Clinical Characteristics, Treatment, and Prognosis of Osteoarticular Brucellosis: A Retrospective Real-World Study in Shenyang, China, 2014-2019.

This study aimed to assess the clinical characteristics, treatment, and prognosis of osteoarticular brucellosis. We conducted a retrospective study enrolling brucellosis patients from the Sixth People's Hospital of Shenyang between September 2014 and June 2019. A total of 1917 participants were admitted during this period. After applying propensity score matching, we retrospectively analyzed 429 patients with osteoarthritis and 429 patients without osteoarthritis. The primary outcome was treatment completion. The secondary outcome was symptom disappearance and seroconversion. Brucellosis patients with osteoarthritis had longer treatment course (160 [134.3-185.7] vs. 120 [102.3-137.7] d, p = 0.008) than those without osteoarthritis. The most common involved site was lumbar vertebrae (290 [67.6%]) in brucellosis patients with osteoarthritis. Longer symptom duration (90 [83.0-97.0] vs. 42 [40.2-43.8], p < 0.001) along with no significant difference in seroconversion (180 [178.8-181.2] vs. 180 [135.1-224.9], p = 0.212) was observed in osteoarthritis patients with treatment course >90 d. Peripheral joint involvement (adjusted hazard ratio [95% confidence interval] 1.485 [1.103-1.999]; p = 0.009) had a shorter symptom duration compared with shaft joint involvement. No significant differences were observed in treatment therapy between doxycycline plus rifampin (DR) or plus cephalosporins (DRC) in treatment course (p = 0.190), symptom persistence (p = 0.294), and seroconversion (p = 0.086). Lumbar vertebra was the most commonly involved site. Even if all symptoms disappeared, Serum agglutination test potentially remained positive in some patients. Compared with peripheral arthritis, shaft arthritis was the high-risk factor for longer symptom duration. The therapeutic effects were similar between DR and DRC. In summary, our study provided important insights into the clinical characteristics, treatment, and outcomes of osteoarticular brucellosis. Clinical Trial Registration number: NCT04020536.

Diagnostic Classification Models for Testlets: Methods and Theory.

Diagnostic classification models (DCMs) have seen wide applications in educational and psychological measurement, especially in formative assessment. DCMs in the presence of testlets have been studied in recent literature. A key ingredient in the statistical modeling and analysis of testlet-based DCMs is the superposition of two latent structures, the attribute profile and the testlet effect. This paper extends the standard testlet DINA (T-DINA) model to accommodate the potential correlation between the two latent structures. Model identifiability is studied and a set of sufficient conditions are proposed. As a byproduct, the identifiability of the standard T-DINA is also established. The proposed model is applied to a dataset from the 2015 Programme for International Student Assessment. Comparisons are made with DINA and T-DINA, showing that there is substantial improvement in terms of the goodness of fit. Simulations are conducted to assess the performance of the new method under various settings.

A feature refinement and adaptive generative adversarial network for thermal infrared image colorization.

Colorizing thermal infrared images poses a significant challenge as current methods struggle with issues such as unrealistic color saturation and limited texture. To address these challenges, we propose the Feature Refinement and Adaptive Generative Adversarial Network (FRAGAN). Our approach enhances the detailed, semantic, and contextual capabilities of image coloring by combining multi-level interactions that integrate the lost detailed information from the encoding stage with the semantic information from the decoding stage. Additionally, we introduce the Residual Feature Refinement Module (RFRM) to improve both the accuracy and generalization ability of the model, thereby elevating the quality of colorization results. The Feature Adaptation Module (FAM) is employed to mitigate sub-region information loss during downsampling. Furthermore, we introduce the Trinity Attention Module (TAM) to accurately capture the spatial and channel-wise interaction features of local semantic information. Extensive experimentation on the KAIST dataset and the FLIR dataset demonstrates the superiority of our proposed FRAGAN methodology, surpassing both the performance metrics and visual quality of current state-of-the-art methods. The colorized images generated by our proposed FRAGAN exhibit enhanced clarity and realism. Our code and models are available at GitHub.

Real-world effectiveness of seasonal influenza vaccination and age as effect modifier: A systematic review, meta-analysis and meta-regression of test-negative design studies.

BACKGROUND: Under the global risk of epidemic rebound of influenza after COVID-19 outbreak, the study aimed to provide a comprehensive evaluation of the seasonal influenza vaccine effectiveness (IVE) and to explore the potential effect modifiers. METHODS: We searched for test-negative design studies with IVE estimates published between January 1, 2017 and December 31, 2022. We estimated pooled IVE using random-effects meta-analysis, and conducted meta-regression with study site, age, sex and comorbidity as explanatory variables. RESULTS: We identified 2429 publications and included 191 in the meta-analysis. The pooled IVE was 41.4 % (95 % CI: 39.2-43.5 %) against any influenza. For specific strains, the IVE was 55.4 % (95 % CI: 52.7-58.1 %) against A/H1N1, 26.8 % (95 % CI: 23.5-29.9 %) against A/H3N2, 47.2 % (95 % CI: 38.1-54.9 %) against B/Yamagata, and 40.6 % (95 % CI: 23.7-53.7 %) against B/Victoria, and the effectiveness against A/H3N2 was significantly lower than A/H1N1 (p < 0.0001) and B/Yamagata (p < 0.0001). The pooled IVE was 39.2 % (95 % CI: 36.5-41.9 %) in preventing influenza-associated outpatient visit and 43.7 % (95 % CI: 39.7-47.4 %) in preventing influenza-related hospitalization. The IVE against any influenza was 48.6 % (95 % CI: 44.7-52.2 %) for children aged < 18 years, 36.7 % (95 % CI: 31.9-41.1 %) for adults aged 18-64 years, and 30.6 % (95 % CI: 26.2-34.8 %) for elderly aged ≥65 years. Meta-regression revealed that the IVE was associated with the average age of study participants, in which both young adults [relative odds ratio (ROR) = 1.225, 95 % confidence interval (CI): 1.099-1.365, p = 0.0002] and elderly (ROR = 1.245, 95 % CI: 1.083-1.431, p = 0.002) manifested a significantly decreased effectiveness compared with children. CONCLUSIONS: Influenza vaccines provided moderate protection against laboratory-confirmed influenza and related outpatient visit and hospitalization. However, the effectiveness may vary substantially by virus type and age group, suggesting the necessity to tailor vaccination strategies especially for older individuals and against the A/H3N2 strain, and to promote annual immunization and annual analysis of vaccine effectiveness.

A novel top-down strategy for in situ construction of vertically oriented hexagonal NiCr LDHs nanosheet arrays with intercalated sulfate ions on Nichrome fiber for selective solid-phase microextraction of phenolic compounds in water samples.

BACKGROUND: Phenolic compounds (PCs) are a class of polar aromatic pollutants with high toxicity in environmental water. Generally the efficient sample preparation is essential for the quantification of ultra-trace target PCs in real water sample before appropriative instrumental analysis. SPME is a convenient, solvent-free and time-saving miniaturized technique and has been recognized as a green alternative to conventional extraction techniques. In SPME, however, commercial fused-silica fibers are limited to the fragility, operation temperature, extraction capacity and selectivity as well as lifetime. Therefore, the development of new SPME fibers is always needed to overcome such limitations. RESULTS: We presented a novel top-down strategy for in situ construction of vertically oriented hexagonal sulfate intercalated NiCr layered double hydroxide nanosheet arrays (NiCr LDHs-SO4 NSAs) on the Nichrome (NiCr) substrate by hydrothermal treatment in NaOH solution containing (NH4)2S2O8. The results showed that much shorter hydrothermal time was needed for the construction of NiCr@NiCr LDHs-SO4 NSAs fiber in the presence of (NH4)2S2O8. Moreover, the unique NiCr LDHs-SO4 NSAs coating offered open access structure, and thereby more available surface area for adsorption. The resulting fiber exhibited better extraction efficiency for phenolic compounds (PCs), faster mass transfer rate, higher mechanical stability, and longer service life than original NiCr@NiCr LDHs NSs fiber and typical commercially fused-silica fibers. After optimizing conditions, the SPME-HPLC-UV method demonstrated a linear range from 0.05 µg L-1 to 200 µg L-1 with LODs of 0.015-0.156 µg L-1 (S/N = 3) and LOQs of 0.048-0.498 µg L-1 (S/N = 10), as well as good repeatability (3.06%-5.22%) and fiber-to-fiber reproducibility (4.32%-6.49%). SIGNIFICANCE: The developed SPME-HPLC-UV method with the constructed fiber was applied to the preconcentration and detection of different types of PCs in real water samples, showing satisfactory recoveries ranging from 86.20% to 107.8% with RSDs of 3.18%-6.69%. This study provides a new strategy for in situ construction of bimetallic hydroxides and their derived nanocomposite coatings on the NiCr fiber substrate in practical SPME application.

Terrestrial dissolved organic matter inputs accompanied by dissolved oxygen depletion and declining pH exacerbate CO2 emissions from a major Chinese reservoir.

Terrestrial inputs and subsequent degradation of dissolved organic matter (DOM) in lake ecosystems can result in rapid depletion of dissolved oxygen (DO). Inputs of terrestrial DOM including organic acids can also lead to decreases in pH. However, to date, few studies have investigated the linkages between terrestrial DOM inputs, DO and pH levels in the water column, and carbon dioxide (CO2) emissions from lake ecosystems. Based on monthly field sampling campaigns across 100 sites in Lake Qiandao, a major man-made drinking water reservoir in China, from May 2020 to April 2021, we estimated an annual CO2 efflux (FCO2) of 37.2 ± 29.0 gC m-2 yr-1, corresponding to 0.02 ± 0.02 TgC yr-1 from this lake. FCO2 increased significantly with decreasing DO, chlorophyll-a (Chl-a) and δ2H-H2O, while FCO2 increased with increasing specific UV absorbance (SUVA254) and a terrestrial humic-like component (C2). We found that DO concentration and pH declined with increasing terrestrial DOM inputs, i.e. increased SUVA254 and terrestrial humic-like C2 levels. Vertical profile sampling revealed that the partial pressure of CO2 (pCO2) increased with increasing terrestrial DOM fluorescence (FDOM), while DO, pH, and δ13C-CO2 declined with increasing terrestrial FDOM. These results highlight the importance of terrestrial DOM inputs in altering physico-chemical environments and fueling CO2 emissions from this lake and potentially other aquatic ecosystems.

Biclustering of Log Data: Insights from a Computer-Based Complex Problem Solving Assessment.

Computer-based assessments provide the opportunity to collect a new source of behavioral data related to the problem-solving process, known as log file data. To understand the behavioral patterns that can be uncovered from these process data, many studies have employed clustering methods. In contrast to one-mode clustering algorithms, this study utilized biclustering methods, enabling simultaneous classification of test takers and features extracted from log files. By applying the biclustering algorithms to the "Ticket" task in the PISA 2012 CPS assessment, we evaluated the potential of biclustering algorithms in identifying and interpreting homogeneous biclusters from the process data. Compared with one-mode clustering algorithms, the biclustering methods could uncover clusters of individuals who are homogeneous on a subset of feature variables, holding promise for gaining fine-grained insights into students' problem-solving behavior patterns. Empirical results revealed that specific subsets of features played a crucial role in identifying biclusters. Additionally, the study explored the utilization of biclustering on both the action sequence data and timing data, and the inclusion of time-based features enhanced the understanding of students' action sequences and scores in the context of the analysis.

Sweat Sensor Based on Wearable Janus Textiles for Sweat Collection and Microstructured Optical Fiber for Surface-Enhanced Raman Scattering Analysis.

Wearable sweat sensors provide real-time monitoring of biomarkers, enabling individuals to gain real-time insight into their health status. Current sensors primarily rely on electrochemical mechanisms, limiting their capacity for the concurrent detection of multiple analytes. Surface-enhanced Raman scattering spectroscopy offers an alternative approach by providing molecular fingerprint information to facilitate the identification of intricate analytes. In this study, we combine a wearable Janus fabric for efficient sweat collection and a grapefruit optical fiber embedded with Ag nanoparticles as a sensitive SERS probe. The Janus fabric features a superhydrophobic side in contact with the skin and patterned superhydrophilic regions on the opposite surface, facilitating the unidirectional flow of sweat toward these hydrophilic zones. Grapefruit optical fibers feature sharp tips with the ability to penetrate transparent dressings. Its microchannels extract sweat through capillary force, and nanoliter-scale volumes of sweat are sufficient to completely fill them. The Raman signal of sweat components is greatly enhanced by the plasmonic hot spots and accumulates along the fiber length. We demonstrate sensitive detection of sodium lactate and urea in sweat with a detection limit much lower than the physiological concentration levels. Moreover, the platform shows its capability for multicomponent detection and extends to the analysis of real human sweat.

Cost and health-related quality of life for children hospitalized with respiratory syncytial virus in Central China.

BACKGROUND: The economic burden of respiratory syncytial virus (RSV) infection and its impact on health-related quality of life (HRQoL) are not well-understood in China. This study assessed total cost and HRQoL for children hospitalized with RSV in Central China. METHODS: Based on a prospective case series study in Henan Province in 2020-2021, inpatients aged 0-59 months with RSV-related acute respiratory infections (ARIs) were included into analysis. Total cost included direct medical cost (sum of medical cost before and during hospitalization), direct non-medical cost, and indirect cost. Direct medical cost during hospitalization data were extracted from the hospital information system. Other costs and HRQoL status were obtained from a telephone survey conducted in the caregivers of the enrolled patients. RESULTS: Among 261 RSV-infected inpatients, caregivers of 170 non-severe cases (65.1%, 170/261) were successfully interviewed. Direct medical cost per episode was 1055.3 US dollars (US$) (95% CI: 998.2-1112.5 US$). Direct non-medical cost and indirect cost per episode were 83.6 US$ (95% CI: 77.5-89.7 US$) and 162.4 US$ (95% CI: 127.9-197.0 US$), respectively. Quality adjusted life years (QALY) loss for non-severe RSV hospitalization was 8.9 × 10-3 (95% CI: 7.9 × 10-3 -9.9 × 10-3 ). The majority of inpatients were <1 year of age comprising significantly higher cost and more QALY loss than older children. CONCLUSIONS: RSV-associated hospitalization poses high economic and health burden in Central China particularly for children <1 year old. Our findings are crucial for determining the priority of interventions and allocation of health resources.

Contour Information-Guided Multi-Scale Feature Detection Method for Visible-Infrared Pedestrian Detection.

Infrared pedestrian target detection is affected by factors such as the low resolution and contrast of infrared pedestrian images, as well as the complexity of the background and the presence of multiple targets occluding each other, resulting in indistinct target features. To address these issues, this paper proposes a method to enhance the accuracy of pedestrian target detection by employing contour information to guide multi-scale feature detection. This involves analyzing the shapes and edges of the targets in infrared images at different scales to more accurately identify and differentiate them from the background and other targets. First, we propose a preprocessing method to suppress background interference and extract color information from visible images. Second, we propose an information fusion residual block combining a U-shaped structure and residual connection to form a feature extraction network. Then, we propose an attention mechanism based on a contour information-guided approach to guide the network to extract the depth features of pedestrian targets. Finally, we use the clustering method of mIoU to generate anchor frame sizes applicable to the KAIST pedestrian dataset and propose a hybrid loss function to enhance the network's adaptability to pedestrian targets. The extensive experimental results show that the method proposed in this paper outperforms other comparative algorithms in pedestrian detection, proving its superiority.

Construction of Bio-TiO2/Algae Complex and Synergetic Mechanism of the Acceleration of Phenol Biodegradation.

Microalgae have been widely employed in water pollution treatment since they are eco-friendly and economical. However, the relatively slow treatment rate and low toxic tolerance have seriously limited their utilization in numerous conditions. In light of the problems above, a novel biosynthetic titanium dioxide (bio-TiO2 NPs)-microalgae synergetic system (Bio-TiO2/Algae complex) has been established and adopted for phenol degradation in the study. The great biocompatibility of bio-TiO2 NPs ensured the collaboration with microalgae, improving the phenol degradation rate by 2.27 times compared to that with single microalgae. Remarkably, this system increased the toxicity tolerance of microalgae, represented as promoted extracellular polymeric substances EPS secretion (5.79 times than single algae), and significantly reduced the levels of malondialdehyde and superoxide dismutase. The boosted phenol biodegradation with Bio-TiO2/Algae complex may be attributed to the synergetic interaction of bio-TiO2 NPs and microalgae, which led to the decreased bandgap, suppressed recombination rate, and accelerated electron transfer (showed as low electron transfer resistance, larger capacitance, and higher exchange current density), resulting in increased light energy utilization rate and photocatalytic rate. The results of the work provide a new understanding of the low-carbon treatment of toxic organic wastewater and lay a foundation for further remediation application.

A Retrospective Modeling Study of the Targeted Non-Pharmaceutical Interventions During the Xinfadi Outbreak in the Early Stage of the COVID-19 Pandemic - Beijing, China, 2020.

What is already known about this topic?: China has repeatedly contained multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks through a comprehensive set of targeted non-pharmaceutical interventions (NPIs). However, the effectiveness of such NPIs has not been systematically assessed. What is added by this report?: A multilayer deployment of case isolation, contact tracing, targeted community lockdowns, and mobility restrictions could potentially contain outbreaks caused by the SARS-CoV-2 ancestral strain, without the requirement of city-wide lockdowns. Mass testing could further aid in the efficacy and speed of containment. What are the implications for public health practice?: Pursuing containment in a timely fashion at the beginning of the pandemic, before the virus had the opportunity to spread and undergo extensive adaptive evolution, could help in averting an overall pandemic disease burden and be socioeconomically cost-effective.

Long-term measles antibody profiles following different vaccine schedules in China, a longitudinal study.

Characterizing the long-term kinetics of maternally derived and vaccine-induced measles immunity is critical for informing measles immunization strategies moving forward. Based on two prospective cohorts of children in China, we estimate that maternally derived immunity against measles persists for 2.4 months. Following two-dose series of measles-containing vaccine (MCV) at 8 and 18 months of age, the immune protection against measles is not lifelong, and antibody concentrations are extrapolated to fall below the protective threshold of 200 mIU/ml at 14.3 years. A catch-up MCV dose in addition to the routine doses between 8 months and 5 years reduce the cumulative incidence of seroreversion by 79.3-88.7% by the age of 6 years. Our findings also support a good immune response after the first MCV vaccination at 8 months. These findings, coupled with the effectiveness of a catch-up dose in addition to the routine doses, could be instrumental to relevant stakeholders when planning routine immunization schedules and supplemental immunization activities.

Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID-19 pandemic in Central China.

Background: Globally, the epidemiology of non-SARS-CoV-2 respiratory viruses like respiratory syncytial virus (RSV) and influenza virus was remarkably influenced by the implementation of non-pharmacological interventions (NPIs) during the COVID-19 pandemic. Our study explored the epidemiological and clinical characteristics of pediatric patients hospitalized with RSV or influenza infection before and during the pandemic after relaxation of NPIs in central China. Methods: This hospital-based prospective case-series study screened pediatric inpatients (age ≤ 14 years) enrolled with acute respiratory infections (ARI) for RSV or influenza infection from 2018 to 2021. The changes in positivity rates of viral detection, epidemiological, and clinical characteristics were analyzed and compared. Results: Median ages of all eligible ARI patients from 2018-2019 were younger than those from 2020-2021, so were ages of cases infected with RSV or influenza (RSV: 4.2 months vs. 7.2 months; influenza: 27.3 months vs. 37.0 months). Where the positivity rate for influenza was considerably decreased in 2020-2021 (1.4%, 27/1964) as compared with 2018-2019 (2.9%, 94/3275, P < 0.05), it was increased for RSV (11.4% [372/3275] vs. 13.3% [262/1964], P < 0.05) in the same period. The number of severe cases for both RSV and influenza infection were also decreased in 2020-2021 compared with 2018-2019. Conclusions: The implemented NPIs have had varied impacts on common respiratory viruses. A more effective prevention strategy for RSV infections in childhood is needed.

SARS-CoV-2 containment was achievable during the early stage of the pandemic: a retrospective modelling study of the Xinfadi outbreak in Beijing.

Prior to the emergence of the Omicron variant, many cities in China had been able to maintain a "Zero-COVID" policy. They were able to achieve this without blanket city-wide lockdown and through widespread testing and an extensive set of nonpharmaceutical interventions (NPIs), such as mask wearing, contact tracing, and social distancing. We wanted to examine the effectiveness of such a policy in containing SARS-CoV-2 in the early stage of the pandemic. Therefore, we developed a fully stochastic, spatially structured, agent-based model of SARS-CoV-2 ancestral strain and reconstructed the Beijing Xinfadi outbreak through computational simulations. We found that screening for symptoms and among high-risk populations served as methods to discover cryptic community transmission in the early stage of the outbreak. Effective contact tracing could greatly reduce transmission. Targeted community lockdown and temporal mobility restriction could slow down the spatial spread of the virus, with much less of the population being affected. Population-wide mass testing could further improve the speed at which the outbreak is contained. Our analysis suggests that the containment of SARS-CoV-2 ancestral strains was certainly possible. Outbreak suppression and containment at the beginning of the pandemic, before the virus had the opportunity to undergo extensive adaptive evolution with increasing fitness in the human population, could be much more cost-effective in averting the overall pandemic disease burden and socioeconomic cost.

Early identification and severity prediction of acute respiratory infection (ESAR): a study protocol for a randomized controlled trial.

BACKGROUND: The outbreak of SARS-CoV-2 at the end of 2019 sounded the alarm for early inspection on acute respiratory infection (ARI). However, diagnosis pathway of ARI has still not reached a consensus and its impact on prognosis needs to be further explored. METHODS: ESAR is a multicenter, open-label, randomized controlled, non-inferiority clinical trial on evaluating the diagnosis performance and its impact on prognosis of ARI between mNGS and multiplex PCR. Enrolled patients will be divided into two groups with a ratio of 1:1. Group I will be directly tested by mNGS. Group II will firstly receive multiplex PCR, then mNGS in patients with severe infection if multiplex PCR is negative or inconsistent with clinical manifestations. All patients will be followed up every 7 days for 28 days. The primary endpoint is time to initiate targeted treatment. Secondary endpoints include incidence of significant events (oxygen inhalation, mechanical ventilation, etc.), clinical remission rate, and hospitalization length. A total of 440 participants will be enrolled in both groups. DISCUSSION: ESAR compares the efficacy of different diagnostic strategies and their impact on treatment outcomes in ARI, which is of great significance to make precise diagnosis, balance clinical resources and demands, and ultimately optimize clinical diagnosis pathways and treatment strategies. Trial registration Clinicaltrial.gov, NCT04955756, Registered on July 9th 2021.

Pathological Networks Involving Dysmorphic Neurons in Type II Focal Cortical Dysplasia.

Focal cortical dysplasia (FCD) is one of the most common causes of drug-resistant epilepsy. Dysmorphic neurons are the major histopathological feature of type II FCD, but their role in seizure genesis in FCD is unclear. Here we performed whole-cell patch-clamp recording and morphological reconstruction of cortical principal neurons in postsurgical brain tissue from drug-resistant epilepsy patients. Quantitative analyses revealed distinct morphological and electrophysiological characteristics of the upper layer dysmorphic neurons in type II FCD, including an enlarged soma, aberrant dendritic arbors, increased current injection for rheobase action potential firing, and reduced action potential firing frequency. Intriguingly, the upper layer dysmorphic neurons received decreased glutamatergic and increased GABAergic synaptic inputs that were coupled with upregulation of the Na+-K+-Cl- cotransporter. In addition, we found a depolarizing shift of the GABA reversal potential in the CamKII-cre::PTENflox/flox mouse model of drug-resistant epilepsy, suggesting that enhanced GABAergic inputs might depolarize dysmorphic neurons. Thus, imbalance of synaptic excitation and inhibition of dysmorphic neurons may contribute to seizure genesis in type II FCD.

Modeling Not-Reached Items in Timed Tests: A Response Time Censoring Approach.

Time limits are imposed on many computer-based assessments, and it is common to observe examinees who run out of time, resulting in missingness due to not-reached items. The present study proposes an approach to account for the missing mechanisms of not-reached items via response time censoring. The censoring mechanism is directly incorporated into the observed likelihood of item responses and response times. A marginal maximum likelihood estimator is proposed, and its asymptotic properties are established. The proposed method was evaluated and compared to several alternative approaches that ignore the censoring through simulation studies. An empirical study based on the PISA 2018 Science Test was further conducted.

Obesity is a risk factor for central precocious puberty: a case-control study.

BACKGROUND: Obesity is an important underlying cause of central precocious puberty (CPP), but previous large studies are flawed by using just age and breast examination to diagnose CPP. We aimed to determine whether overweight and obesity in childhood increases hormonally diagnosed CPP. METHODS: Our retrospective, case-control study recruited 846 children diagnosed as having CPP and randomly sampled 1650 healthy control subjects in Xingtai Third Hospital in China between November 2018 and March 2021. Information was obtained from an electronic medical record and questionnaire investigated in the outpatient visit. Observations were made before the a priori hypothesis. Unconditional logistic regression for analysis was used to determine whether overweight and obesity status and duration of overweight/obesity were associated with CPP. RESULTS: Overweight and obesity were significantly associated with increased odds of CPP among girls, even after adjusting for birth weight, exclusive breastfeeding for 6 month, household income, maternal overweight, paternal overweight, and maternal menarche age (overweight: the adjusted odds ratio (aOR) (95%CI): 1.92 (1.16, 3.24), p = 0.02; obesity: aOR (95%CI): 1.78 (1.13, 3.48), p = 0.03). Furthermore, the effects of overweight and obesity were significant when ongoing for 1 to 2 years, 2 to 3 years, and greater than 3 years, but not at less than 1 year. For boys, association between obesity and increased odds of CPP was observed (aOR (95%CI): 1.68 (1.09, 3.75), p = 0.03). The effects of overweight and/or obesity were only significant when ongoing for greater than 2 years. CONCLUSIONS: Prolonged overweight and obesity in early childhood may be risk factors for CPP, especially in girls. Weight loss might be an important approach for the prevention of precocious puberty in children.