Center In Beijing Research Articles

Spatial Coupling of Mass Transit Networks and Business Centers in China's Megacities: A Complex Network Theory Approach

As fundamental nodal elements in urban spatial structures, the coupling and coordinated development of urban business centers and urban rail transit contributes to the optimization of these structures. Utilizing complex network theory, a model for the urban rail transit network was constructed. The importance and hub nature of urban rail transit stations were evaluated from different angles, including degree centrality, closeness centrality, betweenness centrality, and eigenvector centrality. These metrics examined the station's degree, closeness to other nodes, number of shortest paths, and centrality of neighboring nodes. The coupling relationship between urban rail transit and urban business centers was taken into account, leading to the creation of a coupling and coordination degree model for urban rail transit stations and urban business centers. An analysis of the spatio-temporal evolution of the coupling relationship between urban rail transit and business centers in Beijing, Shanghai, and Guangzhou from 2000 to 2020 was conducted. The findings indicated an interactive and mutually influencing coupling relationship between the urban rail transit network and urban business centers. Over time, the coupling and coordination degree of urban rail transit stations and urban business centers trended from being uncoordinated towards preliminary, moderate, and good coordination. Spatial heterogeneity existed in the coupling and coordination status of different circles, with the best coupling and coordination conditions being in the core area. There was a degree of variance in the coupling and coordination development situation of rail transit stations and business centers in the core areas of different cities. Among them, Shanghai's core area had the best spatial coupling and coordination development situation, Beijing's core area lagged in business center development compared to the construction of the urban rail transit network, while Guangzhou's core area saw urban rail transit network development lag behind its mature business centers. The application of these research findings aids in promoting sustainable urban development. While this study primarily measured the importance of urban rail transit network stations from the node centrality perspective, future studies could further examine the spatial coupling of urban rail transit and business centers from the viewpoints of accessibility and passenger flow.

Neoadjuvant chemotherapy or upfront surgery in hepatoblastoma: A multicenter retrospective study.

We retrospectively investigated the role of neoadjuvant chemotherapy in low-risk patients with hepatoblastoma (HB) who underwent curative resection between February 2009 and December 2017. We also verified the feasibility of the risk stratification system to select the optimal patients for upfront surgery. We compared 5-year overall survival (OS) and event-free survival (EFS) between the upfront surgery (n = 26) and neoadjuvant chemotherapy (n = 104) groups at three oncology centers in Beijing, China. To reduce the effect of covariate imbalance, propensity score matching (PSM) was used. We explored whether preoperative chemotherapy affected surgical outcomes and identified the risk factors for events and death, including resection margin status, PRETreatment EXTent of disease stages, age, sex, pathology classification, and α-fetoprotein levels. The median follow-up period was 64 (interquartile range 60-72) months. After PSM, 22 pairs of patients were identified, and the patient characteristics were similar for all variables included in PSM. In the upfront surgery group, the 5-year EFS and OS rates were 81.8% and 86.3%, respectively. In the neoadjuvant chemotherapy group, the 5-year EFS and OS rates were 81.8% and 90.9%, respectively. No significant differences in EFS or OS were observed between the groups. Pathological classification was the only risk factor for death, disease progression, tumor recurrence, other tumors found during HB diagnosis, and death from any cause (p = .007 and .032, respectively). Upfront surgery achieved long-term disease control in low-risk patients with resectable HB, thus reduced the cumulative toxicity of platinum-based chemotherapy drugs.

Novel Physical Examination Tests for the Diagnosis of Chronic Sacroiliac Joint Dysfunction and Differentiate It From Lumbar Disc Herniation

BACKGROUND: Traditional sacroiliac joint (SIJ) provocation tests have been used to diagnose SIJ pain. However, this can simply be changed to chronic SIJ dysfunction (cSIJD) manifests as mechanical changes in the pelvis and lower extremities in addition to pain. A novel composite of physical examinations based on the iliac pronation, pubic tubercle tenderness, and plantar fascia tenderness tests (IPP triple tests) was designed for the diagnosis of cSIJD. OBJECTIVES: To evaluate IPP triple tests in the diagnosis of cSIJD and differential diagnosis from lumbar disc herniation (LDH) in comparison with traditional provocation tests. STUDY DESIGN: Prospective single-blind controlled study. SETTING: This study was conducted at the Department of Spine and Spinal Cord Surgery of China Rehabilitation Research Center in Beijing, China. METHODS: One hundred and sixty-six patients were assigned into the cSIJD group, LDH group, or healthy control group. The cSIJD diagnosis was confirmed by SIJ injection. The diagnosis of LDH was confirmed according to the 2014 North American Spine Association diagnosis and treatment guidelines for LDH. All patients were examined with IPP triple tests and traditional provocation tests. The sensitivity, specificity, positive and negative likelihood ratios, and areas under the curve (AUCs) were used to evaluate the diagnostic accuracy of the composites or single of the IPP triple tests, and traditional provocation tests. The Delong’s test was used for the comparison among AUCs. The kappa analysis was used for the IPP triple tests and traditional provocation tests compared with the reference standard (REF). The independent t test and chi-square test were used to analyze the influence factors (i.e., age, gender), and group on diagnostic accuracy. RESULTS: There was no statistical difference in gender (chi-squared = 0.282, P = 0.596) and age (F = 0.096, P = 0.757) between the 3 groups. The AUC of the iliac pronation test was 0.903 when it was used alone; the AUC of the novel composites of the IPP triple tests was 0.868 (95% confidence interval [CI] = 0.802-0.919); and the diagnostic accuracy of the traditional provocation test was relatively low (AUC = 0.597, 95% CI = 0.512-0.678). The diagnostic accuracy of the IPP triple tests was higher than that of the traditional provocation test, P < 0.05. Kappa consistency comparison showed that the kappa value between the IPP triple tests and the REF was 0.229, the kappa between the traditional provocation test and the REF was 0.052. The age of the patients with inaccurate diagnosis was higher than that of the patients with accurate diagnosis in both methods (traditional tests, P = 0.599; IPP:P = 0.553). Different types of diseases (groups) affect the accuracy of diagnosis, the proportion of inaccuracy of traditional provocation tests was higher than that of the IPP triple tests (77.8% vs 23.6%) in cSIJD, while the 2 methods have high differential diagnostic accuracy in LDH (96.77%) and control groups (97.56%). LIMITATIONS: Small size of LDH patients and differences in physical tests among examiners. CONCLUSIONS: The novel composites of IPP triple tests have higher accuracy than the traditional provocation tests in diagnosing cSIJD and both have good accuracy in differentiating cSIJD from LDH. IPP triple tests may be an alternative physical examination for clinical screening of cSIJD. KEY WORDS: Sacroiliac joint dysfunction, low back pain, lumbar disc herniation, provocation test, physical examination, kinematics

DC/TMD Axis I diagnostic subtypes in TMD patients from Confucian heritage cultures: a stratified reporting framework.

This study proposed a conceptual framework for reporting Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I conditions and investigated the prevalence of TMD subtypes/categories in patients from Confucian heritage cultures. Variances in gender, age, and TMD chronicity between Chinese (CN) and Korean (KR) patients were also explored. Subjects were recruited from consecutive patients seeking care at two University-based centers in Beijing and Seoul. Eligible patients completed a demographic survey as well as the DC/TMD Symptom Questionnaire and were clinically examined according to the DC/TMD methodology. Axis I diagnoses were subsequently rendered with the DC/TMD algorithms and documented using the stratified reporting framework. Statistical evaluations were performed with chi-square, Mann-Whitney U tests, and logistic regression analysis (α = 0.05). Data of 2008 TMD patients (mean age 34.8 ± 16.2years) were appraised. Substantial differences in female-to-male ratio (CN > KR), age (KR > CN), and TMD duration (KR > CN) were observed. Ranked frequencies of the most common Axis I diagnoses were: CN - disc displacements (69.7%) > arthralgia (39.9%) > degenerative joint disease (36.7%); KR - disc displacements (81.0%) > myalgia (60.2%) > arthralgia (56.1%). Concerning TMD categories, notable differences in the prevalence of intra-articular (CN 55.1% > KR 15.4%) and combined (KR 71.8% > CN 33.4%) TMDs were discerned. Though culturally similar, the two countries require disparate TMD care planning/prioritization. While TMJ disorders in children/adolescents and young adults should be emphasized in China, the focus in Korea would be on TMD pain in young and middle-aged adults. Besides culture, other variables including socioeconomic, environmental, and psychosocial factors can influence the clinical presentation of TMDs. Chinese and Korean TMD patients exhibited significantly more intra-articular and combined TMDs respectively.

Exploring the Integration of Architectural Design and Advanced Structural Analysis for Steel–Glass Structures: A Comparative Study of Different Case Scenarios

It is well known that finite element analysis (FEA) is a powerful tool when it comes to the design and analysis of complex structures for various load combinations, including light steel curve members. This abstract provides an overview of the FEA simulation process for designing such members (cure members), which involves constructing a 3D model, discretising the member into small elements, assigning material properties, defining boundary conditions, conducting the simulation, analysing the results, and making any necessary modifications to the design. FEA simulations can provide valuable insights into the behaviour of light steel curved members under different load combinations. This enables designers to optimise designs for strength, safety, and cost-effectiveness. This article proposes using two commercial 3D software programs, Rhino 7 and Strand7, to complete the FEA simulation of light steel curved members. The 3D model is created in Rhino 7, and the individual elements are discretised into more minor elements using Strand7 for assigning material properties, defining boundary conditions, running simulations, and analysing the results. The paper presents five case studies of steel–glass façades and applies the proposed methodology to each. Examples include Phoenix International Media Center in Beijing, Kazakhstan Pavilion and Science Museum in Astana, Moynihan Train Hall in New York City, Chadstone Shopping Centre in Melbourne, and the central light rail station in The Hague.

Measuring pedestrian flows in public spaces: Inferring walking for transport and recreation using Wi-Fi probes

Differentiating transport and recreational walking in public spaces could promote the precise design of walkable public spaces for different walking demands to encourage more walking behaviors. However, previous studies mainly relied on field observations and self-reports, failing to quantitatively distinguish and depict the spatial-level usage of transport and recreational walking of all pedestrians passing by. This study proposed an approach based on the traffic counts and the number of pedestrians to infer transport and recreation walking in public spaces. A comparative experiment using Wi-Fi probes to collect pedestrian data in a gated residential community and a creative center in Beijing, China, was conducted to verify the applicability of this method. The results demonstrated that the transport walking index (the number of pedestrians) could portray the volume of transport walking, and the recreational walking index (average traffic counts of each pedestrian) could depict the proportion of recreational walking in public spaces. Two tests using different time threshold parameters and field observations verified the robustness of the results. Given the low-cost and long-duration observation, this method can potentially support the process of Post Occupancy Evaluation and Environment and Behavior research in more public spaces to make them more walkable.

Association Between Pre-Radiofrequency Catheter Ablation Serum Lipid Levels and Recurrence of Atrial Fibrillation in 412 Patients in Beijing, China: A Single-Center Study.

BACKGROUND This study from a single center in Beijing, China, included 412 patients with atrial fibrillation (AF) who underwent radiofrequency catheter ablation. We aimed to determine whether pre-ablation serum lipid levels were related to recurrence of atrial fibrillation (RAF). MATERIAL AND METHODS A total of 412 patients with AF who underwent radiofrequency catheter ablation were enrolled in the study. Fasting levels of triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC), were measured at baseline before ablation, and patients were classified according to lipid level quartiles (Q1-Q4). RAF was affirmed via 24-h electrocardiography or 12-lead electrocardiography. RESULTS A total of 82 (19.90%) patients experienced RAF. After adjusting for other relevant factors and sex, univariate logistic regression analysis revealed LDL-C (hazard ratio [HR], 1.17; 95% confidence interval [CI], 0.93-1.47) and TC (HR, 1.17; 95% CI, 0.96-1.42) levels were not significantly related to RAF. Multivariate logistic regression analysis revealed that, compared with the highest quartile (Q4), female patients with lower quartiles of TC had higher RAF, especially Q3 (HR, 16.24; 95% CI, 1.14-231.56). LDL-C levels were higher in Q1 than in Q4 but lower in Q2 and Q3 than in Q4 (Q1: HR, 1.34; 95% CI, 0.08-18.89; Q2: HR, 0.09, 95% CI, 0.06-1.52; Q3: HR, 0.02, 95% CI, 0.14-0.57). CONCLUSIONS This study showed RAF in almost 20% of treated patients and RAF was significantly related to pre-ablation serum levels of LDL-C and TC in women.

Epidemiology and risk prediction of patients with severe burns admitted to a burn intensive care unit in a burn center in beijing: A 5-year retrospective study

ObjectiveThis study was performed to describe the epidemiology of patients with severe burns hospitalized in a burn intensive care unit (BICU), explore the risk factors associated with the patients’ outcomes and evaluate the ability of prognostic scoring systems as risk prediction of mortality. MethodsThe data for this study were derived from patients with severe burns in the BICU of Beijing Jishuitan Hospital from 2015 to 2019. The following epidemiological information and outcomes were collected for retrospective analysis: sex, age, date of injury, etiology of burn, admission time after injury, extent of burn, inhalation injury, length of stay, and outcome. Abbreviated Burn Severity Index (ABSI), prognostic burn index (PBI), the burn index (BI), Belgian Outcome in Burn Injury (BOBI) scores and the revised Baux (rBaux) scores were calculated. ResultsOf the 243 patients included in this study, the median age was 41.00 (22.00) years and the male: female ratio was 4.28:1.00. Most of the burns had occurred from March to July. Flame was the main cause of the burns (77.37%), followed by electricity (14.40%). In total, 78.19% of all patients sustained third-degree burns, and the median burn area and third-degree burn area of patients were 40% (53%) and 15.0% (43.0%) of the total body surface area, respectively. The incidence of inhalation injury was 69.14%. Tracheotomy was performed in 53.89% of the patients with inhalation injuries, and the rate of tracheostomy showing a rising trend. The median length of stay was 37 (40) days, and the case fatality rate was 8.64%. Multivariable logistic regression model indicated that age and third-degree burn area were risk factors for death, and the area under the receiver operating characteristic curve for the full prediction model was 0.921 (95% CI = 0.874–0.967). ConclusionsThe majority of severe burns are flame-related accidents in middle-aged men. Risk prediction model combining age and third-degree burn area has better mortality predictive value.

Association of lung function and blood glucose level: a 10-year study in China

BackgroundAt present, chronic respiratory diseases are a major burden in terms of morbidity and mortality and are of increasing public health concern in China. Meanwhile, the prevalence of diabetes has increased by more than 10 times over the last 40 years. While a few studies have investigated the association between chronic respiratory diseases and diabetes mellitus, the association is not clear. This study aimed to explore this association and provide evidence.MethodsIn this single-center study, we enrolled participants aged ≥ 20 years undergoing at least two regular health check-ups from 2009 to 2019 at MJ Healthcare Center in Beijing. Each health check-up included physical examination, biochemical tests, a pulmonary function test, a questionnaire. A total of 11,107 adults were included, and cross-sectional and longitudinal analyses were performed.ResultsWe found that both prediabetic and diabetic adults had lower lung function than the normal population at baseline, indicating that lung function decline may start from prediabetic status. Quantitatively, with 1-mmol/L increase in fasting plasma glucose level, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC% and FEV1% lowered by 25 ml, 13 ml, 0.71-1.03%, and 0.46-0.72%, respectively. However, no significant difference was found in the rates for the lung function decline among different baseline diabetes statuses.ConclusionPeople with higher blood glucose level had more severe lung function decline, with decline starting from prediabetic status, but no significant difference was noted in the rate of lung function decline based on different baseline diabetic statuses.

Evaluation of the Association of Platelet Count, Mean Platelet Volume, and Platelet Transfusion With Intraventricular Hemorrhage and Death Among Preterm Infants

Platelet transfusion is commonly performed in infants to correct severe thrombocytopenia or prevent bleeding. Exploring the associations of platelet transfusion, platelet count (PC), and mean platelet volume (MPV) with intraventricular hemorrhage (IVH) and in-hospital mortality in preterm infants can provide evidence for the establishment of future practices. To evaluate the associations of platelet transfusion, PC, and MPV with IVH and in-hospital mortality and to explore whether platelet transfusion-associated IVH and mortality risks vary with PC and MPV levels at the time of transfusion. This retrospective cohort study included preterm infants who were transferred to the neonatal intensive care unit on their day of birth and received ventilation during their hospital stay. The study was conducted at a neonatal intensive care unit referral center in Beijing, China, between May 2016 and October 2017. Data were retrieved and analyzed from December 2020 to January 2022. Platelet transfusion, PC, and MPV. Any grade IVH, severe IVH (grade 3 or 4), and in-hospital mortality. Among the 1221 preterm infants (731 [59.9%] male; median [IQR] gestational age, 31.0 [29.0-33.0] weeks), 94 (7.7%) received 166 platelet transfusions. After adjustment for potential confounders, platelet transfusion was significantly associated with mortality (hazard ratio [HR], 1.48; 95% CI, 1.13-1.93; P = .004). A decreased PC was significantly associated with any grade IVH (HR per 50 × 103/μL, 1.13; 95% CI, 1.05-1.22; P = .001), severe IVH (HR per 50 × 103/μL, 1.16; 95% CI, 1.02-1.32; P = .02), and mortality (HR per 50 × 103/μL, 1.74; 95% CI, 1.48-2.03; P < .001). A higher MPV was associated with a lower risk of mortality (HR, 0.83; 95% CI, 0.69-0.98; P = .03). The platelet transfusion-associated risks for both IVH and mortality increased when transfusion was performed in infants with a higher PC level (eg, PC of 25 × 103/μL: HR, 1.20; 95% CI, 0.89-1.62; PC of 100 × 103/μL: HR, 1.40; 95% CI, 1.08-1.82). The platelet transfusion-associated risks of IVH and mortality varied with MPV level at the time of transfusion. In preterm infants, platelet transfusion, PC, and MPV were associated with mortality, and PC was also associated with any grade IVH and severe IVH. The findings suggest that a lower platelet transfusion threshold is preferred; however, the risk of a decreased PC should not be ignored.

The Effects of COVID-19 on Geriatric Hip Fracture Management and 1-Year Mortality in Beijing.

ObjectivesConcerns about the coronavirus disease 2019 (COVID‐19) pandemic resulted in unprecedented challenges to the management of geriatric hip fractures. We aimed to evaluate the effects of the COVID‐19 surge on the time to surgery and 1 year mortality in geriatric patients with hip fracture at a large, urban Level 1 trauma center in Beijing, and to guide the management of geriatric hip fracture patients throughout the COVID‐19 pandemic.MethodsThis single‐center retrospective study included consecutive patients aged ≥65 years and injured 3 weeks prior to admission. Demographic and surgical data were collected between January 20 and May 31, 2020, and from the same period in 2019. Mortality data and functional status were collected at follow‐up of 1‐year after surgery. The primary outcomes were time to surgery and 1 year mortality.ResultsThere were no significant differences in sex, fracture type, and surgical pattern between the 2020 (n = 261) and 2019 time‐matched (n = 307) cohorts. The time from admission to surgery was significantly delayed in the 2020 cohort compared with that in the 2019 cohort (48.9 h vs 20.5 h, p < 0.001). Fewer patients underwent surgery within 48 h in the 2020 cohort (65.5% vs 87.6%, p < 0.001). Surgical delay was also associated with an increased risk of inpatient complications (30.2% vs 20.8%, p = 0.010), however there was no significant difference in the 1‐year mortality rate, nor between pre‐injury and 1 year follow‐up mobility as assessed by Parker score. Only approximately half of the patients in both groups completely returned to their pre‐injury mobility levels.ConclusionsThe COVID‐19 pandemic has significantly increased the surgery waiting time for geriatric patients with hip fractures, which resulted in increased inpatient complications without a higher mortality rate within 1 year. This reinforces the importance of maintaining timely and protocolized care for geriatric hip fractures throughout any subsequent waves of the pandemic.

Retrospective analysis of 2054 cases from 24 hospitals underwent ultrasonic consultation in a tertiary prenatal diagnosis center in Beijing, China.

To investigate the practices of prenatal ultrasound consultation in a region of the China and to describe the rate of concordance between the suspected anomaly and the final diagnosis of the referral examination. Retrospective study with all cases referred from 24 hospitals (Beijing, China) to a tertiary prenatal diagnosis center for ultrasonic consultation in 2018. The concordance between the suspected ultrasonic signs of fetal abnormalities of the referrer and the ultrasonic consultation results were evaluated and divided into full concordance, partial concordance, and discordance. From 1938 patients with suspected ultrasonic signs, 2054 ultrasound consultation records were obtained. The most frequent anomalies for consultation in the first trimester (348, 91.3%) were cystic hygroma (CH), nuchal translucency (NT), or nuchal fold (NF) thickening, followed by signs of brain abnormalities in the second (173, 22.4%) and the third (182, 34.1%) trimester. The discordant rates of the first single signs were 19.8% for the first trimester, 41.6% for the second trimester, and 37.4% for the third trimester, respectively. Our study demonstrated that the discordance of the first single signs was relatively low in the first trimester and higher in the second and third trimesters. The number of sonographers could be increased to ensure timeliness, strengthen training for those with poor concordance rates by referring to appropriate guidelines, and reduce ultrasonic consultation for those with high consistency after further research to save medical resources.

A Cost-Effectiveness Analysis of Comprehensive Smoking-Cessation Interventions Based on the Community and Hospital Collaboration.

BackgroundThe prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown.MethodsWe conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model.ResultsA total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention.ConclusionCI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.

Artificial Intelligence–Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial

Artificial intelligence (AI)-assisted colonoscopy improves polyp detection and characterization in colonoscopy. However, data from large-scale multicenter randomized controlled trials (RCT) in an asymptomatic population are lacking. This multicenter RCT aimed to compare AI-assisted colonoscopy with conventional colonoscopy for adenoma detection in an asymptomatic population. Asymptomatic subjects 45-75 years of age undergoing colorectal cancer screening by direct colonoscopy or fecal immunochemical test were recruited in 6 referral centers in Hong Kong, Jilin, Inner Mongolia, Xiamen, and Beijing. In the AI-assisted colonoscopy, an AI polyp detection system (Eagle-Eye) with real-time notification on the same monitor of the endoscopy system was used. The primary outcome was overall adenoma detection rate (ADR). Secondary outcomes were mean number of adenomas per colonoscopy, ADR according to endoscopist's experience, and colonoscopy withdrawal time. This study received Institutional Review Board approval (CRE-2019.393). From November 2019 to August 2021, 3059 subjects were randomized to AI-assisted colonoscopy (n= 1519) and conventional colonoscopy (n= 1540). Baseline characteristics and bowel preparation quality between the 2 groups were similar. The overall ADR (39.9% vs 32.4%; P < .001), advanced ADR (6.6% vs 4.9%; P= .041), ADR of expert (42.3% vs 32.8%; P < .001) and nonexpert endoscopists (37.5% vs 32.1%; P= .023), and adenomas per colonoscopy (0.59 ± 0.97 vs 0.45 ± 0.81; P < .001) were all significantly higher in the AI-assisted colonoscopy. The median withdrawal time (8.3 minutes vs 7.8 minutes; P= .004) was slightly longer in the AI-assisted colonoscopy group. In this multicenter RCT in asymptomatic patients, AI-assisted colonoscopy improved overall ADR, advanced ADR, and ADR of both expert and nonexpert attending endoscopists. (ClinicalTrials.gov, Number: NCT04422548).

The Chinese version of the Abrams geriatric Self-neglect scale:Translation, validity, and reliability

ObjectivesTo translate, cross-culturally adapt, and validate the Abrams Geriatric Self-neglect Scale (AGSS) for the older population in China. MethodsThe performance of the Chinese version of AGSS (C-AGSS) was evaluated among 334 older adults recruited from three community healthcare centers in Beijing, China. ResultsThe Cronbach's α was 0.601 and the content validity index was 0.96 for the C-AGSS. The unidimensional model of the scale was supported by the confirmatory factor analysis with an excellent model fit. The concurrent validity was demonstrated by the significant correlation (r=0.614, p<0.001) between the C-AGSS and the Scale of the Elderly Self-neglect (Rural). The hypothesized validity and the discriminative validity of the C-AGSS were also approved. ConclusionsThe C-AGSS has acceptable validity and reliability on self-neglect assessment in the Chinese older population. It can be used to classify and quantify the self-neglect of older adults in China.

The Use of a Brief Antenatal Lifestyle Education Intervention to Reduce Preterm Birth: A Retrospective Cohort Study.

Preterm birth is a leading cause of neonatal and child mortality and morbidity worldwide. The aim of this study was to investigate associations between attending a brief antenatal lifestyle education seminar and preterm birth, and whether education timing modifies outcomes. A retrospective cohort study was conducted in a hospital-based antenatal care center in Beijing, China, where a free, 2 h, optional, face-to-face, midwife-led group seminar on healthy lifestyle choices during pregnancy was provided. Among the 3008 eligible women, 1107 (36.8%) attended the seminar during the first trimester, 515 (17.1%) attended during the second trimester or later, and 1386 (46.1%) did not attend. Multiparous women were more likely to not attend or to attend at a later stage. The overall prevalence of preterm birth was 8.7%, but it was higher for women who did not attend the antenatal seminar (11.5%). The risk of preterm birth for first trimester attendees decreased by 53%, and it decreased by 41% for later attendees. Estimates persisted after adjusting pre-existing and gestational covariates. Attending a brief antenatal lifestyle education seminar was associated with lower preterm birth risk, and attending during the first trimester had a better impact than later attendance. The results can inform the development of tailored preterm birth prevention strategies.

The effectiveness of percutaneous endoscopic decompression compared with open decompression and fusion for lumbar spinal stenosis: protocol for a multicenter, prospective, cohort study

BackgroundLumbar spinal stenosis (LSS) is one of the most frequent indications for spine surgery. Open decompression and fusion surgery was the most common treatment and used to be regarded as the golden standard treatment for LSS. In recent years, percutaneous endoscopic decompression surgery was also used for LSS. However, the effectiveness and safety of percutaneous endoscopic decompression in the treatment of LSS have not been supported by high-level evidence. Our aim is to 1) compare the effectiveness of percutaneous endoscopic decompression surgery and open decompression and fusion for the treatment of LSS. 2) Investigate the prognosis risk factors for LSS. 3) Evaluate the influence of percutaneous endoscopic decompression for the stability of operative level, and degeneration of adjacent level.MethodsIt’s a prospective, multicenter cohort study. The study is performed at 4 centers in Beijing. This study plans to enroll 600 LSS patients (300 patients in the percutaneous endoscopic decompression group, and 300 patients in the open decompression and fusion group). The demographic variables, healthcare variables, symptom related variables, clinical assessment (Visual analogue score (VAS), Oswestry disability index (ODI), Japanese Orthopaedic Association score (JOA)), and radiological assessment (dynamic X-ray, CT, MRI) will be collected at baseline visit. Patients will follow up at 3, 6, 12 months. The primary outcome is the difference of improvement of ODI between baseline and 12-month follow-up between the two groups. The secondary outcome is the score changes of preoperative and postoperative VAS, the recovery rate of JOA, MacNab criteria, patient satisfaction, degeneration grade of adjacent level, ROM of operative level and adjacent level, complication rate.DiscussionIn this study, we propose to conduct a prospective registry study to address the major controversies of LSS decompression under percutaneous spinal endoscopy, and investigate the clinical efficacy and safety of percutaneous endoscopic decompression and open decompression in the treatment of LSS.Trial registrationThis study has been registered on clinicaltrials.gov in January 15, 2020 (NCT04254757). (SPIRIT 2a).

The Stigma Resistance Scale for people with mental illness: Transcultural adaption and validation of the Chinese version.

The understanding of stigma resistance and its prevalence is limited due to the limitation of existing measures. This study aims to modify the Stigma Resistance Scale (SRS) and assess the psychometric properties of Chinese patients with mental illness. Seven experts were invited to assess the content validity of the Chinese version of the SRS (C-SRS), which has been translated and adapted into Chinese. Convenience samples were included from two psychiatric hospitals and three community healthcare centers in Beijing, China. A total of 484 patients completed the survey from November 2020 to July 2021. Samples were randomized into two parts exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA (n = 242) yielded three factors with Cronbach's α of 0.932 for the total scale, and 0.835, 0.877, and 0.858 for the subscales. CFA (n = 242) revealed good model fit (χ2 /df = 2.190, RMSEA = 0.070). The domain-total correlation scores were 0.834-0.939. The correlation coefficient of test-retest ranged from 0.726 to 0.887. The correlation coefficient between the C-SRS and Stigma Resistance subscale of the Internalized Stigma of Mental Illness scale was 0.399. This study found that the C-SRS has evidence of excellent reliability and validity for assessing stigma resistance. It could be used in Chinese people with mental illness to identify and address stigma resistance.

Food Retail Network Spatial Matching and Urban Planning Policy Implications: The Case of Beijing, China

Food is the core of urban daily life and socio-economic activities but is rarely the focus of urban planning. The spatial layout of food retail outlets is important for optimizing the urban food system, improving land resource allocation, and encouraging healthy food consumption. Based on food retail POI data, this study employed kernel density estimation, road network centrality, spatial autocorrelation analysis, and locational entropy to analyze the spatial characteristics of supermarkets, produce markets, and small stores in an urban center in Beijing, and explored street coupling and supply-demand matching. The results indicated that within the study area: (1) supermarkets had an obvious “core-periphery” distribution, produce markets had a polycentric distribution, and small stores had a relatively uniform distribution; (2) road network centrality indices revealed a differentiated multi-core-edge distribution; (3) streets with high locational entropy values for supermarkets and produce markets were mostly concentrated in the central area, whereas the matching distribution of small stores was relatively balanced. From the perspective of urban planning, policy implications are proposed based on spatial and social equity, urban-rural differences, population structure and distribution status, and a resilient supply chain. The study findings have practical significance for guiding the development of urban food systems in a healthy, just, and sustainable direction, as well as rational urban land planning.

Factors Related to Diabetes Self-Management Among Patients with Type 2 Diabetes: A Chinese Cross-Sectional Survey Based on Self-Determination Theory and Social Support Theory.

PurposeSelf-management behavior (SMB) plays a significant role in glycemic control. This study aimed to explore the factors related to SMB among patients with type 2 diabetes and how these factors interacted with each other.Patients and MethodsPatients diagnosed with type 2 diabetes were recruited from 18 community healthcare stations (CHSs) from six community healthcare centers (CHCs) in Beijing, China from April to May in 2017. Motivation, competence, autonomy support, social support, self-management skills, adherence to self-monitoring of blood glucose (SMBG) and haemoglobin A1c (HbA1c) measurement were tested by questionnaire. Correlation analysis and path analysis were performed so as to identify the factors associated with patients’ SMB.ResultsA total of 532 participants completed this study. Participants who have good compliance to SMBG got higher scores in social support (F = 7.68, p = 0.01), competence (F = 10.47, p = 0.01), and skills (F = 12.34, p < 0.01). Higher competence (β = 0.03, P < 0.001), higher social support (β = 0.01, P < 0.001), better skills(β = 0.01, P < 0.001) directly led to better adherence to SMBG. Social support had a positive effect on autonomy support (β = 0.69, P < 0.001), motivation (β = 0.45, P < 0.001), competence (β = 0.28, P < 0.001), skills (β = 0.14, P < 0.001), which was also indirectly linked to better adherence to SMBG. Better self-management skills directly led to better adherence to HbA1c measurement (β = 0.03, P < 0.001). Social support had a positive effect on autonomy support (β = 0.69, P < 0.001), motivation (β = 0.45, P < 0.001), competence (β = 0.28, P < 0.001), skills (β = 0.14, P < 0.001), which was also indirectly linked to better adherence to HbA1c measurement.ConclusionSelf-determination theory and social support theory were practical in explaining SMB in Chinese population. Competence, motivation and social support played an important role in diabetic self-management. Paying attention to the promotion of individual’s intrinsic motivation and self-efficacy may be able to help patients maintain self-management behavior in the long-term routine.