HS-SPME-GC-MS untargeted metabolomics reveals key volatile compound changes during Liupao tea fermentation.

This study used headspace solid-phase microextraction-gas chromatography-mass spectrometry and multivariate statistical analysis to comprehensively analyze the volatile components in Liupao tea samples throughout fermentation. In total, 1009 volatile organic compounds were detected and identified, including terpenoids, heterocyclic compounds, esters, ketones, hydrocarbons, alcohols, aromatics, and acids. Principal component and hierarchical cluster analyses, characterize the volatile components of Liupao tea samples were characterized at various fermentation stages. Orthogonal partial least squares discriminant analysis identified 248 differentiating compounds (VIP ≥ 1, P < 0.05, and |Log2FC| ≥ 1.0) during fermentation. K-means clustering analysis showed that 11 metabolites increased significantly throughout the fermentation process, whereas 31 metabolites decreased continuously. Annotation of these differential compounds revealed significant changes in sensory flavor characteristics in "green, sweet, fruity, floral, and woody" flavors. The results demonstrated significant variations in the volatile components of Liupao tea fermentation, along with notable changes in flavor characteristics.

Lymphocyte Infiltration Score and Spatial Characteristics Refined the Prognosis and Denosumab Treatment Responsiveness Indicators for Giant Cell Tumor of Bone.

PURPOSE: The prognostic value of lymphocyte infiltration score (LIS) and its nearest neighbor distance to tumor cells (NNDTC) in giant cell tumor of bone (GCTB) is currently not well established. This study aims to characterize LIS and NNDTC and examine their correlation with denosumab treatment responsiveness, clinicopathologic features, and patient prognosis. METHODS: Using multiplexed quantitative immunofluorescence, LIS was evaluated in 253 tumor specimens, whereas NNDTC was computed using HALO software. Subsequently, we analyzed the association of these parameters with patient outcomes (progression-free survival [PFS] and overall survival [OS]), clinicopathologic features, and denosumab treatment responsiveness. RESULTS: Low LIS was indicative of both poor PFS and OS (both P < .001). In addition, LIS was significantly associated with sex (P = .046), Enneking staging (P < .001), Ki-67 expression (P = .007), and denosumab treatment responsiveness (P = .005). Lower CD8+ (tumor interior [TI]) NNDTC, and CD3+ (TI) NNDTC were associated with worse PFS (P = .003 and .038, respectively), whereas lower CD8+ (TI) NNDTC was associated with worse OS (P = .001), but CD8+ (tumor infiltrating margin) NNDTC had the opposite effect (P = .002). Moreover, NNDTC showed a correlation with several clinicopathologic features. Importantly, LIS outperformed Enneking and Campanacci staging systems in predicting the clinical outcomes of GCTB. CONCLUSION: These findings suggest that LIS is a reliable predictive tool for clinically relevant outcomes and response to denosumab therapy in patients with GCTB. These parameters may prove to be useful in guiding prognostic risk stratification and therapeutic optimization for patients.

The tumor-stroma ratio in giant cell tumor of bone: associations with the immune microenvironment and responsiveness to denosumab treatment.

BACKGROUND: Currently, there is limited understanding regarding the clinical significance of the tumor-stroma ratio (TSR) in giant cell tumor of bone (GCTB). Hence, we aimed to investigate the distribution of TSR in GCTB and explore its correlation with various clinicopathologic factors, immune microenvironment, survival prognosis, and denosumab treatment responsiveness. METHODS: We conducted a multicenter cohort study comprising 426 GCTB patients treated at four centers. TSR was evaluated on hematoxylin and eosin-stained and immunofluorescent sections of tumor specimens. Immunohistochemistry was performed to assess CD3+, CD4+, CD8+, CD20+, PD-1+, PD-L1+, and FoxP3+ TIL subtypes as well as Ki-67 expression levels in 426 tissue specimens. These parameters were then analyzed for their correlations with patient outcomes [local recurrence-free survival (LRFS) and overall survival (OS)], clinicopathological features, and denosumab treatment responsiveness. RESULTS: Low TSR was significantly associated with poor LRFS and OS in both cohorts. Furthermore, TSR was also correlated with multiple clinicopathological features, TIL subtype expression, and denosumab treatment responsiveness. TSR demonstrated similar predictive capabilities as the conventional Campanacci staging system for predicting patients' LRFS and OS. CONCLUSION: The results of this study provide evidence supporting the use of TSR as a reliable prognostic tool in GCTB and as a predictor of denosumab treatment responsiveness. These findings may aid in developing individualized treatment strategies for GCTB patients in the future.

Systematic analysis of innate immune-related genes in the silkworm: Application to antiviral research.

The silkworm, a crucial model organism of the Lepidoptera, offers an excellent platform for investigating the molecular mechanisms underlying the innate immune response of insects toward pathogens. Over the years, researchers worldwide have identified numerous immune-related genes in silkworms. However, these identified silkworm immune genes are not well classified and not well known to the scientific community. With the availability of the latest genome data of silkworms and the extensive research on silkworm immunity, it has become imperative to systematically categorize the immune genes of silkworms with different database IDs. In this study, we present a meticulous organization of prevalent immune-related genes in the domestic silkworm, using the SilkDB 3.0 database as a reliable source for updated gene information. Furthermore, utilizing the available data, we classify the collected immune genes into distinct categories: pattern recognition receptors, classical immune pathways, effector genes and others. In-depth data analysis has enabled us to predict some potential antiviral genes. Subsequently, we performed antiviral experiments on selected genes, exploring their impact on Bombyx mori nucleopolyhedrovirus replication. The outcomes of this research furnish novel insights into the immune genes of the silkworm, consequently fostering advancements in the field of silkworm immunity research by establishing a comprehensive classification and functional understanding of immune-related genes in the silkworm. This study contributes to the broader understanding of insect immune responses and opens up new avenues for future investigations in the domain of host-pathogen interactions.

Synergistic evolution of water-energy-food system resilience and efficiency in urban agglomerations.

With increasing internal and external risks to the WEF system, a single emphasis on efficiency or a lopsided pursuit of resilience can lead to difficulties in adapting to complex changes and resource redundancy. Revealing the synergistic evolutionary characteristics between efficiency and resilience of the WEF system is an effective method to deal with systemic internal and external risks. However, the current study of the WEF system lacks a synergistic perspective on resilience and efficiency. Thus, taking Chengdu-Chongqing Economic Circle (CCEC) as the research object and its geospatial boundary as the system boundary, this paper adopted the entropy-topsis model to evaluate the WEF resilience, and applied the super-efficient SBM model to measure the WEF efficiency accurately, which fully considered the non-expected outputs in the process of resource utilization. Then, applying the development coordination degree model, the synergistic relationship between the two was measured. The results indicated that: the average value of WEF resilience in CCEC increased from 0.414 to 0.485 and showed spatial characteristics of west＞east＞central. The WEF efficiency interval was 0.79-0.93, and cities with average WEF efficiency reaching the effective production frontier accounted for only 37.5%. The clustered distribution of the synergy levels intensified. The number of cities with primary, medium, more advanced, and advanced levels was 6, 6, 1, and 3, respectively, with primary and medium synergy levels dominating. The findings suggest that cities should strengthen regional exchanges and formulate targeted measures based on their own situations. In addition, CCEC should possess a comprehensive understanding of the interdependencies and conflicts that arise between resilience and efficiency throughout the decision-making procedure.

Accuracy of gastric nodule combined with rapid urease test prediction in diagnosing Helicobacter pylori infection in children.

BACKGROUND: The diagnosis of Helicobacter pylori (H. pylori) infection in children remains challenging with the lack of a rapid, cost-effective, and highly accurate diagnostic method. Consequently, this study aimed to investigate the accuracy of the combination of gastric nodule and rapid urease test (RUT) as a diagnostic method for H. pylori infection in children. METHODS: The study included participants who underwent a thorough examination, including gastroscopy, a 13C breath test, RUT, and pathological methylene blue staining, with the gold standard for diagnosing of H. pylori infection being a positive result from both pathological methylene blue staining and 13C breath test. The sensitivity, specificity, positive and negative predictive values, and accuracy of the diagnostic methods were calculated. RESULTS: The accuracy of the different tests for H. pylori infection was evaluated in 2202 participants. A total of 730 (33.2%) children were diagnosed with H. pylori infection (pathological methylene blue staining and 13C breath test, both positive). Gastric nodule had a sensitivity of 87.1% and a specificity of 93.1%, whereas combining gastric nodule and RUT in parallel had the higher accuracy of 95.4%. The accuracy of gastric nodule diagnosis was higher in younger age groups and increased after excluding patients with a history of anti-H. pylori treatment. CONCLUSIONS: The findings of this study suggest that gastric nodules, particularly when combined with RUT, can be a valuable predictor of H. pylori infection in children, offering a simple and feasible alternative to other invasive methods.

Intestinal ultrasound score predicts therapeutic outcomes of infliximab in pediatric patients with Crohn's disease.

BACKGROUND AND AIMS: Objective evaluation of treatment response is critical in the management of Crohn's disease (CD). Compared with endoscopy, intestinal ultrasound (IUS) is non-invasive and well-tolerated. This study is aimed to assess the predictive value of IUS score for treatment response in pediatric CD patients. METHODS: We conducted a retrospective study in pediatric CD patients who underwent endoscopy and IUS at start of infliximab treatment [T0] and after 22-38 weeks [T1] between February 2021 and January 2023. Pediatric Crohn's Disease Activity Index (PCDAI), biochemical parameters, the Simple Endoscopic Score for Crohn's disease (SES-CD) and IUS parameters were collected at two timepoints. IUS scores were assessed by International Bowel Ultrasound Segment Activity Score (IBUS-SAS). RESULTS: Thirty patients were included, with 53.3% reaching endoscopic response and 43.3% endoscopic remission. After infliximab treatment, IBUS-SAS (58.5 ± 24.2 vs 34.4 ± 21.6, p = .0001) was significantly decreased. At T1, change in IBUS-SAS (-38.2 ± 22.0 vs -7.9 ± 24.1, p = .0015) were pronounced in patients with endoscopic response compared with endoscopic non-response. Significant correlation were observed between IBUS-SAS and SES-CD, PCDAI, C-reaction protein, erythrocyte sedimentation rate, hemoglobin, albumin. The most accurate cutoff values for predicting endoscopic response were 57.4% decrease of IBUS-SAS (AUROC: 0.862, p < .001). The optimal cut-off of IBUS-SAS to correlate endoscopic remission was 26.0 (AUROC: 0.686, p = .017). CONCLUSIONS: The validated ultrasound-base score, IBUS-SAS is an effective index for monitoring endoscopic response to infliximab therapy in CD. IUS evaluation could guide treatment decision for pediatric CD.

Single-nucleus sequencing of silkworm larval midgut reveals the immune escape strategy of BmNPV in the midgut during the late stage of infection.

The midgut is an important barrier against microorganism invasion and proliferation, yet is the first tissue encountered when a baculovirus naturally invades the host. However, only limited knowledge is available how different midgut cell types contribute to the immune response and the clearance or promotion of viral infection. Here, single-nucleus RNA sequencing (snRNA seq) was employed to analyze the responses of various cell subpopulations in the silkworm larval midgut to B. mori nucleopolyhedrovirus (BmNPV) infection. We identified 22 distinct clusters representing enteroendocrine cells (EEs), enterocytes (ECs), intestinal stem cells (ISCs), Goblet cell-like and muscle cell types in the BmNPV-infected and uninfected silkworm larvae midgut at 72 h post infection. Further, our results revealed that the strategies for immune escape of BmNPV in the midgut at the late stage of infection include (1) inhibiting the response of antiviral pathways; (2) inhibiting the expression of antiviral host factors; (3) stimulating expression levels of genes promoting BmNPV replication. These findings suggest that the midgut, as the first line of defense against the invasion of the baculovirus, has dual characteristics of "resistance" and "tolerance". Our single-cell dataset reveals the diversity of silkworm larval midgut cells, and the transcriptome analysis provides insights into the interaction between host and virus infection at the single-cell level.

Clinicopathological characteristics and prognostic factors in axial chondroblastomas: a retrospective analysis of 61 cases and comparison with extra-axial chondroblastomas.

BACKGROUND: A comprehensive understanding of the clinical characteristics and prognostic factors associated with axial chondroblastoma (ACB) is still lacking. This study aimed to understand the clinical characteristics and prognostic factors of axial chondroblastoma (ACB) and compare them with extra-axial chondroblastoma (EACB). METHODS: A retrospective review of our institution's local database was conducted, encompassing a total of 132 CB patients, of which 61 were diagnosed with ACB and 71 with EACB. Immunohistochemistry was employed to evaluate the expression levels of vimentin, S100, and cytokeratin. RESULTS: ACB and EACB shared similar characteristics, with the exception of advanced age, tumor size, elevated Vim expression, incidence of surrounding tissue invasion, and postoperative sensory or motor dysfunction. While wide resection and absence of surrounding tissue invasion consistently showed a favorable association with survival in both ACB and EACB cohorts during univariate analysis, most parameters exhibited differential prognostic significance between the two groups. Notably, the significant prognostic factors for local recurrence-free survival in the ACB cohort included the type of resection and the presence of chicken-wire calcification. In the multivariate analysis of overall survival, the type of resection emerged as a significant predictor in the ACB cohort, whereas in the EACB group, the type of resection and the occurrence of postoperative sensory or motor dysfunction were predictive of overall survival. CONCLUSION: There may exist distinct biological behaviors between ACB and EACB, thereby providing valuable insights into the prognostic characteristics of ACB patients and contributing to enhanced outcome prediction in this particular patient population.

The effects of dimethyl fumarate on cytoplasmic LPS-induced noncanonical pyroptosis in periodontal ligament fibroblasts and dental pulp cells.

AIM: Pyroptosis is a type of inflammatory cell death and is related to pulpitis and apical periodontitis. In this study, the aim was to investigate how periodontal ligament fibroblasts (PDLFs) and dental pulp cells (DPCs) respond to pyroptotic stimuli and explore whether dimethyl fumarate (DMF) could block pyroptosis in PDLFs and DPCs. METHODOLOGY: Three methods (stimulation with lipopolysaccharide [LPS] plus nigericin, poly(dA:dT) transfection and LPS transfection) were used to induce pyroptosis in PDLFs and DPCs, two types of fibroblasts related to pulpitis and apical periodontitis. THP-1 cell was used as a positive control. Afterwards, PDLFs and DPCs were treated with or without DMF before inducing pyroptosis to examine the inhibitory effect of DMF. Pyroptotic cell death was measured by lactic dehydrogenase (LDH) release assays, cell viability assays, propidium iodide (PI) staining and flow cytometry. The expression levels of cleaved gasdermin D N-terminal (GSDMD NT), caspase-1 p20, caspase-4 p31 and cleaved PARP were examined by immunoblotting. Immunofluorescence analysis was used to detect the cellular distribution of GSDMD NT. RESULTS: Periodontal ligament fibroblasts and DPCs were more sensitive to cytoplasmic LPS-induced noncanonical pyroptosis than to canonical pyroptosis induced by stimulation with LPS priming plus nigericin or by poly(dA:dT) transfection. In addition, treatment with DMF attenuated cytoplasmic LPS-induced pyroptotic cell death in PDLFs and DPCs. Mechanistically, it was shown that the expression and plasma membrane translocation of GSDMD NT were inhibited in DMF-treated PDLFs and DPCs. CONCLUSIONS: This study indicates that PDLFs and DPCs are more sensitive to cytoplasmic LPS-induced noncanonical pyroptosis and that DMF treatment blocks pyroptosis in LPS-transfected PDLFs and DPCs by targeting GSDMD, suggesting DMF might be a promising drug for the management of pulpitis and apical periodontitis.

The local coupling and telecoupling of urbanization and ecological environment quality based on multisource remote sensing data.

Coordinating the relationship between urbanization and ecological environment quality (EEQ) is crucial to achieving sustainable development. With the development of globalization, the pattern of remote interaction between urbanization and EEQ has gradually increased. However, the current study on the coupling of urbanization and EEQ lacks a remote perspective, and the remote sensing ecological index (RSEI) model has not yet considered the environmental pollution caused by population agglomeration. For these reasons, this study proposes the remote sensing ecological environment index (RSEEI) model and measures the local coupling and telecoupling coordination degree (LTCCD) of urbanization and EEQ in China from 2000 to 2020. According to the results, the rate of change of EEQ in China was -0.00011a-1. RSEEI widens the gap between the east and west of EEQ, differentiated by the Heihe-Tengchong Line. China's urbanization is growing at a 0.0008a-1 rate, with a spatially driven radiation potential with Beijing, Shanghai, Hong Kong, and Macao as the core. LTCCD follows an increasing trend from inland to coastal and west to east. Over 70% of provinces experienced a shift in adjacent LTCCD levels, and 14 provinces moved from disorder to coordination after 2010. The telecoupling strengthens the correlation between urbanization and EEQ among regions compared with traditional coupling. In addition, the eastern coastal areas, the northern and central-south inland areas, and the northwest face different coordination problems.

Decoupling of water resources utilization and coordinated economic development in China's Hexi Corridor based on ecological water resource footprint.

The rapid growth of population and economy leads to a further increase in demand for water resources. The contradiction between supply and demand of water resources has become the main bottleneck restricting sustainable development of a regional social economy. Accurate measurement of regional water usage and the harmonious balance between water consumption (WC) and economic growth (EG) are the premise of regional high-quality development. Based on this premise, this paper studied the arid oasis region, Hexi Corridor, as the research object; utilized the theory of ecological footprint to calculate the ecological footprint (EFW) and ecological carrying capacity (ECCW) of water resources from 2005 to 2019; and quantitatively analyzed the water utilization situation in Hexi Corridor in the past 15 years. Then, combining with the coordinated development decoupling evaluation model, the connection between WC and EG was evaluated. The main results of this study were as follows: (1) During the study period, EFW has shown a fluctuating downward trend, decreasing from 1.745 in 2015 to 1.588 hm2/person in 2019. The average annual EFW per capita of 10,000 yuan of GDP decreased by 10.18%, which showed that the water resources utilization efficiency was gradually increasing. However, there was still a large water deficit. The average water ecological pressure index was 16.55; water resources were under great pressure. (2) From 2005 to 2019, the relationship between WC and EG experienced stages of strong decoupling-weak decoupling-weak negative decoupling-strong decoupling in Hexi Corridor, and the coordination between the two was gradually strengthened. (3) The decoupling status of the Hexi Corridor cities was gradually optimized. Zhangye was the best and in a stable decoupling state, followed by Wuwei and Jiuquan. The number of decoupling years accounted for 85.7% and 78.6% of the evaluation period, respectively. The cities with poor decoupling status were Jiayuguan and Jinchang, and the number of decoupling years accounted for 71.4% and 57.1%, respectively. This study provides some highlights for the formulation of arid oasis regional water strategy.

Mycn deficiency underlies the development of orofacial clefts in mice and humans.

Non-syndromic cleft lip with or without cleft palate (NSCL/P) is the most common subphenotype of non-syndromic orofacial clefts arising from genetic and/or environmental perturbations during embryonic development. We previously identified 2p24.2 as a risk locus associated with NSCL/P in the Chinese Han population, and MYCN is a candidate risk gene in this region. To understand the potential function of MYCN in craniofacial development, we generated Wnt1-Cre;Mycnflox/flox mice that exhibited cleft palate, microglossia and micrognathia, resembling the Pierre Robin sequence (PRS) in humans. Further analyses indicated that the cleft palate was secondary to the delayed elevation of palatal shelves caused by micrognathia. The micrognathia resulted from impaired chondrogenic differentiation in Merkel's cartilage, which limited tongue development, leading to microglossia. In terms of mechanism, Mycn deficiency in cranial neural crest cells (CNCCs) downregulated Sox9 expression by inhibiting Wnt5a in a CNCC-derived chondrogenic lineage in Merkel's cartilage. To investigate whether MYCN deficiency contributed to NSCL/P, we performed direct sequencing targeting all exons and exon-intron boundaries of MYCN in 104 multiplex families with Mendelian NSCL/P and identified a novel pathogenic variant in MYCN. Taken together, our data indicate that ablation of Mycn in mouse CNCCs could resemble PRS by suppressing the Wnt5a-Sox9 signaling pathway in Merkel's cartilage and that mutations in MYCN may be novel potential causes of NSCL/P.

Suppression of gap plasmon resonance for high-responsivity metal-insulator-metal near-infrared hot-electron photodetectors.

Binary metal layers composed of a grating and a thin film are designed for high-responsivity metal-insulator-metal (MIM) near-infrared hot-electron photodetectors (HEPDs). The binary metal grating structure HEPDs demonstrate a strong asymmetrical optical absorption and result in a high current responsivity. In our devices, the top and bottom absorption ratio is as high as 76:1, much higher than that in the traditional grating structure HEPDs. The maximum zero-biased responsivity is 0.585 mA/W at 1550 nm by employing a five-step electrical model, which is 3.42 times that of the traditional silver grating structure devices. Simply changing the grating period enables spectrally selective photodetection covering a wide range of 500 nm at the near-infrared band with net absorption higher than 0.95 and linewidths narrower than 0.7 meV.

NFKB2 inhibits NRG1 transcription to affect nucleus pulposus cell degeneration and inflammation in intervertebral disc degeneration.

Extracellular matrix degradation, reactive oxygen species (ROS) generation, and inflammation in nucleus pulposus (NP) cells contribute to the progression of intervertebral disc degeneration (IDD). NRGs (Neuregulins) play a vital role in the development of the nervous system. In the present study, we found that NRG1 was downregulated within degenerative intervertebral disc and NP tissues, according to both bioinformatics and experimental analyses. Within IL-1ß-stimulated NP cells, we observed degenerative and inflammatory changes, including inhibited cell viability, promoted cell apoptosis and ROS accumulation, reduced collagen II and aggrecan proteins, elevated MMP-3/13 and ADAMTS-4/5 proteins, and upregulated IL-6 and TNF-α mRNA levels. Within IL-1ß-stimulated NP cells, NRG1 expression was also downregulated. NRG1 overexpression attenuated, whereas NRG1 silencing aggravated IL-1ß-induced degenerative and inflammatory changes. Moreover, NRG1 regulated ErbB2/3 activation, contributing to the NRG1 protective function in NP cells. NFKB2 directly targeted the promoter region of NRG1 and inhibited NRG1 expression. In IL-1ß-stimulated NP cells, silencing NFKB2 attenuated, whereas silencing NRG1 aggravated the degenerative changes and inflammation; the effects of NFKB2 silencing were significantly reversed by NRG1 silencing. In conclusion, NRG1 expression is downregulated within degenerative NP tissue samples and IL-1ß-stimulated NP cells. NRG1 might protect against IL-1ß-induced degenerative changes and inflammation. The upregulated NFKB2 might be the reason of NRG1 downregulation in degenerative NP tissues.

The gap of water supply-Demand and its driving factors: From water footprint view in Huaihe River Basin.

Climate change, population growth, the development of industrialization and urbanization are increasing the demand for water resources, but the water pollution is reducing the limited water supply. In recent years, the gap between water supply and demand which shows water scarcity situation is becoming more serious. Clear knowing this gap and its main driving factors could help us to put forward water protection measures correctly. We take the data of Huaihe River Basin from 2001 to 2016 as an example and use ecological water footprint to describe the demand, with the water carrying capacity representing the supply. We analyze the water supply-demand situation of Huaihe River Basin and its five provinces from footprint view in time and space. Then we apply the Logarithmic Mean Divisia Index model to analyze the driving factors of the ecological water footprint. The results show that: (1) the supply and demand balance of Huaihe River Basin was only achieved in year 2003 and 2005. There is also a large difference between Jiangsu province and other provinces in Huaihe River basin, most years in Jiangsu province per capital ecological footprint of water is more than 1 hm2/person except the years of 2003, 2015, and 2016. But other provinces are all less than 1 hm2/person. (2) Through the decomposition of water demand drivers, we concluded that economic development is the most important factor, with an annual contribution of more than 60%. Our study provides countermeasures and suggestions for the management and optimal allocation of water resources in Huaihe River Basin, and also provides reference for the formulation of water-saving policies in the world.

Systematic review with meta-analysis: Probiotics for treating acute diarrhoea in children with dehydration.

AIM: This study aimed to evaluate the effectiveness of probiotics in treating children with acute diarrhoea and dehydration. METHODS: Medline, EMBASE, and the Cochrane Library databases were searched for relevant studies and statistical analysis was performed. RESULTS: A total of 17 randomised controlled trials (RCTs) involving 2861 participants met the inclusion criteria. Compared with placebo, probiotics reduced the duration of diarrhoea (12 RCTs [15, 17], n = 1907, mean difference - 21.33 h, confidence interval (CI) -29.74 to -12.91, high heterogeneity, I2 = 86%), the duration of hospitalisation when compared with placebo (eight RCTs [19, 20], n = 1606, mean difference - 0.83 days, CI -1.53 to -0.12, high heterogeneity, I2 = 96%) and reduced risk of diarrhoea on day 4 or more days (six RCTs [19, 20], n = 1093, risk difference - 0.13, 95% CI -0.17- -0.09, no heterogeneity). CONCLUSIONS: Probiotics alongside rehydration therapy appear to be safe and have clear beneficial effects in shortening the duration of diarrhoea in children with acute diarrhoea and dehydration.

Bathing and toileting difficulties of older adults in rural China: the role of environment.

BACKGROUND: For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). This study aims to examine how environmental factors are associated with difficulty of bathing and toileting among older adults in rural China. METHOD: The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. Logistic regressions were applied to examine how difficulty of bathing and toileting was related to environmental factors such as geographic location, neighbourhood amenity, and related facilities of bathing and toileting. RESULTS: Older adults living in the Southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling for other confounders. Better neighbourhood conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without showering facilities, in public facilities, and outdoors were significantly more likely to have bathing disability than those who showered indoors with facility. Rural older adults who used pedestal pans and indoor buckets for toileting were more likely to have toileting disability than those who used indoor squatting facilities. CONCLUSION: Environmental barriers were associated with functional disability among older adults in rural China, but the disabled individuals may change their environments to adapt to their functional capabilities. Our findings suggest that it is imperative to promote the use of showering facilities and pedestal pans for toileting in rural China.