The participants showed a relatively low level of stroke prevention knowledge and a moderate level of engagement in healthy behaviors. Pearson correlation coefficient between these 2 variables was 0.423 (P < .001). The results of multiple regression analysis showed that stroke prevention knowledge was positively influenced by education level; health behaviors were positively influenced by both gender and stroke prevention knowledge. Findings suggest that male hypertensive patients and those with a lower education level need targeted stroke education. Because knowledge was unrelated to behavior with respect to smoking, alcohol use, and low-salt diet, behavioral interventions should be explored to address these important risk factors among patients at risk for stroke.

This 6‐week longitudinal study aimed to examine a moderated mediation model that may explain the link between school‐related social support (i.e., teacher support and classmate support) and optimal subjective well‐being in school among adolescents (n = 1316). Analyses confirmed the hypothesized model that scholastic competence partially mediated the relations between school‐related social support and subjective well‐being in school, and social acceptance moderated the mediation process in the school‐related social support‐‐> subjective well‐being in school path and in the scholastic competence‐‐> subjective well‐being in school path. The findings suggested that both social contextual factors (e.g., school‐related social support) and self‐system factors (e.g., scholastic competence and social acceptance) are crucial for adolescents' optimal subjective well‐being in school. Limitations and practical applications of the study were discussed.

Background:Previous studies suggested that zinc level was related to a certain diabetic microvascular complication. However, the relationship between zinc level and all the microvascular complications in type 2 diabetic patients remains unknown. The purpose of this study was to analyze the relationship between zinc level and each diabetic microvascular complication and identify the features related to low serum zinc level.Methods:We included the hospitalized patients with type 2 diabetes (T2D) at our department from May 30, 2013 to March 31, 2014. We initially compared the serum zinc levels between patients with specific microvascular complications and those without. We then analyzed the association between zinc level and each microvascular complication. Furthermore, we identified the unique features of patients with high and low serum zinc levels and analyzed the risk factors related to low zinc level.Results:The 412 patients included 271 with microvascular complications and 141 without any microvascular complications. Serum zinc level was significantly lower in patients with diabetic retinopathy (P < 0.001), diabetic nephropathy (DN, P < 0.001), or diabetic peripheral neuropathy (P = 0.002) compared with patients without that specific complication. Lower zinc level was an independent risk factor for DN (odds ratio = 0.869, 95% confidence interval = 0.765–0.987, P < 0.05). The subjects with lower serum zinc level had manifested a longer duration of diabetes, higher level of hemoglobin A1c, higher prevalence of hypertension and microvascular complications, and lower fasting and 2-h C-peptide levels.Conclusions:Lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications, and represented as an independent risk factor for DN. Patients with lower zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function.

Objective: To compare the efficacy of new percutaneous technique (“ultra-mini PCNL”, UMP), shock wave lithotripsy (SWL) and flexible ureteroscopy (FURS) on the treatment of 1–2 cm lower pole kidney stones, and to determine the advantages and disadvantages of each method. Materials and Methods: This prospective study was based on data collected from the files of patients between March 2015 and March 2017. This study recruited a total of 180 patients with single radio-opaque lower caliceal calculi of 1–2 cm. All patients were randomly divided into 3 groups: group A was treated with UMP, group B was treated with FURS by using holmium laser and group C was treated with SWL by using the electromagnetic lithotripter. The average age, sex, size of the stone, the time of operation, the rate of no stone, the time of hospitalization, the rate of retreatment, the cost and the complications of the 3 groups were compared. The success of the operation was defined as no residual stone or < 0.3 cm on computed tomography at 3 months postoperatively. Results: The stone burdens of the groups were equivalent. The re-treatment rate in group C was significantly higher than that in group A and B (30 vs. 1.6%, 5%). The average operating time in group B (93.35 ± 21.64 min) was statistically significantly longer than that in group A and C (68.58 ± 15.82 min, 46.33 ± 5.81 min). Although the time of hospitalization of group A (5.32 ± 1.20 day) was longer than that of group B (3.22 ± 0.52 day) and C (1.08 ± 0.28 day; p < 0.05). The stone-free rate (SFR) in UMP, FURS, SWL were 98, 92, and 73% respectively; the highest SFR was in the UMP group (p < 0.05). The complication rates were evaluated by using the Clavien grading system, which were determined to be 16.67% in UMP, 6.67% in SWL and 8.33% in FURS. In particular, the complications of GI and GII were more common in group A (p < 0.05). Conclusions: UMP, FURS, and SWL are all safe and effective in the treatment of 1–2 cm lower pole kidney stones. UMP and FURS had a better SFR than SWL, but the time of hospitalization in UMP group was longer and there were more complications in the UMP group. In addition, the operation time of FURS is longer as compared to UMP and SWL, and there is a higher rate of postoperative fever. The invasiveness and cost of SWL were lower than that of UMP and FURS, but the re-treatment rate was higher.

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Blood pressure (BP) monitored within 24 h from the beginning of intravenous thrombolysis (IVT) with alteplase, is one of the important factors affecting the prognosis of patients with acute ischemic stroke (AIS). This study aimed to explore longitudinal BP trajectory patterns and determine their association with stroke prognosis after thrombolysis. From November 2018 to September 2019, a total of 391 patients were enrolled consecutively during the study period, and 353 patients were ultimately analyzed. Five systolic (SBP) and four diastolic blood pressure (DBP) trajectory subgroups were identified. The regression analysis showed that when compared with the rapidly moderate stable group, the continuous fluctuation‐very high level SBP group (odds ratio [OR]: 2.743, 95% confidence interval [CI]: 1.008–7.467) was associated with early neurological deterioration (END). Both the rapid drop‐high level SBP (OR: 0.448, 95% CI: 0.219–0.919) and DBP groups (OR: 0.399, 95% CI: 0.219–0.727) were associated with early neurological improvement (ENI). Moreover, there was a U‐shaped correlation between the OR value of SBP trajectory group and favorable outcome (the modified Rankin Scale [mRS] score 0–2) at 3 months: the slow drop‐low level SBP group represent a well‐established unfavorable outcome risk factor (OR:5.239, 95% CI: 1.271–21.595), and extremely high SBP—the continuous fluctuation‐very high level SBP group, are equally associated with elevated unfavorable outcome risk (OR:3.797, 95% CI: 1.486–9.697). The continuous fluctuation‐very high level DBP group was statistically significant in mRS (OR: 3.387, CI: 1.185–9.683). The BP trajectory groups show varying clinical features and risk of neurological dysfunction. The findings may help identify potential candidates for clinical BP monitoring, control, and specialized care.

Introduction Alzheimer's disease (AD) is a chronic neurodegenerative disease that generally starts slowly and leads to deterioration over time. Finding biomarkers more effective to predict AD transition is important for clinical medicine. And current research indicated that the lesion regions occur in both gray matter (GM) and white matter (WM). Methods This paper extracted BOLD time series from WM and GM, combined WM and GM together for analysis, constructed functional connectivity (FC) of static (sWGFC) and dynamic (dWGFC) between WM and GM, as well as static (sGFC) and dynamic (dGFC) FC within GM in order to evaluate the methods and areas most useful as feature sets for distinguishing NC from AD. These features will be evaluated using support vector machine (SVM) classifiers. Results The FC constructed by WM BOLD time series based on fMRI showed widely differences between the AD group and NC group. In terms of the results of the classification, the performance of feature subsets selected from sWGFC was better than sGFC, and the performance of feature subsets selected from dWGFC was better than dGFC. Overall, the feature subsets selected from dWGFC was the best. Conclusion These results indicated that there is a wide range of disconnection between WM and GM in AD, and association between WM and GM based on fMRI only is an effective strategy, and the FC between WM and GM could be a potential biomarker in the process of cognitive impairment and AD.

Background: The initiation of exercise during rehabilitation at the subacute stage could provide stroke survivors with an approach to recovery that capitalizes on unique physiological conditions and promotes spontaneous recovery. We aimed to examine the effects of a tailored sitting Tai Chi program on recovery outcomes among subacute stroke survivors. Methods: We conducted a 12-week assessor-blind randomized controlled trial in China. Subacute stroke survivor-caregiver dyads were recruited and randomly assigned to either the sitting Tai Chi group (n=80) or attention control group (n=80). Outcomes including upper limb function (Fugl-Meyer Assessment Upper Extremity & Wolf Motor Function Test), balance control (Berg Balance Scale), sitting balance control (Trunk Impairment Scale), depressive symptoms (Geriatric Depression Scale Short Form), shoulder range of motion, shoulder pain (ShoulderQ), activities of daily living (Modified Barthel Index), and quality of life (Stroke Specific Quality of Life Scale) were measured at baseline, in-process, immediately post, and 4-week postintervention. Results: Immediately postintervention, the sitting Tai Chi group (n=69) showed significant upper limb function improvement in the primary outcomes including the performance time (regression coefficient of the group-by-time interaction, B=–21.415 [95% CI, –31.000 to –11.831]) and functional ability (B=10.146 [95% CI, 4.886–15.406]) domains of the Wolf Motor Function Test, balance control (B, 4.972 [95% CI, 1.356–8.588]), and sitting balance control (B=4.397 [95% CI, 2.699–6.096]). Compared with the control group (n=65), improvements were also observed in secondary outcomes including depressive symptoms (B=–1.626 [95% CI, –2.304 to –0.948]), shoulder extension (B=4.518 [95% CI, 0.893–8.144]), activities of daily living (B=5.510 [95% CI, 0.450–10.569]), and quality of life (B=15.680 [95% CI, 7.255–24.105]). Conclusions: The results support the effectiveness of a tailored sitting Tai Chi program in improving recovery outcomes among subacute stroke survivors and provide additional knowledge to support the clinical implementation of such a program. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04138407.