2-week prevalence and associated factors of fever, diarrhea, and coexisting fever and diarrhea among children aged 6-23 months in rural Hunan Province.

Fever and diarrhea are key causes of malnutrition, growth and development disorders, and death among children. At present, most studies on the associated factors of fever and diarrhea in children are concentrated in African and South Asian countries, but relevant research in China is very limited. This study was aimed to analyze the two-week prevalence of fever, diarrhea, and coexisting fever and diarrhea among children aged 6-23 months in rural areas of Hunan Province and to explore the associated factors. The survey data of the Nutrition Improvement Program for Children in Poor Areas (NIPCPA) from 2016 to 2023 was used here. NIPCPA is a cross-sectional survey completed annually in Hunan to collect children's nutrition and health indicators. The two-week prevalence rates of fever, diarrhea, and coexisting fever and diarrhea among children aged 6-23 months were 12.2% (2066/16,985), 9.6% (1634/16,985), and 3.2% (542/16,985), respectively. Multivariate logistic regression analysis showed the risks of fever, diarrhea, and coexisting fever and diarrhea were higher among younger children. The high educational level of caregivers, effective consumption of Yingyangbao (a complementary food supplement containing iron, zinc, calcium, vitamins A, D, B1, B2, B12, folic acid, and other micronutrients), and complementary feeding meeting minimum dietary diversity and meeting minimum acceptable diet were protective factors against fever in children, with adjusted odds ratios (aORs) of 0.87 (95%CI: 0.78-0.98), 0.78 (0.69-0.87), 0.73 (0.65-0.82), and 0.74 (0.66-0.84), respectively. Effective consumption of Yingyangbao, and complementary feeding meeting the minimum dietary diversity and meeting minimum acceptable diet were protective factors against diarrhea in children, with aORs of 0.72 (95%CI: 0.63-0.83), 0.79 (0.70-0.91), and 0.80 (0.70-0.92), respectively. Effective consumption of Yingyangbao, and complementary feeding meeting the minimum dietary diversity and meeting minimum acceptable diet were protective factors against coexisting fever and diarrhea among children, with aORs of 0.53 (95%CI: 0.43-0.66), 0.71 (0.58-0.89), and 0.70 (0.56-0.88), respectively. Fever, diarrhea, and the coexisting fever and diarrhea affect one in eight, one in ten, and one in thirty children respectively in rural areas of Hunan. Effective interventions should be actively taken, such as improving the education level of caregivers, enhancing their scientific feeding skills for children, and promoting children's compliance with Yingyangbao consumption, to further reduce the prevalence of fever and diarrhea in children.

A Framework for Single-Panicle Litchi Flower Counting by Regression with Multitask Learning.

The number of flowers is essential for evaluating the growth status of litchi trees and enables researchers to estimate flowering rates and conduct various phenotypic studies, particularly focusing on the information of individual panicles. However, manual counting remains the primary method for quantifying flowers, and there has been insufficient emphasis on the advancement of reliable deep learning methods for estimation and their integration into research. Furthermore, the current density map-based methods are susceptible to background interference. To tackle the challenges of accurately quantifying small and dense male litchi flowers, a framework counting the flowers in panicles is proposed. Firstly, an existing effective algorithm YOLACT++ is utilized to segment individual panicles from images. Secondly, a novel algorithm FlowerNet based on density map regression is proposed to accurately count flowers in each panicle. By employing a multitask learning approach, FlowerNet effectively captures both foreground and background information, thereby overcoming interference from non-target areas during pixel-level regression tasks. It achieves a mean absolute error of 47.71 and a root mean squared error of 61.78 on the flower dataset constructed. Additionally, a regression equation is established using a dataset of inflorescences to examine the application of the algorithm for flower counting. It captures the relationship between the predicted number of flowers by FlowerNet and the manually counted number, resulting in a determination coefficient (R2) of 0.81. The proposed algorithm shows promise for automated estimation of litchi flowering quantity and can serve as a valuable reference for litchi orchard management during flowering period.

Mineral Chemistry and Chronology Investigation of Uraninite in the Jinguanchong Uranium Deposit in Eastern Hunan Province and the Implications for Geological Significance.

Jinguanchong deposit, a part of the Mingyuefeng ore field in eastern Hunan Province, China, is a typical perigranitic uranium deposit (a subtype of granite-related deposit) discovered recently with considerable uranium mineralization. Herein, uraninite, the primary ore mineral in the deposit, was investigated via scanning electron microscopy and electron probe microanalysis. Additionally, laser ablation-inductively coupled plasma-mass spectrometry was used for the first time to determine the in situ U-Pb age and the rare-earth element characteristics of uraninite. Uraninite mainly comprises UO2, CaO, and PbO with a low ThO2 content. Uraninite exhibits a low total content of rare-earth elements with a distinct fractionation between light and heavy rare-earth elements while displaying a negative Eu anomaly. The presence of major elements and rare-earth elements in uraninite suggests its formation within a hydrothermal environment at moderate to low temperatures below 350 °C, thereby classifying the Jinguanchong deposit as a typical hydrothermal vein-type uranium deposit. The uranium metallogenic age is determined to be 93.8 ± 1.4 Ma, falling within the midlate Cretaceous period. This age corresponds to the Mesozoic lithospheric extension and thinning events (approximately 85-95 Ma) in South China, suggesting that the formation of the Jinguanchong uranium deposit might be associated with the tectonic dynamics of lithospheric extension and thinning.

Nocardioides jiangxiensis sp. nov., a novel actinobacterium isolated from lakeside soil, exhibiting the biosynthesis potential of mycofactocin.

A Gram-stain-positive, rod-shaped, non-spore-forming and non-motile bacterium, designated WY-20T, was isolated from a lakeside soil sample collected in Jiangxi Province, PR China. Growth was observed at 20-42 °C (optimum 30 °C), pH 5.0-8.0 (optimum pH 7.0) and salinity of 0-3.0% (w/v; optimum 0.5%). Phylogenetic analysis based on the 16S rRNA gene sequences indicated that strain WY-20T belongs to the genus Nocardioides and showed the highest sequence similarity (98.1%) to N. phosphati WYH11-7T, followed by N. cavernaquae K1W22B-1T (97.8%), N. marmoriterrae JOS5-1T (97.2%) and N. jensenii NBRC 14755T (97.1%). The average nucleotide identity and digital DNA-DNA hybridization values between strains WY-20T and N. phosphati WYH11-7T were 83.5% and 26.2%, respectively. The predominant fatty acids (≥ 10% of the total fatty acids) were C18:1ω9c, C17:0, C16:0, summed feature 8 (C18:1ω7c and/or C18: 1ω6c) and C17:1ω9c. The major menaquinone was MK-8 (H4). The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol and two unidentified phospholipids. In addition, meso-diaminopimelic acid was the diagnostic diamino acid in the cell-wall peptidoglycan. Based on phenotypic, genotypic and phylogenetic pieces of evidence, strain WY-20T represents a novel species in the genus Nocardioides, for which the name Nocardioides jiangxiensis sp. nov. is proposed. The type strain is WY-20T (= GDMCC 4.317T = KACC 23379T).

Provenance and Tectonic Setting of the Lower Cretaceous Huanhe Formation in the Northwestern Ordos Basin and Its Implications for Uranium Mineralization.

The Ordos Basin is an important sandstone-type uranium enrichment region in China, and the Lower Cretaceous Huanhe Formation has attracted significant attention as a newly discovered ore-bearing stratum. To elucidate the provenance, tectonic background, and sedimentary environment constraints on uranium enrichment in the Huanhe Formation sandstone-type uranium deposits, 10 representative sandstone samples from the study area were analyzed by using electron microscopy, X-ray fluorescence (XRF), inductively coupled plasma mass spectrometry (ICP-MS), and electron probe microanalysis. Independent uranium minerals in the Yihewusu area of Hangjin Banner were shown for the first time to be composed mainly of coffinite and titanium-uranium oxide, with trace amounts of pitchblende. The major element diagrams of the sandstone and ratios of Sr/Ba, V/Cr, and U/Th and enrichment factors of Mo and U revealed that the source rocks of the Huanhe Formation sandstone in the study area were intermediate-felsic igneous rocks. The tectonic setting is characterized as an active continental margin, with later deposition in brackish-to-marine water environments. The ore-bearing strata indicate a reducing environment, whereas the nonore-bearing strata indicate a weakly oxidizing environment. With reference to previous studies, the sedimentary material primarily originated from the medium-acidic intrusive rocks exposed in the northern portion of the basin, including the Daqing-Wula Mountains, the Yin Mountains, and middle-acidic intrusions along the eastern margin of the Alxa region in the western part of the basin. The uranium-rich granitic pluton of the source area contributed to the preenrichment of uranium in the target sandstone layer. Under oxidizing aqueous conditions, U6+ migration was activated, whereas under reducing aqueous conditions, U6+ was reduced to U4+, resulting in eventual sedimentation of coffinite as ore.

[Association between infant and young child feeding indicators and the nutritional status of children aged 6-23 months in rural areas of Hunan Province in 2019].

OBJECTIVE: To estimate the status of complementary feeding among infants and young children aged 6-23 months in rural areas of Hunan Province. The association between infant and young child feeding indicators and child undernutrition were assessed. METHODS: A total of 1220 infants and young children aged 6-23 months from 24 investigated places of 6 cities in Hunan Province were selected by multi-stage stratified sampling for physical measurement, hemoglobin(Hb) test and caregiver interview. Complementary diet was analyzed according to the World Health Organization's definition of infant and young child feeding indicators. Z-scores were used to elevate nutrition status. Logistic regression models were used to explore the influencing factors of the nutritional status. RESULTS: The prevalence rates of underweight, stunting, wasting, overweight, obesity and anemia were 3.6%, 4.8%, 2.7%, 10.5%, 2.0% and 16.3%. The percentage of infants and young children aged 6-23 months in rural areas of Hunan Province who get minimum dietary diversity, minimum meal frequency, and minimum acceptable diet was 43.3%, 68.5% and 28.1%. None of the individual infant and young child feeding indicators showed significant association with undernutrition, except minimum meal frequency for obesity and anemia. CONCLUSION: The nutritional status of infants and young children in rural areas of Hunan Province has improved, but the anemia problem is still serious. Complementary feeding frequency is closely associated with anemia for infants and young children.

[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.

Efficacy and safety of Yinchenwuling Powder for nonalcoholic fatty liver disease: A protocol for systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Owing to the complexity of NAFLD pathogenesis, there is still no specific medication for NAFLD that is safe and effective. Yinchenwuling Powder (YCWLP), a classic Chinese formula, has been widely applied to NAFLD and its efficacy has been proven in numerous studies. However, systematic evaluation of the efficacy and safety of YCWLP for NAFLD is still lacking. METHODS: We will search 8 databases to collect randomized controlled trials of patients with NAFLD treated in the YCWLP from the database inception to September 30, 2022. Two researchers will independently perform the selection of studies, data extraction, and assessment of the risk of bias. The Cochrane Review Manager (RevMan5.4) software will be used for data synthesis and analysis. RESULTS: Comprehensive evidence of YCWLP for the treatment of NAFLD will be provided in this study. CONCLUSION: The efficacy and safety of YCWLP in treating NAFLD will be proved, providing feasible and effective clinical recommendations for the treatment of NAFLD.

Numerical and experimental study on the relationship between pull-out force and indentation depth of aviation wire crimp terminal.

To study the numerical relationship between the pull-out force and indentation depth of aviation wire crimp terminal, the crimping process between electrical contacts and stranded conductors and the tensile process of crimping assembly were simulated by the explicit dynamic finite element method. Regarding the variation trend of the tension of the crimping assembly with the tensile displacement during the tensile process and the failure mode, the numerical results and the experimental results showed a high degree of fit, and the relative error of the pull-out force was only 2.6%, which verified the reliability of the established numerical model. This model obtained the pull-out force curve of the crimp terminal that changes with the indentation depth. The authors suggest selecting the interval where the pull-out force is not less than 95% of the peak value, and the depth is less than the corresponding value at the peak value as the best value range of the indentation depth.

[Relationship between sugary food intake and myopia in 11-14 years old Chinese children in 2019-2021].

OBJECTIVE: To investigate the relationship between the intake of sugary foods and the occurrence and development of myopia in children aged 11-14 in China. METHODS: In the 28 urban and rural survey sites in 14 provinces that implemented the "China Children's Nutrition and Health System Survey and Application for 0-18 Years Old" project, a multi-stage stratified random cluster sampling method was adopted, and finally 12 397 adolescent children aged 11 to 14 were selected in the analysis. Demographic characteristics, myopia information and the intake of sugary food(cakes, preserved fruits, candies, chocolates and ice cream) were collected through questionnaires. Multifactor Logistic regression was used to analyze the relationship between sugary food intake and myopia in children. RESULTS: The median daily intake of sugary foods(cakes, preserved fruits, candies, chocolates and ice cream)of 11-14 year old boys and girls in China was 11.4 g and 11.2 g respectively, 33.9% of boys and 34.2% of girls consumed ≥22 g of sugary food every day. The myopia rates of boys with intakes of <2 g, 2-21 g and ≥22 g were 36.0%, 39.2% and 41.6%, and girls' myopia rates were 45.9%, 51.8% and 55.1%. The result of Logistic regression analysis showed that after controlling for confounding factors such as age, gender, region, weekly high-intensity physical activity time, daily screen time, daily sleep time and daily intake of sugary beverages, compared with boys whose daily intake of sugary food was less than 2 g, the risk of myopia for boys whose daily intake of sugary food reached 2-21 g and ≥22 g was 1.18 and 1.23 times, for girls whose daily intake was less than 2 g, the risk of myopia was 1.27 times and 1.38 times for girls whose intake reached 2-21 g and ≥22 g(P<0.05). No matter whether confounding factors were controlled or not, there was no correlation between the intake of sugary foods and the degree of myopia(P>0.05). CONCLUSION: The consumption of sugary food such as cakes, preserved fruits, candies, chocolates and ice cream among children aged 11 to 14 in China is common, and there is a certain degree of positive correlation with the prevalence of myopia, but no correlation is observed with the degree of myopia.

A novel approach for estimating the flowering rate of litchi based on deep learning and UAV images.

Litchi flowering management is an important link in litchi orchard management. Statistical litchi flowering rate data can provide an important reference for regulating the number of litchi flowers and directly determining the quality and yield of litchi fruit. At present, the statistical work regarding litchi flowering rates requires considerable labour costs. Therefore, this study aims at the statistical litchi flowering rate task, and a combination of unmanned aerial vehicle (UAV) images and computer vision technology is proposed to count the numbers of litchi flower clusters and flushes in a complex natural environment to improve the efficiency of litchi flowering rate estimation. First, RGB images of litchi canopies at the flowering stage are collected by a UAV. After performing image preprocessing, a dataset is established, and two types of objects in the images, namely, flower clusters and flushes, are manually labelled. Second, by comparing the pretraining and testing results obtained when setting different training parameters for the YOLOv4 model, the optimal parameter combination is determined. The YOLOv4 model trained with the optimal combination of parameters tests best on the test set, at which time the mean average precision (mAP) is 87.87%. The detection time required for a single image is 0.043 s. Finally, aiming at the two kinds of targets (flower clusters and flushes) on 8 litchi trees in a real orchard, a model for estimating the numbers of flower clusters and flushes on a single litchi tree is constructed by matching the identified number of targets with the actual number of targets via equation fitting. Then, the data obtained from the manual counting process and the estimation model for the other five litchi trees in the real orchard are statistically analysed. The average error rate for the number of flower clusters is 4.20%, the average error rate for the number of flushes is 2.85%, and the average error for the flowering rate is 1.135%. The experimental results show that the proposed method is effective for estimating the litchi flowering rate and can provide guidance regarding the management of the flowering periods of litchi orchards.

A novel UBE2A splice site variant causing intellectual disability type Nascimento.

X-linked intellectual disability type Nascimento (XLID) is a rare disease caused by variants in the ubiquitin-conjugating enzyme E2A gene (UBE2A). Patients with XLID have similar phenotypes, including speech impairments, severe intellectual disability, hearing loss, wide facies, synophrys, generalized hirsutism, and urogenital abnormalities. Till date, only two splice-site variants of the UBE2A gene have been observed in patients with X-linked ID type Nascimento. Here, we report the case of a Chinese boy with a syndrome clinically similar to XLID with speech impairment, severe intellectual disability, and moderate hearing loss. However, different characteristics were also present in the patient, including an inability to maintain his head in an upright posture. Both of the patient's palms have a single transverse palmar crease. Subsequent whole-exome sequencing revealed a novel splice site variant in UBE2A (c.241 + 1 G > A). Our study not only expands the variant spectrum and clinical characteristics of UBE2A deficiency syndrome but also provides clinical evidence for genetic diagnoses.

Prevalence and associated factors for stunting, underweight and wasting among children under 6 years of age in rural Hunan Province, China: a community-based cross-sectional study.

BACKGROUND: The existing epidemiological data cannot represent the situation of undernutrition among Chinese children, particularly those in rural China. Hence, in this community-based cross-sectional study, the prevalence and associated factors of stunting, underweight and wasting among children (age < 6 years) from rural Hunan Province were analyzed. METHODS: Totally 5529 children aged 0 to 71 months and their caregivers were randomly chosen by multistage stratified cluster sampling from 72 villages from rural Hunan, which were distributed in 24 towns of 12 counties. Data about the children and their mothers, caregivers and family conditions was acquired using unified questionnaire, and the length/height and weight of each child were measured using unified instruments. The prevalence of undernutrition among children was evaluated using the length/height for age, weight for age, weight for length/height, and body mass index for age z scores, which were computed according to the 2006 and 2007 WHO Child Growth Standards. RESULTS: The prevalence of stunting, underweight, and wasting among the 5529 children were 4.4% (241), 3.9% (217), and 4.0% (221), respectively. The significant associated factors on higher risks of undernutrition in the children were low birth weight, maternal gestational weight gain <10 kg (stunting); low birth weight, maternal gestational weight gain <10 kg, ethnicity of caregivers being minority, large family size (underweight); low birth weight, ethnicity of caregivers being minority, large family size (wasting). High education level of caregivers and high family food expenditure were common protective factors for all three types of undernutrition, except that high family food expenditure was not protective against wasting. CONCLUSIONS: The prevalence of stunting, underweight and wasting is low among rural children under age of 6 years in Hunan. As for the measures, the gestational care and reasonable diet of mothers should be strengthened, and nutritional deficiency during pregnancy be avoided, which will prevent low birth weight. The local economic development and the education level of caregivers need to be further improved, especially for minorities.

Prevalence and factors associated with overweight or obesity among 2- to 6-year-old children in Hunan, China: a cross-sectional study.

OBJECTIVE: To compare the prevalence of overweight or obesity (ow/ob) with WHO BMI cut-off points, International Obesity Task Force (IOTF) cut-off points and Chinese BMI criteria and examine its potential factors among preschool children in Hunan Province. DESIGN: A cross-sectional survey including anthropometric measurements and questionnaires about children's information, caregivers' socio-demographic characteristics and maternal characteristics. χ2 tests and univariate and multivariate binary logistic regression were performed to evaluate the possible factors of ow/ob. SETTING: Hunan, China, from September to October 2019. PARTICIPANTS: In total, 7664 children 2 to 6 years of age. RESULTS: According to Chinese BMI criteria, about 1 in 7-8 children aged 2-6 years had ow/ob in Hunan, China. The overall estimated prevalence of ow/ob among 2- to 6-year-old children was significantly higher when based on the Chinese BMI criteria compared with the WHO BMI cut-off points and IOTF cut-off points. According to Chinese BMI criteria, ow/ob was associated with residing in urban areas, older age, male sex, eating snacking food more frequently, macrosomia delivery, caesarean birth, heavier maternal prepregnancy weight and pre-delivery weight. CONCLUSION: The prevalence of ow/ob in preschool children in Hunan Province remains high. More ow/ob children could be screened out according to Chinese BMI cut-offs compared with WHO and IOTF BMI criteria. In the future, targeted intervention studies with matched controls will be needed to assess the long-term effects of intervention measures to provide more information for childhood obesity prevention and treatment.

Standardized treatment and determinants on 9,059 syphilis-infected pregnant women during 2015-2018 in Hunan, China.

This study was aimed to describe the standardized treatment rate of syphilis-infected pregnant women in Hunan province and to explore the determinants for standardized treatment. All syphilis-infected pregnant women registered in the Information System of Prevention of Mother-to-Child Transmission of Syphilis Management (IPMTCT) in Hunan between January 2015 and December 2018 were included in this study. Among 9,059 pregnant women with syphilis, 7,797 received syphilis treatment, with a treatment rate of 86.1%, and 4,963 underwent standardized syphilis treatment, with an average standardized treatment rate of 54.8%. The facilitators for the standardized treatment included abnormal reproductive histories (aOR = 1.15, 95%CI:1.03-1.28), time of first prenatal care within 1-12 weeks (aOR = 5.17, 95%CI:4.19-6.37) or within 13-27 weeks (aOR = 5.56, 95%CI:4.46-6.92), previous syphilis infection (aOR = 1.64, 95%CI: 1.48-1.81), and definite syphilis infection status of sexual partner (negative: aOR = 1.73, 95%CI:1.57-1.91; positive: aOR = 1.62, 95%CI:1.34-1.95). The barriers included marital status being unmarried/divorced/widowed (aOR = 0.81, 95%CI: 0.65-0.99), pluripara (aOR = 0.58, 95%CI: 0.46-0.74), number of children ≥ 2 (aOR = 0.45, 95%CI: 0.35-0.57), and syphilis clinical stage being primary/secondary/tertiary (aOR = 0.72, 95%CI: 0.58-0.88) or unclear (aOR = 0.78, 95%CI: 0.70-0.86). Though the treatment rate of syphilis-infected pregnant women was high, the standardized treatment rate was low. The facilitators and barriers on standardized treatment of gestational syphilis were identified at the patient level.

Anemia prevalence, severity and associated factors among children aged 6-71 months in rural Hunan Province, China: a community-based cross-sectional study.

BACKGROUND: In recent 10 years, with the rapid socioeconomic development and the extensive implementation of children nutrition improvement projects, the previous epidemiological data cannot reflect the actual level of anemia among children in China, especially in rural areas. Therefore, this study analyzed the prevalence, severity and associated factors of anemia among children aged 6-71 months in rural Hunan Province. METHODS: A community-based cross-sectional study was conducted. Through multistage stratified cluster sampling, 5229 children aged 6 to 71 months and their caregivers were randomly selected from 72 villages across 24 towns in 12 counties from rural Hunan. The demographic characteristics of children and their caregivers, feeding practice, nutritional status of children, caregivers' anemia-related feeding knowledge, and gestational conditions of mothers were acquired by using a unified questionnaire. Peripheral blood from the left-hand middle fingertip was sampled from each child, and hemoglobin concentration was measured using a HemoCue301 portable hemoglobin analyzer (Sweden). Associated factors analyses involving overall anemia and anemia severities were conducted on multivariate logistic regression models. RESULTS: The overall anemia prevalence was 8.8%, and the prevalence of mild, moderate and severe anemia was 6.3, 2.5 and 0.1%, respectively. Children age groups of 6-11 months, 12-23 months and 36-47 months, exclusive breast-feeding within 6 months after birth, and maternal moderate/severe anemia were significantly associated with an increased risk of overall anemia in children. Children age groups of 6-11 months and 12-23 months were significantly associated with an increased risk of mild anemia in children. Children age groups of 6-11 months, 12-23 months and 36-47 months, low caregivers' anemia-related feeding knowledge level, and maternal moderate/severe anemia were significantly associated with an increased risk of moderate/severe anemia in children. Children who underwent regular physical examination were less likely to have moderate/severe anemia. The common protective factor for overall, mild and moderate/severe anemia in children was high family income. CONCLUSIONS: The anemia status of preschool children in rural Hunan Province was a mild public health problem and associated with children age group, feeding practice, regular physical examination, family income, caregivers' anemia-related feeding knowledge level, and maternal moderate/severe anemia.

Maternal HIV infection and risk of adverse pregnancy outcomes in Hunan province, China: A prospective cohort study.

This study described the prevalence of adverse pregnancy outcomes (APOs) in Chinese HIV-infected pregnant women, and examined the relationship between maternal HIV infection /HIV-related factors and APOs.This prospective cohort study was carried out among 483 HIV-infected pregnant women and 966 HIV-uninfected pregnant women. The HIV-infected and HIV-uninfected women were enrolled from midwifery hospitals in Hunan province between October 2014 and September 2017. All data were extracted in a standard structured form, including maternal characteristics, HIV infection status, HIV-related factors and their pregnancy outcomes. APOs were assessed by maternal HIV infection status and HIV-related factors using logistic regression analysis.The incidences of stillbirth (3.9% vs 1.1%), preterm birth (PTB) (8.9% vs 3.7%), low birth weight (LBW) (12.2% vs 3.1%) and small for gestational age (SGA) (21.3% vs 7.0%) were higher in HIV-infected women than HIV-uninfected women, with adjusted ORs of 2.77 (95%CI: 1.24-6.17), 2.37 (95%CI: 1.44-3.89), 4.20 (95%CI: 2.59-6.82) and 3.26 (95%CI: 3.26-4.64), respectively. No differences were found in neonatal asphyxia or birth defects between HIV-infected and HIV-uninfected groups, with adjusted ORs of 1.12 (95%CI: 0.37-3.43) and 1.10 (95%CI: 0.51-2.39), respectively. Among HIV-infected pregnant women, different antiretroviral (ARV) regimens were significantly associated with stillbirths, but not PTB, LBW or SGA. Compared with untreated HIV infection (10.1%), both mono/dual therapy and HAART were associated with a reduced risk of stillbirths (2.0% and 3.2%, respectively), with an AOR of 0.19 (95%CI: 0.04-0.92) and 0.31 (95%CI: 0.11-0.85), respectively. Initial time of ARV drugs use and HIV infection status of the sexual partner were not associated with maternal APOs.The findings of this study indicated that maternal HIV infection was associated with significantly increased risks of stillbirth, PTB, LBW and SGA, but not neonatal asphyxia or birth defects. On the condition that most HIV-infected pregnant women started ARV therapy in or after the second trimester, both mono/dual therapy and HAART had a protective effect on stillbirth compared with untreated HIV infection. As some important confounders were not effectively controlled and the specific regimens of HAART were not analyzed, the above findings may have certain bias.

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.

Maternal cosmetics use during pregnancy and risks of adverse outcomes: a prospective cohort study.

To probe into the associations between maternal personal cosmetics use during pregnancy and risk of adverse outcomes, and explore the potential dose-response relationships, we carried out a prospective cohort study involving 9710 pregnant women in Zhuzhou City and Xiangtan City in Hunan province during 2016-2017. A structured questionnaire was used to collection information for the pregnant women and their pregnancy outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by binary or multinomial logistic regressions. The study population included 4652 (47.9%) cosmetics non-users and 5058 (52.1%) cosmetics users. Cosmetics use was associated with an increased risk of small for gestational age (SGA) (aOR = 1.23, 95%CI 1.04 to 1.44), compared with cosmetics non-users. A positive dose-response relationship between frequency of cosmetics use and SGA was observed, although a borderline association was found at low use frequency (1-2 times per week; aOR = 1.18, 95%CI 0.99 to 1.40) and moderate use frequency (3-4 times per week; aOR = 1.23, 95%CI 0.92 to 1.64). High-frequency of cosmetics use (≥5 times per week) was significantly correlated with a higher risk of SGA (aOR = 1.83, 95%CI 1.25 to 2.69). No significant association between personal cosmetics use and the risk of preterm birth, low birth weight, macrosomia, or large for gestational age was observed. The present study suggests that personal cosmetics use will increase the risk of SGA, but further research is required to determine which cosmetic products may account for the higher risk of SGA.

The relationship between extreme temperature and emergency incidences: a time series analysis in Shenzhen, China.

Extreme temperature has been reported to be associated with an increase in acute disease incidence in several cities. However, few similar studies were carried out in Shenzhen, which is a subtropical city located in the southern China. This study explored the relationship between the emergency incidences and extreme temperatures, and investigated the role of air pollutants played in the temperature-related effects on human health in Shenzhen. We conducted a distributed lag nonlinear model study on the effect of extreme temperatures on emergency incidences in Shenzhen city during 2013-2017. Here, only the total emergency incidences, emergency incidences for respiratory diseases, and cardiovascular diseases were taken into consideration. Air pollution, subgroups, and seasons were adjusted to investigate the impacts of extreme temperatures on emergency incidences. Relative risk (RR) and 95% confidence intervals were calculated with the R software. From lag 0 to 21 days, the RR of temperature-total emergency department visits, temperature-cardiovascular, and temperature-respiratory diseases was 1.09 (95% CI: 0.98-1.20), 1.22 (95% CI: 0.96-1.56), and 1.06 (95% CI: 0.70-1.60) at extremely low temperature (first percent of temperature, 10 °C), respectively. During the same lag days, the RR was 1.02 (95 % CI: 0.92-1.14), 0.64 (95% CI: 0.49-0.86), and 0.92 (95% CI: 0.56-1.53) between extremely high temperature and total emergency department visits, cardiovascular, and respiratory diseases, respectively. The cumulative effects gradually went up with time for all types of emergency incidences in warm seasons (5 days moving average of temperature < 22 °C). However, the cumulative effects of total emergency incidences and Cvd emergency incidences were increased within the first lag 5 days, and then decreased until lag 21 in hot seasons (5 days moving average of temperature ≥ 22 °C). The cumulative effects of Res emergency incidences showed a declined trend from lag 0 to lag 21. The elderly (≥ 65, P1: RR = 1.49, 95% CI (1.30, 1.71); P99: RR = 0.86, 95% CI (0.71, 1.04)) and men (P1: RR = 1.27, 95% CI (1.14, 1.42)) seemed to be more vulnerable to extreme temperature than the younger (≤ 64, P1: RR = 1.19, 95% CI (1.08, 1.32); P99: RR = 1.00, 95% CI (0.89, 1.12)) and women (P1: RR = 1.17, 95%CI (1.06, 1.30)). The effects of extremely low temperature on all types of emergency incidences were stronger than those of extremely high temperature in the whole year. In addition, impacts of cold weather lasted about several days while those of hot weather were acute and rapid. An increased frequency of emergency incidences is predicted by rising temperatures variations. These results have clinical and public health implications for the management of emergency incidences.