Quality of childcare and delayed child development in left-behind children in China.

BACKGROUND: Inequalities in job opportunities and income prompts many Chinese parents to leave rural regions to work in urban regions. Their children are left behind in rural regions, subjected to worse quality of childcare that jeopardizes their development. This study aimed to examine the association between quality of childcare and delayed child development in under-three years children left behind in China. METHODS: Cross-sectional national survey was conducted in children left behind in rural China in 2017. Exploratory and confirmatory factor analysis was used to develop a quality of childcare index. Mutlilevel analyses determined factors associated with quality of childcare and child development on a province and individual level. RESULT: The largest population of at-risk children left behind were found in higher-GDP provinces. Children left behind had the lowest mean quality of childcare score. Multilevel analysis found that province level accounted for a great proportion of variance observed. CONCLUSIONS: While migration to urban regions for work may improve household income, a trade-off in worse quality of childcare and developmental delays exists. With improving household income often being the greatest contributing factor for parental migration, policies to reduce inequalities in job opportunities and wealth between rural and urban regions are required. IMPACT: Previous studies identified higher prevalence of developmental delays in children left behind in China. However, quality of childcare has not been examined. Based on WHO's Nurturing Care Framework, we developed a quality of childcare index to assess its association with child development in children left behind. Greatest proportion of children left behind at-risk of developmental delays resided in higher-GDP states, indicating a trade-off in worse quality of childcare and developmental delays. Since improving household income is the main factor for parental migration, policies to close inequalities in job opportunities and wealth between rural and urban regions are required.

[Weidiao-3 Mixture Improves the Clinical Efficacy of Immunotherapy for Advanced Gastric Cancer by Regulating Intestinal Flora].

Objective To investigate the effects of Weidiao-3(WD-3)Mixture on the clinical efficacy of immunotherapy for advanced gastric cancer and the intestinal flora.Methods Fifty-one patients with advanced gastric cancer treated in Wuxi Traditional Chinese Medicine Hospital from January 2020 to December 2021 were randomized into a WD-3 group(immunotherapy + WD-3 Mixture,one dose per day)(n=25)and a gastric cancer(GC) group(only immunotherapy)(n=26)according to the admission time.Ten healthy volunteers were included as the healthy control group.The Karnofsky score and the Quality of Life Questionnare-Core score were evaluated before and after treatment,and the clinical efficacy was compared after treatment.After treatment,the stool samples were collected for 16SrRNA gene high-throughput sequencing and targeted metabolomics.The α and ß diversity and structure of the intestinal flora and the content of short-chain fatty acids were compared between groups.Results The quality of life in both groups improved after treatment and was better in the WD-3 group than in the GC group(P=0.035).The dry mouth(P=0.038)and altered taste(P=0.008)were mitigated in the WD-3 group after treatment,and the reflux(P=0.001)and dry mouth(P=0.022)were mitigated in the GC group after treatment.After treatment,the WD-3 group outperformed the GC group in terms of dysphagia(P=0.047)and dry mouth(P=0.045).The WD-3 group was superior to the GC group in terms of objective remission rate and disease control rate,with prolonged median progression-free survival and median overall survival(P=0.039,P=0.043).The α and ß diversity indexes of the intestinal flora showed no significant differences between WD-3 and GC groups(all P>0.05).At the phylum level,WD-3 and GC groups had lower relative abundance of Firmicutes(P=0.038,P=0.042)and higher relative abundance of Proteobacteria(P=0.016,P=0.015)than the healthy control group.The relative abundance of Actinomycetes in the GC group was lower than that in the healthy control group(P=0.035)and the WD-3 group(P=0.046).At the genus level,the GC group had lower relative abundance of Bifidobacteria and Coprococcus than the healthy control group and the WD-3 group(all P<0.001).LEfSe revealed the differences in the relative abundance of 6 intestinal bacterial taxa between the WD-3 group and the GC group.At the genus level,Saccharopolyspora had higher relative abundance in the WD-3 group than in the healthy control group and only existed in the WD-3 group.The content of isobutyric acid and isovaleric acid in the WD-3 group was higher than that in the healthy control group(P=0.037,P=0.004).Conclusion WD-3 Mixture may increase the relative abundance of Bifidobacteria and Coprococcus and the content of isobutyric acid and isovaleric acid to alter the intestinal microecology,thereby improving the efficacy of immunotherapy for gastric cancer.

Correlates of suicidal ideation in rural Chinese junior high school left-behind children: A socioecological resilience framework.

Introduction: Suicide is one of the top five causes of adolescent mortality around the world. The socioecological resilience framework in explaining the risk factors and protective factors for suicidal ideation in left-behind children (LBC) has not been well explored. The current study aims to compare the prevalence of suicidal ideation in LBC and non-LBC, and explore its correlations with resilience factors among LBC. Methodology: This study was part of an epidemiological survey conducted by UNICEF exploring mental health outcomes in left-behind children. We implemented a cross-sectional study collecting data from 11 provinces and 1 municipal, with 5,026 participants (3,359 LBC, 1,667 controls) in year one junior high school living in impoverished areas of rural China. Data on suicidal ideation, self-harm, resilience factors including health-risk behaviors, psychological wellbeing as it was measured by the Strengths and Difficulties Questionnaire, peer relationship within the school environment, and family support were collected. Results: Overall prevalence of suicidal ideation among LBC was 7.2% which is significantly different from 5.5% reported by NLBC (χ2 = 4.854, p = 0.028). LBC reported a higher prevalence of self-harm (16.4%) than NLBC (13.0%; χ2 = 10.232, p = 0.001), but there was no difference in the prevalence of suicide plan, suicide attempt or help-seeking. LBC had significantly poorer psychological feeling, and greater emotional and behavioral difficulties peer relationship in the school environment than controls. In the multiple logistic regression, history of self-harm was the greatest predictor for suicidal ideation among LBC (OR = 2.078, 95% CI: 1.394-3.100, p < 0.001). Health risk behavior including previous smoking attempt, poor psychological feeling, and emotional and behavior difficulties, and poor peer relationship within school environment, were also significant risk factors for suicidal ideation among LBC. Conclusion: The prevalence of suicidal ideation and self-harm was greater among left-behind than non-left-behind children. Our results show resilience factors including previous self-harm, emotional and behavioral problems, smoking, and poor peer relationship are significantly associated with suicidal ideation in left-behind adolescents.

The identifiability of gene regulatory networks: the role of observation data.

Identifying gene regulatory networks (GRN) from observation data is significant to understand biological systems. Conventional studies focus on improving the performance of identification algorithms. However, besides algorithm performance, the GRN identification is strongly depended on the observation data. In this work, for three GRN S-system models, three observation data collection schemes are used to perform the identifiability test procedure. A modified genetic algorithm-particle swarm optimization algorithm is proposed to implement this task, including the multi-level mutation operation and velocity limitation strategy. The results show that, in scheme 1 (starting from a special initial condition), the GRN systems are of identifiability using the sufficient transient observation data. In scheme 2, the observation data are short of sufficient system dynamic. The GRN systems are not of identifiability even though the state trajectories can be reproduced. As a special case of scheme 2, i.e., the steady-state observation data, the equilibrium point analysis is given to explain why it is infeasible for GRN identification. In schemes 1 and 2, the observation data are obtained from zero-input GRN systems, which will evolve to the steady state at last. The sufficient transient observation data in scheme 1 can be obtained by changing the experimental conditions. Additionally, the valid observation data can be also obtained by means of adding impulse excitation signal into GRN systems (scheme 3). Consequently, the GRN systems are identifiable using scheme 3. Owing to its universality and simplicity, these results provide a guide for biologists to collect valid observation data for identifying GRNs and to further understand GRN dynamics.

ReaxFF-MPNN machine learning potential: a combination of reactive force field and message passing neural networks.

Reactive force field (ReaxFF) is a powerful computational tool for exploring material properties. In this work, we proposed an enhanced reactive force field model, which uses message passing neural networks (MPNN) to compute the bond order and bond energies. MPNN are a variation of graph neural networks (GNN), which are derived from graph theory. In MPNN or GNN, molecular structures are treated as a graph and atoms and chemical bonds are represented by nodes and edges. The edge states correspond to the bond order in ReaxFF and are updated by message functions according to the message passing algorithms. The results are very encouraging; the investigation of the potential, such as the potential energy surface, reaction energies and equation of state, are greatly improved by this simple improvement. The new potential model, called reactive force field with message passing neural networks (ReaxFF-MPNN), is provided as an interface in an atomic simulation environment (ASE) with which the original ReaxFF and ReaxFF-MPNN potential models can do MD simulations and geometry optimizations within the ASE. Furthermore, machine learning, based on an active learning algorithm and gradient optimizer, is designed to train the model. We found that the active learning machine not only saves the manual work to collect the training data but is also much more effective than the general optimizer.

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.

Outcomes of the national programme on prevention of mother-to-child transmission of hepatitis B virus in China, 2016-2017.

BACKGROUND: In addition to providing free hepatitis B vaccine (HBvacc) series to all infants in China since 2005, the national programme on prevention of mother-to-child transmission (PMTCT) of hepatitis B virus (HBV) started providing free hepatitis B immunoglobulin for all new-borns born to hepatitis B surface-antigen (HBsAg) positive mothers in 2010. However, few studies have evaluated the effectiveness of the PMTCT programme. Therefore, we aimed to investigate the outcomes of the programme and identify associated factors. METHOD: Using a cross-sectional study design, we collected data on 4112 pairs of HBsAg-positive mothers and their children aged 7-22 months in four representative provinces through interviews and medical record review. We tested HBsAg and hepatitis B surface antibody (anti-HBs) of children by enzyme-linked immunosorbent assay at designated maternal and child hospital laboratories. We used logistic regression to analyse factors associated with child HBsAg and anti-HBs positivity. RESULTS: Thirty-five children were HBsAg positive, indicating the mother-to-child transmission (MTCT) rate was 0.9% (0.6-1.1%). The anti-HBs positive rate was 96.8% (96.3-97.4%). Children receiving HBvacc between 12 and 24 h of birth were 2.9 times more likely to be infected than those vaccinated in less than 12 h (adjusted odds ratio [aOR] = 2.9, 95% confidence interval [CI]: 1.4-6.3, P = 0.01). Maternal hepatitis B e-antigen (HBeAg) positivity was associated with higher MTCT rate (aOR = 79.1, 95% CI: 10.8-580.2, P <  0.001) and lower anti-HBs positive rate (aOR = 0.4, 95% CI: 0.3-0.6, P <  0.001). Children with low birth weight (LBW) were 60% less likely to be anti-HBs positive than those with normal birth weight (aOR = 0.4, 95% CI: 0.2-0.8, P = 0.01). CONCLUSIONS: The MTCT rate was lower than the 2030 WHO elimination goal, which implies the programme is on track to achieve this target. As earlier HBvacc birth dose (HBvcc-BD) was associated with lower MTCT rate, we suggest that the PMTCT programme work with the Expanded Programme on Immunization (EPI) to modify the current recommendation for early HBvcc-BD to a requirement. Our finding that LBW was associated with lower anti-HBs positivity points to the need for further studies to understand factors associated with these risks and opportunities for program strengthening. The programme needs to ensure providing essential test to identify HBeAg-positive mothers and their infants and provide them with appropriate medical care and follow-up.

Understanding Robust Adaptation Dynamics of Gene Regulatory Network.

Robust adaptation is a critical attribute for gene regulatory network (GRN), understanding the relationship between adaptation and the GRN topology, and corresponding parameters is a challenging issue. The work in this paper includes: first, seven constraint multiobjective optimization algorithms are used to find sufficient solutions to get more reliable statistic rules. Meanwhile, the algorithms are compared to facilitate the future algorithm selection; second, a fuzzy c-mean algorithm is used to analyze solutions and to classify the solutions into different groups; third, the histogram analysis for all satisfactory solutions shows the preferred parameter range, i.e., parameter motif. The contributions of this paper includes: 1) Two new adaptation indices i.e., peak time and settle down time, are proposed for the first time to give more accurate description of the robust adaptation. Our conclusion is that some solutions even with satisfactory sensitivity and precision are not practically of robust adaptation because of too long time needed. 2) The relationship between topology, parameter set, and robust adaptation of GRN is discovered in the sense of both preferred topology and parameter motif. Our conclusion is that the robust adaptation depends more on the GRN topology than the model parameter set in two feasible topologies.

Finding Robust Adaptation Gene Regulatory Networks Using Multi-Objective Genetic Algorithm.

Robust adaptation plays a key role in gene regulatory networks, and it is thought to be an important attribute for the organic or cells to survive in fluctuating conditions. In this paper, a simplified three-node enzyme network is modeled by the Michaelis-Menten rate equations for all possible topologies, and a family of topologies and the corresponding parameter sets of the network with satisfactory adaptation are obtained using the multi-objective genetic algorithm. The proposed approach improves the computation efficiency significantly as compared to the time consuming exhaustive searching method. This approach provides a systemic way for searching the feasible topologies and the corresponding parameter sets to make the gene regulatory networks have robust adaptation. The proposed methodology, owing to its universality and simplicity, can be used to address more complex issues in biological networks.

Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study.

BACKGROUND: Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old. METHODS: This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length. RESULTS: Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage. CONCLUSIONS: Our data based on caregiver's self-report suggested that partial breastfeeding and bed-sharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.

[Development of sleep/wake patterns in infants during the first 12 months of life].

OBJECTIVE: This was a nationwide study of sleep circadian in term infants. The aim was to understand the development characteristics of infants' sleep/wake patterns longitudinally in their own home environments over the first 12 months of life. METHOD: Totally 524 healthy term infants from 9 urban districts took part in this project Their sleep/wake patterns over 24 h were recorded using parental sleep diaries, from the 2nd day to 12 months old. RESULT: The results showed that infant daytime sleep changed significantly at 0-2, 3-4, 5-6, and 8-9 months after birth, and the change was the fastest in the first month, the mean percentage of daytime sleep decreased from 82.4% at Day 2 to 62.8% at 1 month old. Also, the average number of naps reduced from 3.7 to 2 across the infancy. The ability of continuous sleep throughout the night gradually enhanced from 1 month old, and the nocturnal longest sleep time extended to 6.8 h at 4 months of age as well as the nighttime awakening frequency less than 0.5 over 6 months old. Additionally, the nighttime sleep increased significantly at 4 and 9 months after birth, where the proportion of nighttime sleep increased from 55.8% at Day 2 to 64.3% of 4 months and 71.2% of 9 months respectively. In general, the total sleep time over a 24 h period presented a downward trend as the infant aged. CONCLUSION: The periods 0-6 and 8-9 months after birth were the key periods for the development of infant sleep.

[Study on prevalence and risk factors of sleep disorder among Chinese children aged 0 to 23 months in city].

OBJECTIVE: To investigate the prevalence and main influences on sleep disorder among Chinese children aged 0 to 23 months, as to providing scientific interventions for infant sleep disorder. METHODS: All 7601 children under two years old were selected by stratifying samples from twelve cities in China. The objects' parents were surveyed with questionnaire. All data were analyzed with SPSS statistical software. RESULTS: The total incidence of sleep disorders at 0 to 23 months was 21.94%. The main problems were difficulty falling asleep, nighttime waking and snoring. Feeding manner, sleep environment, sleep-associated habits and medical conditions were all influences on infant's sleep disorder. CONCLUSIONS: Enhancing sleep health education to change parents' nurturing modes should be an important role in preventing infant sleep disorders.