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BackgroundIn December 2019, pneumonia cases of unknown origin were reported in Wuhan City, Hubei Province, China. Identified as the coronavirus disease (COVID-19), the number of cases grew rapidly by human-to-human transmission in Wuhan. Social media, especially Sina Weibo (a major Chinese microblogging social media site), has become an important platform for the public to obtain information and seek help. ObjectiveThis study aims to analyze the characteristics of suspected or laboratory-confirmed COVID-19 patients who asked for help on Sina Weibo. MethodsWe conducted data mining on Sina Weibo and extracted the data of 485 patients who presented with clinical symptoms and imaging descriptions of suspected or laboratory-confirmed cases of COVID-19. In total, 9878 posts seeking help on Sina Weibo from February 3 to 20, 2020 were analyzed. We used a descriptive research methodology to describe the distribution and other epidemiological characteristics of patients with suspected or laboratory-confirmed SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. The distance between patients’ home and the nearest designated hospital was calculated using the geographic information system ArcGIS. ResultsAll patients included in this study who sought help on Sina Weibo lived in Wuhan, with a median age of 63.0 years (IQR 55.0-71.0). Fever (408/485, 84.12%) was the most common symptom. Ground-glass opacity (237/314, 75.48%) was the most common pattern on chest computed tomography; 39.67% (167/421) of families had suspected and/or laboratory-confirmed family members; 36.58% (154/421) of families had 1 or 2 suspected and/or laboratory-confirmed members; and 70.52% (232/329) of patients needed to rely on their relatives for help. The median time from illness onset to real-time reverse transcription-polymerase chain reaction (RT-PCR) testing was 8 days (IQR 5.0-10.0), and the median time from illness onset to online help was 10 days (IQR 6.0-12.0). Of 481 patients, 32.22% (n=155) lived more than 3 kilometers away from the nearest designated hospital. ConclusionsOur findings show that patients seeking help on Sina Weibo lived in Wuhan and most were elderly. Most patients had fever symptoms, and ground-glass opacities were noted in chest computed tomography. The onset of the disease was characterized by family clustering and most families lived far from the designated hospital. Therefore, we recommend the following: (1) the most stringent centralized medical observation measures should be taken to avoid transmission in family clusters; and (2) social media can help these patients get early attention during Wuhan’s lockdown. These findings can help the government and the health department identify high-risk patients and accelerate emergency responses following public demands for help.

Teacher empathy has become an essential topic in educational research for enhancing students' learning achievement. However, most existing studies focused on the direct relationship between teacher empathy and students' learning achievement. They ignored the mediation of student factors (e.g., students' sense of school belonging) between teacher empathy and learning achievement. Among the few studies that included sense of school belonging, most were based on classroom-based observations, which render the generalizability of their findings uncertain. The present study was designed to investigate the relationship between teacher empathy, students' sense of school belonging, and learning achievement with data from the Programme for International Student Assessment (PISA) 2018 generated by 506,317 15-year-olds from 75 countries/territories (mean age = 15.79, SD = 0.29; 51% girls). Results of multilevel structural equation modeling showed that teacher empathy was positively related to reading achievement directly and indirectly through students' sense of school belonging. Specifically, students' sense of school belonging mediated 29% of the total effect of teacher empathy on reading achievement. These results have theoretical implications for future research in teacher empathy on the importance of simultaneously including other student features, such as students' cognitive and emotional differences. The results also have practical implications for teacher training on raising teachers' attention to student emotions during reading instruction.

Background The number of depression patients has exceeded 300 million worldwide, and its high disability rate has attracted global attention. However, the relationship between temperature-humidity index (Humidex) and depression remains to be explored. Objective To explore the relationship between Humidex of the twenty-four solar terms and depression. Methods Outpatient data of depression patients (n=18 289) admitted to the Psychology Department, Mental Health Center of Jiading District from 2016-10-08 to 2019-10-07 were collected, including gender, age, time of treatment, number of outpatient visits and specialist visits. The data of daily mean temperature, relative humidity, rainfall, air pressure and mean wind speed in Jiading District from 2016-10-08 to 2019-10-07 published by Shanghai Meteorological Bureau were collected to calculate Humidex. The included patients were divided into the groups of ≤18 years (n=157) , 19-44 years (n=3 099) , 45-59 years (n=4 848) , 60-74 years (n=6 270) and≥75 years (n=3 915) according to different ages. The relationship between Humidex of twenty-four solar terms and depression was estimated by using the combination of nonhomogeneous Poisson distribution and distributed-lag nonlinear model. Correlation between Humidex and meteorological variables was calculated using Pearson correlation analysis. Relative risk rates (RR) of Humidex and depression were calculated of twenty-four solar terms using median Humidex as control. Results A total of 18 289 patients with depression were included from 2016-10-08 to 2019-10-07, including 6 900 males and 11 389 females. The Lesser Cold solar term corresponded to the lowest average Humidex and highest number of depression patients, the Great Heat solar term corresponded corresponded to the highest average Humidex and lowest number of depression patients from 2016-10-08 to 2017-10-07. The Great Cold solar term corresponded to the lowest average Humidex and highest number of depression patients, the Great Heat solar term corresponded to the highest average Humidex and lowest number of depression patients from 2017-10-08 to 2018-10-07. The Great Cold solar term corresponded to the lowest average Humidex and highest number of depression patients, the Great Heat corresponded to the highest average Humidex and lowest number of depression patients from 2018-10-08 to 2019-10-07. Humidex in 24 solar terms showed a nonlinear relationship with the overall population risk of depression. The top two solar terms corresponding to Humidex of depression risk distribution for total population, male, female, ≤18 years, 19-44 years, 45-59 years, 60-74 years, and ≥75 years were the Great Cold and Beginning of Spring solar terms, Great Heat solar term corresponded to the lowest depression risk distribution. The maximum lag effect was observed on the 10th day of the Great Cold and Beginning of Spring solar terms (RR=1.020, 95%CI=1.001-1.040) , and the lag effect was observed on the 8th day of Great Heat solar term and lasted to the 9th day. The lag effect was observed on the 7th day after the Great Cold and Beginning of Spring and the maximum lag effect was observed on the 9th day (RR=1.054, 95%CI=1.007-1.104) , which lasted until the 11th day in the 60-74 years group. The lag effect was observed on the 1st day and 8th day after the Great Heat, and lasted to the 2nd day and 10th day, respectively, with the maximum lag effect on the 10th day (RR=0.952, 95%CI=0.911-0.994) in male depression patients. The lag effect was observed on the 8th day after the Great Heat solar term and lasted to the 9th day in the 60-74 years group. Conclusion Humidex in the Great Cold and Beginning of Spring solar terms are risk factors for depression. Clinically, accurate diagnosis and treatment should be provided for different depression patients according to Humidex in different solar terms, and individualized intervention programs should be formulated.

In 2020, the lockdown of Wuhan due to the outbreak of COVID-19 impacted various aspects of local college students' life and may further negatively affect their psychological state. This study was conducted among 652 Wuhan local college students during the quarantine of this city. We assessed their psychological state using Depression-Anxiety-Stress Scale 21 and evaluated their living condition including diet, schedule, recreational activities, social contact, academic life, and attention paid to pandemic news. Results showed that 16.87% of the students reported stress, 28.68% with anxiety, and 35.12% had depression. According to multivariate logistic regression analysis, having a medical background was associated with higher stress levels; students who had an irregular diet and schedule were more likely to develop stress, anxiety, and depression; students with their academic life affected had a higher prevalence of anxiety and depression. By studying local students in the hardest-hit area during the pandemic, our findings can provide references for the improvement of college students' mental health in the long term.

This study uses a cognitive diagnosis model (CDM) approach to investigate the associations among specific L2 reading subskills. Participants include 1,203 Year-4 English major college students randomly selected from the nationwide test takers of Band 8 of Test for English Majors (TEM8), a large-scale English proficiency test for senior English majors in China. Their English reading was measured using a reading comprehension subtest of the TEM8. Based on the CDM output on latent class size estimates, the chi-square test of independence was used to uncover the associations among reading subskills, and odds ratio estimation was used to determine the strengths of those associations. The CDM output on attribute mastery prevalence was used to establish the stochastic direction of the associations between reading subskills. The study has the following findings: a reading subskill network displaying significant subskill associations together with their strengths and directions can be established through a CDM approach, and the patterns of reading subskill associations based on cognitive levels and local/global comprehension resonate with major reading process models and reflect the hierarchical and compensatory characteristics of reading subskills.

Gratitude has mostly been explored in relation to well-being but whether it is associated with school-related outcomes such as motivation and engagement has seldom been explored. Motivation and engagement, however, are critical to students' academic success. Hence, the aim of this study was to examine how gratitude is associated with different types of academic motivation (amotivation, controlled motivation, and autonomous motivation) and engagement (cognitive, behavioural, and emotional). We recruited 1099 Chinese university students and asked them to answer questionnaires assessing their levels of gratitude, motivation, and engagement. Structural equation modelling revealed that gratitude was positively associated with controlled motivation, autonomous motivation, and academic engagement but negatively associated with amotivation. Autonomous motivation partially mediated the relationship between gratitude and academic engagement. The findings of this study elucidate the theoretical linkages among gratitude, motivation, and engagement, demonstrating the importance of gratitude for school-related outcomes.

Studies on utility value, metacognitive strategies, and achievement have usually examined these variables in a static manner. However, each of these variables changes across time and the relationships among them are dynamic. Hence, studies that examine changes in individual trajectories (change in each variable over time) and concurrent trajectories (how relationships among the variables change over time) are needed. The current study examined both the individual and concurrent trajectories of utility value, metacognitive strategies, and achievement using a three-wave longitudinal sample of 6,776 Hong Kong secondary students (Mean age at Time 1 = 13.23, SD = 1.06). Results of the latent growth models indicated that intrinsic utility value declined while achievement increased across three years. Multivariate latent growth modeling showed that students who started with higher levels of metacognitive strategy use experienced a slower decline in intrinsic utility value. Moreover, the faster metacognitive strategy use increased over the years, the slower intrinsic utility value declined and the faster achievement increased. This study suggests the importance of examining the dynamic relationships among motivation, strategy use, and achievement.

Formative assessment has been considered an essential concept for motivating and improving learning. However, implementing formative assessment has been confronted with challenges in Confucian-heritage culture (CHC) contexts such as Hong Kong and Shanghai, where the atmosphere of high-stakes tests dominates at policy and classroom levels. Whether formative assessment can lead to learning achievement in examination-oriented contexts remains an open issue. To unleash the potential benefits of formative assessment, CHC cities such as Hong Kong have been making great efforts to create conditions that can bring about the positive effect of formative assessment on learning achievement. To test this potential benefit of formative assessment in CHC contexts, the current study compared the impact of formative assessment on reading achievement in Hong Kong and Shanghai by including the mediation of motivation between formative assessment and achievement. Results of multi-group path analysis with the Programme for International Student Assessment (PISA) 2009 data showed: (a) a positive direct effect of formative assessment on achievement in Hong Kong and a negative direct effect in Shanghai, (b) a positive indirect effect through motivation both in Hong Kong and Shanghai, and (c) a total positive effect in both Hong Kong and Shanghai, but this total effect was more substantial in Hong Kong whereas trivial in Shanghai. The positive impact of formative assessment, particularly the relatively more significant total effect on the Hong Kong side, supports the potential of using formative assessment to enhance student learning in CHCs through local policy reform on assessment and teacher training on assessment literacy.

Research Findings: The study examined the latent profiles of approaches to learning (ATL) in Chinese preschoolers and the association of profile membership with their academic school readiness. A total of 235 preschoolers (M[subscript age] = 58.07 months, SD = 10.09 months) were sampled and evaluated with the School Readiness Composite (SRC) of the Bracken Basic Concept Scale-Revised, and early achievement tests in language and literacy and mathematics excepted from the East Asia-Pacific Early Child Development Scales (EAP-ECDS). The children's class teachers (N[subscript teacher] = 18) rated their ATL using a newly developed teacher-rating scale, and one of their parents (N[subscript parent] = 235) completed a survey questionnaire measuring family demographics. Results of latent profile analysis have yielded four latent profiles of ATL: the low group (27.66%), the positive group (20.85%), the middle of the road group (37.87%), and the social and persistent group (13.62%). The hierarchical regression analysis indicated that ATL profile membership was significantly related to academic school readiness, in terms of basic concept readiness and early language, literacy, and mathematics achievements. In addition, higher levels of ATL were associated with higher levels of academic school readiness. Policy and Practices: The findings highlighted the importance of ATL in young children, and positive ATL should be nurtured during the early years to promote their school readiness.

Background: The COVID-19 pandemic has brought unprecedented challenges to the world, creating significant impact on people's lives and subjective wellbeing. While previous studies have shown that students' wellbeing and how they manage their emotions are critical to students' learning, less research has considered their specific impacts on student engagement in online learning. Aims: The aim of this study is to examine how students' subjective wellbeing and emotion regulation strategies (viz cognitive reappraisal and expressive suppression) are associated with student engagement in online learning during the pandemic. Sample: A total of 965 students from a university in China participated in the study. Methods: The data were collected online during the COVID-19 from March to July 2020, which included measures of wellbeing, emotion regulation strategies, and online learning engagement. Results: Structural equation modelling results showed that wellbeing was positively associated with both the use of reappraisal and suppression. Moreover, mediation analysis showed that reappraisal partially mediated the relationship between wellbeing and all types of online learning engagement (including cognitive, emotional and behavioural engagements). Conversely, suppression was found to have a small mediating effect between wellbeing and behavioural engagement of online learning only. No such effect was found on cognitive and emotional engagements. Conclusions: The findings provide evidence on the positive relationship between wellbeing and both the strategies of suppression and reappraisal during the pandemic. However, only reappraisal has positive impact on learning, suggesting the importance of effective regulation strategies on students' online engagement. Theoretical and practical implications of the findings are discussed.

We investigated whether perceived teacher enjoyment of teaching predicted student achievement via students' enjoyment across Eastern and Western contexts. Data came from the Program for International Student Assessment (PISA) 2018 focusing on the reading domain. The respondents were 84,017 adolescents (51% girls) with a mean age of 15.17 years old from both the West (US, UK, Australia, and New Zealand) and the East (Mainland China, Hong Kong SAR, Macau SAR, Taipei, Singapore, Japan, and Korea). The results show that perceived teachers' teaching enjoyment and reading enjoyment predicted reading achievement in both the Western and Asian students. Perceived teacher enjoyment related to student enjoyment demonstrating emotional contagion, and the association between perceived teacher enjoyment and student achievement was mediated by student enjoyment. We did not find cross-cultural differences in the strength of emotional contagion demonstrating cross-cultural universality. Implications for education and cross-cultural research are discussed., Author(s): Qiuzhi Xie [sup.1] , Ronnel B. King [sup.2] , Yuyang Cai [sup.3] Author Affiliations: (1) grid.43519.3a, 0000 0001 2193 6666, Department of Curriculum and Instruction, United Arab Emirates University, [...]

Background: Socioeconomic status (SES) and motivation are both important predictors of student achievement. However, most studies have investigated these factors separately, and very few have looked into the interplay between SES and motivation as determinants of student reading achievement. Aims: We intend to bridge this gap by examining a model of SES predicting reading achievement through motivation (i.e., expectancy and value) at both student and school levels. Sample: We used the data from the Programme for International Student Assessment (PISA) 2018 of 26,281 students from four regions in Greater China (Mainland China, Hong Kong, Macau, and Taipei). Methods: We used multi-group multilevel path analysis to test whether SES would predict reading achievement mediated by expectancy and value in student and school levels across four regions, with gender as a covariate. Results: Results showed that at the student level, SES significantly predicted reading achievement indirectly through both expectancy and value across four regions. At the school level, the relationship between school SES and school reading achievement was mostly direct. Conclusion: The study was able to demonstrate the motivational gap as a pathway in which economic inequality can contribute to students' reading achievement gap.

This study investigated the relationship between formative assessment and reading achievement in Hong Kong, a Confucian Heritage Culture (CHC) society. 4,837 Hong Kong students were surveyed in a nine-item questionnaire that was used as indicator variable of formative assessment strategies. The study used multi-group structural equation modelling (MG-SEM) to examine the effects of formative assessment strategies on reading achievement across low-, medium-, and high-achievers controlling for gender and social economic status (SES) effects. The result showed that after controlling for SES and gender effects, there was significant effect of formative assessment strategies with low- and medium-reading achievers but not with high-reading achievers. Implications are drawn to inform formative assessment research and practice relevant to students' reading achievement in CHC societies and other educational contexts.

Thinking skills play a critical role in determining language performance. Recent advancement in cognitive diagnostic modelling (CDM) provides a powerful tool for obtaining fine-grained information regarding these thinking skills during reading. Studies are scant, however, exploring the relations between thinking skills and language performance, not to mention studies examining the variation of this association with language proficiency. The current study explored this variation through the lens of the Island Ridge Curve (IRC). Drawing on an English reading test data by 2,285 students, we identified five thinking skills using CDM. Next, we followed guidelines of IRC and put students into four language proficiency groups to examine the relations of each skill identified through reading tasks to language performance across groups. Results of multi-group path analysis showed the effect of each skill identified through reading test fluctuated in the pattern of the IRC. The potential of IRC for examining the moderation of language proficiency on language factors is discussed.

Reading strategy instruction is positively related to students' reading literacy. However, little is known about how reading instruction that emphasizes different types of reading strategies affects reading literacy. This study examined how Singapore primary school teachers' reading strategy instruction affected Grade Four students' reading literacy, and how reading strategy instruction was affected by teacher collaboration and other teacher characteristics. To control for possible effects of student characteristics on their reading literacy, we also included at the student level the students' gender and their socioeconomic status as represented by their parents' educational level. We used a multilevel structural equation modeling approach to analyze the Progress in International Reading Literacy Study 2016 (PIRLS 2016) data provided by 6,327 Singapore students nested within 356 teachers. At the teacher level, (1) teachers' instruction on reading strategies can be categorized into micro-level reading strategy instruction and macro-level reading strategy instruction; (2) only instruction on the macro-level of comprehension significantly affected students' reading literacy; and (3) teachers' reading strategy instruction was positively impacted by their collaboration with other teachers. At the student level, reading literacy was positively affected by the parents' educational level, the language the students used before starting school, and the students' gender (in favor of girls). The findings suggest that the relationship between reading strategy instruction and reading literacy is complex. To develop learners' reading literacy, teachers should emphasize both micro-level reading strategies and macro-level reading strategies in their reading instruction.

Background: Meta-analytic studies show that the benefits of the growth mindset on academic achievement are heterogenous. Past studies have explored how individual characteristics and proximal environmental factors could explain these variations, but the role of the broader sociocultural environment has seldom been explored. Aims: We investigated society-level social axioms to explain variations in growth mindset effects on achievement across cultures. We hypothesized that three society-level social axioms (social complexity, fate control, and reward for application) imply social norms that would either support or obstruct the growth mindset effect. Sample and methods: We conducted multilevel SEM with random slopes using data from 273,074 students nested within 39 countries/territories. Results: We found "weaker" growth mindset effects in societies with "stronger" social complexity beliefs; societies believing that there are multiple solutions to problems have social norms that obstruct the growth mindset effects on achievement. No moderating effects were found with other social axioms. Conclusion: Relevant cultural-level normative beliefs should be considered to better assess the relevance of the growth mindset construct.

Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19). We conducted a retrospective study of COVID-19 inpatients in Wuhan Pulmonary Hospital (Wuhan, China) from January 1 to February 29, 2020. The subjects were divided into four groups due to different treatment regimes. We used the Kaplan–Meier method to determine the cumulative rates of in-hospital death and the Cox proportional hazard model to calculate the risk factors and corresponding hazard ratios. A total of 185 patients were included in this study. The median age of the patients was 62 years, including 94 men and 91 women. Kaplan–Meier analysis demonstrated that mortality was higher in older patients, higher in men, and lower in the low-flow oxygen therapy group. Body mass index (BMI) had no influence on mortality, as well as high flow oxygen therapy, Lopinavir–ritonavir (LPV/r) therapy, and the interferon-alpha add LPV/r therapy. Cox proportional hazard regression confirmed that the low flow oxygen therapy was independent protective factor for in-hospital death after adjusting for age, gender, and BMI. In conclusion, the mortality was higher in older patients, higher in men, and lower in the low-flow oxygen therapy group. BMI had no influence on mortality, as well as high flow oxygen therapy, LPV/r therapy, and interferon-alpha add LPV/r therapy.

The purpose of the present study was to examine whether parents' utility value perceptions predicted their children's utility value perceptions, demonstrating social contagion effects. We also examined whether utility value would predict achievement. This is a cross-sectional study that utilized data from a subsample of adolescent students from the Program for International Student Assessment (PISA 2015), which focused on science learning and achievement from 18 regions. We performed multi-level structural equation modeling to analyze the data. Results revealed that parents' utility value perceptions predicted students' utility value perceptions, which, in turn, predicted science achievement. The findings of this study provide evidence of the social contagion of utility value perceptions from parents to their children and the critical role of utility value in predicting achievement across various regions/countries. Our study highlights the crucial role parents play in adolescents' motivational and learning outcomes and suggest parental involvement in programs toward enhancing adolescents' motivation and achievement.

Background: Expectancy-value theory posits that higher levels of utility-value yield better achievement outcomes. Much of the existing research on utility value has focused on the individual as the unit of analysis. Person-culture fit theory, however, suggests that it is also important to consider the fit between the person and the broader society one is embedded in. The greater the fit, the more optimal outcomes ensue. However, to our knowledge past studies have not examined utility value from a person-culture fit perspective. Aims: This study aimed to examine whether person-culture fit in utility value, defined as the match between the student's and the society's utility value perceptions, is associated with more optimal outcomes. More specifically, we examined: (1) how utility value predicted achievement; and (2) whether societal-level utility value changed the magnitude of the relationship between student-level utility value and achievement. Sample: We used the Programme for International Student Assessment (PISA) 2009 data provided by 502,261 15-year-old students from 73 countries/societies. Methods: Multilevel random-slopes structural equation modelling was used. Results: Across all societies, students with higher utility value had better achievement. Moreover, in societies where schooling is highly valued, students' utility value was a stronger predictor of achievement in reading, math, and science confirming our person-culture fit hypothesis. Conclusion: These findings signify the importance of person-culture fit in utility value. It also has important implications for motivation research by demonstrating the need to take the broader societal context into account and moving beyond an exclusive focus on the individual student as the unit of analysis.

ObjectiveTo explore the association between total iron， iron supplements， dietary total iron， heme iron intake and the risk of gestational diabetes mellitus（GDM）.MethodsA total of 668 pregnant women who gave birth in one hospital in Shanghai during January 2020 to July 2021 were included in a retrospective cohort study. Baseline characteristics and data of iron supplements in second trimester were collected through a questionnaire. A simplified dietary frequency questionnaire was used to quantify the food intake in second trimester. Total iron， iron supplements， dietary total iron， and heme iron intake was classified into groups by quintile and median. The association between iron intake from different sources and risk of GDM was determined using logistic regression analysis.ResultsAfter correction for age， family history of diabetes， overweight / obesity before pregnancy， hemoglobin（Hb）in first trimester， energy， carbohydrate energy， protein， and free sugar， it showed no association between total iron intake and risk of GDM （P>0.05）， while elevated risk of GDM among women with high iron supplements intake （OR=1.65； 95%CI： 1.14‒2.39）， and decreased risk of GDM among those with high dietary total iron intake （OR=0.53； 95%CI： 0.35‒0.81）. However， no association was found between heme iron intake and risk of GDM （P>0.05）.ConclusionHigh dietary total iron intake may be a protective factor， while high iron supplements may be a risk factor for GDM. It suggests that pregnant women should carefully choose high-dose iron-containing supplements in the absence of iron deficiency， as dietary iron intake should be the priority.

This study examined the profiles of L2 strategy use and their association with different types of L2 reading achievement. A total of 1491 college students responded to a strategy use questionnaire evaluating the efficiency of strategy use immediately after they took an English reading test. Results of latent profile analysis revealed: (1) there were three profiles of strategy users, namely, low-efficiency, moderate-efficiency, and high-efficiency strategy users; (2) higher strategy use profiles had a higher probability of belonging to higher levels of reading achievers; meanwhile (3) lower-efficiency strategy users displayed to a substantial extent the probability (albeit relatively small) of belonging to higher-level reading achievers and higher-strategy users also had probability of belonging to lower-level reading achievers. The study added value by focusing on the efficiency aspect of strategy use and by providing granular information regarding the uneven membership belongingness of different strategy users across different types of L2 readers.