The association analysis between fatigue and body composition loss in patients with nasopharyngeal carcinoma during radiotherapy: An observational longitudinal study.

PURPOSE: This study aimed to reveal the association of fatigue with weekly changes in the body composition in patients with nasopharyngeal carcinoma (NPC) and identified the independent strength. METHODS: Four body composition indexes and fatigue were assessed before treatment (T0, baseline) and once a week throughout radiotherapy (T1-T7). Generalized additive mixed models (GAMMs) were used to explore the trajectories and longitudinal relationships of fatigue and weekly changes in body composition. The marginal structural model (MSM) was used to control the effect of depression and anxiety. RESULTS: The trajectories of fatigue in 105 participants reached a peak in the fifth week, and changes in body composition started appearing from the second week. Four body composition indexes, weight, body mass index (BMI), body fat rate, and lean body weight loss weekly were positively associated with fatigue. High magnitude of effects was revealed when anxiety and depression were controlled as time-dependent confounders. The positive associations with fatigue were manifested in patients aged >53 years, those with senior high and above education, no drinking, >5000 Y/month of family inflow, ≥ stage III, or those receiving a dose of ≥70 Gy, ≥3 cycles of induced chemotherapy, and ≤1 cycle of concurrent chemotherapy. CONCLUSIONS: Loss of weight, BMI, body fat rate, and lean body weight could be used to independently evaluate the development of fatigue in patients with NPC during radiotherapy. Positive associations between fatigue and weekly body composition loss were found in patients with certain characteristics.

Could nutrition status predict fatigue one week before in patients with nasopharynx cancer undergoing radiotherapy?

BACKGROUND: Patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy experience significant fatigue, which is frequently underestimated due to the lack of objective indicators for its evaluation. This study aimed to explore the longitudinal association between fatigue and nutrition status 1 week in advance. METHODS: From January 2021 to June 2022, a total of 105 NPC patients who received intensity-modulated radiation therapy were enrolled in the observational longitudinal study. The significant outcomes, including the Piper Fatigue Scale-12 (PFS-12), the Scored Patient-Generated Subjective Global Assessment (PG-SGA), four body composition indices, and the Hospital Anxiety and Depression Scale (HADS), were assessed weekly from pre-treatment until the completion of radiotherapy (T0-T7) to explore their relationship. RESULTS: The trajectories of PFS-12 and all dimensions for 105 participants reached a peak during the fifth week. Sensory fatigue consistently received the highest scores (T0 = 1.60 ± 2.20, T5 = 6.15 ± 1.57), whereas behavior fatigue exhibited the fastest increase over time (T0 = 1.11 ± 1.86, T5 = 5.47 ± 1.70). Higher PG-SGA scores were found to be weakly explainable for aggravating fatigue (ß = 0.02 ~ 0.04). Unlike generalized additive mixed models, marginal structural models (MSM) produced larger effect values (ß = 0.12 ~ 0.21). Additionally, body composition indices showed weakly negative relationships with fatigue in MSMs one week in advance. CONCLUSIONS: The PG-SGA may be a more accurate predictor of future-week fatigue than individual body composition indicators, particularly when HADS is controlled for as a time-dependent confounder.

Association between Bisphenol A exposure and body composition parameters in children.

Background: Although there is evidence linking Bisphenol A (BPA) exposure to obesity, research examining its relationship with body composition parameters in young children is limited. Methods: A cross-sectional investigation was conducted on 200 preschool children aged between 4 and 6 years in Guangzhou, China. BPA exposure was assessed through urine samples using ultra-high performance liquid chromatography- tandem mass spectrometry, and body composition parameters were measured through bioelectrical impedance analysis (InBody770). Results: The median urinary BPA concentration was 0.556 µg/L (IQR: 0.301 - 1.031 µg/L) and creatinine-adjusted BPA concentration was 0.930 µg/g (IQR: 0.551 - 1.586 µg/g). BPA levels were significantly associated with body mass index (ß= 1.15; 95%CI: 0.47, 1.83), body fat mass (ß= 1.14; 95%CI: 0.39, 1.89), fat free mass (ß= 0.92; 95%CI: 0.26, 1.58), and percent body fat (ß= 3.44; 95%CI: 1.17, 5.71) after adjusting for potential confounding factors. Similarly, adjusted models with log10-transformed creatinine-adjusted BPA concentrations as a continuous variable showed similar trends. Positive linear associations were observed between quartiles of BPA concentrations and body composition parameters, with the highest coefficients in the fourth quartile. Conclusion: Our study provides further evidence of positive correlations between BPA exposure and body composition parameters in children aged 4 to 6 years. These findings highlight the potential health risks associated with obesity-related body composition parameters in young children. Further investigations are needed to confirm this association and explore the underlying mechanisms.

Investigation of Microplastics (≥10 µm) in Meconium by Fourier Transform Infrared Microspectroscopy.

Microplastics are prevalent emerging pollutants with widespread distribution in air, land and water. They have been detected in human stool, blood, lungs, and placentas. However, human fetal microplastic exposure remains largely under-studied. To assess fetal microplastic exposure, we investigated microplastics using 16 meconium samples. We used hydrogen peroxide (H2O2), nitric acid (HNO3) and a combination of Fenton's reagent and HNO3 pretreatment methods respectively to digest the meconium sample. We analyzed 16 pretreated meconium samples with an ultra-depth three-dimensional microscope and Fourier transform infrared microspectroscopy. The result showed that H2O2, HNO3 and Fenton's reagent combined with HNO3 pretreatment methods could not digest our meconium samples completely. Alternatively, we developed a novel approach with high digestion efficiency using petroleum ether and alcohol (4:1, v/v), HNO3 and H2O2. This pretreatment method had good recovery and non-destructive advantages. We found no microplastics (≥10 µm) in our meconium samples, indicating that microplastic pollution levels in the fetal living environment are miniscule. Different results between previous studies' and ours underscore that comprehensive and strict quality control are necessary for further studies on microplastic exposure using human bio-samples.

[Breast milk intake of Chinese infants aged 0-5 months in 2019-2021].

OBJECTIVE: To describe the breast milk intake of infants aged 0-5 months in China and its trends, and to analyze the effects of feeding mode, gender and regions on breast milk intake. METHODS: Data were extracted from Ministry of Science and Technology's basic resource survey project "China's 0-18-year-old children's nutrition and health system survey and application" project. Caregivers were face to face interviewed to collect the basic information of infants. Weighing method was used to measure 24 hourly breast milk intake of infants aged 0-5 months in China. The rank sum test was used to compare the differences in breast milk intake between groups, the Spearman rank sum test was used to analyze the trend of breast milk intake with increasing age, and the general linear regression model was used to analyze the effects of gender and region on breast milk intake. RESULTS: The mean breast milk intake of exclusively breastfed infants aged 0-5 months was 800.1 g/d, ranging from 696.4 to 937.7 g/d. Breast milk intake increased with age and remained stable at 5 months(ß=29.6, P=0.009). There was a statistically significant difference in breast milk intake among infants in different month age groups(χ~2=17.96, P=0.003). Infants aged 0-5 months who are exclusively breastfed were fed 8 times in 24 hours, the breast milk intake per each time is 103.4-152.5 g, the duration of each feeding is 20.4-24.6 min, and the breast milk intake per minute is 4.4-7.0 g. Except for 5 months of age, there was no gender difference in the 24-hour breast milk intake of exclusively breastfed infants aged 0 to 4 months(P>0.05). Except for 4-month-old exclusively breastfed infants, there was no regional differences in the breast milk intake of others(t=-4.25, P<0.001). In the mixed feeding group, breast milk + complementary feeding group and breast milk + formula powder + complementary feeding group, the breast milk intake of infants aged 0-5 months were 341.1-496.7 g, 239.1-742.7 g and 90.0-508.0 g, respectively. CONCLUSION: In 2019-2021, infants aged 0-5 months in China Breast milk intake increased with age, and remained stable at 5 months. The breast milk intake of infants aged 0-5 months in different regions or genders is similar except for individual months. The introduction of formula or complementary food directly affects the intake of breast milk in infants.

Gender-specific association between serum ferritin and neurodevelopment in infants aged 6 to 12 months.

Early iron deficiency has detrimental consequences on neurodevelopment; whether male and female infants are equally susceptible to the functional outcomes of iron deficiency is unclear. This study aimed to investigate the sex differences in the association between serum ferritin levels and neurodevelopment in infants. Data for this cross-sectional study were drawn from hospital information and early childhood development program service systems at Guangdong Women and Children's Hospital, Guangzhou, China. In total, 4579 infants aged 6-12 months were included from July 2018 to March 2020. Their neurodevelopment was assessed using the Children Neuropsychological and Behavior Scale-Revision 2016. Serum ferritin levels were measured by chemiluminescence assay. The association between serum ferritin levels and neurodevelopmental delay in each domain was estimated using logistic regression models adjusted for potential confounders. The mean concentration of serum ferritin was 35.56 ± 21.57 ng/mL. Serum ferritin levels were significantly higher in female than in male infants (P < 0.001). Iron deficiency (serum ferritin levels < 12 ng/mL) was significantly more prevalent in male than in female infants (P < 0.001). Linear regression revealed a positive association between serum ferritin levels and general quotient, gross motor, fine motor, language, and adaptive behavior in females. Iron deficiency was significantly associated with an increased risk of adaptive behavior delay in females (adjusted odds ratio (OR), 2.22; 95% confidence interval (CI): 1.17-4.20). Iron deficiency anemia was associated with an increased risk of developmental delay for general quotient (adjusted OR, 4.88; 95% CI: 1.74-13.65), fine motor (adjusted OR = 2.58, 95%: CI: 1.13-5.94) and adaptive behavior (adjusted OR, 3.38; 95% CI: 1.51-7.57) among females, but not in males. Associations between serum ferritin levels and neurodevelopment in infants aged 6-12 months were sex-related. Females with iron deficiency, especially those with iron-deficiency anemia, were more susceptible to neurodevelopmental delay than males.

[Association of beverages intake with myopia among 11-14-year-old Chinese children in 2019-2021].

OBJECTIVE: To describe beverages intake and its association with myopia among 11-14-year-old children in China. METHODS: Multi-stage stratified cluster random sampling was used and children aged 11 to 14 years were selected from 28 cities and rural areas in 14 provinces in China, and a total of 12 397 children were included in this study. Information including demographic characteristics, myopia status, dietary intake, physical activity, screen time, sleep duration were collected from questionnaire survey. RESULTS: During 2019-2021, the prevalence of myopia among children aged 11 to 14 in China was 45.0%. The median beverages intake was 42.7 g/d. Children who did not drink beverages and whose beverages intake was <150 g/d and ≥150 g/d accounted for 42.8%, 44.8% and 48.4%, respectively. Multivariate Logistic regression analysis showed that girls' beverages intake ≥150 g/d was still a risk factor for the prevalence of myopia after controlling for confounding factors such as age, area, physical activity, screen time, sleep duration and intake of sugary food(OR=1.24, 95%CI 1.08-1.42, P<0.05). Among children with myopia, mild myopia, moderate and above myopia accounted for 71.6% and 28.4% among boys and 73.8% and 26.3% among girls, respectively. There was no statistically significant regression between beverages intake and myopia in boys and girls regardless of whether confounding factors were adjusted(P >0.05). CONCLUSION: Children's beverages intake was generally common in China in 2019-2021. Children who consumed higher beverages were more likely to have myopia than that did not consume beverages.

Cluster Analysis and Discriminant Analysis for Determining Post-Earthquake Road Recovery Patterns.

The transport network in eastern Japan was severely damaged by the 2011 Tohoku earthquake. To understand the road recovery conditions after a large earthquake, a large amount of time is needed to collect information on the extent of the damage and road usage. In our previous study, we applied cluster analysis to analyze the data on driving vehicles in Fukushima prefecture to classify the road recovery conditions among municipalities within the first six months after the earthquake. However, the results of the cluster analysis and relevant factors affecting road recovery from that study were not validated. In this study, we proposed a framework for determining post-earthquake road recovery patterns and validated the cluster analysis results by using discriminant analysis and observing them on a map to identify their common characteristics. In addition, our analysis of objective data reflecting regional characteristics showed that the road recovery conditions were similar according to the topography and the importance of roads.

Correlation between vitamin D levels and bone metabolism in children with cow's milk allergy.

OBJECTIVE: Research is limited regarding biochemical markers of bone metabolism among children with cow's milk protein allergy (CMPA). We aimed to determine differences in vitamin D and bone metabolism markers between infants with CMPA and healthy infants and explore relationships between these in a cross-sectional study. METHODS: In total, we included 41 children diagnosed with CMPA and under systematic medical and nutritional care at our center, and 50 healthy children as a control group. We reviewed demographic and clinical characteristics and measured serum biomarkers. RESULTS: We found that serum 25-hydroxyvitamin D (25(OH)D) levels among infants in the CMPA group were significantly lower than those in the control group, and levels of bone-specific alkaline phosphatase (BALP), serum phosphorus, and serum calcitonin were reduced. Pearson correlation analysis showed that serum 25(OH)D concentrations in the CMPA group were negatively correlated with parathyroid hormone but not significantly correlated with calcitonin and BALP. Logistic regression showed that CMPA was a risk factor for vitamin D deficiency. CONCLUSIONS: Our study indicated that CMPA was associated with disturbances in bone metabolism. Levels of vitamin D in children with CMPA were lower than those in healthy children. CMPA was a risk factor for vitamin D deficiency.

Large retrospective cohort study of the association between maternal 25-hydroxyvitamin D status and birth weight of neonate.

BACKGROUND: The effect of maternal vitamin D levels on the birth weight of the offspring remains controversial, as the results are inconsistent between different populations. This large retrospective cohort study aimed to assess the relationship between maternal vitamin D levels and birth weight of neonates in southern China. METHODS: Serum samples were collected from 10,586 Chinese women at 13-27 weeks of pregnancy, and the 25-hydroxyvitamin D (25(OH)D) level of the participants was assessed. Using the INTERGROWTH-21st standards, the offspring were classified into three groups based on their gestational age and birth weight, which were small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). The differences in vitamin D levels among the different groups were compared, and their correlation with newborn birth weight was analyzed. RESULTS: The average maternal vitamin D concentration was 61.1 nmol/L. The 25(OH)D concentrations were 50-75 nmol/L, 25-50 nmol/L and below 25 nmol/L in 45.5%, 29.5%, and 1.6% of the participants, respectively. No significant differences were observed in the vitamin D levels between the three groups. With the increase in 25(OH)D levels, the risk of SGA and LGA tended to increase and decrease, respectively. AGA was not affected by the 25(OH)D levels. The results of the curve fitting and threshold effect analyses did not support the correlation between vitamin D levels and SGA or LGA. Based on the univariate prediction model and the model adjusted for risk factors, the area under the curve was extremely small. Thus, 25(OH)D levels are not an effective predictor of SGA and LGA. CONCLUSIONS: Low maternal vitamin D levels were not associated with SGA or LGA.

Second-trimester 25-hydroxyvitamin D status in pregnant women from southern China and risk of macrosomia: a large-scale retrospective cohort study.

PURPOSE: The association between maternal vitamin D concentrations and birth weight is controversial. We conducted a large-scale retrospective cohort study in southern China to explore this relationship. METHODS: From July 2017 to April 2019, we enrolled 10,586 pregnant women and measured serum vitamin D [via 25-hydroxyvitamin D, 25(OH)D] in the second trimester using electrochemiluminescence immunoassays. The association between macrosomia and 25(OH)D was analyzed using logistic regression and ROC curve. RESULTS: Average vitamin D concentration was 61.1 ± 20.2 nmol/L. Additionally, 31.1% participants had 25(OH)D concentrations <50.0 nmol/L, while 68.9% exhibited concentrations ≥50.0 nmol/L. Of the subjects, 3.2% of women delivered macrosomic infants (neonatal birth weight ≥4000 g) and 96.8% did not. The macrosomia group had lower vitamin D concentrations than the non-macrosomia group (59.5 ± 22.3 vs. 61.2 ± 20.1, p < .05). Approximately a third of each group had vitamin D < 50.0 nmol/L (non-macrosomia, 31.3%; macrosomia, 35.9%; p = .055). After adjusting for confounding variables, women with 25(OH)D ≥ 50.0 nmol/L had 24.3% lower macrosomia risk than women with 25(OH)D < 50.0 nmol/L (adjusted OR = 0.757, 95% CI = 0.599-0.956, p = .0193). The predictive accuracy of vitamin D concentrations for evaluating macrosomia risk was 0.667 area under the ROC curve. CONCLUSION: Maternal vitamin D levels are negatively correlated with macrosomia. Elevating vitamin D above 50.0 nmol/L may reduce macrosomia incidence.

A partially hydrolyzed formula with synbiotics supports adequate growth and is well tolerated in healthy, Chinese term infants: A double-blind, randomized controlled trial.

OBJECTIVES: The aim of this study was to evaluate growth and gastrointestinal tolerance in infants fed a partially hydrolyzed protein formula (pHF) with a synbiotic mixture of short-chain galacto-oligosaccharides and long-chain fructooligosaccharides (scGOS/lcFOS; 9:1) and Bifidobacterium breve M-16V (test formula) compared with an intact protein infant formula (IF) with scGOS/lcFOS (control formula). METHODS: This randomized, double-blind, controlled, multicenter trial enrolled healthy, fully formula-fed Chinese infants (≤44 d) who received either the test (n = 112) or control formula (n = 112) until 17 wk of age. Fully breastfed infants served as a reference (n = 60). Anthropometrics, gastrointestinal symptoms, and adverse events were assessed monthly. Primary outcome was weight gain in grams per day from baseline to 17 wk of age. RESULTS: Equivalence in daily weight gain (primary outcome) was demonstrated between the test and control groups (estimated mean difference [SE]: -0.36 [0.93] g/d, 90% confidence interval [CI], -1.90 to 1.18) as well as between each IF group and the breastfed reference group (test: 0.02 [1.05] g/d, 90% CI, -1.71 to 1.75; control: 0.36 [1.04] g/d, 90% CI, -1.35 to 2.08). There were no clinically relevant differences in gastrointestinal tolerance or adverse events between the formula groups. CONCLUSION: A pHF with synbiotics supports adequate growth and is well tolerated in healthy, term-born Chinese infants. Additionally, infant growth and gastrointestinal tolerance measures of both IF groups were comparable to the breastfed group and can be considered suitable and well tolerated for use.

Characterization and epitope prediction of phosphopyruvate hydratase from Penaeus monodon (black tiger shrimp).

Shellfish allergies constitute an important cause of food-induced anaphylactic reactions, which pose challenges to food safety and human health worldwide. In the present study, the specific IgE (sIgE) binding characteristics of different shrimp proteins of black tiger shrimp (Penaeus monodon) to the sera of eight shrimp-allergic patients from China were studied by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and nanoliquid chromatography time-of-flight mass spectrometry. According to the PLGS scores (>2000) and the sequence coverage (>40%), eight proteins with sIgE binding activity were identified, including myosin heavy chain type 1 (K4Q4N8), hemocyanin (G1AP69 and Q95V28), phosphopyruvate hydratase (O96656), arginine kinase (C7E3T4), tropomyosin (A1KYZ2), sarcoplasmic calcium binding protein (H7CHW2) and glyceraldehyde-3-phosphate dehydrogenase (A0A097BQP2). Among these eight proteins, phosphopyruvate hydratase was a prevalent IgE-binding protein among these Chinese patients with binding observed in 100% of sera. Moreover, 13 peptides were predicted as epitopes of phosphopyruvate hydratase. These new details help us to understand the crustacean IgE-binding proteins especially Penaeus monodon IgE-binding proteins, that would cause allergic reaction to Chinese patients. And our findings may provide essential information to improve allergy prevention and clinical treatment to shrimp allergy in China. PRACTICAL APPLICATION: This research may have diagnostic and therapeutic value for shrimp allergies in China.

Comparison of Gut Microbiota Between Infants with Atopic Dermatitis and Healthy Controls in Guangzhou, China.

PURPOSE: Evidence on the role of the gut microbiota in atopic dermatitis is inconsistent as human intestinal microbiota is influenced by geography. This cross-sectional study therefore aimed to compare differences in the gut microbiota of infants with atopic dermatitis and healthy infants in Guangzhou, China, by analyzing their stool. PATIENTS AND METHODS: The composition of the intestinal microbiota was analyzed from the stool samples of 20 infants with atopic dermatitis (AD group) and 25 healthy infants (non-AD group) (1-6 months old), using full-length 16S rRNA gene sequencing. The Wilcoxon test was used to analyze the relative abundance of bacteria by phylum, family, genus, and species between groups; microbial community richness and diversity were compared between the two groups. RESULTS: There were no significant differences in the microbial community richness and diversity between the two groups. At the phylum level, 11 bacterial phyla were found; most sequences belonged to one of the three dominant bacterial phyla - Firmicutes, Proteobacteria, and Bacteroidetes. The top 10 microbes at the phylum, family, and genus levels showed no significant changes in their composition within the gut microbiota between the AD and non-AD groups. A decrease in the ratio of the Streptococcus genus was found in atopic dermatitis group when compared with healthy controls (p=0.048). CONCLUSION: A decrease in the abundance of Streptococcus was found in children with AD. The role of Streptococcus in the development of AD needs to be confirmed in a large cohort study.

Iron Status in Relation to Low-Level Lead Exposure in a Large Population of Children Aged 0-5 Years.

There are limited data regarding low lead exposure and iron status in Chinese children. This study aimed to examine the association between low-level lead exposure and iron status in a large population of children aged 0-5 years. We reviewed the records of children aged 0-5 years who had blood lead, iron, ferritin, and hemoglobin measurements during 2014-2017 at the Guangdong Women and Children Hospital. We identified 17,486 children with a blood lead level < 100 µg/L. Multiple linear and logistic regression analyses were performed to estimate the associations between blood lead levels and blood iron, serum ferritin, and hemoglobin. The mean concentrations of blood lead, iron, ferritin, and hemoglobin were 31.50 µg/L, 7.50 mmol/L, 46.98 ng/mL, and 120.41 g/L, respectively. Adjusting for age and sex, blood lead was negatively correlated with iron (r = - 0.073, p < 0.05), ferritin (r = - 0.043, p < 0.05), and hemoglobin (r = - 0.047, p < 0.05). Compared with the 1st quintile of lead exposure, the 5th quintile of lead exposure was associated with a 0.146 mmol/L decrease in blood iron, a 4.678 ng/mL decrease in serum ferritin, and a 1.245 g/L decrease in hemoglobin. Adjusted odds ratios (95% confidence interval) for the 5th quintile of blood lead were 1.39 (1.25-1.55) for iron deficiency and 1.45 (1.26-1.67) for anemia, relative to the 1st quintile. Our study findings confirmed the previously established association of blood lead levels with decreasing iron status and extended previous findings to even low-level lead exposure in Chinese children.

Effect of Pandemic-Related Confinement on Vitamin D Status Among Children Aged 0-6 Years in Guangzhou, China: A Cross-Sectional Study.

PURPOSE: Pandemic-related confinement helps to contain the transmission of the novel coronavirus disease (COVID-19) but restricts children's exposure to sunlight, thereby possibly affecting their 25-hydroxyvitamin D [25(OH)D] levels. This study aimed to examine the effect of COVID-19 measures on 25(OH)D levels in children. PATIENTS AND METHODS: This study included children who underwent health checks between March 1 and June 30, 2020, and those over the equivalent period during 2017-2019 (N = 3600). Children's 25(OH)D levels and the proportion of children with vitamin D deficiency were compared between different observation periods. RESULTS: The mean serum 25(OH)D level was 84 ± 25nmol/L. The overall proportion of children with vitamin D deficiency (25(OH)D level <50 nmol/L) was 4.6%. Home confinement led to an increase in the proportion of children aged 3-6 years with vitamin D deficiency during March 1-June 30, 2020 compared with the same months in previous years, and the most noticeable increase was found in March 2020. In children aged 3-6 years, 25(OH)D levels were lower in 2020 (65 ± 17nmol/L) than during 2017-2019, and the proportion of those with vitamin D deficiency was higher in 2020 (19.0%) than in previous years. Among children aged 0.5-1 and 1-3 years, 25(OH)D levels were higher (97 ± 25 nmol/L, 91 ± 27 nmol/L), while the proportion of children with vitamin D deficiency was lower in 2020 (2.3%, 3.0%) than during 2017-2019. CONCLUSION: The 25(OH)D levels tended to decrease gradually with increasing age. Reduced sunlight exposure during confinement is associated with lower 25(OH)D levels among children aged 3-6 years. Therefore, vitamin D supplementation for children aged >3 years is recommended.

Associations Between Serum 25-Hydroxyvitamin D Levels and Thyroid Function Parameters in Previously Healthy Children Aged 6 to 24 Months.

PURPOSE: Vitamin D deficiency has been linked to overt thyroid diseases. Data on the effects of vitamin D status on thyroid function in children are less examined. The goal of the present study was to explore the association between serum 25-hydroxyvitamin D [25(OH)D] levels and thyroid function parameters in early childhood. PATIENTS AND METHODS: This was a cross-sectional study involving record-linkage of children's data of routine health check-ups for promoting early childhood development at Guangdong Women and Children's Hospital; 2869 children aged 6-24 months were included from January 2015 to May 2017. Serum 25(OH)D, thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels were measured using the electrochemiluminescence immunoassay. RESULTS: The study population had a mean serum 25(OH)D level of 79.7 ± 28.1 nmol/L and 12.5% vitamin D deficiency and 36.0% insufficiency rates. The rates of thyroid dysfunctions detected were 2.9% hypothyroidism, 4.2% subclinical hypothyroidism, 0.9% hyperthyroidism, and 1.7% subclinical hyperthyroidism among the previously healthy children aged 6 to 24 months. Serum 25(OH)D levels had no significant correlation with TSH (r = 0.022, P = 0.236), FT3 (r = 0.014, P = 0.440) and FT4 (r = -0.059, P = 0.056) levels. No significant difference in the levels of thyroid hormones was found between the different quartiles of 25(OH)D level. Vitamin D deficiency [25(OH)D < 50 nmol/L] was associated with hypothyroidism (adjusted odds ratio = 2.16, 95% confidence interval: 1.18-3.94) but not with subclinical hypothyroidism, hyperthyroidism, and subclinical hyperthyroidism. CONCLUSION: Vitamin D deficiency is slightly associated with hypothyroidism. No associations were found between serum 25(OH)D levels and thyroid-related measures (TSH, FT3, and FT4) in previously healthy children aged 6-24 months.

The Effects of Online Homeschooling on Children, Parents, and Teachers of Grades 1-9 During the COVID-19 Pandemic.

BACKGROUND Beginning in the 2020 spring semester, due to the COVID-19 pandemic, all school-age children in China were homeschooled via live/recorded broadcasts, online group communication, and software-based homework submission. This study assessed the effects of and proper preparation for this educational approach. MATERIAL AND METHODS The homeschooling behaviors and feelings of school-age children were assessed with 2010 online surveys obtained separately from students, parents, and teachers of grades 1-9 in 15 Chinese provinces. Answers were compared among low- (grades 1-3), middle- (grades 4-6), and high- (grades 7-9) grade groups. The chi-square test was used to identify significant differences between groups. RESULTS We found that 76% of the respondents thought the homeschooling style was acceptable. However, teachers were concerned that students' interest, focus, and academic performance would decline. Sixty-nine percent of the parents reported their children had more than 3 hours of daily screen time, and 82% of students had less than 2 hours of daily outdoor activity. Ninety-five percent of the parents were concerned about their children's eyesight. Additionally, 17.6% of the students were suspected to have emotional or behavioral problems according to the parent-rated Strengths and Difficulties Questionnaire (SDQ) results. The Self-Rating Anxiety Scale (SAS) results of parents and teachers showed higher levels of anxiety than usual. CONCLUSIONS Students should continue the going-to-school rhythm at home to cope with changes caused by the COVID-19 pandemic. Integrated grade-specific approaches are needed. Because long screen time and insufficient outdoor activities can severely affect children's eyesight, appropriate eye-protection measures should be implemented.

1,2-Dichloroethane induces cerebellum granular cell apoptosis via mitochondrial pathway in vitro and in vivo.

1,2-Dichloroethane (1,2-DCE) is a widely used chlorinated organic toxicant, but little is known about the cerebellar dysfunction induced by excessive exposure to it. To uncover 1,2-DCE-induced neurotoxicity in cerebellar granular cells (CGCs), and to investigate the underlying mechanisms, we explored this, both in vitro and in vivo. Our findings showed significant cell viability inhibition in human CGCs (HCGCs) treated with 1,2-DCE. Flow cytometry and mitochondrial membrane potential analyses discovered an increase in apoptotic-mediated cell death in HCGCs after 1,2-DCE treatment. This HCGC apoptosis was involved in the increases of protein expression in Cytochrome c, Caspase-3, Bad, Bim, transformation related protein 53, Caspase-8, tumor necrosis factor-α, and Survivin. Quantitative real-time PCR (qPCR) and western blot confirmed the increases in Cytochrome c, Caspase-3, cleaved Caspase-3, and Bad in HCGCs after 1,2-DCE treatment. Bax inhibitor peptide V5 rescued 1,2-DCE-induced HCGC apoptosis. Furthermore, 80 CD-1 male mice were exposed to 1,2-DCE by inhalation at 0, 100, 350, and 700 mg/m3 for 6 h/day for 4 weeks. An open field test found abnormal neurobehavioral changes in the mice exposed to 1,2-DCE. Histopathological examination showed significantly shrunken and hypereosinophilic cytoplasm with nuclear pyknosis in mouse CGCs from the 700 mg/m3 1,2-DCE group. TdT-mediated dUTP nick-end labeling assay verified significant increases in apoptotic positive cells in the mouse CGCs after 1,2-DCE exposure. We confirmed the increases in the expressions of Cytochrome c, Caspase-3, cleaved Caspase-3 and Bad in the mice exposed to 1,2-DCE. These findings suggest that 1,2-DCE exposure can induce CGC apoptosis and cerebellar dysfunction, at least in part, through mitochondrial pathway.

Using epidemiological data to identify needs for child-rearing support among Chinese parents: a cross-sectional survey of parents of children aged 6 to 35 months in 15 Chinese cities.

BACKGROUND: The quality of the family environment-in particular, the kind of parenting children receive in their early years-plays a critical role in influencing children's growth and development. To facilitate the development and delivery of appropriate parenting and family interventions for Chinese parents, this study explores the prevalence of the difficulties that may arise in the course of child-rearing, the associated sociodemographic factors and parents' help-seeking behavior. METHODS: A cross-sectional self-reporting survey was conducted with a sample of 2229 parents of children between 6 and 35 months of age. Using a stratified random-digit design, parents from 15 Chinese cities were surveyed to determine their child-rearing difficulties, support-seeking behavior and their preferences for service delivery. The sociodemographic factors that influenced major child-rearing difficulties were analyzed using bivariate and logistic analyses. RESULTS: The majority (87.5%) of Chinese parents of children aged 6-35 months reported experiencing child-rearing difficulties. Nearly one third (31.5%) of parents reported experiencing major difficulties. Feeding and sleep problems were most often reported. Regression analysis revealed that major child-rearing difficulties most often involved male children (OR = 1.35, 95% CI 1.11-1.64), single-child households (OR = 1.38, 95% CI 1.07-1.77), and households with financial problems (OR = 1.40, 95% CI 1.06-1.85). Just over one third of parents (33.44%) sought professional support, while 21.37% had attended a parenting course in the past year. Prefer ways of sourcing parental support included professional online platform (69.24%), self-help books (43.70%), face-to-face consultation (24.99%), and attending lectures (36.57%). CONCLUSIONS: Child-rearing difficulties are common among parents of children between 6 and 35 months of age in Chinese cities. The family with boys, single-child, financial problems, and father not joining in child-rearing may face the high risk to major child-rearing difficulties. The national initiative to provide more guidance and support for child-rearing difficulties is worthwhile, as is the development of online parenting programs.