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Background Despite 3‐year survival being used as a primary endpoint in some randomized controlled trials (RCTs), limited evidence supports the use of intermediate endpoints to evaluate the effect of new therapies in esophageal squamous cell cancer (ESCC). This study aimed to systematically evaluate progression‐free survival at 3 years (3‐year PFS) and overall survival (OS) among patients with ESCC. Methods We identified 528 patients newly diagnosed with locally advanced ESCC who received definitive radiotherapy. OS was compared with an age‐ and sex‐matched general Chinese population using the standardized mortality ratio (SMR). Regression analysis was used to validate the correlation between PFS and OS using published data. Results The annual risk of progression decreased to 11.5% after 3 years. Patients who did not achieve 3‐year PFS had a median postprogression survival (PPS) of 7.3 months, with a 5‐year OS rate of 9.6% and a SMR of 15.0 (95% confidence interval [CI], 12.9–17.5). Conversely, the SMR for patients who achieved 3‐year PFS was 0.9 (95% CI, 0.6–1.3). We observed a significant correlation between log hazard ratio (HR) (PFS) and log HR (OS) at the trial level (r = 0.89; 95% CI, 0.88–0.90). The strongest correlation was observed between 3‐year PFS and 5‐year OS in RCTs and retrospective studies. Conclusions Patients exhibiting progression within 3 years experienced poor survival, whereas patients achieving 3‐year PFS had excellent outcomes. Our study supports 3‐year PFS as a reliable primary endpoint for study design and risk stratification in locally advanced ESCC. 1. The annual progression and death hazards decreased to less than 20% over the first 3 years for patients with locally advanced esophageal squamous cell carcinoma. 2. Patients who were progression‐free within 3 years after initial treatment experienced favorable long‐term outcomes, with overall survival times not distinguishable from that of age‐ and sex‐matched Chinese populations. Conversely, patients who experienced disease progression within 3 years had very poor prognosis. 3. 3‐year progression free survival can be used as a potential endpoint for trial design and risk stratification in future studies.

Previous research suggests that gains in positive mental health (often termed flourishing, welibeing, or competence) is associated with stronger academic achievement. This study examines the relationship between positive mental health at school entry and academic achievement at Grade 3, drawing on a representative sample of Australian children with linkage to results of standardized academic testing. Propensity score analysis was used and small positive associations were found between positive mental health and most academic outcomes. Associations were modest in size but sustained over the 3-year period and were similar across a range of academic skills. Future intervention research should assess the potentially wider ranging impact of targeting positive mental health outcomes in the early years of schooling.

Background To further optimize birth policy, China implemented a new three-child policy to allow per couple to have up to three children on May 31, 2021. Methods A national cross-sectional survey was conducted among 18 to 49-year-old Chinese parents who had at least one child in June 2021. We calculated the prevalence of self-reported childrearing barriers and used univariate logistic regression and multivariate logistic regression to analyze associated factors. Results 94.7% of the respondents self-reported barriers to rearing children aged 0–3 years, and the biggest barrier included high time cost (39.3%), high parenting cost (36.5%) and high education cost (13.5%). Women (aOR 1.49, 95%CI 1.13,1.96) and people with college degree or above (aOR 3.46, 95%CI 2.08, 5.75) were associated with higher prevalence of childrearing barriers, and people who intended to have a second child (aOR 0.58, 95%CI 0.40, 0.83) and people who intended to have a third child (aOR 0.51,95%CI 0.37, 0.71) were less likely to report childrearing barriers. The biggest barrier was more likely to be high time cost for parents one of whom is only child (aOR1.21, 95%CI 1.03, 1.42) and physical factors for parents both of whom are only child (aOR 1.56,95%CI 1.08, 2.26). Conclusions The prevalence of barriers to rearing children aged 0–3 years was high among Chinese people of childbearing age who had children. Full consideration should be given to the barriers of people with different sociodemographic characteristics and people with fertility intention, thus making targeted childrearing policies and supporting measures to reduce the burden on people of childbearing age, encourage suitable couples to have a second or third child and then cope with China’s aging population.

As part of the Connecting Mathematics Learning through Spatial Reasoning project, a Spatial Reasoning Mathematics Program (SRMP) intervention was implemented with one cohort of 30 students in grades 3 through 4. The SRMP embedded transformation skills in learning sequences comprising repeating and growing patterns, 2D and 3D relationships, structuring area and perimeter, directionality and perspective-taking. Analysis indicated a significantly better gain by the experimental group on the PASA-2 measure of awareness of pattern and structure and on the PASA-Sp assessment of spatial ability at the post-SRMP period. However, there were no significant differences found between groups on the PATMaths4 test of mathematics achievement. Qualitative analyses indicated that students demonstrated the development of complex spatial concepts well beyond curriculum expectations. The SRMP highlighted the important role of patterning and spatial structuring in the formation and representation of spatial concepts.

In this exploratory descriptive study, changes in one cohort’s responses to an authentic statistical investigation at the commencement of years 3 and 4 were analysed. Forty-four students made predictions by interpreting a data table of historical monthly temperatures, represented these data and explained their reasoning. An Awareness of Mathematical Pattern and Structure (AMPS) framework was extended to analyse students’ responses at five increasing levels of predictive reasoning. More developed predictive reasoning was observed in year 4 than for year 3, as well as large individual differences in both years. Most year 4 students (87%) made predictions within the historical range, relative to half the same cohort in year 3 (54%). More year 4 students (79%) made predictions based on extraction, clustering and aggregation of these data than those in year 3 (51%). Year 4 students noticed patterns such as seasonal trends and variability in these data and observed measures of central tendency. By year 4, 57% of students’ representations demonstrated transnumeration using extracted data from the table, including pictorial, column and line graphs. However, most students’ representations and explanations of these data lagged behind their predictions at both year levels.

Outdoor activity is known to protect against childhood myopia, particularly in school-aged children. However, limited evidence exists regarding how reduced outdoor exposure influences refractive development in younger children, especially those under 3 years old. We conducted a cross-sectional, population-based study of 70,490 children aged 0–6 years in Guangzhou, China, from 2018 to 2023. Annual refractive screenings were performed using a validated non-cycloplegic photoscreener (SW-800 refractive screener, Suoer Electronics, China). Children were stratified by age group and screening year. We analyzed trends in mean spherical equivalent (SE) and premyopia prevalence (SE between − 0.50 and + 0.75 diopters (D)), focusing on the effects of reduced outdoor activity in 2020 . Between 2018 and 2019, the equivalent spherical refractive error (SE) in children across all age groups remained stable, indicating a consistent hyperopic reserve. For the 1-year-old group, the SE was 0.66 ± 1.30 D in 2018 and 0.64 ± 1.19 D in 2019. For the 2-year-old group, the SE was 0.61 ± 1.06 D in 2018 and 0.63 ± 0.95 D in 2019. In the 3-6-year-old group, the mean SE ranged from 0.35 ± 0.83 D to 0.56 ± 0.88 D. During the same period, the prevalence of pre-myopia was between 50.96% and 77.99%. In 2020, during the home confinement period, all age groups showed a significant myopic shift, with the mean SE decreasing by 0.36–0.56 D compared to 2019. Specifically, for the 1-year-old group, the SE was 0.14 ± 0.75 D; for the 2-year-old group, it was 0.07 ± 0.42 D; for the 3-year-old group, it was 0.08 ± 0.50 D; for the 4-year-old group, it was 0.04 ± 0.56 D; for the 5-year-old group, it was 0.08 ± 0.53 D; and for the 6-year-old group, it was − 0.01 ± 0.46 D. The prevalence of pre-myopia reached its peak in all age groups in 2020 (80.26% in the 1-year-old group, and exceeding 94% in the 2-6-year-old groups), showing a significant increase compared to 2018–2019.The risk of pre-myopia in 2018 and 2019 was significantly lower than in 2020 (all OR < 0.30, P < 0.001). This study employed a cross-sectional design, with participants studied by year and age group independently. The trends observed reflect population-level refractive changes rather than individual longitudinal recovery trajectories. Reduced outdoor activity is associated with transient, age-dependent myopic shifts in children aged 0–6 years, particularly among those under 3 years. Findings support early integration of outdoor exposure in paediatric myopia prevention strategies.

In the last decade, there has been tremendous growth in the number of accelerated three-year medical pathway programs. The needs of accelerated pathway students are different from traditional students, and a robust mentoring program should be developed to address specific issues and guarantee student success. We describe a unique approach to the development of a mentoring program for accelerated three-year MD students at New York University Grossman School of Medicine.

Engaging students in comparing and contrasting, forming conjectures, generalising and justifying is critical to develop their mathematical reasoning, but there are untapped opportunities for primary school students to improve these reasoning processes in mathematics lessons. Through a case study of one task, this paper reports on levels of justifying and the connections to other reasoning processes of comparing and contrasting, forming conjectures and generalising observed among Year 3–4 Australian and Canadian students (9–10-year olds) using the mathematical reasoning actions and levels (MRAL) framework (Authors 2017). The findings revealed that examining commonalities and differences was critical to allow Year 3–4 students to form conjectures and generalise for themselves. Justifying by examples and seeking counterexamples to evaluate the conjecture were prevalent with some students attempting to develop logical argument. The findings have implications for frameworks that assess students’ levels of justifying and for teacher actions that encourage students to communicate their reasoning through oral and non-verbal as well as written communications.

ObjectivesThis study was performed to determine the use of technological devices among 0–3 year old children and the attitudes and behaviours of their parents for the use of technological devices.MethodsThis cross-sectional study was conducted in five family health centers located in Zonguldak City Center. Study group was composed of a total of 500 parents who admitted to five family health centers between April 04-June 01, 2018, who had a child of 0–3 years old and who approved to participate in the study. Data of the study were collected through face-to-face interview technique by using Data Collection Form.ResultsIn this study, the majority of the parents (82.4%) and children (81.8%) were using at least one of the technological devices. Smartphones (40.8%) were the most commonly used technological devices among the children; and it was followed by television (39.6%) and tablet/computer (19.6%), respectively. Nearly half of the children were using at least one of the technological devices for an average of 2–5 h per day. Parents allowed their children to use technological devices in order to do housework, silence the child when cried, to feed the child, to be able to make him/her sleep, to entertain her/him when he/she spoiled and to spend some time with friends, respectively.ConclusionsThe results of this study reveal the necessity for the parents to get counseling service about the health risks that may occur in children due to long-term use of technological devices and about spending effective time with children.