Assessing attitudes towards biostatistics education among medical students: adaptation and preliminary evaluation of the Chinese version survey of attitudes towards statistics (SATS-36).

BACKGROUND: Despite the numerous advantages of mastering biostatistics, medical students generally perceive biostatistics as a difficult and challenging subject and even experience anxiety during the courses. Evidence for the correlation between students' academic achievements and their attitudes, indicating that attitudes at the beginning of the biostatistics course may affect cognitive competence at the end of the course and subsequently influence student academic performance. However, there are current disagreements regarding the measurement and evaluation of attitudes related to statistics. Thus, there is a need for standard instruments to assess them. This study was conducted to develop a Chinese version of the Survey of Attitudes Toward Statistics (SATS-36) in order to acquire a valid instrument to measure medical students' attitudes toward biostatistics under Chinese medical educational background. METHODS: The Chinese version SATS-36 was developed through translation and back-translation of the original scale, with subsequent revisions based on expert advice to ensure the most appropriate item content. The local adaption was performed with a cohort of 1709 Chinese-speaking medical undergraduate and graduate students enrolled in biostatistics courses. And then, the reliability, validity and discrimination of the questionnaires were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods. RESULTS: The Chinese version SATS-36 consisted of 36 items and loaded a five-factor structure by factor analysis, which offered an alternative similar but not equal to that original six-factor structure. The cumulative variance contribution rate was 62.20%, the Cronbach's α coefficient was 0.908, the Guttman split-half reliability coefficient was 0.905 and the test-retest reliability coefficient was 0.752. Discriminant analysis revealed small to large significant differences in the five attitude subscales. CONCLUSIONS: The Chinese version SATS-36 with good validity and reliability in this study can be used to evaluate the learning framework of Chinese medical students.

Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support.

BACKGROUND: COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship. METHODS: The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses. RESULTS: Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01). CONCLUSION: Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

The nutritional literacy of breast cancer patients receiving chemotherapy and its association with treatment self-regulation and perceived social support.

PURPOSE: Chemotherapy can lead to malnutrition and post-menopausal recurrence among breast cancer (BC) patients, who need to achieve nutritional literacy (NL) to cope. The objective of this study was to explore the NL level in Chinese BC patients receiving chemotherapy and its predictors including both internal motivation and the external environment. METHODS: A total of 326 BC female patients from three hospitals were enrolled. Participants completed the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA), Chinese version from the Treatment Self-Regulation Questionnaire (TSRQ-C), and the Perceived Social Support Scale (PSSS) to assess NL, treatment self-regulation, and social support. Stepwise multivariate linear regression was used to identify the main factors of NL. RESULTS: The total NL score was 151.31 ± 16.85, the "knowledge understanding" dimension had the lowest score. In the final regression model, patients with higher scores for "autonomous motivation" and "introjected regulation" on the TSRQ-C and "family support" and "other support" on the PSSS, higher educational levels and average monthly household incomes and endocrine therapy had higher NL levels (adjusted R2 = 66.7%, p < 0.05). CONCLUSIONS: The overall NL score among Chinese BC patients receiving chemotherapy was satisfactory, but the knowledge understanding score was low. Higher autonomous motivation, introjected regulation, family support and other support scores, higher educational and household income levels, and endocrine therapy were predictors of NL in female patients. Interventions should be designed according to the specific performances and predictors of NL in female patients.

Duplicated adrenal veins in primary aldosteronism misdiagnosed with ectopic aldosteronoma due to apparent bilateral aldosterone suppression.

BACKGROUND: Primary aldosteronism (PA) is considered the number one aetiology for secondary hypertension. Apart from confirmatory tests and localisation of PA determined by computed tomography (CT), adrenal venous sampling (AVS) is used to define whether aldosterone hypersecretion occurs inside one or both adrenal glands. However, even correctly-performed AVS may lead to undiagnostic results such as apparent bilateral adrenal suppression (apparent bilateral aldosterone suppression), in which the adrenal aldosterone-to-cortisol ratios (AC ratios) are decreased bilaterally compared to the peripheral blood sample, with several causes contributing to it. CASE DESCRIPTION: Here, we describe the case of a 48-year-old man who was referred to our department for further investigation with a history of refractory hypertension, hypokalaemia, and aortic dissection. His hypertension and hypokalaemia were initially attributed to ectopic aldosteronoma due to his adrenal CT scan and AVS results. However, the correct diagnosis of an adenoma with duplicated right adrenal veins (duplicated adrenal veins) due to apparent bilateral aldosterone suppression was confirmed during surgery. CONCLUSION: AVS is the gold standard accepted for PA subtyping, but sometimes when apparent bilateral aldosterone suppression is present, it can give ambiguous results. Duplicated right adrenal veins, may impact results, thus, AVS may not accurately provide evidence of unilateral hypersecretion for all PA patients. Repeat AVS or adrenal surgery can provide worthwhile diagnostic conclusions.

The recognition and diagnosis of primary aldosteronism (PA) have increased in recent years and clinicians usually require adrenal venous sampling (AVS) to identify the affected side, and it's crucial for further treatments of PA patients (surgery or medicine).We presented an example of unilateral aldosteronoma with duplicated adrenal veins whose AVS results suggested apparent bilateral aldosterone suppression (the adrenal venous aldosterone/cortisol ratios are bilaterally lower than the peripheral ratios). He was misdiagnosed with ectopic aldosteronoma due to computed tomography (CT) features, but surgery findings revealed duplicated adrenal veins.Unclear AVS results such as apparent bilateral aldosterone suppression can lead to a missed diagnosis of unilateral PA, preventing patients from receiving potentially curative adrenal resection.Our case can serve as an example for clinicians that encounter the same condition to provide further investigational clues to ensure the correct aetiological diagnosis for patients with PA.

Diagnostic efficiency and safety of rapid on-site evaluation combined with CT-guided transthoracic core needle biopsy in suspected lung cancer patients.

OBJECTIVE: The efficacy of rapid on-site evaluation (ROSE) combined with computed tomography-guided transthoracic core needle biopsy (CT-guided TCNB) is rarely investigated. This study aimed to evaluate the diagnostic efficiency and safety of ROSE combined with CT-guided TCNB for suspected lung cancer patients. MATERIALS AND METHODS: Clinical data from 285 patients who received CT-guided TCNB for suspected lung cancer in Huashan Hospital from 2015 to 2018 were retrospectively analysed. Of these 163 patients underwent CT-guided TCNB combined with ROSE (ROSE group), while the remaining 122 patients underwent without ROSE (non-ROSE group). The smears from TCNB were quickly processed with Diff-Quick staining and analysed by a skilled cytologist on-site. The consistency of ROSE with the final clinicopathological diagnosis and the diagnostic efficiency and safety of ROSE combined with CT-guided TCNB in suspected lung cancer patients were evaluated. RESULTS: ROSE was highly concordant with pathological diagnosis (κ = 0.791; P < 0.001), with an accuracy of 95.7%. Diagnostic accuracy was significantly higher in the ROSE compared with the non-ROSE group (96.3% vs 86.1%; P = 0.002), with overall incidences of complications of 36.8% and 23.8%, respectively. Minor pneumothorax without drainage was slightly greater in the ROSE compared with the non-ROSE group (14.1% vs 6.6%; P = 0.046). However, there was no significant difference in serious complications between the two groups. CONCLUSION: ROSE was highly consistent with the final clinicopathological diagnosis for suspected lung cancer. ROSE further improved the diagnostic efficiency of CT-guided TCNB with no increased incidence of serious complications.

Comparative efficacy of five surgical methods in the treatment of mitral regurgitation: A systematic review and network meta-analysis.

OBJECTIVE: This study has been compared the effectiveness of different surgical methods in the treatment of mitral regurgitation (MR) in adults by using the network meta-analysis method, so as to provide reference for clinical selection of the best surgical scheme. METHODS: The PubMed, EMBASE, the Cochrane Library, CNKI, and Chongqing VIP Information databases were comprehensively searched until December 2020. We collected retrospective comparative studies on surgical procedures including 3D endoscopic mitral valve surgery (3D-MVS), robot-assisted mitral valve surgery (R-MVS); totally thoracoscopic mitral valve surgery (T-MVS), small incision mitral valve surgery (M-MVS), and traditional thoracotomy mitral valve surgery (C-MVS). Stata16.0 and Addis1.16.8 software was used for network meta-analysis using the Bayesian approach. RESULTS: A total of 31 studies were included, 12,998 patients, involving five surgical methods. Network meta-analysis showed that: in terms of complications (odds ratio [OR]: 0.65, 95% CI: 0.13-3.00, probability rank = 0.37) and MR (OR: 0.03, 95% CI: 0.0-8315, probability rank = 0.64), the 3D-MVS group had the lowest event rate. In terms of blood transfusion rate (OR: 0.55, 95% CI: 0.16-1.84, probability rank = 0.45), T-MVS had the lowest event rate. In addition, with the exception of operation time and chest drainage, the R-MVS group has the best curative effect. CONCLUSION: This minimally invasive surgery has their own advantages and disadvantages. Overall, 3D-MVS is most satisfactory, but more samples are needed.

Estimating and validating the structure of feeding behavior networks.

PURPOSE: Network analysis has been widely used in psychometrics over the past decade, yet it is unknown that whether this methodology could be applied in the field of child health assessment such as caregivers' feeding behavior and child eating behavior. Our study leveraged network psychometrics method to estimating and examining the network structure of Chinese Preschoolers' Caregivers' Feeding Behavior Scale (CPCFBS), and compared the applicability of network methods in the feeding behavior scale. METHODS: The CPCFBS was previously applied in a sample of 768 preschoolers' caregivers, used to estimate the structure of feeding behavior networks. Network structure was estimated with Gaussian Graphical Model. Dimensionality was detected using Exploratory Graph Analysis (EGA). The network structural consistency was tested using EGA bootstrap. The network structure was compared with the original structure using model fit indices and reliability. RESULTS: A seven-dimensional EGA network was explored after rearranging four items and deleting one item with unstable structural consistency. The absolute fit and relative fit of EGA structure were better than the original structure. The EGA structure had nearly same values of the reliability with the original structure. CONCLUSION: Our study presented a novel perspective for feeding behavior analytical strategies, and demonstrated that network analysis was applicable and superior in exploring the structure of feeding behavior scales. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Nearly-Unity Quantum Yield and 12-Hour Afterglow from a Transparent Perovskite of Cs2 NaScCl6 :Tb.

Unlike afterglow phosphors, transparent crystals free of scattering issues hold great potential in applications such as volumetric displays and three-dimensional encryption. Here, a double-perovskite host of ca. 85 % transparency, a Cs2 NaScCl6 single crystal, was grown in aqueous solution. Through heavy doping of Tb ions, the crystal exhibited a high photoluminescence quantum yield (PL QY) up to 98.2 %. Both steady-state and transient PL spectroscopic investigation revealed a cross-relaxation efficiency (ηCR ≈99 %) between Tb ions, greatly mitigated the electron saturation on the 5 D3 level and encouraged the radiative route against quenching. The doped crystal displayed an intense afterglow of up to 12 h after ceasing the X-ray excitation, allowing it to be used in a radiation-storage battery which has a linear scaling capacity with loading weight. Our work opens possibilities in photo-stimulated volumetric display and three-dimensional information storage.

CTR9-mediated JAK2/STAT3 pathway promotes the proliferation, migration, and invasion of human glioma cells.

BACKGROUND: CTR9 (Cln three requiring 9) has been reported to be implicated in protein modification and oncogenesis of several human cancers. However, the protein expression and mechanism of CTR9 in glioma progression remain unclear. METHODS: We analyzed mRNA expression of CTR9 and CTR9-related survival curves in the public database. Then, we detected CTR9 expression in glioma tissues and constructed U251 and U87 cells with stable silencing or overexpression of CTR9. Cell function tests and Western blot were conducted to explore the effects of CTR9 on glioma proliferation, invasion and migration, and the specific mechanism. All the date was presented as means ± SEM. Two-sample t test and one-way analysis of variance (ANOVA) were used to identify whether there was a significant difference between each group of data. RESULTS: We found that CTR9 was overexpressed in glioma and inversely associated with glioma patient survival. The results manifested that knockdown of CTR9 suppressed the proliferation, migration, and invasion of glioma cells, while overexpression facilitated them. The underlying molecular mechanism may involve the regulation of JAK2/STAT3 pathway by CTR9. CONCLUSION: Our present study indicates that CTR9 is highly expressed in glioma and related to glioma grading and prognosis. CTR9 regulates malignant behaviors of glioma cells by activating JAK2/STAT3 pathway. Therefore, CTR9 may be a promising biomarker for the targeted therapy and prognosis evaluation of glioma.

Caregivers' feeding behaviour, children's eating behaviour and weight status among children of preschool age in China.

BACKGROUND: Childhood overweight and obesity have become significant public health challenges worldwide. The present study aimed to investigate whether caregivers' feeding behaviour and children's eating behaviour were associated with the weight status of preschool children in China. METHODS: A cross-sectional questionnaire was administered to 912 caregivers of preschool children from April to July 2016. Caregivers' feeding behaviours were assessed by the Chinese Preschooler's Caregiver Feeding Behaviour Scale. Children's eating behaviours were evaluated using the Chinese Preschooler's Eating Behaviour Questionnaire. After controlling for demographic characteristics, multiple linear regression and logistic regression analyses were performed to evaluate the relationship between caregivers' feeding behaviour, children's eating behaviour and children's body mass index (BMI). RESULTS: The results showed that weight concerns on the part of caregivers (ß = 0.53) and food responsiveness on the part of children (ß = 0.93) were positively correlated with children's BMI, whereas caregivers' responsibility for feeding (ß = -0.68) and children's external eating (ß = -0.53) were negatively correlated with BMI. Among caregiver feeding behaviours, weight concerns [odds ratio (OR) =4.54, p < 0.001] and behaviour-restricted feeding (OR =0.29, p < 0.001) were positively correlated with children's BMI. A child's food responsiveness (OR =4.04, p < 0.001) was also positively correlated with his/her BMI, whereas the child's satiety responsiveness (OR =0.42, p < 0.001) and emotional eating habits (OR =0.56, p < 0.001) were negatively correlated with overweight/obesity status. CONCLUSIONS: Our study demonstrated that children's eating behaviour and caregivers' feeding behaviour were associated with weight status among preschool children in China. Behaviour interventions on caregivers and their children may prevent or reduce weight problems in preschool children.

Inferior Vena Cava Filter Migrated to Left Ventricle.

Inferior vena cava (IVC) filters have been widely used to prevent pulmonary emboli in patients with venous thromboembolism. Here we report a rare case of complete pericardial tamponade with severe mitral and tricuspid valve regurgitation due to a fractured IVC filter. A 38-year-old male came to our emergency department with a 19-day history of progressive chest tightness. Chest x-ray revealed a tethering catheter fractured at the level of the junction of the superior vena cava and the right atrium. We performed open surgery and discovered that a steel wire had punctured the atrioventricular septum, the mitral valve, and finally the posterior wall of the left ventricle. The patient recovered quite well and was discharged after 1 week.

Preliminary evaluation of the Chinese version of the Baby Eating Behaviour Questionnaire.

BACKGROUND: This study was conducted to develop a Chinese version of the Baby Eating Behaviour Questionnaire (BEBQ) and to evaluate its reliability and validity. METHODS: The Chinese version of the BEBQ was developed by translation and back-translation of the original BEBQ, followed by revision according to experts on the most appropriate item content. Mothers of 300 infants aged <12 months were recruited for survey participation from the paediatric outpatient departments of two large general hospitals in Xi'an, China. Fifty of the mothers were selected randomly for retesting after 2 weeks. Face-to-face surveys included explanation of the process, administration of the Chinese version of the BEBQ with regard to the exclusive breast-feeding period, and demographic data collection. The reliability, validity and discrimination of the questionnaire were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods. RESULTS: The Chinese version of the BEBQ consists of 15 items in four dimensions (food responsiveness, enjoyment of food, slowness in eating and satiety responsiveness). The cumulative variance contribution rate was 58.4%, the Cronbach's α coefficient was 0.93, the Guttman split-half reliability coefficient was 0.87 and the test-retest reliability coefficient was 0.75. The satiety responsiveness and food responsiveness scores differed significantly according to gestational age at birth, infant sex and average monthly weight gain (all P < 0.05). The enjoyment of food score differed significantly according to average monthly weight gain (P < 0.05). CONCLUSIONS: The Chinese version of the BEBQ showed good reliability and validity and can be used to evaluate infants' appetite through the assessment of eating behaviour.

X-linked hypophosphatemic rickets caused by a de novo PHEX gene variation in a family. / 一个PHEXåŸºå› æ–°å‘å˜å¼‚å¯¼è‡´çš„X-è¿žé”ä½Žç£·æ€§ä½å»ç— å®¶ç³».

X-linked hypophosphatemic rickets (XLH) is caused by inactivating mutations in the PHEX gene and is the most common form of hereditary rickets. The treatment is more complicated compared with the general rickets. A family were admitted to the Department of Endocrinology, Hainan General Hospital in 2018. The proband was a 3-year-6-month-old female, Han nationality. She was admitted to hospitalization for bilateral knee valgus and walking instability. The patient's parents were not in consanguineous marrige, and there was no similar medical history in the family. The patient presented with "O" leg, bracelet sign, chicken breast, and low blood phosphorus. Typical change of rickets also appeared in her X-ray examination. The DNAs of the peripheral blood were extracted from the patient and her parents. All coding exons and flanking regions of PHEX gene in the patient were amplified by PCR, and the mutant sites of the family members were testified by a generation sequencing. A heterozygous variation (c.1482+5G>C) affecting splicing outcome was detected at the splicing region of intron 13 of PHEX gene in the patient. The variation has been included in the human gene mutation database (HGMD). No variation was found in the proband's parents, the PHEX gene in the patient was a de novo variation. Our research provided reference for the future genetic counseling for this patient and enriched the research data on the relationship between genotype and clinical manifestations.

Solution-Grown Chloride Perovskite Crystal of Red Afterglow.

We report the growth of a halide-based double perovskite, Cs2 Nax Ag1-x InCl6 :y%Mn, via a facile hydrothermal reaction at 180 °C. Through a co-doping strategy of both Na+ and Mn2+ , the as-prepared crystals exhibited a red afterglow featuring a high color purity (ca. 100 %) and a long duration time (>5400 s), three orders of magnitude longer than those solution-processed organic afterglow crystals. The energy transfer (ET) process between self-trapped excitons (STE) and activators was investigated through time-resolved spectroscopy, which suggested an ET efficiency up to 41 %. Importantly, the nominal concentration of dopants, especially in the case of Na+ , was found a useful tool to control both energy level and number distribution of traps. Cryogenic afterglow measurements suggested that the afterglow phenomenon was likely governed by thermal-activated exciton diffusion and electron tunneling process.

Assessing the proxy response bias of EQ-5D-3 L in general population: a study based on a large-scale representative household health survey using propensity score matching.

BACKGROUND: Proxy respondent-someone who assists the intended respondent or responds on their behalf-are widely applied in the measurement of health-related quality of life (HRQL). However, proxies may not provide the same responses as the intended respondents, which may bias the findings. OBJECTIVES: To determine whether the use of proxies is related to socio-demographic characteristics of the intended respondent, and to assess the possible proxy response bias of Chinese version of EQ-5D-3 L in general population. METHODS: A cross-sectional study based on a provincially representative sample from 2013 National Health Service Survey (NHSS) in Shaanxi, China was performed. HRQL was measured by Chinese version of EQ-5D-3 L. Propensity score matching (PSM) was used to get matched pairs of self-reports and proxy-reports. Before and after PSM, univariate logistic and linear models including the indicator of proxy response as the only independent variable, were employed to assess the possible proxy response bias of the dimensional and overall health status of EQ-5D-3 L respectively. RESULTS: 19.9% of the responses involved a proxy. Before PSM, the proxy-report group was younger in age and reported less unhealthy lifestyle, lower prevalence of disease, and less hospitalization than the self-report group. After PSM, it showed that the proxy-report group was statistically more likely to report health problem on each dimension of EQ-5D-3 L, with odds ratios larger than one comparing with self-report group. The means of EQ-5D-3 L index and EQ VAS of proxy-report group were 0.022 and 0.834 lower than self-report group. CONCLUSIONS: Significantly negative proxy response bias was found in Chinese EQ-5D-3 L in general population, and the magnitude of the bias was larger in physical dimensions than psychological dimensions after using PSM to control confounders.

Survival and Versatility of the Flow-Through Lateral-Thigh Free Flap in Severe Electrical Injuries to the Wrist.

BACKGROUND: The hand and wrist are most often in contact with electrical currents and thus most vulnerable to severe electrical burns. The treatment of such severe injury via surgical intervention remains a big challenge because of the vast tissue necrosis and the segmental vascular injury. The flow-through lateral-thigh free flap has been used effectively to resurface these defects and to reconstruct segmental vascular defects. METHODS: Between January 2014 and June 2017, 11 male patients aged 19 to 53 years were admitted to the burn unit of our institution. Each presented with severe electrical burns to the wrist with long segmental vascular injury, and 2 cases suffered from electrical burn on both wrists. After radical debridement, the soft-tissue and segmental artery defects were rebuilt through the application of flow-through lateral-thigh free flap for 1 of the ulnar or radial artery injury (7/12). Ulnar artery defects were rebuilt through the application of flow-through lateral-thigh free flap, and radial artery revascularization was done using a greater saphenous vein graft for both ulnar and radial artery injuries (5/12). Vascular condition was closely monitored throughout the treatment period. RESULTS: Forearm amputation was performed in 1 case as a result of distal immediate necrosis postinjury. Successful limb salvage was achieved in the other 12 wrists. Infection beneath the flap occurred in 3 cases but resolved after debridement. Over the course of the 3- to 12-month follow-up period, the free flaps maintained good texture and sharpness, distal circulation of affected limb became well established, and the appearances of the donor sites were acceptable. CONCLUSIONS: High-voltage electrical burns of the wrist are highly destructive, and sophisticated management of damage requires concomitant vascular reconstruction and soft-tissue coverage. The flow-through anterolateral-thigh flap is an optimal solution for this problem. Emphasis must be placed on the affected blood vessel throughout the treatment period.

Red Blood Cell Distribution Width Predicts Postoperative Death of Infective Endocarditis.

Infectious endocarditis (IE) is a rare disease with high mortality rate. Recently, red cell distribution width (RDW) has drawn special attention for predicting cardiovascular disease. This study aims to explore the relationship between RDW value and postoperative death of IE patients.Clinical records of patients with definite IE from Chinese People's Liberation Army General Hospital department of cardiovascular surgery were collected and analyzed. Clinical, echocardiographic, and biochemical variables were evaluated along with RDW.Results: A total of 158 consecutive IE patients (mean age 47.0 ± 16.3 years, male 61.4%) were enrolled in this study. According to receiver operating characteristic (ROC) curve analysis, the optimal RDW cutoff value for predicting mortality was 15.45% (area under the curve 0.913, P < 0.001). A total of 28 patients (17.8%) died postoperatively; of these, 89.3% had RDW value >15.45%. Binary regression analysis showed that aging, multiple valvular involved, valvular vegetation formation, pulmonary hypertension, and high RDW are strong predictors of postoperative death. Multiple regression analysis revealed that high RDW value was independent predictors of postoperative mortality in patients with IE (ß: 3.704, 95% confidence interval (95%CI): 2.729-604.692, P < 0.05).IE has a high inhospital mortality rate, and increased RDW is an independent predictor of postoperative death in these patients.

FNDC3B circular RNA promotes the migration and invasion of gastric cancer cells via the regulation of E-cadherin and CD44 expression.

Circular RNAs (circRNAs) are a new class of RNAs, and many studies have identified thousands of circRNAs in tumor cells. Fibronectin type III domain-containing protein 3B (FNDC3B) circular RNA (circFNDC3B, circBase ID: hsa_circ_0006156) circularizes with exons 5 and 6. Gibson Assembly DNA technology was used to construct a circFNDC3B expression vector without a splice site and restriction enzyme site. We showed that circFNDC3B increased migration and invasion in gastric cancer (GC). Ectopic expression of circFNDC3B reduced the level of E-cadherin protein to promote the epithelial-mesenchymal transition in GC. RNA immunoprecipitation assays and RNA pull-down assays confirmed that circFNC3B increased CD44 expression, which was associated with cell adhesion, via the formation of a ternary complex of circFNDC3B-IGF2BP3-CD44 mRNA. These results indicated that circFNDC3B was associated with the degree of malignancy to highlight the specific characteristics of cell invasion.

Correlation between Children's eating behaviors and caregivers' feeding behaviors among preschool children in China.

The aim of this study was to explore the relationship between caregivers' feeding behaviors and children's eating behaviors among preschoolers in China. From April to July 2016, a cross-sectional survey was administered to 912 preschoolers' caregivers in China. The Chinese Preschooler's Caregiver Feeding Behavior Scale (CPCFBS) and Chinese Preschooler's Eating Behavior Questionnaire (CPEBQ) were used to assess caregivers' feeding behaviors and children's eating behaviors, respectively. Pearson correlation and canonical correlation analysis (CCA) based on principal component analysis were performed to explore the relationships between them. Two interpretable canonical variables and structures were yielded through CCA. The first canonical variable could explain 35.1% and 29.0% of the total variance of the caregivers' feeding behaviors and the children's eating behaviors variable groups, respectively, with a canonical correlation coefficient of 0.659 (rU1,V1 = 0.659, P < 0.001). The second canonical variable could explain 17.6% and 14.9% of the total variance of the caregivers' feeding behaviors and the children's eating behaviors variable groups, respectively, with a canonical correlation coefficient of 0.309 (rU2,V2 = 0.309, P < 0.001). According to the canonical structure, higher performance behaviors of the caregiver, such as encouragement of healthy eating, responsibility for feeding, supervision of eating, behavior restricted feeding, content restricted feeding and lower weight concerns, were associated with reasonable behaviors of children, including lower emotional eating, food responsiveness, unhealthy eating habits and higher initiative eating. Our results demonstrated that caregivers' feeding behaviors were the major influencing factors of children's eating behaviors, and caregivers' encouragement of healthy eating, responsibility for feeding, supervision of eating, restricted feeding and lower weight concerns were associated with reasonable children's eating behaviors, especially low children's emotional eating, low food responsiveness, infrequent unhealthy eating habits, frequent initiative eating, infrequent satiety responsiveness and food fussiness behaviors.

Assessment of a block curriculum design on medical postgraduates' perception towards biostatistics: a cohort study.

BACKGROUND: Biostatistics is a key but challenging subject in medical curricula that is usually delivered via a didactic approach in China. However, whether it is the best teaching approach to improve the learner's competency, especially for medical postgraduates is yet to be proved. Therefore, a block curriculum design was initially developed to provide selective education to the postgraduates towards the professional career of their interest. A questionnaire was designed to assess the students' perceptions toward biostatistics as these affective factors might impact the learning process. Thus, the present study aimed to detect whether the new block curriculum design could promote the students' positive perceptions and further improve the course achievement. METHODS: This cohort study investigated and assessed the perceptions toward biostatistics of the first-year postgraduates undergoing traditional teaching and block teaching, respectively. Structural equation modeling was applied to explore the association between perception and course achievement in the block teaching group. RESULTS: With a response rate of 97.84 and 96.67% from the two cohorts respectively, 499 block teaching postgraduates had more positive perceptions as compared to 465 traditionally teaching postgraduates with Likert 5-point agreement response mean of 3.50 vs. 3.31 for course value, 3.66 vs. 2.97 for course comment, and 4.29 vs. 4.10 for expectation. Moreover, block teaching students presented superior confidence about academic statistical knowledge, and therefore, 77.96% of them approved of the new teaching approach. Age, specialty, research experience, logical thinking capacity, mathematical basics, and computer basics might influence the postgraduates' self-assessment ability (all P < 0.05). Structural equation modeling confirmed a positive correlation between perceptions and the course achievements with a reasonable fit. CONCLUSIONS: The block curriculum design in the biostatistics course improved the postgraduates' positive perception and may have had a positive role in improving postgraduates' achievement in learning biostatistics.