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As China's urbanization accelerates, ecological environmental issues have become increasingly prominent, and how to achieve the synergistic development of urbanization and ecological environment is worth exploring. The paper uses the Super-SBM model and the improved entropy method to calculate the ecological efficiency and the new urbanization in 63 counties in Zhejiang Province from 2000 to 2019. Furthermore, the coupling coordination degree between new urbanization and ecological efficiency is discussed with the coupling degree model, Markov chain, and spatial correlation methods, and its influencing factors are explored by the geographic detector. The results show that: (1) The development trends of new urbanization and ecological efficiency in Zhejiang Province counties both present a "U" shape. Their inflection points appeared in 2005 and 2006, respectively. The gap between counties is gradually narrowing. (2) The coupling coordination degree between new urbanization and ecological efficiency in Zhejiang Province counties also develops in a "U" shape with the minimum value appearing in 2006. Its temporal evolution is dominated by advancement towards a higher level and maintenance of the original type, with most countries advancing from General Disorder to Preliminary Coordination. There is a good positive correlation in the spatial distribution, showing significant High-High and Low-Low agglomeration. (3) In detecting the driving factors, the explanatory power of economic development, natural conditions and social conditions diminishes sequentially. The interaction groups mostly are nonlinear enhancements, and the rest are all two-factor enhancements. Social factors are the main interaction objects. (4) The empirical analysis verified the efficacy of the "Two Mountains" theory and the importance of government investment in the regional coordinated development. [ABSTRACT FROM AUTHOR]

Most of the existing studies on maker-space focus on internal subjects (such as makers) or external factors (such as policy support, ecological environment, and more). There has been relatively little discussion on the design of a series of mechanisms of maker-space. This paper theorizes the operating mechanism for platform services, resource gathering, network connections and endogenous cultural protection for the maker-space. It uses the method of fuzzy set qualitative comparative analysis (fsQCA) to analyze data from 63 maker-spaces in Zhejiang Province. The study proposes a reasonable mechanism design scheme for maker-space. The results show that the innovativeness of a maker-space is the result of the synergistic effect of various operating mechanisms. Among them, the platform service function, the channel for gathering resources, the formal linkages, and the culture for sharing achievements are indispensable support mechanisms for maker-spaces. Two effective ways to promote innovation in maker-space are outlined: first, preventing interventions from external resource providers; second, building an inclusive culture of trial and error. [ABSTRACT FROM AUTHOR]

As more attention is given to green and sustainable industries, an analysis of the industrial impacts on all aspects of life, including inclusive affluence, is gradually developing. Idle rural residential land is a valuable resource and an important factor in promoting sustainable development. Balanced urban and rural development contributes to inclusive prosperity, so understanding the relationship between industry and the balanced development of urban and rural can significantly impact social development. In China, achieving the balanced development requires narrowing the urban-rural income gap. This paper analyzed the impact of reallocating idle rural residential land on promoting the balanced development. The study found that industry development has a positive impact on the balanced development, with a regression coefficient of 1.478. Regions with higher industry indices in counties had better outcomes regarding the balanced development. When the development of rural industry derived from idle residential land was in good condition, the effect increased by 3.326 percentage. The results showed heterogeneity, with the regression coefficient of industry development on the balanced development in county-level cities being 0.498 larger than in urban areas. In summary, the reallocation of idle residential land can promote sustainable development, increase residents' income, and improve overall regional economic development. The results are applicable to the comprehensive reallocation of rural land resources. [ABSTRACT FROM AUTHOR]

The employment of college students is an important issue that affects national development and social stability. In recent years, the increase in the number of graduates, the pressure of employment, and the epidemic have made the phenomenon of 'slow employment' increasingly prominent, becoming an urgent problem to be solved. Data mining and machine learning methods are used to analyze and predict the employment prospects for graduates and provide effective employment guidance and services for universities, governments, and graduates. It is a feasible solution to alleviate the problem of 'slow employment' of graduates. Therefore, this study proposed a feature selection prediction model (bGEBA-SVM) based on an improved bat algorithm and support vector machine by extracting 1694 college graduates from 2022 classes in Zhejiang Province. To improve the search efficiency and accuracy of the optimal feature subset, this paper proposed an enhanced bat algorithm based on the Gaussian distribution-based and elimination strategies for optimizing the feature set. The training data were input to the support vector machine for prediction. The proposed method is experimented by comparing it with peers, well-known machine learning models on the IEEE CEC2017 benchmark functions, public datasets, and graduate employment prediction dataset. The experimental results show that bGEBA-SVM can obtain higher prediction Accuracy, which can reach 93.86%. In addition, further education, student leader experience, family situation, career planning, and employment structure are more relevant characteristics that affect employment outcomes. In summary, bGEBA-SVM can be regarded as an employment prediction model with strong performance and high interpretability. [ABSTRACT FROM AUTHOR]

The Above Ground Biomass (AGB) of seaweeds is the most fundamental ecological parameter as the material and energy basis of intertidal ecosystems. Therefore, there is a need to develop an efficient survey method that has less impact on the environment. With the advent of technology and the availability of popular filming devices such as smartphones and cameras, intertidal seaweed wet biomass can be surveyed by remote sensing using popular RGB imaging sensors. In this paper, 143 in situ sites of seaweed in the intertidal zone of GouQi Island, ShengSi County, Zhejiang Province, were sampled and biomass inversions were performed. The hyperspectral data of seaweed at different growth stages were analyzed, and it was found that the variation range was small (visible light range < 0.1). Through Principal Component Analysis (PCA), Most of the variance is explained in the first principal component, and the load allocated to the three kinds of seaweed is more than 90%. Through Pearson correlation analysis, 24 parameters of spectral features, 9 parameters of texture features (27 in total for the three RGB bands) and parameters of combined spectral and texture features of the images were selected for screening, and regression prediction was performed using two methods: Random Forest (RF), and Gradient Boosted Decision Tree (GBDT), combined with Pearson correlation coefficients. Compared with the other two models, GBDT has better fitting accuracy in the inversion of seaweed biomass, and the highest R2 was obtained when the top 17, 17 and 11 parameters with strong correlation were selected for the regression prediction by Pearson's correlation coefficient for Ulva australis, Sargassum thunbergii, and Sargassum fusiforme, and the R2 for Ulva australis was 0.784, RMSE 156.129, MAE 50.691 and MAPE 28.201, the R2 for Sargassum thunbergii was 0.854, RMSE 790.487, MAE 327.108 and MAPE 19.039, and the R2 for Sargassum fusiforme was 0.808, RMSE 445.067 and MAPE 28.822. MAE was 180.172 and MAPE was 28.822. The study combines in situ survey with machine learning methods, which has the advantages of being popular, efficient and environmentally friendly, and can provide technical support for intertidal seaweed surveys. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the impact of village debt on land transfer. Based on the county-level panel data of village finance and land transfer in 90 counties and 4 economic development zones of Zhejiang Province from 2013 to 2017, this paper carried out multivariate statistical analysis and set a fixed effect model to control the endogenous influence of region and time. It found that village debt as a pressure may encourage village committees to promote rural land transfer, and then especially promote land flows into agricultural firms; as a mechanism, the burden of village organization's transactional debt (historical debt and administrative debt) is the key to promoting the rural land flow to agricultural enterprises; through further analysis, it is found that the village committee seeks "win-win" opportunities by intervening in land circulation to ensure the rights and interests of farmers and to obtain village benefits from them. This paper finds that this kind of push effect has the threshold, the debt will play a significant role in promoting when the debt rate is between 4.65% and 7.9%. In addition, there is regional heterogeneity in the contribution of debt, which exists only in plain, non-coastal and high-dependence areas. The results of this paper verify the view that "community mechanism and market mechanism are embedded and supported each other in acquaintance society" in the theory of community governance. In practice, it provides a realistic basis for policy makers to implement the policy of encouraging farmland circulation and properly deal with the problem of village debt. [ABSTRACT FROM AUTHOR]

Social and organizational innovations are one of the most effective ways to gain social collaboration for effective, rapid, and coordinated interventions. An analysis of the relationship among organizational performance (OP), social innovations (SI) and organizational innovation (OI) in social organizations (SOs) is little discussed in the literature and much less with main component analysis. This paper is an effort to provide some empirical evidences about social and organizational innovations that social organizations in China have implemented to address the social issues of the society. A survey of Chinese SO's is conducted during beginning two months of 2022 in provinces of Jiangsu, Guangdong and Zhejiang to attain the statistics and assessing the insights of the executives of the SOs participating in this study with respect to organizational performance, social and organizational innovations. The technique used to select the sample is a non-probabilistic sampling and multiple linear regression model is applied to determine the partial impact of organizational innovations and social innovations on the organizational performance. The grouping of the variables is carried out through main components analysis. The empirical findings of the study highlight that Chinese SOs are innovative because they adopt management strategies to address the social issues associated with their institutional mission. There are four groups of derived components from organizational and social innovations based on the empirical evidence: SO's innovative activities to modify the environment; inside innovative measures to enhance SO's performance; innovative activities of SO's to enhance their relationships with outside actors; innovative measures to improve the management of SOs related to their mission and institutional projects. The findings of this study offer an efficient solution to government and policy makers for involving SOs in terms of planning of social development in China. The social and organizational innovations are very necessary to overcome the social issues so government should encourage the establishment and sustainability of social organizations. [ABSTRACT FROM AUTHOR]

Based on the perspective of ecology and innovation management, this paper selects seven elements from two aspects, innovation subject and innovation environment, to construct the evaluation index system for the health of pharmaceutical innovation ecological rainforest in Zhejiang from 2011 to 2019, together with the entropy weighted TOPSIS method and the obstacle factor diagnosis model. We find that the health of the pharmaceutical industry in Zhejiang can be measured as three stages: stagnation period, recovery period and development period. There is a relative balance between the development of innovation subject and innovation environment. The resilience of innovation subjects, followed by economic and cultural environment, is the key factor hindering the innovation of pharmaceutical industry in Zhejiang. Finally, we propose four countermeasures, including "deploying high-level service chains, broadening investment and financing channels for enterprises, building a reservoir of global talents, and creating an inclusive and open soft environment". [ABSTRACT FROM AUTHOR]

In China, rapid urbanization and the decline of the canal's shipping function have directly led to the decline of the space and style of ancient towns with canals. The ancient town of Xixing, known to be the first canal town, is located west of the Zhedong canal section of the Grand Canal. It used to be the most active transportation hub and trade transit point in the east Zhejiang Province. However, the canal is now facing problems in protection and renewal, which require urgent attention. For example, the streets of the ancient town are separated from the water system space, the self-organizing and development ability of the ancient town has weakened, and the spatial vitality is scarce. Firstly, by comparing and analyzing whether the canal is used as a road network under two different spatial scales, the area with the highest degree of spatial integration is obtained before judging whether the canal has an important influence and control on the street spaces of the ancient town. Secondly, as the canal is no longer used as a transportation network nowadays, the internal spatial structure characteristics of streets and alleys are analyzed. Finally, the topological structure analysis is carried out in the 3 km area from the border of the planning control area, and the integrated development of the ancient town space and urban transportation network is then discussed. Further, the vitality renewal strategies of the ancient town under different spatial scales are put forward to provide the empirical basis and decision-making reference for the better sustainable development of ancient towns with canals. According to research, once the ancient town is considered on a larger urban scale, the areas with the best integration and accessibility, like the water-adjoined spaces change to intersection spaces and urban road network areas. Consequently, in order to realize the sustainable development of Xixing ancient town, the city system must overcome its shortfalls in operation. The methods and conclusions in the paper can effectively contribute to the development of the ancient town. The research significantly helps to improve the average land sharing, commercial distribution, and public facilities layout in the practice of protection and development in ancient towns and provides an empirical basis and decision-making references for relevant management departments. [ABSTRACT FROM AUTHOR]

Brucellosis is a bacterial disease caused by brucella; mainly spread by direct contact transmission through the brucella carriers, or indirect contact transmission by the environment containing large quantities of bacteria discharged by the infected individuals. At the beginning of 21st century, the epidemic among dairy cows in Zhejiang province, began to come back and has become a localized prevalent epidemic. Combining the pathology of brucellosis, the reported positive data characteristics, and the feeding method in Zhejiang province, this paper establishes an dynamic model to excavate the internal transmission dynamics, fit the real disease situation, predict brucellosis tendency and assess control measures in dairy cows. By careful analysis, we give some quantitative results as follows. (1) The external input of dairy cows from northern areas may lead to high fluctuation of the number of the infectious cows in Zhejiang province that can reach several hundreds. In this case, the disease cannot be controlled and the infection situation cannot easily be predicted. Thus, this paper encourages cows farms to insist on self-supplying production of the dairy cows. (2) The effect of transmission rate of brucella in environment to dairy cattle on brucellosis spreading is greater than transmission rate of the infectious dairy cattle to susceptible cattle. The prevalence of the epidemic is mainly aroused by environment transmission. (3) Under certain circumstances, the epidemic will become a periodic phenomenon. (4) For Zhejiang province, besides measures that have already been adopted, sterilization times of the infected regions is suggested as twice a week, and should be combined with management of the birth rate of dairy cows to control brucellosis spread. [ABSTRACT FROM AUTHOR]

Objective: The aim was to develop a predictive tool for anticipating postpartum endometritis occurrences and to devise strategies for prevention and control. Methods: Employing a retrospective approach, the baseline data of 200 women diagnosed with postpartum endometritis in a tertiary maternity hospital in Zhejiang Province, spanning from February 2020 to September 2022, was examined. Simultaneously, the baseline data of 1,000 women without endometritis during the same period were explored with a 1:5 ratio. Subsequently, 1,200 women were randomly allocated into a training group dataset and a test group dataset, adhering to a 7:3 split. The selection of risk factors for postpartum endometritis involved employing random forests, lasso regression, and traditional univariate and multifactor logistic regression on the training group dataset. A nomogram was then constructed based on these factors. The model's performance was assessed using the area under the curve (AUC), calculated through plotting the receiver operating characteristic (ROC) curve. Additionally, the Brier score was employed to evaluate the model with a calibration curve. To gauge the utility of the nomogram, a clinical impact curve (CIC) analysis was conducted. This comprehensive approach not only involved identifying risk factors but also included a visual representation (nomogram) and thorough evaluation metrics, ensuring a robust tool for predicting, preventing, and controlling postpartum endometritis. Results: In the multivariate analysis, six factors were identified as being associated with the occurrence of maternal endometritis in the postpartum period. These factors include the number of negative finger tests (OR: 1.159; 95%CI: 1.091–1.233; P < 0.05), postpartum hemorrhage (1.003; 1.002–1.005; P < 0.05), pre-eclampsia (9.769; 4.64–21.155; P < 0.05), maternity methods (2.083; 1.187–3.7; P < 0.001), prenatal reproductive tract culture (2.219; 1.411–3.47; P < 0.05), and uterine exploration (0.441; 0.233–0.803; P < 0.001).A nomogram was then constructed based on these factors, and its predictive performance was assessed using the area under the curve (AUC). The results in both the training group data (AUC: 0.803) and the test group data (AUC: 0.788) demonstrated a good predictive value. The clinical impact curve (CIC) further highlighted the clinical utility of the nomogram. Conclusion: The development of an individualized nomogram for postpartum endometritis infection holds promise for doctors in screening high-risk women, enabling early intervention and ultimately reducing the rate of postpartum endometritis infection. This comprehensive approach, integrating key risk factors and predictive tools, enhances the potential for timely and targeted medical intervention. [ABSTRACT FROM AUTHOR]

Rising income inequality challenges economic and social stability in developing countries. For China, the fastest-growing global digital economy, it could be an effective tool to promote inclusive development, narrowing urban–rural income disparity. It investigates the role of digital financial inclusion (DFI) in narrowing the urban–rural income gap. The study uses panel data from 52 counties in Zhejiang Province, China, from 2014 to 2020. The results show that the development of DFI significantly reduces rural–urban and rural income inequality. The development of DFI helps optimize industrial structure and upgrade the internal structure of agriculture, facilitating income growth for people in rural areas. Such effects are greater in poorer counties. Our findings provide insights into why rapid DFI and the narrowing of the rural–urban income disparity exist in China. Moreover, our results provide clear policy implications on how to reduce the disparity. The most compelling suggestion is that promoting the optimization of industrial structure through DFI is crucial for narrowing the urban–rural income gap. [ABSTRACT FROM AUTHOR]

Female entrepreneurs have irreplaceable status and essential significance in entrepreneurship research. Improving females' entrepreneurial intentions is an important topic in this area. Accordingly, this study, based on the theory of planned behavior, investigates the factors that affect female students' entrepreneurial intention at China's vocational colleges and whether household income moderates the relationship between entrepreneurial education, attitude, competence, self-efficacy and entrepreneurial intention. 2149 females from vocational colleges in Guangdong Province, Zhejiang Province, and Jiangxi Province were randomly chosen to participate in the study. They had taken part in entrepreneurial courses throughout 2021–2022. In addition, data were analyzed by structural equation modeling partial least squares. The results demonstrate that entrepreneurial education did not directly affect female students' intentions. Entrepreneurial competence, self-efficacy, and attitude positively affect entrepreneurial intention. It is further concluded that household income significantly moderates the relationship between entrepreneurial education, attitude, competence, and intention. However, there is no significant difference in the relationship between self-efficacy and entrepreneurial intention between high and low-household-income students. While females continue to confront sexism in the workplace, it is crucial that we conduct empirical research into the factors influencing female entrepreneurial intention to boost economic growth and gender parity. This research helps bridge a gap in the prior literature and adds substantial value to encouraging female entrepreneurs. [ABSTRACT FROM AUTHOR]

Improving agricultural total factor productivity is crucial for comprehensive rural revitalization and building a strong agricultural nation. Digital inclusive finance amalgamates the benefits of digital technology and inclusive finance, mitigating financial exclusion in agricultural production. It fosters rural revitalization and the modernization of agriculture by bolstering farmers' innovation, entrepreneurship, and agricultural technology advancements. Consequently, it significantly enhances overall agricultural total factor productivity. This study uses panel data from 2011 to 2020 to empirically investigate the impact and mechanism of digital inclusive finance on agricultural total factor productivity in Zhejiang Province, China. The research results show that digital inclusive finance significantly enhances agricultural total factor productivity in Zhejiang Province, which holds true even after a series of robustness tests. Analysis of the mechanism reveals that the integrated development of rural industries plays a crucial mediating role in empowering agricultural total factor productivity through digital inclusive finance. Furthermore, heterogeneity analysis indicates that the positive effect of digital inclusive finance on agricultural total factor productivity is more pronounced in the northeastern region of Zhejiang Province and in areas ranked in the second tier of agricultural development. Therefore, we recommend comprehensively enhancing the development of digital inclusive finance in rural areas, fostering a financial ecosystem that integrates rural industries, promoting the coordinated development of digital inclusive finance in different regions, and comprehensively improving agricultural total factor productivity. [ABSTRACT FROM AUTHOR]

The digital economy is a new impetus to promote high-quality economic development. We use the policies of Zhejiang Information Economy Development Demonstration Base (IEDD) and Zhejiang Software and Information Service Industry Base (SISI) established between 2015 and 2017 to design a quasi-natural experiment. By using a panel data from 2005 to 2020 in Zhejiang and the difference-in-differences model, we test the impacts of IEDD and SISI policies on digital economy development. We find that there are significant spatial differences for digital economy in Zhejiang. IEDD and SISI policies improve the digital economy development, that is, the policy advantages can indeed be transformed into industrial advantages. The IEDD policy can promote the digital economy industry development by enhancing the digital infrastructure and financial development; SISI policy can promote the development of the digital economy industry by promoting financial development. The results of quantile regression show that the promotion effect of IEDD and SISI policies increases with the improvement of the industrial basis of regional digital economy. The results of group regression show that the IEDD policy promotes the digital economy development in counties and county-level cities of Zhejiang, and the SISI policy plays a significant role in municipal districts. [ABSTRACT FROM AUTHOR]

Styrax, the balsam refined from the trunk of Liquidambar orientalis Mill. has a variety of applications in the perfumery and medical industry, especially for use in traditional Chinese medicine. However, the resources of styrax are in shortage due to being endangered of this plant. Grafting can improve the adaptability of plants to unfavorable environmental conditions. We tried to graft the L. orientalis Mill. on L. formosana Hance which was widely distributed in Jiangsu and Zhejiang provinces of China in an attempt to obtain styrax from grafted L. orientalis Mill. (grafted styrax, SG). Whether SG can become an alternative application of commercially available styrax (SC) need be further investigated. The components of SG were analyzed by GC-MS, and the results showed that the chromatograms of SG, SC, and styrax standard (SS) were consistent. The ration of 12 major chemical components based peak area in SG, SC, and SS were 93.95%, 94.24%, and 95.86% respectively. The assessment of toxicity, antithrombotic activity, and myocardial infarction protection of SG and SC was evaluated by using the zebrafish model, the results showed that SG and SC have the similar toxicological properties as evidenced by acute toxicity test, developmental toxicity and teratogenicity, and long-term toxicity test. Both SG and SC significantly decreased the thrombosis and increased blood flow velocity of zebrafish induced by adrenaline hydrochloride, inhibited myocardial apoptosis, myocardial infarction and myocardial inflammation in zebrafish induced by isoproterenol hydrochloride. Moreover, SG had an obvious improvement effect on cardiac output, while SC has no effect. Collectively, SG is similar to SC in chemical composition, toxicological properties, antithrombotic activity, and myocardial infarction protection effects, and may be used as a substitute for styrax to reduce the collection for wild L. orientalis Mill. and increase the available styrax resources. [ABSTRACT FROM AUTHOR]

Background: Pulmonary rehabilitation (PR) has been recognized to be an effective therapy for chronic obstructive pulmonary disease (COPD). However, in China, the application of PR interventions is still less promoted. Therefore, this cross-sectional study aimed to understand COPD patients' intention to receive PR, capture the potential personal, social and environmental barriers preventing their willingness of receiving PR, and eventually identify demanding PR services with the highest priority from patients' point of view. Methods: In total 237 COPD patients were recruited from 8 health care facilities in Zhejiang, China. A self-designed questionnaire was applied to investigate patients' intention to participate in PR and potentially associated factors, including personal dimension such as personal awareness, demographic factors, COPD status and health-related literacy/behaviors, as well as social policies and perceived environmental barriers. The demand questionnaire of PR interventions based on the Kano model was further adopted. Results: Among the 237 COPD patients, 75.1% of COPD patients were willing to participate in PR interventions, while only 62.9% of the investigated patients had heard of PR interventions. Over 90% of patients believed that the cost of PR services and the ratio of medical insurance reimbursement were potential obstacles hindering them from accepting PR services. The multiple linear regression analysis indicated that the PR skills of medical staff, knowledge promotion and public education levels of PR in the community, patients' transportation concerns and degree of support from family and friends were significantly associated with willingness of participation in PR interventions. By using the Kano model, the top 9 most-requisite PR services (i.e., one-dimensional qualities) were identified from patients' point of view, which are mainly diet guidance, education interventions, psychological interventions and lower limb exercise interventions. Subgroup analysis also revealed that patients' demographics, such as breathlessness level, age, education and income levels, could influence their choice of priorities for PR services, especially services related to exercise interventions, respiratory muscle training, oxygen therapy and expectoration. Conclusions: This study suggested that PR-related knowledge education among patients and their family, as well as providing basic package of PR services with the most-requisite PR items to COPD patients, were considerable approaches to promote PR attendance in the future. [ABSTRACT FROM AUTHOR]

Taking 27 cities in the Yangtze River Delta as an example, the time section data from 2009 to 2019 are selected, and the location entropy index and the modified E-G index are introduced to measure the collaborative agglomeration level of intercity manufacturing industry in the Yangtze River Delta. The spatial weight matrix is constructed based on the highway mileage between cities. Using Moran's index and Local Moran's index, this article analyzes the spatial correlation of the collaborative agglomeration level of intercity manufacturing industry in the Yangtze River Delta. The results show that: Firstly, the overall agglomeration degree of manufacturing industry of cities in the Yangtze River Delta shows a fluctuating downward trend. The agglomeration degree of manufacturing industry in Jiangsu and Zhejiang Provinces has decreased, that of most cities in Anhui Province has increased steadily. Secondly, the collaborative agglomeration level of manufacturing industry between Shanghai, Nanjing, Hangzhou and other cities in Jiangsu and Zhejiang Provinces showed a downward trend, while the collaborative agglomeration level with Anhui cities increased steadily. The collaborative agglomeration level of manufacturing industry between Wuxi, Suzhou, Nanjing and cities with obvious advantages in manufacturing industry agglomeration degree shows an upward trend, while the collaborative agglomeration level with other cities has declined. The collaborative agglomeration level of intercity manufacturing industry in Hefei has generally improved, especially the collaborative agglomeration quality and depth of manufacturing industry between Hefei and other cities in Anhui Province have significantly improved. Thirdly, the regions with high collaborative agglomeration level of intercity manufacturing industry in the Yangtze River Delta are still mainly concentrated in Jiangsu and Zhejiang Provinces. Although there has been a trend of westward transfer in the past decade, the overall change range is small, and the spatial correlation of the collaborative agglomeration level of intercity manufacturing industry shows a weakening trend as a whole. [ABSTRACT FROM AUTHOR]

To reveal the effect pattern of expressways on regional soil moisture, in this study, using trend analysis and buffer zone analysis methods, the data of VSWI (vegetation supply water index) in central Zhejiang Province from 2005 to 2016 were extracted from landsat7 satellite data using a single window algorithm, and spatial analysis was used to investigate the law of its differentiation. The results show that the multi-year average is 0.01879, between 0.01035–0.02774, showing a gentle decreasing trend, and there are obvious regional variations in space. We found that the impact of the new expressway and interchange on the VSWI in the buffer zone lasted for more than two years, and the VSWI increased in space farther away from the road, and this trend returned to normal at 8 km. Finally, the development patterns of the VSWI in the buffer zone of the newly established expressway and the interchange are approximately the same. [ABSTRACT FROM AUTHOR]

The spatial layout of the coastal forts defense system of the Ming Dynasty of China has been studied in a relatively comprehensive way. Nonetheless, ancient defense mechanisms have not been fully revealed. Previous studies have focused more on the macro and meso levels. Studies into its microscopic construction mechanism need to be enhanced. This research attempts to quantify and validate the rationality of the ancient microscopic defense mechanism, using the ancient defense mechanism of Pu Zhuang Suo-Fort in Zhejiang Province as an instance. This study concentrates on the distribution of firepower strength beyond the walls of coastal defense forts, as well as the effect of wall height on firepower defense capabilities. There is a specific firepower attenuation area near the walls due to the firing blind area in the coastal forts defense system. And the construction of the moat plays an additive role in its defensive capability. Meanwhile, the height of the fort wall will also affect the range of the firing blind zone under Yangmacheng. In theory, there is a reasonable height range of the wall and a proper position of the moat. This height range can meet both good economy and defensive capabilities. In turn, the position of the moats and the height of the walls can verify the rationality of the construction mechanism of the coastal forts' defense system. [ABSTRACT FROM AUTHOR]

Information consumption is a kind of economic activity that directly or indirectly takes information products and information services as consumption objects. Most of the existing studies have established the "formula" of rural information consumption in promoting economic and social development, while few efforts have been devoted to study the quantitative reciprocities between them. Therefore, this study aims to investigate the relationship between information consumption in rural areas and regional economic development with a case study of Zhejiang, China. Based on rural information consumption-related indexes, basic geographic data, and other publicly available regional economic development related data, we conduct the exploration with the spatial Durbin model (SDM). The study indicates that (1) from the perspective of spatial analysis, the economic development level of all prefecture-level cities in Zhejiang, China has a significant positive spatial correlation; (2) in rural areas, the network infrastructure improvement, information industry clustering, etc. can accelerate enhancing information consumption and promote regional economic development; and (3) facilitate the development of rural information consumption is conducive to alleviate the imbalance of regional economic development. It is hoped that our study can help understand the current situation of information consumption in rural China and provide a theoretical reference for rural economic and social development. [ABSTRACT FROM AUTHOR]

To measure the effects of air pollution on human activities, this study applies statistical/econometric modeling to hourly data of 9 million mobile phone users from six cities in China's Zhejiang Province from December 18 to 21, 2013. Under a change in air quality from "Good" (Air Quality Index, or AQI, between 51 and 100) to "Heavily Polluted" (AQI between 201 to 300), the following effects are demonstrated. (i) Consistent with the literature, for every one million people, 1, 482 fewer individuals are observed at parks, 95% confidence interval or CI (−2, 229, −735), which represents a 15% decrease. (ii) The number of individuals at shopping malls has no statistically significant change. (iii) Home is the most important location under worsening air quality, and for every one million people, 63, 088 more individuals are observed at home, 95% CI (47, 815, 78, 361), which represents a 19% increase. (iv) Individuals are on average 633 meters closer to their home, 95% CI (529, 737); as a benchmark, the median distance from home ranges from 300 to 1900 meters across the cities in our sample. These effects are not due to weather or government regulations. We also provided provisional evidence that individuals engage in inter-temporal activity substitutions within a day, which leads to mitigated (but not nullified) effects of air pollution on daily activities. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the effects of leader-member exchange (LMX) on job and life satisfaction among nurses in China and to examine the mediating effect of individual and collaborative job crafting between LMX and job and life satisfaction. The study recruited 263 nurses who worked in hospitals in Zhejiang province, China. A set of self-administered questionnaires were used to measure the variables of LMX, job crafting, job and life satisfaction. The data was analyzed using the partial least square structural equation modelling (PLS-SEM). The results reveal that LMX has a significant positive influence on job crafting and job satisfaction. Collaborative job crafting has a significant positive influence on the job satisfaction of nurses, whereas individual job crafting does not. Moreover, LMX will affect job satisfaction and life satisfaction through a partial mediating effect of both individual and collaborative job crafting. Finally, the article discusses the academically and practical implications, and also provide some suggestions and directions for the future research. [ABSTRACT FROM AUTHOR]

To analyze the results of HIV screening and the HIV-positive rate based on different HIV detection strategies in Zhejiang Province, China. Data were downloaded from the AIDS Prevention and Control Information System on May 1, 2019. HIV screening, prevalence, and incidence data were analyzed from 2008 to 2018. The incidence of HIV was calculated from the results of BED testing. SPSS software (ver. 19.0) was used for the analysis. The number of people screened for HIV increased by 229.7% from 2008 to 2018, while the incidence of HIV increased from 1.14‱ (2010) to 1.67‱ (2018), peak by 2015 (2.28‱). The proportion of people screened for HIV in medical institutions increased from 62.0% in 2008 to 67.1% in 2018, while of all positive tests, 47.9% were conducted at medical institutions in 2008, which increased to 63.2% in 2018. VCT and STD clinic attendees, who had only 4.5% of all those undergoing HIV tests, accounted for 23.7% of all HIV positive in 2018. The rate of HIV-positive people and incidence of HIV both increased in Zhejiang Province between 2008 and 2015. The most effective strategy for detecting HIV new cases is screening visitors to VCT and STD clinics. [ABSTRACT FROM AUTHOR]

Jinyunpelta sinensis is a basal ankylosaurine dinosaur excavated from the mid Cretaceous Liangtoutang Formation of Jinyun County, Zhejiang Province, China. In the present study, its dental microwear was observed using a confocal laser microscope. Jinyunpelta had steep wear facets that covered most of buccal surfaces of posterior dentary teeth. Observation of dental microwear on the wear facet revealed that scratch orientation varied according to its location within the wear facet: vertically (i.e. apicobasally) oriented scratches were dominant in the upper half of the wear facet, and horizontally (i.e. mesiolaterally) oriented ones were in the bottom of the facet. These findings indicated that Jinyunpelta adopted precise tooth occlusion and biphasal jaw movement (orthal closure and palinal lower jaw movement). The biphasal jaw movement was widely observed among nodosaurids, among ankylosaurids, it was previously only known from the Late Cretaceous North American taxa, and not known among Asian ankylosaurids. The finding of biphasal jaw movement in Jinyunpelta showed sophisticate feeding adaptations emerged among ankylosaurids much earlier (during Albian or Cenomanian) than previously thought (during Campanian). The Evolution of the biphasal jaw mechanism that contemporaneously occurred among two lineages of ankylosaurs, ankylosaurids and nodosaurids, showed high evolutionary plasticity of ankylosaur jaw mechanics. [ABSTRACT FROM AUTHOR]

Dental caries is one of the most common infectious diseases affecting 6–8-year-old children, especially their first permanent molars (FPMs). This study explored the prevalence of dental caries on FPMs by analyzing the oral health status of 1,423,720 children aged 6–8 years in Zhejiang Province, China. The data were extracted from the dental electronic records of the schoolchildren attending the Oral Health Promotion Project (OHPP), conducted during 2013–2017 in Zhejiang Province. Multiple logistic regression models were used to determine the factors affecting dental caries. Boys and girls accounted for 53.2% and 46.8% of the subjects, respectively. From 2013 to 2017, the prevalence of dental caries on FPMs increased: 2013: 20.4%; 2014: 25.3%; 2015: 24.5%; 2016: 27.0%; and 2017: 29.0%, despite the OHPP conducted. Based on multiple logistic regression model, girls had a significantly higher risk of FPM caries compared to boys (OR = 1.38, 95% CI: 1.37–1.39, p < 0.0001); compared with the caries rates in urban areas, the caries risk was significantly higher in rural areas (OR = 1.15, 95% CI: 1.14–1.16, p < 0.0001). In terms of geographic location in Zhejiang Province, the odds ratios of the caries risk of the east, south, west, and north were 1.35 (1.33–1.36), 1.3 (1.28–1.31), 0.81 (0.8–0.83), and 0.82 (0.81–0.84), respectively (p < 0.0001), by considering the central region as a reference. The caries prevalence of FPMs was high, with an increasing tendency and gender, social, cultural, and environmental factors affecting the caries prevalence. [ABSTRACT FROM AUTHOR]

A new nematode species of the genus Phasmarhabditis was isolated from the body surface of a slug (Philomycus bilineatus Benson, PB). Morphological and molecular analyses confirmed this nematode as a new species. The nematode was named Phasmarhabditis zhejiangensis sp. nov. (Nematoda: Rhabditidae) and is dioecious. In males, the open bursa with genital papillae is characterized by the formula 1-1-1-2-1-3, and the spicule length is 58μm. In female, the vulva is located approximately in the middle of the body. The nematode belongs to papillosa group because of its tail shape pointed with filiform tip. The phasmids are rod-shaped. The posterior anus is slightly swollen. P. zhejiangensis was further characterized by internal transcribed spacer (ITS), 18S rDNA and 28S rDNA sequences. After the sequencing results were compared with sequences available from the National Center for Biotechnology Information (NCBI), the maximum similarities of ITS, 18S and 28S sequences were 89.81%, 96.22% and 95.28%, respectively. Phylogenetic analyses placed Phasmarhabditis zhejiangensis sp. nov. in the genus Phasmarhabditis. [ABSTRACT FROM AUTHOR]

Background: The number of dengue fever (DF) cases and the number of dengue outbreaks have increased in recent years in Zhejiang Province, China. An unexpected dengue outbreak was reported in Hangzhou in 2017 and caused more than one thousand dengue cases. This study was undertaken to evaluate the effectiveness of the actual control measures, estimate the proportion of inapparent infections during this outbreak and simulate epidemic development based on different levels of control measures taking inapparent infections into consideration. Methods: The epidemic data of dengue cases in Hangzhou, Zhejiang Province, in 2017 and the number of the people exposed to the outbreaks were obtained from the China Information Network System of Disease Prevention and Control. The epidemic without intervention measures was used to estimate the unknown parameters. A susceptible-exposed-infectious/inapparent-recovered (SEIAR) model was used to estimate the effectiveness of the control interventions. The inapparent infections were also evaluated at the same time. Results: In total, 1137 indigenous dengue cases were reported in Hangzhou in 2017. The number of indigenous dengue cases was estimated by the SEIAR model. This number was predicted to reach 6090 by the end of November 2, 2017, if no control measures were implemented. The total number of reported cases was reduced by 81.33% in contrast to the estimated incidence without intervention. The number of average daily inapparent cases was 10.18 times higher than the number of symptomatic cases. The earlier and more rigorously the vector control interventions were implemented, the more effective they were. The results showed that implementing vector control continuously for more than twenty days was more effective than every few days of implementation. Case isolation is not sufficient enough for epidemic control and only reduced the incidence by 38.10% in contrast to the estimated incidence without intervention, even if case isolation began seven days after the onset of the first case. Conclusions: The practical control interventions in the outbreaks that occurred in Hangzhou City were highly effective. The proportion of inapparent infections was large, and it played an important role in transmitting the disease during this epidemic. Early, continuous and high efficacy vector control interventions are necessary to limit the development of a dengue epidemic. Timely diagnosis and case reporting are important in the intervention at an early stage of the epidemic. [ABSTRACT FROM AUTHOR]

To study the relationship between the glazed pottery from southern China and the lead-glazed pottery in northern China in the Han Dynasty (202BC-220AD), 34 samples unearthed from Shangyu(上虞), Zhejiang Province have been studied by LA-ICP-AES, SEM/EDS and XRD. The results showed that these samples included the typical lead-glazed pottery, the proto-porcelain and the glazed pottery using both lead and calcium as glaze fluxing agents. Previously, the lead-glazed pottery type was considered as the main northern products during the Han dynasty while the calcium-glazed pottery type or the proto-porcelain was the representative of the south of China. However, apart from the two typical types above, a new variety of glaze categorized as the calcium-lead glaze was discovered in the samples from Shangyu. This indicates that there were technology exchanges and amalgamation of lead-glaze and calcium-glaze between the south and the north during the Han Dynasty. As a result, a new type of glazed potteries with both features was created, which had a more beautiful appearance than the proto-porcelain but perhaps had some undesirable aspects. The manufacturing process of the new variety might also lay foundations for the invention of celadon. [ABSTRACT FROM AUTHOR]

Background: Dengue is one of the most important vector-bore infectious diseases in China because of its drastic increase in incidence, geographic extension and profound influence on China’s economy. This study aims to retrospectively uncover the epidemiological profile of dengue in Zhejiang, one of the most developed provinces in China, and to find the problem existing in dengue control and prevention. Methodology: Descriptive analyses on the dengue incidence and associated factors were performed. We also identified potential space-time cluster and generated the risk map of dengue. Principal findings: A total of 529 cases were reported in Zhejiang Province from 2005 to 2016, and 44.4% were imported. 67.7% of cases were 25~60 years old and the overall male-to-female sex ratio was 1.09:1. Dengue was reported all year round and 70.7% of cases occurred between August and October. Indigenous cases were only reported in the period between July to November and more than half occurred in September. Geographically, dengue was most distributed in Jinghua (3.62 per million), Shaoxing (1.00 per million) and Taizhou (0.81 per million) prefecture level cities. Outbreaks were confirmed in Yiwu, Keqiao and Huangyan counties in 2009, 2015, and 2016, respectively. 73.9% cases would seek medical advice within two days after onset and be confirmed within 9 days after onset. 75.6% would be recognized as dengue within 8 days after their first visit. The time intervals between onset and confirmation (median 7 vs 6 days; Wilcoxon rank sum test Z = -2.40, P = 0.016), first visit and confirmation (median 7 vs 6 days; Wilcoxon rank sum test Z = -2.59, P = 0.009) of indigenous cases were significantly longer than those of imported ones. However, the time intervals between onset and first visit for indigenous cases was shorter (median 0 vs 1 days; Wilcoxon rank sum test Z = -2.10, P = 0.036). Fever (99.1%), fatigue (81.9), rash (63.7%), headache (67.2%) and myalgia (52.60%) were the most frequently mentioned symptoms. Conclusions: Zhejiang has recently witnessed an increase in incidence and geographic extension of dengue. Timely diagnosis is important to stop local transmission and outbreak. [ABSTRACT FROM AUTHOR]

China has recorded positive growth rates of grain production for the past eleven consecutive years. This is a remarkable accomplishment given that China’s rapid industrialization and urbanization has led to a vast reduction of arable land and agricultural labor to non-agricultural sectors. While there are many factors contributing to this happy outcome, one potential contributing factor that has received increasing attention is the emergence of agricultural production outsourcing, a new rural institution that has emerged in recent years. This study aims to contribute to the limited but growing literature on agricultural production outsourcing in China. Specifically, this study analyzes factors affecting farmers’ decisions to outsource any or some production tasks using data from rice farmers in Zhejiang province. Results from a logistic model show that farm size and government subsidy encourages farmers to outsource while ownership of agricultural machines and land fragmentation have negative effects on farmers’ decisions to outsource production tasks. Results also showed that determinants of outsourcing decisions vary with the production tasks that farmers outsourced. [ABSTRACT FROM AUTHOR]

Background: Hepatitis A is a common acute hepatitis caused by hepatitis A virus (HAV). Annually, it affects 1.4 million people worldwide. Between 1991 and 1994, HAV infections were highly endemic in Zhejiang Province (China), with 78,720 reported HAV infections per year. Hepatitis A vaccine came on the market in 1995 and was implemented for voluntary immunization. Since 2008, hepatitis A vaccine has been integrated into the national childhood routine immunization program. Objective: To understand the current epidemiological profile of hepatitis A in Zhejiang Province since hepatitis A vaccine has been available for nearly two decades. Methods: This study used the 2005–2014 National Notifiable Diseases Reporting System data to evaluate the incidence rate of notified hepatitis A cases in Zhejiang Province. Results: The overall trend of incidence rate of notified hepatitis A cases significantly decreased from 2005 to 2014 (P< 0.001). During the study period, the reported incidence rate in individuals aged ≤19 years declined to the historically lowest record in 2014. Compared with individuals aged ≤19 years, those aged ≥20 years showed the highest incidence rate (P< 0.001). Majority of HAV infected cases were Laborers, accounting for approximately 70% of reported cases. Conclusions: Childhood immunization strategy with hepatitis A vaccine seemed to be effective in decreasing notified hepatitis A incidence rate in individuals aged ≤19 years. Those aged ≥20 years were observed to be the most susceptible population. The vast majority of hepatitis A cases were notified among Laborers. Therefore, we strongly suggest that future preventive and control measures should focus more on adults, particularly Laborers, in addition to the current childhood hepatitis A vaccination programme. [ABSTRACT FROM AUTHOR]

Hand, foot and mouth disease (HFMD) is one of the major public health concerns in China. Being the province with high incidence rates of HFMD, the epidemiological features and the spatial-temporal patterns of Zhejiang Province were still unknown. The objective of this study was to investigate the epidemiological characteristics and the high-incidence clusters, as well as explore some potential risk factors. The surveillance data of HFMD during 2008–2012 were collected from the communicable disease surveillance network system of Zhejiang Provincial Center for Disease Control and Prevention. The distributions of age, gender, occupation, season, region, pathogen’s serotype and disease severity were analyzed to describe the epidemiological features of HFMD in Zhejiang Province. Seroprevalence survey for human enterovirus 71 (EV71) in 549 healthy children of Zhejiang Province was also performed, as well as 27 seroprevalence publications between 1997 and 2015 were summarized. The spatial-temporal methods were performed to explore the clusters at county level. Furthermore, pathogens’ serotypes such as EV71 and coxsackievirus A16 (Cox A16) and meteorological factors were analyzed to explore the potential factors associated with the clusters. A total of 454,339 HFMD cases were reported in Zhejiang Province during 2008–2012, including 1688 (0.37%) severe cases. The annual average incidence rate was 172.98 per 100,000 (ranged from 72.61 to 270.04). The male-to-female ratio for mild cases was around 1.64:1, and up to 1.87:1 for severe cases. Of the total cases, children aged under three years old and under five years old accounted for almost 60% and 90%, respectively. Among all enteroviruses, the predominant serotype was EV71 (49.70%), followed by Cox A16 (26.05%) and other enteroviruses (24.24%) for mild cases. In severe cases, EV71 (82.85%) was the major causative agent. EV71 seroprevalence survey in healthy children confirmed that occult infection was common in children. Furthermore, literature summary for 26 seroprevalence studies during 1997–2015 confirmed that 0–5 years group showed lowest level of EV71 seroprevalence (29.1% on average) compared to the elder children (6–10 years group: 54.6%; 11–20 years group: 61.8%). Global positive spatial autocorrelation patterns (Moran’s Is>0.25, P<0.05) were discovered not only for mild cases but also for severe cases, and local positive spatial autocorrelation patterns were revealed for counties from the eastern coastal and southern regions. The retrospective space-time cluster analysis also confirmed these patterns. Risk factors analyses implied that more EV71 and less sunshine were associated with the clusters of HFMD in Zhejiang Province. Our study confirmed that Zhejiang Province was one of the highly epidemic provinces in China and that the epidemiological characteristics of HFMD were similar to other provinces. Occult infection in elder children and adults was one of the important reasons why most HFMD cases were children aged under-five. Combining the results of spatial autocorrelation analysis and the space-time cluster analysis, the major spatial-temporal clusters were from the eastern coastal and southern regions. The distribution of pathogens’ serotypes and the level of sunshine could be risk factors for, and serve as an early warning of, the outbreak of HFMD in Zhejiang Province. [ABSTRACT FROM AUTHOR]

Background: To date, there have been a total of 637 laboratory-confirmed cases of human infection with avian influenza A (H7N9) virus across mainland China, with 28% (179/637) of these reported in Zhejiang Province. Surveillance of avian H7N9 virus was conducted to investigate environmental contamination during H7N9 outbreaks. We sought to evaluate the prevalence of H7N9 in the environment, and the effects of poultry market closures on the incidence of human H7N9 cases. Methods: We collected 6740 environmental samples from 751 sampling sites across 11 cities of Zhejiang Province (China) between January 2013 and March 2014. The presence of H7N9 was determined by reverse transcription polymerase chain reaction, with prevalence compared between sites and over time. The relationship between environmental contamination and human cases of H7N9 infection were analyzed using Spearman’s ranked correlation coefficient. Results: Of the 6740 samples, 10.09% (680/6740) were H7N9-positive. The virus was found to circulate seasonally, and peaked during the spring and winter of 2013–2014. The prevalence of the virus decreased from the north to the southeast of the province, coinciding with the geographical distribution of human H7N9 cases. Compared with other sampling sites, live poultry markets (LPMs) had the highest prevalence of H7N9 virus at 13.94% (667/4784). Of the various sample types analyzed, virus prevalence was highest for chopping board swabs at 15.49% (110/710). The prevalence of the virus in the environment positively correlated with the incidence of human H7N9 cases (r2 = 0.498; P < 0.01). Cities with a higher incidence of human H7N9 cases also had a higher prevalence of H7N9 among samples and at sampling sites. Following the closure of LPMs at the end of January 2014, the prevalence of H7N9 decreased from 19.18% (487/2539) to 6.92% (79/1141). This corresponded with a decrease in the number of human H7N9 cases reported. Conclusions: The prevalence of H7N9 virus in environmental samples oscillated seasonally, regardless of whether LPMs were open. The presence of H7N9 in environmental samples positively correlated with the number of human H7N9 cases, indicating that eradication of the virus from the environment is essential in reducing the numbers of H7N9 cases and halting the spread of the virus. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQOL) has become a concept commonly used in the related research. Using the World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF), this study evaluated the Quality of Life (QOL) of people living with HIV/AIDS (PLWHA) in Zhejiang province, China, and assessed the influences of demographic, laboratory and disease-related variables on QOL. This cross-sectional study was conducted among PLWHA aged ≥ 18 years in Taizhou municipality, Zhejiang province, China, between August 1 and October 31, 2014. A multiple linear regression model was used to analyze the influential factors. Of 403 subjects, 72.48% were male, 72.46% had received a high- school or above education, 94.79% were of Han ethnicity, and 65.51% were non farmers. The total score of QOL was 15.99±1.99. The scores of QOL in physiological, psychological, social relation, and environmental domains were 14.99 ±2.25, 14.25 ±2.12, 13.22 ±2.37, and 13.31 ±1.99 respectively. Except the total score of QOL and the score of environmental domain (p<0.05), the scores in other domains had no significant difference with the results of the national norm level. The multiple linear regression model identified the physical domain related factors to be age (β = -0.045), CD4 count (β = 0.002), and ART adherence(β = 1.231). And it also showed that psychological domain related factors included CD4 count (β = 0.002) and WHO clinical stage (β = -0.437); social domain related factors included WHO clinical stage (β = -0.704) and ART adherence (β = 1.177); while environmental domain related factors included WHO clinical stage (β = -0.538), educational status(β = 0.549) and ART adherence(β = 1.078).Those who are young, with higher level of education, higher CD4 count and good access and adherence of ART, are likely to have better QOL among PLWHA in Zhejiang province. This suggests that in addition to ART, many other factors should be taken into consideration to improve the QOL of PLWHA. The relatively lower scores the subjects received in social relation and environmental domains also suggest that social relation and environmental interventions need to be strengthened. [ABSTRACT FROM AUTHOR]

Objectives: This is a population based descriptive study that examined the trends in childhood mortality among under five children and the major causes under five mortality in Zhejiang Province, China. Methods: A population-based survey was conducted through a province-level surveillance network. The mortality rate and leading causes of death for children under 5 years of age were analyzed. The trend in the mortality rate for children under five and cause-specific mortality rates were analyzed by chi-square with SPSS 13.0 software. Results: In Zhejiang Province, during 1997-2012, mortality rates in neonates, postneonatal infants, and children under 5 years were reduced by 64.2% (from 7.85 to 2.81 per 1000 livebirths), 66.7% (from 12.73 to 4.24 per 1000 livebirths), and 63% (from 15.76 to 5.85 per 1000 livebirths), respectively. The mortality rates in children under 5 years of age decreased by 59.5% (from 11.09 to 4.49 per 1000 livebirths) and 65.8% (from 19.30 to 6.61 per 1000 livebirths) in urban and rural areas, respectively. Prematurity/low birth weight and congenital heart disease were in the top five causes of death in children under 5 years of age during 1997-2012. Conclusions: Zhejiang province has achieved great progress in the reduction of mortality rates in children under five-years-old during the past two decades. The future tasks on reduction of mortality rate still rely on how to improve the management of premature birth/low birth weight, reduce birth defects and prevent accidental deaths in Zhejiang Province. [ABSTRACT FROM AUTHOR]

Background: Influenza is a contagious disease with high transmissibility to spread around the world with considerable morbidity and mortality and presents an enormous burden on worldwide public health. Few mathematical models can be used because influenza incidence data are generally not normally distributed. We developed a mathematical model using Extreme Value Theory (EVT) to forecast the probability of outbreak of highly pathogenic influenza. Methods: The incidence data of highly pathogenic influenza in Zhejiang province from April 2009 to November 2013 were retrieved from the website of Health and Family Planning Commission of Zhejiang Province. MATLAB “VIEM” toolbox was used to analyze data and modelling. In the present work, we used the Peak Over Threshold (POT) model, assuming the frequency as a Poisson process and the intensity to be Pareto distributed, to characterize the temporal variability of the long-term extreme incidence of highly pathogenic influenza in Zhejiang, China. Results: The skewness and kurtosis of the incidence of highly pathogenic influenza in Zhejiang between April 2009 and November 2013 were 4.49 and 21.12, which indicated a “fat tail” distribution. A QQ plot and a mean excess plot were used to further validate the features of the distribution. After determining the threshold, we modeled the extremes and estimated the shape parameter and scale parameter by the maximum likelihood method. The results showed that months in which the incidence of highly pathogenic influenza is about 4462/2286/1311/487 are predicted to occur once every five/three/two/one year, respectively. Conclusions: Despite the simplicity, the present study successfully offers the sound modeling strategy and a methodological avenue to implement forecasting of an epidemic in the midst of its course. [ABSTRACT FROM AUTHOR]

Mosquito-borne diseases (MBDs) are still threats to public health in Zhejiang. In this study, the associations between the time-lagged mosquito capture data and MBDs incidence over five years were used to examine the potential effects of mosquito abundance on patterns of MBDs epidemiology in Zhejiang during 2008–2012. Light traps were used to collect adult mosquitoes at 11 cities. Correlation tests with and without time lag were performed to investigate the correlations between MBDs incidence rates and mosquito abundance by month. Selected MBDs consisted of Japanese encephalitis (JE), dengue fever (DF) and malaria. A Poisson regression analysis was performed by using a generalized estimating equations (GEE) approach, and the most parsimonious model was selected based on the quasi-likelihood based information criterion (QICu). We identified five mosquito species and the constituent ratio of Culex pipiens pallens, Culex tritaeniorhynchus, Aedes albopictus, Anopheles sinensis and Armigeres subalbatus was 66.73%, 21.47%, 6.72%, 2.83% and 2.25%, respectively. The correlation analysis without and with time lag showed that Culex mosquito abundance at a lag of 0 or 1 month was positively correlated with JE incidence during 2008–2012, Ae. albopictus abundance at a lag of 1 month was positively correlated with DF incidence in 2009, and An. sinensis abundance at a lag of 0–2 months was positively correlated with malaria incidence during 2008–2010. The Poisson regression analysis showed each 0.1 rise of monthly mosquito abundance corresponded to a positive increase of MBD cases for the period of 2008–2012. The rise of mosquito abundance with a lag of 0–2 months increased the risk of human MBDs infection in Zhejiang. Our study provides evidence that mosquito monitoring could be a useful early warning tool for the occurrence and transmission of MBDs. [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome virus (SFTSV) infections have recently been found in rural regions of Zhejiang. A severe fever with thrombocytopenia syndrome (SFTS) surveillance and sero-epidemiological investigation was conducted in the districts with outbreaks. During the study period of 2011–2014, a total of 51 SFTSV infection cases were identified and the case fatality rate was 12% (6/51). Ninety two percent of the patients (47/51) were over 50 years of age, and 63% (32/51) of laboratory confirmed cases occurred from May to July. Nine percent (11/120) of the serum samples from local healthy people without symptoms were found to be positive for antibodies to the SFTS virus. SFTSV strains were isolated by culture using Vero, and the whole genomic sequences of two SFTSV strains (01 and Zhao) were sequenced and submitted to the GenBank. Homology analysis showed that the similarity of the target nucleocapsid gene from the SFTSV strains from different geographic areas was 94.2–100%. From the constructed phylogenetic tree, it was found that all the SFTSV strains diverged into two main clusters. Only the SFTSV strains from the Zhejiang (Daishan) region of China and the Yamaguchi, Miyazakj regions of Japan, were clustered into lineage II, consistent with both of these regions being isolated areas with similar geographic features. Two out of eight predicted linear B cell epitopes from the nucleocapsid protein showed mutations between the SFTSV strains of different clusters, but did not contribute to the binding ability of the specific SFTSV antibodies. This study confirmed that SFTSV has been circulating naturally and can cause a seasonal prevalence in Daishan, China. The results also suggest that the molecular characteristics of SFTSV are associated with the geographic region and all SFTSV strains can be divided into two genotypes. [ABSTRACT FROM AUTHOR]

Background: Exposure to electromagnetic field (EMF) emitted by mobile phone and other machineries concerns half the world’s population and raises the problem of their impact on human health. The present study aims to explore the effects of electromagnetic field exposures on sleep quality and sleep duration among workers from electric power plant. Methods: A cross-sectional study was conducted in an electric power plant of Zhejiang Province, China. A total of 854 participants were included in the final analysis. The detailed information of participants was obtained by trained investigators using a structured questionnaire, which including socio-demographic characteristics, lifestyle variables, sleep variables and electromagnetic exposures. Physical examination and venous blood collection were also carried out for every study subject. Results: After grouping daily occupational electromagnetic exposure into three categories, subjects with long daily exposure time had a significantly higher risk of poor sleep quality in comparison to those with short daily exposure time. The adjusted odds ratios were 1.68 (95%CI: 1.18, 2.39) and 1.57 (95%CI: 1.10, 2.24) across tertiles. Additionally, among the subjects with long-term occupational exposure, the longer daily occupational exposure time apparently increased the risk of poor sleep quality (OR (95%CI): 2.12 (1.23∼3.66) in the second tertile; 1.83 (1.07∼3.15) in the third tertile). There was no significant association of long-term occupational exposure duration, monthly electric fee or years of mobile-phone use with sleep quality or sleep duration. Conclusions: The findings showed that daily occupational EMF exposure was positively associated with poor sleep quality. It implies EMF exposure may damage human sleep quality rather than sleep duration. [ABSTRACT FROM AUTHOR]

Objective: To identify the risk factors and source of infection leading to human infections with the Influenza A(H7N9) virus in urban and rural areas. Methods: We conducted a case-control investigation to identify potential exposures and risk factors. Controls were randomly selected from the same community as the cases using random digit dialing. We used exact conditional logistic regression to evaluate the exposures and risk factors, stratified by urban and rural residence. Results: Buying live or freshly slaughtered poultry from a market was significantly associated with illness onset among both urban [48% of 25 case-patients and 12% of 125 control-persons, adjusted odds ratio (AOR) = 19, 95% CI: 2.3–929] and rural (33% of 18 case-patients and 8.9% of 90 control-persons, AOR = 13, 95% CI:1.5–∞) residents. In rural area, tending to home-raised poultry (56% of 18 case-patients and 10% of 90 control-persons, AOR = 57, 95% CI: 7.5–∞) and existence of a poultry farm in the vicinity of the residence (28% of 18 case-patients and 5.6% of 90 control-persons, AOR = 37, 95% CI: 3.8–∞) were also significantly associated with disease onset. Presence of underlying medical conditions was a significant risk factor for urban residents (76% of 25 case-patients and 13% of 125 control-persons, AOR = 49, 95% CI: 7.1–2132). Conclusions: Buying live or freshly slaughtered poultry from a market is a risk factor for both urban and rural residents, tending to home-raised poultry and existence of a poultry farm in the vicinity of the residence are risk factors unique for rural residents. The virus might have been in stealth circulation in the poultry population before infecting humans. We recommend strict poultry market management and multisectoral collaboration to identify the extent of poultry infection in China. [ABSTRACT FROM AUTHOR]

A total of 134 cases of H7N9 influenza infection were identified in 12 provinces of China between March 25 and September 31, 2013. Of these, 46 cases occurred in Zhejiang Province. We carried out a preliminary comparison of characteristics between rural and urban H7N9 cases from Zhejiang Province, China. Field investigations were conducted for each confirmed H7N9 case. A standardized questionnaire was used to collect information about demographics, exposure history, clinical signs and symptoms, timelines of medical visits and care after onset of illness. Of the 46 H7N9 cases in Zhejiang Province identified between March 25 and September 31, 2013, there were 16 rural cases and 30 urban cases. Compared to urban cases, there was a higher proportion of females among the rural cases [11/16 (69%) vs. 6/30 (20%), P = 0.001]. Among the rural cases, 14/15 (93%) with available data had a history of recent poultry exposure, which was significantly higher than that among urban cases (64%, P = 0.038). More patients from the rural group had a history of breeding poultry compared with those from the urban group [38% (6/16) vs. 10% (3/30), respectively; P = 0.025]. Interestingly, the median number of medical visits of patients from rural areas was higher than that of patients from urban areas (P = 0.046). There was no difference between the two groups in terms of age distribution, fatality rate, incubation period, symptoms, and underlying medical conditions. In conclusion, compared to patients from urban areas, more patients from rural areas were female, had an exposure history, had a history of breeding poultry, and had a higher number of medical visits. These findings indicate that there are different exposure patterns between patients living in rural and urban areas and that more rural cases were infected through backyard poultry breeding. [ABSTRACT FROM AUTHOR]

Environmental pollution with toxic heavy metals can lead to the possible contamination of the rice. Selected metals (As, Cd, Hg and Pb) and their accumulation in rice collected from Zhejiang, China were analyzed to evaluate the potential health risk to the local adults and children. The mean levels found in rice were as follows: As, 0.080 mg/kg; Cd, 0.037 mg/kg; Hg, 0.005 mg/kg; Pb, 0.060 mg/kg. The estimated daily intakes (EDIs) were calculated in combination of the rice consumption data. The mean intakes of As, Cd, Hg and Pb through rice were estimated to be 0.49, 0.23, 0.03 and 0.37 µg/kg bw/day for adults, and 0.34, 0.29, 0.04 and 0.47 µg/kg bw/day for children. The 97.5th percentile (P97.5) daily intakes of As, Cd, Hg and Pb were 1.02, 0.64, 0.37 and 1.26 µg/kg bw/day for adults, and 0.63, 0.83, 0.47 and 1.63 µg/kg bw/day for children. The risk assessment in mean levels showed that health risk associated with these elements through consumption of rice was absent. However, estimates in P97.5 level of Cd and Pb for children, and Hg for adults have exceeded the respective safe limits. [ABSTRACT FROM AUTHOR]

Objective: To investigate the levels of primary health care services for children and their changes in Zhejiang Province, China from 1998 to 2011. Methods: The data were drawn from Zhejiang maternal and child health statistics collected under the supervision of the Health Bureau of Zhejiang Province. Primary health care coverage, hospital deliveries, low birth weight, postnatal visits, breastfeeding, underweight, early neonatal (<7 days) mortality, neonatal mortality, infant mortality and under-5 mortality were investigated. Results: The coverage rates for children under 3 years old and children under 7 years old increased in the last 14 years. The hospital delivery rate was high during the study period, and the overall difference narrowed. There was a significant difference (P<0.001) between the prevalence of low birth weight in 1998 (2.03%) and the prevalence in 2011 (2.71%). The increase in low birth weight was more significant in urban areas than in rural areas. The postnatal visit rate increased from 95.00% to 98.45% with a significant difference (P<0.001). The breastfeeding rate was the highest in 2004 at 74.79% and lowest in 2008 at 53.86%. The prevalence of underweight in children under 5 years old decreased from 1.63% to 0.65%, and the prevalence was higher in rural areas. The early neonatal, neonatal, infant and under-5 mortality rates decreased from 6.66‰, 8.67‰, 11.99‰ and 15.28‰ to 1.69‰, 2.36‰, 3.89‰ and 5.42‰, respectively (P<0.001). The mortality rates in rural areas were slightly higher than those in urban areas each year, and the mortality rates were lower in Ningbo, Wenzhou, and Jiaxing regions and higher in Quzhou and Lishui regions. Conclusion: Primary health care services for children in Zhejiang Province improved from 1998 to 2011. Continued high rates of low birth weight in urban areas and mortality in rural areas may be addressed with improvements in health awareness and medical technology. [ABSTRACT FROM AUTHOR]

Objective: The aims of current study were to assess the level of tobacco knowledge, anti-tobacco messages and major information channels in Zhejiang. Methods: Face-to-face interviews were conducted with 2112 adults in Zhejiang. Data on demographic information, smoking status, tobacco knowledge, anti-tobacco messages and major information channels was collected. Results: The findings revealed that only 31.87% of the population were aware that smoking could cause all three diseases (stoke, heart disease, and lung cancer), 86.09% were aware that smoking causes lung cancer, 46.43% and 42.40% were aware that smoking causes stroke and heart attack, respectively. Residence and education level had significant effects on awareness, while the effects of smoking status, gender, age, and household monthly income were not significant. There were five major information channels as follows: television (67.52%), newspapers or magazines (40.79%), billboards (30.02%), public walls (24.72), and radio (23.79%). Respondents got the following anti-tobacco messages from mass media: “No smoking in public” (66.34%), “No smoking in front of other people” (35.18%) and “Not offering cigarettes to one another” (22.82%). Conclusions: The tobacco knowledge among residents in Zhejiang province is relatively poor. Improved information channels and content of anti-tobacco messages are necessary to increase the public’s tobacco knowledge, particularly among rural residents and people with less education. [ABSTRACT FROM AUTHOR]

Prunus pananensis Z. L. Chen, W. J. Chen & X. F. Jin, a new species of Rosaceae from central Zhejiang, China is described and illustrated. Micromorphological characters of the indumentum on young shoots, leaves, petioles and peduncles, including scanning electron microscope [SEM] images, are provided. This new species is morphologically similar to P. schneiderianae Koehne in having its young shoots, petioles and pedicels all densely villose, but differs in having bracts persistent, styles glabrous, stipules 8-9 mm long, stamens 28-30 of per flower, and drupes glabrous. The new species is also similar to P. discoidea (Yü & C. L. Li) Yü & C. L. Li ex Z. Wei & Y. B. Chang in having 2 or 3 flowers in an umbellate inflorescence, and bracts persistent and marginally glandular, but it differs in having young shoots and petioles densely covered with yellowish- brown villose trichomes; leaves rounded or slightly cordate at base, the mid-ribs and lateral veins abaxially densely covered with yellowish-brown villose trichomes; and hypanthium ca. 3 mm long, shorter than sepals. The atpB-rbcL and trnL-F intergenic chloroplast spacers are selected for identification of the new and its similar species. [ABSTRACT FROM AUTHOR]

Few case control studies were conducted to explore risk factors for severe cases of 2009 influenza A (H1N1) with the mild cases as controls. Mild and severe cases of 2009 influenza A (H1N1), 230 cases each, were randomly selected from nine cities in Zhejiang Province, China, and unmatched case control study was conducted. This study found that it averagely took 5 days for the severe cases of 2009 influenza A (H1N1) to start antiviral therapy away from onset, 2 days later than mild cases. Having chronic underlying diseases and bad psychological health combined with chronic underlying diseases were two important risk factors for severe cases, and their OR values were 2.39 and 5.85 respectively. Timely anti-viral therapy was a protective factor for severe cases (OR = 0.35, 95% CI: [0.18-0.67]). In conclusion, psychological health education and intervention, as well as timely anti-viral therapy, could not be ignored in the prevention, control and treatment of 2009 influenza A (H1N1). [ABSTRACT FROM AUTHOR]

The Thousand-Island Lake region in Zhejiang Province, China is a highly fragmented landscape with a clear point-in-time of fragmentation as a result of flooding to form the reservoir. Islands in the artificial lake were surveyed to examine how population sex ratio of a dioecious plant specie Pistacia chinensis B. was affected by landscape fragmentation. A natural population on the mainland near the lake was also surveyed for comparison. Population size, sex ratio and diameter at breast height (DBH) of individuals were measured over 2 years. More than 1,500 individuals, distributed in 31 populations, were studied. Soil nitrogen in the different populations was measured to identify the relationship between sex ratio and micro-environmental conditions. In accordance with the results of many other reports on biased sex ratio in relation to environmental gradient, we found that poor soil nitrogen areas fostered male-biased populations. In addition, the degree of sex ratio bias increased with decreasing population size and population connectivity. The biased sex ratios were only found in younger individuals (less than 50 years old) in small populations, while a stable 1:1 sex ratio was found in the large population on the mainland. We concluded that the effects of landscape fragmentation on the dioecious population sex ratio were mainly achieved in relation to changing soil nitrogen conditions in patches and pollen limitation within and among populations. Large populations could maintain a more suitable environment in terms of nutrient conditions and pollen flow, subsequently maintaining a stable sex ratio in dioecious plant populations. Both micro-environmental factors and spatial structure should be considered in fragmented landscape for the conservation of dioecious plant species. [ABSTRACT FROM AUTHOR]