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Background: With potential of deep learning in musculoskeletal image interpretation being explored, this paper focuses on the common site of rotator cuff tears, the supraspinatus. It aims to propose and validate a deep learning model to automatically extract the supraspinatus, verifying its superiority through comparison with several classical image segmentation models. Method: Imaging data were retrospectively collected from 60 patients who underwent inpatient treatment for rotator cuff tears at a hospital between March 2021 and May 2023. A dataset of the supraspinatus from MRI was constructed after collecting, filtering, and manually annotating at the pixel level. This paper proposes a novel A-DAsppUnet network that can automatically extract the supraspinatus after training and optimization. The analysis of model performance is based on three evaluation metrics: precision, intersection over union, and Dice coefficient. Results: The experimental results demonstrate that the precision, intersection over union, and Dice coefficients of the proposed model are 99.20%, 83.38%, and 90.94%, respectively. Furthermore, the proposed model exhibited significant advantages over the compared models. Conclusion: The designed model in this paper accurately extracts the supraspinatus from MRI, and the extraction results are complete and continuous with clear boundaries. The feasibility of using deep learning methods for musculoskeletal extraction and assisting in clinical decision-making was verified. This research holds practical significance and application value in the field of utilizing artificial intelligence for assisting medical decision-making. [ABSTRACT FROM AUTHOR]

Objective: This study points to probing the inclination and mapping knowledge domain of acupuncture for Parkinson's disease through bibliometrics. Methods: A search was conducted on 1 February 2024 using the Web of Science to identify papers published on acupuncture for Parkinson's disease. The analysis included scientific research, countries, organizations, authors/cited authors, keywords, journals, and cited references. Bibliometric data were analyzed using VOSviewer software, CiteSpace, GraphPad Prism, and Scimago Graphica. The studies on acupuncture for Parkinson's disease were visualized as a network map according to the publication year. Results: The cumulative publication trend on acupuncture for Parkinson's disease is increasing year by year. China is the leading contributor in this field. International collaboration is predominantly concentrated in Europe, while institutional collaboration is chiefly limited to Chinese universities specializing in traditional Chinese medicine. Park HJ is the most prolific author, with "Movement Disorders" being the journal with the most publications. "Brain Research" is identified as a key journal, reflecting a focus on neuroscience. Kim SN is the most cited author, while Eisenberg DM is a prominent author in this field. Research topics such as mouse models, systematic reviews, and non-motor symptoms are frequently explored, with messenger RNA of substantia nigra emerging as a notable keyword in this field. Choi YG's 2009 paper, published in the Neuroscience Letters journal, is a critical reference in this field. Key papers include Eisenberg DM's 1998 study on randomized trials of acupuncture for non-motor symptoms of PD, as well as research focusing on the neuroinflammatory regulatory mechanisms of acupuncture for PD. Conclusion: The bibliometric analysis offers an exhaustive generality of the advancement and worldwide trends in acupuncture treatments for Parkinson's disease, shedding light on potential avenues for prospective research. [ABSTRACT FROM AUTHOR]

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the supply and demand of medical resources. In terms of the spatial layout, three indexes were included: Firstly, the service coverage rates of different levels of medical institutions, based on residents' medical orientations, were calculated using network analysis methods. Secondly, the Huff-2SFCA method was improved to calculate the accessibility of medical resources for four different modes of transportation. Then, the Health Resource Agglomeration Degree (HRAD) and Population Agglomeration Degree (PAD) were used to quantify the equity of medical resources. In terms of the supply and demand of medical resources, one index was included: the supply–demand ratio of medical resources during sudden public health events, which was calculated using the number of beds per thousand people as an indicator. These four indexes were weighted using the entropy weight method to obtain the rationality grade of medical resource spatial allocation in Taiyuan City. The study found that the rationality evaluation level of medical resource allocation in the central urban area of Taiyuan City followed a "concentrically decreasing" pattern. The rating ranged from "very reasonable" to "less reasonable", with the area of each level expanding gradually. The areas rated within the top two categories only accounted for 19.92% of the study area, while the area rated as "less reasonable" occupied 38.73% of the total area. These results indicate that the model accounted for residents' travel for various medical orientations and the availability of resources during public health emergencies. It considered both the spatial layout and supply and demand of medical resources, offering recommendations for the precise allocation of urban medical resources. [ABSTRACT FROM AUTHOR]

Adequate blood supply, a prerequisite for flap survival after grafting, makes angiogenesis of the flap the biggest problem to be solved. Researches have been conducted around vascularisation in correlation with flap grafting. However, bibliometric analyses systematically examining this research field are lacking. As such, we herein sought to conduct comprehensive comparative analyses of the contributions of different researchers, institutions, and countries to this research space in an effort to identify trends and hotspots in angiogenesis and vascularisation in the context of flap grafting. Publications pertaining to angiogenesis and vascularisation in the context of flap grafting were retrieved from the Web of Science Core Collection. References were then analysed and plotted using Microsoft Excel 2019, VOSviewer, and CiteSpace V. In total, 2234 papers that were cited 40 048 times (17.63 citations/paper) were included in this analysis. The greatest number of studies were from the United States, with these studies exhibiting both the highest number of citations (13 577) and the greatest overall H‐index (60). For The institutions that published the greatest number of studies were WENZHOU MEDICAL UNIVERSITY (681), while UNIVERSITY OF ERLANGEN NUREMBERG has the highest number of citations (1458), and SHANGHAI JIAO TONG UNIVERSITY holds the greatest overall H‐index (20). The greatest number of studies in this research space were published by Gao WY, while Horch RE was the most commonly cited researcher in the field. The VOS viewer software clustered relevant keywords into three clusters, with clusters 1, 2, 3, and 4 corresponding to studies in which the keywords 'anatomy', 'survival', 'transplantation', 'therapy' most frequently appeared. The most promising research hotspot‐related terms in this field included 'autophagy', 'oxidative stress', 'ischemia/reperfusion injury', which exhibited a most recent average appearing year (AAY) of 2017 and after. Generally speaking, the results of this analysis indicate that the number of articles exploring angiogenesis and flap‐related research has risen steadily, with the United States and China being the two countries publishing the greatest proportion of studies in this field. The overall focus of these studies has shifted away from 'infratest and tissue engineering' towards 'mechanisms'. In the future, particular attention should be paid to emerging research hotspots, which include 'ischemia/reperfusion injury' and treatments for promoting vascularization, such as 'platelet‐rich plasma'. In light of these findings, funding agencies should continue increasing their investment in the exploration of the concrete mechanisms and interventional therapeutic relevance of angiogenesis during flap transplantation. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the scientific research ability of Chinese specialist nurses (SNs) in the Guangxi Zhuang Autonomous Region and its influencing factors. Design: A cross‐sectional design. Methods: A total of 652 SNs in the Guangxi Zhuang Autonomous Region were investigated from March to October 2021. The nursing scientific research ability level was measured using the Nursing Research Competence of Nurses Self‐evaluation Scale. Descriptive statistics, univariate analysis and ordinal logistic regression analysis were used to evaluate factors affecting the scientific research ability of SNs. Results: The median score of scientific research ability of SNs was 31 (interquartile range: 19–41). Approximately 74.8% of clinical speciality nurses had low scientific research ability. Educational background, working hospital level, being the first author of a published paper and successful application for scientific research projects were identified as factors influencing scientific research ability score. [ABSTRACT FROM AUTHOR]

Background: For adults with inflammatory bowel disease (IBD), they experience many challenges in dietary decision‐making. Thus, this study examined the perspective and experiences of adults with IBD in dietary decision‐making. Objective: This study aimed to explore the perception and consideration of people with IBD in their daily dietary decisions through monitoring, interpretation and action during the decision‐making process. Design: A qualitative study of individuals affected by IBD was conducted through semistructured interviews. Results: Twenty patients were recruited from four tertiary hospitals in Nanjing, China, and each participant completed a semistructured interview. The majority of participants reported on the process and experience of dietary decision‐making. Key themes were categorised into three stages: (1) assessing needs, preferences and food cues (monitor); (2) moving from experience to expertise (interpret) and (3) balancing expectations amidst limitations (act). The majority of participants reported that their decisions were shaped by assessing current disease status and food cues. Those interviewed with IBD were willing to make tradeoffs for bowel stability, but their decisions were also influenced by past dietary experiences and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a significant barrier to healthy eating decisions. Positive or negative feelings accompanied dietary decisions. Conclusion: Although most people with IBD change their diet after diagnosis, the changes made are often inconsistent with existing dietary recommendations. Several factors can influence the dietary decision‐making process. This study will help assess the experiences of people with IBD in dietary decision‐making to encourage the formation of targeted dietary health and well‐being interventions. Knowledge of nutrition and diet should be provided in education and training programmes for IBD management. Patient or Public Contribution: The first three authors of this paper were the lead researchers in this study's design. These authors were mentored by patient researchers who also contributed to the manuscript, and the research process was co‐lead and directed by other patient participants and consultants. The results of this paper were directly obtained from patient participants. [ABSTRACT FROM AUTHOR]

In the past few years, drones have been adopted as a novel delivery tool towards medical supplies, improving delivery service efficiency due to fast speed and neglection of geographical limitations. However, the flight endurance of a battery‐operated drone is limited for long‐distance medical supplies delivery operations. Recharging stations, as a kind of drone facility, allow multiple stops for drones to supplement the power to overcome the flight‐range limitations. This paper studies drone‐assisted long‐distance medical supplies delivery with recharging stations in rural communities by a mixed integer linear programming model. To illustrate the applicability of this model and explore the key factors influencing delivery efficiency of medical supplies, a case study from China is conducted. The results indicate that enhancements on the speed of a truck or a drone can yield considerable delivery cost reduction. In addition, drone‐recharging technology advances can improve delivery efficiency of medical supplies in rural communities. [ABSTRACT FROM AUTHOR]

To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Background: Interleukin17 (IL17) is an important cytokine in host defense at mucosal surfaces and also mediates many autoimmune diseases, including rheumatoid arthritis (RA). In recent years, many types of research relevant to the structure and function of IL17 have been identified. However, there is no bibliometric analysis in this research field. This study aims to explore the history, research hotspots, and emerging trends of IL17 from the perspective of the structure and function dynamics. Methods: Articles relevant to IL17 in the last two decades were retrieved through the Web of Science Core Collection (WoSCC) database. The bibliometric analysis was performed by VOSview. Results: A total of 882 papers in this research were analyzed from 65 countries, and the rate of published articles has increased from 2008 annually, with the USA, China, and Germany leading the research effort. Frontiers in Immunology has significantly impacted research in this field and the University of Pittsburgh was the leading institution. Gaffen, Sarah L. from the University of Pittsburgh was the most productive researcher in this field and Papp Ka from the Probity Medical Research Incorporate of Canada is the most co-cited author. The analysis of keywords showed that inflammation, expression, Th17 cells, and cytokines were the main hotspots and frontier directions of IL17. The trend of clinical application in the future is the development of new therapy drugs based on the structure of IL17 or IL17 signaling pathway molecular. Conclusions: Our research summarized the developments and research trends of IL17 and would help researchers understand the research status of IL17 and provide a reference for future researchers as soon as possible. [ABSTRACT FROM AUTHOR]

The implementation of the research results is seen as a crucial step in the development of innovation in the transport sector. Moving to such an implementation is not always easy or straightforward. It requires a suitable organizational framework both inside as well as outside research producing entities and a number of other facilitating factors that are usually found within an innovation ecosystem. The paper examines systematically the conditions and prevailing practices for transport research implementation in Europe (the European Union) and China and draws useful insights as to the factors that influence such implementation, the incentives, and other facilitating provisions that the research funding organizations can take. It also analyses the current practice and lessons learned for research implementation on the road to innovation production in four major areas of transport research namely: Automated Mobility, Intelligent Railways, Shared and Micromobility applications, and Electromobility. [ABSTRACT FROM AUTHOR]

Improving physical, mental and cognitive health is a strategic choice to help developing countries cross the middle-income trap. This paper used data from the 2019 China Rural Children Health and Nutrition Survey (n = 826), and used the Ordered Probit (Oprobit), Logit and ordinary least squares (OLS) analytical methods to systematically analyze the implications of parental migration on multidimensional health. The results indicate that parental migration significantly harms the physical and mental health of rural children, and that mobile phone addiction has a significant moderating effect. Moreover, parental migration has a greater impact on the physical health, mental health and cognitive ability of boys and rural children with low family income, while parents with higher nutrition knowledge and education can effectively improve the physical health and cognitive ability of their children. In conclusion, in order to improve the multidimensional health of rural children, the government should strengthen the policy of care and support for children whose parents migrate. Schools and families should pay attention to the supervision of rural children's mobile phone addiction. [ABSTRACT FROM AUTHOR]

Objective: Unequal utilization of medical services will have a significant impact on the consumption of resources entitled through health insurance claims of patients. With the proposal of the goal of Healthy China, it is essential to achieve the equity of medical service utilization of patients with rare diseases to further promote social equity and justice. To analyze the consumption of medical resources of rare disease patients, so as to explore how different medical insurance types impact patients' medical resources consumption. This study pioneeringly used medical data from Peking Union Medical College Hospital. By analyzing the consumption data, this paper fills the research gap of existing studies on the analysis of medical service utilization inequality based on the perspective of insurance participation by examining the effects of different types of insurance coverage on medical resource consumption of hemophiliacs. At the same time, rare disease patients as a minority group have long been neglected in the analysis of medical resource consumption, and this paper fills the research gap of medical service utilization of this group to a certain extent by taking hemophiliacs as the object of analysis. Methods: Based on the medical data of hemophilia patients in Peking Union Medical College Hospital from 2010 to 2020, we analyze the consumption of medical resources of the patients, and use a multiple regression model to explore how different medical insurance types impact patients' medical resources consumption. Results: The study has three main findings. Firstly, the disparity in medical expenditure among different hemophilia patients is quite obvious, and the drug expense accounts for a large proportion of the total cost. Secondly, the ratio of reimbursement is generally low, and there is a wide difference in the amount of reimbursement for different types of medical insurance. Thirdly, the resource consumption of patients with different medical insurance types differs a lot. Conclusion: In order to improve the current medical insurance system and mechanism for providing orphan drugs, we put forward the following suggestions. First of all, the medical security system should expand its coverage to eliminate the medical expenditure gap between different hemophilia patients, therefore better promoting equity under the same insurance type. At the same time, the reimbursement level of medical expenses for patients with rare diseases should be appropriately improved, so as to reduce the financial burden of patients with rare diseases, and promote the realization of economic equity. In addition, society should pay special attention to the disadvantaged groups, reduce the differences between various medical insurance, and improve the level of health and equity of the whole society. [ABSTRACT FROM AUTHOR]

Background: Talent is a crucial resource for economic and social development, serving as the driving force behind urban progress. As China experiences rapid growth in digital city construction, the capability of e-services continues to improve incessantly. In China, the new-generation highly educated migrants (NGHEMs) account for ~ 20–30% of the total floating populations. This study aimed to explore the settlement intention of new-generation highly educated migrations in China from the new perspective of urban e-service capabilities. Furthermore, the mechanism of the urban e-services on the settlement intention on the NGHEMs will be proved. Methods: This paper employed data of China Migrants Dynamic Survey in 2017 and Evaluation Report of Government E-service Capability Index (2017). Descriptive analyses were conducted to investigate the factors influencing the settlement intention of NGHEMs in the destination city. Based on the principle of utility maximization, LASSO regression was employed to select individual and city characteristics that determined the settlement intention of NGHEMs. The impact of urban e-services on settlement intention was analyzed by using ordinal logit model. Additionally, robustness check, endogeneity analysis, and heterogeneity analysis were performed to validate the benchmark regression results. Finally, mediation model was employed to examine whether urban e-services enhance the settlement intention of NGHEMs by improving urban livability and urban innovation. Results: The results indicate that the urban e-services promote the NGHEMs' settlement intention in the destination cities. Moreover, the results are still robust through a series of robustness tests. Furthermore, from the perspective of individual and regional heterogeneity, urban e-services significantly enhances the settlement intention of NGHEMs with male and female, married and urban household registration, and urban e-services can promote the settlement intention of NGHEMs with over 3 million inhabitants and those in the eastern regions of China. Finally, the intermediary effect test shows that urban e-services promote the settlement intention of NGHEMs through urban livability and urban innovation. Conclusion: This study highlights the important impact of urban e-services on the settlement intention of new-generation highly educated migrants. The conclusions of this study provide suggestions for the government to use when designing policies to enhance the settlement intention of the NGHEMs and to improve the development of urban e-services. [ABSTRACT FROM AUTHOR]

Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Background: Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods: This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results: 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion: The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the most common cause of dementia. Accurate prediction and diagnosis of AD and its prodromal stage, i.e., mild cognitive impairment (MCI), is essential for the possible delay and early treatment for the disease. In this paper, we adopt the data from the China Longitudinal Aging Study (CLAS), which was launched in 2011, and includes a joint effort of 15 institutions all over the country. Four thousand four hundred and eleven people who are at least 60 years old participated in the project, where 3,514 people completed the baseline survey. The survey collected data including demographic information, daily lifestyle, medical history, and routine physical examination. In particular, we employ ensemble learning and feature selection methods to develop an explainable prediction model for AD and MCI. Five feature selection methods and nine machine learning classifiers are applied for comparison to find the most dominant features on AD/MCI prediction. The resulting model achieves accuracy of 89.2%, sensitivity of 87.7%, and specificity of 90.7% for MCI prediction, and accuracy of 99.2%, sensitivity of 99.7%, and specificity of 98.7% for AD prediction. We further utilize the SHapley Additive exPlanations (SHAP) algorithm to visualize the specific contribution of each feature to AD/MCI prediction at both global and individual levels. Consequently, our model not only provides the prediction outcome, but also helps to understand the relationship between lifestyle/physical disease history and cognitive function, and enables clinicians to make appropriate recommendations for the elderly. Therefore, our approach provides a new perspective for the design of a computer-aided diagnosis system for AD and MCI, and has potential high clinical application value. [ABSTRACT FROM AUTHOR]

The paper aims to develop prediction model that integrates clinical, radiomics, and deep features using transfer learning to stratifying between high and low risk of thymoma. Our study enrolled 150 patients with thymoma (76 low-risk and 74 high-risk) who underwent surgical resection and pathologically confirmed in Shengjing Hospital of China Medical University from January 2018 to December 2020. The training cohort consisted of 120 patients (80%) and the test cohort consisted of 30 patients (20%). The 2590 radiomics and 192 deep features from non-enhanced, arterial, and venous phase CT images were extracted and ANOVA, Pearson correlation coefficient, PCA, and LASSO were used to select the most significant features. A fusion model that integrated clinical, radiomics, and deep features was developed with SVM classifiers to predict the risk level of thymoma, and accuracy, sensitivity, specificity, ROC curves, and AUC were applied to evaluate the classification model. In both the training and test cohorts, the fusion model demonstrated better performance in stratifying high and low risk of thymoma. It had AUCs of 0.99 and 0.95, and an accuracy of 0.93 and 0.83, respectively. This was compared to the clinical model (AUCs of 0.70 and 0.51, accuracy of 0.68 and 0.47), the radiomics model (AUCs of 0.97 and 0.82, accuracy of 0.93 and 0.80), and the deep model (AUCs of 0.94 and 0.85, accuracy of 0.88 and 0.80). The fusion model integrating clinical, radiomics and deep features based on transfer learning was efficient for noninvasively stratifying high risk and low risk of thymoma. The models could help to determine surgery strategy for thymoma cancer. [ABSTRACT FROM AUTHOR]

Background: Group Model Building (GMB) is a participatory system dynamics method increasingly used to address complex public health issues like obesity. GMB represents a set of well-defined steps to engage key stakeholders to identify shared drivers and solutions of a given problem. However, GMB has not yet been applied specifically to develop multi-duty interventions that address multiple inter-related issues such as malnutrition in all its forms (MIAIF). Moreover, a recent systematic review of empirical applications of a systems approach to developing obesity interventions found no published work from non-western, low- and middle-income countries (LMICs). In this paper we describe adaptations and innovations to a common GMB process to co-develop systemic MIAIF interventions with Chinese decision-makers. Methods: We developed, piloted and implemented multiple cultural adaptations and two methodological innovations to the commonly used GMB process in Fang Cheng Gang city, China. We included formal, ceremonial and policy maker engagement events before and between GMB workshops, and incorporated culturally tailored arrangements during participant recruitment (officials of the same seniority level joined the same workshop) and workshop activities (e.g., use of individual scoring activities and hand boards). We made changes to the commonly used GMB activities which enabled mapping of shared drivers of multiple health issues (in our case MIAIF) in a single causal loop diagram. We developed and used a 'hybrid' GMB format combining online and in person facilitation to reduce travel and associated climate impact. Results: Our innovative GMB process led to high engagement and support from decision-makers representing diverse governmental departments across the whole food systems. We co-identified and prioritised systemic drivers and intervention themes of MIAIF. The city government established an official Local Action Group for long-term, inter-departmental implementation, monitoring and evaluation of the co-developed interventions. The 'hybrid' GMB format enabled great interactions while reducing international travel and mitigating limitations of fully online GMB process. Conclusions: Cultural and methodological adaptations to the common GMB process for an Asian LMIC setting were successful. The 'hybrid' GMB format is feasible, cost-effective, and more environmentally friendly. These cultural adaptations could be considered for other Asian settings and beyond to address inter-related, complex issues such as MIAIF. [ABSTRACT FROM AUTHOR]

As the economy and society develop and the standard of living improves, people's health awareness increases and the demand for health information grows. This study introduces an advanced BERT-LDA model to conduct topic-sentiment analysis within online health communities. It examines nine primary categories of user information requirements: causes, symptoms and manifestations, examination and diagnosis, treatment, self-management and regulation, impact, prevention, social life, and knowledge acquisition. By analyzing the distribution of positive and negative sentiments across each topic, the correlation between various health information demands and emotional expressions is investigated. The model established in this paper integrates BERT's semantic comprehension with LDA's topic modeling capabilities, enhancing the accuracy of topic identification and sentiment analysis while providing a more comprehensive evaluation of user information demands. This research furthers our understanding of users' emotional reactions and presents valuable insights for delivering personalized health information in online communities. [ABSTRACT FROM AUTHOR]

Objectives: The global coronavirus disease 2019 (COVID‐19) pandemic has not been well controlled, and vaccination could be an effective way to prevent this pandemic. By accommodating attribute nonattendance (ANA) in a discrete choice experiment (DCE), this paper aimed to examine Chinese public preferences and willingness to pay (WTP) for COVID‐19 vaccine attributes, especially the influence of ANA on the estimated results. Methods: A DCE was designed with four attributes: effectiveness, protection period, adverse reactions and price. A random parameter logit model with an error component (RPL‐EC) was used to analyse the heterogeneity of respondents' preferences for COVID‐19 vaccine attributes. Two equality constraint latent class (ECLC) models were used to consider the influence of ANA on the estimated results in which the ECLC‐homogeneity model considered only ANA and the ECLC‐heterogeneity model considered both ANA and preference heterogeneity. Results: Data from 1,576 samples were included in the analyses. Effectiveness had the highest relative importance, followed by adverse reactions and protection period, which were determined by the attributes and levels presented in this study. The ECLC‐heterogeneity model improved the goodness of fit of the model and obtained a lower probability of ANA. In the ECLC‐heterogeneity model, only a small number of respondents (29.09%) considered all attributes, and price was the most easily ignored attribute (64.23%). Compared with the RPL‐EC model, the ECLC‐homogeneity model obtained lower WTPs for COVID‐19 vaccine attributes, and the ECLC‐heterogeneity model obtained mixed WTP results. In the ECLC‐heterogeneity model, preference group 1 obtained higher WTPs, and preference groups 2 and 3 obtained lower WTPs. Conclusions: The RPL‐EC, ECLC‐homogeneity and ECLC‐heterogeneity models obtained inconsistent WTPs for COVID‐19 vaccine attributes. The study found that the results of the ECLC‐heterogeneity model considering both ANA and preference heterogeneity may be more plausible because ANA and low preference may be confused in the ECLC‐homogeneity model and the RPL‐EC model. The results showed that the probability of ANA was still high in the ECLC‐heterogeneity model, although it was lower than that in the ECLC‐homogeneity model. Therefore, in future research on DCE (such as the field of vaccines), ANA should be considered as an essential issue. Public Contribution: Chinese adults from 31 provinces in mainland China participated in the study. All participants completed the COVID‐19 vaccine choice questions generated through the DCE design. [ABSTRACT FROM AUTHOR]

China's innovation policies for artificial intelligence (AI) are widely considered as having made a remarkable achievement, which offers us a pertinent case to explore how to design and implement an effective innovation policy mix for an emerging technology. On the basis of literature on the characteristics of emerging technologies and the typology of innovation policy, this paper proposes a four‐dimensional framework. It then conducts a categorical principal component analysis and a k‐prototype cluster analysis by using data on 116 China's AI policy programmes from 2009 to 2021, which show that the characteristics of the innovation policy mix can be captured by the four dimensions. Furthermore, our analysis indicates that China's AI innovation policy mix evolves following the changing characteristics of AI technology over time. This paper has some implications for designing AI innovation policy mixes in other countries and designing innovation policy mixes for other emerging technologies. [ABSTRACT FROM AUTHOR]

The large-scale application of blockchain technology is an expected to be an inevitable trend. This study revolves around published papers and articles related to blockchain technology, relevance analysis and sorting through the retrieved documents with six core layers of blockchain: Application Layer, Contract Layer, Actuator Layer, Consensus Layer, Network Layer and Data Layer. Based on the analysis results, this study found that China's research is more towards the preference and application of landing and industry and smart cities with blockchain as the underlying technology. International research is more focused on the research of finance as the underlying technology of blockchain and tries to combine crypto assets with real industries, such as crypted assets and payment systems for traditional industries. This paper studies the impact of monetary entropy on cryptocurrencies in smart cities and uses the monetary entropy formula to measure the crypto-economic entropy. We use Kolmogorov entropy to describe the degree of chaos in the cryptocurrency market in a smart city. The study illustrates the current status of blockchain technology and applications from the perspective of cryptocurrency in a smart city. We find that smart cities and cryptocurrencies have a mutually reinforcing effect. [ABSTRACT FROM AUTHOR]

Object: To analyze the trend of the coupling and coordination of the supply and demand of healthcare resources between the elderly population and healthcare resources in China during the period of 2012–2022, to reveal the impact of the growth of the elderly population on the relationship between the supply and demand of healthcare resources, and to put forward suggestions to improve the coupling and coordination between the supply and demand of healthcare resources and the elderly population, in order to cope with the challenges of an aging society. Methods: By obtaining relevant data from authoritative data sources such as China Statistical Yearbook, Health and Health Statistics Yearbook, and the Chinese government website from 2012 to 2022, we constructed a comprehensive measurement index for the three systems of elderly population, healthcare resource supply, and healthcare resource demand; Using the entropy value method to assign weights to the indicators, combined with the coupling coordination degree model, to reveal the changes of the elderly population change and the supply and demand of medical and health resources; using ArcGIS technology, to study the spatial characteristics of the elderly population change and the supply and demand of medical and health resources. Results: From 2012 to 2022, the supply and demand of healthcare resources and the variation of the elderly population in China show a continuous growth trend, and the comprehensive development level of the system gradually climbs from a low level to a high level. The fluctuation of coupling degree and coordination degree rises, although the coordination degree has always been lower than the coupling degree, but the distance between the coordination degree and the coupling degree gradually narrows with the passage of time. The coordination degree between population aging and medical and health resources development shows spatial heterogeneity in China, with the eastern region significantly higher than the western region/. Conclusions: The coupling degree between population aging and healthcare resource supply and demand in China from 2012 to 2022 shows a general upward trend from low coupling to medium-high coupling, but it is worth noting that even though the degree of coupling increases, the degree of coordination is still relatively lagging behind, suggesting that the government and relevant departments need to pay more attention to coordinated allocation and management of healthcare resources. At the same time, the spatial differences in the degree of coordination among provinces suggest that future policymakers should take regional differences into full consideration in policymaking and sustainable development. [ABSTRACT FROM AUTHOR]

We introduce a new family of mechanisms for one-sided matching markets, denoted pick-an-object (PAO) mechanisms. When implementing an allocation rule via PAO, agents are asked to pick an object from individualized menus. These choices may be rejected later on, and these agents are presented with new menus. When the procedure ends, agents are assigned the last object they picked. We characterize the allocation rules that can be sequentialized by PAO mechanisms and the ones that can be implemented in a robust truthful equilibrium. We justify the use of PAO as opposed to direct mechanisms by showing that its equilibrium behavior is closely related to the one in obviously strategy-proof (OSP) mechanisms, but implements commonly used rules, such as Gale-Shapley DA and top trading cycles, which are not OSP implementable. We run laboratory experiments comparing truthful behavior when using PAO, OSP, and direct mechanisms to implement different rules. These indicate that agents are more likely to behave in line with the theoretical prediction under PAO and OSP implementations than their direct counterparts. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Funding: This research is funded by the National Natural Science Foundation of China [Grant 72033006]. R. Hakimov was supported by the Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung [Project 100018_189152]. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.4908. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy and safety of cortical bone trajectory (CBT) screw and pedicle screw (PS) internal fixation in the treatment of adjacent segment degeneration (ASD) after lumbar fusion. Methods: This study was registered on International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023484937). We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database, and Wei Pu Database by computer to collect controlled clinical studies on the efficacy and safety of cortical bone trajectory (CBT) screw and pedicle screw (PS) internal fixation in the treatment of adjacent segment degeneration (ASD) after lumbar fusion from database establishment to November 2023. Two researchers screened the literature, extracted data and evaluated the risk of bias of the included studies, recorded the authors, and sample size, and extracted the intraoperative blood loss, operation time, Oswestry disability index (ODI), Visual analogue scale (VAS), disc height (DH), hospital length stay and complications in each study. Meta-analysis was performed using Revman 5.4 software provided by Cochrane Library. Results: A total of 6 cohort studies (CS) and 1 randomized controlled study with a total of 420 patients were included in this study, including 188 patients in the CBT group and 232 patients in the PS group. The CBT group had lower intraoperative blood loss than the PS group [mean difference (MD) = -129.38, 95% CI (-177.22, -81.55), P < 0.00001] and operation time was shorter than that of the PS group [MD = -1.42, 95% CI (-2.63, -0.20), P = 0.02]. Early postoperative back and leg pain improved more significantly in the CBT group [MD = -0.77, 95% CI (-1.35, -0.19), P = 0.01; MD = -0.24, 95% CI (-0.37, -0.10), P = 0.0005]. Conclusion: Compared with PS, CBT for adjacent segment degeneration after lumbar fusion has the advantages of less intraoperative blood loss, shorter operation time, and less back and leg pain in the early postoperative period. [ABSTRACT FROM AUTHOR]

Background: Dementia is a progressive neurodegenerative condition, while metabolic syndrome (MetS) is characterized by a combination of metabolic abnormalities such as hypertension, high blood sugar, and obesity. There exists a connection and overlap between the two conditions in certain aspects, and both are influenced to varying degrees by the process of aging. This study presents an overview of the current research landscape regarding dementia and MetS through bibliometric analysis. Methods: A systematic search was conducted to retrieve relevant literature on dementia and MetS published between 1 January 2000, and 30 November 2023, from the Web of Science Core Collection database. Various bibliometric tools, including VOSviewer, CiteSpace, and the R software package “bibliometrix,” were utilized for analysis. Results: A total of 717 articles were identified, showing an upward trend in annual publications. Leading contributors included the United States, Italy, and China, with institutions such as the University of California System at the forefront. The Journal of Alzheimer’s Disease emerged as the top publisher, while research published in Neurology garnered significant citations. Noteworthy authors encompassed Panza, Francesco; Frisardi, Vincenza; and Feldman, Eva L, with Kristine Yaffe being the most cited author (280 citations). Recent studies have focused on themes like “gut microbiota,” “neuroinflammation,” “fatty acids,” and “microglia.” Conclusion: This bibliometric analysis summarizes the foundational knowledge structure in the realm of dementia and MetS from 2000 to 2023. By highlighting current research frontiers and trending topics, this analysis serves as a valuable reference for researchers in the field. [ABSTRACT FROM AUTHOR]

INTRODUCTION The rapid growth of e-cigarette usage among youth and young people has emerged as a significant public health concern. It is imperative to initiate effective vaping prevention campaigns and undertake relevant research to address this pressing issue. This research seeks to identify effective video advertisements to deter young people from starting to use e-cigarettes. It aims to offer evidence-based insights and recommendations for creating communication materials and designing messages for youth e-cigarette prevention efforts. METHODS College students aged 18-24 years (n=40) participated in focus groups within this qualitative study. After viewing four stimulus videos, participants discussed what they perceived as effective and ineffective video characteristics, as well as suggestions for future videos. RESULTS Effective video characteristics included the use of real-life testimonials, displaying specific health hazards, revealing harmful chemical ingredients and the deceptive nature of flavors, and positively perceived effectiveness. Participants generally found that videos with strong visual impact and graphics were more engaging and that approaches using fear and emotion were more effective. Ineffective characteristics included complex and exaggerated information, lack of empathy and irrelevance, insufficiently specific information, extreme and death-themed content, industry messages, as well as preachy tones, animations, metaphors, dull formats, excessive length, and scenes of e-cigarette use. CONCLUSIONS Developing anti-e-cigarette campaign materials for youth necessitates target audience-focused qualitative research. This helps in deeply exploring and identifying effective themes and messages, as well as video characteristics and details while avoiding ineffective or even misleading messages and themes from young people's perspectives outside the United States. Future development of e-cigarette prevention videos for Chinese college students may consider incorporating localized real-life testimonial cases to convey specific harms, including self-efficacy information, and utilizing fear and emotional appeals. [ABSTRACT FROM AUTHOR]

INTRODUCTION Healthcare workers are integral to public smoking cessation; however, their own smoking behavior can create a significant obstacle to intervening in patients' cessation efforts. Conversely, their success in quitting can enhance their ability to support patients. Research on smoking behavior, particularly smoking cessation among Chinese psychiatric professionals is limited. This study addresses this gap by examining the factors associated with smoking cessation in this population, providing insights for targeted tobacco control policies. METHODS A cross-sectional survey was conducted, targeting psychiatric professionals including psychiatrists and psychiatric nurses, in 41 tertiary psychiatric hospitals in China. From January to March 2021, a WeChat-based questionnaire was distributed to collect demographic, occupational, and health-behaviors (including smoking) data. Statistical analyses, including the chi-squared test and adjusted binary logistic regression analysis, were conducted to identify the factors associated with smoking cessation. RESULTS Among the 12762 psychiatric professionals who participated in the survey, 11104 (87.0%) were non-smokers, 1196 (9.4%) were current smokers, and 462 (3.6%) were ex-smokers. Several factors were found to be associated with smoking cessation. Women had a higher prevalence of ex-smokers than men (AOR=1.88; 95% CI: 1.332-2.666, p<0.001). Compared to East China, the prevalence of exsmokers among participants in Central and Northeast China was lower. Older age (≥50 years), higher level of education (Master's degree or higher), and non-drinkers, showed a higher likelihood of being ex-smokers. Notably, compared to current smokers, ex-smokers reported a lower prevalence of burnout (AOR=0.70; 95% CI: 0.552-0.892, p=0.004). CONCLUSIONS Smoking cessation interventions or health promotion programs should also focus on gender, age, education level, region, alcohol use, and burnout to effectively address smoking cessation within this specific professional group. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. METHODS Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. RESULTS The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). CONCLUSIONS Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this paper is to describe blood services in the Aba Tibetan and Qiang Regions, (hereinafter referred to as Aba Prefecture), a region of China's Qinghai–Tibetan Plateau, the third largest area of Tibet and the main inhabited area of the Qiang people. Design: We present a comprehensive investigation into blood donations, donors, screening and supply in the 13 counties of Aba Prefecture based on data from 2013 to 2018. Geography and population were also used to analyze the differences in blood services among different regions. Participants: The number of blood donors totaled 19,047. Results: Over the past 6 years, blood donations have increased by 29 and clinical blood usage by 45%. The blood donation rate was 3.4‰ and per capita blood use was 1.04 mL, both of which were significantly lower than the national average, and blood donation decreased with altitude. It should be noted that the donation rate of the Tibetan and Qiang peoples is much lower than that of the Han population. Moreover, the rejection rate of blood in laboratory testing was found to be higher than the national average, especially in counties located at higher altitudes. Conclusions: Blood donations and usage increased every year in Aba Prefecture, but blood shortage is still an important issue. In addition, the prevalence of transfusion–transmitted diseases is relatively high, which may be linked to lower-education and unfavorable geographical and medical conditions. [ABSTRACT FROM AUTHOR]

After three years of global rampage, the COVID-19 epidemic, the most serious infectious disease to occur worldwide since the 1918 influenza pandemic, is nearing its end. From the global experience, medical control and social control are the two main dimensions in the prevention and control of COVID-19. From the perspective of "two types of control", namely medical control and social control, this paper finds that the political system, economic structure, and cultural values of the United States greatly limit the government's ability to impose social control, forcing it to adopt medical control to fight the virus in a single dimension. In contrast, China's political system, economic structure, and cultural values allow its government to adopt stringent, extensive, and frequent social control, as well as medical control to fight the virus. This approach departs from the traditional pathway of fighting the epidemic, i.e., "infection–treatment–immunization", thereby outpacing the evolution of the virus and controlling its spread more rapidly. This finding helps explain why the Chinese government adopted a strict "zeroing" and "dynamic zeroing" policy during the first three years, at the cost of enormous economic, social, and even political legitimacy. It was not until late 2022, when the Omicron variant with the waning virulence became prevalent, that China chose to "coexist" with the virus, thus avoiding a massive epidemic-related death. While the United States adopted a pulsed-style strategy at the beginning of the epidemic, i.e., "relaxation–suppression–relaxation–suppression", and began to "coexist" with the virus in just one year, resulting in a large number of excess deaths associated with the epidemic. The study contributes to explaining the difference in the interplay between public health priorities and COVID-19 response strategies in China and the United States, based on the specific public health context and the perspective of "medical control" and "social control". [ABSTRACT FROM AUTHOR]

Aim. This paper aimed to examine the current state of nurse safety behavior, and the effect of work engagement on it, and to explore the mediating effect of self-efficacy between work engagement and nurse safety behavior in specialized cancer hospitals. Background. Nurse safety behavior affects the quality of care and outcomes for patients with cancer. The research proves that self-efficacy is associated with work engagement, but the relationship between self-efficacy, work engagement, and nurse safety behavior needs to be clarified. Methods. This study used a convenience sampling method to survey 957 nurses from January to February 2023. The survey included tertiary specialized cancer hospitals in five provinces in China. Sociodemography information, the Work Engagement Scale, the Self-Efficacy Scale, and the Nurse Safety Behavior Scale were used for the survey. A Questionnaire Star program collected all the data automatically. The Statistical Package for the Social Sciences version 24 was employed for Pearson correlation and multiple regression analysis to examine the association between work engagement, self-efficacy, and nurse safety behavior. Structural equation models were built using Analysis of Moment Structures version 24.0 software. Results. The results showed that the nurse safety behavior was at a high level in specialized cancer hospitals. There was a significant positive relationship between the variables work engagement, self-efficacy, and nurse safety behavior with coefficients ranging from 0.244 to 0.564. The results of structural equation modeling revealed that self-efficacy partially mediated the effect between work engagement and nurse safety behavior, accounting for 25.3% of the total effect. Conclusion. Self-efficacy mediates the relationship between work engagement and nurse safety behavior, and by increasing self-efficacy, nurse safety behavior can be improved, thus ensuring patient safety. Implications for Nursing Management. Managers should promote high work engagement and nurse safety behaviors by fostering nurses' self-efficacy. [ABSTRACT FROM AUTHOR]

Acknowledging the extreme risk COVID-19 poses to humans, this paper attempted to analyze and compare case fatality rates, identify the existence of learning curves for COVID-19 medical treatments, and examine the impact of vaccination on fatality rate reduction. Confirmed cases and deaths were extracted from the "Daily Situation Report" provided by the World Health Organization. The results showed that low registration and low viral test rates resulted in low fatality rates, and the learning curve was significant for all countries except China. Treatment for COVID-19 can be improved through repeated experience. Vaccinations in the U.K. and U.S.A. are highly effective in reducing fatality rates, but not in other countries. The positive impact of vaccines may be attributed to higher vaccination rates. In addition to China, this study identified the existence of learning curves for the medical treatment of COVID-19 that can explain the effect of vaccination rates on fatalities. [ABSTRACT FROM AUTHOR]

This paper examines the perception of risk associated with the presence of coronavirus in food purchased online and online vs. offline food shopping during the COVID-19 epidemic. The influence of COVID-19 status on risk perception was tested using the data collected from 742 consumers between December 2021 and January 2022. The empirical approach distinguished between the epidemic's status in a province (or region), city, and other areas of the country and applied the ordered logit technique. The regional and citywide epidemic increased the perception that online purchases carry the virus and are riskier than those made offline. Further examination showed that the regional/provincial epidemic created the perception that packaging or social media use were risk factors when purchasing food online. Heterogeneity analysis showed that risk perception was significantly higher in affected cities than in non-affected provinces or other provinces. Risk perception differed across five online food categories, with the highest levels for online-ordered meals and fresh products. Strengthening COVID-19 prevention and control in cities and the province, managing risk due to the handling of food purchased online, and government monitoring of social media use will lessen consumers' risk perceptions and encourage the use of online food offers during epidemics. [ABSTRACT FROM AUTHOR]

Digital skin defects resulting from trauma are often associated with dysfunction of the digital nerve and the extensor and flexor tendons in the affected fingers. The repair of these complex tissue defects requires a graft containing multiple tissues that can be used to reconstruct the tendons and nerves and restore the skin. Such procedures can cause multiple injuries and significant damage to the donor site. The current study used a novel technique to repair complex dorsal and palmar digital soft‐tissue defects. First, multiple tissues were cut and collected from the donor site. Then, part of the flexor carpi ulnaris tendon was transplanted to repair the tendon defect, and a medial antebrachial cutaneous nerve graft was used to repair the digital nerve defect. Finally, a skin flap was used to cover the skin defect. This paper reports on 31 cases of complex soft‐tissue digital defects, with defect areas of 2–18 cm2. One patient presented with a postoperative arterial crisis in the flap. All other patients recovered without experiencing a vascular crisis, flap necrosis, or wound infection. The postoperative flaps were similar in texture to the original digital skin. The sensation and the extension/flexion functions in the affected fingers recovered well. The effect on grip strength, wrist flexion, and forearm sensation was minor and the postoperative total active motion scores of the affected digits were good or excellent in 96.77% of the cases. The flap sensation recovery rate was also excellent in 83.87% of the cases. The present technique facilitates the repair of multiple dorsal and palmar digital soft‐tissue, tendon and nerve defects, reduces the damage to the donor site, and significantly improves the success of surgical repair. [ABSTRACT FROM AUTHOR]

Online medical consultation (OMC) is generating considerable interest among researchers and practitioners due to the mandatory quarantine measures implemented during the COVID-19 pandemic in China. However, the acceptance rate of OMC has declined over time. This paper aims to empirically investigate OMC acceptance using a proposed research model by integrating the technology acceptance model (TAM) with trust and its antecedent variables. A quantitative self-administered cross-sectional survey was conducted to collect data from 260 healthcare consumers. A partial least squares structural equation modeling method was used to examine the data. Results revealed that healthcare consumers' behavioral intention was influenced by attitudes, while perceived usefulness and trust significantly influenced behavioral intention through attitude as a mediator. In addition, perceived risk, perceived privacy protection, network externalities, cognitive reputation, and interactivity directly influenced trust. Overall, the research model explained 50% of the variance in attitude and 71% of the variance in behavioral intention. The study's findings should provide useful insights into making effective design, development, and implementation decisions for OMC services. [ABSTRACT FROM AUTHOR]

In order to explore and analyze the effect of music therapy interventions on college students with excessive anxiety, this paper selected 240 year 2017- to year 2020-enrolled undergraduates from a comprehensive university in Taiyuan City, Shanxi Province, in Central China as research objects. These college students had been diagnosed as excessive anxiety and were randomly divided into two groups—intervention group and control group—with 120 students in each group. The control group received conventional mental health treatment for college students, while the intervention group received music therapy interventions on this basis with 3 times a week for 24 times. The instruments used in the music therapy include piano, percussion instruments, melodic instruments, and diffuse instruments; the specific implementation of each therapy is divided into five parts: warm-up, rhythm percussion, song singing, instrumental ensemble, and music appreciation. The study results show that before treatment, the excessive anxiety score of college student in the control group was 63-76 with an average score of 72.58 ± 5.27 ; after treatment, that was 45-64 with an average score of 54.46 ± 6.82 ; before treatment, the excessive anxiety score of college student in the intervention group was 62-78 with an average score of 72.56 ± 5.51 ; after treatment, that was 26-44 with an average score of 33.19 ± 5.51. Before treatment, there was no significant difference in the excessive anxiety scores between the two groups of college students (P > 0.05); after treatment, the excessive anxiety scores of the two groups were lower than those before treatment, and the reduction degrees in the intervention group were bigger than those in the control group, with statistically significant difference (P < 0.05). Therefore, music therapy interventions can significantly reduce the excessive anxiety of college students; the analysis also shows that factors such as gender, grade, major, origin, repertoire type, therapy type, and anxiety type could affect the effect of music therapy interventions to some certain extent. For example, the effect of music therapy interventions on college students in psychology or related majors is better than that of students in other majors; the effect of receptive music therapy is better than that of creative and improvised music therapy; the effect of music therapy interventions on college students' life event, romantic relationship, and social anxiety is better than that on college students' test and job-hunting anxiety. [ABSTRACT FROM AUTHOR]

In order to supplement and improve the landscape evaluation system of traditional villages and play a positive guiding role in the specific protection and development of village landscape, this paper proposes the ecological landscape environment evaluation of traditional villages in Guanzhong from the perspective of rural revitalization. First of all, the relevant national and provincial evaluation standards are deeply studied, and the comprehensive evaluation system of the traditional village landscape in the Guanzhong region is constructed by using expert scoring and an analytic hierarchy process, which includes 6 criteria and 25 indicators. Three typical villages of different types and different development stages, namely, village A, village B, and Village C, were selected for landscape investigation and comprehensive evaluation. The results show that the weight of village location and landscape pattern is the largest, that is, the most important. The second is architectural landscape, with a weight of 0.236, accounting for a high proportion. Then, it is the natural landscape and street landscape, with a weight of 0.1-0.2. Finally, it is the intangible cultural landscape and landscape style protection, with a weight of less than 0.1. The alpha value of the comprehensive evaluation questionnaire of the village A is 0.984. The alpha value of the comprehensive evaluation questionnaire of village B is 0.941. The alpha value of the comprehensive evaluation questionnaire for the landscape of village C is 0.986, which is greater than 0.8. Conclusion. This study makes a comprehensive evaluation of the landscape of typical traditional villages. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking is an independent and modifiable risk factor for the onset and development of psoriasis; however, evidence on the association between tobacco smoking and psoriasis treatment efficacy is limited. This study aimed to explore the influence of smoking on treatment efficacy in a cohort of patients with psoriasis in Shanghai, China. METHODS Patients with psoriasis were recruited from the Shanghai Skin Disease Hospital between 2021 and 2022. The treatment for patients with psoriasis includes acitretin, methotrexate, narrow-band ultraviolet/benvitimod, and biologics. Data were collected using a structured questionnaire, physical examination, and disease severity estimation at baseline, week four, and week eight. The achievement of a ≥75% reduction in psoriasis area and severity index (PASI75) score from baseline to week 8 was set as the primary outcome for treatment efficacy estimation. Data were analyzed using SAS 9.4. RESULTS A total of 560 patients with psoriasis were enrolled in this study, who were predominantly males (72.9%). The average age of patients was 48.4 years, and 38.8% of them were current smokers, 5.0% of them were former smokers. The median score of PASI among patients changed from 11.1 (interquartile range, IQR: 7.9-16.6) at baseline to 6.2 at week 4 and 3.1 at week 8, and 13.8% and 47.3% of patients with psoriasis achieved PASI75 at weeks 4 and 8, respectively. Logistic regression indicated that patients without tobacco smoking had a higher proportion of PASI75 achievement at week 8. The adjusted odds ratio (AOR) was 11.43 (95% CI: 6.91-18.89), 14.14 (95% CI: 8.27-24.20), and 3.05 (95% CI: 1.20-7.76) for non-smokers compared with smokers, current smokers, and former smokers, respectively. Moreover, former smokers had higher PASI75 achievement than current smokers (AOR=3.37), and patients with younger smoking initiation age, longer smoking duration, and higher smoking intensity had lower PASI75 achievement. CONCLUSIONS Tobacco smoking was negatively associated with PASI75 achievement both in current and former smokers, and former smokers had higher PASI75 achievement than current smokers. The implementation of tobacco control measures is beneficial for improving treatment responses. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking prevalence is high in China, and healthcare workers are important for tobacco control. This study aimed to determine the smoking status, cognition of tobacco hazards, and smoking cessation-related knowledge among respiratory healthcare workers, and to explore their ability to provide smoking cessation assistance. METHODS A cross-sectional study was conducted in 2021 among 1028 respiratory healthcare workers from 89 hospitals in Fujian Province, China. A self-designed electronic questionnaire was used to collect data on smoking status, knowledge of smoking hazards, and smoking cessation knowledge. Descriptive statistics were calculated for all questions. Logistic regression analysis was used to explore the relationship between awareness of the tobacco control goals of Healthy China 2030 and demographic characteristics. RESULTS Among the healthcare workers surveyed, 3.4% were smokers, all of whom were male. Most respondents (99.4%) were aware of smoking as a cause of lung cancer, but awareness of smoking as a cause of non-respiratory cancer was lower. The awareness rate of smoking cessation support was high (>90%), but only 40.0% of participants were aware of the Healthy China 2030 tobacco control targets. Male (HR=2.16; 95% CI: 1.69-2.80) and participation in the cessation clinic (HR=1.47; 95% CI: 1.10-1.96) were associated with higher awareness of the targets. CONCLUSIONS Respiratory healthcare workers in Fujian Province demonstrated a high level of awareness regarding behavioral and pharmacotherapy support for smoking cessation. In order to enable healthcare workers to play a more active role in tobacco control, there is a need to increase public awareness of smoking cessation services in Fujian Province. [ABSTRACT FROM AUTHOR]

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China. In recent years, lung cancer has shown a high incidence trend, seriously affecting the health of the population. In this paper, we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province, in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province. Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019, we calculated the incidence rate, medium incidence rate, world incidence rate and other related indexes; we used Joinpoint to calculate the annual percentage change (APC) for trend analysis. Results In 2019, a total of 3757 new cases of lung cancer were reported in Gansu province, accounting for 14.96% of all new malignant tumors. The incidence rate, medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105, 25.78/105, 25.86/105; and the cumulative rate of 0-74 years old, and the truncation rate of 35-64 years old were 3.23%, 40.03/105, respectively. The incidence of lung cancer rises with age, and is high in the age group of 40 years and above, and the incidence peaks in the male and female populations in the group of 75 years and above, and the group of 80 years and above, respectively. The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend, and the rate of increase was relatively fast, with an APC 5.39% (P<0.05); Separately, according to gender, urban and rural areas, the incidence of lung cancer in all populations showed an increasing trend, and the APC of male, female, urban and rural populations were 4.98%, 6.39%, 6.26%, and 4.64%, respectively (all P<0.05). According to the trend analysis of lung cancer incidence rate by age group, only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15% (P<0.05). Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year, and there are differences in the incidence of lung cancer in people of different genders, regions and age groups, so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence. [ABSTRACT FROM AUTHOR]

In this paper, we consider optimization problems over closed embedded submanifolds of Rn , which are defined by the constraints c(x) = 0. We propose a class of constraint-dissolving approaches for these Riemannian optimization problems. In these proposed approaches, solving a Riemannian optimization problem is transferred into the unconstrained minimization of a constraint-dissolving function (CDF). Different from existing exact penalty functions, the exact gradient and Hessian of CDF are easy to compute. We study the theoretical properties of CDF and prove that the original problem and CDF have the same first-order and second-order stationary points, local minimizers, and Łojasiewicz exponents in a neighborhood of the feasible region. Remarkably, the convergence properties of our proposed constraint-dissolving approaches can be directly inherited from the existing rich results in unconstrained optimization. Therefore, the proposed constraint-dissolving approaches build up short cuts from unconstrained optimization to Riemannian optimization. Several illustrative examples further demonstrate the potential of our proposed constraint-dissolving approaches. Funding: The research of N. Xiao and K.-C. Toh is supported by the Ministry of Education of Singapore Academic Research Fund Tier 3 [Grant MOE-2019-T3-1-010]. The research of X. Liu is supported in part by the National Natural Science Foundation of China [Grants 12125108, 11971466, 12288201, 12021001, and 11991021]; the National Key R&D Program of China [Grants 2020YFA0711900 and 2020YFA0711904]; and the Key Research Program of Frontier Sciences, Chinese Academy of Sciences [Grant ZDBS-LY-7022]. [ABSTRACT FROM AUTHOR]

INTRODUCTION Exposure to advertising is a determinant of electronic cigarette (e-cigarette) use among young adults. Few studies have explored the underlying mechanisms of advertising exposure on e-cigarette use among young Chinese adults. METHODS An online survey was administered to a sample of 2956 young adults (aged 20-34 years) who were never smokers, from April to May 2022, in China. Mediation analyses were used to test the mediating effects of curiosity and harm perception, and moderated mediation models were conducted to examine whether the relationships in mediation modeling vary across different levels of socioeconomic status (household income, education level, and residence). RESULTS Greater advertising exposure was associated with a higher likelihood of e-cigarette use (AOR=1.39; 95% CI: 1.26-1.54) and curiosity about e-cigarettes (AOR=1.33; 95% CI: 1.25-1.42), and the latter mediated the association between advertising exposure and e-cigarette use (proportion mediated=26.9%; 95% CI: 15.8%-40.7%) while harm perception did not. Additionally, the effect of advertising exposure on curiosity was moderated by household income (p=0.03) and residential area (p=0.001), and was stronger among participants with lower socioeconomic status. CONCLUSIONS E-cigarette advertising may promote young adults' experimentation by increasing their curiosity towards the products. Socially disadvantaged groups may be more susceptible to e-cigarette advertising. The study suggests that the government should explore options for better regulation of e-cigarettes to prevent initiation by never smokers and protect vulnerable populations. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking conventional cigarettes or vaping (SV) poses significant health threats to adolescents. School climate and school identification are key elements of the school environment and potential factors of SV. Based on the Stress Coping Theory, the mediations between school climate/school identification and SV, via perceived stress/active coping, were examined. METHODS A cross-sectional survey was conducted among secondary school students from February to March 2022 in Taizhou, China. Structural equation modeling was used. RESULTS The prevalence of SV among the 7526 participants was 4.7% (singular use of conventional cigarettes: 3.2%; singular use of electronic cigarettes: 3.6%; dual use: 2.1%). School climate, school identification, and active coping were positively, and perceived stress (family stress, academic stress, and peer-related stress) were negatively associated with SV. The association between school climate and SV was fully mediated via: 1) school climate → perceived stress → SV; 2) school climate → active coping → SV; and 3) school climate → perceived stress → active coping → SV. The effect sizes were 52.1%, 43.8%, and 6.3%, respectively. Similar partial mediation mechanisms were found between school identification and SV, with relatively small effect sizes (<10%). CONCLUSIONS This study observed the prevalence of SV among Chinese secondary school students. School climate and school identification had both significant direct and indirect (via perceived stress/active coping) effects on SV. Positive school environments may reduce students' stress and promote active coping. The stress coping mechanisms explained the association between school climate and SV better than between school identification and SV. [ABSTRACT FROM AUTHOR]

Background: Workplace social support might have a protective function against migraine in the social context of China, as close co-worker relationships and collectivism are acknowledged as work values in Chinese society. Objectives: This paper aimed to analyse the association between migraine and workplace social support. The validity and reliability of the Chinese version of the Support scale of the Demand-Control-Support Questionnaire (DCSQ) used were also determined. Methods: Following international guidelines, this study was carried out in two stages. Stage I involved translations and pilot testing to assess content and face validity of the Chinese version of the DCSQ Support scale. Stage II was a cross-sectional survey (N = 677 bank employees) to evaluate structural validity, internal consistency and test-retest reliability of the Support scale, as well as to examine the association between workplace social support and a migraine-positive diagnosis. Results: A high level of social support in the workplace was associated with a 74% decreased likelihood of migraine (adjusted OR = 0.26, 95%CI: 0.14–0.46). Of the six aspects of workplace social support, co-worker support had the greatest protective effect (adjusted OR = 0.49, 95% CI: 0.39–0.60). The Chinese version of the DCSQ Support scale established satisfactory content and face validity (I-CVIs ≥ 0.78; S-CVIAVE ≥ 0.90). Confirmatory factor analysis verified its one-dimensional theoretical factor, with adequate internal consistency (Cronbach's α 0.98; item-total correlations ≥ 0.80) and test-retest reliability (weighted Kappa coefficients 0.81–0.87; percentages agreement 85.23–88.92%). Conclusions: In the Chinese social context, workplace social support could protect against migraine, with the strongest benefit coming from co-workers. This study also provides a Chinese-language DCSQ Support scale as a valid and reliable instrument for measuring workplace social support. [ABSTRACT FROM AUTHOR]

Background WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness (hospitalisations) every year. We aimed to improve the understanding of influenza-associated hospitalisation estimates at a national and global level. Methods We performed a systematic literature review of English- and Chinese-language studies published between 1995 and 2020 estimating influenza-associated hospitalisation. We included a total of 127 studies (seven in Chinese) in the meta-analysis and analyzed their data using a logit-logistic regression model to understand the influence of five study factors and produce national and global estimates by age groups. The five study factors assessed were: 1) the method used to calculate the influenza-associated hospitalisation estimates (rateor time series regression-based), 2) the outcome measure (divided into three envelopes: narrow, medium, or wide), 3) whether every case was laboratory-confirmed or not, 4) whether the estimates were national or sub-national, 5) whether the rates were based on a single year or multiple years. Results The overall pooled influenza-associated hospitalisation rate was 40.5 (95% confidence interval (CI) = 24.3-67.4) per 100 000 persons, with rates varying substantially by age: 224.0 (95% CI = 118.8-420.0) in children aged 0-4 years and 96.8 (95% CI = 57.0-164.3) in the elderly aged >65 years. The overall pooled hospitalisation rates varied by calculation method; for all ages, the rates were significantly higher when they were based on rate-based methods or calculated on a single season and significantly lower when cases were laboratory-confirmed. The national hospitalisation rates (all ages) varied considerably, ranging from 11.7 (95% CI = 3.8-36.3) per 100 000 in New Zealand to 122.1 (95% CI = 41.5-358.4) per 100 000 in India (all age estimates). Conclusions Using the pooled global influenza-associated hospitalisation rate, we estimate that seasonal influenza epidemics result in 3.2 million cases of severe illness (hospitalisations) per annum. More extensive analyses are required to assess the influence of other factors on the estimates (e.g. vaccination and dominant virus (sub)types) and efforts to harmonize the methods should be encouraged. Our study highlights the high rates of influenza-associated hospitalisations in children aged 0-4 years and the elderly aged 65+ years. [ABSTRACT FROM AUTHOR]

Background: Surgical site infection (SSI), as one of the most common hospital-acquired infection, is usually associated with increased morbidity, mortality, and health care burden. SSI is a significant perioperative complication after colon cancer surgery, particularly for left-sided colon cancer. This paper describes the background and design of the "Surgical Site Infection after intracorporeal anastomosis for Left-sided Colon Cancer: study protocol for a non-inferiority multicenter Randomized Controlled Trial (STARS)." The STARS trial aims to compare the incidence of SSI after intracorporeal anastomosis and extracorporeal anastomosis after radical resection of colon cancer and to explore the risk factors of SSI.Methods: A total of 354 left colon cancer patients from 8 hospitals in China will be enrolled in this multi-center randomized controlled study. The primary outcome of this study is the incidence of SSI 30 days after left-sided colon cancer surgery. Secondary outcome measures include operation time, blood loss, conversion rate, incidence of perioperative complications, completeness of resection, number of lymph nodes collected and postoperative recovery characteristics, 3-year disease-free survival, and 5-year overall survival. The first patient was enrolled in January 2021.Discussion: To our knowledge, this is the first prospective multicenter study to investigate whether there is a difference in the SSI incidence after intracorporeal and extracorporeal anastomosis for left-sided colon cancer in China. The results may provide more evidence that supports performing total laparoscopic left-sided colon cancer surgery.Trial Registration: The trial has been registered on ClinicalTrials.gov website (ID: NCT04201717). Registered on September 22, 2020. [ABSTRACT FROM AUTHOR]

Green finance can effectively support industrial upgrading and technology development, such as artificial intelligence (AI). In this paper, we attempt to pursue the possibility of a win-win situation for achieving an eco- and tech-friendly society. By asking where and how we could develop green finance and AI innovation simultaneously, this paper conducts an empirical investigation on the influence of green finance on the development of AI in China from 2011 to 2020. Based on the panel data from the 30 provinces, we introduce spatial measurement, policy effect, heterogeneity, and threshold analyses to present deeper insights into the impact of green finance on AI innovations. Indeed, green finance could promote the progress of AI innovation. China's green finance pilot policy is verified to promote the progress of local AI innovations. Furthermore, the spatial spillover effect and regional heterogeneity are observed as well. The promotion effect is most significant in the western area, where the green finance index is relatively low. Besides, the threshold analysis also considers how to increase the marginal effect of green finance in different areas. Finally, several policy recommendations are proposed, which contribute to providing specific directions for the policymakers to improve AI innovation and achieve sustainable development at the same time. [ABSTRACT FROM AUTHOR]

Background: Shexian Dryland Stone Terraced System (SDSTS) in the Taihang Mountains was formally recognized as Globally Important Agricultural Heritage Systems (GIAHS) by Food and Agriculture Organization on May 20, 2022. People there have been relying on the terraced fields for centuries, using various plants, including medicinal plants. However, little information was reported about the flora in SDSTS, nor medicinal plants. Thus, the present study aims to identify and document medicinal plants traditionally used by the local people living around the SDSTS and associated ethnobotanical knowledge. Methods: We conducted investigations in Shexian County, Hebei Province, North China, where SDSTS is distributed. Then, Wangjinzhuang, a community located in the core zone of SDSTS, was chosen as the case site. We selected the informants through purposive and snowball sampling. The data were collected through semi-structured interviews, participant observation, and key informant interviews. The medicinal plants traditionally used by the local people were documented and analyzed. We examined and confirmed the botanical identification based on voucher specimens and by cross-checking the descriptions with the series of books, scientific papers on medicinal plants, and the plant databases. Results: The local people have rich traditional knowledge to collect and use medicinal plants in SDSTS. Records of 123 medicinal plant species belonging to 51 families were obtained from SDSTS. Asteraceae was represented by 16 species, followed by Fabaceae, Lamiaceae and Ranunculaceae. (They all have 8 species.) The majority of the reported plant species were commonly processed into decoctions. And 180 diseases affecting humans were reported to be treated with traditional medicinal plants from SDSTS. Conclusion: It is the first ethnobotanical study on medicinal plants in China-Nationally Important Agricultural Heritage Systems, and in globally important agricultural heritage systems as well. Medicinal plants are crucial for people living in Shexian County. It is necessary to recognize and respect traditional knowledge peculiar to the mountainous region of northern China, especially for those involved in the human–nature interaction and the role of knowledge in agrobiodiversity conservation and rural development that local residents have persisted for centuries. [ABSTRACT FROM AUTHOR]