Aims and Objectives To determine the health‐related quality of life (HRQoL) of COVID‐19 patients after discharge and its predicting factors. Background COVID‐19 has caused a worldwide pandemic and led a huge impact on the health of human and daily life. It has been demonstrated that physical and psychological conditions of hospitalised COVID‐19 patients are impaired, but the studies focus on physical and psychological conditions of COVID‐19 patients after discharge from hospital are rare. Design A multicentre follow‐up study. Methods This was a multicentre follow‐up study of COVID‐19 patients who had discharged from six designated hospitals. Physical symptoms and HRQoL were surveyed at first follow‐up (the third month after discharge). The latest multiple laboratory findings were collected through medical examination records. This study was performed and reported in accordance with STROBE checklist. Results Three hundred eleven patients (57.6%) were reported with one or more physical symptoms. The scores of HRQoL of COVID‐19 patients at third month after discharge, except for the dimension of general health, were significantly lower than Chinese population norm ( p < .001). Results of logistic regression showed that female (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.04–3.06), older age (≥60 years) (OR: 2.44, 95% CI: 1.33–4.47) and the physical symptom after discharge (OR: 40.15, 95% CI: 9.68–166.49) were risk factors for poor physical component summary; the physical symptom after discharge (OR: 6.68, 95% CI: 4.21–10.59) was a risk factor for poor mental component summary. Conclusions Health‐related quality of life of discharged COVID‐19 patients did not come back to normal at third month after discharge and affected by age, sex and the physical symptom after discharge. Relevance to clinical practice Healthcare workers should pay more attention to the physical and psychological rehabilitation of discharged COVID‐19 patients. Long‐term follow‐up on COVID‐19 patients after discharge is needed to determine the long‐term impact of COVID‐19.

Background and Purpose— Stroke disability is a major health burden in rural China where rehabilitation services are inadequate. We aimed to determine the effectiveness of a novel nurse-led, caregiver-delivered model of stroke rehabilitation in rural China. Methods— A multicenter prospective, randomized open, blinded outcome assessed, controlled trial was conducted in 3 rural county hospitals in China: Zhangwu, Liaoning Province (Northeast); Qingtongxia, Ningxia Hui Autonomous Region (Northwest); and Dianjiang, Chongqing Municipality (Southwest). Adult patients (age 18–79 years) with residual disability (Barthel Index score ≤80/100) after a recent acute stroke were randomized to a new service model or usual care. The new intervention was multifaceted and was based on a task-shifting / training-the-trainers model, supported by a custom-designed smartphone application, where patients and caregivers received evidence-based in-hospital education and stroke rehabilitation training (focus on mobility, self-care, and toileting), delivered by trained nurses before hospital discharge, and 3 postdischarge support telephone calls. Outcome assessments were undertaken before hospital discharge and at 3 and 6 months. Primary outcome was physical functioning (Barthel Index scores) at 6 months, assessed by research staff blind to treatment allocation, adjusted for baseline covariates in an intention-to-treat analysis. Secondary outcomes included measures of mobility, health-related quality of life, mood, and caregiver burden. The study included a process evaluation that assessed intervention fidelity. Results— From November 2014 to December 2016, 246 stroke patients were randomized to intervention (n=118) or control (n=128) groups. There was no statistically significant difference in adjusted 6-month Barthel Index scores between groups (70.1 versus 74.1, mean difference, −4.0 [95% CI, −10.0 to 2.9]), nor any differences across the other outcome measures. Process evaluation interviews revealed that the intervention was desirable and positively accepted by nurses, caregivers, and patients but was considered too complex despite efforts to simplify materials for the rural context. Key strategies identified for future studies included the use of community health workers, smartphone application enhancement, and simpler and more frequent training for nurses, caregivers, and patients. Conclusions— A novel nurse-led, digital supported, caregiver-delivered stroke rehabilitation program did not improve patient physical functioning after stroke in rural China. Further stroke rehabilitation research suitable for resource-poor settings is required, with several components being suggested through stakeholder interviews in our study. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT02247921.

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This study investigated three-dimensional (3D) texture as a possible diagnostic marker of Alzheimer's disease (AD). T1-weighted magnetic resonance (MR) images were obtained from 17 AD patients and 17 age and gender-matched healthy controls. 3D texture features were extracted from the circular 3D ROIs placed using a semi-automated technique in the hippocampus and entorhinal cortex. We found that classification accuracies based on texture analysis of the ROIs varied from 64.3% to 96.4% due to different ROI selection, feature extraction and selection options, and that most 3D texture features selected were correlated with the mini-mental state examination (MMSE) scores. The results indicated that 3D texture could detect the subtle texture differences between tissues in AD patients and normal controls, and texture features of MR images in the hippocampus and entorhinal cortex might be related to the severity of AD cognitive impairment. These results suggest that 3D texture might be a useful aid in AD diagnosis.

Colloidal small-sizeC dS quantum dots (QDs) are produced usually with low particle yield, together with side products such as the particular precursor compounds (PCs) of magic-size clusters (MSC). Here,w er eport our synthesis of small-sizeCdS QDs without the coexistence of the PC and thus with enhanced particle yield. Foraconventional reaction of cadmium oleate (Cd(OA) 2)a nd sulfur (S) in 1-octadecene (ODE), we show that after the formation of the PC in the prenucleation stage,t he addition of tri-n-octylphosphineo xide (TOPO) facilitates the production of small-sizeQ Ds.W e demonstrate that TOPO fragmentizes the PC that have formed, which enables the nucleation and growth of small-sizeQ Ds even at room temperature.O ur findings introduce an ew approach to making small-sizeQDs without the coexistence of the PC and with improved particle yield. Providing experimental evidence for the two-pathwaymodel proposed for the pre-nucleation stage of colloidal binary QDs,the present study aids in the advance of non-classical nucleation theory.

ObjectiveChina’s population is ageing and fall-related injury in older Chinese people is a growing public health concern. This review aims to synthesise existing evidence on the incidence, risk factors and economic burden of fall-related injury among older Chinese people to inform health service planning.MethodsA systematic search of literature on falls and injury among older people living in China was performed in six electronic databases including both English and Chinese databases. Results were combined using narrative synthesis due to the heterogeneity of included studies.ResultsA total of 93 studies from Mainland China, Taiwan and Hong Kong were included in this review. Most of these studies were descriptive; 82 reported the incidence of fall-related injury among older Chinese people, 7 studies examined the risk factors for fall-related injury and 22 studies described the economic burden of fall-related injury. The incidence of fall-related injury reported among older Chinese people ranged from 0.6% to 19.5%. Risk factors significantly associated with fall-related injury among older Chinese included older age, female sex, walking aid use, living environments, chronic disease, medication usage, visual impairment and a fall direction other than forward. The cost of fall-related injury among older Chinese people ranged from US$16 to US$3812 per person per fall.ConclusionFalls-related injuries are a significant public health issue for older Chinese people. Further studies using prospective design to identify risk factors and the economic burden of fall-related injuries are needed.

Background Physical activity (PA) and dietary intake are important modifiable factors associated with health outcomes. However, Chinese pregnant women’s PA and dietary intake are only vaguely understood. The aim of this study was to reveal the characteristics of PA and dietary intake of Chinese women in different trimesters as well as the associations between PA and dietary intake. Methods This is a cross-sectional observational study. PA, dietary intake, and demographics of 1077 Chinese pregnant women were measured. The Chi-square test, Kruskal-Wallis test, multiple logistic regression, and multiple linear regression were used for data analysis. Results About 57.1% of the participants met the international guideline for PA. Household activity and occupational activity contributed the most to the total PA, while sports/exercise contributed little. The mean energy intake of the participants was 2008 ± 748.0 kcal. Most participants had normal energy intake, but they obtained excessive energy from fat (mean = 41.7 ± 8.7%). PA was not found to be significantly associated with dietary intake. Further, the participants who were unemployed during pregnancy (OR = 0.72, 95% CI: 0.55–0.95; p < 0.05) or had no exercise habits before pregnancy (OR = 0.62, 95% CI: 0.47–0.80; p < 0.01) were less likely to meet the PA guideline. The participants in the third trimester (OR = 1.43, 95% CI: 1.03–1.99; p < 0.05) were more likely to meet the PA guideline compared to those in the first trimester. The older participants (> 30 years) showed higher dietary intake than the younger (< 25 years) participants ( p < 0.01). Conclusions The total PA of Chinese women during pregnancy mostly consists of household and occupational activities, but little sports/exercise. Starting exercise before pregnancy may help women achieve adequate PA during pregnancy. Moreover, these women consumed an excessive amount of fat and their diet intake varies by age.

Importance Cortical dysfunction in PD may be caused by disruption to ascending systems or intrinsic cortical neuropathology. We introduce and conduct a joint analysis of metabolism and atrophy capable of identifying whether metabolic disruption occurs in mild PD without cortical atrophy. Objective To determine the extent and spatial pattern of cortical involvement in mild Parkinson Disease (PD). Design Observational. Participants Twenty-three cognitively normal participants with mild PD (mean Hoehn & Yahr stage 2) and 21 healthy controls (HC) Main Outcome Measures Cortical thickness (obtained from analysis of structural MRI with FreeSurfer) and cerebral perfusion measures (obtained from ASL) analyzed independently and then together in a joint multiple factorial analysis to identify spatial patterns of perfusion and cortical thickness. Results We identify a pattern of changes in perfusion and cortical thickness characterized by symmetric parietal cortical thinning and reduced precuneus perfusion, with relative preservation of thickness and perfusion in the anterior cingulate cortex (ACC), right prefrontal gyrus, and medial frontal gyrus. The expression of this pattern is correlated with motor system symptoms and speed of processing. Conclusions and Relevance A spatial pattern of joint parietal cortical thinning and disproportionate reduction in perfusion occurs in our nondemented PD sample. We found no PD-related components of reduced perfusion without cortical thinning. This suggests that PD affects the cortex itself, even when symptoms are relatively mild.