Testosterone production by testicular Leydig cells (LCs) in male mammals is energetically demanding and prone to mitochondrial damage. Despite these challenges, LCs exhibit remarkable longevity and minimal turnover, suggesting the existence of specialized mechanisms that maintain LC mitochondrial homeostasis under such constrains. Here we identify a mitochondrial transfer network between LCs and different testicular macrophage (tMac) subpopulations. Leydig cells release extracellular vesicles containing defective mitochondria, which are eliminated by CD206hi tMacs in a TREM2-dependent process. Deletion of Trem2 in tMacs disrupts this transfer, leading to impaired testosterone synthesis. Conversely, LCs acquire extracellular vesicles containing functional mitochondria from MHCIIhi tMacs through ITGβ1-VCAM1 interactions. Loss of Vcam1 in LCs hinders this mitochondrial transfer, thereby compromising testosterone production. Together, our findings reveal an unrecognized mitochondrial transfer network between LCs and tMacs that safeguards LC homeostasis and testosterone production, offering valuable insights into intercellular communication mechanisms that maintain tissue homeostasis.

Testicular tissue cryopreservation is essential for fertility preservation in prepubertal boys who cannot produce semen, but the process triggers oxidative stress, mitochondrial dysfunction, and excessive mitophagy that deplete spermatogonial stem cells (SSCs) and compromise later spermatogenesis. We evaluated whether melatonin (MLT), a mitochondria-targeted antioxidant, mitigates cryoinjury in a prepubertal C57BL/6 mouse model using a controlled slow-freezing protocol supplemented with graded MLT doses. Across histology, immunofluorescence, Western blotting, transmission electron microscopy, flow cytometry, ELISAs, and integrated transcriptomic-metabolomic profiling, cryopreservation alone induced reactive oxygen species (ROS) overproduction, disrupted mitochondrial integrity, activated PINK1/Parkin-mediated mitophagy, and increased apoptosis with loss of undifferentiated spermatogonial marker (PLZF) and SSC marker (UCHL1). MLT at an optimal concentration of 10-7 M preserved testicular architecture, maintained undifferentiated spermatogonia and SSC marker expression, suppressed ROS accumulation, restored redox balance, and alleviated mitochondrial damage while tempering excessive PINK1/Parkin-dependent mitophagy. Omics analyses showed that MLT reprogrammed cryo-induced disturbances in oxidative stress and metabolic pathways and was associated with suppression of MAPK-mediated apoptotic signaling. In an ectopic transplantation (xenograft) model, grafts pretreated with MLT exhibited improved spermatogenic recovery and reduced fibrotic remodeling compared with untreated controls. Pharmacologic activation of mitophagy with CCCP supported the role of mitophagy modulation in MLT's protective effects. Collectively, these data indicate that 10-7 M MLT effectively safeguards cryopreserved testicular tissue by maintaining SSC viability and mitochondrial/redox homeostasis while limiting maladaptive mitophagy and apoptosis, supporting its use as a practical adjunct to male fertility preservation protocols for prepubertal patients undergoing gonadotoxic therapy.

Carbon dots (CDs) are unintentionally formed during thermal processing of food and are emerging environmental pollutants that may pose health risks. We investigated the reproductive toxicity of food-derived CDs via the gut-testicular axis by exposing male mice to environmentally relevant doses (25 and 100 mg kg-1 d-1) for 15 weeks. Multi-omics analysis (including metagenomics, transcriptomics, and metabolomics) revealed that CDs significantly altered the gut microbiota composition, reducing beneficial bacteria (Akkermansia muciniphila, P<0.01) while increasing pathogenic bacteria (Desulfovibrionaceae, P<0.001). Functional analysis revealed upregulation of the lipopolysaccharide (LPS) biosynthesis pathway (P<0.001) and reduced levels of barrier-protective tryptophan metabolites. Time-series studies established a mechanistic sequence: microbiota disruption (days 1-3), intestinal barrier dysfunction (days 3-5), blood-testis barrier damage (days 5-7), testicular inflammation, and reproductive dysfunction. Dose-dependent testicular toxicity included reduced testosterone synthesis (P<0.001), impaired spermatogonial stem cell maintenance due to downregulation of PLZF, and impaired fertility. Testicular transcriptomics analysis revealed activation of the IL-17 signaling pathway and inhibition of steroidogenesis. This study provides comprehensive evidence that CD induces male reproductive toxicity through microbiota-dependent mechanisms, emphasizing the environmental health implications of dietary nanoparticle exposure.

Numerous actin-related proteins (ARPs) deficiencies have been confirmed to cause sperm acrosomal structural abnormalities, representing significant genetic factors in male infertility. We identified a patient with a missense mutation in ACTRT3, who presented with teratozoospermia and experienced embryonic developmental arrest following intracytoplasmic sperm injection (ICSI). Further analysis revealed ultrastructural abnormalities in the sperm acrosome. To validate these findings, we generated a conditional knockout transgenic mouse model. Male homozygous mutant mice recapitulated the human phenotype, exhibiting consistent acrosomal ultrastructural defects, infertility, and embryonic developmental arrest. To overcome this limitation, a dual-agonist artificial oocyte activation (AOA) protocol combining ionomycin and SrCl2 was developed. This strategy successfully rescued blastocyst formation in Actrt3-deficient mouse models and enabled embryos from the affected couple to develop to the blastocyst stage after ICSI, culminating in a successful pregnancy post-transfer. The combinatorial AOA approach outperformed monotherapy by synergistically restoring PLCZ1-associated calcium signaling defects, providing a tailored solution for infertility linked to actin-related protein deficiencies.

Air pollutants have been linked to adverse effects on male reproductive health. However, large-scale multicenter studies on the association of air pollutants with male infertility and semen quality remain scarce. Here, we retrospectively collected data from 25,682 men at three reproductive centers in eastern China from 2015 to 2022 to investigate the relationships between air pollution exposure, semen quality and male infertility risk at different stages of sperm development, and whether semen quality mediates the relationship between air pollutants and male infertility risk. The exposure levels of PM2.5, PM10, SO2, NO2, O3, and CO during the entire period of sperm development for the study participants were 27.60 (IQR 21.40 -36.00) μg/m3, 47.70 (IQR 38.41 -59.56) μg/m3, 9.00 (IQR 7.64 -11.54) μg/m3, 29.60 (IQR 20.87 -39.24) μg/m3, 97.70 (IQR 83.15 -111.15) μg/m3, 0.80 (IQR 0.68 -0.88) mg/m3, respectively. During the sperm development period, higher levels of PM2.5, PM10, SO2, NO2 and CO exposure were associated with lower progressive motility and normal morphology, while associated with higher male infertility risk (all P < 0.05). These associations were also observed at different critical periods of sperm development, with effect sizes greater at spermatogenesis stage I and II (all P < 0.05). In addition, our results suggested that progressive motility and normal morphology statistically significantly mediated the association of air pollution exposure with male infertility risk (all P < 0.05). Our findings suggest an association between ambient air pollution and decreased semen quality as well as elevated male infertility risk, which appears to be partially mediated by reduced sperm motility and morphology.

Does Pseudomonas aeruginosa impair endometrial receptivity by inhibiting STAT3 phosphorylation through its type III secretion system (T3SS)? Yes, P. aeruginosa utilizes its T3SS to suppress STAT3 phosphorylation in endometrial epithelial cells, disrupting transcriptional activation and reducing receptivity. Endometrial receptivity is critical for successful embryo implantation, yet approximately 50-60% of IVF cycles fail due to implantation issues. Recurrent implantation failure (RIF) affects 15% of women undergoing IVF, often linked to impaired endometrial receptivity. The window of implantation (WOI) depends on precise transcriptional activation of endometrial epithelial cells, but the mechanisms underlying its dysregulation remain unclear. Emerging evidence suggests that aberrant endometrial microbiota may play a role, but specific pathogens and their mechanisms remain unidentified. Single-cell transcriptomics was performed on mid-secretory endometrial samples from 9 RIF patients and 5 controls. Tissue-resident bacteria were identified using the CSI pipeline. The causal role of P. aeruginosa was validated in antibiotic-treated mouse models with bacterial transplantation, combined with FISH, immunofluorescence, and transcriptomic analyses. Endometrial samples were collected from RIF patients and controls. Single-cell RNA sequencing was used to analyze cell types and transcriptional states. P. aeruginosa colonization was assessed using CSI and SAHMI pipelines. Mouse models were used to verify the impact of P. aeruginosa on embryo implantation, STAT3 phosphorylation, and receptivity gene expression. Single-cell transcriptomic analysis of mid-secretory endometrial samples from 9 RIF patients and 5 controls identified six major cell types, with secretory epithelial cells showing disrupted phase transitions in RIF patients. Pseudotime analysis revealed impaired Phase 3 to Phase 4 transition, linked to suppressed STAT3 phosphorylation. P. aeruginosa was significantly enriched in RIF epithelial cells and associated with inhibited STAT3 phosphorylation. Mouse experiments confirmed reduced implantation rates, suppressed STAT3 phosphorylation, and downregulated receptivity genes following P. aeruginosa colonization. Further mechanistic studies indicated that P. aeruginosa utilizes its type III secretion system (T3SS) to inhibit the JAK/STAT pathway, specifically targeting STAT3 phosphorylation. This suppression disrupts transcriptional activation, impairing endometrial receptivity. Additionally, functional enrichment analysis highlighted key pathways affected by P. aeruginosa, including cytokine signaling and cell adhesion, further supporting its role in receptivity impairment. These findings were consistent across multiple analyses, including single-cell RNA sequencing, functional enrichment, and animal models, minimizing the role of chance. The study provides robust evidence that P. aeruginosa, through its T3SS, plays a critical role in reducing endometrial receptivity by interfering with STAT3 signaling, offering a potential therapeutic target for improving IVF outcomes in RIF patients. The study’s sample size, though sufficient for single-cell analysis, may limit generalizability. Mouse models, while informative, may not fully replicate human endometrial physiology. Further validation in larger cohorts and mechanistic studies are needed. This study identifies P. aeruginosa as a key pathogen impairing endometrial receptivity through T3SS-mediated STAT3 signaling inhibition, offering new insights into the microbial etiology of RIF. These findings could lead to targeted therapies, such as microbiota modulation or T3SS inhibition, to improve IVF outcomes. No

Introduction Adenomyosis is a prevalent gynaecological disorder affecting women of reproductive age, yet the underlying etiology and cellular-molecular mechanisms driving its pathogenesis remain poorly understood. Gonadotropin-releasing hormone agonists (GnRHa) are commonly used to improve clinical pregnancy rates in affected patients; however, their effects on specific cellular niches within the diseased uterus have not been fully elucidated. Objective This study aimed to profile adenomyosis at both the single-cell and spatial transcriptomic levels to examine various cell populations and systematically evaluate the effects of GnRHa treatment. Methods To characterize in depth the cellular and molecular landscape of adenomyosis, we employed single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics (Geo-seq) to profile 15 participants, including 11 patients with adenomyosis (three untreated and eight treated with GnRHa) and four control participants. For validation using immunofluorescence and immunohistochemistry, we included an additional two control subjects and 11 patients with adenomyosis. Furthermore, publicly available scRNA-seq datasets from samples collected during the proliferative phase of the menstrual cycle were incorporated for comparison. Results Our analysis revealed that ectopic endometrial glands in adenomyosis were enriched with ciliated epithelial cells, a feature that persisted following GnRHa treatment, suggesting a potential role of these cells in disease pathogenesis. Immune-inflammatory signatures, including elevated CD4+ T cells and LYVE1+ macrophages, were prominent in untreated adenomyosis, contributing to a pro-angiogenic microenvironment. This inflammatory and angiogenic activity was partially mitigated by GnRHa therapy. Notably, mast cells were found to be concentrated in the junctional zone, implicating this region as a potential site of disease initiation. Conclusion Our findings provide evidence for the invagination theory, highlighting the involvement of ciliated epithelial cells and immune-angiogenic crosstalk in adenomyosis pathogenesis. Moreover, this study demonstrates that GnRHa exerts therapeutic effects through the normalization of immune cell composition and restoration of epithelial-stromal interaction, offering novel mechanistic insights into its mode of action.

Widespread utilization of neonicotinoid insecticides (NNIs) has led to their infiltration into the human body, resulting in their detrimental effects on human health. To date, studies on the impact of NNI exposure levels on the female reproductive endocrine system are limited. To address this, we aimed to explore the impact of exposure to NNIs in the environment on ovarian reserve and sex hormones to investigate potential endocrine-mediated reproductive toxicity. Using liquid chromatography-tandem mass spectrometry, we collected and analyzed fifteen kinds of NNIs in 436 paired serum and follicular fluid samples from women undergoing IVF/ICSI, who were recruited in southern China. Linear regression model and BKMR model were applied to explore the associations between NNIs exposure and sex hormones and ovarian reserve. We found that NNIs exposure was associated with alterations of sex hormones and decrease of ovarian reserve, suggesting endocrine disrupting effects of NNIs. Our study provides evidence that environmental exposure to NNIs may disrupt the functional dynamics of hypothalamus-pituitary-ovary (H-P-O) axis regulation in women undergoing IVF/ICSI.

Background:A high proportion of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) present with comorbid erectile dysfunction (ED), but evidence-based therapeutic interventions specifically targeting this patient population remain understudied in clinical trials. Aim:To assess the efficacy of Ningmitai capsule (NMT), an oral traditional Chinese herbal formulation, combined with sildenafil versus monotherapy in alleviating symptoms among a cohort of participants with CP/CPPS and ED. Methods:A multi-center, randomized clinical trial was conducted from March 2019 to December 2022 at six tertiary hospitals in China. A total of 214 participants diagnosed with CP/CPPS and ED were randomized 1:2:2 to receive orally sildenafil (25 mg, q.n.), NMT (0.38 g × 4 capsules, t.i.d.), or a combination of both for 4 weeks. Validated Chinese version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF-5) and the Erection Hardness Score (EHS) questionnaires were administered at baseline, week 2, and week 4. Outcomes:The primary endpoint was the reduction in NIH-CPSI pain domain scores from baseline to week 4. Results:All treatment groups exhibited statistically significant decreases in NIH-CPSI total, pain, urinary and quality of life (QoL) domain scores within 2 weeks, with improvements sustained until the end of the treatment. The combination group demonstrated superior pain score reductions versus sildenafil monotherapy at both timepoints (week 2: mean difference [MD] -2.82 ± 3.27 vs. -1.26 ± 3.45, P = 0.043; week 4, MD -3.57 ± 3.50 vs. -1.07 ± 2.94, P = 0.009). Notably, combination therapy achieved greater IIEF-5 score enhancements compared to NMT alone (P < 0.05) and higher responder rates than either sildenafil or NMT monotherapy (P < 0.05). No significant differences were found among the three arms concerning EHS. No adverse events were reported. Clinical Implications:NMT-sildenafil combination therapy may serve as a viable alternative to α-blocker-based regimens for CP/CPPS-ED patients, potentially circumventing the orthostatic hypotension risk associated with the concurrent use of phosphodiesterase 5 inhibitors (PDE5i) and α-blockers. Strengths and Limitations:Strengths include a prospective randomized design, which is well controlled. Limitations encompass the absence of placebo control and long-term follow-up. Conclusion:NMT-sildenafil combination therapy demonstrates significantly greater benefits of ameliorating pain symptoms and improving erectile function in men with CP/CPPS and ED compared to either monotherapy, with favorable tolerability profiles. Registration:The study protocol was reviewed and approved by the institutional ethics committee and was registered at ClinicalTrials.gov (NCT06064448).

Objectives To investigate benefits of diary intervention in a pediatric intensive care unit (PICU) on sleep quality and stress-related disorders in critically ill children and anxiety and depression in their parents. Methods This single-blind, two-arm, randomized controlled trial enrolled 94 dyads. The control group (n = 47) received standard care; the experimental group (n = 47) additionally received a diary intervention. We compared the sleep quality and stress disorders of children, and anxiety, depression, and stress disorders among parents at various time-points, between groups. Results Data of 83 dyads were ultimately analyzed (loss-to-visit rate: 11.7 %). During the PICU stay, the experimental group showed significantly shorter total awakening time of each sleep episode and mean duration of each awakening per sleep session than the control group (P = 0.006; P = 0.032). The Childhood Stress Disorder Checklist scores of children in the experimental group were significantly lower than those in the control group at 1 and 3 months post-discharge (P = 0.003; P = 0.006). Parents in the experimental group reported significantly lower anxiety scores at PICU discharge and 1 month thereafter (P < 0.001; P = 0.015). At discharge, depression scores were significantly lower in the experimental group; this difference remained significant at 1 and 3 months post-discharge (P < 0.001; P < 0.05). At PICU discharge, parental scores were significantly lower in the experimental group than in the control group (P < 0.001). Conclusions The PICU diary intervention effectively improved the children’s sleep quality and was associated with stress reduction in parents during their children’s PICU stay and up to 3 months post-discharge. The intervention was also associated with a reduction in negative parental emotions up to 3 months after PICU discharge. Implications for Clinical Practice These findings offer valuable insights into supporting the psychological well-being of pediatric patients and their caregivers during and after PICU admission.

The death of spermatogonia leads to decreased spermatogenesis and male infertility. Spermatogonia are vulnerable to various external damaging factors, which can cause cell death. However, the mechanism is still unclear. In this study, we found that the actin-related protein T2 (ACTRT2) is specifically expressed in testicular tissue and is associated with spermatogenesis. In vitro, when GC-1 cells (spermatogonial cell line) were treated with busulfan, the proportion of cell death in the low-ACTRT2 group increased significantly. Reactive oxygen species accumulation and typical mitochondrial changes associated with ferroptosis occurred. In vivo, the seminiferous tubules in ACTRT2-/- mice were significantly shrunken. In addition, after being treated with busulfan, spermatogenesis in ACTRT2+/- mice decreased significantly compared to that in wild-type mice. In ACTRT2+/- testes, the expression levels of acyl-CoA synthetase long-chain family member 4 and arachidonic acid 15-lipoxygenase-1 (ALOX15) were upregulated, while the expression levels of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) were downregulated. Finally, we found that the expression of solute carrier family 11 member 2 (SLC11A2), iron responsive element binding protein 2 (IREB2), and transferrin receptor protein 1 (TFRC) increased significantly in the low-ACTRT2 group, which transports iron into the cell to increase the intracellular unstable iron pool. In conclusion, ACTRT2 deficiency leads to intracellular iron overload and damage to mitochondria, ultimately increasing spermatogonia vulnerability to ferroptosis.

PURPOSE:This study was conducted to evaluate the efficacy of a WeChat-based parent-child creative art therapy (PCCAT) program on child-parent relationships and psychological well-being in mothers of children with autism spectrum disorder (ASD). DESIGN AND METHODS:A two-arm randomized controlled trial was employed. Sixty-eight child-parent dyads were recruited and followed up in a special training school from August 2022 to March 2023. They were randomly assigned to either the intervention group (n = 34) receiving WeChat-based PCCAT plus online home visits or control group (n = 34) receiving online home visits alone. Outcomes were assessed using the Child-Parent Relationship Scale (C-PRS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Posttraumatic Growth Inventory (PTGI) at baseline, 12-week (T1), and 24-week (T2) follow-ups. RESULTS:Sixty dyads completed the 24-week protocol. Linear mixed model analyses revealed significant group×time interaction effects for C-PRS, SAS, SDS, and PTGI scores (p < 0.001). Pairwise comparisons demonstrated significantly lower anxiety (SAS) and depression (SDS) scores, alongside higher parent-child relationship (C-PRS) and posttraumatic growth (PTGI) scores in the intervention group versus controls (all p < 0.05). Participant satisfaction data indicated 86.6 % of mothers reported extremely satisfaction with the program, with 93.3 % of dyads maintaining >90 % participation adherence. CONCLUSION:The WeChat-based PCCAT program effectively improved parent-child relationships, reduced maternal anxiety and depression, and enhanced posttraumatic growth. PRACTICE IMPLICATIONS:This nurse-led intervention demonstrates feasibility for integration into ASD family management protocols. The program's digital delivery format suggests potential adaptability across comparable platforms, warranting implementation in broader clinical contexts. TRIAL REGISTRATION:Chinese Clinical Trials Registry, ChiCTR2200062598. Registration date: 13/08/2022.

BackgroundPublic health emergencies impose unique challenges on pregnant women, affecting their physiological, psychological, and social wellbeing. This study, focusing on the context of the corona virus disease in 2019 (COVID-19) pandemic in China, aims to comprehensively explore the experiences of pregnant women amidst diverse public health crises. Herein, we investigate the health education needs of pregnant Chinese women in regard to public health emergencies to provide a scientific foundation for the development of targeted health education strategies.ObjectiveThe study described in this article aims to explore the health education needs of pregnant Chinese women in the context of public health emergencies specifying the types of emergencies of pandemics and to provide a scientific basis for targeted health education interventions.MethodsThirteen pregnant women were purposively selected, and the rationale for this sample size lies in the qualitative nature of the study, seeking in-depth insights rather than generalizability. Data collection involved semi-structured interviews, and the Colaizzi, which is a structured qualitative technique used to extract, interpret, and organize significant statements from participant descriptions into themes, providing a comprehensive understanding of their lived experiences.ResultsThe analysis yielded six prominent themes encompassing the following areas: I. Personal protection and vaccine safety; II. Knowledge of maternal health; III. Knowledge of fetal health; IV. Knowledge of childbirth; V. Knowledge of postpartum recovery; and VI. Knowledge sources of health education for pregnant women and their expectations of healthcare providers. Theme I was analyzed with two sub-themes (needs for personal protection knowledge, vaccine safety knowledge needs); Theme II was analyzed with three sub-themes (nutrition and diet, exercise and rest, sexual life); Theme III was analyzed with three sub-themes (medications and hazardous substances, pregnancy check-ups, and fetal movement monitoring); Theme IV was analyzed with three sub-themes (family accompaniment, analgesia in childbirth, and choice of mode of delivery); Theme V was analyzed with one sub-theme (knowledge of postnatal recovery); Theme VI was analyzed with one sub-theme (expectations of Healthcare providers). Sub-themes within each main theme were identified, offering a nuanced understanding of the multifaceted challenges faced by pregnant women during public health emergencies. The interrelation between sub-themes and main themes contributes to a holistic portrayal of their experiences.ConclusionThe study emphasizes the need for healthcare professionals to tailor health education for pregnant women during emergencies, highlighting the role of the Internet in improving information dissemination. It recommends actionable strategies for effective health communication, ensuring these women receive comprehensive support through digital platforms for better health outcomes during public health crises.

The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95

Aim. Midwives are prone to suboptimal health status (SHS), while there is a lack of unified measurement standard of SHS for them to early detect and prevent SHS. This study aimed to evaluate validity and reliability of Subhealth Measurement Scale V1.0 (SHMS V1.0) in midwives. Design and Methods. The cross-sectional study had 842 midwives from 46 midwifery institutions in southeastern China completing the SHMS V1.0 with 39 items. Internal consistency, test-retest reliability, and concurrent validity of SHMS V1.0 were assessed. Project analysis and confirmatory factor analysis (CFA) were performed to assess construct validity. Results. SHMS V1.0 had acceptable reliability with Cronbach's alpha and a test-retest reliability coefficient of 0.908 and 0.804, respectively. The correlation coefficients between each item and corresponding dimension and those between dimension and corresponding subscale were all greater than 0.4. The CFA supported the structure of SHMS V1.0 with strong factor loadings and excellent fit indexes in the first-order and modified second-order factor model, illustrating that SHMS V1.0 had good construct validity among midwives. The concurrent validity for SHMS V1.0 showed large correlation with FS-14, but the social subscale showed medium correlations with fatigue, inferring that SHMS V1.0 can more comprehensively reflect SHS of midwives than FS-14, especially for social health symptoms. Practice Implications. SHMS V1.0 with excellent psychometric properties can accurately and reliably evaluate the SHS of midwives. These findings of our study provide an important measurement tool and inspiration for midwives to early detect and prevent SHS.

BackgroundThe benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China.AimTo translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women.MethodsThe PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022.ResultsReliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (p<0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth.ConclusionThe Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.

BACKGROUND:Compliance with screen time guidelines among children worldwide remains low, and there is insufficient evidence on the current prevalence in China. This study aimed to investigate the prevalence of compliance with screen time guidelines among children under 3 years old in Fujian Province, East China, identify risk factors and their independent effects, and develop a risk discrimination model for targeted interventions. METHODS:A cross-sectional survey was conducted among low-income families recruited from welfare programs at 96 sites in both urban and rural areas of Fujian Province, China. Face-to-face interviews gathered sociodemographic data, lifestyle information, attitudes towards screen exposure, and details on screen media device ownership. A multivariable logistic regression model was employed to identify independent risk factors for compliance with screen time guidelines, while the area under the receiver operating characteristic curve (AUC) was used to evaluate the model's discrimination ability. RESULTS:A total of 4,707 children participated in the survey. The rates of compliance with screen time guidelines were 56.8% for children under 1 year old, 18.8% for those between 1 and 2 years old, and 81.9% for those between 2 and 3 years old. The multivariable regression analysis identified negative attitudes towards screen exposure, co-viewing and engagement, as well as single child, as significant positive independent factors for compliance with the guidelines. The risk discrimination model demonstrated good performance, with an AUC of 0.845 and 0.812 in the two younger age groups, but showed medium discrimination with an AUC of 0.691 for children between 2 and 3 years old. CONCLUSIONS:Compliance with screen time guidelines among young children in Fujian Province, East China, is generally adequate, but notably low among children between 1 and 2 years old. Targeted interventions are needed to improve compliance, particularly for this age group.