Dietary Diversity and Its Contribution to the Magnitude of Anaemia among Pregnant Women:Evidence from Rural Areas of Western China

Background: Prenatal anaemia causes serious consequences for both mother and foetus, and dietary factors are suggested to be associated with anaemia. However, research in pregnant women living in rural areas is limited. We aim to assess the contribution of dietary diversity to the magnitude of prenatal anaemia in rural China and identify the interactions between dietary diversity and several sociodemographic and maternal characteristics in relation to anaemia. 'Methods: A multi-stage random cluster sampling method was used to select pregnant women in rural western China. The Woman’s Dietary Diversity Score was created to measure dietary diversity, which was recoded into terciles. Multinomial logistic regression models were used to assess the associations between dietary diversity score terciles and the magnitude of prenatal anaemia. Multiplicative interactions were tested by adding the product term of dietary diversity and several sociodemographic and maternal characteristics into the regression models. Results: Out of 969 participants, 54.3% were measured as anaemic, with 28.6% mildly anaemic and 25.7% moderately to severely anaemic. There was an absence of agreement between self-reported and measured anaemia status (κ = 0.28, 95% CI [0.22–0.34]). Participants in the highest dietary diversity score tercile had lower odds of being moderately to severely anaemic after adjusting for potential confounders (RRR = 0.65, 95% CI [0.44, 0.98]). In participants with moderate to severe anaemia, significant interactions were found between dietary diversity score terciles, age, and parity (p for interaction &lt; 0.05).Conclusions: The prevalence of prenatal anaemia in rural China remains high, and pregnant women living in these areas are insufficiently aware of their anaemia status. Improving dietary diversity is needed to manage prenatal anaemia in rural areas.</p

Mantle Dynamics of the North China Craton: New Insights from Mantle Transition Zone Imaging Constrained by P-To-S Receiver Functions

Cratons are generally defined as stable continental blocks with a strong cratonic root that typically is at least ∼200 km thick. Many cratons have undergone little internal tectonism and destruction since their formation, but some of them, such as the eastern part of the North China Craton (NCC), the Dharwar Craton and the Wyoming Craton, have lost their thick cratonic root and become reactivated in recent geological history, leading to widespread Meso-Cenozoic volcanisms. The mechanisms responsible for such decratonization remain debated. To provide new constraints on models leading to decratonization, in this study we stack 612 854 source-normalized P-to-S conversions (receiver functions or RFs) from the 410 and 660 km discontinuities (d410 and d660, respectively) bordering the mantle transition zone (MTZ) recorded at 1986 stations in the NCC. Both the number of RFs and the number of stations are unprecedented in the study area. The average apparent depths of the d410 and d660 and the thickness of the MTZ are 413 ± 6, 669 ± 8 and 255 ± 6 km, respectively. A depression of up to 37 km and mean 11 km of the d660 are clearly observed beneath the eastern NCC, mainly caused by the possible existence of a relatively large amount of water in the MTZ. Our study provides strong observational evidence for geodynamic modelling that suggests water in the MTZ can be driven out into the upper mantle by poloidal mantle flow induced by the subduction and retreat of subducted oceanic slabs. The results are consistent with the weakening of the lithosphere beneath the eastern NCC by the release of water (in the form of structurally bound H/OH) brought down to the MTZ by subduction of the Pacific slab. Continuous slab dehydration and the ascent of fluids would have triggered intraplate volcanism and mantle upwelling in the eastern NCC, as evidenced by the spatial correspondence among the lower-than-normal upper-mantle seismic velocities, unusually large depressions of the d660, Cenozoic basaltic volcanism and thinning of the cratonic lithosphere

Distinct slab interfaces imaged within the mantle transition zone

Oceanic lithosphere descends into Earth’s mantle at subduction zones and drives material exchange between Earth’s surface and its deep interior. The subduction process creates chemical and thermal heterogeneities in the mantle, with the strongest gradients located at the interfaces between subducted slabs and the surrounding mantle. Seismic imaging of slab interfaces is key to understanding slab compositional layering, deep-water cycling and melting, yet the existence of slab interfaces below 200 km remains unconfirmed. Here, we observe two sharp and slightly dipping seismic discontinuities within the mantle transition zone beneath the western Pacific subduction zone that coincide spatially with the upper and lower bounds of the high-velocity slab. Based on a multi-frequency receiver function waveform modelling, we found the upper discontinuity to be consistent with the Mohorovičić discontinuity of the subducted oceanic lithosphere in the mantle transition zone. The lower discontinuity could be caused by partial melting of sub-slab asthenosphere under hydrous conditions in the seaward portion of the slab. Our observations show distinct slab–mantle boundaries at depths between 410 and 660 km, deeper than previously observed, suggesting a compositionally layered slab and high water contents beneath the slab

Maternal Dietary Diversity and Small for Gestational Age:The Effect Modification by Pre-Pregnancy Body Mass Index and Gestational Weight Gain in a Prospective Study within Rural Sichuan, China (2021–2022)

Infants born small for gestational age (SGA) remains a significant global public health concern, with potential interconnections among maternal diet, pre-pregnancy BMI, gestational weight gain (GWG), and SGA. This prospective study investigated the association between dietary diversity (DD) during pregnancy and the risk of SGA, as well as the synergistic effect of DD with pre-pregnancy BMI and GWG on SGA. Maternal dietary intake during pregnancy was assessed using 24 h dietary recalls, and dietary diversity scores (DDS) were calculated based on the FAO’s Minimum Dietary Diversity for Women index. Infant information was followed up. The Poisson regression model was employed to determine the association between maternal DD and SGA. Interactions between DD and pre-pregnancy BMI or GWG were evaluated under additive and multiplicative models. Among the 560 singleton live births, 62 (11.07%) were classified as SGA. After adjusting for potential confounders, the DDS exhibited a protective effect against SGA (aRR: 0.76; 95% CI: 0.62–0.95). DD modified the association between being underweight prior to pregnancy and SGA on the additive scale (interaction contrast ratio = 7.39; 95% CI: 5.84, 8.94). These findings suggest that improving dietary diversity during pregnancy, particularly among women with a low pre-pregnancy BMI, may be a feasible strategy to reduce the risk of SGA newborns.</p

First metatarsal single-screw minimally invasive chevron-akin osteotomy: A cost effective and clinically reliable technique

PurposeThe common disease hallux valgus results in foot discomfort and dysfunction. Less soft tissue damage and faster wound healing have made minimally invasive surgery (MIS) more popular. However, little research has compared the fixation results of minimally invasive chevron-akin (MICA) osteotomy thus far. In this study, the clinical and radiographic results of MICA with first metatarsal single- or dual-screw fixation are being examined.MethodsA total of 107 feet of 103 patients with mild to moderate symptomatic hallux valgus treated MICA from January 2018 to June 2020 were retrospective evaluated, with at least 12-months follow-up. 51 patients underwent single-screw fixation procedures and 52 patients received dual-screw fixation procedures. Patients were assessed preoperatively and at the final follow-up with radiographic measurements [hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA)] and clinical scores (american orthopaedic foot and ankle society (AOFAS) forefoot score, visual analog scale (VAS) and Manchester-Oxford Foot Questionnaire (MOxFQ) scores). The coughlin satisfaction scores were also obtained.ResultsBoth groups showed significantly improved HVA, IMA and DMAA at the final follow-up (P &lt; 0.001). Regarding clinical outcomes, the AOFAS, VAS and MOxFQ in two categories also significantly improved postoperatively (P &lt; 0.001). There was no obvious difference in the clinical and radiographic outcomes between the two groups (HVA, P = 0.833; IMA, P = 0.073; DMAA, P = 0.35; AOFAS, P = 0.48; VAS, P = 0.86; MOxFQ, P = 0.87). However, the single-screw fixation group showed significantly lower operation time and less number of intraoperative fluoroscopy (P &lt; 0.001). No serious complications were observed in either group. The single-screw fixation technique saves at least $1,086 compared with the dual-screw group.ConclusionAt the final follow-up, both the single- and dual-screw fixation groups had comparable good to excellent clinical and radiographic outcomes, as well as a similar incidence of complications. Additionally, the single-screw fixation group reduces overall surgical costs, number of intraoperative fluoroscopy and operational time

Application of mixed reality technology in talocalcaneal coalition resection

ObjectivesWith positive outcomes recorded, the mixed reality (MR) technology has lately become popular in orthopedic surgery. However, there are few studies that specifically address the utility of MR in talocalcaneal coalitions (TCC) resection. Our goal in this retrospective study is to assess certain data while examining the viability of using MR to treat TCC resection.MethodsSix consecutive patients with TCC diagnosed by computed tomography (CT) for which nonoperative therapy had failed and MR system assisted TCC resection were included in this study from March 2021 to December 2021. The feasibility and accuracy of TCC resection were assessed by post-operation radiography. The American Orthopaedic Foot &amp; Ankle Society (AOFAS) hindfoot score and visual analog scale (VAS) score were used to assess the recovery condition and pain level pre- and post-operation.ResultsThe surgeon can accurately resect the TCC according to the preoperatively determined range by superimposing the holographic model with the actual anatomy of the TCC using an MR system. Additionally, no additional x-ray was necessary while operating. Mean follow-up was 10.3 months, with a minimum of 6 months. There is a significant difference between the preoperative AOFAS score of 53.4 ± 3.8 and the 6-month follow-up AOFAS score of 97.3 ± 2.2 (p &lt; 0.05). There is also a significant difference between the preoperative VAS score of 8.1 ± 0.7 and the 6-month follow-up VAS score of 1.7 ± 0.4 (p &lt; 0.05). All individuals had clinical subtalar mobility without stiffness following surgery.ConclusionWhile the TCC resection operation is being performed, the application of MR technology is practicable, effective, and radiation-free, giving surgeons satisfactory support