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This paper aims to demonstrate the impact of coal enterprises’ vertical integration on the performance of innovation corporate social responsibility (ICSR) and to elaborate its specific transmission path through financing structure and market power. This paper takes the data of A-share listed coal company from 2008 to 2017 as samples, uses input-output table method to measure the degree of vertical integration, and explores the relationship between the four factors through multiple linear regression and Bootstrap method. We found that: (1) the vertical integration of coal enterprises has positive incentives for the promotion of ICSR. (2) Financing structure and market power play a chain intermediary role in this process of incentive. (3) In areas with high marketization process, vertical integration has more significant incentive effect on ICSR. The paper extends the research on the relationship between vertical integration and innovation, which provides a reference for the improvement of China’s supply-side reform and corporate social responsibility (CSR) fulfillment policy. It is helpful to promote the sustainable development of the coal industry, stimulate the innovation vitality of enterprises, and improve the fulfillment of CSR. [ABSTRACT FROM AUTHOR]

In this paper, we aim to establish a mathematical model to design a maximizing social welfare intervention mechanism of healthcare service goods in China. The intervention mechanism is helpful to facilitate the adoption of the healthcare service goods. We consider a research problem that regulates the supply chain system for healthcare service goods by an intervention mechanism, and two intervention strategies composed of demand-growth strategy and subsidy strategy are used to the combination of intervention mechanism. Then this paper presents a new method based on fuzzy set and bilevel programming to design the intervention mechanism. To demonstrate the effectiveness of the proposed model, we conduct a case study for Wudang personalized health package and verify our model by the specific result analysis, the result indicates that our joint intervention mechanism is helpful to achieve the target and increase social welfare. [ABSTRACT FROM AUTHOR]

In recent years, with the rapid development of China's air transport industry and the change in market consumption structure, service quality has become one of the important factors affecting airline revenue. How to formulate a reasonable pricing strategy and maintain competitiveness in the fierce market competition has become an urgent problem for airlines. First, the impact factor of service quality level in the traditional pricing model is introduced and a static price competition model for multi-oligopoly airlines based on service quality is established in this paper. And then, a dynamic pricing model based on service quality of the multi-oligopoly airlines is established. The model incorporates the weight factor of service quality impact, which is used to indicate the weight of the service quality level in the process of airline dynamic pricing. The research results show that the service quality level of airlines has an indispensable influence on its development. Airlines should improve service quality as soon as possible to enhance market competitiveness and achieve sustainable development. [ABSTRACT FROM AUTHOR]

Based on the calculation of the inclusive financial development level of 22 provinces and 4 municipalities in China from 2004 to 2017, this paper uses the Kernel density estimation method to further analyze the evolution of the inclusive financial index. Based on the above analysis, we make empirical analysis of the impact of China's inclusive financial inclusion development index on farmers' entrepreneurship using static panel and dynamic panel estimation method. The empirical conclusions show that there are certain differences in inclusive financial inclusion development level in various provinces in China. Improving the inclusion development level of inclusive finance can better promote farmers' entrepreneurship. Urbanization level, economic openness and regional economic development level have a significant positive effect on farmers' entrepreneurship, while farmers' income and education level have a significant negative effect on farmers' entrepreneurship. It is possible to promote farmers' entrepreneurship by improving the inclusive development level of inclusive finance, combining urbanization, increasing government investment in productive fixed assets, increasing economic openness and improving regional economic development. [ABSTRACT FROM AUTHOR]

This paper develops two-stage inverse data envelopment analysis models with undesirable outputs to formulate resource plans for 16 Chinese listed commercial banks whose outputs are increased and overall efficiency is kept unchanged in the short term. We use these models to meet three different output targets, namely, increasing both the desirable and undesirable outputs by the same percentage, increasing these outputs by different percentages, and increasing only the desirable outputs while keeping the undesirable outputs unchanged. We find that operation cost and interest expense are more flexible than labor in the adjustment process and that deposits have no obvious law of change. The findings of this work provide some suggestions for bank managers. [ABSTRACT FROM AUTHOR]

The deterioration of water quality has become a primary environmental concern worldwide. Understanding the status of water quality and identifying the influencing factors are important for water resources management. However, reported analyses have mostly been conducted in small and focused areas. It is still unclear if factors driving spatial variation in water quality would be different in extended spatial scales. In this paper, we analyzed spatial pattern of inland surface water quality in China using a dataset with four water quality parameters (i.e., pH, DO, NH4+-N and CODMn) and the water quality level. We tested the effects of anthropogenic (i.e., land use and socio-economic) and natural (i.e., climatic and topographic) factors on spatial variation in water quality. The study concluded that the overall inland surface water quality in China was at level III (fair). Water quality level was strongly correlated with CODMn and NH4+-N concentration. In contrast to reported studies that suggested land use patterns were the determinants of inland surface water quality, this study revealed that both anthropogenic and natural factors played important roles in explaining spatial variation of inland surface water quality in China. Among the tested explanatory variables, mean elevation within watershed appeared as the best predictor for pH, while annual precipitation and mean air temperature were the most important explanatory variables for CODMn and DO, respectively. NH4+-N concentration and water quality level were most strongly correlated with the percent of forest cover in watershed. Compared to studies at smaller spatial scales, this study found different influencing factors of surface water quality, suggesting that factors may play different roles at different spatial scales of consideration. Therefore management policies and measures in water quality control must be established and implemented accordingly. Since currently adopted parameters for monitoring of inland surface water quality in China are largely influenced by natural variables, additional physicochemical and biological indicators are needed for a robust assessment of human impacts on water quality. [ABSTRACT FROM AUTHOR]

This paper combines a Granger causality test and a VAR model to investigate the relationships among oil price shocks, global economic policy uncertainty (GEPU), and China’s industrial economic growth. Based on monthly data from 2000 to 2017, we reveal that GEPU and world oil prices jointly Granger cause China's industrial economic growth; world oil prices have a positive effect on China's industrial economic growth, while GEPU has a negative effect. Further analyses investigate the asymmetry effect of oil prices and find that the negative component shows a more significant impact on China's industrial economic growth. The results are robust to different oil price and EPU proxies. [ABSTRACT FROM AUTHOR]

Background: In this research, an meta-analysis was performed for assessment of the associations between O6-methyguanine-DNA methyltransferase (MGMT) promoter hypermethylation possessing low-grade intraepithelial lesion (LSIL), high-grade intraepithelial lesion (HSIL), cervical cancer (CC), and clinicopathological characters of CC. Methods: Literature selection were conducted through searching PubMed, Web of science, EMBASE, China National Knowledge Infrastructure and Wanfang databases (up to November 2018). An assessment of associations between MGMT methylation and LSIL, HSIL, CC risk and clinicopathological characteristics was performed through pooled odds ratios (ORs) with relevant 95% confidence intervals (CIs). Subgroup analyses, meta-regressions and Galbraith plots were conducted to conduct an exploration on the possible sources of heterogeneity. The genome-wide DNA methylation array studies were extracted from Gene Expression Omnibus (GEO) databases for validation of these outcomes. Results: In this meta-analysis of 25 published articles, MGMT hypermethylation gradually elevated the rates among control group (12.16%), LSIL (20.92%), HSIL (36.33%) and CC (41.50%) specimens. MGMT promoter methylation was significant associated with the increased risk of LSIL by 1.74-fold (P<0.001), HSIL by 3.71-fold (P<0.001) and CC by 7.08-fold (P<0.001) compared with control. A significant association between MGMT promoter methylation with FIGO stage was also found (OR = 2.81, 95% CI: 1.79–4.41, p<0.001). The results of GEO datasets showed that 5 CpG sites in MGMT with a great diagnostic value for the screening of cervical cancer. Conclusion: The meta-analysis indicated the association between MGMT promoter hypermethylation and squamous intraepithelial lesion and cervical cancer. MGMT methylation detection might have a potential value to be an epigenetic marker for the clinical diagnosis of cervical cancer. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that D-dimer levels are significantly correlated with the differential diagnosis and clinicopathological features of breast cancer. However, the results are currently limited and controversial. Therefore, we performed this meta-analysis to evaluate the relationship between D-dimer levels and breast cancer. Materials and methods: The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature, and Wanfang databases were searched to find studies that assessed the association of D-dimer with clinicopathological features of breast cancer and its usefulness in aiding with differential diagnosis. The standardized mean difference (SMD) was applied as the correlation measure. Results: A total of 1244 patients with breast cancer from 15 eligible studies were included in the meta-analysis. D-dimer levels were higher in the breast cancer group than in the benign (SMD = 1.02; 95% confidence interval [CI] = 0.53–1.52) and healthy (SMD = 1.27; 95% CI = 0.85–1.68) control groups. In addition, elevated D-dimer levels were associated with progesterone receptor-negative tumors (SMD = -0.25; 95% CI = -0.44–-0.05). Similarly, there was a significant correlation between D-dimer levels and tumor node metastasis staging (n = 11, SMD = 0.82; 95% CI = 0.57–1.06) and lymph node involvement (n = 8, SMD = 0.79; 95% CI = 0.50–1.09). In contrast, other clinicopathological factors, including estrogen receptor expression and human epidermal growth factor receptor 2 expression, were not associated with D-dimer levels. Conclusion: The results of this meta-analysis indicate that plasma D-dimer levels can be used as an important reference for the early identification and staging of breast cancer. [ABSTRACT FROM AUTHOR]

We undertook a systematic review of the diagnostic accuracy of artificial intelligence-based software for identification of radiologic abnormalities (computer-aided detection, or CAD) compatible with pulmonary tuberculosis on chest x-rays (CXRs). We searched four databases for articles published between January 2005-February 2019. We summarized data on CAD type, study design, and diagnostic accuracy. We assessed risk of bias with QUADAS-2. We included 53 of the 4712 articles reviewed: 40 focused on CAD design methods (“Development” studies) and 13 focused on evaluation of CAD (“Clinical” studies). Meta-analyses were not performed due to methodological differences. Development studies were more likely to use CXR databases with greater potential for bias as compared to Clinical studies. Areas under the receiver operating characteristic curve (median AUC [IQR]) were significantly higher: in Development studies AUC: 0.88 [0.82–0.90]) versus Clinical studies (0.75 [0.66–0.87]; p-value 0.004); and with deep-learning (0.91 [0.88–0.99]) versus machine-learning (0.82 [0.75–0.89]; p = 0.001). We conclude that CAD programs are promising, but the majority of work thus far has been on development rather than clinical evaluation. We provide concrete suggestions on what study design elements should be improved. [ABSTRACT FROM AUTHOR]

Background: Ageing is becoming a considerable public health burden in China, which produces great societal development challenges. Healthy and active longevity could ease the ageing burden on families and communities. To date, most studies of the oldest-old distribution are focused on a simple scale from spatial perspective, and the multi-scale spatio-temporal clusters trend in the oldest-old population has not yet been determined. Thus, the objective in present study is to use a new method to evaluate the spatio-temporal pattern and detect the risk clusters in the oldest-old population from three scales. Methods: Individuals aged 65 years or older and individuals aged 80 years or older on three scales in China from 2000 to 2010 were used. The exploratory spatial data analysis was performed using Moran’s I statistic, and the pattern of the oldest-old clusters among humans was examined by using the spatial scan statistical method. Then, spatial stratified heterogeneity was used to explore the factors affecting the spatial heterogeneity of the oldest-old population. Results: The oldest-old index in the southeast coastal areas is higher than that in the northwest inland areas in China. A three-ladder terrain distribution of the oldest-old index from west to east is obvious. The overall pattern of the oldest-old index evolves from a “concave” shape to an “east-west uplift, and northern collapse” shape. Space-time analysis revealed that high-risk areas were concentrated in five regions: the Yangtze River Delta, the Pearl River Delta, the Southeast Coast, Sichuan and Chongqing, and the Central Plains. The oldest-old cluster at different scales shows a similar pattern, but local differences exist. The risk at the prefecture scale and county scale is greater than at the interprovincial scale; the sublevel can identify clusters that have not been identified at the previous level, especially the bordering areas of prefectures and counties; and more risk units and greater relative risk are found in urban areas than in rural areas. Conclusions: The results emphasized that spatial scan statistics can be used to estimate the spatial clusters of the oldest-old people. The detection of these clusters might be highly useful in the surveillance of the ageing phenomenon, thus helping local public health authorities measure the population burden at all locations, identifying geographical areas that require more attention, and evaluating the impacts of intervention programs. [ABSTRACT FROM AUTHOR]

Tourist congestion at hot spots has been a major management concern for UNESCO World Heritage Sites and other iconic protected areas. A growing number of heritage sites employ technologies, such as cameras and electronic ticket-checking systems, to monitor user levels, but data collected by these monitoring technologies are often under-utilized. In this study, we illustrated how to integrate data from hot spots by camera-captured monitoring and entrance counts to manage use levels at a World Heritage Site in Southeastern China. 6,930 photos of a congestion hotspot (scenic outlook on a trail) were collected within the park at a 10-minute interval over 105 days from January to November 2017. The entrance counts were used to predict daily average and maximum use level at the hotspots. Results showed that the average use level at the congestion hotspot did not exceed the use limit mandated by the park administration agency. However, from 9:20 am to 12:00 pm, the use level at hotspots exceeded visitor preferred use level. Visitor use level was significantly higher at the hotspot during a major Chinese “Golden Week”. The daily entrance counts significantly predicted the average and maximum use level at the hotspot. Based on our findings, park managers can achieve the management goals by permitting the corresponding number of visitors passing the entrances. The gap manifested the complexities in visitor capacity management at high-use World Heritage Sites and other protected areas and calls for innovative monitoring and management strategies. [ABSTRACT FROM AUTHOR]

To tackle urban water issues, the Chinese government has promoted the construction of sponge cities in recent years. Thirty cities have been designated as experimental sites to serve as models for future sponge city construction, as more than 80% of the built-up urban areas in China must reach the standards of sponge cities by 2030. Greening plants play an important role in sponge cities, and water-use efficiency (WUE) is a vital index to determine whether plants could adapt to and grow healthily in environments with water deficits. In this study, WUE of greening plants was quantified by measuring the stable carbon isotope fractionation. Suitable plants for the green spaces in Guyuan sponge city, in northern China, were selected based on their WUE, and the main factors affecting WUE were studied in four habitats within the city. Plant species identity had the greatest effect on WUE, while habitat and plant life form had lower effect, illustrating that WUE is a relatively stable and reliable index for the classification of plant species. We can improve the WUE and ecological function of green spaces in sponge cities by using isotope technology to select suitable plant species with high WUE. To our knowledge, this study is the first to select plant species for sponge city by using this method, providing a quick and scientific method for the selection of greening plants for future sponge cities. [ABSTRACT FROM AUTHOR]

Bosten Lake is an important region of Northwest China that has transformed from a freshwater lake to a saltwater lake since the 1970s. The water quality in the Bosten Lake basin is important for social and economic development, and nitrogen (N) and phosphorus (P) are the key indicators of water quality. The land use data, precipitation data and Digital Elevation Model (DEM) data with the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model were used to simulate the N and P exports of the Bosten Lake basin. The spatial and temporal dynamics of nitrogen and phosphorus exports, and the response of nitrogen and phosphorus exports to land use change and precipitation change were analyzed between 2000 and 2015. The results show that the amount of N and P exports increased during 2000–2015, and the N and P exports are mainly distributed around Bosten Lake. The N and P exports are greatly affected by cultivated land, built-up areas and grassland, while they are less affected by other land use types. The high precipitation areas with small exports of N and P are mainly distributed in mountain areas, while small precipitation areas with large exports of N and P are distributed in plains where the cultivated land and built-up areas are concentrated. The InVEST model can be used in Northwest China, and the statistical downscaling of reanalysis precipitation data can be used in the InVEST model to improve the simulation accuracy in the data scarce regions of Northwest China. [ABSTRACT FROM AUTHOR]

Prior to the introduction of wheat and barley from Central Asia during the Neolithic period, northern Chinese agricultural groups subsisted heavily on millet. Despite being the focus of many decades of intensive interest and research, the exact route(s), date(s), and mechanisms of the spread and adoption of wheat and barley into the existing well-established millet-based diet in northern China are still debated. As the majority of the important introduced crops are C3 plants, while the indigenous millet is C4, archaeologists can effectively identify the consumption of any introduced crops using stable carbon isotope analysis. Here we examine published stable isotope and dental caries data of human skeletal remains from 77 archaeological sites across northern and northwestern China. These sites date between 9000 to 1750 BP, encompassing the period from the beginning of agriculture to wheat’s emergence as a staple crop in northern China. The aim of this study is to evaluate the implications of the spread and adoption of these crops in ancient China. Detailed analysis of human bone collagen δ13C values reveals an almost concurrent shift from a C4-based to a mixed C3/ C4– based subsistence economy across all regions at around 4500–4000 BP. This coincided with a global climatic event, Holocene Event 3 at 4200 BP, suggesting that the sudden change in subsistence economy across northern and northwestern China was likely related to climate change. Moreover, the substantially increased prevalence of dental caries from pre–to post–4000 BP indicates an increase in the consumption of cariogenic cereals during the later period. The results from this study have significant implications for understanding how the adoption of a staple crop can be indicative of large-scale environmental and socio-political changes in a region. [ABSTRACT FROM AUTHOR]

The reasons and processes that led hunter-gatherers to transition into a sedentary and agricultural way of life are a fundamental unresolved question of human history. Here we present results of excavations of two single-occupation early Neolithic sites (dated to 7.9 and 7.4 ka) and two high-resolution archaeological surveys in northeast China, which capture the earliest stages of sedentism and millet cultivation in the second oldest center of domestication in the Old World. The transition to sedentism coincided with a significant transition to wetter conditions in north China, at 8.1–7.9 ka. We suggest that these wetter conditions were an empirical precondition that facilitated the complex transitional process to sedentism and eventually millet domestication in north China. Interestingly, sedentism and plant domestication followed different trajectories. The sedentary way of life and cultural norms evolved rapidly, within a few hundred years, we find complex sedentary villages inhabiting the landscape. However, the process of plant domestication, progressed slowly over several millennia. Our earliest evidence for the beginning of the domestication process appear in the context of an already complex sedentary village (late Xinglongwa culture), a half millennia after the onset of cultivation, and even in this phase domesticated plants and animals were rare, suggesting that the transition to domesticated (sensu stricto) plants in affluent areas might have not played a substantial role in the transition to sedentary societies. [ABSTRACT FROM AUTHOR]

Objective: To investigate morbidity for patients after the primary surgical management of cervical cancer in low and middle-income countries (LMIC). Methods: The Pubmed, Cochrane, the Cochrane Central Register of Controlled Trials, Embase, LILACS and CINAHL were searched for published studies from 1st Jan 2000 to 30th June 2017 reporting outcomes of surgical management of cervical cancer in LMIC. Random-effects meta-analytical models were used to calculate pooled estimates of surgical complications including blood transfusions, ureteric, bladder, bowel, vascular and nerve injury, fistulae and thromboembolic events. Secondary outcomes included five-year progression free (PFS) and overall survival (OS). Findings: Data were available for 46 studies, including 10,847 patients from 11 middle income countries. Pooled estimates were: blood transfusion 29% (95%CI 0.19–0.41, P = 0.00, I2 = 97.81), nerve injury 1% (95%CI 0.00–0.03, I2 77.80, P = 0.00), bowel injury, 0.5% (95%CI 0.01–0.01, I2 = 0.00, P = 0.77), bladder injury 1% (95%CI 0.01–0.02, P = 0.10, I2 = 32.2), ureteric injury 1% (95%CI 0.01–0.01, I2 0.00, P = 0.64), vascular injury 2% (95% CI 0.01–0.03, I2 60.22, P = 0.00), fistula 2% (95%CI 0.01–0.03, I2 = 77.32, P = 0.00,), pulmonary embolism 0.4% (95%CI 0.00–0.01, I2 26.69, P = 0.25), and infection 8% (95%CI 0.04–0.12, I2 95.72, P = 0.00). 5-year PFS was 83% for laparotomy, 84% for laparoscopy and OS was 85% for laparotomy cases and 80% for laparoscopy. Conclusion: This is the first systematic review and meta-analysis of surgical morbidity in cervical cancer in LMIC, which highlights the limitations of the current data and provides a benchmark for future health services research and policy implementation. [ABSTRACT FROM AUTHOR]

Objective: Many studies focused on reasons behind the increasing incidence and the spread of human brucellosis in mainland China, yet most of them lacked comprehensive consideration with quantitative evidence. Hence, this study aimed to further investigate the epidemic mechanism and associated factors of human brucellosis so as to provide thoughts for future countermeasures in China and the rest of the world. Methods: Data of human brucellosis incidence and some associated factors in economy, animal husbandry, transportation as well as health and hygiene were collected at provincial level from 2005–2016. Time series plots were first used to visualize the annual incidence and annual rate of change of human brucellosis for each province, then cluster analysis categorized all the 31 provinces of mainland China based on their incidence time series during the study period. In addition, according to the characteristics of data, the dynamic panel data model in combination with supervised principal component analysis was proposed to explore effects of associated factors on human brucellosis. Results: 1. The incidence rate of human brucellosis in mainland China increased three-fold from 1.41 per 100,000 people in 2005 to 4.22 per 100,000 people in 2014, though it went down a little in 2015 and 2016. Incidence rates in the north have always been higher than those in the south, but the latter also experienced an upward trend especially between 2012 and 2016. 2. The 31 provinces of mainland China were categorized into three clusters, and each cluster had its own characteristics of incidence time series. 3. The impact of health and hygiene situations on the prevention and control work of human brucellosis was still very limited and trivial (regression coefficient = -0.02). Therefore, it was plausible to presume that improving the personal average number of medical institutes and the proportion of rural medical expenditure might be helpful in preventing and controlling human brucellosis. Conclusions: The epidemic status of human brucellosis has changed in both spatial and temporal dimensions in recent years in mainland China. Apart from traditional control measures, more attention should be paid to the improvement of medical healthcare especially in rural areas in the hope of enhancing the control effect. [ABSTRACT FROM AUTHOR]

Hand, foot, and mouth disease (HFMD) is well recognized as one of the major threats to children's health globally. The increasing complexity of the etiology of HFMD still challenges disease control in China. There is little surveillance of the molecular epidemiological characteristics of the enteroviruses (EVs) that cause HFMD in Neijiang city or the Sichuan Basin area in Southwest China. In this study, demographic and epidemiological information for 14,928 probable HFMD cases was extracted and analyzed to describe the epidemic features of HFMD in Neijiang city from Jan 2010 to Dec 2017. The swab samples of select probable HFMD cases from 2012 to 2017 were tested by reverse transcription (RT) real-time PCR to identify the serotype distribution of EVs, and 110 randomly selected RT-real-time PCR positive samples were then amplified and analyzed for the VP1 or VP4 regions of EVs to further analyze the phylogenetic characteristics of the circulating strains in this area. The eight-year average annual incidence was 49.82 per 100,000 in Neijiang. The incidence rates varied between 19.51 and 70.73 per 100,000, demonstrating peaks of incidence in even-number years (2012, 2014 and 2016). The median age of the probable cases was 27 months and the interquartile range (25th to 75th percentile) of ages for the probable HFMD cases was between 14 and 42 months. The male-to-female ratio of the probable HFMD cases was 1.47:1, and scattered children were the major population classification (81.7%). Two epidemic peaks were observed: one major peak between April and July and the other lesser peak between October and December. Of 6513 probable cases tested with RT-real-time PCR, 4015 (61.6%) were positive for enterovirus with the serotype distribution as follows: EV71+, 30.1% (n = 1210); CV-A16+, 28.7% (n = 1154) and a sole pan-enterovirus+, 41.1% (n = 1651). A total of 91 cases (82.7%, 91/110) were successfully amplified and underwent phylogenetic analysis: all EV71+ cases were C4a serotype (n = 23/30); all CV-A16+ cases were B2b serotype (n = 24/30); of 42 sole pan-enterovirus+ samples, 20 were CV-A6, 14 were CV-A10 and the rest within this group were CV-A4 (n = 4), CV-A8 (n = 2), CV-A9 (n = 1) and CV-B3 (n = 1). Our findings provide important evidence that aids the improvement of strategies for vaccination against HFMD and comprehensive disease control in China. [ABSTRACT FROM AUTHOR]

Accurately predicting reference evapotranspiration (ET0) with limited climatic data is crucial for irrigation scheduling design and agricultural water management. This study evaluated eight machine learning models in four categories, i.e. neuron-based (MLP, GRNN and ANFIS), kernel-based (SVM, KNEA), tree-based (M5Tree, XGBoost) and curve-based (MARS) models, for predicting daily ET0 with maximum/maximum temperature and precipitation data during 2001–2015 from 14 stations in various climatic regions of China, i.e., arid desert of northwest China (NWC), semi-arid steppe of Inner Mongolia (IM), Qinghai-Tibetan Plateau (QTP), (semi-)humid cold-temperate northeast China (NEC), semi-humid warm-temperate north China (NC), humid subtropical central China (CC) and humid tropical south China (SC). The results showed machine learning models using only temperature data obtained satisfactory daily ET0 estimates (on average R2 = 0.829, RMSE = 0.718 mm day−1, NRMSE = 0.250 and MAE = 0.508 mm day−1). The prediction accuracy was improved by 7.6% across China when information of precipitation was further considered, particularly in (sub)tropical humid regions (by 9.7% in CC and 12.4% in SC). The kernel-based SVM, KNEA and curve-based MARS models generally outperformed the others in terms of prediction accuracy, with the best performance by KNEA in NWC and IM, by SVM in QTP, CC and SC, and very similar performance by them in NEC and NC. SVM (1.9%), MLP (2.0%), MARS (2.6%) and KNEA (6.4%) showed relatively small average increases in RMSE during testing compared with training RMSE. SVM is highly recommended for predicting daily ET0 across China in light of best accuracy and stability, while KNEA and MARS are also promising powerful models. [ABSTRACT FROM AUTHOR]

Objectives: Nation-wide hepatitis B vaccination coverage among healthcare workers (HCWs) is not well researched in China. This study aims to investigate the self-reported hepatitis B vaccination status among HCWs in China. Methods: We conducted a cross-sectional survey of health_care workers’ vaccination statuses in 120 hospitals in China by collecting demographic and vaccination data. Univariate and multivariate logistic regression analysis were used to assess factors associated with hepatitis B vaccination coverage. Results: Eighty-six percent (2,666/3,104) of respondents reported having received at least one dose of the hepatitis B vaccination and 60% (1,853/3,104) reported having completed ≥3 doses of the hepatitis B vaccination. Factors associated with completing ≥3 doses of the hepatitis B vaccination included workplaces offering free hepatitis B vaccination with vaccination management, age, medical occupation, hospital level, acceptable hepatitis B knowledge and having received training on hepatitis B. HCWs in workplaces offering a free hepatitis B vaccine with vaccination management were 1.4 times more likely (OR = 1.4, 95% CI: 1.1–1.8) to complete their hepatitis B vaccination compared to HCWs in workplaces that did not offer a free hepatitis B vaccine. Either the possession of acceptable hepatitis B knowledge or an age of 30–39 years increased the odds of complete hepatitis B vaccination by 1.3-fold (95% CIs: 1.1–1.5 and 1.1–1.7, respectively) over their referent category. The receipt of training on hepatitis B was also associated with a higher percentage of completing the hepatitis B vaccination (OR = 1.5, 95% CI: 1.2–1.8). The main self-reported reason for incomplete hepatitis B vaccination was “forgot to complete follow-up doses” among 43% (234/547) of respondents. Among those who never received any hepatitis B vaccination, only 30% (131/438) intended to be vaccinated. Obtaining immunity from work (40%) and hospitals that did not provide hepatitis B vaccination activities (40%) were the top reasons mentioned for refusing hepatitis B vaccination. Conclusions: The complete hepatitis B vaccination rate among HCWs in China is low, and the desire of HCWs for vaccination is indifferent; therefore, education campaigns are needed. In addition, a free national hepatitis B vaccination policy for HCWs that includes vaccination management should be prioritized to improve hepatitis B coverage among HCWs who are at-risk for HBV infection. [ABSTRACT FROM AUTHOR]

The impact of environmental change on internal migration has received wide attention in recent years. Mass internal migration has been a significant economic and social phenomenon in China, and soil erosion is a major environmental problem that impacts sustainable socioeconomic development. This study aims to identify the impact of soil erosion on internal migration in China at the county level based on gravity model by analyzing related data, such as the sixth national population census data and the soil and water conservation survey data. The results of spatial overlay could not identify an obvious relationship between soil erosion and net outmigration in China. The traditional gravity model of migration is modified to analyze the impact of soil erosion on net outmigration while other variables are controlled. The results indicate that only serious soil erosion increases the possibility of outmigration and that the impact is considerably higher in agricultural counties than in non-agricultural counties. In general, the impact of soil erosion on internal migration is far less than the impact of socioeconomic factors. [ABSTRACT FROM AUTHOR]

Background: China has a substantial tuberculosis (TB) disease burden and an aging population. Seniors have a higher risk of developing TB disease compared to younger age groups. Active case finding (ACF) could help identify seniors with TB disease. Methods: From March to June 2017, we included ACF during annual physical check-ups for persons aged ≥ 65 years in Bayi, Sichuan Province. Seniors with clinical TB symptoms (i.e., cough lasting ≥ 2 weeks and/or hemoptysis) or one or more risk factors (e.g., previous TB disease, diabetes, and heavy alcohol consumption) were offered chest x-rays. We used acid-Fast Bacilli smear and solid culture laboratory testing for TB confirmation. We calculated the yield (i.e., cases identified among seniors screened) and cost per new each TB case detected. Focus group-interviews were conducted with health care workers and seniors to evaluate project acceptability. Participation rates and acceptability were used to assess feasibility. Results: Of the 2,393 seniors residing in Bayi, 2,049 (85.6%) were enrolled in the pilot project. Of these seniors, 794 (38.7%) presented with at least one TB risk factor and 74 (3.6%) had symptoms consistent with active TB disease. Three seniors (0.2%)–each presenting with at least one risk factor—were diagnosed with active TB. The project yielded 146 TB cases per 100,000 seniors screened; the cost per case detected was $4,897. Most workers supported ACF if additional resources and staff could be provided. Seniors appreciated the convenience of this integrated health service approach. Conclusions: Although the yield was lower than expected, ACF appeared feasible in Bayi. Targeting seniors with at least one known TB risk factor could help detect previously unidentified TB cases. However, similar projects in communities with a higher TB prevalence are needed to further evaluate the yield and required resources prior to implementation on a larger scale. Findings from our pilot project should be combined with data from these future ACF projects to improve TB screening criteria. [ABSTRACT FROM AUTHOR]

School socioeconomic status (SES) is studied primarily as a variable to explain academic achievement; however, few previous studies have investigated how SES can influence individual student's academic achievement. The present study used a national representative sample of 10,784 grade 7 to 9 students (53.2% boys and 46.8% girls) in mainland China to examine the links between school SES and students' math and Chinese achievements, including the math and Chinese teacher-student relationships as mediating factors. The parents provided family socioeconomic information and the students reported on their teacher-student relationships. Achievements in math and Chinese were assessed using standardized tests. Multilevel mediation analyses revealed that school SES was positively related to students' math and Chinese achievements. Moreover, the link between school SES and students' math achievement was partially mediated by students' perception of the math teacher-student relationship. The Chinese teacher-student relationship had no mediating effect. This study indicated that school SES can influence individual student's academic achievement via their perception of teacher-student relationship. The poverty and lack of resources is obvious, yet low SES schools could make efforts in improving teacher-student relationship's quality to promote students' academic performance. Meanwhile, low SES schools should receive more attention from policymakers to improve teaching quality and school climate. Furthermore, the study findings could be used for future research on the gap between low and high SES schools. [ABSTRACT FROM AUTHOR]

Hantaviruses can cause hantavirus pulmonary syndrome (HPS) in the Americas and hemorrhagic fever with renal syndrome (HFRS) in Eurasia. In recent decades, repeated outbreaks of hantavirus disease have led to public concern and have created a global public health burden. Hantavirus spillover from natural hosts into human populations could be considered an ecological process, in which environmental forces, behavioral determinants of exposure, and dynamics at the human–animal interface affect human susceptibility and the epidemiology of the disease. In this review, we summarize the progress made in understanding hantavirus epidemiology and rodent reservoir population biology. We mainly focus on three species of rodent hosts with longitudinal studies of sufficient scale: the striped field mouse (Apodemus agrarius, the main reservoir host for Hantaan virus [HTNV], which causes HFRS) in Asia, the deer mouse (Peromyscus maniculatus, the main reservoir host for Sin Nombre virus [SNV], which causes HPS) in North America, and the bank vole (Myodes glareolus, the main reservoir host for Puumala virus [PUUV], which causes HFRS) in Europe. Moreover, we discuss the influence of ecological factors on human hantavirus disease outbreaks and provide an overview of research perspectives. [ABSTRACT FROM AUTHOR]