School climate and left-behind children's achievement motivation: The mediating role of learning adaptability and the moderating role of teacher support.

School climate has been reported to have an important impact on children's achievement motivation, but the mechanism for the impact of school climate on left-behind children has not been fully explored. The purpose of this study is to investigate the roles of left-behind children's learning adaptability and teacher support in mediating and moderating the relationship between school climate and achievement motivation. In this study, 1,417 left-behind children were surveyed. The results showed that: (1) after controlling for gender and age, the school climate still had a positive effect on the achievement motivation of left-behind children (c' = 0.177, p < 0.001). (2) School climate perceived by left-behind children directly predicted their achievement motivation, and indirectly through their learning adaptability (a1 = 0.338, p < 0.001; b = 0.341, p < 0.001). In other words, left-behind children's learning adaptability may play an intermediary role between school climate and achievement motivation. (3) The indirect effect of school climate on achievement motivation through learning adaptability was moderated by teacher support (a2 = 0.153, p < 0.001), and this indirect effect was more significant for left-behind children who perceived high teacher support. The research reveals the importance of school climate and teacher support to the growth and development of left-behind children, thus holding theoretical significance for improving the achievement motivation of left-behind children.

Anti-N-methyl-D-aspartate receptor encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types: A case report and brief literature review.

RATIONALE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder that is most frequently induced by ovarian teratoma in young females. The condition can be controlled and reversed via ovarian tumor resection and immunotherapy. However, anti-NMDAR encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types is rarely reported in the literature. PATIENT CONCERNS: A 23-year-old woman presented with seizures. DIAGNOSES: The diagnosis was anti-NMDAR encephalitis associated with ovarian teratomas based on positive anti-NMDAR antibody tests in both the cerebrospinal fluid and serum, and the detection of bilateral ovarian lesions on pelvic computed tomography. The postoperative histopathologic examination confirmed that the left lesion was an immature teratoma, and the right lesion was a mature teratoma. INTERVENTIONS: We performed surgical resection of the ovarian teratomas and administered immunotherapy for the control of anti-NMDAR encephalitis. Chemotherapy was administered for the immature teratoma. OUTCOMES: The patient recovered without any postoperative complications. She has been confirmed to be in complete clinical remission, and has not had a recurrence during 18 months of follow-up. LESSONS: Anti-NMDAR encephalitis induced by bilateral ovarian teratomas of differing histopathologic types (1 immature and 1 mature) is rare. Early diagnosis and treatment with tumor resection, immunotherapy, and chemotherapy are critical for a good prognosis.

Prevalence of metabolic syndrome in Mainland China: a meta-analysis of published studies.

BACKGROUND: Metabolic syndrome (MS) comprises a set of conditions that are risk factors for cardiovascular diseases and diabetes. Numerous epidemiological studies on MS have been conducted, but there has not been a systematic analysis of the prevalence of MS in the Chinese population. Therefore, the aim of this study was to estimate the pooled prevalence of MS among subjects in Mainland China. METHODS: We performed a systematic review by searching both English and Chinese literature databases. Random or fixed effects models were used to summarize the prevalence of MS according to statistical tests for heterogeneity. Subgroup, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using Egger's test. RESULTS: Thirty-five papers were included in the meta-analysis, with a total population of 226,653 Chinese subjects. Among subjects aged 15 years and older, the pooled prevalence was 24.5% (95% CI: 22.0-26.9%). By sex, the prevalences were 19.2% (95% CI: 16.9-21.6%) in males and 27.0% (95% CI: 23.5-30.5%) in females. The pooled prevalence of MS increased with age (15-39 years: 13.9%; 40-59 years: 26.4%; and 60 years: 32.4%). Individuals living in urban areas (24.9%, 95% CI: 18.5-31.3%) were more likely to suffer from MS than those living in rural areas (19.2%, 95% CI: 14.8-23.7%). Hypertension was the most prevalent component of MS in males (52.8%), while the most prevalent component of MS for females was central obesity (46.1%). CONCLUSIONS: Our systematic review suggested a high prevalence of MS among subjects in Mainland China, indicating that MS is a serious public health problem. Therefore, more attention should be paid to the prevention and control of MS.

The optimal velocity criterion in the diagnosis of unilateral middle cerebral artery stenosis by transcranial Doppler.

We evaluated the optimal flow velocity of transcranial doppler (TCD) in detecting unilateral middle cerebral artery (MCA) stenosis and stenosis grading by magnetic resonance angiography (MRA) as the reference standard. 302 nonconsecutive patients with unilateral MCA stenosis detected by TCD underwent MRA of the intracranial arteries. The peak systolic velocity (PSV), mean flow velocity (MFV), and end-diastolic velocity (EDV) of each MCA were recorded. 604 MCA were categorized into four groups depending on the stenosis severity: normal MCA (n = 319, 52.8%), mild stenosis (n = 94, 15.6%), moderate stenosis (n = 66, 10.9%), and severe stenosis (n = 125, 20.7%). Significant differences in PSV, MFV, and EDV between these four groups were observed (P < 0.001, respectively). The optimal cutoff velocities for detecting MCA stenosis were: PSV = 160 cm/s, MFV = 100 cm/s, EDV = 60 cm/s; the optimal cutoff points to distinguish mild from moderate stenosis were: PSV = 200 cm/s, MFV = 120 cm/s, EDV = 80 cm/s; the cutoffs to distinguish moderate from severe stenosis were: PSV = 280 cm/s, MFV = 180 cm/s, EDV = 110 cm/s. Using PSV as the diagnostic criteria, the correlation for diagnosing MCA stenosis using TCD and MCA was good (Kappa number κ = 0.668); using as MFV criteria, κ = 0.641. The optimal cutoff PSV values in stenosis grading on TCD were 160, 200, and 280 cm/s. The optimal cutoff MFV values were 100, 120, and 180 cm/s. PSV is more accurate than MFV in detecting and grading MCA stenosis.