. [ABSTRACT FROM AUTHOR]

With the development of science and technology, especially the popularity of the Internet, mobile phone, and computer, college students' lifestyle is changing, which leads to the "Zhai" phenomenon. More and more students house in the dorm or home. They reduce the communication with the outside world. This phenomenon not only reduces the survivability of the students, but also causes no small impact to their physical and mental health. Students are the hope of the society. If they are indulged in "Zhai" lifestyle, they will be difficult to take the responsibilities of the future development in the country. "Zhai" has become stern problems in current society, schools and families. No doubt a study on the relevant topic is of realistic value. Under the background, based on survey data, I do quantitative analysis combined with qualitative analysis, on the basis of extensive reading relevant literature, trying to use the theory to extract the data. The conclusions are: More and more college students (especially male and senior students) choose "Zhai" lifestyle; The results confirm "Zhai" produces plenty of negative influence on college students' physical and mental health; Although "Zhai" lifestyle has effected students health, they have not aware of the harm of "Zhai". So at last the paper gives the rational proposal.

The development in uncrewed aerial vehicle (UAV) technologies over the past decade has led to a plethora of platforms that can potentially enable greenhouse gas emission quantification. Here, we report the development of a new air sampler, consisting of a pumped stainless coiled tube of 150 m in length with controlled time stamping, and its deployment from an industrial UAV to quantify CO 2 and CH 4 emissions from the main coking plant stacks of a major steel maker in eastern China. Laboratory tests show that the time series of CO 2 and CH 4 measured using the sampling system is smoothed when compared to online measurement by the cavity ring-down spectrometer (CRDS) analyzer. Further analyses show that the smoothing is akin to a convolution of the true time series signals with a heavy-tailed digital filter. For field testing, the air sampler was mounted on the UAV and flown in virtual boxes around two stacks in the coking plant of the Shagang Group (steel producer). Mixing ratios of CO 2 and CH 4 in air and meteorological parameters were measured from the UAV during the test flight. A mass-balance computational algorithm was used on the data to estimate the CO 2 and CH 4 emission rates from the stacks. Using this algorithm, the emission rates for the two stacks from the coking plant were calculated to be 0.12±0.014 t h -1 for CH 4 and 110±18 t h -1 for CO 2 , the latter being in excellent agreement with material-balance-based estimates. A Gaussian plume inversion approach was also used to derive the emission rates, and the results were compared with those derived using the mass-balance algorithm, showing a good agreement between the two methods. [ABSTRACT FROM AUTHOR]

To date, the relationship between conjunctivitis and air pollutants has been widely concerned, but the conclusions are not very unified. This study aims to explore the short-term effects of ambient ozone (O3) on the conjunctivitis outpatient visits in Pudong New Area, Shanghai. A quasi-Poisson model combined with the distributed lag nonlinear model (DLNM) was performed to study the short-term effects of O3 on the risk of outpatient visits for conjunctivitis, after controlling the effects of temperature, relative humidity and wind speed. Taking the median concentration of O3 as a reference, the moderate high O3 (75th percentile) showed the largest effect estimates for single and cumulative lag effects at lag 4 (RR 1.013, 95% confidence interval [CI] 1.006–1.019) and lag 0–10 (RR 1.075, 95%CI 1.025–1.128), respectively. Our study suggested that the moderate high O3 increased the chances of conjunctivitis outpatient visits and had an evident lag effect. [ABSTRACT FROM AUTHOR]

What is Known and Objective: To Investigate the pharmacokinetic/pharmacodynamic (PK/PD) parameters of high‐dose tigecycline in plasma and sputum of patients with hospital‐acquired pneumonia (HAP), and provide a therapeutic regimen of multidrug‐resistant bacteria (MDRB) infections. Methods: Blood/sputum samples were collected at intervals after tigecycline had reached a steady‐state. Tigecycline concentrations in specimens were determined by high‐performance liquid chromatography (HLPC), PK parameters were evaluated by WinNonlin software using a non‐compartment model. The probability of target attainments (PTAs) at different minimal inhibitory concentrations (MICs) were calculated for achieving the PK/PD index with Crystal Ball software by 10,000‐patient Monte Carlo Simulation. Results: In plasma, the maximum concentration (Cmax) and area under the concentration–time curve from 0 to 12 h (AUC0–12h) were 2.21 ± 0.17 mg/L and 15.29 ± 1.13 h mg/L, respectively. In sputum, they were 2.48 ± 0.21 mg/L and 19.46 ± 1.82 h mg/L, respectively. The mean lung penetration rate was 127.27%. At the MIC ≤4 mg/L, the PTAs in plasma and sputum were 100.00%. When the MIC increased to 8 mg/L, the PTAs in plasma and sputum mostly were < 90.00% according to two criteria. What is New and Conclusion: In this study, we explored PK/PD of high‐dose tigecycline in plasma and sputum. From a PK/PD perspective, high‐dose tigecycline had greater therapeutic outcomes in HAP treatment caused by MDRB. Antimicrobial‐drug concentrations should be determined to optimize their clinical use. [ABSTRACT FROM AUTHOR]

Purpose: Public health measures during COVID-19 have led to an unprecedented change in social lifestyle which might have an impact on the allergen sensitization in population. We sought to explore the prevalence patterns of serum inhalant and food allergen-specific IgE (sIgE) sensitization and serum total immunoglobulin E (tIgE) level among patients with clinical symptoms of suspected allergic diseases before and during the COVID-19 pandemic in south China. Patients and Methods: A large epidemiology study was conducted on the prevalence patterns of sIgE sensitization and serum tIgE level among 13,715 patients with allergic symptoms in south China from 2017 to 2020. Chi-square test and Fisher exact test were used to test statistical significance of allergen sensitization difference among years. Logistic regression was performed to assess the magnitudes of the differences among years by adjusted odds ratios and 95% confidence intervals. Results: The number of hospital visits for patients with suspected allergy symptoms decreased during COVID-19. The positive rates of indoor inhalant allergens (house dust mites, German cockroach, dog dander) and tIgE increased significantly in 2020, while no significant differences were found in food allergens (egg white, milk, soya bean, shrimp) before and during the COVID-19 pandemic. The odds of sIgE positives in indoor inhalant allergens and tIgE positive for 2017 and 2020 were all larger than 1.00. After grouping by age and gender, there were significant differences in the positive rates of indoor inhalant allergens and tIgE when comparing 2020 with 2017. Conclusion: The prevalence of sensitization increased significantly to indoor inhalant allergens but not to food allergens in south China during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose: Past research has documented a significant relationship between family violence and adolescent violence. However, much is unknown about the processes through which this association occurs, especially in the non-Western cultural context. To address this gap, we propose an integrated model encompassing multiple pathways that connect family violence to adolescent violence. Specifically, this study investigates how family violence is related to adolescent violence through violent peer association, normative beliefs about violence, and negative emotions. Method: We tested the model using the two-wave survey data collected from a probability sample of more than 1,100 adolescents residing in one of the largest metropolitan areas in China in 2015 to 2016. Results and Conclusions: The results indicated that family violence predicted adolescent violence perpetration. Violent peer association, normative beliefs, and negative emotions, however, mediated much of the relationship between family violence and adolescent violence. [ABSTRACT FROM AUTHOR]

Allergies to German cockroaches had a higher prevalence in southern regions (Southwest China, South China, and East China) than in northern regions (North China and Northeast China). We believe this is the first large study to investigate the prevalence of allergen sensitization in the patients with allergic symptoms from all the seven geographic regions of mainland China. Prevalence of sensitivity to cockroach allergens and IgE cross-reactivity between cockroach and house dust mite allergens in Chinese patients with allergic rhinitis and asthma. [Extracted from the article]

Background: Group A rotavirus (RVA), despite being a leading cause of gastroenteritis in infants and young children, is less studied in Shanxi Province, China. The current study was conducted to determine the prevalence and genetic characterization of RVA in hospitalized children younger than 10 years of age with the diagnosis of acute gastroenteritis in Shanxi Province, China.Methods: A hospital-based active surveillance of rotavirus gastroenteritis was conducted at Children's Hospital of Shanxi from Jan 1, 2015, through Dec 31, 2019. Rotavirus was detected in stool samples by real-time quantitative reverse transcription PCR (qRT-PCR). G- and P-genotypes were determined by reverse transcription PCR (RT-PCR) and nucleotide sequencing.Results: A total of 961 children younger than 10 years of age was enrolled over the study period, of whom 183 (19.0%) were positive for RVA. The highest RVA-infection frequency (23.7%) was found among children aged 12-23 months, and the seasonal peak was in December. G9P[8] was most prevalent (76.0%), followed by G3P[8] (7.1%), G2P[4] (3.3%), G1P[8] (0.5%) and G9P[4] (0.5%).Conclusions: These results report for the first time that RVA was one of the main causes of severe infectious gastroenteritis in children, and a high proportion of G9P[8] strains circulating in most areas of Shanxi Province. While the protective efficacy of the rotavirus vaccines has been demonstrated against G9P[8] strains, our results highlight that the dominant strains have not been effectively controlled in China. [ABSTRACT FROM AUTHOR]

Biomass is an important indicator for monitoring vegetation degradation and productivity. This study tests the applicability of Hyperspectral Remote-Sensing in situ measurements for high-precision estimation aboveground biomass (AGB) on regional scales of Khorchin grassland in Inner Mongolia, China. In order to improve prediction accuracy of AGB which is frequently used as an indicator of aboveground net primary productivity (ANPP), this paper combined ground measurement with remote sensing inversion to build the spectral model. The ground normalized difference vegetation index (SOC_NDVI) calculated from ground spectral of grassland vegetation which was measured by a portable visible/NIR hyperspectral spectrometer (SOC 710). Meanwhile, the remote normalized difference vegetation index (TM_NDVI) calculated from remote spectral of grassland vegetation which was measured by Thematic Mapper (TM) from Landsat 8 which launched by National Aeronautics and Space Administration (NASA). According to regression analysis for the relationship between AGB and SOC_NDVI, SOC_NDVI and TM_NDVI, the evaluation model for aboveground biomass was developed (AGB = 12.523×e3.370×(0.462×TM_NDVI+0.413), standard error = 24.74 g m-2, R2 = 0.636, p < 0.001). The model accuracy verification results show that the correlation between the measured value and the predicted value of biomass was better with low model standard error. The model could make up for the lack of timeliness and comprehensiveness of conventional ground biomass survey, and provide technical support for high-precision large-area productivity estimation and ecological degradation diagnosis of regional scale grassland. [ABSTRACT FROM AUTHOR]

Background: Cesarean section (CS) rate has risen dramatically and stayed at a very high level in China over the past two to three decades. Given the short- and long-term adverse effects of CS, effective strategies are needed to reduce unnecessary CS. We aimed to evaluate whether a multifaceted intervention would decrease the CS rate in China.Methods: We carried out a cluster-randomized field trial with a multifaceted intervention in Shanghai, China, from 2015 to 2017. A total of 20 hospitals were randomly allocated into an intervention or a control group. The intervention consisted of more targeted health education to pregnant women, improved hospital CS policy, and training of midwives/doulas for 8 months. The study included a baseline survey, the intervention, and an evaluation survey. The primary outcome was the changes of overall CS rate from the pre-intervention to the post-intervention period. A subgroup analysis stratified by the Robson classification was also conducted to examine the CS change among women with various obstetric characteristics.Results: A total of 10,752 deliveries were randomly selected from the pre-intervention period and 10,521 from the post-intervention period. The baseline CS rates were 42.5% and 41.5% in the intervention and control groups, respectively, while the post-intervention CS rates were 43.4% and 42.4%, respectively. Compared with the control group, the intervention did not significantly reduce the CS rate (adjusted OR = 0.92; 95% CI 0.73, 1.15). Similar results were obtained in subgroup analyses stratified by the risk level of pregnancy, maternal age, number of previous CS, or parity. Scarred uterus and maternal request remained the primary reasons for CS after the interventions in both groups. The intervention did not alter the perinatal outcomes (adjusted change of risk score = - 0.06; 95%CI - 0.43, 0.31).Conclusions: A multifaceted intervention including more targeted prenatal health education, improved hospital CS policy, and training of midwives/doulas, did not significantly reduce the CS rate in Shanghai, China. However, our experience in implementing a multifaceted intervention may provide useful information to other similar areas with high CS use.Trial Registration: This trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (ChiCTR-IOR-16009041) on 17 August 2016. [ABSTRACT FROM AUTHOR]

With the widespread implementation of antiretroviral therapy in many countries, the HIV/AIDS epidemic has declined. However, little is known about the prevalence of adherence rate to Highly Active Antiretroviral Therapy (HAART) in patients with HIV infection in China. This is the first meta-analysis of cross-sectional studies of treatment adherence (≥ 95%) to HAART in Chinese patients. Both English (PubMed, PsycINFO, EMBASE, and Web of Science) and Chinese (WanFang, CNKI, and SinoMed) databases were systematically and independently searched by three investigators. Studies with adherence rate estimates of HAART were included. Adherence rate estimates of each eligible study were extracted and pooled using the random-effects model. A total of 40 studies conducted in China were eligible and analyzed. The mean rate of ≥ 95% adherence to HAART was 81.1% (95%CI: 75.1%–88.0%, I2 = 97.3%) at one week, 80.9% (95%CI: 74.7%–85.9%, I2 = 96.6%) at one month, and 68.3% (95%CI: 46.1%–84.4%, I2 = 97.1%) at 3 months or longer. Subgroup analyses revealed that samples with no gender predominance, low education level, middle economic region, rural area, older age (42.3 years), and recent publication (2013 or later) were correlated to higher HAART adherence. The average rate of HAART adherence was relatively high in China, which indicates effective HIV/AIDS policy, prevention and control measures. However, the HAART adherence rate decreased over the study time period. [ABSTRACT FROM AUTHOR]

Abstract Herein, crop (vegetables and rice, n = 30), soil (n = 14), dust (n = 12), and PM10 (n = 25) samples were collected to assess the environmental quality of a former e-waste recycling area and evaluate the related health risks. In dust and PM 10 , the concentrations of heavy metals (Cd, Cu, Ni, Pb, and Zn) were lower than previously reported values, although the numbers for soil, vegetables, and rice remained high. The average accumulation factors of heavy metals in crops decreased in the order of Zn > Cd > Ni > Cu > Pb, and soil was identified as the largest contributor to crop pollution. Heavy metal ingestion largely occurred via rice consumption, which accounted for a significant fraction of the total average daily dose (ADD; 75.2–86.7% in children and 78.0–91.7% in adults), especially for Cd, Cu, Ni, and Zn. However, in the case of Pb, soil ingestion accounted for 48.9% of the ADD in adults, while in children, vegetable, rice, and dust ingestion accounted for 44.7%, 28.6%, and 23.7% of the ADD, respectively. The combined exposure hazard indices at the fifth, median, and 95th percentiles for all heavy metals were determined as 2.54, 9.40, and 40.1 for adults and as 3.75, 13.7, and 58.4 for children, respectively. In terms of health risk, crop consumption was identified as the major exposure pathway for both children and adults, featuring a contribution of 99.9%. In addition, the 95th percentile carcinogenic risks for Pb exceeded the acceptable level. Thus, this work shows that to reduce the health risk for local residents in the former e-waste area, more attention should be paid to soil repair. Highlights • Combing multiple exposure pathways to assess the human health risk of residents. • Heavy metals in dust and PM 10 showed an overall decreasing trend. • Soil is the largest contributor to crop pollution refer to heavy metals. • Crop consumption is the major exposure pathway for human health risk. • More attention should be paid to food safety, particularly to Cd of rice in this area. [ABSTRACT FROM AUTHOR]

It is known that iodine deficiency during pregnancy can interfere with normal fetal growth and development. However, iodine levels of pregnant women in Shanghai, China, and factors that could influence its levels remain unclear. A total of 916 pregnant women were selected from the Maternal and Child Care Service Centre of Minhang District in Shanghai. Morning urinary iodine (UI) and iodine content of salt from the participants' home were measured, and UI concentration was adjusted by creatinine concentrations. Serum tri-iodothyronine, thyroxin, free tri-iodothyronine, free thyroxine and thyroid-stimulating hormone were tested in the second trimester of pregnancy by time-resolved fluoroimmunoassay. The median levels of UI in pregnant women were 156·3, 176·9 and 175·1 μg/g creatinine in the first, second and third trimesters of pregnancy, respectively. The prevalence of UI deficiency (UI < 150 μg/g creatinine) was 48·3, 34·2 and 36·2 % in the three trimesters of pregnancy, respectively. Factors that significantly influenced the UI levels include the following: iodine content of household salt; age; occupation; multivitamin supplement with iodine; seaweed intakes. Furthermore, UI and iodine content of salt were moderately correlated (r 0·406, P< 0·001). In addition, there was no significant association between UI and thyroid hormone levels. The present study showed a high prevalence of UI deficiency in pregnant women in Shanghai, especially during the first trimester of pregnancy. Both iodine content of household salt and multivitamin supplement with iodine are the main determinants of UI levels in Shanghai. [ABSTRACT FROM PUBLISHER]

Purpose: Human exposure to particulate matter emitted from on-road motor vehicles includes complex mixtures of heavy metals from tyres, brakes, part wear, and resuspended road sediment. The purpose of this study was to determine the concentrations of 14 platinum-group and other traffic-related heavy metals in road sediment within the metropolitan area of Guangzhou, China, with a view to identifying their sources and assessing the extent of anthropogenic influence on heavy metal contamination of road sediment. Materials and methods: Thirty-five samples of road sediment were collected. The concentrations of Cr, Mn, Ni, Cu, Zn, La, Ce, Mo, Cd, Pb, Ba, and Rh were measured by inductively coupled plasma-mass spectrometry. Pt and Pd were analyzed by isotopic dilution-inductively coupled plasma-mass spectrometry. Multivariate statistical analysis and enrichment factor methods were employed to identify the sources of these heavy metals and to assess anthropogenic influences on their occurrence. Results and discussion: The mean concentrations of Pt, Pd, Rh, Cr, Mn, Ni, Cu, Zn, La, Ce, Mo, Cd, Pb, and Ba in the road sediment samples were 68.24, 93.15, 23.85, 147.5, 712.3, 47.24, 177.5, 1254, 47.50, 96.62, 4.91, 3.00, 198.1, and 641.3 ng g, respectively. Very weak to significant linear positive correlations were found among the various heavy metals. The elemental composition of road sediment was dominated by five principal components. Three clusters were identified through cluster analysis, and enrichment factors were calculated relative to soils in China. The sources and degree of contamination of the heavy metals are discussed based on the results. Conclusions: The mean concentrations of heavy metals are higher than background values, especially for Pt, Pd, Rh, Cd, and Zn. Four main sources are identified: (1) Pt, Pd, and Rh were derived from traffic sources; (2) La, Ce, Mn, and Ba were derived mainly from natural sources; (3) Cr, Ni, Cu, Mo, Cd, and Pb showed mixed traffic-industry sources; and (4) Zn originated mainly from industrial sources. Enrichment factor analysis supported this source identification and further indicated that contamination of road sediment in Guangzhou is extremely high for Pt, Pd, and Rh; moderate to very high for Cd, Zn, Pb, Cu, and Mo; and minimal for Cr, Ni, La, Ce, and Ba. [ABSTRACT FROM AUTHOR]

Here we present seasonal chemical characteristics, formations, sources of PM 2.5 in the year 2020 in Suzhou, Yangtze River Delta, China. Expectedly, organic matter (OM) found to be the most dominant component of PM 2.5 , with a year-average value of 10.3 ± 5.5 μg m−3, followed by NO 3 − (6.7 ± 6.5 μg m−3), SO 4 2− (3.3 ± 2.5 μg m−3), NH 4 + (3.2 ± 2.8 μg m−3), EC (1.1 ± 1.3 μg m−3), Cl− (0.57 ± 0.56 μg m−3), Ca2+ (0.55 ± 0.91 μg m−3), K+ (0.2 ± 1.0 μg m−3), Na+ (0.18 ± 0.45 μg m−3), and Mg2+ (0.09 ± 0.15 μg m−3). Seasonal variations of PM 2.5 showed the highest average value in spring, followed by winter, fall, and summer. Meanwhile, the formation mechanisms of the major PM 2.5 species (NO 3 −, SO 4 2−, and OM) varied in seasons. Interestingly, NO 2 may have the highest conversion rate to NO 3 − in spring, which might be linked with the nighttime chemistry due to the high relative humidity. Moreover, OM in summer was mainly produced by the daytime oxidation of volatile organic compounds, while local primary organic aerosols might play a significant role in other seasons. Source apportionment showed that the more-aged PM 2.5 contributed significantly to the PM 2.5 mass (42%), followed by the dust-related PM 2.5 (38%) and the less-aged PM 2.5 (21%). Potential contribution source function (PSCF) results indicated that aged PM 2.5 were less affected by transportation than dust-related PM 2.5. • Chemical composition, formations, and source apportionment of PM 2.5 in Suzhou were characterized. • The highest PM 2.5 levels were observed in spring, followed by winter, fall, and summer. • NO 2 may have the highest conversion rate to NO 3 − in spring due to high RH. • OM in summer was mainly produced by the daytime oxidation of VOCs. • More-aged PM 2.5 contributed significantly in comparison with dust-related and less-aged PM 2.5. [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., (© 2024. The Author(s).)

Background: The triglyceride-glucose (TyG) index, recognized for its cost-efficiency and simplicity, serves as an accessible indicator of insulin resistance. Yet, its correlation with the risk of prediabetes and diabetes (Pre-DM/DM) in the Chinese demographic remains uncertain. Consequently, our study explored the association between the TyG index and the development of Pre-DM/DM within the Chinese population., Methods: The retrospective cohort study was carried out utilizing data from a health screening initiative. The study included 179541 adults over 20 who underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. The correlation between the TyG index and Pre-DM/DM risk was investigated using Cox regression analysis. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore their non-linear connection., Results: The mean age of study participants was 41.18 ± 12.20 years old, and 95255 (53.05%) were male. During a median follow-up of 3.01 years, 21281 (11.85%) participants were diagnosed with Pre-DM/DM. After adjusting the potential confounding factors, the results showed that the TyG index was positively correlated with incident Pre-DM/DM (HR: 1.67, 95%CI: 1.62-1.71, P< 0.001). Additionally, a non-linear association was observed between the TyG index and the onset of Pre-DM/DM, with an inflection point identified at 8.73. Hazard ratios (HR) to the left and right of this inflection point were 1.95 (95%CI: 1.86-2.04) and 1.34 (95%CI: 1.27-1.42), respectively. Furthermore, sensitivity analyses confirmed the stability of these findings., Conclusion: The TyG index exhibited a non-linear positive relationship with the risk of Pre-DM/DM. These findings imply that maintaining the TyG index at a lower, specified threshold may be beneficial in mitigating the onset of Pre-DM/DM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cao, Hu, Xiao, Zan, Chang, Han, Zhang and Wang.)

Although most people living with HIV (PLWH) receiving antiretroviral therapy (ART) achieve continuous viral suppression, some show detectable HIV RNA as low-level viremia (LLV) (50-999 copies/mL). Drug resistance mutations (DRMs) in PLWH with LLV is of particular concern as which may lead to treatment failure. In this study, we investigated the prevalence of LLV and LLV-associated DRMs in PLWH in Zhengzhou City, China. Of 3616 ART-experienced PLWH in a long-term follow-up cohort from Jan 2022 to Aug 2023, 120 were identified as having LLV. Of these PLWH with LLV, we obtained partial pol and integrase sequences from 104 (70 from HIV-1 RNA and 34 from proviral DNA) individuals. DRMs were identified in 44 individuals. Subtyping analysis indicated that the top three subtypes were B (48.08%, 50/104), CRF07&#95;BC (31.73%, 33/104), and CRF01&#95;AE (15.38%, 16/104). The proportions of nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs) associated DRMs were 23.83% (24/104), 35.58% (37/104), 5.77% (6/104), and 3.85% (4/104), respectively, which contributed to an overall prevalence of 42.31% (44/104). When analyzed by individual DRMs, the most common mutation(s) were V184 (18.27%, 19/104), followed by V179 (11.54%, 12/104), K103 (9.62%, 10/104), Y181 (9.62%, 10/104), M41 (7.69%, 8/104), and K65R (7.69%, 8/104). The prevalence of DRMs in ART-experienced PLWH with LLV is high in Zhengzhou City and continuous surveillance can facilitate early intervention and provision of effective treatment., (© 2024. The Author(s).)

Objectives: This study aimed to assess the prevalence and related factors of myopia among school-aged children after COVID-19 pandemic., Design: Cross-sectional study., Setting: Pudong New Area, Shanghai., Participants: 1722 children aged 7-9 randomly selected from 8 primary schools were screened from 1 February 2023 to 30 April 2023., Main Outcome Measures: Children's height, weight and eye parameters were examined. Myopia was defined as a cycloplegic spherical equivalent ≤-0.50 dioptres in either eye. A vision-related behaviour questionnaire was applied to investigate the associations between myopia and its risk factors., Results: Of the 1722 individuals enrolled, 25.6% (456) had myopia. After adjusting other characteristics, the following factors were associated with an increased rate of myopia: age (9 years vs 7 years, adjusted OR (AOR) 1.84, 95% CI 1.18 to 2.85, p=0.007), parental myopia status (both myopia vs none, AOR 5.66, 95% CI 3.71 to 8.63, p<0.001; one myopia vs none, AOR 2.92, 95% CI 1.93 to 4.42, p<0.001), reading books too close (yes vs no, AOR 1.58, 95% CI 1.20 to 2.08, p=0.001), writing with a tilted head (yes vs no, AOR 1.37, 95% CI 1.05 to 1.77, p=0.019), sleep patterns (early to bed late to rise vs early to bed early to rise, AOR 1.52, 95% CI 1.02 to 2.26, p=0.039). By contrast, a higher monthly household income and the habit of reading while lying down were associated with lower risk of myopia., Conclusions: The prevalence of myopia is of concern among young school-aged children after COVID-19. Correcting eye use behaviour and improving sleep habits may reduce myopia. Also, gender differences should be considered in prevention strategies for children's myopia., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Postpartum contraception is essential to preventing unintended pregnancies and short interpregnancy intervals. The first year after childbirth is a critical period with a high risk of unintended pregnancy and induced abortion. However, the postpartum contraceptive services are weak in China's existing maternal and child healthcare system. We propose to evaluate the effects of integrating postpartum contraceptive services into the existing perinatal care system via a cluster randomised controlled trial., Methods and Analysis: This cluster randomised controlled trial involves all 13 communities of Minhang District, Shanghai, China. Communities will be randomly allocated, seven in the intervention group and six in the control group. One thousand and three hundred women, 100 women in each community, will be recruited in the study. Women assigned to the intervention group will receive postpartum contraceptive education and counselling during pregnancy, childbirth hospitalisation, postpartum home visits and the 42-day postpartum clinic check-up. Women in the control group will receive routine antenatal and postpartum care. Participants will be recruited in the first trimester during pregnancy and followed up to 1 year postpartum. The primary outcome is the incidence of unintended pregnancy within 1 year after childbirth., Ethics and Dissemination: The trial received ethical approval from the Ethics Committee of Shanghai Minhang District Maternal and Child Health Care Hospital (#[2020]KS-02, #[2020]KS-05, #[2020]KS-05-EX). Results will be published in academic journals and disseminated in multiple formats for the health professionals and the public., Trial Registration Number: ChiCTR2000034603., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Organophosphate esters (OPEs) are synthetic chemicals used in various commercial products. Accumulating evidence has shown that they may act as metabolic disruptors. However, no study has investigated the long-term effects of gestational OPEs exposure on childhood adiposity. Breast milk represents the optimal nutritional form of feeding for infants and may protect against the adverse effects of gestational OPEs exposure on offspring development. Using data from the Shanghai-Minhang birth cohort study, we investigated the associations of gestational OPEs exposure with adiposity measures in children up to 6 years of age, and whether breastfeeding could modify these associations. A total of 733 mother-child pairs with available data on OPE concentrations and child anthropometry were included. Eight OPE metabolites were assessed in maternal urine samples collected at 12-16 weeks of pregnancy. Information on children's weight, height, arm circumference, and waist circumference was collected at birth and 0.5, 1, 4, and 6 years of age. Weight-for-age and body mass index-for-age z scores were calculated. The duration of children's breastfeeding was categorized as ≤4 months or >4 months. The generalized estimate equation and Bayesian Kernel Machine Regression models were used to examine the associations of OPEs exposure with children's adiposity measures. Selected OPEs exposure was associated with higher children's adiposity measures. Particularly, we found stronger associations of bis(1-chloro-2-propyl) phosphate (BCIPP), bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), and di-o-cresyl phosphate and di-p-cresyl phosphate (DCP) with higher adiposity measures in children breastfed for ≤4 months, while little evidence of associations was found among those breastfed for >4 months. Our study suggested that gestational OPEs exposure could alter children's adiposity measures, but the potential effects were attenuated if children were breastfed for >4 months., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

In December 2019, the COVID-19 pandemic quickly spread throughout China and beyond, posing enormous global challenges. With prompt, vigorous, and coordinated control measures, mainland China contained the spread of the epidemic within two months and halted the epidemic in three months. Aggressive containment strategy, hierarchical management, rational reallocation of resources, efficient contact tracing, and voluntary cooperation of Chinese citizens contributed to the rapid and efficient control of the epidemic, thus promoting the rapid recovery of the Chinese economy. This review summarizes China's prevention and control strategies and other public health measures, which may provide a reference for the epidemic control in other countries., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The effects of aryl-organophosphate esters (aryl-OPEs) on female reproduction health are still unclear owing to the lack of specific exposure biomarkers. Here, we analyzed the hydroxylated metabolites of three aryl-OPEs (phenyl diphenyl phosphate [TPhP], 2-ethylhexyl diphenyl phosphate [EHDPP], and tricresyl phosphate [TCrP]) and diphenyl phosphate (DPhP) in urine samples from 913 women of childbearing age, and explored the association between exposure to the aryl-OPEs and reproductive hormone levels. The detection frequencies of 2-ethyl-5-hydroxyhexyl diphenyl phosphate (5-OH-EHDPP), phenyl di-p-tolyl phosphate (4-OH-MDTP), and 4-hydroxyphenyl diphenyl phosphate (4-OH-TPhP) were 94.6 %, 93.3 %, and 84.2 %, respectively. Multivariate linear regression analyses revealed that the quartiles of 4-OH-TPhP were positively associated with the progesterone (P4) level (p-trend = 0.008), and the P level in the highest quartile of 5-OH-EHDPP was 7.2 % (95 % CI, 5.7 % to 8.7 %) higher than that in the lowest quartile. The 17β-estradiol levels in the highest quartiles of 4-OH-TPhP and 5-OH-EHDPP were 15.0 % (95 % CI, 13.7 % to16.1 %) and 5.9 % (95 % CI, 15.7 % to 16.1 %) lower than those in the lowest quartiles, respectively. The anti-Müllerian hormone level linearly increased across the quartiles of 4-OH-MDTP (p-trend = 0.036), and the follicle-stimulating hormone exhibited the opposite trend (p-trend = 0.0047). These results indicate that aryl-OPEs may disrupt hormone homeostasis using their specific biomarkers and may negatively affect female reproduction., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Recent evidence has revealed that the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) may be closely associated with metabolic syndrome and insulin resistance. However, it is unclear whether the AST/ALT ratio correlates with prediabetes risk. The aim of our study was to examine the association between AST/ALT ratios and the risk of prediabetes among a large cohort of Chinese subjects., Methods: This retrospective cohort study recruited 75204 Chinese adults with normoglycemia at baseline who underwent physical examinations at the Rich Healthcare Group from 2010 to 2016. The AST/ALT ratio at baseline was the target independent variable, and the risk of developing prediabetes during follow-up was the dependent variable. Cox proportional-hazards regression was used to evaluate the independent association between the AST/ALT ratio and prediabetes. This study identified nonlinear relationships by applying a generalized additive model (GAM) and smooth curve fitting. In order to assess the robustness of this study, we performed a series of sensitivity analyses. Moreover, we performed a subgroup analysis to evaluate the consistency of the association in different subgroups. Data from this study have been updated on the DATADRYAD website., Results: The AST/ALT ratio was negatively and independently related to the prediabetes risk among Chinese adults (HR: 0.76, 95% CI: 0.75-0.84, P&lt;0.0001) after adjusting demographic and biochemical covariates. Furthermore, a nonlinear relationship between the AST/ALT ratio and the risk of developing prediabetes was found at an inflection point of 1.50 for the AST/ALT ratio. When the AST/ALT ratio was to the left of the inflection point (AST/ALT ratio ≤ 1.50), the AST/ALT ratio was negatively related to the prediabetes risk (HR:0.70, 95%CI: 0.65-0.76, P&lt;0.0001). In contrast, the relationship tended to be saturated when the AST/ALT ratio was more than 1.50 (HR: 1.01, 95%CI: 0.89-1.15, P=0.8976). Our findings remained robust across a range of sensitivity analyses. Subgroup analysis revealed that other variables did not alter the relationship between the AST/ALT ratio and prediabetes risk., Conclusion: This study revealed that AST/ALT ratio was negatively and independently associated with prediabetes risk among Chinese participants. The relationship between the AST/ALT ratio and prediabetes risk was nonlinear, and AST/ALT ratio ≤ 1.50 was strongly inversely correlated with prediabetes risk., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cao, Zhang, Yuan, Zan, Zhang, Xue, Wang and Zheng.)

Animal studies demonstrated that paternal alcohol exposure before conception increases the risk of adverse neurodevelopment in offspring, but limited evidence is known in humans. Based on Shanghai-Minhang Birth Cohort Study, we aimed to examine associations between preconceptional paternal alcohol consumption and child behavioral problems. Paternal alcohol consumption during the last 3 months before conception was obtained by maternal report. Children born to fathers who drank alcohol at least once a week were classified as exposed. Child behavioral problems were assessed using the Child Behavior Checklist (CBCL) at age of 2, 4, and 6. Negative binomial regression was used to estimate the rate ratio (RR) of CBCL raw scores in 796 offspring. The risks of rating scores on anxious/depressed were increased by 33% (RR 1.33, 95% CI 1.09, 1.61) and 37% (RR 1.37, 95% CI 1.02, 1.84) among boys in the exposed group at age of 4 and 6, respectively. We also found that risks of somatic complaints were increased by 18% (RR 1.18, 95%CI 1.00, 1.40) and 65% (RR 1.65, 95%CI 1.14, 2.38) among girls in the exposed group at age of 4 and 6. The increased risks of sleep problems (RR 1.25, 95% CI 1.00, 1.55) in girls at age 4, thought problems (RR 1.32, 95% CI 1.01, 1.73) in girls at age 6, rule-breaking behaviors (RR 1.35, 95% CI 1.09, 1.67) in boys at age 6 were also found. The risks of CBCL scores on anxious/depressed and sleep problems in girls at age 4, as well as the risks of somatic complaints and rule-breaking behaviors in boys at age 6 increased with the level of exposure to paternal alcohol consumption. Our findings provided preliminary evidence that preconceptional paternal alcohol consumption may increase risks of child behavioral problems., (© 2022. The Author(s).)

Importance: The long-term health outcomes and symptom burden of COVID-19 remain largely unclear., Objective: To evaluate health outcomes of COVID-19 survivors 1 year after hospital discharge and to identify associated risk factors., Design, Setting, and Participants: This retrospective, multicenter cohort study was conducted at 2 designated hospitals, Huoshenshan Hospital and Taikang Tongji Hospital, both in Wuhan, China. All adult patients with COVID-19 discharged between February 12 and April 10, 2020, were screened for eligibility. Of a consecutive sample of 3988 discharged patients, 1555 were excluded (796 declined to participate and 759 were unable to be contacted) and the remaining 2433 patients were enrolled. All patients were interviewed via telephone from March 1 to March 20, 2021. Statistical analysis was performed from March 28 to April 18, 2021., Exposures: COVID-19., Main Outcomes and Measures: All patients participated in telephone interviews using a series of questionnaires for evaluation of symptoms, along with a chronic obstructive pulmonary disease (COPD) assessment test (CAT). Logistic regression models were used to evaluate risk factors for fatigue, dyspnea, symptom burden, or higher CAT scores., Results: Of 2433 patients at 1-year follow-up, 1205 (49.5%) were men and 680 (27.9%) were categorized into the severe disease group as defined by the World Health Organization guideline; the median (IQR) age was 60.0 (49.0-68.0) years. In total, 1095 patients (45.0%) reported at least 1 symptom. The most common symptoms included fatigue, sweating, chest tightness, anxiety, and myalgia. Older age (odds ratio [OR], 1.02; 95% CI, 1.01-1.02; P < .001), female sex (OR, 1.27; 95% CI, 1.06-1.52; P = .008), and severe disease during hospital stay (OR, 1.43; 95% CI, 1.18-1.74; P < .001) were associated with higher risks of fatigue. Older age (OR, 1.02; 95% CI, 1.01-1.03; P < .001) and severe disease (OR, 1.51; 95% CI, 1.14-1.99; P = .004) were associated with higher risks of having at least 3 symptoms. The median (IQR) CAT score was 2 (0-4), and a total of 161 patients (6.6%) had a CAT score of at least 10. Severe disease (OR, 1.84; 95% CI, 1.31-2.58; P < .001) and coexisting cerebrovascular diseases (OR, 1.95; 95% CI, 1.07-3.54; P = .03) were independent risk factors for CAT scores of at least 10., Conclusions and Relevance: This study found that patients with COVID-19 with severe disease during hospitalization had more postinfection symptoms and higher CAT scores.

Per- and polyfluoroalkyl substances (PFASs) have been manufactured and widely used for over 60 years. Currently, there are thousands of marketed PFASs, but only dozens of them are routinely monitored. This work involved target, nontarget, and suspect screening of PFASs in the liver of Indo-Pacific humpback dolphin ( Sousa chinensis ) and finless porpoise ( Neophocaena phocaenoides ), two resident marine mammals in the South China Sea, stranded between 2012 and 2018. Among the 21 target PFASs, perfluorooctane sulfonate and 6:2 chlorinated polyfluoroalkyl ether sulfonate (6:2 Cl-PFESA) predominated in the samples, accounting for 46 and 30% of the total PFASs, respectively. Significantly higher total target PFAS concentrations ( p < 0.05) were found in dolphin liver samples [3.23 × 10 3 ± 2.63 × 10 3 ng/g dry weight (dw)] than in porpoise liver samples (2.63 × 10 3 ± 1.10 × 10 3 ng/g dw). Significant increasing temporal trends ( p < 0.05) were found in the concentrations of two emerging PFASs, perfluoroethylcyclohexane sulfonate and 2,3,3,3-tetrafluoro-2-propanoate in porpoises, indicating increasing pollution by these emerging PFASs. Forty-four PFASs from 9 classes were additionally identified by nontarget and suspect screening, among which 15 compounds were reported for the first time in marine mammals. A primary risk assessment showed that the emerging PFAS 6:2 Cl-PFESA could have possible adverse effects in terms of reproductive injury potential on most of the investigated cetaceans.

Background: China was the first country in the world to experience a large-scale COVID-19 outbreak. The rapid spread of the disease and enforcement of public health measures has caused distress among vulnerable populations such as pregnant women. With a limited understanding of the novel, emerging infectious disease, pregnant women have sought ways to access timely and trusted health care information. The mental health status of pregnant women during this public health emergency, as well as how they responded to the situation and where and how they obtained antenatal care information, remain to be understood., Objective: This study aimed to evaluate the mental health status of pregnant women during the COVID-19 epidemic in China by measuring their perceived stress, anxiety, and depression levels; explore the approaches used by them to access antenatal health care information; and determine their associations with maternal mental health status., Methods: We conducted a web-based, cross-sectional survey to assess the mental health status of Chinese pregnant women by using the validated, Chinese version of Perceived Stress Scale, Self-Rating Anxiety Scale, and Edinburgh Depression Scale. We also collected information on the various approaches these women used to access antenatal care information during the early stage of the COVID-19 epidemic, from February 5 to 28, 2020., Results: A total of 1873 pregnant women from 22 provinces or regions of China participated in the survey. The prevalence of perceived stress, anxiety, and depression among these participants was 89.1% (1668/1873; 95% CI 87.6%, 90.4%), 18.1% (339/1873; 95% CI 16.4%, 19.9%), and 45.9% (859/1873; 95% CI 43.6%, 48.1%), respectively. Hospitals' official accounts on the Chinese social media platforms WeChat and Weibo were the most popular channels among these pregnant women to obtain antenatal care information during the COVID-19 outbreak. Access to antenatal care information via the hospitals' official social media accounts was found to be associated with a significantly lower risk of perceived stress (adjusted odds ratio [aOR] 0.46, 95% CI 0.30-0.72; P=.001), anxiety (aOR 0.53, 95% CI 0.41-0.68; P<.001), and depression (aOR 0.73, 95% CI 0.59-0.91; P=.005). Access to health care information via hospital hotlines or SMS was found to be significantly associated with a lower risk of anxiety only (OR 0.77, 95% CI 0.60-0.98; P=.04)., Conclusions: During the COVID-19 outbreak in China, pregnant women experienced high levels of perceived stress, anxiety, and depression. During such public health emergencies, mental health care services should be strengthened to reassure and support pregnant women. Specific information targeted at pregnant women, including information on how to cope in an emergency or major disease outbreak, developed and disseminated by health care institutions via social media platforms could be an effective way to mitigate mental health challenges and ensure epidemic preparedness and response in the future., (©Hong Jiang, Longmei Jin, Xu Qian, Xu Xiong, Xuena La, Weiyi Chen, Xiaoguang Yang, Fengyun Yang, Xinwen Zhang, Nazhakaiti Abudukelimu, Xingying Li, Zhenyu Xie, Xiaoling Zhu, Xiaohua Zhang, Lifeng Zhang, Li Wang, Lingling Li, Mu Li. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.01.2021.)

Purpose: This study aimed to analyze the topological characteristics of brain structural network in pediatric epilepsy patients with vagus nerve stimulation (VNS) by applying graph theoretical approaches., Methods: Nine patients with generalized seizures and eight normal controls (NC) were enrolled. Based on diffusion tensor imaging, graph theory analysis was used to characterize the topological properties in preoperative patients (EP-pre), postoperative patients (EP-post) and NC. The global properties included clustering coefficient (Cp), shortest path length (Lp), small-worldness (γ, λ, δ), global network efficiency (Eg) and local network efficiency (Eloc). The regional properties included degree centrality (DC), nodal efficiency (NE), nodal local efficiency (NLE) and nodal shortest path length (Np). Two sample t-test and paired sample t-test were utilized to compare properties difference., Results: All three groups followed small-world characteristics. There was no significant difference in small-worldness, Cp, Lp, Eg or Eloc between EP-pre and EP-post. Compared with EP-pre: DC in EP-post decreased in the right cuneus and right temporal gyri, while increased in the right paracentral lobule; NE in EP-post decreased in the left dorsolateral superior frontal gyrus, right cuneus, right supramarginal gyrus, and right rolandic operculum, while increased in the right paracentral lobule; NLE in EP-post decreased in the left posterior cingulate gyrus and right supramarginal gyrus, while increased in the left parahippocampal gyrus; NP in EP-post decreased in the right paracentral lobule, while increased in the right cuneus., Conclusion: VNS causes topological characteristics changes in pediatric patients with generalized seizures through regulating regional properties in some brain structures., (Copyright © 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

After analyzing the immune characteristics of patients with severe coronavirus disease 2019 (COVID-19), we have identified that pathogenic T cells and inflammatory monocytes with large amount of interleukin 6 secreting may incite the inflammatory storm, which may potentially be curbed through monoclonal antibody that targets the IL-6 pathways. Here, we aimed to assess the efficacy of tocilizumab in severe patients with COVID-19 and seek a therapeutic strategy. The patients diagnosed as severe or critical COVID-19 in The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) and Anhui Fuyang Second People's Hospital were given tocilizumab in addition to routine therapy between 5 and 14 February 2020. The changes of clinical manifestations, computerized tomography (CT) scan image, and laboratory examinations were retrospectively analyzed. Fever returned to normal on the first day, and other symptoms improved remarkably within a few days. Within 5 d after tocilizumab, 15 of the 20 patients (75.0%) had lowered their oxygen intake, and 1 patient needed no oxygen therapy. CT scans manifested that the lung lesion opacity absorbed in 19 patients (90.5%). The percentage of lymphocytes in peripheral blood, which decreased in 85.0% of patients (17/20) before treatment (mean, 15.52 ± 8.89%), returned to normal in 52.6% of patients (10/19) on the fifth day after treatment. Abnormally elevated C-reactive protein decreased significantly in 84.2% of patients (16/19). No obvious adverse reactions were observed. All patients have been discharged on average 15.1 d after giving tocilizumab. Preliminary data show that tocilizumab, which improved the clinical outcome immediately in severe and critical COVID-19 patients, is an effective treatment to reduce mortality., Competing Interests: The authors declare no competing interest., (Copyright © 2020 the Author(s). Published by PNAS.)

The mechanisms through which conflicting parental relationship and parenting practices influence adolescent antisocial behavior have not been adequately understood. To bring more understanding to the mechanisms, this study investigates how marital discord interrelates with interparental inconsistency in parenting practices, and how these family conditions influence juvenile delinquency through their spillover effects on mental health problems, parental attachment and delinquent peer association among Chinese adolescents. Findings obtained from a structural equation modeling analysis of survey data collected from a probability sample of 2,496 adolescents (mean age = 15.16 years) are generally consistent with the spillover effect hypothesis. The results demonstrate that mental health problems, parental attachment, and delinquent peer association operate as critical mediators linking marital discord and interparental inconsistency to juvenile delinquency.

Background: Serum periostin levels have been reported to be an indicator of Th2 inflammation in asthmatic patients., Objective: This study aimed to investigate serum levels of periostin in patients with allergic bronchopulmonary aspergillosis (ABPA) and to evaluate its diagnostic and monitoring value in the disease., Methods: Patients with ABPA (n = 19) and asthma (n = 24), including severe asthma with fungal sensitisation (SAFS, n = 11) and severe asthma without fungal sensitization (SAwFS, n = 13), were enrolled. Serum levels of periostin were analysed by enzyme-linked immunosorbent assay. Serum total IgE and Aspergillus fumigatus specific IgE, IgG were measured by ImmunoCAP. Levels of cytokines (IFN-γ, IL-4, IL-5, IL-8, IL-10, IL-13 and IL-17A) were measured by Meso Scale Discovery (MSD)., Results: Serum levels of periostin in ABPA patients (85.55 ng/mL, [68.28-166] ng/mL) were higher than those in SAFS (50.99 ng/mL, [32.02-71.80] ng/mL; P < 0.01). Among the analysed cytokines, IL-5 levels in ABPA (1.55 pg/mL, [0.96-3.33] pg/mL) were higher than those in SAFS (0.31 pg/mL, [0.26-0.56] pg/mL; P < 0.05) or SAwFS (0.34 pg/mL, [0.21-0.56] pg/mL; P < 0.01). Serum periostin levels was positively associated with total IgE levels (r = 0.319, P < 0.05), serum IL-5 levels (r = 0.484, P < 0.01) and blood eosinophil counts (r = 0.428, P < 0.05). In ROC analysis, the clinical reference value of periostin was 68.8 ng/mL for differential diagnosis of ABPA and SAFS, with the area under the curve (AUC) of 0.81. Longitudinally, serum periostin levels did not change significantly after treatment in ABPA., Conclusions: These findings suggested that serum levels of periostin were up-regulated in ABPA patients, which may be associated with eosinophilic inflammation., (© 2019 Blackwell Verlag GmbH.)

The performance of three machine learning methods (support vector regression, random forests and artificial neural network) for estimating the LAI of paddy rice was evaluated in this study. Traditional univariate regression models involving narrowband NDVI with optimized band combinations as well as linear multivariate calibration partial least squares regression models were also evaluated for comparison. A four year field-collected dataset was used to test the robustness of LAI estimation models against temporal variation. The partial least squares regression and three machine learning methods were built on the raw hyperspectral reflectance and the first derivative separately. Two different rules were used to determine the models' key parameters. The results showed that the combination of the red edge and NIR bands (766 nm and 830 nm) as well as the combination of SWIR bands (1114 nm and 1190 nm) were optimal for producing the narrowband NDVI. The models built on the first derivative spectra yielded more accurate results than the corresponding models built on the raw spectra. Properly selected model parameters resulted in comparable accuracy and robustness with the empirical optimal parameter and significantly reduced the model complexity. The machine learning methods were more accurate and robust than the VI methods and partial least squares regression. When validating the calibrated models against the standalone validation dataset, the VI method yielded a validation RMSE value of 1.17 for NDVI(766,830) and 1.01 for NDVI(1114,1190), while the best models for the partial least squares, support vector machine and artificial neural network methods yielded validation RMSE values of 0.84, 0.82, 0.67 and 0.84, respectively. The RF models built on the first derivative spectra with mtry = 10 showed the highest potential for estimating the LAI of paddy rice., Competing Interests: The authors declare no conflicts of interest. The authors also declare that the author Xiaohua Zhang is employed by a commercial company, “Surveying and Mapping Institute of China Nuclear Industry CO., LTD., Xi’an, Shaanxi, China.” This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Stereoisomers of 1,2,5,6,9,10-hexabromocyclododecane (HBCD) and 1,2-dibromo-4-(1,2-dibromoethyl)-cyclohexane (TBECH) were determined in sediments and 30 marine species in a marine food web to investigate their trophic transfer. Lipid content was found to affect the bioaccumulation of ΣHBCD and ΣTBECH in these species. Elevated biomagnification of each diastereomer from prey species to marine mammals was observed. For HBCD, biota samples showed a shift from γ- to α-HBCD when compared with sediments and technical mixtures; trophic magnification potential of (-)-α- and (+)-α-HBCD were observed in the food web, with trophic magnification factors (TMFs) of 11.8 and 8.7, respectively. For TBECH, the relative abundance of γ- and δ-TBECH exhibited an increasing trend from abiotic matrices to biota samples; trophic magnification was observed for each diastereomer, with TMFs ranging from 1.9 to 3.5. The enantioselective bioaccumulation of the first eluting enantiomer of δ-TBECH in organisms at higher TLs was consistently observed across samples. This is the first report on the trophic transfer of TBECH in the food web. The estimated daily intake of HBCD for Hong Kong residents was approximately 16-times higher than that for the general population in China, and the health risk to local children was high, based on the relevant available reference dose.

Long non-coding RNAs (lncRNAs) perform distinct functions in various biological processes in mammals, including sex differentiation. However, the roles of lncRNAs in other vertebrates, especially in the Chinese soft-shell turtle (Pelodiscus sinensis), remain to be clarified. In this study, we performed genome-wide analysis of the lncRNA expression profiles in gonad tissues and screened numerous sex-specific lncRNAs in the Chinese soft-shell turtle. Of the 363,310,650 clean reads obtained, 5,994 sequences were typed as lncRNAs, of which 4,463 were novel. A selection of sex-specific lncRNAs (♀ 932, ♂ 449) from female ovaries and male testis were shown to act on target genes in cis and in trans, and most were involved in gonad differentiation based on Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Furthermore, interactions among the differentially expressed lncRNA-mRNAs and protein coding genes were identified by construction of correlation networks. Overall, our systematic analysis of lncRNA expression profiles in gonad tissues revealed numerous sex-specific lncRNAs in P. sinensis. Thereby, these findings provide new insights into the function of lncRNAs in sex differentiation and highlight a group of candidate lncRNAs for future studies.

Stereoisomeric compositions of 1,2,5,6,9,10-hexabromocyclododecane (HBCD) and 1,2-dibromo-4-(1,2-dibromoethyl)cyclohexane (TBECH) were investigated in the blubber of two species of marine mammals, finless porpoises ( Neophocaena phocaenoides) and Indo-Pacific humpback dolphins ( Sousa chinensis), from the South China Sea between 2005 and 2015. The concentrations of ΣHBCD in samples of porpoise ( n = 59) and dolphin ( n = 32) ranged from 97.2 to 6,260 ng/g lipid weight (lw) and from 447 to 45,800 ng/g lw, respectively, while those of ΣTBECH were both roughly 2 orders of magnitude lower. A significant increasing trend of ΣHBCD was found in dolphin blubber over the past decade. The diastereomeric profiles exhibited an absolute predominance of α-HBCD (mostly >90%), while the proportions of four TBECH diastereomers in the samples appeared similar. A preferential enrichment of the (-)-enantiomers of α-, β-, and γ-HBCD was found in most blubber samples. Interestingly, the body lengths of porpoises showed a significant negative correlation with the enantiomer fractions of α-HBCD. Significant racemic deviations were also observed for α-, γ-, and δ-TBECH enantiomeric pairs. This is the first report of the presence of TBECH enantiomers in the environment. The estimated hazard quotient indicates that there is a potential risk to dolphins due to HBCD exposure.

Background: Estimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes. Adjuvant endocrine therapy is widely used for hormone receptor-positive (HR+) early-stage breast cancer (EBC), and evidence suggests that aromatase inhibitors (AIs) may improve QoL for these patients. This study evaluated QoL in postmenopausal Chinese patients with HR+ EBC taking AIs., Methods: This was a prospective, multicenter, and observational study that had no intent to intervene in the current treatment of recruited patients. Eligible patients were recruited within 7 days of beginning adjuvant treatment with AIs. The Functional Assessment of Cancer Therapy-Breast (FACT-B) scale was used to evaluate the patients' QoL. Data were collected at baseline and at 6, 12, 18, and 24 months., Results: From June 2010 to October 2013, a total of 494 patients with HR+ EBC were recruited from 21 centers. There was a 7.51-point increase in the patients' mean FACT-B trial outcome index (TOI), from 90.69 at baseline to 98.72 at 24 months (P < .0001). The mean TOI scores at baseline, 6, 12, and 18 months were 90.69, 94.36, 97.71, and 96.75, respectively (P < .0001, for all). The mean (FACT-B) emotional well-being subscale scores at baseline, 6, 12, 18, and 24 months were 16.32, 16.55, 17.34 (P < .0001), 17.47 (P < .0001), and 17.85 (P < .0001), respectively, and social well-being scores were 18.61, 19.14 (P < .04), 19.35 (P < .008), 18.32, and 18.40, respectively. In the mixed model, baseline TOI, clinical visits, prior chemotherapies, age group, and axillary lymph-node dissection presented statistically significant effects on the change of FACT-B TOI and FACT-B SWB, whereas only baseline TOI, clinical visits, and prior chemotherapies presented statistically significant effects on the change of FACT-B EWB. FACT-B TOI, being the most pertinent and precise indicator of patient-reported QoL, demonstrated significant changes reflecting clinical benefit of adjuvant AIs endocrine therapy in the QoL of HR + EBC patients., Conclusions: The study demonstrated significant improvements in the long-term QoL of postmenopausal Chinese patients with HR+ EBC at 6, 12, 18, and 24 months after starting treatment with AIs. The current study indicates improved long-term QoL with AI adjuvant treatment, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes., Trial Registration: Clinicaltrials.gov NCT01144572.

Objective: To evaluate the impact of body mass on recurrence and progression in patients with Ta, T1 urothelial bladder cancer., Methods: Data from 469 patients with Ta, T1 bladder cancer who were treated with transurethral resection of bladder tumor at our center during 2006-2014 were retrospectively studied. According to body mass index (BMI), patients were divided into three groups: normal weight (BMI < 24 kg/m(2)), overweight (24 kg/m(2) ≤ BMI < 28 kg/m(2)) and obesity (BMI ≥ 28 kg/m(2)). Clinicopathologic features were compared across groups. Kaplan-Meier curves and Cox proportional hazards regression analyses were employed to assess the association between body mass and oncologic outcomes., Results: Compared with patients with normal weight, overweight and obese counterparts showed significantly shorter recurrence-free or progression-free survival. In multivariate analyses, being overweight was an independent factor for recurrence and obesity was for both recurrence and progression. The presence of diabetes mellitus (DM) was not a strong risk factor for the entire cohort, while it became a significant predictor for both recurrence and progression in the subgroup of overweight and obese patients., Conclusion: Excessive body mass seems to act as independent risk factors for worse oncologic outcomes of Ta, T1 bladder cancer. Further studies should be carried out to elucidate the exact impact of obesity, DM or even other metabolic disorders.

Objective: To validate the European Organization for Research and Treatment of Cancer (EORTC) model and the Spanish Urological Club for Oncological Treatment (CUETO) model in Chinese patients with nonmuscle-invasive bladder cancer (NMIBC)., Materials and Methods: A retrospective study was performed of 363 Chinese patients with NMIBC treated at our hospital from January 2003 to September 2010. Most of these patients had undergone intravesical chemotherapy after transurethral resection of the bladder tumor. The scores for recurrence and progression were calculated using the 2 models. Next, all the patients were divided into 4 risk groups according to their scores. The Kaplan-Meier method was used to estimate the probabilities of recurrence and progression according to both models. Discrimination was assessed using the concordance index., Results: The EORTC model successfully stratified our patients into 4 groups with statistically significant different probabilities of recurrence. For progression, only the intermediate- and high-risk groups could be reasonably distinguished using the EORTC model. The CUETO model stratified neither the recurrence nor the progression risks. The concordance index using the EORTC and CUETO model was 0.711 and 0.663 for recurrence and 0.768 and 0.741 for progression, respectively., Conclusion: Compared with the CUETO risk tables, the EORTC model showed more value in predicting recurrence and progression in Chinese patients with NMIBC, most of whom received intravesical chemotherapy after transurethral resection of the bladder tumor. Prospective multicenter studies should be performed of large cohorts to construct an ideal prognostic model for Chinese patients with NMIBC., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: To evaluate the effects of leukocyte-depleting filtration on myocardial and pulmonary protection and the inflammatory response in patients undergoing valve surgery., Methods: Fifty-two patients who underwent mitral valve or mitral and aortic valve replacement were randomized into two groups with or without a leukocyte-depleting filter during surgery. The filter was used from 10 minutes before the release of the aortic cross-clamp to the end of cardiopulmonary bypass., Results: Total leukocyte and neutrophil counts showed a short-term reduction in patients undergoing leukocyte filtration, but there was no significant difference between the two groups during the study. Serum levels of cardiac troponin I were lower than that of the control group (p=0.030). Leukocyte depletion resulted in a significantly higher oxygenation index (p=0.002) and a lower respiratory index (p=0.003) compared with the control group. Serum levels of interleukin-8 were significantly elevated in patients undergoing leukocyte filtration compared with patients without leukocyte filtration (p=0.001). There were no statistically significant differences between the two groups with regards to the concentration of interleukin-6 and TNFα, or the duration of intensive care and hospital stay., Conclusions: Leukocyte depletion is associated with improved myocardial and lung protection but does not appear to attenuate the inflammatory response in valve surgery.