BACKGROUND: Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China. METHODS: This cross-sectional study enrolled all infants born at 24 +0 to 31 +6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage. RESULTS: A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks' gestation to 3120/3960 (78.8%) at 30 to 31 weeks' gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS. CONCLUSIONS The use rate of ACS remained low for infants at 24 to 31 weeks' gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.
Humans ; Infant, Newborn ; Infant ; Pregnancy ; Female ; Gestational Age ; Infant, Premature ; Intensive Care Units, Neonatal ; Cross-Sectional Studies ; Adrenal Cortex Hormones/therapeutic use*

Objective: To comprehensively assess the current status of extrauterine growth restriction (EUGR) in very preterm infants (VPI) and its associated factors in Chinese neonatal intensive care units (NICU). Methods: In this cohort study, 6 179 preterm infants born at <32 weeks' gestation were included, who were admitted to 57 hospitals in the China Neonatal Network in 2019 and hospitalized for ≥7 days. EUGR was evaluated by a cross-sectional definition (weight at discharge<10^th percentile for postmenstrual age), a longitudinal definition (decline in weight Z score>1 from birth to discharge), and weight growth velocity. The comparison between infants with and without EUGR was conducted by t-test, Mann-Whitney U test or χ² test as appropriate. Multivariable Logistic regression models were used to evaluate associations between EUGR with different definitions and maternal and neonatal factors, clinical practices, and neonatal morbidities. Results: A total of 6 179 VPI were enrolled in the study, with a gestational age of (29.8±1.5) weeks and birth weight of (1 365±304) g; 56.2% (3 474) of them were male. Among them, 48.4% (2 992 VPI) were cross-sectional EUGR and 74.9% (4 628 VPI) were longitudinal EUGR. Z score of weight was (0.13±0.78) at birth and decrease to (-1.35±0.99) at discharge. The weight growth velocity was 10.13 (8.42, 11.66) g/(kg·d). Multivariate Logistic regression analysis showed that among the influential factors that could be intervened after birth, late attainment of full enteral feeds (OR_adjust=1.01, 95%CI 1.01-1.02, P<0.001; OR_adjust=1.01, 95%CI 1.01-1.02, P<0.001), necrotizing enterocolitis≥Ⅱstage (OR_adjust=2.64, 95%CI 1.60-4.35, P<0.001; OR_adjust=1.62, 95%CI 1.10-2.40, P<0.001) and patent ductus arteriosus (OR_adjust=1.94, 95%CI 1.50-2.51, P<0.001; OR_adjust=1.63, 95%CI 1.29-2.06, P<0.001) were all associated with increased risks of both cross-sectional and longitudinal EUGR. In addition, late initiation of enteral feeds (OR_adjust=1.06, 95%CI 1.02-1.09, P=0.020) and respiratory distress syndrome (OR_adjust=1.45, 95%CI 1.24-1.69, P<0.001) were all associated with cross-sectional EUGR. Breast milk feeding (OR_adjust=1.33, 95%CI 1.05-1.68, P<0.001) was associated with a higher risk of longitudinal EUGR. Conclusions: The incidence of EUGR in VPI in China is high. Some modifiable risk factors provide priorities to improve postnatal growth for VPI. Nutritional management of VPI and the efforts to decrease the incidence of complications are still the focus of clinical management in China.
Female ; Humans ; Infant, Newborn ; Male ; Cohort Studies ; East Asian People ; Infant, Premature ; Infant, Premature, Diseases ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal

Far-infrared rays (FIR) are known to have various effects on atoms and molecular structures within cells owing to their radiation and vibration frequencies. The present study examined the effects of FIR on gene expression related to glucose transport through microarray analysis in rat skeletal muscle cells, as well as on mitochondrial biogenesis, at high and low glucose conditions. FIR were emitted from a bio-active material coated fabric (BMCF). L6 cells were treated with 30% BMCF for 24 h in medium containing 25 or 5.5 mM glucose, and changes in the expression of glucose transporter genes were determined. The expression of GLUT3 (Slc2a3) increased 2.0-fold (p < 0.05) under 5.5 mM glucose and 30% BMCF. In addition, mitochondrial oxygen consumption and membrane potential (ΔΨm) increased 1.5- and 3.4-fold (p < 0.05 and p < 0.001), respectively, but no significant change in expression of Pgc-1a, a regulator of mitochondrial biogenesis, was observed in 24 h. To analyze the relationship between GLUT3 expression and mitochondrial biogenesis under FIR, GLUT3 was down-modulated by siRNA for 72 h. As a result, the ΔΨm of the GLUT3 siRNA-treated cells increased 3.0-fold (p < 0.001), whereas that of the control group increased 4.6-fold (p < 0.001). Moreover, Pgc-1a expression increased upon 30% BMCF treatment for 72 h; an effect that was more pronounced in the presence of GLUT3. These results suggest that FIR may hold therapeutic potential for improving glucose metabolism and mitochondrial function in metabolic diseases associated with insufficient glucose supply, such as type 2 diabetes.

Far-infrared rays (FIR) are known to have various effects on atoms and molecular structures within cells owing to their radiation and vibration frequencies. The present study examined the effects of FIR on gene expression related to glucose transport through microarray analysis in rat skeletal muscle cells, as well as on mitochondrial biogenesis, at high and low glucose conditions. FIR were emitted from a bio-active material coated fabric (BMCF). L6 cells were treated with 30% BMCF for 24 h in medium containing 25 or 5.5 mM glucose, and changes in the expression of glucose transporter genes were determined. The expression of GLUT3 (Slc2a3) increased 2.0-fold (p < 0.05) under 5.5 mM glucose and 30% BMCF. In addition, mitochondrial oxygen consumption and membrane potential (ΔΨm) increased 1.5- and 3.4-fold (p < 0.05 and p < 0.001), respectively, but no significant change in expression of Pgc-1a, a regulator of mitochondrial biogenesis, was observed in 24 h. To analyze the relationship between GLUT3 expression and mitochondrial biogenesis under FIR, GLUT3 was down-modulated by siRNA for 72 h. As a result, the ΔΨm of the GLUT3 siRNA-treated cells increased 3.0-fold (p < 0.001), whereas that of the control group increased 4.6-fold (p < 0.001). Moreover, Pgc-1a expression increased upon 30% BMCF treatment for 72 h; an effect that was more pronounced in the presence of GLUT3. These results suggest that FIR may hold therapeutic potential for improving glucose metabolism and mitochondrial function in metabolic diseases associated with insufficient glucose supply, such as type 2 diabetes.

Purpose: This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. Methods: The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. Results: Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. Conclusion Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.

To investigate the prevalence of Toxoplasma gondii in pork on the market in Korea, an in-house enzyme-linked immunosorbent assay for tissue fluid (CAU-tf-ELISA) was developed using a soluble extract of T. gondii RH strain tachyzoites. As the standard positive controls, the piglets were experimentally infected with T. gondii: Group A (1,000 cysts-containing bradyzoites), Group B (500 cysts-containing bradyzoites) and Group C (1.0×103 or 1.0×104 tachyzoites). The CAU-tf-ELISA demonstrated infection intensity-dependent positivity toward tissue fluids with average cut-off value 0.15: 100% for Group A, 93.8% for Group B and 40.6% for Group C. When tissue-specific cut-off values 0.066–0.199 were applied, CAU-tf-ELISA showed 96.7% sensitivity, 100% specificity, 100% positive and 90.0% negative predictive values. When compared with the same tissue fluids, performance of CAU-tf-ELISA was better than that of a commercial ELISA kit. Of the 583 Korea domestic pork samples tested, anti-T. gondii antibodies were detected from 9.1% of whole samples and 37.9% from skirt meat highest among pork parts. In the 386 imported frozen pork samples, 1.8% (skirt meat and shoulder blade) were positive for anti-T. gondii antibodies. In Korea, prevalence of anti-T. gondii antibodies in the pork on retail markets appeared high, suggesting that regulations on pig farming and facilities are necessary to supply safe pork on the tables.
Agriculture ; Antibodies ; Enzyme-Linked Immunosorbent Assay ; Korea ; Meat ; Prevalence ; Red Meat ; Sensitivity and Specificity ; Shoulder ; Social Control, Formal ; Toxoplasma

The original version of this article contained errors in Tables. The contents of Table 4, 5, and 6 should be corrected.

PURPOSE: This study was conducted to develop a nutrition quotient (NQ) to assess overall dietary quality and food behaviors of Korean adults. METHODS: The NQ was developed in three steps: item generation, item reduction, and validation. Candidate items of the NQ checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the Korea National Health and Nutrition Examination Survey (2010 ~ 2013) data, and national nutrition policies and recommendations. A total of 368 adults (19 ~ 64 years) participated in a one-day dietary record survey and responded to 43 items in the food behavior checklist. Pearson's correlation coefficients between responses to the checklist items and nutritional intake status of the adults were calculated. Item reduction was performed, and 24 items were selected for a nationwide survey. A total of 1,053 nationwide adult subjects completed the checklist questionnaires. Exploratory and confirmatory factor analyses were performed to develop a final NQ model. RESULTS: The 21 checklist items were used as final items for NQ. Checklist items were composed of four factors: nutrition balance (seven items), food diversity (three items), moderation for the amount of food intake (six items), and dietary behavior (five items). The four-factor structure accounted for 41.8% of the total variance. Indicator tests of the NQ model suggested an adequate model fit (GRI = 0.9693, adjusted GFI = 0.9617, RMR = 0.0054, SRMR = 0.0897, p < 0.05), and item loadings were significant for all subscales. Standardized path coefficients were used as weights of the items. The NQ and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ for adults would be a useful tool for assessing adult dietary quality and food behavior. Further investigations of adult NQ are needed to reflect changes in their food behavior, environment, and prevalence of chronic diseases.
Adult* ; Checklist ; Chronic Disease ; Diet Records ; Eating ; Humans ; Korea ; Nutrition Policy ; Nutrition Surveys ; Prevalence ; Weights and Measures

PURPOSE: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. METHODS: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. RESULTS: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.
Aged ; Checklist ; Humans ; Nutrition Policy ; Nutrition Surveys ; Weights and Measures

PURPOSE: The purpose of this study was to develop a nutrition quotient for adolescents (NQ-A) to assess overall dietary quality and food behavior of Korean adolescents. METHODS: Development of the NQ-A was undertaken in three steps: item generation, item reduction, and validation. Candidate items of the NQ-A checklist were selected based on literature reviews, results of the fifth Korea National Health and Nutrition Examination Survey data, dietary guidelines for Korean adolescents, expert in-depth interviews, and national nutrition policies and recommendations. A total of 213 middle and high school students participated in a one-day dietary record survey and responded to 41 items in the food behavior checklist. Pearson's correlation coefficients between the responses to the checklist items along with nutritional status of the adolescents were calculated. Item reduction was performed, and 24 items were selected for the nation-wide survey. A total of 1,547 adolescents from 17 cities completed the checklist questionnaire. Exploratory factor and confirmatory factor analyses were performed to develop a final NQ-A model. RESULTS: Nineteen items were finalized as the checklist items for the NQ-A. Checklist items were composed of five factors (balance, diversity, moderation, environment, and practice). The five-factor structure accounted for 47.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-A and five-factor scores were calculated based on the obtained weights of the questionnaire items. CONCLUSION: Nutrition Quotient for adolescents (NQ-A) would be a useful instrument for evaluating dietary quality and food behavior of Korean adolescents. Further research on NQ-A is needed to reflect changes in adolescent's food behavior and environment.
Adolescent* ; Checklist ; Diet Records ; Humans ; Korea ; Nutrition Policy ; Nutrition Surveys ; Nutritional Status ; Weights and Measures