The network structures of mental and behavioral problems among children and adolescents in China using propensity score matching: A comparison between one-child and multi-child families based on a nationwide survey.

BACKGROUND: Exploring networks of mental and behavioral problems in children and adolescents may identify differences between one-child and multi-child families. This study compared the network structures of mental and behavioral problems in children and adolescents in one-child families versus multi-child families based on a nationwide survey. METHODS: Propensity score matching (PSM) was used to match children and adolescents from one-child families with those from multi-child families. Mental and behavioral problems were assessed using the Achenbach's Child Behavior Checklist (CBCL) with eight syndromal subscales. In the network analysis, strength centrality index was used to estimate central symptoms, and case-dropping bootstrap method was used to assess network stability. RESULTS: The study included 39,648 children and adolescents (19,824 from one-child families and 19,824 from multi-child families). Children and adolescents from multi-child families exhibited different network structure and higher global strength compared to those from one-child families. In one-child families, the most central symptoms were "Social problems", "Anxious/depressed" and "Withdrawn/depressed", while in multi-child families, the most central symptoms were "Social problems", "Rule-breaking behavior" and "Anxious/depressed". CONCLUSION: Differences in mental and behavioral problems among children and adolescents between one-child and multi-child families were found. To address these problems, interventions targeting "Social problems" and "Anxious/depressed" symptoms should be developed for children and adolescents in both one-child and multi-child families, while other interventions targeting "Withdrawn/depressed" and "Rule-breaking behavior" symptoms could be useful for those in one-child and multi-child families, respectively.

Association of hypertension and depression with mortality: an exploratory study with interaction and mediation models.

BACKGROUND: The association of hypertension and depression with mortality has not been fully understood. We aimed to explore the possible independent or joint association of hypertension and depression with mortality. Their interaction effects on mortality and possible mediating role were also investigated. METHODS: Associations of hypertension, depression, and their interaction with all-cause and cardiovascular disease (CVD) mortality were evaluated using multivariate Cox proportional hazards regression models. The mediation analysis was conducted with a Sobel test. RESULTS: A total of 35152 participants were included in the final analysis. Hypertension and depression were independently associated with increased risk of all-cause and CVD mortality. The co-existence of hypertension and depression resulted in a 1.7-fold [95% confidence interval (CI): 1.3-2.1] increase in all-cause mortality and a 2.3-fold (95% CI: 1.4-3.7) increase in CVD mortality compared to those with neither of them. Hypertension and depression showed no significant multiplicative (P for interaction, 0.587) and additive interaction (P for relative excess risk of interaction, 0.243; P for Interaction on additive scale, 0.654) on all-cause mortality, as well as on CVD mortality. Depression did not mediate the relationship between hypertension and all-cause (Z=1.704, P=0.088) and CVD mortality (Z=1.547, P=0.122). Hypertension did not mediate the relationship between all-cause and CVD mortality as well. CONCLUSION: Hypertension and depression were related to all-cause and CVD mortality independently and the co-existence of them increased the risk of mortality. However, there is no interaction effect of them on mortality, and hypertension or depression did not mediate the association of each other with mortality.

The effects of health risk behaviors to excess mortality in the population with depression: A cohort study based on NHANES data.

BACKGROUND: The population with depression had a considerable excess mortality risk. This increased mortality may be attributed to the biological consequences of depression or the substantial prevalence of health risk behaviors (HRBs). This study aimed to quantify the combined effects of four major HRBs - smoking, excessive alcohol use, physical inactivity, and an unhealthy diet - on excess mortality among depressed individuals. METHODS: This study included 35,738 adults from the National Health and Nutrition Examination Survey 2005-06 to 2017-18, with mortality follow-up data censored through 2019. The standardized prevalence of HRBs was calculated for populations with and without depression. Poisson regression models were used to calculate the mortality rate ratio (MRR). Based on model adjusting for socio-demographic factors, the attenuation of MRR was determined after further adjustment for HRBs. RESULTS: A total of 3147 participants were identified as having depression. All HRBs showed a significantly higher prevalence among the population with depression. After adjusting for socio-demographic factors, depression was associated with 1.7 and 1.8 times higher all-cause and cardiovascular disease mortality rate, respectively. Further adjustment for all current HRBs resulted in a 21.9 % reduction in all-cause mortality rate and a 15.4 % decrease in cardiovascular disease mortality rate. LIMITATION: HRBs were reported at a single time point, and we are unable to demonstrate a causal effect. CONCLUSION: At least 1/5 of excess mortality for population with depression was attributable to HRBs. Efforts should be made to address HRBs among population with depression.

Enhancing soil redox dynamics: Comparative effects of Fe-modified biochar (N-Fe and S-Fe) on Fe oxide transformation and Cd immobilization.

Biochar and modified biochar have gained wide attention for Cd-contaminated soil remediation. This study investigates the effects of rape straw biochar (RSB), sulfur-iron modified biochar (S-FeBC), and nitrogen-iron modified biochar (N-FeBC) on soil Fe oxide transformation and Cd immobilization. The mediated electrochemical analysis results showed that Fe modification effectively enhanced the electron exchange capacity (EEC) of biochar. After 40 days of anaerobic incubation, compared to the treatment without biochar (CK), the concentrations of CaCl2-extractable Cd in N-FeBC, S-FeBC, and RSB treatments decreased by 79%, 53%, and 23%, respectively. Compared with S-FeBC, N-FeBC significantly decreased the soil Eh and increased soil pH within the first 15 days, which could be attributed to its higher EEC and alkalinity. There is a negative correlation between the concentration of CaCl2-extractable Cd and soil pH (p < 0.01). The sequential extraction results showed that both N-FeBC and S-FeBC promoted Cd transfer from acid-soluble to Fe/Mn oxides bound fraction (Fe/Mn-Cd). N-FeBC significantly increased the concentration of amorphous Fe oxides (amFeox) from 4.0 g kg-1 in day 1 to 4.6 g kg-1 in day 15 by promoting the NO3--reducing Fe(II) oxidation process, while S-FeBC significantly increased amFeox from 4.0 g kg-1 in day 15 to 4.8 g kg-1 in day 40 by promoting the Fe(II) recrystallization. There is a positive correlation between the concentration of amFeox and Fe/Mn-Cd (p < 0.01). The scanning electron microscopy analysis showed that Cd was bound to the amFeox coating on the surface of Fe-modified biochar. By acting as an electron shuttle, the active surface of Fe-modified biochar may serve as a hotspot for Fe transformation, which promotes amFeox formation and Cd immobilization. This study highlights the potential of Fe-modified biochar for the remediation of Cd-contaminated soils and provides valuable insights into the development of effective remediation approaches for Cd-contaminated soils.

Highly efficient adsorption of ciprofloxacin from aqueous solutions by waste cation exchange resin-based activated carbons: Performance, mechanism, and theoretical calculation.

This study focused on the preparation of a highly efficient activated carbon adsorbent from waste cation exchange resins through one-step carbonization to remove ciprofloxacin (CIP) from aqueous solutions. Scanning electron microscopy, X-ray diffraction, Fourier-transform infrared spectrometry, and X-ray photoelectron spectroscopy were used to characterize the physicochemical properties of the carbonized materials. The CIP removal efficiency, influencing factors, and adsorption mechanisms of CIP on the carbonized resins were investigated. Density functional theory (DFT) computations were performed to elucidate the adsorption mechanisms. The CIP removal reached 93 % when the adsorbent dosage was 300 mg/L at 25 °C. The adsorption capacity of the carbonized resins to CIP gradually decreased with an increasing pH from 3.0 to 7.0 and sharply declined with a pH from 7.0 to 11.0. The adsorption process better fitted by the pseudo second-order kinetic and Langmuir models, indicating that the interaction between CIP and the carbonized resins was monolayer adsorption. The maximum adsorption capacity fitted by the Langmuir model was 384.4 mg/g at 25 °C. Microstructural analysis showed that the adsorption of CIP on the carbonized resins was a joint effect of H-bonding, ion exchange, and graphite-N adsorption. Computational results signified the strong H-bonding and ion exchange interactions existed between CIP and carbonized resins. The high adsorption and reusability suggest that waste cation exchange resin-based activated carbons can be used as an effective and reusable adsorbent for removing CIP from aqueous solutions.

Comprehensive analysis of circRNA expression profile and circRNA-miRNA-mRNA network susceptibility to very early-onset schizophrenia.

To explore the potential role of circular RNAs (circRNAs) in children developing very early-onset schizophrenia (VEOS). Total RNA was extracted from the plasma samples of 10 VEOS patients and eight healthy controls. Expression profiles of circRNAs, micro RNAs (miRNAs), and messenger RNAs (mRNAs) were analyzed using RNA-seq. The interaction networks between miRNAs and targets were predicted using the miRanda tool. A differentially expressed circRNA-miRNA-mRNA (ceRNA) network was further constructed. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of the target mRNAs in the ceRNA network were performed to predict the potential functions of their host genes. The patient group and the control group were also compared on the regulatory patterns of circRNAs on mRNAs. 1934 circRNAs were identified from the samples and reported for the first time in schizophrenia. The circRNA expression levels were lower in the VEOS group than in the healthy control group, and 1889 circRNAs were expressed only in the control group. Differential expression analysis (i.e., log2fold change > 1.5, p 0.05) identified 235 circRNAs (1 up-regulated, 234 down-regulated), 11 miRNAs (7 up-regulated, 4 down-regulated), and 2,308 mRNAs (1906 up-regulated, 402 down-regulated) respectively. In VEOS, a ceRNA network with 10 down-regulated circRNA targets, 6 up-regulated miRNAs, and 47 down-regulated mRNAs was constructed. The target genes were involved in the membrane, the signal transduction, and the cytoskeleton and transport pathways. Finally, different expression correlation patterns of circRNA and mRNA in the network were observed between the patient group and the control group. The current research is the first to reveal the differentially expressed circRNAs in the plasma of VEOS patients. A circRNA-miRNA-mRNA network was also conducted in this study. It may be implied that the circRNAs in this network are potential diagnostic biomarkers for VEOS and they play an important role in the onset and development of VEOS symptoms.

The prevalence of SCT in China, its comorbidity with ADHD and its association with life events and parental-rearing behaviors.

Although sluggish cognitive tempo (SCT) symptoms are often observed in children with attention deficit hyperactivity disorder (ADHD), an increasing number of studies have highlighted its uniqueness. Nevertheless, no national survey on SCT among children and adolescents has been conducted in China. Hence, this research aims to study SCT in China and to evaluate the differences between SCT and ADHD symptoms by comparing their risk factors in terms of life events (LE) and parental rearing behaviors (PRB). This cross-sectional study used data from a survey on 71,929 children and adolescents in 5 province-level regions in China to study the incidence and demographic information of SCT in the Chinese population. Subsequently, the study investigated the comorbidity of ADHD and SCT, and conducted three logistic regressions on the LE and PRB scores to predict whether participants develop symptoms of ADHD or SCT, or neither symptom. 6658 participants were allocated into the SCT group, and the weighted point prevalence of SCT was 9.78%. 36.34% of participants with ADHD (n = 676) were found to demonstrate SCT symptoms, whereas no statistically significant difference was observed in its comorbidity to the three ADHD subtypes (χ2 = 1.668, p > 0.05, Δ = 2). The regression results on the presence or absence of ADHD revealed paternal excessive-interference and rejection, and maternal favoring were associated with ADHD diagnosis, whereas paternal punishment and favoring and maternal emotional warmth was related to the absence of ADHD symptoms. Academic stress and maternal excessive-interference were associated with SCT symptoms, and maternal emotional warmth associated with SCT absence. Concerning the presence of ADHD-only or SCT-only symptoms, LE adaptation was found to relate to SCT-only symptoms, while PRB paternal rejection and maternal favoring were associated with ADHD-only symptoms. While evidencing the high prevalence of SCT in China, our findings supported that although ADHD and SCT were highly comorbid, they may be considered two independent disorders with different risk factors. Specifically, participants with SCT symptoms are more vulnerable to stress from LE and tend to face more maladjustment than ADHD and normally-developing participants, and maternal rearing behaviours are the key factors to SCT symptoms. SCT brings global challenges in its diagnosis and treatment, and the challenge is more severe in a mentally stressful environment. Therefore, stress management and SCT etiology studies are recommended.

Meta-analysis of the efficacy of digital therapies in children with attention-deficit hyperactivity disorder.

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that commonly occurs in childhood. The aim of this meta-analysis was to summarize the available evidence for the efficacy of digital therapeutics in children and adolescents with ADHD. Methods: We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), and Web of Science (science and social science citation index) databases for relevant studies and used Stata 15.0 software to carry out the meta-analysis. Results: A total of 31 studies involving 2169 participants (1665 boys and 504 girls) aged 4-17 years old were included in the final analysis. The meta-analysis results showed that digital interventions improved the symptoms of inattention with an effect value of -0.20 (95% confidence interval [CI] -0.36, -0.04) and decreased the continuous performance task (CPT) reaction time (effect, -0.40, 95% CI -0.73, -0.07) in ADHD patients. The score for impulsive hyperactivity was slightly decreased (effect, -0.07, 95% CI -0.23, 0.09). Moreover, executive function was improved (effect, 0.71, 95% CI 0.37, 1.04). The capability of working memory appeared to be increased (effect, 0.48, 95% CI 0.21, 0.76) between the two groups. Visual appraisal of the sensitivity analysis suggested the absence of heterogeneity, and no obvious publication bias was detected. Discussion: Based on the existing literature evidence, we conclude that digital therapy can be a promising therapeutic strategy for ADHD patients.

Association between acrylamide exposure and the odds of developmental disabilities in children: A cross-sectional study.

Background: The association between acrylamide exposure and the odds of developmental disabilities (DDs) is unclear. We conducted this analysis to explore whether acrylamide exposure is related to DDs. Methods: We analyzed a sample of 1,140 children aged 6-17 years old from the US National Health and Nutrition Examination Survey 2013-2014 to 2015-2016. DDs were determined by reports of parents. Acrylamide exposure was evaluated by the hemoglobin adducts of acrylamide (HbAA) and its major metabolite glycidamide (HbGA). We investigated the association using binomial logistic regression analysis by taking HbAA and HbGA as continuous or quartile variables. Restricted cubic splines (RCS) were used to explore the non-linear relationship between HbAA or HbGA and the odds of DDs. Interaction analysis and propensity score matching (PSM) were used to validate the results. Results: A total of 134 participants were reported to have DDs. The median level of HbAA and HbGA was 41.6 and 40.5 pmol/g Hb, respectively. HbAA and HbGA were not associated with the odds of DDs when taken as continuous variables. When divided into quartiles, there was no evidence for a linear trend for HbAA and HbGA. RCS showed that there was a J-shaped association between HbGA and the odds of DDs (P for non-linearity, 0.023). The results were consistent in interaction analysis by age, gender, and race, and after PSM. Conclusion: HbGA level was associated with the odds of DDs in a J-shaped manner among children. Further investigation is warranted to determine the causality and underlying mechanisms.

The synergistic effect of depression and moderate chronic kidney disease on the all-cause and cardiovascular disease mortality among adults: a retrospective cohort study.

BACKGROUND: The relationship between the coexistence of depression and moderate chronic kidney disease (CKD) and mortality is unclear. We aimed to investigate whether there is a synergistic effect of depression and moderate CKD on the all-cause and cardiovascular disease (CVD) mortality among adults. METHODS: We studied 24,412 participants from the National Health and Nutrition Examination Survey 2005-2014 with a mortality follow-up assessment in 2015. Four groups were created based on depression and CKD status: Group 1, no depression and no CKD; Group 2, depression present and no CKD; Group 3: no depression and CKD present; Group 4: depression present and CKD present. Moderate CKD was defined as an estimated glomerular filtration rate of 15-59 mL/min/1.73 m2 (Stage 3-4) or one-time urine albumin-to-creatinine ratio ≥ 30 mg/g. Depression was defined as the 9-item Patient Health Questionnaire score of 10 or more. Cox proportional hazards regression models were used to calculate the multivariate-adjusted hazard ratios (HRs) of death for Group 4 with other groups. RESULTS: Over a mean follow-up of 5.8 years, 1783 deaths were documented, including 338 deaths from CVD. The HR for all-cause mortality in Group 4 was 3.62 (95% CI: 2.69-4.87), 2.99 (1.92-4.66), and 1.75 (1.29-2.37) when compared with Group 1, 2, and 3, respectively. The HR for CVD mortality in Group 4 was 3.89 (1.68-9.00), 1.90 (0.86-4.21), and 1.97 (1.17-3.32) when compared with Group 1, 2, and 3, respectively. CONCLUSIONS: There might be a synergistic effect of depression and moderate CKD on all-cause mortality. Moreover, depression might increase the risk of CVD mortality in individuals with moderate CKD.

Roll the Tape: Implementing and Harnessing the Power of Trauma Video Review.

Trauma video review (TVR) is a powerful technology with a rapidly expanding role in trauma performance improvement, education, and research. Video review is particularly well suited for evaluating elements not found in the medical record such as rapid changes in patient condition, medical decision making, resuscitation tempo, and team leadership. As such, TVR is an ideal tool for general surgery trainee education and as a means to evaluate multiple ACGME Core Competencies and entrustable professional activities. This article describes the development of a TVR program and the novel way in which we have integrated TVR into our resident trauma curriculum.

Exploration of Mutated Genes and Prediction of Potential Biomarkers for Childhood-Onset Schizophrenia Using an Integrated Bioinformatic Analysis.

Childhood-onset schizophrenia (COS) is an unusual severe neurodevelopmental disorder of unknown etiology. In this study, we aimed to survey the missense variants in new cases of COS and also identify possible pathology biomarkers for COS. We found one list of mutated genes such as TTN, MUC12, and MUC2, which are the candidates to be involved in the etiology of COS. Next, we used WGSNA to predict COS disease-related genes and identified differential DNA methylation among COS disease groups, COS dangerous groups, and normal groups and found eight methylation sites that can be used as the diagnostic biomarkers. A total of six key genes are obtained through the intersection analysis between weighted correlation network analysis (WGCNA) mode, methylation-related genes, and differentially expressed genes (DGenes). These genes may play important roles in the progression of COS and serve as the potential biomarkers for future diagnosis. Our results might help to design the molecule or gene-targeted drugs for COS.

Chemical Diversity and Potential Target Network of Woody Peony Flower Essential Oil from Eleven Representative Cultivars (Paeonia × suffruticosa Andr.).

Woody peony (Paeonia × suffruticosa Andr.) has many cultivars with genetic variances. The flower essential oil is valued in cosmetics and fragrances. This study was to investigate the chemical diversity of essential oils of eleven representative cultivars and their potential target network. Hydro-distillation afforded yields of 0.11-0.25%. Essential oils were analyzed by GC-MS and GC-FID which identified 105 compounds. Three clusters emerged from multivariate analysis, representative of phloroglucinol trimethyl ether ('Caihui'), citronellol ('Jingyu', 'Zhaofen' and 'Baiyuan Zhenghui') and mixed (the rest of the cultivars) chemotypes. 'Zhaofen' and 'Jingyu' also exhibited low levels of other rose-related compounds. The main components were subjected to a target network approach. Drug-likeness screening gave 20 compounds with predictive blood-brain barrier permeation. Compound target network identified six key compounds, namely nerol, citronellol, geraniol, geranic acid, cis-3-hexen-1-ol and 1-hexanol. Top enriched terms in GO, KEGG and DisGeNET were mostly related to the central nervous system (CNS). Protein-protein interactions revealed a core network of 14 targets, 11 of which were CNS-related (targets for antidepressants, analgesics, antipsychotics, anti-Alzheimer's and anti-Parkinson's agents). This work provides useful information on the production of woody peony essential oils with specific chemotypes and reveals their potential importance in aromatherapy for alternative treatment of CNS disorders.

Ecological risk assessment for organophosphate esters in the surface water from the Bohai Sea of China using multimodal species sensitivity distributions.

Organophosphate esters (OPEs) as the foremost substitutes of brominated flame retardants have been ubiquitously found in the aquatic environment around the world. However, the information on the community-level risks induced by OPEs to the marine ecosystem remains scarce. This study adopted ten commonly used species sensitivity distribution (SSD) parametric statistical approaches coupled with the acute-to-chronic transformation for the toxicity data to fit the sensitivity distributions of different species to four major OPE congeners including triethyl phosphate (TEP), tri-n-butyl phosphate (TnBP), tri(2-chloroethyl) phosphate (TCEP), and tris(1-chloro-2-propyl) phosphate (TCPP) in the surface water of the Bohai Sea. All SSD models except Exponential for TnBP, TCEP, and TCPP fitted well the chronic toxicity data for the four OPE congeners. Discrepancies appeared among the best fitting models for different congeners, which also happened to the fitting results from the multiple SSD models for each congener. Based on the best fitting models, the hazard concentrations corresponding to the cumulative probability of 5% were 3.58 mg/L, 0.116 mg/L, 1.30 mg/L, and 1.44 mg/L for TEP, TnBP, TCEP, and TCPP, respectively. The risks induced by the four OPE congeners to the Bohai Sea ecosystem were negligible during the monitoring period because of both the risk quotients and the hazard indexes far <0.1. This study drew a clear picture of the joint ecological risks of TEP, TnBP, TCEP, and TCPP to the Bohai Sea environment. The application of multimodal SSD statistical methods will benefit the accurate derivation of water quality criteria and the community-level ecological risk assessment for pollutants.

[Vehicle Air Pollutant Emission Inventory and Characterization in Henan Province from 2016 to 2019].

Based on the collected urban motor vehicle activity ownership and traffic flow of highways, combined with the mileage and source profiles of VOCs, using the emission factor method, we established high-resolution emission inventories from 2016 to 2019 for urban and 2016-based highway motor vehicles, respectively, in Henan Province, China. The results showed that gasoline vehicles, particularly minibuses and ordinary motorcycles, were the main contributors of CO, VOCs, and NH3, whereas heavy-duty and light-duty diesel trucks emitted SO2, NOx, and PM. Vehicles with China 1, China 3, and China 4 emission standards contributed significantly to pollutant emissions in the fleet. The temporal variation in traffic flow was consistent with the changes in freight and passenger traffic, with higher coefficients of variation for highways from August to October and the lowest in November. The weekly and daily changes in urban trunk roads showed distinct weekend effects and clear double-peak features, respectively. High-value emission areas were concentrated in urban centers with dense transport networks and high traffic volumes and on roads radiating outward from urban areas. The Lianhuo Expressway and the Beijing-Hong Kong-Macau Expressway were high-emission roads. Light-duty gasoline vehicles made the largest contribution to the ozone formation potential (OFP) of VOCs from motor vehicles. Five species, such as ethylene and propylene, contributed significantly to VOC emissions and OFP. The average annual growth rate of vehicle ownership from 2016 to 2019 was 5.7%. Compared with 2016, VOC emissions increased by 2.8% in 2019, whereas emissions of other pollutants showed decreasing trends of different degrees, with decreases of 76.3%, 51.7%, 50.3%, 43.1%, 16.7%, and 5.9% for SO2, PM2.5, PM10, NH3, CO, and NOx, respectively. The emission reduction percentage of each pollutant in 2019 under the control policies relative to the baseline scenario ranged from 15.6% to 82.4%.

Multi-exposure X-ray image fusion quality evaluation based on CSF and gradient amplitude similarity.

Due to the limitation of dynamic range of the imaging device, the fixed-voltage X-ray images often produce overexposed or underexposed regions. Some structure information of the composite steel component is lost. This problem can be solved by fusing the multi-exposure X-ray images taken by using different voltages in order to produce images with more detailed structures or information. Due to the lack of research on multi-exposure X-ray image fusion technology, there is no evaluation method specially for multi-exposure X-ray image fusion. For the multi-exposure X-ray fusion images obtained by different fusion algorithms may have problems such as the detail loss and structure disorder. To address these problems, this study proposes a new multi-exposure X-ray image fusion quality evaluation method based on contrast sensitivity function (CSF) and gradient amplitude similarity. First, with the idea of information fusion, multiple reference images are fused into a new reference image. Next, the gradient amplitude similarity between the new reference image and the test image is calculated. Then, the whole evaluation value can be obtained by weighting CSF. In the experiments of MEF Database, the SROCC of the proposed algorithm is about 0.8914, and the PLCC is about 0.9287, which shows that the proposed algorithm is more consistent with subjective perception in MEF Database. Thus, this study demonstrates a new objective evaluation method, which generates the results that are consistent with the subjective feelings of human eyes.

Comprehensive evaluation of organophosphate ester contamination in surface water and sediment of the Bohai Sea, China.

This study investigated the occurrence and profile of 14 organophosphate esters (OPEs) in surface water and sediment of the whole Bohai Sea. A total of 53 pairs of surface water and sediment samples were collected and the contained OPEs were quantified using a gas chromatography-mass spectrometry (GC-MS). The average concentrations of OPEs in surface water and sediment were in the range of 0-92.9 ng/L and 0.001-8.58 ng/g dry weight (dw), respectively, with tri (2-chloroethyl) phosphate (TCEP) as the predominant congener in both compartments. The total concentrations of 14 OPEs (∑14OPEs) in surface water and sediment were in the range of 10.9-516.4 ng/L and 1.42-52.9 ng/g dw, respectively. The inventories of ∑14OPEs were calculated to be 179.3 tons in the water and 101.5 tons in the sediment. Based on the risk quotients (RQs), the ecological risks of OPEs to the aquatic organisms in the Bohai Sea were considered to be negligible.

[Therapeutic effects of different drug regimens and metabolic markers in children with bipolar affective disorder: a comparative analysis].

OBJECTIVE: To study the changes in metabolic markers and clinical outcome after treatment with different drug regimens in children with bipolar affective disorder. METHODS: A retrospective analysis was performed on the medical data of 220 children with bipolar affective disorder who attended the hospital from January 2017 to January 2020. According to the treatment method, 112 children treated with atypical antipsychotic drugs alone were enrolled as the control group, and 108 children treated with atypical antipsychotic drugs combined with mood stabilizer were enrolled as the study group. The two groups were compared in terms of baseline data, changes in related metabolic markers[fasting insulin (FIN), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after treatment, incidence rate of metabolic syndrome, and clinical outcome. RESULTS: There were no significant differences in the baseline data including age, sex, and course of disease between the two groups (P > 0.05). The study group had a significantly higher overall response than the control group (92.6% vs 82.1%, P < 0.05). Before treatment, there were no significant differences in the levels of FIN and HbAlc between the two groups (P > 0.05). After treatment, the control group had a significant increase in the level of FIN and a significantly higher level of FIN than the study group (P < 0.05). The study group showed no significant change in the level of FIN after treatment (P > 0.05). There was no significant difference in the level of HbAlc between the two groups before and after treatment (P > 0.05). Before treatment, there were no significant differences in the levels of TC, TG, HDL-C, and LDL-C between the two groups (P > 0.05), and after treatment, the control group had significant increases in TC and TG and significantly higher levels of TC and TG than the study group (P < 0.05). The study group showed no significant changes in TC and TG after treatment (P > 0.05). There were no significant differences in the levels of HDL-C and LDL-C between the two groups before and after treatment (P > 0.05). The study group had a significantly lower incidence rate of metabolic syndrome than the control group (2.8% vs 9.8%, P < 0.05). CONCLUSIONS: Atypical antipsychotic drugs combined with mood stabilizer in the treatment of bipolar disorder in children have little effect on the level of metabolic markers, and the curative effect is significant.

Emotional and Behavioral Problems of Left-Behind Children in Impoverished Rural China: A Comparative Cross-Sectional Study of Fourth-Grade Children.

PURPOSE: Children who are left behind when their parents migrate for work have a high prevalence of emotional and behavioral problems, which affect social function and increase family burden. To date, no national survey has been conducted on the emotional and behavioral problems of left-behind children (LBC) in China. This study aimed to investigate the emotional and behavioral outcomes of primary school LBC in the fourth grade in impoverished rural China and the possible influences of family environment and parenting practices. METHODS: A cross-sectional study was carried out in 27 rural counties in the central and western parts of China from November 2016 to January 2017. The method of quota sampling was adopted to achieve a representative sample using postweighting adjustment. The survey sample was distributed proportionately across each county. LBC were defined as children aged <16 years who had two parents leave home to work or one parent leave home while the other lost the capacity to rear their children. The term "non-left-behind children" (NLBC) refers to children who have at least one parent who has not migrated for work. The Strengths and Difficulty Questionnaire (SDQ) was applied to measure children's emotional and behavioral problems. RESULTS: After the weighted calculations were performed, there were 1,147 LBC and 3,953 NLBC. The proportion of abnormal SDQ total scores (>17) was significantly higher in the LBC group than in the NLBC group (15.6% vs. 11.6%; p < .01). Binary regression analysis showed that high levels of insomnia (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.04-2.27), loneliness (OR 1.65, 95% CI 1.13-2.43), and self-harm (OR 1.92, 95% CI 1.17-3.16) may increase the risk of abnormal SDQ total scores in LBC. CONCLUSIONS: LBC showed a higher prevalence of abnormal SDQ total scores than NLBC. Insomnia, loneliness, and self-harm behavior were associated with abnormal SDQ total scores in LBC.

Comparison of receptor models for source identification of organophosphate esters in major inflow rivers to the Bohai Sea, China.

A better understanding of the sources of organophosphate esters (OPEs) is a prerequisite for OPE control and the establishment of related environmental policies. Sources of OPEs in 35 major inflow rivers to the Bohai Sea of China were quantitatively analyzed using three effective receptor models (principal component analysis-multiple linear regression (PCA-MLR), positive matrix factorization (PMF), and Unmix) in this paper. The similarities and differences in results from PCA-MLR, PMF, and Unmix were discussed in depth. All three models well predicted the spatial variability of the total concentrations of nine OPEs (triethyl phosphate, tri-n-butyl phosphate, triisobutyl phosphate, tri (2-ethylhexyl) phosphate, tri (2-chloroethyl) phosphate, tris(1-chloro-2-propyl) phosphate, tris(1,3-dichloro-2-propyl) phosphate, triphenyl phosphate, and triphenylphosphine oxide) (∑9OPEs) (r2 = 0.90-0.96, p = 0.000) and explained 98.4%-101.2% of the observed ∑9OPEs. The predicted ∑9OPEs values from each pairwise model were significantly correlated (r2 = 0.88-0.91, p = 0.000). Three OPE sources were extracted by all three models: rigid and flexible polyurethane foam/coating, cellulosic/acrylic/vinyl polymer/unsaturated polyester, and polyvinyl chloride, contributing 49.9%, 29.7%, and 20.5% by PCA-MLR, 57.9%, 28.6%, and 13.5% by PMF, and 47.9%, 30.8%, and 22.4% by Unmix to the ∑9OPEs, respectively. PMF was recommended as the preferred receptor model for analyzing OPE sources in water during the monitoring period because of its optimal performance.