Search Results (408)

Background/Objectives: While immigrants represent 21% of Canada’s total population, they represent 30% of the country’s older population. Sociocultural and economic barriers to the Canadian healthcare system have been frequently reported among older adult immigrants. These barriers are intricately linked to a vastly understudied phenomenon-transnational health practices (THP), which may involve travelling to home countries for healthcare, accessing medicine and health-related information and resources linked to home countries. This study aimed to explore the relationships among local healthcare experiences in Canada, individual characteristics and use of THP among older adult immigrants. Methods: A mixed-methods approach was used combining statistical, spatial and qualitative methods to analyze group patterns of THP and its influencing factors. Primary data was collected through surveys and focus groups of older Mainland Chinese and older South Korean immigrants residing in Toronto. They are the two largest East Asian groups in Canada, with documented transnational ties with their home country. Results: The study found that THP were sought by both groups but were more prevalent among older Chinese immigrants. By integrating quantitative and qualitative analyses, the study revealed complex relationships between THP and barriers in local healthcare access relating to wait times, cost, language, availability, spatial accessibility and quality of care, for different types of care including primary, specialist, eye and dental care. Conclusions: The study generates new knowledge on THP in Canada and adds to the growing body of literature on transnational healthcare practices and behaviours among migrants across different countries and regions. It provides implications to inform health policy and deliver care for older adult immigrants as their populations continue to increase. Full article

Bahaba taipingensis (Chinese bahaba) is a critically endangered fish endemic to China’s coastal waters, valued for both ecological and economic reasons and known as the “panda of the sea”. Captive breeding and stock enhancement are key conservation strategies, yet the genetic composition of released individuals directly affects program outcomes. This study combined mitochondrial and whole-genome resequencing to compare F₁-generation fish with wild populations. At the mitochondrial level, 60 SNPs were detected in F₁ individuals and 72 in wild populations, with haplotype analyses revealing retention of most common maternal lineages but reduced diversity. Nuclear genome analysis showed comparable genetic diversity between groups. Nucleotide diversity (π) was 0.000423 in F₁ fish and 0.000401 in the wild population. However, the F₁ cohort exhibited a higher inbreeding coefficient (F_IS = −0.030) than the wild group (F_IS = −0.118), suggesting early allele frequency shifts, thereby suggesting early genotype frequency shifts. Runs of homozygosity (ROH) analysis showed that the total number and length of ROH regions in the F₁ cohort (686, 283,089.25 kb) were significantly greater than those in the wild population (171, 52,607.30 kb). Genome-wide F_ST between groups was 0.035, and PCA indicated genetic homogenization in F₁ fish. N_e analysis showed that the wild population declined rapidly over generations and stabilized at a low level, indicating genetic diversity loss under environmental stress and highlighting the role of artificial breeding. These findings highlight the need for improved broodstock management and long-term genetic monitoring. Full article

Background: Health system literacy is crucial for immigrants to navigate health care systems and access necessary services. Little is known about how well immigrants understand and use the healthcare system in Canada. This study aimed to adapt and validate a health system literacy scale for the Canadian context (HSL-CAN). Methods: A cross-sectional online survey was conducted from March 11 to July 19, 2024, among Chinese individuals aged 30 or older who have lived in Canada for at least 6 months. The HSL-CAN was developed through a literature review, patient and provider consultation, and adaptation of the European Health Literacy Population Survey 2019–2021 for navigational health literacy measurement (HLS₁₉–NAV) and was then translated into simplified and traditional Chinese. Content validity was evaluated via stakeholders’ feedback, and structural validity was evaluated via exploratory and confirmatory analyses (EFA/CFA). Convergent and discriminant validity, as well as known-group validity, were tested using correlations with the HLS₁₉-SF12, ANOVA (or t-test), and effect size. Internal consistency was measured with Cronbach’s alpha coefficient and composite reliability. Results: Initially, HSL-CAN contained 25 items developed using a five-point Likert response scale. Some minor revisions were made according to the stakeholders’ feedback (n = 12). Five redundancy items were removed based on the EFA. CFA supported a one-factor model with good fit indices (CFI = 0.960, TLI = 0.955, SRMR = 0.033, RMSEA = 0.025),${\chi }^2$/df = 1.41). The scale showed a solid internal reliability (Cronbach’s alpha = 0.81; composite reliability = 0.812). The HSL-CAN is highly correlated with the “health care” construct but lowly with the “health prevention and promotion” construct of HLS₁₉–SF12. Known-group validity showed large mean differences by education, income, and non-cancer chronic comorbidities and small to moderate mean differences by gender, age groups, employment status, self-rated health, and assistance needed to see a healthcare provider. Conclusions: The HSL-CAN is the first validated instrument to evaluate health system literacy in the Chinese population in Canada. Given strong validity and reliability, the instrument can be useful for research and practice, although further refinement is recommended before using this scale on the general population in Canada. Full article

In light of the increasing focus on global climate change and environmental issues, countries around the world are collaboratively working towards the establishment of a low-carbon economy (LCE). As the most populous developing nation, China is proactively advocating for low-carbon economic development as a means to achieve sustainable growth. Nevertheless, the efficiency of the low-carbon economy (LCEE) exhibits considerable variation across different regions within China. This article seeks to explore the regional disparities in LCEE throughout the country and to identify the factors that contribute to these variations. Firstly, this paper examines the advancements in LCEE research, concentrating on an analysis of 30 Chinese provinces. Employing the Multi-directional Efficiency Analysis (MEA) framework alongside the global Malmquist (GM) index, this study evaluates the efficiency of the low-carbon economy across the 30 provinces from 2010 to 2021. Secondly, by integrating spatial autocorrelation analysis techniques, the research encompasses a multifaceted examination, including spatiotemporal analysis, regional disparities, driving factors, and potential for improvement. The findings indicate significant discrepancies in LCEE among various provinces in China. Notably, LCEE tends to be higher in the eastern coastal regions, attributed to their advanced economic development, whereas the western inland areas generally exhibit lower efficiency levels due to comparatively limited economic progress. Thirdly, LCEE exhibits significant spatial heterogeneity, with clear high–high and low–low clustering patterns, revealing systemic coordination gaps between eastern coastal and central/western regions. Fourthly, from the decomposition results of the global Malmquist index, it can be seen that efficiency change (EC) is less than 1 and technology change (TC) is greater than 1, which promotes the improvement of LCEE. Technical efficiency is the main factor affecting the improvement of LCEE. Full article

Background: Borderline personality disorder (BPD), a significant personality trait frequently observed in young adults, is associated with challenges in mental health and academic performance. Screening for BPD symptoms is essential. The Screening Instrument for Borderline Personality Disorder (SI-Bord) is widely used to assess general BPD symptoms. However, despite being translated and culturally adapted, the psychometric properties of the Chinese version of the SI-Bord have not been thoroughly investigated in a Chinese population. Objectives: The aim of the study was to evaluate the psychometric properties of the Chinese version of the Screening Instrument for Borderline Personality Disorder (SI-Bord) among university students using confirmatory factor analysis (CFA). Methods: Participants completed the SI-Bord along with the Perceived Stress Scale (PSS), the Meaning in Life Questionnaire (MLQ), the Experiences in Close Relationships–Revised (ECR-R), and the Rosenberg Self-Esteem Scale (RSES). Results: A total of 715 Chinese university students (mean age = 20.33 years; age range = 18–25), including 385 males (54.2%) and 325 females (45.5%), participated in this study. The unidimensional model demonstrated adequate fit indices. The SI-Bord showed significant correlations with the PSS and ECR-R (attachment anxiety), alongside smaller correlations with the MLQ, supporting its convergent and discriminant validity. The Chinese version of the SI-Bord exhibited good reliability. Invariance testing confirmed at least metric invariance across various groups. Conclusions: The Chinese version of the SI-Bord demonstrates strong validity and reliability as a tool for screening for core BPD symptoms among Chinese university students. Further studies are encouraged to evaluate the validity of the SI-Bord across diverse groups, including age, socioeconomic status, and geographic regions. Applying it in clinical BPD samples will further enhance its utility across Chinese populations. Full article

Background: The co-occurrence of obesity and elevated blood pressure (EBP) in childhood represents a critical but underrecognized public health concern, with potential long-term consequences for cardiometabolic health. Understanding its trends and disparities is essential for early prevention strategies. Methods: This study analyzed data from 1,692,660 Han Chinese children and adolescents aged 7–18 years collected across seven waves of the Chinese National Survey on Students’ Constitution and Health (CNSSCH) from 1985 to 2019. Joinpoint regression was used to estimate temporal trends, and logistic generalized additive models were fitted to predict prevalence through 2030. Results: The prevalence of co-occurring obesity and EBP increased from 0.06% in 1985 to 2.36% in 2019 and is projected to reach 5.87% by 2030. A slowdown in the growth rate was observed approximately in 2000. Notably, rural areas experienced a faster and more recent rise, especially among girls, suggesting widening disparities. Conclusions: The growing dual burden of obesity and EBP in Chinese youth, especially in rural areas, calls for urgent and integrated interventions. Public health efforts must prioritize early prevention, with equitable policies that engage schools, families, and communities, particularly in underserved populations. Full article

Background: Chinese Red Steppe cattle (CRS) combine indigenous environmental resilience with moderate dairy performance, whereas Holstein cattle (HOL), despite their high milk yield, suffer reduced genetic diversity and compromised adaptation. A comparative analysis of their population genetic architecture and selection signatures can reveal valuable targets for CRS dairy improvement. Methods: We genotyped 61 CRS and 392 HOL individuals using the Illumina GGP Bovine 100K SNP array and performed stringent quality control. Population structure was assessed via principal component analysis, neighbor-joining trees, and sparse nonnegative matrix factorization. Historical effective population size (Ne) and divergence time were inferred with SMC++. Genome-wide selection scans combined Fixation Index (FST) and Cross-Population Composite Likelihood Ratio test (XP-CLR); overlapping high-confidence regions were annotated and subjected to GO and KEGG enrichment analyses. Results: CRS and HOL were clearly separated along PC1 (explaining 57.48% of variance), with CRS exhibiting high internal homogeneity and weak substructure, versus greater diversity and complex substructure in HOL. SMC++ indicated a split approximately 3500 years ago (700 generations) and a pronounced recent decline in Ne for both breeds. Joint selection mapping identified 767 candidate genes; notably, the ACSM1/2B/3/4 cluster on chromosome 25—key to butanoate metabolism—showed the strongest signal. Enrichment analyses highlighted roles for proteasome function, endoplasmic reticulum stress response, ion homeostasis, and RNA processing in regulating milk fat synthesis and protein secretion. Conclusion: This study delineates the genetic divergence and demographic history of CRS and HOL, and pinpoints core genes and pathways—particularly those governing butanoate metabolism and protein quality control—underlying dairy traits. These findings furnish molecular markers and theoretical guidance for precision breeding and sustainable utilization of Chinese Red Steppe cattle. Full article

This convergent mixed-methods investigation explores the changing place of Buddhism in Chinese youth lives in the post-pandemic era using data from a national survey (N = 2812) and semi-structured interviews (n = 24). Although traditional religious affiliation is still generally low among participants, Buddhism still serves as an important psychosocial and symbolic resource. In contrast to doctrinal commitments, youth connect with Buddhism through emotional identification, ritual adaptability, and virtual arenas. Results indicate a unique profile of symbolic-affective religiosity, whereby Buddhism is selectively taken up as an emotional regulation tool, moral guide, and existential reassurer. This form of engagement is frequently enabled by digital rituals, smartphone applications, and social media interactions, highlighting the mediatized character of modern spiritual engagement. Subgroup analysis reveals considerable heterogeneity among this population with differences by region, gender, level of education, and religion of family background, which implies that “Buddhist youth” in China must be conceived as a pluralistic and fluid category. The study contributes to scholarship on youth spirituality and post-institutional religion by emphasizing the functional rather than theological dimensions of religious engagement among East Asia’s younger generations. Full article

IgA nephropathy (IgAN) is the most prevalent primary glomerulonephritis worldwide, with a heterogeneous clinical course that may progress to end-stage kidney disease (ESKD) in approximately 20% of patients. Despite recent advances, including the U.S. Food and Drug Administration (FDA) approval of three novel agents, optimal therapeutic strategies remain uncertain, and access to new drugs is often limited. This underscores the need to evaluate established and widely available options such as mycophenolate mofetil (MMF). The aim of this review is to critically assess the role of MMF, either as monotherapy or in combination with systemic corticosteroids, in the treatment of IgAN based on evidence cited in the KDIGO 2024 Draft Guidelines. We analyzed seven major clinical studies—five randomized controlled trials and two long-term observational studies—with particular focus on the influence of histological activity on treatment outcomes. The Oxford classification was applied to explore whether specific histological variables correlate with prognosis and predict treatment response. Trials conducted in Chinese cohorts demonstrated significant benefits of MMF, including proteinuria reduction, delayed progression to ESKD, and improved long-term renal outcomes, particularly in patients with recent disease onset and active proliferative lesions such as endocapillary hypercellularity and crescent formation. In contrast, studies from Western populations generally failed to demonstrate comparable benefit possibly due to differences in disease chronicity, histopathological patterns, and genetic background. Overall, MMF appears most effective when initiated early and in patients with histologic evidence of intraglomerular inflammation. It may represent a viable steroid-sparing option in appropriately selected patients, particularly where access to newly approved agents is restricted. These population- and pathology-based differences highlight the need for individualized treatment decisions and further research to refine the therapeutic role of MMF in IgAN. Full article

Background: China has the largest number of patients with type 2 diabetes (T2D) worldwide, and the chronic complications and economic burden associated with T2D are becoming increasingly severe. Developing accurate and widely applicable risk prediction models is of great significance for the early identification of and intervention in high-risk populations. However, current Chinese models still have many shortcomings in terms of methodological design and clinical application. Objective: This study conducts a systematic review and narrative synthesis of existing risk prediction models for type 2 diabetes in China, aiming to identify issues with existing models and provide references with which Chinese scholars can develop higher-quality risk prediction models. Methods: This study followed the PRISMA guidelines to conduct a systematic search of the literature related to T2D risk prediction models in China published in English journals from October 2019 to October 2024. The databases included PubMed, CNKI and Web of Science. Included studies had to meet criteria such as clear modeling objectives, detailed model development and validation processes, and a focus on non-diabetic populations in China. A total of 20 studies were ultimately selected and comprehensively analyzed based on model type, variable selection, validation methods, and performance metrics. Results: The 20 included studies employed various modeling methods, including statistical and machine learning approaches. The AUC values of the models ranged from 0.728 to 0.977, indicating overall good predictive capability. However, only one study conducted external validation, and 45% (9/20) of the studies binned continuous variables, which may have reduced the models’ generalization ability and predictive performance. Additionally, most models did not include key variables such as lifestyle, socioeconomic factors, and cultural background, resulting in limited data representativeness and adaptability. Conclusions: Chinese T2DM risk prediction models remain in the developmental stage, with issues such as insufficient validation, inconsistent variable handling, and incomplete coverage of key influencing factors. Future research should focus on strengthening multicenter external validation, standardizing modeling processes, and incorporating multidimensional social and behavioral variables to enhance the clinical utility and cross-population applicability of these models. Registration ID: CRD420251072143. Full article

Despite the growing number of older adults engaging in voluntary migration, there is a lack of knowledge about their psychological well-being in cross-cultural contexts. This cross-sectional study investigated factors associated with psychological well-being among older Chinese migrants residing in Chiang Mai, Thailand. Between December 2024 and February 2025, 204 Chinese migrants aged 60 and above who had resided in Chiang Mai for at least six months participated in a survey in Chinese. The survey measured sociodemographic and psychosocial factors including perceived health, income, marital status, number of co-residing family members, social support, acculturative stress, sense of mastery, and loneliness. Multiple regression analysis showed that gender (female) (p = 0.006), better perceived health status (p = 0.021), higher income (p = 0.007), more co-residing family members (p = 0.037), a greater sense of mastery (p = 0.009), and lower levels of loneliness (p < 0.001) were each independently associated with better psychological well-being. In contrast, neither general family support nor acculturative stress was a statistically significant predictor. These findings highlight the significant roles of financial security, family co-residence, personal empowerment, and social connectedness in shaping overall well-being. Strategies to improve psychological well-being in this population should focus on strengthening emotional connectedness, supporting the development of meaningful family and social relationships, and supporting economic stability. Full article

Background: With China’s rapidly aging population, frailty has become a growing concern among older adults. Physical activity (PA) is known to mitigate frailty-related decline, yet few studies have examined these associations longitudinally. Methods: Using five waves (2011–2020) of CHARLS data, we analyzed Chinese adults aged 60+ to assess the association between frailty—measured by a frailty index (FI)—and PA across various types (light, moderate, vigorous, total, and leisure). A generalized linear mixed-effects model was used, adjusting for demographic, socioeconomic, and health-related factors. Results: All PA types were significantly associated with lower odds of concurrent frailty, including light (OR = 0.37), moderate (OR = 0.37), vigorous (OR = 0.40), total (OR = 0.23), and leisure PA (OR = 0.56). Lagged PA also predicted reduced frailty risk over time, except for light PA. Conclusion: Regular PA is linked to a lower risk of frailty among older Chinese adults. These findings underscore the importance of sustained PA as a strategy to promote healthy aging and inform public health interventions for this population. Full article

Trust in Traditional Thai Medicine (TTM) among Thai people has been reduced due to a lack of objective standards and the susceptibility of the general population to false information. The emergence of generative artificial intelligence (Gen AI) has significantly impacted various industries, including traditional medicine. However, previous Gen AI models have primarily focused on prescription generation based on Traditional Chinese Medicine (TCM), leaving TTM unexplored. To address this gap, we propose a novel fast-learning fine-tuned language model fortified with TTM knowledge. We utilized textual data from two TTM textbooks, Wat Ratcha-orasaram Ratchaworawihan (WRO), and Tamra Osot Phra Narai (NR), to fine-tune Unsloth’s Gemma-2 with 9 billion parameters. We developed two specialized TTM tasks: treatment prediction (TrP) and herbal recipe generation (HRG). The TrP and HRG models achieved precision, recall, and F1 scores of 26.54%, 28.14%, and 24.00%, and 32.51%, 24.42%, and 24.84%, respectively. Performance evaluation against TCM-based generative models showed comparable precision, recall, and F1 results with a smaller knowledge corpus. We further addressed the challenges of utilizing Thai, a low-resource and linguistically complex language. Unlike English or Chinese, Thai lacks explicit sentence boundary markers and employs an abugida writing system without spaces between words, complicating text segmentation and generation. These characteristics pose significant difficulties for machine understanding and limit model accuracy. Despite these obstacles, our work establishes a foundation for further development of AI-assisted TTM applications and highlights both the opportunities and challenges in applying language models to traditional medicine knowledge systems in Thai language contexts. Full article

Background/Objectives: The global food system faces mounting pressures from population growth, dietary transitions, and resource and environmental constraints. Hybrid foods, which combine nutritional, environmental, and economic advantages, are increasingly regarded as a promising solution. This study examined consumer acceptance and willingness to pay (WTP) for a novel hybrid food product—beef rice. Methods: Based on online survey data collected from 1536 Chinese consumers, this study measured food neophobia and investigated its influence on WTP for beef rice. In addition, it explored the moderating effects of four distinct types of information interventions. Results: More than 80% of respondents expressed a willingness to purchase beef rice. Food neophobia exerted a significant negative effect on WTP (β = –1.538, p < 0.001). Among the information treatments, environmental information significantly mitigated the negative impact of food neophobia on WTP (β = 0.573, p < 0.01), while health-related and combined framings did not show significant effects. Conclusions: Chinese consumers generally hold a positive attitude toward hybrid foods such as beef rice. However, food neophobia significantly reduces their WTP. Environmental information shows a significant moderating effect and may serve as an effective strategy to enhance consumer acceptance of novel hybrid food products. Full article

Background: Dyslipidemia affects over 30% of Chinese adults, with awareness rates below 20%. Promoting nutrition education programs in the general population is important, but few studies have investigated the specific strategies and their efficacy. Methods: This longitudinal study was conducted in a representative sample of community-dwelling adults in Lu’an City, central-eastern China. After recruitment and propensity score matching, the personalized and conventional nutrition education groups included 306 and 612 participants, respectively. We provided standardized nutrition education based on the Dietary Guidelines for Chinese Residents (2022) for the conventional group, and personalized nutrition advice based on individual food intake and the guidelines for the personalized group. Serum total cholesterol (TC), high-density lipo-protein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured at baseline and again after follow-up. Results: Three years after the intervention, the average levels of TC, LDL-C, and TG in both groups all increased. After adjusting for covariates, an increase in HDL-C was greater in the personalized group than in the convention group, while the increment in TG was less pronounced. LDL-C changes were similar between the groups. The beneficial effect of personalized nutrition education on HDL-C levels was more pronounced in women (p_interaction < 0.05). Similar results were observed among participants with dyslipidemias and after excluding all lipid-lowering medication users. Conclusions: We conducted personalized nutrition education through medical students’ community practice projects among Chinese community residents, revealing that personalized nutrition education based on dietary surveys could significantly improve blood lipid profiles in general residents and individuals with dyslipidemias compared to conventional nutrition education. Full article