Effect of artificial natural light on the development of myopia among primary school-age children in China:a three-year longitudinal study

AIM:To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children.METHODS:This is a prospective,randomized control,intervention study.A total of 1840 students from 39 classes in 4 primary schools in Foshan participated in this study.The whole randomization method was adopted to include classes as a group according to 1:1 randomized control.Classrooms in the control group were illuminated by usual light,and classrooms in the intervention group were illuminated by artificial natural light.All students received uncorrected visual acuity and best-corrected visual acuity measurement,non-cycloplegic autorefraction,ocular biometric examination,slit lamp and strabismus examination.Three-year follow-up,the students underwent same procedures.Myopia was defined as spherical equivalent refraction≤-0.50 D and uncorrected visual acuity<20/20.RESULTS:There were 894 students in the control group and 946 students in the intervention group with a mean±SD age of 7.50±0.53y.The three-year cumulative incidence rate of myopia was 26.4%(207 incident cases among 784 eligible participants at baseline)in the control group and 21.2%(164 incident cases among 774 eligible participants at baseline)in the intervention group[difference of 5.2%(95%CI,3.7%to 10.1%);P=0.035].There was also a significant difference in the three-year change in spherical equivalent refraction for the control group(-0.81 D)compared with the intervention group[-0.63 D;difference of 0.18 D(95%CI,0.08 to 0.28 D);P<0.001].Elongation of axial length was significantly different between in the control group(0.77 mm)and the intervention group[0.72 mm;difference of 0.05 mm(95%CI,0.01 to 0.09 mm);P=0.003].CONCLUSION:Artificial natural light in the classroom of primary schools can result in reducing incidence rate of myopia during a period of three years.

Research Progress in Integrated Chinese and Western Medicine Health Management for School-Age Children with Asthma

Objective:The purpose of this study is to investigate the application of Chinese and Western medicine in the health management of school-age children with asthma and its research progress,with a view to providing a more comprehensive and effective management strategy for the clinic.Methods:Using the method of literature review,this study systematically searched and analyzed the relevant studies on the combination of Chinese and Western medicine in the health management of school-aged children with asthma in recent years,focusing on Chinese medicine treatment,Western medicine treatment,and the combined health management of Chinese and Western medicine.Results:Chinese medicine treatment,Western medicine treatment,and the health management mode of combining Chinese and Western medicine showed unique advantages in school-age asthmatic children.Through the comprehensive use of Chinese medicine’s diagnosis and treatment,Chinese medicine conditioning,Chinese medicine characteristic therapy,and Western medicine’s modern medical methods,it not only effectively relieved asthma symptoms but also significantly improved the quality of life of the children.At the same time,this management mode also focuses on the psychological guidance and family care of the children,forming an all-round and multi-level health management system.Conclusion:The health management strategy of combining Chinese and Western medicine has a broad application prospect in school-age asthmatic children,and its specific interventions and mechanisms of action should be further studied to provide more scientific and systematic guidance for clinical practice.

The Prevalence of Congenital Heart Disease among School-Age Children in China:A Meta-Analysis and Systematic Review

Objectives:To estimate the prevalence of Congenital Heart Disease(CHD)in school-age children,to identify the extent to which altitude affects the prevalence of the disease,and to examine trends in prevalence over time in China.Methods:Seven databases were systematically searched and last retrieved on September 10,2021 for all studies reporting the prevalence of CHD in children after 1970 in China,which were then divided into high and low altitude regions based on 2500 meters above sea level.The random-effected model was used to combine prevalence data and subgroups analysis.The baseline data of all cases and individuals were used for comparison to calculate the odds ratio(OR)for overall and different altitude prevalence.Results:A total of 12,926,083 individuals(aged 3-18 years),with 31,835 cases from 86 studies,were included in the analysis.The pooled CHD prevalence of total children was 4.69[95%confidence interval(CI):4.10 to 5.29]per 1000 children.Overall,temporal trends analysis indicated that the prevalence of CHD in children continuously decreased with time,from 6.19(95%CI:4.50 to 7.88)per 1000 children in 1976-1985 to 3.30(95%CI:2.49;4.38)per 1000 children in 2016-2021.The OR for the prevalence of CHD in children from high and low altitudes with baseline data was 2.84(95%CI:2.48 to 3.27)and 1.31(95%CI:1.13 to 1.53)(χ^(2)=53.89,p<0.01),respectively.The OR of the prevalence of CHD in male children compared to females was 0.60(95%CI:0.53 to 0.68)at high altitudes and 0.79(95%CI:0.71 to 0.89)at low altitudes.Among the seven most common subtypes,patent ductus arteriosus was the most common at high altitudes,while atrial septal defects were the most common at low altitudes.Conclusion:This study provides valuable insights for further disease prevention and etiological exploration.The overall decreasing trend in the prevalence of CHD in children over time may indicate a positive effect of perinatal management and treatment during infancy.

Report on Childhood Obesity in China (4) Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.

Report on Childhood Obesity in China (1) Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.

Waist Circumference Distribution of Chinese School-age Children and Adolescents

Background Waist circumference （WC）, a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China. Objective To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160 225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, noah rural, south rural, and Hong Kong, for analyzing the distribution of WC. Results A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A or Netherlands demonstrated the necessary of setting up China＇s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method. Conclusion The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.

Visual problems: a review of prevalence studies on visual impairment in school-age children

Childhood visual impairment(VI) have a significant impact on the educational achievement, career choices and social life of affected individual, and in children, is mainly due to either preventable or treatable causes. Reliable data on the prevalence and causes of VI in children will guide the development of a systematic vision screening program for its early detection and successful treatment of possible causes. The purpose of this literature review is to summarize the available data on prevalence and causes of VI in school-age children from various regions globally. A discussion on the major findings highlighting the definition criteria, classifications and limitations for further studies is also presented.

Improving school physical education to increase physical activity and promote healthy growth of Chinese school-aged children Time for action

Throughout its more than 5000-year history, China has a long tradition of encouraging active engagement in physical and sport activities This enduring tradition, however, has been facing some major headwinds as China continues to expe- rience demographic and environmental changes related to aging, urbanization, and lifestyle shifts.

Step it up： Promoting physical activity in school-aged children and adolescents in China

In this special issue of the Journal of Sport and Health Science, a series of articles describe the results of the 2016 Physical Activity and Fitness in China--The Youth Study. The results show a relatively high prevalence of sedentary behaviors, unhealthy weight, lower fitness levels, and lower levels of engagement in physical exercise and fitness activities than antici- pated.

Evidence of increasing risk of schistosomiasis among school-age children in municipality of Calatrava,Province of Negros Occidental,Philippines

Objective:To explore risk of school-age children being infected with schistosomiasis in selected villages in the municipality of Calatrava,province of Negros Occidental,Philippines.Methods:As part of the monitoring and evaluation of the helminth control program in the province of Negros Occidental,parasitological monitoring,through the use microscopy of stool samples processed using Kato-Katz technique,was conducted to describe the baseline and follow-up parasitological status of school-age children in 2010 and 2012.respectively.Seven villages from the municipality of Calatrava were selected as study sites.Results:During baseline assessment,only one case of schistosomiasis was reported from the village of Marcelo.During follow-up assessment,32 cases(6.9%) of schistosomiasis were reported and the prevalence of moderate-heavy intensity infection was 13% in six villages.Among the seven villages included in the follow-up,Minapasuk had the highest prevalence at 14.6%.while San Isidro reported no case of schistosomiasis.Conclusions:Non-endemic villages,which have reported positive cases in school-age children,may need to be assessed for possible cndemicity for schistosomiasis.Transmission of the disease may need to be determined in these villages through active parasitological and malacological surveillance.Other nonendemic villages adjacent to or share river networks with endemic villages in Calatrava may need to be explored for possible introduction of the disease,especially after typhoons and Hooding.Establishing endemicity for schistosomiasis in these villages will help infected and at risk individuals to receive yearly treatment to reduce morbidities caused by this disease.

Obesity, Body Fat Distribution, and Physical Activity in School-age Children: an Urban and Rural Comparison in Valparaíso, Chile

This study analyze the relation between body composition, physical activity （PA）, and sex in Chilean children from rural and urban public educational institutions. The prevalence of obesity （according to BMI） was 30.88% in urban children and 28.93% in rural children. Central obesity presented mainly in the rural girls. Approximately 90% of the participants reported 〈7 h of PA/week, regardless of residential area. In addition, central fat was strongly associated with rural residence; the children reported lower PA levels, and they presented a higher prevalence of central fat. The results reflect the need to implement programs to improve PA conditions in the child urban-rural population.

The Neurocognitive Assessment of HIV-Infected School-Aged Nigerian Children

Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Standard Progressive Matrices (RPM). The children were subdivided (Piaget’s developmental staging) into two sub-groups: the concrete operation stage (6 - 11 years) and the formal operation stage (12 - 15 years) for analysis. Result: The mean RPM score for the HIV positive children was 18.2 (8.0 - 47.0, SD 9.8) which was significantly lower than the score of 27.2 (8.0 - 52.0, SD 13.8) for the HIV negative children (p < 0.001). On the RPM grading and using the HIV negative children as the standard, 56.5% of the HIV positive children had cognitive performance at below average to intellectually defective range. Conclusion: School-aged HIV positive children had significantly lower cognitive scores compared with age and gender-matched HIV negative children. Routine neuropsychological evaluation of all school-aged HIV-infected children is recommended. Early detection of cognitive impairment will help in planning appropriate interventions.

Effect of dexmedetomidine on the stress reaction caused by sevoflurance anesthesia in school-age children with different personality characteristics

Objective:To observe the effect of dexmedetomidine on the stress reaction caused by sevoflurance anesthesia during the perianesthesia period in school-age children with different personality characteristics.Methods:A total of 160 children who were admitted in our hospital for transumbilical single-port laparoscopic hernia inner ring ligation were included in the study and randomized into dexmedetomidine (D) group and midazolam (M) group. The children were performed with Eysenck Personality Questionnaire before operation (children edition). Children were divided into the emotion group (group I) and stable group (group II). The operation was performed under sevoflurance inhalation anesthesia. Patients in DI and DII groups were given 1 μg/kg DEX, MI and MII groups were given 0.05 mg/kg midazolam, for 15 min. MAP and HR one day before operation (T0), before anesthesia induction (T1), 1 min after pneumoperitoneum establishment (T2), the time after pulling out the laryngeal mask (T3), and the time after shifting from the recovery room (T4) were recorded. A volume of 6 mL venous blood 1 d before operation and 4 h after operation was collected. Blood sugar concentration, cortisol and IL-6 levels were detected.Results:MAP at T1, T2, T3, and T4 in DI and MI groups were significantly elevated when compared with at T0. MAP at T2 and T3 in DII group was significantly elevated when compared with at T0. MAP at T2, T3, and T4 in MII group was significantly elevated when compared with at T0. When compared with DI group, MAP at T1, T2, and T3 in DII group was significantly reduced;MAP at T2, T3, and T4 in MI group was significantly elevated;MAP at T1 in MII group was significantly reduced. When compared with DII group, MAP at T2, T3, and T4 in MI and MII groups was significantly elevated. HR at T1, T2, T3, and T4 was significantly elevated when compared with at T0. When compared with DI group, HR at T1, T2, and T3 in DII group was significantly reduced;HR at each timing point in MI group was significantly elevated;HR at T1 in MII group was significantly reduced, while at T2, T3, and T4 was significantly elevated. When compared with DII group, HR at each timing point in MI group was significantly elevated;HR at T2, T3, and T4 in MII group was significantly elevated. Except for DII group, the blood sugar, cortisol, and IL-6 levels were significantly elevated when compared with before operation. When compared with D1 group, the blood sugar and cortisol levels at T1 in DII group were significantly reduced;the blood sugar, cortisol, and IL-6 levels at T1 in MI and MII groups were significantly elevated. When compared with DII group, the blood sugar, cortisol, and IL-6 levels at T1 in MI and MII groups were significantly elevated.Conclusions:Application of hydrochloric DEX in sevoflurance anesthesia in children can effectively inhibit the excitability of sympathetic nervous system caused by operation, alleviate the stress reaction, and maintain the stability of hemodynamics, which is benefit for the postoperative rehabilitation.

Prevalence and Risk Factors Associated with Tungiasis among School-Aged Children in the City of Port Gentil, Ogooué-Maritime Province, Gabon in Central Africa

Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortunately, in this country, no study has ever been undertaken on this disease. However, in both urban and rural areas of this country, it causes disfigurement and mutilation of the feet or hands in infested persons, and is sometimes responsible for the school dropout of many children. It is in this context that this timely and relevant research was conducted to assess the prevalence and risk factors associated with Tungiasis in school-aged children in the city of Port Gentil, Ogooué-Maritime province, Gabon in Central Africa. Materials and Methods: This prospective and cross-sectional study took place from May 22 to August 18, 2022, in two popular and underprivileged neighborhoods of the city of Port Gentil. It consisted of a physical diagnosis of the participants, and with the help of a questionnaire submitted to their parents/guardians, numerous data were collected. Entered into an Excel 2016 spreadsheet, the data were exported to the R software in its R Commander interface, for two types of analyses. A univariate and a multivariate analysis, using logistic regression, first on socio-demographic characteristics and then on habitual and environmental behavioral characteristics, was performed and the variables in this analysis reported odds ratios and their 95% confidence intervals. The results were statistically significant at p Results: A total of 637 school-aged children with a mean age of 12.73 years and a standard deviation of 5.44, were registered and examined for this study. Among them, Tunga penetrans infestation was found in 242 children, indicating an overall prevalence of 37.99% (95% CI [0.34 - 0.41]). Univariate and multivariate analyses, using logistic regression, first according to socio-demographic characteristics and then according to risk factors indicated that, the age groups of 5 to 9 years (Adjusted Odds Ratio = 9.27;95% CI: [6.66 - 12. 91]) and 10 - 14 years (Adjusted Odds Ratio = 0.16;95% CI: [0.10 - 0.25]), Eshira ethnicity (Adjusted Odds Ratio = 7.46;95% CI: [2.97 - 18.76]), child’s primary education level (Adjusted Odds Ratio = 0.008;95% CI: [0.006 - 0.011]), Father’s/Guardian’s education level (Adjusted Odds Ratio = 0.22;95% CI: [0.13 - 0.35]), homemaker status (Adjusted Odds Ratio = 4.89;95% CI: [3.51 - 6. 79]) and risk factors such as: promiscuity with dogs, cats or other animals around the house (Adjusted Odds Ratio = 38.30;95% CI: [22.13 - 66.26]), wearing shoes a few times (Adjusted Odds Ratio = 0.02;95% CI [0.01 - 0.03]), walking sometimes barefoot, on land or sand (Adjusted Odds Ratio = 0.28;95% CI: [0.18 - 0.42]), having other sources of water consumed than the tap (Adjusted Odds Ratio = 0.25;95% CI: [0.16 - 037]), living in a dwelling with soil or sand (Adjusted Odds Ratio = 6.8;95% CI: [4.58 - 10.09]), having average housing conditions (Adjusted Odds Ratio = 46.8;95% CI [24.29 - 90.16]), and the number of people living in the family that was greater than or equal to 6 (Adjusted Odds Ratio = 0.1;95% CI [0.07 - 0.13]), were significantly associated with the prevalence of Tungiasis. Conclusion: The results of this study will inform control programs and water and sanitation interventions for the Tunga penetrans epidemic in Port Gentil, Gabon.

Association between <i>Helicobacter pylori</i>Infection and Iron Deficiency Anemia among School-Age Children in Sohag University Hospital, Upper Egypt

Background: Helicobacter pylori (H. pylori) infection has been suggested as a cause of iron deficiency anemia (IDA) refractory to iron therapy. Objective: The aim of this work was to evaluate the association between H. pylori infection and IDA among school-age children. Subjects and Methods: This was a prospective case-control study conducted for one year starting from March 2015 and included 200 school-age children with IDA and 50 age and sex matched non-anemic controls, attending pediatric outpatient clinic at Sohag university Hospital, Sohag, Upper Egypt. All of participants were subjected to clinical evaluation and the following investigations: CBC, serum iron, total iron binding capacity, serum ferritin and a quantitative detection of H. pylori IgG antibodies. Results: Totally, 72 (36%) children with IDA and 6 (12%) non-anemic controls had positive level for H. pylori specific IgG (P = 0.036). H. pylori IgG antibody titer showed significant positive correlation with age and significant negative correlation with each of Hb level, MCV, HCT and serum ferritin. Age was higher (p H. pylori positive IDA cases in comparison to H. pylori negative IDA cases. Conclusion: The results of this study demonstrate significant association between positive serology for H. pylori infection and IDA in school-age children. Moreover, infection may increase the severity of anemia.

Prevalence and Factors Associated with Iron Deficiency Anemia among School-Age Children in Primary Schools in Burao City, Somaliland, 2020

Background: Anemia is a global public health problem affecting the majority of the population of the world in both developed and developing countries with major consequences on human health as well as social and economic development. It is the world’s second leading cause of disability of the whole global disease burden. It affects 1.62 billion (24.8%) of the population, among them, it is affecting 305 million (25.4%) school-age children (SAC). Objectives: The main objective of this study was to assess the prevalence and factors associated with anemia among school-age children in primary schools in Burao city, Somaliland, 2020. Materials & Methods: A school-based cross-sectional study design was done in four primary schools in Burao, Somaliland. About 285 school-age children in the age group between 6 - 14 years were selected with a respondent rate of 93.4%. Random sampling was used to select schools and systemic random sampling was used to identify children from the selected schools. Socio-demographic data was collected by using a questionnaire & interviews of respondents in addition to anthropometric measurements, hemoglobin measurement, and stool examination. Complete Blood Counting (CBC) was used to determine the mean corpuscular (kor-PUS-kyu-lar) volume (MCV) and hematocrit (HMC) levels to detect hemoglobin status of the children. Data was entered and analyzed using SPSS statistical software for Windows version 21. Anthropometric data was analyzed using ANTHRO Plus. Bivariate logistic regression and multivariable logistic regression were used to identify independent predictors of anemia in school adolescent girls. Statistical significance was set at p < 0.05. Results: A total of 285 school-age children were included in this study. The overall prevalence of anemia was (23.1%) (CI: 18.1%, 28.1%) with the mean and standard deviation of (12.7 ± 1.59). Out of the anemic children, 20.4% were mild and 2.3% and 0.4% of them were moderate and severe, respectively. Children’s from illiterate mothers (AOR = 2.37;95% CI: 1.14, 4.94. P-value = 0.020), consuming organ meat less than once a week (AOR = 2.19;95% CI: 1.05, 4.43. P-value = 0.036) and having parasites in stool (AOR = 5.21;95% CI: 1.10, 24.6. P-value = 0.037) were identified as statistically independent associated factors with prevalence of anemia in school-age children’s from Burao, Somaliland. Conclusion: Prevalence of anemia in Burao city, Somaliland primary schools was a moderate public health problem in the current study area. Nutrition education, iron folic acid supplementation program, deworming, good hygiene, and sanitation are playing an important role in the prevalence of anemia and we recommend to give them more attention from ministry of education and ministry of health in Somaliland.

Survey and clinical considerations of gender identity in lower primary school children

BACKGROUND Gender consciousness directly affects the development of gender identity,which is a continuous and lifelong process.Meanwhile,hospitalization is a part of many children's lives and has an impact on their gender development.AIM To investigate the current situation of gender identity in lower primary school children by conducting a survey of 202 hospitalized children in the lower grades and to provide a theoretical basis and foundation for the cultivation of gender identity and medical treatment of children based on the results.This study aims to inspire clinical medical staff to scientifically and reasonably arrange hospital wards for lower primary school children and pay attention to gender protection during the medical treatment process and to help children shape a unified and clear gender identity,which will enable them to better integrate into society and promote their personality development.METHODS The gender consciousness scale for elementary and middle school students was RESULTS Gender identity was already present in lower primary school children.The children's gender roles and gender equality consciousness were strong,exceeding the critical value,but their gender characteristics,gender identity,and gender ideal consciousness were weak.Children aged 6 had the weakest gender identity,and girls had significantly stronger gender identity than boys.CONCLUSION Gender identity is already present in lower primary school children,providing a basis and inspiration for the cultivation of gender identity and medical treatment of lower primary school children.Clinical medical staff should be aware of and understand these results and should scientifically and reasonably arrange hospital wards for lower primary school children.

Two different autorefractors for vision screening in children and adolescents

AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.

Distribution and correlation of refractive parameters in children with different corneal curvatures in southeast China

AIM:To analyze the distribution of refractive status in school-age children with different corneal curvatures(CC)and the correlation between CC and refractive status.METHODS:A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included.Uncorrected distance visual acuity(UCDVA),non-cycloplegic refraction,axial length(AL),horizontal and vertical corneal curvature(K1,K2)were measured and spherical equivalent(SE),corneal curvature radius(CCR)and axial length/corneal radius of curvature ratio(AL/CR)were calculated.UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia.According to the different CCRs,the patients were divided into the lower corneal curvature(LCC)group(CCR≥7.92)and the higher corneal curvature(HCC)group(CCR<7.92).Each group was further divided into the normal AL subgroup and the long AL subgroup.The refractive parameters were compared to identify any differences between the two groups.RESULTS:Both SE and AL were greater in the LCC group(P=0.013,P<0.001).The prevalence of myopia was 38% in the LCC group and 44% in the HCC group(P<0.001).The proportion of children without screening myopia was higher in the LCC group(62%)than in the HCC group(56%).Among these children without screening myopia,the proportion of long AL in the LCC group(24%)was significantly higher than that in the HCC group(0.012%;P<0.001).The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group.CONCLUSION:School-aged children in the LCC group have a lower incidence of screening myopia and longer AL.Low CC can mask SE reduction and AL growth to some extent,and the change of AL growth change more in children with low CC than high CC.Before the onset of myopia,its growth rate is even faster than that after the onset of myopia.

Global prevalence and gender inequalities in at least 60 min of self-reported moderate-to-vigorous physical activity 1 or more days per week:An analysis with 707,616 adolescents

Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.