Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study.

OBJECTIVE: To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered. DESIGN: We conducted a population-based, cross-sectional study between October and December 2016. Logistic regression models were used to examine the predictors of accepting free vision screening and cataract surgery. SETTING: Rural communities in Handan, China. PARTICIPANTS: Adults aged 50 years or older, with presenting visual acuity ≤6/18 in the better seeing eye, suspected by examining ophthalmologist to be due to cataract. RESULTS: Among 613 persons with cataract identified on a population basis, 596 (97.2%) completed the household survey (mean (SD) age, 71.5 (10.0) years; 79.8% female). A total of 214 persons (35.9%) refused participation, while 382 (64.1%) took part in the vision screening. A total of 193 (50.5%) participants were found eligible for surgery, while 189 (49.5%) were not. Among 99 randomly selected participants who were offered immediate free surgery, surgery was accepted by 77 participants (77.8%) and refused by 22 (22.2%). In the multivariate model, being engaged in income-generating activities (p<0.01), self-reported better physical capacity (p<0.001) and having had a recent physical examination (p=0.01) were significantly associated with acceptance of vision screening. The only variable significantly associated with acceptance of surgery was presenting visual acuity, with better vision inversely associated with acceptance of surgery (p<0.05) models. CONCLUSION: Our results suggest that refusal of basic eye examinations may be at least as important a determinant of low surgical rates in rural China as lack of acceptance of surgery itself.

Parental migration and children's dietary diversity at home: Evidence from rural China.

There is a growing literature documenting the link between parental migration and children's health. However, few studies have explained the underlying mechanism of this observed relationship. This paper examines the effect of parental migration on children's health through dietary diversity, using survey data collected in a less developed prefecture in South Central China in 2018. To overcome the potential endogeneity of parental migration, we instrument parental migration with the proportion of households with migrated labor force at the village level, and find that parental migration reduces children's dietary diversity at home. Moreover, we provide suggestive evidence that the reduction in dietary diversity may attribute to significant negative separation effects whereas minimal positive income effects in migrant-sending households. This study highlights the negative effects of labor migration on the next generation's nutrition. In those developing countries with a high prevalence of labor migration, policies that facilitate access to dietary diversity of those left-behind children are warranted.

Preschool or/and kindergarten? The long-term benefits of different types of early childhood education on pupils' skills.

BACKGROUND: Developing countries have witnessed great progress in early childhood education (ECE) enrollment rate over the past three decades. Preschool and kindergarten are the two most common types of ECE in developing countries. Questions remain as to which of the two types of ECE is more effective in promoting child development in developing countries, including both cognitive and non-cognitive skills. The objective of this paper is to examine the long-term benefits of attending preschool or/and kindergarten on pupils' cognitive and non-cognitive skills in rural China. METHODOLOGY: We pooled data from two large-scale surveys conducted by the authors themselves at 136 rural primary schools in 20 counties from three provinces in northwestern China in 2009. The final study sample consisted of 9,839 pupils who both reported their ECE experience and completed cognitive and non-cognitive tests. We measured pupils' cognitive skills by standardized math test scores and grade retention, and their non-cognitive skills by both self-reported self-efficacy, mental health, and teacher-reported behaviors. Inverse Probability Weighting (IPW) was used to balance the pre-treatment variables between the treatment (Any ECE, Preschool Only, Kindergarten Only, or Preschool+Kindergarten) and comparison (No ECE) groups. RESULTS: Results from IPW show that compared with their peers without any ECE experience, pupils with any ECE experience perform better in cognitive skills (0.118 standard deviations (s.d.) increase in the TIMSS, 7.1 percentage point (pp) decrease in the probability of grade retention) but not in non-cognitive skills. By ECE types, attending kindergarten only is associated with a 0.150 s.d. increase in the TIMSS, a 7.0 pp decrease in the probability of grade retention, and a 0.059 s.d. decrease in the index of behavioral problems of pupils. Moreover, attending both preschool and kindergarten predicts a lower probability of grade retention, but attending preschool only has few benefits. Heterogenous analyses suggest that the long-term benefits of ECE are more prominent among the Han pupils from households with higher socio-economic status. CONCLUSIONS: Our findings imply that increasing access to ECE can be an effective instrument to improve pupils' skills in less-developed rural areas of China, especially their cognitive skills. Among different types of ECE, attending kindergarten contributes more to pupils' skill development in rural China than other types. We call for strengthened efforts to ensure equal access to quality ECE for preschool-aged children in rural China.

Single-Component Color-Tunable Smart Organic Emitters with Simultaneous Multistage Stimuli-Responsiveness and Multimode Emissions.

Achieving color-tunable emission in single-component organic emitters with multistage stimuli-responsiveness is of vital significance for intelligent optoelectronic applications, but remains enormously challenging. Herein, we present an unprecedented example of a color-tunable single-component smart organic emitter (DDOP) that simultaneously exhibits multistage stimuli-responsiveness and multimode emissions. DDOP based on a highly twisted amide-bridged donor-acceptor-donor structure has been found to facilitate intersystem crossing, form multimode emissions, and generate multiple emissive species with multistage stimuli-responsiveness. DDOP pristine crystalline powders exhibit abnormal excitation-dependent emissions from a monomer-dominated blue emission centered at 470 nm to a dimer-dominated yellow emission centered at 550 nm through decreasing the ultraviolet (UV) excitation wavelengths, whereas DDOP single crystals show a wide emission band with a main emission peak at 585 nm when excited at different wavelengths. The emission behaviors of pristine crystalline powders and single crystals are different, demonstrating emission features that are closely related to the aggregation states. The work has developed color-tunable single-component organic emitters with simultaneous multistage stimuli-responsiveness and multimode emissions, which is vital for expanding intelligent optoelectronic applications, including multilevel information encryption, multicolor emissive patterns, and visual monitoring of UV wavelengths.

Percutaneous angioplasty and/or stenting versus aggressive medical therapy in patients with symptomatic intracranial atherosclerotic stenosis: a 1-year follow-up study.

Background: Symptomatic intracranial atherosclerotic stenosis (sICAS) is one of the common causes of ischemic stroke. However, the treatment of sICAS remains a challenge in the past with unfavorable findings. The purpose of this study was to explore the effect of stenting versus aggressive medical management on preventing recurrent stroke in patients with sICAS. Methods: We prospectively collected the clinical information of patients with sICAS who underwent percutaneous angioplasty and/or stenting (PTAS) or aggressive medical therapy from March 2020 to February 2022. Propensity score matching (PSM) was employed to ensure well-balanced characteristics of two groups. The primary outcome endpoint was defined as recurrent stroke or transient ischemic attack (TIA) within 1 year. Results: We enrolled 207 patients (51 in the PTAS and 156 in the aggressive medical groups) with sICAS. No significant difference was found between PTAS group and aggressive medical group for the risk of stroke or TIA in the same territory beyond 30 days through 6 months (P = 0.570) and beyond 30 days through 1 year (P = 0.739) except for within 30 days (P = 0.003). Furthermore, none showed a significant difference for disabling stroke, death and intracranial hemorrhage within 1 year. These results remain stable after adjustment. After PSM, all the outcomes have no significant difference between these two groups. Conclusion: The PTAS has similar treatment outcomes compared with aggressive medical therapy in patients with sICAS across 1-year follow-up.

Agricultural production diversity, child dietary diversity and nutritional status in poor, rural Gansu Province of China.

Research has shown mixed findings on the link between production diversity and household dietary diversity. The question is whether this link holds for children. In this study we examine the relationship between household's agricultural production diversity and child dietary diversity, and between production diversity and child nutritional status. Smallholder farm households (n = 1067) and children (n = 1067) aged 3-16 years from two then nationally designated poverty counties in Gansu Province of China were interviewed in 2019. Production diversity was assessed with the production richness score and production diversity score. Production diversity was calculated from agricultural production data covering a period of 12 months. Child dietary diversity was assessed with food variety score (FVS) and dietary diversity score (DDS). DDS was calculated based on 9 food groups using a 30-day recall method. Data were analysed using Poisson and Probit regression models. We find that both agricultural production richness score and revenue generated from selling agricultural products are positively associated with food variety score, with the relationship being stronger for the latter. Moreover, production diversity score is positively associated with children's dietary diversity score whereas negatively associated with their probability of being stunted, but not with their probabilities of being wasted or zinc deficient. Household social economics status were also positively associated with child dietary diversity.

Integrating reduced amino acid composition into PSSM for improving copper ion-binding protein prediction.

Copper ion-binding proteins play an essential role in metabolic processes and are critical factors in many diseases, such as breast cancer, lung cancer, and Menkes disease. Many algorithms have been developed for predicting metal ion classification and binding sites, but none have been applied to copper ion-binding proteins. In this study, we developed a copper ion-bound protein classifier, RPCIBP, which integrating the reduced amino acid composition into position-specific scoring matrix (PSSM). The reduced amino acid composition filters out a large number of useless evolutionary features, improving the operational efficiency and predictive ability of the model (feature dimension from 2900 to 200, ACC from 83 % to 85.1 %). Compared with the basic model using only three sequence feature extraction methods (ACC in training set between 73.8 %-86.2 %, ACC in test set between 69.3 %-87.5 %), the model integrating the evolutionary features of the reduced amino acid composition showed higher accuracy and robustness (ACC in training set between 83.1 %-90.8 %, ACC in test set between 79.1 %-91.9 %). Best copper ion-binding protein classifiers filtered by feature selection progress were deployed in a user-friendly web server (http://bioinfor.imu.edu.cn/RPCIBP). RPCIBP can accurately predict copper ion-binding proteins, which is convenient for further structural and functional studies, and conducive to mechanism exploration and target drug development.

The Role of High-Resolution Magnetic Resonance Imaging in Cerebrovascular Disease: A Narrative Review.

High-resolution magnetic resonance imaging (HRMRI) is the most important and popular vessel wall imaging technique for the direct assessment of vessel wall and cerebral arterial disease. It can identify the cause of stroke in high-risk plaques and differentiate the diagnosis of head and carotid artery dissection, including inflammation, Moya Moya disease, cerebral aneurysm, vasospasm after subarachnoid hemorrhage, reversible cerebral vasoconstriction syndrome, blunt cerebrovascular injury, cerebral arteriovenous malformations, and other stenosis or occlusion conditions. Through noninvasive visualization of the vessel wall in vitro, quantified assessment of luminal stenosis and pathological features of the vessel wall can provide clinicians with further disease information. In this report, technical considerations of HRMRI are discussed, and current clinical applications of HRMRI are reviewed.

Blood pressure excursion on admission and intravenous thrombolysis in ischemic stroke.

BACKGROUND: Blood pressure (BP) excursion on admission was common in patients with acute ischemic stroke, but its influence on thrombolysis effect was not fully evaluated. METHODS: Patients with acute ischemic stroke who received thrombolysis without subsequent thrombectomy were included. Admission BP excursion was defined as higher than 185/110 mmHg. Multivariate logistic regression analysis was used to evaluate the relationship between admission BP excursion and poor outcome as well as hemorrhage rates and mortality. Poor outcome was defined as a 90-day modified Rankin Scale score 3-6. Subgroup analysis was performed according to stroke severity, which was assessed by the National Institutes of Health Stroke Scale (NIHSS) score, and hypertension status. RESULTS: A total of 633 patients were enrolled and 240 participants (37.9%) had admission BP excursion. Admission BP excursion was associated with poor outcome [adjusted odds ratio (OR) 0.64, 95% confidence interval 0.42-0.99, P  = 0.046]. No significant difference was found regarding hemorrhage rates or mortality between patients with and without admission BP excursion. In subgroup analysis, admission BP excursion was related to poor outcome in patients with NIHSS score at least 7 (adjusted OR 1.89, 95% confidence interval 1.03-3.45, P  = 0.038), but not in patients with NIHSS score less than 7 ( P for interaction <0.001). CONCLUSION: Admission BP excursion above the guideline thresholds did not increase postthrombolysis hemorrhage risk or mortality, but was associated with poor outcome, especially in patients with severe stroke.

Emotional Warmth and Rejection Parenting Styles of Grandparents/Great Grandparents and the Social-Emotional Development of Grandchildren/Great Grandchildren.

Parenting styles are crucial in the process of forming social emotions in children. They are also vital for creating effective family policies in order to improve a child's early development. As such, it is important to acknowledge the enduring association of parenting styles across generations, as well as their impact on early child development. In this study, the question as to whether the warm and hostile parenting styles of a parent/grandparent mediate the relationships between the emotional warmth and rejection parenting styles of a grandparent/great grandparent, as well as the subsequent social-emotional development of a grandson/great grandson and/or a granddaughter/great granddaughter, was examined. Cross-sectional assessment data from 194 primary caregivers of children between 6 and 36 months were analyzed using mediation analyses. In addition, moderated mediation models were used to test heterogeneity effects. This study found evidence that the warm and hostile parenting styles of a parent/grandparent mediated the associations between the emotional warmth and rejection parenting styles of a grandparent/great grandparent, as well as the subsequent socio-emotional development of a grandchild/great grandchild. Parents/grandparents tend to use a warm parenting style when the child is a boy, thereby resulting in fewer socio-emotional problems. This study provides empirical evidence for the purposes of preventive services to improve caregivers' parenting styles in the early stages of a child's development. Researchers and family practitioners should continue to support families with intervention or therapeutic techniques in order to mitigate potential lasting consequences.

Does money matter for child nutrition? Exploration of a preschool nutrition program in rural South-Central China.

OBJECTIVES: The aim of this study was to examine the relationship between poverty and children's nutritional outcomes. METHODS: Drawing on a 2018 survey of the preschool nutrition program conducted in the Xiangxi Autonomous Prefecture, Hunan Province, China, we applied propensity score matching to estimate the average treatment effects on the treated children. RESULTS: The most striking result was that although poverty is often used as predictive of poor childhood nutrition, this effect was only significant for weight-for-age z-score and height-for-age z-score, but not for other nutritional indicators, cognition, or social emotional indexes. The results varied using different measures of poverty. The weak linkage between poverty and children's nutritional outcomes was confirmed by a series of robustness checks by changing the covariates for matching, adopting other matching methods, using bootstrapping standard errors, and building on machine learning tools. CONCLUSIONS: A single tool of small money transfer would have limited effects, but considerable income increases that lift the poor out of poverty are important for the poor. Additionally, a mixed tool of financial support and nutritional knowledge may lead to better outcomes, especially for those living above the poverty line.

A Glycemia-Based Nomogram for Predicting Outcome in Stroke Patients after Endovascular Treatment.

Objective: Higher fasting glucose is thought to be associated with adverse outcome in patients receiving endovascular treatment (EVT), while the effect of glycosylated hemoglobin (HbA1c) on outcome is controversial. We combined fasting blood glucose (FBG) with HbA1c and evaluated their relationship with the three-month functional outcome in patients who underwent EVT. Methods: Data from 739 consecutive ischemic stroke patients who underwent EVT from April 2015 to August 2021 were retrospectively reviewed. HbA1c was used to estimate the chronic glucose level according to the following formula: chronic glucose level (mg/dL) = 28.7 × HbA1c (%) - 6.7. Patients were split into two groups in accordance with the three-month modified Rankin Scale (mRS). Univariate and multivariate analyses were utilized to investigate the association of outcome with blood glucose and to identify other predictors of prognosis. Results: Patients with poor outcome had significantly higher FBG, chronic glycemia, FBG/chronic glycemic ratio, and difference between FBG and chronic glycemia (ΔA-C). FBG, the FBG/chronic glycemic ratio, and ΔA-C remained to be associated with poor outcome after adjustment. We then established a glycemia-based nomogram with a concordance index of 0.841, and it showed favorable clinical utility according to decision curve analysis. Conclusions: Glycemia after EVT was connected with the functional outcome and a nomogram based on glycemia may be used to predict prognosis in stroke patients treated with EVT.

The Association between High Mobility Group Box 1 and Stroke-Associated Pneumonia in Acute Ischemic Stroke Patients.

Objective: This study aimed to investigate the association between high-mobility-group box 1 (HMGB1) and stroke-associated pneumonia (SAP) in acute ischemic stroke (AIS) patients. Methods: AIS patients were enrolled in two centers. The serum samples were collected within the first 24 h after admission, and HMGB1 levels were measured by enzyme-linked immunosorbent assay. Logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of SAP for HMGB1 concentrations. Restricted cubic splines (RCS) were performed to explore the shapes of the association between HMGB1 concentrations and SAP. Results: From January 2022 to May 2022, a total of 420 AIS patients were enrolled. Ninety-six (22.9%) patients develop SAP. The levels of HMGB1 in the SAP group were higher than those in the non-SAP group (p < 0.001). Using the first quartile of HMGB1 group as a reference, patients in the fourth quartile of HMGB1 group had the highest likelihood of experiencing SAP in the unadjusted model (OR = 3.687; 95% CI: 1.851−7.344), age- and sex-adjusted model (OR = 3.511; 95% CI: 1.725−7.147), and multivariable-adjusted model (OR = 2.701; 95% CI: 1.045−6.981). HMGB1 was also independently associated with SAP as a continuous variable in the unadjusted model (OR = 1.132; 95% CI: 1.069−1.199), age- and sex-adjusted model (OR = 1.131; 95% CI: 1.066−1.200), and multivariable-adjusted model (OR = 1.096; 95% CI: 1.011−1.188). RCS showed a linear association between HMGB1 and SAP (p for linear trend = 0.008) Conclusions: HMGB1 might be able to act as a potential biomarker of SAP in AIS patients.

Construction of a Glycaemia-Based Signature for Predicting Acute Kidney Injury in Ischaemic Stroke Patients after Endovascular Treatment.

Background: Hyperglycaemia is thought to be connected to worse functional outcomes after ischaemic stroke. However, the association between hyperglycaemia and acute kidney injury (AKI) after endovascular treatment (EVT) remains elusive. The purpose of this study was to investigate the influence of glycaemic on AKI after EVT. Methods: We retrospectively collected the clinical information of patients who underwent EVT from April 2015 to August 2021. Blood glucose after EVT was recorded as acute glycaemia. Chronic glucose levels were estimated by glycosylated haemoglobin (HbA1c) using the following formula: chronic glucose levels (mg/dL) = 28.7 × HbA1c (%) − 46.7. AKI was defined as an increase in maximum serum creatinine to ≥1.5 baseline. We evaluated the association of AKI with blood glucose. A nomogram was established to predict the risk of AKI, and its diagnostic efficiency was determined by decision curve analysis. Results: We enrolled 717 acute ischaemic stroke patients who underwent EVT. Of them, 205 (28.6%) experienced AKI. Acute glycaemia (OR: 1.007, 95% CI: 1.003−1.011, p < 0.001), the acute/chronic glycaemic ratio (OR: 4.455, 95% CI: 2.237−8.871, p < 0.001) and the difference between acute and chronic glycaemia (ΔA-C) (OR: 1.008, 95% CI: 1.004−1.013, p < 0.001) were associated with the incidence of AKI. Additionally, age, atrial fibrillation, ASITN/SIR collateral grading, postoperative mTICI scale, and admission NIHSS were also significantly correlated with AKI. We then created a glycaemia-based nomogram, and its concordance index was 0.743. The net benefit of the nomogram was further confirmed by decision curve analysis. Conclusions: The glycaemia-based nomogram may be used to predict AKI in ischaemic stroke patients receiving EVT.

Association between Diet Quality and Health Outcomes among Children in Rural Areas of Northwest China.

This study aims to examine the relationship between diet quality and health outcomes among children in rural remote areas of China. We draw on a cross-sectional dataset of 1216 children from two counties in the Gansu Province in Northwest China. Child health outcomes were assessed with both anthropometric measurements and reports by primary caregivers of the children. Child diet quality was assessed with the diet quality score (DQS) using information from a food frequency questionnaire (FFQ). Our data show the prevalence of stunting and underweight among sample children were 12% and 11%, respectively; 27% of children were reported by their caregivers as unhealthy, and 60% of children had at least one of the seventeen selected non-communicable diseases (NCDs) over the past 14 days. Overall, 780 (72%) children have at least one of the four above-mentioned health problems. Results from logistic regression models show that a higher DQS was significantly associated with a lower likelihood of being stunted and a higher likelihood of being reported healthy after adjusting for confounders. These findings imply that improving child diet quality might be an option when designing interventions to improve child health.

Porous organic polymers for high-performance supercapacitors.

With the aim of addressing the global warming issue and fossil energy shortage, eco-friendly and sustainable renewable energy technologies are urgently needed. In comparison to energy conversion, studies on energy storage fall behind and remain largely to be explored. By storing energy from electrochemical processes at the electrode surface, supercapacitors (SCs) bridge the performance gap between electrostatic double-layer capacitors and batteries. Organic electrode materials have drawn extensive attention because of their special power density, good round trip efficiency and excellent cycle stability. Porous organic polymers (POPs) have drawn extensive attention as attractive electrode materials in SCs. In this review, we present and discuss recent advancements and design principles of POPs as efficient electrode materials for SCs from the perspectives of synthetic strategies and the structure-performance relationships of POPs. Finally, we put forward the outlook and prospects of POPs for SCs.

SNHG15 is a negative regulator of inflammation by mediating TRAF2 ubiquitination in stroke-induced immunosuppression.

BACKGROUND: Abnormal expression of long noncoding RNAs (lncRNAs) has been reported in the acute stage of acute ischemic stroke (AIS). This study aimed to explore differential lncRNA expression in the subpopulations of peripheral blood mononuclear cells (PBMCs) from AIS patients and further evaluate its underlying mechanisms in stroke-induced immunosuppression. METHODS: We reanalyzed lncRNA microarray data and investigated abnormally expressed lncRNAs in the subpopulations of PBMCs by magnetic cell sorting and real-time quantitative PCR. The potential mechanism of small nucleolar RNA host gene 15 (SNHG15) was explored through in vitro and in vivo approaches. RESULTS: The stroke-induced SNHG15 acted as a checkpoint to inhibit peripheral inflammatory responses. Functional studies showed that SNHG15 promoted M2 macrophage polarization. Mechanistically, SNHG15 expression was dysregulated through the Janus kinase (JAK)-signal transducer and activator of transcription 6 (STAT6) signaling pathway. SNHG15, localized in the cytoplasm, interfered with K63-linked ubiquitination of tumor necrosis factor receptor-associated factor 2 and thereby repressed the activation of mitogen-activated protein kinase and nuclear factor kappa-B signaling pathways and prevented the production of proinflammatory cytokines. Administration of an adenovirus targeting SNHG15 improved stroke-induced immunosuppression in mice. CONCLUSIONS: This study identified SNHG15 as a negative regulator of inflammation in stroke-induced immunosuppression, suggesting it as a novel biomarker and therapeutic target in stroke-associated infection. Trial registration ClinicalTrials.gov NCT04175691. Registered November 25, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04175691 .

Cumulative experience improves the procedures of mechanical thrombectomy.

BACKGROUND: Mechanical thrombectomy has been widely performed for large vessel occlusion stroke. The present study aimed to determine whether cumulative experience could improve thrombectomy outcomes. METHODS: In this retrospective single-center analysis, patients who underwent mechanical thrombectomy with the Solitaire stent in 3 years from 25 April 2015 were enrolled in the current study. Patients' characteristics, durations of admission and treatment, recanalization rates, clinical outcomes, and hemorrhage transformation rates were compared among the 3 years. Logistic analysis was used to analyze the independent correlation of the years and procedural outcomes. RESULTS: A total of 222 patients underwent mechanical thrombectomy in the 3 years: 50 in the first year, 68 in the second year, and 104 in the third year. Door-to-puncture time (P < 0.001) and puncture-to-recanalization time (P = 0.033) decreased significantly among the 3 years, while successful recanalization rates increased (P = 0.001). Logistic regression analysis showed an independent increase in the successful recanalization rates in the second year and third year (P = 0.020, P = 0.001) as compared to that in the first year. CONCLUSIONS: Cumulative experience might improve the procedures of mechanical thrombectomy. The current findings suggested a potential benefit for centralization in the treatment of large vessel occlusion stroke.

Association of dietary diversity and cognition in preschoolers in rural China.

OBJECTIVES: We sought to investigate the cognition of preschoolers in rural China and examine the relationship between dietary diversity and cognition. METHODS: We performed a cross-sectional survey analysis. In 1334 preschoolers ages 3 to 5, from 26 preschools in two nationally designated poverty counties in Hunan Province in China, we calculated the dietary diversity score (DDS) using a 24-h recall method. To measure children's cognitive ability, we assessed the Working Memory Index and Verbal Comprehension Index on the Mandarin-language version of the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition. Multiple linear regression models were used to estimate the association between DDS and cognitive test scores. RESULTS: A total of 22% of children had a Working Memory Index that was either extremely low or borderline, and 31% of children had a Verbal Comprehension Index that was either extremely low or borderline. The mean (± SD) DDS was 5.65 ± 1.30. Those preschoolers with medium DDS (5 or 6) or high DDS (7 to 9) scored higher on both Working Memory Index-respectively, mean difference (MD), 1.327; 95% confidence interval (CI), 0.246-3.901; and MD, 2.067, 95% CI, 0.261-4.641-and Verbal Comprehension Index-MD, 0.168; 95% CI, 0.072-2.135; and MD, 0.398; 95% CI, 0.032-2.137-than did those with low DDS (0 to 4). CONCLUSIONS: Consuming a more diverse diet may contribute to better cognition in preschoolers. Future research is needed to better understand the possible causal effect of dietary diversity on cognitive development.

Home Environment and Early Development of Rural Children: Evidence from Guizhou Province in China.

Delays in early child development are among the aspects underlying the persistent developmental gaps between regions and social strata. This study seeks to examine the relationship between the home environment and early child development in less-developed rural areas by drawing on data from 445 children from villages in Guizhou province in southwest China. A demographic questionnaire, the Home Observation Measurement of the Environment (HOME), and the Bayley Scales of Infant Development, version III (BSID-III), were used to measure the child's demographic characteristics, home environment, and early development outcomes, respectively. Our data show that the sample children suffer a delay in various dimensions of child development and a deficit in the HOME scale. The results from a hierarchical regression model suggest that the availability of learning material at home, caregivers' responsiveness and organization sub-scales are significantly positively correlated with the early development of sample children, after controlling for general socioeconomic status, health, and nutrition, and this correlation differs by gender. These results imply that the provision of learning material to households, promoting caregivers' responsiveness and organization in less-developed rural areas could improve early child development among deprived children.