Comparative analysis of medical treatments for long-term control of normal tension glaucoma: A systematic review and model-based network meta-analysis.

BACKGROUND: To evaluate and compare the long-term efficacy of medical treatments for normal tension glaucoma (NTG) in controlling intraocular pressure (IOP), and establish a hierarchical ranking based on their effectiveness. 'Long-term' is defined as a treatment duration of over 12 weeks in randomised controlled trials (RCTs). METHODS: This systematic review and model-based network meta-analysis (MBNMA) collected data of 795 patients with 997 eyes from RCTs. Patients with NTG were selected based on strict inclusion/exclusion criteria, with randomsation procedures and masking as reported in the individual trials. Eight different medications were compared, including prostaglandin analogues, beta-blockers, brimonidine, unoprostone isopropyl, brovincamine, and palmitoylethanolamide (PEA). Notably, PEA is an oral medication, while other drugs are topical agents. RESULTS: Primary outcome is the long-term efficacy of IOP control across medications with different follow-up durations. Among the eight medications, PEA demonstrates the highest efficacy (Surface under the cumulative ranking, SUCRA = 7.46%), followed by two prostaglandin analogues: travoprost (SUCRA = 6.86%) and latanoprost (SUCRA = 6.76%), then two beta-blockers: nipradilol (SUCRA = 4.90%) and timolol (SUCRA = 4.89%). Both brimonidine and unoprostone isopropyl have SUCRA scores below 4.0%, indicating modest but limited efficacy. Brovincamine has the lowest SUCRA score (1.32%), reflecting minimal effectiveness. CONCLUSIONS: This study revealed PEA as a promising agent for long-term IOP control in NTG patients, suggesting potential use as primary or adjunctive therapy. The outcomes call for PEA's consideration in clinical practice and highlight the need for further research into its long-term efficacy and safety for NTG.

Simultaneous Necking and Barreling Deformation Behaviors in Bending of Single-Crystal Gold Micro-Cantilever.

Necking and barreling deformation behaviors occurred simultaneously during the bending test of a single-crystal gold micro-cantilever (sample A) with the loading direction parallel to the [1-10] orientation and the neutral plane parallel to the [110] orientation. In contrast, for another single-crystal gold micro-cantilever, sample B, with the loading direction aligned parallel to the [0.37 -0.92 0.05] orientation and the neutral plane parallel to the [0.54 0.28 0.78] orientation, predominant slip band deformation was noted. Sample A exhibited activation of four slip systems, whereas sample B demonstrated activity in only a single-slip system. This difference suggests that the presence of multiple slip systems contributes to the concurrent occurrence of necking and barreling deformations. Furthermore, variations in the thickness of the micro-cantilevers resulted in observable strengthening, indicating that the effect of sample size is intricately linked to the geometry of the cross-section, which we have termed the "sample geometry effect".

A full reference quality assessment method with fused monocular and binocular features for stereo images.

Aiming to automatically monitor and improve stereoscopic image and video processing systems, stereoscopic image quality assessment approaches are becoming more and more important as 3D technology gains popularity. We propose a full-reference stereoscopic image quality assessment method that incorporate monocular and binocular features based on binocular competition and binocular integration. To start, we create a three-channel RGB fused view by fusing Gabor filter bank responses and disparity maps. Then, using the monocular view and the RGB fusion view, respectively, we extract monocular and binocular features. To alter the local features in the binocular features, we simultaneously estimate the saliency of the RGB fusion image. Finally, the monocular and binocular quality scores are calculated based on the monocular and binocular features, and the quality scores of the stereo image prediction are obtained by fusion. Performance testing in the LIVE 3D IQA database Phase I and Phase II. The results of the proposed method are compared with newer methods. The experimental results show good consistency and robustness.

Secure traceability mechanism of green electricity based on smart contracts and provenance model.

Green and low-carbon development is an important part of global sustainable development. Green power trading provides strong support and assurance for promoting green and low-carbon development. Due to the long cycle of green power data chains and their susceptibility to malicious tampering, the integrity and traceability of data are difficult to guarantee. Therefore, this paper first proposes a security provenance model with enhanced relations based on the core structure of PROV and blockchain technology, which can securely capture provenance records, use the transfer time and number of transactions between various links in the traceability network as reasoning clues, realize the correlation tracing of the green electricity transfer process. Under the model, a traceability mechanism of green electricity is designed based on smart contracts. Trustworthy green electricity data collection is achieved through data filling and data verification techniques. Traceability query technique is adopted to achieve trustworthy traceability of green electricity. And the effectiveness of the proposed solution is demonstrated through simulation experiments.

Manipulation of interfacial charge dynamics for metal-organic frameworks toward advanced photocatalytic applications.

Compared to other known materials, metal-organic frameworks (MOFs) have the highest surface area and the lowest densities; as a result, MOFs are advantageous in numerous technological applications, especially in the area of photocatalysis. Photocatalysis shows tantalizing potential to fulfill global energy demands, reduce greenhouse effects, and resolve environmental contamination problems. To exploit highly active photocatalysts, it is important to determine the fate of photoexcited charge carriers and identify the most decisive charge transfer pathway. Methods to modulate charge dynamics and manipulate carrier behaviors may pave a new avenue for the intelligent design of MOF-based photocatalysts for widespread applications. By summarizing the recent developments in the modulation of interfacial charge dynamics for MOF-based photocatalysts, this minireview can deliver inspiring insights to help researchers harness the merits of MOFs and create versatile photocatalytic systems.

Dual-plasmonic Au@Cu7S4 yolk@shell nanocrystals for photocatalytic hydrogen production across visible to near infrared spectral region.

Near infrared energy remains untapped toward the maneuvering of entire solar spectrum harvesting for fulfilling the nuts and bolts of solar hydrogen production. We report the use of Au@Cu7S4 yolk@shell nanocrystals as dual-plasmonic photocatalysts to achieve remarkable hydrogen production under visible and near infrared illumination. Ultrafast spectroscopic data reveal the prevalence of long-lived charge separation states for Au@Cu7S4 under both visible and near infrared excitation. Combined with the advantageous features of yolk@shell nanostructures, Au@Cu7S4 achieves a peak quantum yield of 9.4% at 500 nm and a record-breaking quantum yield of 7.3% at 2200 nm for hydrogen production in the absence of additional co-catalysts. The design of a sustainable visible- and near infrared-responsive photocatalytic system is expected to inspire further widespread applications in solar fuel generation. In this work, the feasibility of exploiting the localized surface plasmon resonance property of self-doped, nonstoichiometric semiconductor nanocrystals for the realization of wide-spectrum-driven photocatalysis is highlighted.

Saliency detection of textured 3D models based on multi-view information and texel descriptor.

Saliency-driven mesh simplification methods have shown promising results in maintaining visual detail, but effective simplification requires accurate 3D saliency maps. The conventional mesh saliency detection method may not capture salient regions in 3D models with texture. To address this issue, we propose a novel saliency detection method that fuses saliency maps from multi-view projections of textured models. Specifically, we introduce a texel descriptor that combines local convexity and chromatic aberration to capture texel saliency at multiple scales. Furthermore, we created a novel dataset that reflects human eye fixation patterns on textured models, which serves as an objective evaluation metric. Our experimental results demonstrate that our saliency-driven method outperforms existing approaches on several evaluation metrics. Our method source code can be accessed at https://github.com/bkballoon/mvsm-fusion and the dataset can be accessed at 10.5281/zenodo.8131602.

Optical adaptive power control based on atmospheric channel reciprocity for mitigating turbulence disturbances in free-space optics communication.

A continuous time-domain adaptive power model of transmitter optical and control algorithm based on atmospheric turbulence channel reciprocity are explored for mitigating the free-space optical communication (FSOC) receiver optical intensity scintillation and bit error rate (BER) deterioration. First, a transmitter optical adaptive power control (OAPC) system architecture using four wavelength optical signals based on atmospheric turbulence channel reciprocity is proposed, and electronically variable optical attenuator (EVOA) and erbium-doped fiber amplifier (EDFA) are employed as the main OAPC units for power adaptation. Moreover, a reciprocity evaluation model for gamma-gamma (G-G) continuous-time signals is generated using the autoregressive moving average (ARMA) stochastic process, which takes into account the delay time and system noise, and a reciprocity-based OPAC algorithm is proposed. Numerical simulations were also performed to analyze the signal reciprocity characteristics under different turbulence, noise, and sampling time mismatch at both ends, as well as the scintillation index (SI) performance under OAPC system operation. Simultaneously, the time-domain signals of continuous quadrature amplitude modulation -16 (QAM-16) and QAM-32 real states are fused with the gamma-gamma (G-G) reciprocal turbulence continuous signals to analyze the probability density function (PDF) and bit error ratio (BER) performance after OAPC correction. Finally, a 64 Gpbs QAM-16 OPAC communication experiment was successfully executed based on an atmospheric turbulence simulator. It is shown that the OAPC correction is carried out using reciprocity at millisecond sampling delay, the light intensity scintillation of the communication signal can be well suppressed, the signal-to-noise ratio (SNR) is greatly improved, the suppression is more obvious under strong turbulence, the overall BER reduction is greater than 2.8 orders of magnitude with the OAPC system, and this trend becomes more pronounced as the received power increases, even reach 6 orders of magnitude in some places. This work provides real time-domain continuous signal samples for real signal generation of communication signals in real turbulence environments, adaptive coding modulation using reciprocity, channel estimation, and optical wavefront adaptive suppression, which are the basis of advanced adaptive signal processing algorithms.

An Efficient Recognition Method for Orbital Angular Momentum via Adaptive Deep ELM.

For orbital angular momentum (OAM) recognition in atmosphere turbulence, how to design a self-adapted model is a challenging problem. To address this issue, an efficient deep learning framework that uses a derived extreme learning machine (ELM) has been put forward. Different from typical neural network methods, the provided analytical machine learning model can match the different OAM modes automatically. In the model selection phase, a multilayer ELM is adopted to quantify the laser spot characteristics. In the parameter optimization phase, a fast iterative shrinkage-thresholding algorithm makes the model present the analytic expression. After the feature extraction of the received intensity distributions, the proposed method develops a relationship between laser spot and OAM mode, thus building the steady neural network architecture for the new received vortex beam. The whole recognition process avoids the trial and error caused by user intervention, which makes the model suitable for a time-varying atmospheric environment. Numerical simulations are conducted on different experimental datasets. The results demonstrate that the proposed method has a better capacity for OAM recognition.

Adaptation of rhizosphere bacterial communities of drought-resistant sugarcane varieties under different degrees of drought stress.

Sugarcane is highly sensitive to changes in moisture, and increased drought severely restricts its growth and productivity. Recent studies have shown that plant growth-promoting microorganisms are essential to reduce the adverse effects of environmental stresses, especially drought. However, our knowledge about the dynamics of rhizosphere microbial community structure in sugarcane under varying degrees of drought stress is limited. We analyzed the effects of different degrees of drought stress on the rhizosphere microbial communities of Zhongzhe 1(ZZ1) and Zhongzhe 6(ZZ6) with differences in drought resistance, by combining soil enzyme activity, nutrient content, and physiological and morphological characteristics of sugarcane roots. The results showed that rhizosphere bacterial community began to change at a field capacity of 50%, enriching the sugarcane rhizosphere with drought-resistant bacteria. The core strains of ZZ1 and ZZ6 rhizosphere enrichment were mainly Streptomycetales, Sphingomonadales, and Rhizobiales. However, compared to ZZ1, the changes in rhizosphere bacterial abundance in ZZ6 were primarily associated with the abundance of Streptomycetales as drought levels increased. Rhizobiales and Streptomycetales, enriched in the rhizosphere of ZZ6 under drought, were positively correlated with root tip number and total root length (TRL), increasing the distribution area of roots and, thus, improving water and nutrient uptake by the roots thereby enhancing the resistance of sugarcane to drought stress. This research enhances our understanding of the composition of the rhizosphere microbial community in sugarcane under different levels of drought stress and its interaction with the roots, thereby providing valuable insights for enhancing drought resistance in sugarcane. IMPORTANCE Drought stress is expected to further increase in intensity, frequency, and duration, causing substantial losses in sugarcane yields. Here, we exposed sugarcane to varying degrees of drought treatment during growth and quantified the eventual composition of the resulting sugarcane rhizosphere bacterial community groups. We found that sugarcane rhizosphere under mild drought began to recruit specific bacterial communities to resist drought stress and used the interactions of root tip number, total root length, and drought-resistant strains to improve sugarcane survival under drought. This research provides a theoretical basis for the rhizosphere microbiome to help sugarcane improve its resistance under different levels of drought stress.

Platinum Metallization of Polyethylene Terephthalate by Supercritical Carbon Dioxide Catalyzation and the Tensile Fracture Strength.

Polyethylene terephthalate (PET) is known to be highly inert, and this makes it difficult to be metallized. In addition, Pt electroless plating is rarely reported in the metallization of polymers. In this study, the metallization of biocompatible Pt metal is realized by supercritical CO2 (sc-CO2)-assisted electroless plating. The catalyst precursor used in the sc-CO2 catalyzation step is an organometallic compound, palladium (II) acetylacetonate (Pd(acac)2). The electrical resistance is evaluated, and a tape adhesion test is utilized to demonstrate intactness of the Pt layer on the PET film. The electrical resistance of the Pt/PET with 60 min of the Pt deposition time remains at a low level of 1.09 Ω after the adhesion test, revealing positive effects of the sc-CO2 catalyzation step. A tensile test is conducted to evaluate the mechanical strength of the Pt/PET. In-situ electrical resistances of the specimen are monitored during the tensile test. The fracture strength is determined from the stress value when the short circuit occurred. The fracture strength is 33.9 MPa for a specimen with 30 min of the Pt deposition time. As the Pt deposition time increases to 45 min and 60 min, the fracture strengths reach 52.3 MPa and 65.9 MPa, respectively. The promoted fracture strength and the decent electrical conductivity demonstrate the advantages toward biomedical devices.

Enhanced secret-key generation from atmospheric optical channels with the use of random modulation: erratum.

An erratum is given to correct two typos of Eq. (28) in [Opt. Express30(25), 45862 (2022)10.1364/OE.476856]. The corrections do not impact on the results and conclusions of the original article.

Enhanced secret-key generation from atmospheric optical channels with the use of random modulation.

Secret-key extraction from atmospheric optical channels can generate common keys used by two communicating parties to encrypt their transmitted confidential information. The correlation time of turbulence-induced optical fluctuations imposes a restriction on the number of extracted uncorrelated key bits per second. To break this restriction, we propose a novel randomness sharing scheme between two communicating parties using an atmospheric optical channel equipped with random modulation and develop mathematical models for the common randomness source created by such a randomness-sharing scheme. Our randomness-sharing scheme provides the legitimate parties with the ability to decrease the temporal autocorrelation of the said common randomness source, which is called controllable common randomness source with memory (CCRSM), thereby enabling an enhanced secret-key extraction that can break the aforementioned restriction. Both the autocorrelation of the legitimate parties' observations of the CCRSM and the cross-correlation of the two legitimate parties' observations of the CCRSM are formulated and examined theoretically. It is found that the performing random modulation can decorrelate consecutive observations of the CCRSM obtained by the legitimate parties using a sampling interval smaller than the correlation time of turbulence-induced optical fluctuations. The cross-correlation coefficient of the eavesdropper's and legitimate parties' observations of the CCRSM is dealt with theoretically and the eavesdropping risk in the CCRSM-based key extraction is inspected for the fully-disclosed-single-modulation worst eavesdropping (FDSM-WE) scenario, partially-disclosed-single-modulation worst eavesdropping (PDSM-WE) scenario and double-modulation worst eavesdropping (DM-WE) scenario. It is shown that the FDSM-WE scenario has the highest degree of eavesdropping risk. Finally, the lowest limit of the secret-key capacity in consideration of using the CCRSM is theoretically formulated. The effects of random modulation on such the lowest limit are quantitatively analyzed from an information-theoretic perspective. It is manifested that random modulation does not harm the potential of extracting secret keys from the CCRSM's randomness component stemming from turbulence-induced optical fluctuations.

Generation of temporal fading envelope sequences for the FSOC channel based on atmospheric turbulence optical parameters.

The temporal characteristics of the free space optical communication (FSOC) turbulence fading channel are essential for analyzing the bit error rate (BER) performances and compiling the rationale of adaptive signal processing algorithms. However, the investigation is still limited since the majority of temporal sequence generation fails to combine the autocorrelation function (ACF) of the FSOC system parameters, and using the simplified formula results in the loss of detailed information for turbulence disturbances. In this paper, considering the ACF of engineering measurable atmospheric parameters, we propose a continuous-time FSOC channel fading sequence generation model that obeys the Gamma-Gamma (G-G) probability density function (PDF). First, under the influence of parameters such as transmission distance, optical wavelength, scintillation index, and atmospheric structural constant, the normalized channel fading models of ACF and PSD are established, and the numerical solution of the time-domain Gaussian correlation sequence is derived. Moreover, the light intensity generation model obeying the time-domain correlation with statistical distribution information is derived after employing the rank mapping, taking into account the association between the G-G PDF parameters and the large and small scales turbulence fading channels. Finally, the Monte Carlo numerical method is used to analyze the performances of the ACF, PDF, and PSD parameters, as well as the temporal characteristics of the generated sequence, and the matching relationships between these parameters and theory, under various turbulence intensities, propagation distances, and transverse wind speeds. Numerical results show that the proposed temporal sequence generation model highly restores the disturbance information in different frequency bands for the turbulence fading channels, and the agreement with the theoretical solution is 0.999. This study presents essential numerical simulation methods for analyzing and evaluating the temporal properties of modulated signals. When sophisticated algorithms are used to handle FSOC signals, our proposed temporal sequence model can provide communication signal experimental sample data generating techniques under various FSOC parameters, which is a crucial theoretical basis for evaluating algorithm performances.

Which fetal growth charts should be used? A retrospective observational study in China.

BACKGROUND: The fetal growth charts in widest use in China were published by Hadlock >35 years ago and were established on data from several hundred of American pregnant women. After that, >100 fetal growth charts were published around the world. We attempted to assess the impact of applying the long-standing Hadlock charts and other charts in a Chinese population and to compare their ability to predict newborn small for gestational age (SGA). METHODS: For this retrospective observational study, we reviewed all pregnant women ( n  = 106,455) who booked prenatal care with ultrasound measurements for fetal biometry at the Shenzhen Maternity and Child Healthcare Hospital between 2012 and 2019. A fractional polynomial regression model was applied to generate Shenzhen fetal growth chart ranges for head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL). The differences between Shenzhen charts and published charts were quantified by calculating the Z -score. The impact of applying these published charts was quantified by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts. The sensitivity and area under the receiver operating characteristic curves of published charts to predict neonatal SGA (birthweight <10th centile) were assessed. RESULTS: Following selection, 169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed. When using Hadlock references (<3rd centile), the proportions of small heads and short femurs were as high as 8.9% and 6.6% in late gestation, respectively. The INTERGROWTH-21st standards matched those of our observed curves better than other charts, in particular for fat-free biometry (HC and FL). When using AC<10th centile, all of these references were poor at predicting neonatal SGA. CONCLUSIONS: Applying long-standing Hadlock references could misclassify a large proportion of fetuses as SGA. INTERGROWTH-21st standard appears to be a safe option in China. For fat-based biometry, AC, a reference based on the Chinese population is needed. In addition, when applying published charts, particular care should be taken due to the discrepancy of measurement methods.

Comparative Genomics of Three Colletotrichum scovillei Strains and Genetic Analysis Revealed Genes Involved in Fungal Growth and Virulence on Chili Pepper.

Colletotrichum scovillei causes anthracnose of chili pepper in many countries. Three strains of this pathogen, Coll-524, Coll-153, and Coll-365, show varied virulence on chili pepper. Among the three strains, Coll-365 showed significant defects in growth and virulence. To decipher the genetic variations among these strains and identify genes contributing to growth and virulence, comparative genomic analysis and gene transformation to show gene function were applied in this study. Compared to Coll-524, Coll-153, and Coll-365 had numerous gene losses including 32 candidate effector genes that are mainly exist in acutatum species complex. A cluster of 14 genes in a 34-kb genomic fragment was lost in Coll-365. Through gene transformation, three genes in the 34-kb fragment were identified to have functions in growth and/or virulence of C. scovillei. CsPLAA encoding a phospholipase A2-activating protein enhanced the growth of Coll-365. A combination of CsPLAA with one transcription factor CsBZTF and one C6 zinc finger domain-containing protein CsCZCP was found to enhance the pathogenicity of Coll-365. Introduction of CsGIP, which encodes a hypothetical protein, into Coll-365 caused a reduction in the germination rate of Coll-365. In conclusion, the highest virulent strain Coll-524 had more genes and encoded more pathogenicity related proteins and transposable elements than the other two strains, which may contribute to the high virulence of Coll-524. In addition, the absence of the 34-kb fragment plays a critical role in the defects of growth and virulence of strain Coll-365.

HDAC6 inhibitor ACY-1215 improves neuropathic pain and its comorbidities in rats of peripheral nerve injury by regulating neuroinflammation.

The fact that neuropathic pain (NP) has no effective therapy and is frequently accompanied by psychiatric comorbidities is well established. Aberrant neuroinflammation plays an important role in the development and maintenance of NP. HDAC6 inhibitors have been demonstrated to ameliorate mechanical allodynia brought on by chemotherapy and peripheral nerve damage. However, its pharmacological mechanisms and its effects on NP-related mental disorders have not been fully elucidated. The present study was dedicated to exploring the effects of ACY-1215 (a specific HDAC6 inhibitor) on neuroinflammation and behavioral abnormalities associated with NP. In this work, spinal nerve ligation (SNL) was performed as an NP model on rats. Mechanical allodynia, cognitive impairment, and depressive-like behavior caused by SNL were attenuated by continuous intraperitoneal injection of ACY-1215. Moreover, ACY-1215 administration suppressed SNL-induced neuroinflammatory responses (including microgliosis, the elevation of pro-inflammatory factors IL-1ß and TNF-α) in ligation of the ipsilateral spinal dorsal horn (iSDH), hippocampus (HPC) and prefrontal cortex (PFC). Mechanistically, MyD88-dependent pro-inflammatory pathways (MyD88/NF-κB and MyD88/ERK) were activated in the iSDH following SNL and were inhibited by ACY-1215. Moreover, ACY-1215 enhanced the acetylation modification of MyD88 and inhibited the SNL-induced elevation of MyD88 without affecting its transcription in the iSDH. These findings suggest that pharmacological inhibition of HDAC6 can ameliorate NP and its psychiatric complications through modulating neuroinflammation, in part by blocking the MyD88-mediated pro-inflammatory pathways. The possible mechanism is that ACY-1215 prevents the elevation of MyD88 reactivity by increasing its acetylation level. Notably, neither SNL nor ACY-1215 significantly altered MyD88 expression in HPC and PFC, indicating differentiated pro-inflammatory mechanisms in the supraspinal neural regions.

Bioavailability of antimony and arsenic in a flowering cabbage-soil system: Controlling factors and interactive effect.

Soil contamination with antimony (Sb) and arsenic (As) has become a well-recognized environmental and human health issue. Consumption of vegetables, especially leafy vegetables, is one of the most important sources of Sb and As exposure in humans. Accordingly, it is necessary to understand the behaviors of Sb and As in the vegetable-soil system. Moreover, although Sb and As are often assumed to have similar biogeochemical behavior, identified differences in the controlling factors affecting mobility and bioavailability of Sb and As in soils need further investigation. In this study, 112 pairs of soil and flowering cabbage samples were collected from typical farmland protection areas and vegetable-producing regions across the Pearl River Delta (PRD), South China. The contamination levels of Sb and As in soils and harvested cabbages across the PRD were investigated. The main factors affecting the mobility and bioavailability of Sb and As in the cabbage-soil system were disentangled using a random forest model. The contamination levels of Sb in the cabbages and soils of the PRD were generally low, but the soils were moderately polluted by As. Increased concentrations of Fe oxides could decrease Sb accumulation in cabbages but increased the mobilization of As in soils to some extent. In contrast, Al oxides contributed strongly to the mobilization of Sb and the immobilization of As. Moreover, an increased sand content promoted the mobility of Sb and As, whereas increased silt and clay contents showed inhibitory effects. The interactions of As and Sb with Fe oxides decreased the mobility of Sb but moderately increased the mobility of As in soils. Overall, the behaviors of Sb and As in the cabbage-soil system under the effect of several important environmental factors showed some differences indicating that these differences should be considered in the remediation of co-contaminated soils.

Association Between Violent Discipline at Home and Risk of Illness and Injury in Children: Findings From a Cross-sectional Study in Rural Western China.

To estimate the prevalence of violent discipline at home against young children, and to explore the potential association between violent discipline at home and multifaceted health risks in children. A community-based cross-sectional survey was conducted in twenty rural counties of weight provinces in western China. The information about child neglect and socio-demographic factors, exposure to different forms of violent discipline at home and four health outcomes was collected by face-to-face interview. Before analysis, the included interviews were weighted by the double-weighted comprehensive weighting. The proportion of children reported by primary caregivers to have experienced different forms of violent discipline by gender were calculated. To adjust the clustering effect of the survey design, two-level univariate and multivariate logistic regression models were constructed to evaluate the potential association between a child's exposure to violent discipline at home and risk of suffering from diarrhea, fever, cough and injury. A total of 3,682 weighted interviews were finally included in the analysis. The prevalence of any violent discipline, psychological aggression, any physical punishment and severe physical punishment were 76.4%, 57.5%, 68.3% and 14.1%, respectively. In multivariate analysis, after adjusting for clustering, there was still a positive association between a child's exposure to psychological aggression and risk of diarrhea (adjusted OR: 1.47, 95%CI: 1.14-1.90) and injury (adjusted OR: 1.95, 95%CI: 1.36-2.80); a child's exposure to any physical punishment and risk of diarrhea (adjusted OR: 1.36, 95%CI: 1.04-1.77), cough (adjusted OR: 1.37, 95%CI: 1.14-1.66), and injury (adjusted OR: 2.05, 95%CI: 1.37-3.06); and a child's exposure to severe physical punishment and risk of injury (adjusted OR: 2.07, 95%CI: 1.41-3.05). Considering that using violent discipline at home is prevalent in rural western China, and it could threaten young children's health, effective measures to prevent young children from violent discipline are urgently needed.

Protocol of a prospective and multicentre China Teratology Birth Cohort (CTBC): association of maternal drug exposure during pregnancy with adverse pregnancy outcomes.

BACKGROUND: As reported, 27-93 % of pregnant women take at least one drug during pregnancy. However, drug exposure during pregnancy still lacks sufficient foetal safety evidence of human origin. It is urgent to fill the knowledge gap about medication safety during pregnancy for optimization of maternal disease treatment and pregnancy drug consultation. METHODS AND ANALYSIS: The China Teratology Birth Cohort (CTBC) was established in 2019 and is a hospital-based open-ended prospective cohort study with the aim of assessing drug safety during pregnancy. Pregnant women who set up the pregnancy health records in the first trimester or who seek drug consultation regardless of gestational age in the member hospitals are recruited. Enrolled pregnant women need to be investigated four times, namely, 6-14 and 24-28 weeks of gestational age, before discharge after hospital delivery, and 28-42 days after birth. Maternal medication exposure during pregnancy is the focus of the CTBC. For drugs, information on the type, name, and route of medication; start and end time of medication; single dose; frequency of medication; dosage form; manufacturer; and reason for medication is collected. The adverse pregnancy outcomes collected in the study include birth defects, stillbirth, spontaneous abortion, preterm birth, post-term birth, low birth weight, macrosomia, small for gestational age, large for gestational age and low Apgar score. CTBC uses an electronic questionnaire for data collection and a cloud system for data management. Biological samples are collected if informed consents are obtained. Multi-level logistic regression, mixed-effect negative binomial distribution regression and spline function regression are used to explore the effect of drugs on the occurrence of birth defects. DISCUSSION: The findings of the study will assist in further understanding the risk of birth defects and other adverse pregnancy outcomes associated with maternal drug exposure and developing the optimal treatment plans and drug counselling for pregnant women. TRIAL REGISTRATION: This study was approved by the Research Ethics Committee of the West China Second Hospital of Sichuan University and registered at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/index.aspx , registration number ChiCTR1900022569 ).