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Summary: This study revealed that there was no significant linear relationship between fasting C-peptide (FCP) level and bone mineral density (BMD) or fracture risk in type 2 diabetes mellitus (T2DM) patients. However, in the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with whole body (WB), lumbar spine (LS), and femoral neck (FN) BMD and negatively correlated with fracture risk. Purpose: To explore the relationship between C-peptide and BMD and fracture risk in T2DM patients. Methods: 530 T2DM patients were enrolled and divided into three groups by FCP tertiles, and the clinical data were collected. BMD was measured by dual-energy X-ray absorptiometry (DXA). The 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was evaluated by adjusted fracture risk assessment tool (FRAX). Results: In the FCP ≤ 1.14 ng/ml group, FCP level was positively correlated with WB, LS, and FN BMD, while FCP was negatively correlated with fracture risk and osteoporotic fracture history. However, FCP was not correlated with BMD and fracture risk and osteoporotic fracture history in the 1.14 < FCP ≤ 1.73 ng/ml and FCP > 1.73 ng/ml groups. The study has shown that FCP was an independent factor influencing BMD and fracture risk in the FCP ≤ 1.14 ng/ml group. Conclusions: There is no significant linear relationship between FCP level and BMD or fracture risk in T2DM patients. In the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with WB, LS, and FN BMD and negatively correlated with fracture risk, and FCP is an independent influencing factor of BMD and fracture risk. The findings suggest that FCP may predict the risk of osteoporosis or fracture in some T2DM patients, which has a certain clinical value. [ABSTRACT FROM AUTHOR]

To study the seismic vulnerabilities and performances of typical bridges, data from a field investigation of 2134 bridges on 22 highway sections hit by the Wenchuan earthquake that occurred in China on May 12, 2008, were collected and processed. From the sample data of the empirical seismic-damage observations, 1409 simply supported girder bridges, 107 continuous girder bridges, and 612 arch bridges were selected. The latest version of the Chinese seismic intensity standard was utilized to evaluate the fragility of bridge samples in different macroseismic intensity zones, and the empirical vulnerability matrix and multidimensional regression comparison model of typical bridge clusters were developed. Taking the bridge length, the coordinate azimuth of the bridge location, the number of spans, the geometric form of the pier columns, and the type of bearings and foundations as the single factors influencing vulnerability and assuming (i) the line type and bridge length, (ii) the types of pier column and foundation, and (iii) the number of spans, the type of bearings, foundations, and linearity as the coupled factors influencing vulnerability, the aforementioned typical bridges were subjected to comparative vulnerability analysis. Innovative fragility regression and probability comparison models of typical bridges were developed considering the influence of multiple factor coupling. A novel vulnerability evaluation model was proposed based on the characteristic parameters and damage grade of bridge clusters in the umbrella earthquake area, and the model was optimized and verified by using the typical bridge database of the Wenchuan earthquake. [ABSTRACT FROM AUTHOR]

Background: The Knee Injury and Osteoarthritis Outcomes Score (KOOS) is a free clinical tool commonly used to evaluate the symptoms and functional status of patients with knee injury. For people who speak Chinese, the Hong Kong Chinese and Singapore Chinese versions are preferred. However, variations in the Chinese language and culture are influenced by the country's geography. KOOS for Mainland China has not been reported. Therefore, the current study was to cross-culturally translate the original English version into a simplified Chinese version and to investigate its psychometric properties. Methods: The simplified Chinese KOOS was obtained through forward-backward translation according to appropriate guidelines. A total of 158 individuals with knee osteoarthritis (KOA) were recruited from 13 hospitals in China to examine the psychometric properties. The test-retest questionnaire was performed at an interval of 5–7 days. Test-retest reliability and internal consistency were evaluated using the intraclass correlation coefficient (ICC) and Cronbach's alpha, respectively. The data of the first test were used to analyse the construct validity of the simplified Chinese KOOS and Chinese SF-36 through convergent and discriminant validity using Spearman's correlation coefficient. Results: Cross-cultural translation exhibited minor cultural differences, and the questionnaire was well understood by the patients. The data from 128 patients, used for the test-retest reliability study, showed good to excellent reliability, with an ICC of 0.808–0.976 for all KOOS subscales. The Cronbach's alpha for all subscales ranged from 0.757 to 0.970, indicating acceptable internal consistency. There was a low-to-high correlation between the five domains of the simplified Chinese version of the KOOS and all domains of the SF-36 in construct validity. Conclusion: The simplified Chinese KOOS demonstrated acceptable reliability and validity. In clinical practice and research, this version can help provide valuable information on health-related quality of life for Chinese individuals with KOA in mainland China. [ABSTRACT FROM AUTHOR]

Titanium products, regarded as a strategic metal by many national governments, play important and irreplaceable roles in national defence and military applications. China has built a large-scale titanium industrial chain, and its status and development pathways will greatly affect the global market. Several researchers contributed a set of reliable statistical data to bridge the knowledge gap in evaluating the industrial layout and the entire structure of China's titanium industry with little literature information regarding the management of metal scrap in the manufacturers of titanium products. To bridge this data gap, we present a dataset of annual metal scrap circularity to uncover China's evolution of the titanium industry today, which contains off-grade titanium sponge, low-grade titanium scrap, and recycled high-grade titanium swarf with the relevant circularity of the titanium industry in China at the national level from 2005 to 2020. [ABSTRACT FROM AUTHOR]

Disclosure of HIV status offers potential benefits to individuals and is also good for public health. Limited studies have been conducted to gain insight into the current situation and associated factors of HIV disclosure among HIV-positive Chinese men who have sex with men (MSM) in the era of "treat all." We carried out a cross-sectional study among MSM receiving antiretroviral therapy from October 2020 to January 2021 at a hospital in Jinan, China. We used univariate and multivariable logistic regression to examine the factors associated with general disclosure and disclosure to family, friends, and sexual partners. Of the 585 participants recruited, 62.2% reported HIV disclosure, among which 25.3% had disclosed their status to family members, 25.3% had disclosed it to friends, and 28.4% had disclosed it to partners. The findings suggest that HIV disclosure is more likely to occur among individuals who are younger, married/cohabiting, and who self-identify as homosexual/bisexual. Participants with higher education levels or personal monthly incomes are less likely to disclose their HIV status. Furthermore, related factors of disclosure vary across the types of disclosure targets. Given the positive outcomes of disclosure, interventions and implementation research to facilitate it are urgently needed for MSM. [ABSTRACT FROM AUTHOR]

China's rise, along with deepening Sino-European economic relations, seems to have a strong impact on the diplomatic outlook of actors in Europe. An interesting phenomenon is that, while several major European states have become strategic partners of China, they remain US allies at the same time. In the context of trade tensions and a possible decoupling between China and the USA, what are the diplomatic effects of the close economic relations between Europe and China? To find the answer, this study builds models on the functions of trade and partnerships with China with respect to voting choice of China's partners, including those in Europe, in the United Nations General Assembly (UNGA). After making a statistical analysis and presenting detailed analysis on France, Germany, the UK, and Poland, this paper finds that the close economic and trade ties do indeed enhance voting similarity between China and major states in Europe in the UNGA. [ABSTRACT FROM AUTHOR]

In the process of green and smart mine construction under the context of carbon neutrality, China's coal safety situation has been continuously improved in recent years. In order to recognize the development of coal production in China and prepare for future monitoring and prevention of safety incidents, this study mainly elaborated on the basic situation of coal resources and national mining accidents over the past five years (2017–2021), from four dimensions (accident level, type, region, and time), and then proposed the preventive measures based on accident statistical laws. The results show that the storage of coal resources has obvious geographic characteristics, mainly concentrated in the Midwest, with coal resources in Shanxi and Shaanxi accounting for about 49.4%. The proportion of coal consumption has dropped from 70.2% to 56% between 2011 and 2021, but still accounts for more than half of the all. Meanwhile, the accident-prone areas are positively correlated with the amount of coal production. Among different levels of coal mine accidents, general accidents had the highest number of accidents and deaths, with 692 accidents and 783 deaths, accounting for 87.6% and 54.64% respectively. The frequency of roof, gas, and transportation accidents is relatively high, and the number of single fatalities caused by gas accidents is the largest, about 4.18. In terms of geographical distribution of accidents, the safety situation in Shanxi Province is the most severe. From the time distribution of coal mine accidents, the accidents mainly occurred in July and August, and rarely occurred in February and December. Finally, the "4 + 4" safety management model is proposed, combining the statistical results with coal production in China. Based on the existing health and safety management systems, the managements are divided into four sub-categories, and more specific measures are suggested. [ABSTRACT FROM AUTHOR]

Most of the international mineral statistics are limited to production, import and export figures only. However, such statistics are not sufficient to identify possible market trends or supply risks. The political restructuring in Europe and China's rapidly increasing demand for mineral raw materials since the turn of the millennium has led to imbalances in the demand and supply of raw materials in many countries. In the present work, the importance of a more in-depth exploratory data analysis is explained. The paper also deals with the need to record raw material exploration projects. While most statistics are limited to the production figures and thus only allow a retrospect into the past only, information about the resources verified in exploration projects would also allow a glimpse into the future. Despite this need, many institutions that have compiled such statistics in the past have discontinued them meanwhile. Reduced budget and staff shortages are some of the reasons for this. For this reason, close cooperation between the few remaining organizations is urgently required. [ABSTRACT FROM AUTHOR]

The present study aims to examine and compare, in both mobile phone addicts (MPAs) and possible-MPAs, (1) the direct effect of mobile phone addiction (MPA) levels on adolescent depressive symptoms, and (2) the indirect effect of MPA levels on depressive symptoms as mediated by parent-adolescent relationships. We recruited 1766 Chinese adolescents (53.2% male; Mage= 13.30, SD = 2.00, range from 10 to 18 years) from Shenzhen Shuijing Primary School, Shenzhen Longcheng Middle School, and High School of Shenzhen Overseas Chinese Town in China. The participants completed a questionnaire survey that measured MPA levels, parent-adolescent relationships, and depressive symptoms. The results showed that (1) The direct effect of MPA on adolescent depressive symptoms was stronger than that of possible MPA; (2) the indirect effect of MPA on depressive symptoms through parent-adolescent relationships was stronger than that of possible MPA. This study expanded the interdependent relationship between Internet addiction and depression by illustrating the mediating mechanism of parent-adolescent relationships in the link between different levels of MPA and adolescent depressive symptoms, having made an important contribution to the development of family-based prevention and intervention strategies for adolescent depressive symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Malnutrition is associated with increased incidence of heart failure (HF). Left ventricular (LV) remodeling is one of the most important processes in the occurrence and evolution of HF. However, the association between nutritional status and LV remodeling is not well known. The study aimed to investigate the association between malnutrition and LV remodeling. Design: The study was a retrospective observation study. Setting and Participants: We included patients from the registry of Cardiorenal Improvement study from January 2007 to December 2018 at Guangdong Provincial People's Hospital. Measurements: The primary endpoint was LV remodeling, defined as an absolute decrease in LV ejection fraction ≥10% after discharge compared with baseline. Nutritional status was assessed by the Controlling Nutritional Status (CONUT) score. Eligible patients were divided into absent-mild malnutrition group (CONUT score ≤4) and moderate-severe malnutrition group (CONUT score >4). Univariable and multivariable logistic regression was performed to verify the association between malnutrition and left ventricular remodeling. Results: A total of 7,217 patients (mean age 61.3±10.5 years, 71.7% male) were included in the final analysis, among which 712 (9.9%) had LV remodeling. The incidence of LV remodeling in moderate-severe malnutrition group was significantly higher than that in absent-mild malnutrition group (12.9% vs. 9.5%, p=0.002). In multivariable logistic regression, moderate-severe malnutrition group was significantly associated with 1.69-fold increased risk of LV remodeling after adjusting confounders (OR: 1.69, CI: 1.32–2.16). Similar results were observed in subgroup stratified by age, gender, and coronary artery disease. Conclusion: Nearly one eighth of patients were classified as moderate-severe malnutrition, 12% of whom had LV remodeling. Moderate-severe malnutrition was associated with 69% increased risk of LV remodeling. Further studies are needed to prospectively evaluate the nutrition-oriented managements on outcomes in LV remodeling. [ABSTRACT FROM AUTHOR]

Accurate location-based big data has a high resolution and a direct interaction with human activities, allowing for fine-scale population spatial data to be realized. We take the average of Tencent user location big data as a measure of ambient population. The county-level statistical population data in 2018 was used as the assigned input data. The log linear spatially weighted regression model was used to establish the relationship between location data and statistical data to allocate the latter to a 0.01° grid, and the ambient population data of mainland China was obtained. Extracting street-level (lower than county-level) statistics for accuracy testing, we found that POP2018 has the best fit with the actual permanent population (R2 = 0.91), and the error is the smallest (MSEPOP2018 = 22.48 WorldPop = 37.24 LandScan = 100.91). This research supplemented in the refined spatial distribution data of people between census years, as well as presenting the application technique of big data in ambient population estimation and zoning mapping. Measurement(s) population Technology Type(s) location-based big data Factor Type(s) spatial region Sample Characteristic - Environment spatial region Sample Characteristic - Location China [ABSTRACT FROM AUTHOR]

Anastomotic stenosis is a serious complication after anterior resection for rectal carcinoma. In this study, we explored the factors influencing the development of anastomotic stenosis after the operation. The clinical data of 420 patients who underwent surgery between January 2013 and December 2019 in the Department of Colorectal Surgery, Changshu Hospital Affiliated to Soochow University, were analyzed. The causes of anastomotic stenosis were investigated with logistic regression. A total of 52 patients developed anastomotic stenosis (12.4%). Univariate analysis showed that gender (χ2 = 5.878, P = 0.012), protective stoma (χ2 = 4.224, P = 0.038) and distance from lower edge of tumor to anal verge (t = 3.346, P = 0.001), and anastomotic leak (χ2 = 9.432, P = 0.003) were statistically significant in the correlation of postoperative anastomotic stenosis. Logistic regression analysis showed that gender (OR = 1.662, 95%CI 1.026~2.694, P = 0.012), distance from lower edge of tumor to anal verge (OR = 0.856, 95%CI 0.822~0.892, P = 0.001), and anastomotic leak (OR = 2.455, 95%CI 1.192~3.863, P = 0.003) were independent factors of anastomotic stenosis. Male patients, the lower edge of the tumor close to the anal verge, and patients who had an anastomotic leak after surgery are more likely to develop anastomotic stenosis. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the relationship between anthropometric indices, including abdominal volume index (AVI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), conicity index (C index), body mass index (BMI), body roundness index (BRI), body adiposity index (BAI), A body shape index (ABSI) and cardiovascular risk factors, and their abilities to predict metabolic syndrome (MetS) in adults. Methods: A cross-sectional study of 76,915 participants (30,912 females and 46,003 males) aged between 14 and 100 years was conducted. AVI, WHR, WHtR, BMI, conicity index (C index), BRI, BAI, and ABSI were measured and calculated. Pearson correlation analysis and linear regression analysis were used to examine the relationship between anthropometric indicators and the components of MetS, while binary logistic regression analysis was used to assess the relationship between anthropometric indicators and overall MetS. The receiver operating characteristic curve (ROC) was used to analyze and calculate the area under the curve (AUC). Then, a 95% confidence interval (95% CI) was calculated to evaluate the ability of anthropometric indicators to predict MetS and determine the optimal cutoff value of each anthropometric indicator. The optimal cutoff value was determined by the Youden index. Results: MetS prevalence was 21.71% in males and 9.5% in females. Participants with MetS were older and had higher values of glucose, triglyceride, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP) than those without MetS. The high-density lipoprotein cholesterol (HDL-C) values of males and females with MetS were lower than the values found in those without MetS. Mean values of all anthropometric indicators in men and women with MetS were significantly higher than the mean values in those without MetS. After adjusting for age, alcohol consumption, and smoking, anthropometric indexes AVI, WHR, WHtR, C index, BMI, and BRI were all associated with cardiovascular risk factors (p < 0.001). Among men over the age 60 years old, an AVI cutoff of 16.0 predicted MetS with a sensitivity of 74.70% and a specificity of 84.90%. The area under the ROC curve was 0.84 (p < 0.001). Among women over the age of 60 years, an AVI cutoff of 12.8 predicted MetS with a sensitivity of 90.13% and a specificity of 63.72%. The area under the ROC curve was 0.80 (p < 0.001). Among men aged 30–60 years, an AVI cutoff of 16 predicted MetS with a sensitivity of 80.44% and a specificity of 82.36%. The area under the ROC curve was 0.85 (p < 0.001). Among women aged 30–60 years, an AVI cutoff of 12.82 predicted MetS with a sensitivity of 87.72% and a specificity of 83.47%. The area under the ROC curve was 0.90 (p < 0.001). Among men under the age of 30 years, an AVI cutoff of 16.22 predicted MetS with a sensitivity of 87.97% and a specificity of 88.65%. The area under the ROC curve was 0.92 (p < 0.001). Among women under the age of 30 years, an AVI cutoff of 12.79 predicted MetS with a sensitivity of 95.92% and a specificity of 93.79%. The area under the ROC curve was 0.97 (p < 0.001). AVI showed the strongest ability to distinguish MetS across genders and different age groups. Conclusion: AVI, WHR, WHtR, BMI, C index, and BRI were all associated with cardiovascular risk factors. The anthropometric index is a useful screening tool for MS, its components, and cardiovascular risk factors. Among all the indices examined, AVI can best distinguish MetS. [ABSTRACT FROM AUTHOR]

It has been found that people with disabilities remain at the margin as far as the different aspects of their lives are concerned. This paper tests the hypothesis that disability leads to lower quality of life among older adults in low and middle-income countries. The data from the Study on Global Ageing and Adult Health (SAGE) was used in this study which was conducted in Ghana, China, India, Russia, South Africa and Mexico. The disability scores have been made utilising Item Response Theory, Partial Credit Model and are centered on eight functioning and health areas. Bivariate analysis, binary logistic regression and pooled regression analysis have been used to fulfil the objectives of the paper. The findings reveal that disability acts as a hindrance in attaining a high quality of life (HQOL) amongst the older adults in the above mentioned low and middle-income countries. The older adults with disability are as much as 60% less likely to enjoy an HQOL with respect to the older adults without disability. Better socio-economic development like improved health care for disabled older adults with disability enhanced living standards for both abled and disabled, efficient pension schemes for older adults with disability and effective social service schemes would be very much essential to improve overall QOL among older adults. [ABSTRACT FROM AUTHOR]

Introduction: This population-based cross-sectional study aimed to identify the best predictor of the 10-year cardiovascular (CV) high risk among old and new anthropometric indices. Methods: We investigated 76,915 adults older than 18 years of age living in southwest China. Ten obesity indices were calculated. The 10-year cardiovascular disease (CVD) risk was estimated using the Framingham risk score. Receiver operating characteristic curve analysis was performed to assess the ability of the anthropometric index to predict the 10-year high risk of CVD events. Results: The waist-to-hip ratio (WHR) had the highest area under the curve (AUC) value (0.711; sensitivity: 62.22%, specificity: 42.73%) in men, while the body fat index (BAI) had the lowest AUC value (0.624, sensitivity: 49.07%, specificity: 54.84%). The waist-to-height ratio (WHtR) and the body roundness index (BRI) showed the highest AUC value (0.751, sensitivity: 39.24%, 39.83%, specificity: 75.68%, 68.59%) in women, while the BAI showed the lowest AUC value (0.671, sensitivity: 53.15%, specificity: 57.14%). Conclusions: The WHR was the best anthropometric measure for assessing the 10-year high risk of CVD in men, while the WHtR and BRI were the best measures for women. In men, the WHR should be < 0.88, and in women, the WHtR should be < 0.502 or the BRI should be < 3.41. [ABSTRACT FROM AUTHOR]

Helicopter Parenting (HP) refers to parenting behaviors such as overinvolvement and developmentally inappropriate support during late adolescence and emerging adulthood. To date, this construct has mainly been examined in Western cultures. This research developed and validated a multi-dimensional HP measure for mothers and late-adolescent children in Mainland China. Study 1 explored initial factor structure of HP with an online sample of Mainland Chinese mothers (N = 433; Mage = 43.63 years). Study 2 confirmed this structure with a new online sample of mothers (N = 461; Mage = 44.39 years), and assessed construct invariance between mothers of high school and college students. Study 3 confirmed this HP structure with mother-adolescent dyads (N = 248; Mothers: Mage = 44.29 years; Adolescents: Mage = 17.37 years) and assessed construct invariance and construct validity between dyad members. Across the three studies, results suggested a 16-item measure with four factors (advice/affect management, anticipatory problem solving, information-seeking, and emphasis on academic performance), which also loaded on a higher-order HP factor. The measure had good internal consistencies (αs ≥ 0.844). Fits for mother-reported high school and college student measurement invariance model, and mother-adolescent invariance model were acceptable when constraining all factor loadings. Mother and adolescent HP reports were modestly positively correlated. Within-respondent correlations in Studies 2 and 3 showed that the total HP scores were positively correlated with behavioral control and emotional support. However, mother-reported HP was negatively correlated with adolescent-reported emotional support, suggesting discrepant views about which parenting behaviors are helpful vs. overbearing. Mother- and adolescent-reported HP scores were not related to adolescent-reported psychological control or self-efficacy. This study offers a concise, multidimensional Chinese HP measure which is useful to examine Chinese mother-adolescent reporter discrepancies, as well as associations between Chinese HP and youth's psychological functioning. Highlights: This research developed a 16-item measure of HP, with four factors, that was invariant between mothers' and adolescents' reports in Mainland China. Results suggested that Chinese mothers and their adolescent children differed in views of the extent to which parenting behaviors were supportive vs. overbearing. In contrast to Western studies, HP was not associated with youth perceptions of psychological control or self-efficacy. [ABSTRACT FROM AUTHOR]

The reverse transcription-quantitative polymerase chain reaction (RT-qPCR) approach has been widely used to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, instead of using it alone, clinicians often prefer to diagnose the coronavirus disease 2019 (COVID-19) by utilizing a combination of clinical signs and symptoms, laboratory test, imaging measurement (e.g., chest computed tomography scan), and multivariable clinical prediction models, including the electronic nose. Here, we report on the development and use of a low cost, noninvasive method to rapidly sniff out COVID-19 based on a portable electronic nose (GeNose C19) integrating an array of metal oxide semiconductor gas sensors, optimized feature extraction, and machine learning models. This approach was evaluated in profiling tests involving a total of 615 breath samples composed of 333 positive and 282 negative samples. The samples were obtained from 43 positive and 40 negative COVID-19 patients, respectively, and confirmed with RT-qPCR at two hospitals located in the Special Region of Yogyakarta, Indonesia. Four different machine learning algorithms (i.e., linear discriminant analysis, support vector machine, stacked multilayer perceptron, and deep neural network) were utilized to identify the top-performing pattern recognition methods and to obtain a high system detection accuracy (88–95%), sensitivity (86–94%), and specificity (88–95%) levels from the testing datasets. Our results suggest that GeNose C19 can be considered a highly potential breathalyzer for fast COVID-19 screening. [ABSTRACT FROM AUTHOR]

Multiple cropping is a widespread approach for intensifying crop production through rotations of diverse crops. Maps of cropping intensity with crop descriptions are important for supporting sustainable agricultural management. As the most populated country, China ranked first in global cereal production and the percentages of multiple-cropped land are twice of the global average. However, there are no reliable updated national-scale maps of cropping patterns in China. Here we present the first recent annual 500-m MODIS-based national maps of multiple cropping systems in China using phenology-based mapping algorithms with pixel purity-based thresholds, which provide information on cropping intensity with descriptions of three staple crops (maize, paddy rice, and wheat). The produced cropping patterns maps achieved an overall accuracy of 89% based on ground truth data, and a good agreement with the statistical data (R2 ≥ 0.89). The China Cropping Pattern maps (ChinaCP) are available for public download online. Cropping patterns maps in China and other countries with finer resolutions can be produced based on Sentinel-2 Multispectral Instrument (MSI) images using the shared code. Measurement(s) area of different cropping patterns Technology Type(s) phenology-based approach Factor Type(s) type of cropping pattern Sample Characteristic - Organism Organism Sample Characteristic - Environment cultivated environment Sample Characteristic - Location China [ABSTRACT FROM AUTHOR]

Hydro-morphological processes (HMPs) are some of the most destructive natural disasters. Understanding the spatiotemporal characteristics of HMPs across China is important for enabling better disaster estimation and prevention at the national scale. However, few studies have focused on the spatiotemporal HMP characterization under various geomorphic settings in China, which may shed light on their regional/national evolution. To bridge this research gap, we analysed the longest HMP time series available in China, which including 47,483 HMP records, to detect spatiotemporal patterns. Specifically, we run several tests namely, Mann–Kendall test, wavelet analysis, Monthly Frequency, and Index of Dispersion, with the objective of detecting the temporal evolution, trends, period, and clustering of HMPs in six geomorphological regions (geomorphic-regions): Eastern Plain, South Eastern Mountain (SEM), North Central Plateau, North Western Basin, South Western Mountain (SWM), and Tibetan Plateau. Our results show that in the last decades have been associated with a marked increase in HMPs and this should be accounted for, especially in those areas where we have retrieved high spatiotemporal clustering (e.g., SEM, SWM). Besides, the main periodicity of HMPs is approximately 12–25 years for most of China since the 1980s, which showed analogous patterns with precipitation anomalies. This study provides a preliminary reference for revealing the spatiotemporal characteristics of HMPs in the context of climate change; therefore, the information provided can be crucial to plan engineering applications with specific return period. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Spiritual Perspectives Scale (SPS) into a Mandarin Chinese version (C-SPS) and evaluate its psychometric properties among 154 palliative care nurses from twelve community healthcare centres in Shanghai, China. Exploratory factor analysis suggested two factors (spiritually related activities and spiritual beliefs), accounting for 67.49% of the total variance. The Cronbach's α of the total C-SPS score was 0.89, and its split-half coefficient (Spearman-Brown reliability coefficient) was 0.72. The C-SPS showed consistently acceptable psychometric properties of reliability and validity. It can be used to evaluate the level of spiritual perspectives of nurses in China. [ABSTRACT FROM AUTHOR]

The climate in China is extremely abnormal in July 2020, which is largely attributed to the anomalous activities of the Western Pacific Subtropical High (WPSH). In the present study, statistical analysis and diagnostic calculation of individual terms of the complete form of vorticity equation are conducted to investigate features of meridional movement of WPSH in July 2020, and the mechanism for the anomalous meridional movement of the WPSH is also explored. Results indicate that in July 2020, the western segment of the WPSH ridge line persistently remained to the south of its climatological position, especially in the lower troposphere. Meanwhile, the eastern segment of the ridge line continuously stayed to the north of its normal position. Such a configuration leads to a large meridional span of the WPSH ridge line and is directly responsible for the super long Meiyu season in eastern China in the summer of 2020. The persistent southward shift of the WPSH ridge line in its western segment is attributed to the maintenance of strong positive vorticity anomalies to the north of the WPSH ridge line. Whereas the abnormally frequent southward invasion of cold air and the activities of troughs in the mid- and high-latitude regions are the main reasons for the maintenance of the vorticity anomalies to the north of the WPSH ridge line. In addition, the anomalously southward WPSH combined with the Indian ocean SST anomalies inhibited the development of tropical convection in the South China Sea—Philippines, which subsequently weakened the vorticity anomalies to the south of the WPSH ridge line and made the P-J teleconnection pattern exhibiting in abnormally negative phase, and resulting in anomalous cyclonic circulation and negative geopotential height developed in the middle and lower troposphere over southern Japan, which further caused the WPSH centroid locating southward and restricted the northward movement of the WPSH. [ABSTRACT FROM AUTHOR]

Though a continued increase in life expectancy is a significant public health achievement, keeping older adults active and maintaining their well-being is challenging. Active aging requires physical health, mental health, functional independence, economic stability, social participation, and spiritual identification. Among all these factors, social cohesion has significant importance, but there is a dearth of studies focusing on older adults' social cohesion. Thus, the present study focuses on the level of social cohesion among older adults and its variation among the different economic classes. This article uses data from the Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa during 2007–10. Social cohesion scores have been constructed using Item Response Theory Partial Credit Model. Also, bivariate analysis, concentration curves, concentration indices, and multivariate regressions have been used for the analysis presented in this paper. This study confirms the strong predictive power of age, wealth, education, and working status of older adults on their social cohesion across the countries. Higher social non-cohesion is found among the economically poor older adults in Mexico, Russia, India, and China. In contrast, it is just opposite in the case of older adults in South Africa. Governments should develop policies to foster a society with a high level of social inclusion, social capital, and social diversity, to achieve further advancement in social cohesion. [ABSTRACT FROM AUTHOR]

Summary: Arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery. It is important to improve short-term survival rates by optimizing the respiratory and cardiac function of geriatric patients before they undergo surgery. Introduction: This study aims to investigate the 30-day mortality and related risk factors for elderly patients following surgery for hip fractures. Methods: This retrospective study examined chart reviews for evaluating associations of gender, age, fracture site, biochemical indicators, pre-surgery comorbidities, number of pre-surgery comorbidities, time to surgery and anesthesia and surgery methods with postoperative 30-day mortality in elderly hip fracture surgery patients. Results: A total of 1,004 patients were included in the study and 43 (4.3%) patients died within 30 days after surgery. Univariate analysis showed that patients in the non-survival group had a higher mean age, higher leukocyte counts, lower hemoglobin and albumin levels, a higher proportion of arrhythmias, pneumoniae and cardiac insufficiency and number of presurgical comorbidities than the survival group (all P-values < 0.05). Multivariate logistic analysis further confirmed that arrhythmia (OR = 2.033, P = 0.038), pneumonia (OR = 2.246, P = 0.041), cardiac insufficiency (OR = 2.833, P = 0.029), high leukocyte count (OR = 1.139, P = 0.009), and low albumin (OR = 0.925, P = 0.041) were all significant risk factors for mortality 30 days after surgery. Conclusions: This study demonstrates that arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery. [ABSTRACT FROM AUTHOR]

Objectives: Tooth loss, which usually leads to malnutrition, is common in the elderly. However, limited information is available regarding its association with sarcopenia. This study aimed to investigate the relationship between loss of occlusal pairs of tooth and sarcopenia. Design: A cross-sectional retrospective study was performed. Setting: The elderly who participated in the National Basic Public Health Project in the Maigaoqiao Community Medical Center in Nanjing, Jiangsu Province, China. Participants: A total of 2850 individuals aged ≥60 years were enrolled. Measurements: Sarcopenia was defined according to the criteria proposed by the Asian Working Group for Sarcopenia. A trained dentist assessed oral health status and counted the number of present teeth. Logistic regression analyses were performed to evaluate the association between the loss of occlusal pairs and sarcopenia. Results: The prevalence of sarcopenia was 7.1% (201/2850). Univariate logistic regression analysis showed that loss of occlusal pairs was associated with sarcopenia [anterior occlusal pairs (AOPs): odd ratio (OR) = 1.292, 95% confidence interval (CI) = 1.158–1.442; posterior occlusal pairs (POPs): OR = 1.147, 95% CI = 1.018–1.221]. Multivariate logistic regression analysis indicated that loss of POPs was still an independent risk for sarcopenia (OR = 1.108, 95% CI = 1.007–1.220) after adjustment for traditional confounders. Subgroup analysis showed that loss of POPs was more significantly linked to sarcopenia in those with advanced age (≥80years) (OR = 1.307, 95% CI = 1.116–1.532) and in females (OR = 1.165, 95%CI = 1.038–1.308). Compared to individuals with ≥5 occluding pairs of POPs, those with <5 occluding pairs of POPs had a higher incidence of sarcopenia. Conclusions: Loss of POPs is associated with an increased risk of sarcopenia in the elderly in a Chinese population. Further research on the mechanism of the observed causal relationship is needed. [ABSTRACT FROM AUTHOR]

Background: Copper is associated with mild cognitive impairment (MCI). However, there is a lack of relevant population studies with large sample sizes. Aims: This study used baseline data from a cohort study to determine the distribution characteristics of MCI in the elderly and to estimate the association between whole blood copper concentrations and MCI. Methods: MCI status was screened by the Mini-Mental State Examination (MMSE) scale and Activities of Daily Living (ADL) scale. The concentration of copper in whole blood was determined by Inductively Coupled Plasma Mass Spectrometer (ICP-MS). Results: A total of 1057 subjects with an average age of 71.82 ± 6.45 years were included in this study. There were 215 patients with MCI, and the prevalence of MCI was 20.34%. After adjusting for general demographic variables, logistic regression analysis showed that the risk of MCI in the elderly with high copper level was 1.354 times higher than that in the elderly with low copper level (OR 1.354, 95% CI 1.047–1.983, P = 0.034). Conclusion: In this study, it was found that the prevalence of MCI was different in gender, age, education level and other aspects, and a higher copper level in the elderly was significantly related to the occurrence of MCI. The association was stronger in older adults and men. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyse the effects of demographic factors, clinical factors, and genetic polymorphisms of related gene loci on warfarin bleeding-related complications in the Han population. Methods: Retrospective medical record review. The study cases were patients treated at the Fujian Medical University Union Hospital from March 2016 to February 2020, and all received regular warfarin anticoagulation treatment for at least 3 months, and were provided the initial standard dose and stable dose of warfarin. Results: Data were collected from 451 qualifying patients (47% male, 53% female). The average age of patients was 53.8 ± 12.2 years, and the average body surface area was 1.6 ± 0.18 m2. There were nine major bleeding events and 141 minor bleeding events. In the univariate logistic analysis, the p-value of the four factors body weight, body surface area (BSA), amiodarone, and rs429358 was < 0.10. However, the final p-values for amiodarone and rs429358 were < 0.05 in the multifactorial logistic analysis. Conclusions: The ApoE (rs429358) gene polymorphism influences bleeding complications in Chinese Han patients treated with warfarin. The sample size of this study was relatively small; hence an international study with a larger sample size is needed in the future. [ABSTRACT FROM AUTHOR]

Aim: Sleep-disordered breathing (SDB) is common among adolescents and is associated with short- and long-term consequences. Data on the prevalence and epidemiologic characteristics of SDB in Chinese adolescents are limited. The purpose of this study was to examine the prevalence, epidemiologic characteristics, and associated factors of SDB using a large sample of Chinese adolescents. Subjects and methods: Participants were from the baseline of the Shandong Adolescent Behavior and Health Cohort (SABHC) and included 11,831 adolescents (aged 14.97 ± 1.46 years old) from five middle schools and three high schools in Shandong Province, China. Adolescents completed a self-administered questionnaire on sleep-related variables, demographics, general health, family, and school information. SDB was defined as report of loud snoring or snorting/gasping or stopping breathing during sleep occurring weekly. Results: In this sample, 8.3% of the adolescents snored loudly at least once per week and 2.1% snored loudly almost every night. Snorting/gasping and stopping breathing at least once a week affected 6.6% and 2.0% of adolescents, respectively. The prevalence of weekly SDB was 13.4% according to adolescent report. Multiple logistic regression analysis revealed that SDB was independently associated with male gender, body mass index (BMI), chronic diseases, ever smoking, ever drinking, insomnia, daytime sleepiness, poor family economic status, and low father education level. Conclusion: SDB is prevalent in Chinese adolescents, and multiple factors are associated with SDB. These associations also require longitudinal epidemiologic studies to clarify the complex nature of their relationships and opportunities for and effects of intervention. [ABSTRACT FROM AUTHOR]

Background: Headache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity. Methods: We used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses. Results: For migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R2 (0–0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R2 (0.04–0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16–56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant. Conclusion: Relief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving. [ABSTRACT FROM AUTHOR]

Low anterior resection syndrome (LARS) comprises a collection of symptoms affecting patients' defecation after restorative surgery for rectal cancer. The aim of this work was to study the incidence and risk factors for LARS in China. Rectal cancer patients undergoing total mesorectal excision and colorectal anastomosis between May 2012 and January 2015 were identified from a single center. The patients completed the LARS score questionnaire through telephone. The clinical and pathological factors that may influence the occurrence of LARS were analyzed using univariate and multivariate logistic regression analysis. The influence of postoperative recovery time and pelvic dimensions on the occurrence of LARS was also analyzed. This study included 337 patients, at an average age of 61.03 SD11.32. The mean LARS score of the patients was 14.08 (range 0–41). A total of 126 patients (37.4%) developed LARS after surgery, including 63 (18.7%) severe cases. Compared with the scores within the initial 6 postoperative months, the LARS scores of the patients in 6~18 months after the surgery showed significant reductions (p < 0.01). In multivariate analysis, lower locations of anastomosis, pre-surgery radiotherapy, and shorter postoperative recovery time were significant predisposing factors for LARS. A subgroup analysis revealed that patients suffering from LARS over 18 months after surgery were found to have a significantly shorter interspinous distance than those without LARS (p < 0.05). LARS could improve over time after surgery. Lower anastomotic level and pre-surgery radiotherapy are risk factors for LARS. [ABSTRACT FROM AUTHOR]

Purpose: Studies have demonstrated improvements in hand hygiene (HH) compliance through interventions, noting the negative association of HH and healthcare associated infections (HAIs), but how to sustain long-term improvement is still unknown in the Chinese population. This study sought to determine the extent of change in HH compliance after multimodal HH interventions, and to evaluate the relationship between that change and HAI incidence. Methods: We conducted a longitudinal study in a general teaching hospital in China from 2017 to 2020. Trained investigators observed HH practices based on the World Health Organization's 5 moments for HH. We identified the incidence of HAIs using semi-automated constant surveillance software. We used the Cochran–Mantel–Haenszel test to assess the secular trend of HH compliance and HAIs. The Spearman correlation coefficient (rs) was used to evaluate the relationship between the incidence of HAIs and compliance with HH. Results: The study made 480,943 observations, where HH was occurring between 2017 and 2020. HH compliance increased from 68.90 to 91.76% during that period (Ptrend < 0.01), while the incidence of HAIs decreased from 1.10 to 0.91%. Compliance also increased for each moment type and for each healthcare worker (Ptrend < 0.01). Lower HH compliance was observed in before-patient contact and after contact with patient surroundings, and among interns and cleaners. We also observed a weak but statistically significant negative correlation between the monthly HH compliance and incidence of HAIs (rs = − 0.27; P = 0.037). Conclusions: The multimodal HH implementation delivered sustained improvement in HH compliance, and this change was associated with a decline in the incidence of HAIs. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are common in the elderly and have a high risk of mortality. Several risk prediction models for mortality of hip fracture have been developed, but most of them are difficult to apply accurately in clinical practice. Aims: The objective of the present study was to perform an external validation of a new published preoperative risk score for predicting mortality. Methods: We carried out a retrospective cohort study from January 2014 to December 2018 for elderly hip fracture patients discharged from a orthopedic center in China. The preoperative risk score was calculated for each patient, and further divided into two groups: low-risk group (score < 24 points) and high-risk group (score ≥ 24 points) using the receiver operating characteristic (ROC) curve. The outcome was 30-day, 6-month and 1-year all-cause mortality, and the relationship between the risk score and mortality was assessed by univariate and multivariate Cox proportional hazard models. The area under the curve (AUC), Hosmer–Lemeshow test and calibration plots were used to test the discrimination and calibration. Results: A total of 460 consecutive patients were included in the study, and high-risk score was an independent risk factor for 30-day mortality [Hazard ratio (HR) 6.70; 95% Confidence interval (CI) 1.82–24.69; p = 0.004], 6-month mortality (HR 2.94; 95% CI 1.68–5.17; p < 0.001) and 1-year mortality (HR 3.30; 95% CI 2.09–5.20; p < 0.001). Also, each point increase in the risk score resulted in a 11% increase in 30-day mortality (HR 1.11; 95% CI 1.07–1.16; p < 0.001), 6% increase in 6-month mortality (HR 1.06; 95% CI 1.04–1.09; p < 0.001), and 5% increase in 1-year mortality (HR 1.05; 95% CI 1.03–1.07; p < 0.001). Moreover, the risk score had an AUC of 0.89 (95% CI 0.80–0.98) for 30-day mortality, 0.77 (95% CI 0.70–0.83) for 6-month mortality, and 0.76 (95% CI 0.70–0.81) for 1-year mortality. Calibration plots showed a good calibration between observed and predicted mortality, which was also demonstrated by the Hosmer–Lemeshow test. Conclusion: Our present study findings indicated that the preoperative risk score was an accurate mortality risk assessment tool for elderly hip fracture patients, regardless of short- and long-term follow-up. [ABSTRACT FROM AUTHOR]

Objective: To investigate the mechanism of Tojapride, a Chinese herbal formula extract, on strengthening the barrier function of esophageal epithelium in rats with reflux esophagitis (RE). Methods: Ten out of 85 SD rats were randomly selected as the sham group (n10), and 75 rats were developed a reflux esophagitis model (RE) by the esophageal and duodenal side-to-side anastomosis. Fifty successful modeling rats were divided into different medicated groups through a random number table including the model, low-, medium-, and high-dose of Tojapride as well as omeprazole groups (n10). Three doses of Tojapride [5.73, 11.46, 22.92 g/(kg•d)] and omeprazole [4.17 mg/(kg•d)] were administrated intragastrically twice daily for 3 weeks. And the rats in the sham and model groups were administered 10 mL/kg distilled water. Gastric fluid was collected and the supernatant was kept to measure for volume, pH value and acidity. Esophageal tissues were isolated to monitor the morphological changes through hematoxylin-eosin (HE) staining, and esophageal epithelial ultrastructure was observed by transmission electron microscopy. The expressions of nuclear factor kappa-light-chain-enhancer of activated B cells p65 (NF-KBp65), κB kinase beta (IKKß), occludin, and zonula occludens-1 (ZO-1) in the esophageal tissues were measured by immunohistochemistry and Western blot, respectively. Results: The gastric pH value in the model group was significantly lower than the sham group (P<0.05). Compared with the model group, gastric pH value in the omeprazole and medium-dose of Tojapride groups were significantly higher (P<0.05). A large area of ulceration was found on the esophageal mucosa from the model rats, while varying degrees of congestion and partially visible erosion was observed in the remaining groups. Remarkable increase in cell gap width and decrease in desmosome count was seen in RE rats and the effect was reversed by Tojapride treatment. Compared with the sham group, the IKKß levels were significantly higher in the model group (P<0.05). However, the IKKß levels were down-regulated after treatment by all doses of Tojapride (P<0.01 or P<0.05). The occluding and ZO-1 levels decreased in the model group compared with the sham group (Ps0.01 or Ps0.05), while both indices were significantly up-regulated in the Tojapride-treated groups (P<0.01 or P<0.05). Conclusions: Tojapride could improve the pathological conditions of esophageal epithelium in RE rats. The underlying mechanisms may involve in down-regulating the IKKß expression and elevating ZO-1 and occludin expression, thereby alleviating the inflammation of the esophagus and strengthening the barrier function of the esophageal epithelium. [ABSTRACT FROM AUTHOR]

Background: Evidence of the association between marital status and cognitive function in Chinese older adults is limited. Aims: To examine the relationship between marital status and cognitive function and to explore the role of gender amongst older adults from three Chinese communities. Methods: A total of 1376 participants aged 60 years or over were included in this cross-sectional study. Cognitive function was assessed using the Chinese version of the mini-mental state examination (MMSE). Marital status and other variables were collected using a standardized questionnaire. Multiple linear regression models were used to examine associations between marital statuses and cognitive function amongst the target population. The moderating role of gender in these potential associations has also been explored. Results: In univariate linear regression models, compared to being married, both being widowed (β [95% CI]: −1.46[−2.78 to − 0.13]) and being single (β [95% CI]: − 4.88[−6.43 to − 3.38]) were associated with lower MMSE scores. After adjustment for confounding factors, the significant association of being widowed with MMSE scores disappeared (β [95% CI: − 0.08[− 1.04 to 0.86]), but the association of being single with MMSE scores still existed (β [95% CI]: − 1.87[− 3.17 to − 0.58]). Furthermore, the association of being single with MMSE scores was statistically significant in men (β [95% CI]: − 5.25[− 7.17 to − 3.33]) but not in women (β [95% CI: 0.88[− 0.87 to 2.64]). Discussion and conclusions: Being single was associated with poorer cognitive function compared with their married counterparts in older Chinese men but not in women. More preventive measurements should be implemented for single men to reduce or delay cognitive decline. This is particularly important in the context of an aging population in China. [ABSTRACT FROM AUTHOR]

Purpose: To identify the risk factors of calcineurin inhibitor (CNI)–associated new-onset diabetes mellitus (NODM) in chronic kidney disease (CKD) treatment. Methods: We retrospectively screened patients treated with CNIs in our hospital from January 2015 to December 2018. The inclusion criteria were as follows: a clear diagnosis of CKD and patients receiving CNI treatment. We compared patients with and without CNI-associated NODM. Results: Ninety-eight of the 336 assessed patients met the inclusion criteria, 15 (15.3% [15/98]) of whom developed CNI-associated NODM. Multiple logistic regression analysis revealed that baseline glycosylated hemoglobin (OR=4.141; 1.024–16.743; p=0.046) and CNI trough concentration (1 year) (OR=1.028; 1.009–1.047, p=0.004) were independent risk factors for NODM. In contrast, glucocorticoid type (prednisone) (OR=0.075; 0.011–0.526, p=0.009) was identified as an independent protective factor for NODM. Using a receiver operating characteristic curve, a cutoff cyclosporin A trough concentration of 102.1 ng/mL was identified as a predictive factor of NODM. Univariate logistic regression showed that the incidence of diabetes was significantly higher in patients with baseline glycosylated hemoglobin in non-diabetic range but higher than 5.65% (10.2% vs. 29.2%, p=0.038). One NODM patient (6.7% [1/15]) recovered at 12.7 months after the onset of diabetes mellitus. Conclusions: We recommend that more attention be paid to patients with baseline glycosylated hemoglobin in non-diabetic range but higher than 5.65% during CKD treatment with CNIs. High trough concentrations of cyclosporin A, particularly those >102.1 ng/mL, contribute to NODM. CNI-associated NODM may be reversible in the treatment of CKD. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the relationship between cognitive performance and obesity parameters, such as body mass index (BMI), visceral fat area (VFA), waist circumference (WC), and waist-to-hip ratio (WHR) in western China. Study Design: A cross-sectional study. Methods: 3914 participants, aged ≥50 years, were recruited in this study. Anthropometrics measurements, life-style factors, chronic disease comorbidities, and sleep qualities were recorded for each participant. Among the anthropometrics, BMI, WC, and WHR were assessed using standard procedures, while VFA was calculated using bioelectrical impedance analysis. Cognitive performance was estimated using the Short Portable Mental Status Questionnaire (SPMSQ). Finally, relationships between cognitive abilities and BMI, VFA, WC, and WHR were evaluated using univariate and multivariate regression analyses. Results: Cognitive decline (CD) occurred at a rate of 13.29% among the 3914 participants. A strong correlation was observed between cognitive abilities and BMI of male patients aged 50–59 yrs (OR 1.116,95% CI1.002–1.242), in the adjusted model. Alternately, WHR was shown to be significantly related to CD in females aged ≥70 years (OR 0.041, 95% CI0.002–0.671). WC was shown to have a strong association with CD in males (OR 1.023,95% CI1.003–1.024). Lastly, WHR was closely connected to CD in participants with BMI < 25 kg/m2 (OR 0.022,95% CI0.002–0.209). Conclusions: Our findings suggest that a higher middle age BMI is associated with CD, whereas, in the elderly population, a higher WHR is related to improved cognitive performance. Further investigation is warranted to elucidate a relationship between VFA and CD. [ABSTRACT FROM AUTHOR]

To control the deformation disaster and explore the effective in-situ evaluation method of filling in the Loess Plateau of China, the laboratory tests and cone penetration test (CPT), dynamic penetration test (DPT), standard penetration test (SPT) were carried out for a case of filling with large area. The research was performed based on data distribution, non-uniformity evaluation, correlation and sensitivity analysis. The results are as follows: (1) the filling filled by layered compaction still has non-uniformity. The distribution of CPT tip resistance is consistent with collapsibility coefficient and obeys logarithmic normal distribution. The distribution of CPT side friction and SPT hammer number are consistent with moisture content, void ratio and dry density and obey normal distribution. The distribution of DPT hammer number does not correspond to any soil properties index. The CPT also has the advantages to reflect layered compaction characteristics along filling depth and distinguish the boundary between filling and undisturbed soil. (2) Three test methods can all reflect the non-uniformity of soil properties in depth direction. However, for the horizontal direction, the CPT results can best reflect non-uniformity of actual collapse deformation, followed by SPT and DPT is the worst. (3) For the testing of filling compaction state, CPT tip resistance and SPT have good mathematical correlation, and the sensitivity of CPT tip resistance is significantly higher than other methods. For the testing of filling collapse deformation capacity, the CPT tip resistance, DPT and SPT all have good correlation and sensitivity. So CPT tip resistance has the best cooperation between correlation and sensitivity. (4) The CPT (especially tip resistance part) can be effectively applied to the properties evaluation of silty loess filling. The tip resistance to void ratio and collapsibility coefficient follow the exponential function and logarithmic function respectively. [ABSTRACT FROM AUTHOR]

To investigate the influence of the home environment, defined as family socioeconomic status (SES) (parent education level, household income), student resource-mediated SES (access to nutritional resources and cognitively stimulating experiences), reading ability, and difficulty with homework on quality of life in children and adolescents residing in urban and suburban areas in Hangzhou City, Zhejiang Province, China. This study included 3200 Grade 3–6 students from 8 elementary schools in Hangzhou City. Assessments included questionnaires that evaluated student quality of life, family SES, resource-mediated SES (dietary behavior and the home literacy environment), reading ability, and difficulty with homework. The effects of the home environment on student quality of life were analyzed by univariate analysis, multiple linear regression analysis, and structural equation modeling. Overall, 80.6% of students had a medium or better quality of life. Young age (Grade 3 or 4), female sex, household income of 10000–15000 RMB, high breakfast consumption, daily intake of fruit, a balanced diet, and good reading habits were positively correlated with student quality of life (P < 0.05), while overuse of electronic devices was negatively correlated with quality of life (P < 0.05). Dietary behaviors, home literacy environment, and student reading ability and difficulty with homework directly affected quality of life. Family SES indirectly affected student quality of life. Children and adolescents in China should have access to good nutrition and cognitively stimulating experiences to enhance their well-being and provide them with social and academic advantages. Highlights: The influence of the home environment on quality of life in students in China was explored with structural equation modeling. Student quality of life was directly affected by diet, the literacy environment, reading ability and difficulty with homework. Student quality of life was indirectly affected by family socioeconomic status. These findings will inform the development of programs that promote improved quality of life in Chinese children. [ABSTRACT FROM AUTHOR]

This paper measured the efficiency of green science and technology (S&T) innovation in 30 Chinese provinces from 2008 to 2017 by constructing a three-stage super-efficiency DEA model that contains undesired output and then analyzed the spatial performance for these provinces. The purpose is to calculate exactly the extent to which S&T innovation in different regions of China has contributed to economic development, excluding negative impacts on the ecological environment and any spatial differences that have emerged in the past decade. The results show that the overall performance of green S&T innovation efficiency in Chinese regions was poor in the past decade, and there is still much room for improvement. In addition, China's investment in S&T innovation and environmental management is inefficient and wasteful. From the temporal perspective, efficiency in green innovation shows a slowly increasing trend. From the spatial perspective, the efficiency shows a strict correlation with economic development, that is, an obvious three-level spatial distribution pattern of "east, middle, and west". [ABSTRACT FROM AUTHOR]

The principle of equal treatment is fundamental to the fairness of any pretrial detention system, yet scholarship on this issue in the Chinese context is scarce. Based on 520 samples concerning pretrial decisions from one city court in China, this study reveals that the principle of equal treatment was not well enforced in that particular pretrial context. Our statistical analysis shows that legal factors such as the seriousness of the crime, a defendant's prior criminal record, and joint-crime status (i.e., several perpetrators commit a crime jointly), as well as some extra-legal demographic factors significantly influence pretrial decisions on release or detention. We added new variables of domicile, joint-crime, and the type of pretrial detention within the context of the Chinese system. This theoretical focus on contextual factors may be useful for similar European studies. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) bring about a range of psychological distress and symptom deterioration to headache patients especially to some migraineurs. Compared to migraineurs or normal control, medication overuse headache (MOH) patients are more likely to experience a worse psychological distress and poorer outcome in non-COVID-19 time. However, in COVID-19 pandemic, whether MOH patients would have greater physical and mental symptom deterioration or worse relief of headache symptoms and medications overuse remained unclear. We aim to investigate the impact of COVID-19 on MOH patients to guide for a better management in this study. Methods: We enrolled MOH patients who were diagnosed and treated at headache clinic of West China Hospital. Information of the pre-pandemic 3 months period and COVID-19 pandemic period was collected. Univariate and multivariate logistic regression were performed to identify independent factors associated with changes in headache symptoms and drug withdrawal. Results: Seventy-eight MOH patients were enrolled into the study ultimately. In comparison to pre-pandemic period, fewer MOH patients reported decreased headache days, intensity and days with acute medications per month during the pandemic. Available access to regular prophylactic medications was significantly associated with a reduction of at least 50% in headache days and decrease in headache intensity per month with respective odds ratios of 39.19 (95% CI 3.75–409.15, P = 0.002) and 10.13 (95% CI 2.33–44.12, P = 0.002). Following abrupt withdrawal and high educational level were both significant factors in decreasing headache intensity. Male sex was significantly associated with decrease in days with acute medication per month during the pandemic (odds ratios 4.78, 95%CI 1.44–15.87, P = 0.011). Conclusions: Our findings reflect that MOH patients experienced a worse relief of headache symptoms and drug withdrawal during the pandemic. Available access to regular prophylactic medications was the significant independent factor for improvement of headache symptoms. Male sex was significantly associated with decreased days with acute medications per month. [ABSTRACT FROM AUTHOR]

Recent studies have shown that the temporary storage and manipulation of depth information (working memory for depth; WMd) is largely different from that of visual information in a 2D context (visual working memory; VWM). Although there has been abundant evidence on VWM showing that cueing a memory item during retention could bias attention to its internal representation and thus improves its memory performance (a retro-cue effect), it is unknown whether such an effect differs for WMd that is nested in a 3D context compared with that in a conventional 2D context. Here, we used a change detection task to investigate the effect of attentional selection on WMd by testing several types of retro-cue. The memory array consisted of items positioned at various stereoscopic depth planes, and a cue was presented during retention. Participants needed to make judgments on whether the depth position of target (one memory item) had changed. Our study showed reliable valid retro-cue benefits but no invalid retro-cue cost, indicating that the relational information may be registered in WMd to prevent a strategical removal of the unattended item. There was also a slight improvement in memory performance for cueing depth order compared with that for cueing other feature dimensions or 2D locations. The attentional effect on memory representation in a 3D context is different from that in a 2D context, and the divergence may suggest the distinctive nature of working memory for depth. [ABSTRACT FROM AUTHOR]

Purpose: Comprehensive understanding glioma metabolic characters is of great help for patient management. We aimed to compare amide proton transfer imaging (APTw) and magnetization transfer imaging (MT) in predicting glioma malignancy and reflecting tumor proliferation. Methods: Thirty low-grade gliomas (LGGs) and 39 high-grade gliomas (HGGs) were prospectively included, of which 58 samples Ki-67 levels were quantified. Anatomical MRI, APTw, and MT were scanned, and magnetization transfer ratio (MTR) and asymmetric magnetic transfer ratio at 3.5 ppm (MTRasym(3.5ppm)) were calculated. ROIs were semi-automatically drawn with ImageJ, from which histogram features, including 5th, 25th, 50th, mean, 70th, 90th, and 95th percentiles were extracted. The independent t test was used to test differences in LGGs and HGGs, and correlations between histogram features and tumor grades, Ki-67 were revealed by Spearman's rank or Pearson's correlation analysis. Results: The maximum correlation coefficient (R) values of APTw were 0.526 (p < 0.001) with tumor grades and 0.397 (p < 0.001) with Ki-67 at 90th percentiles, while only 5th and 25th percentiles of MT significantly correlated with tumor grades. Moreover, APTw features were significantly different in LGGs and HGGs, except 5th percentile. The most significantly different feature was 95th percentile, providing the excellent AUC of 0.808. However, the best feature in MTR was 5th percentiles with AUC of 0.703. Combing 5th and 95th of APTw achieved highest AUC Of 0.837. Conclusions: Both APTw and MT provide quantitative information for tumor metabolite imaging. However, APTw supplys more specific information in reflecting glioma biological behaviors than MT, and well differentiates glioma malignancy. [ABSTRACT FROM AUTHOR]

Transgender women (TGW) worldwide report disproportionate violence victimization, depression and condomless anal intercourse (CAI), but the mechanism of the coexistence remains unclear. Using snowball sampling, we recruited 198 self-identified TGW in Shenyang, China between April 2017 and July 2017, and conducted confidential questionnaire survey among them. Positive HIV status was reported by 49 (24.7%) participants. 117 (59.1%) reported at least one type of lifetime violence victimization, with transactional sexual partners being the main violence perpetrators. 108 (54.5%) reported mild to severe depression. 105 (53.0%) reported having CAI with their sexual partners during the last 6 months. Path analysis showed that the association between participants' violence victimization and CAI was fully mediated by their depression (indirect effect: 0.083, p = 0.014; direct effect: 0.137, p = 0.121). We suggest to incorporate violence screening and prevention and mental health services into intervention strategies to prevent CAI among Chinese TGW. [ABSTRACT FROM AUTHOR]

Globally, urban has been the major contributor to greenhouse gas (GHG) emissions and thus plays an increasingly important role in its efforts to reduce CO2 emissions. However, quantifying city-level CO2 emissions is generally a difficult task due to lacking or lower quality of energy-related statistics data, especially for some underdeveloped areas. To address this issue, this study used a set of open access data and machine learning methods to estimate and predict city-level CO2 emissions across China. Two feature selection technologies including Recursive Feature Elimination and Boruta were used to extract the important critical variables and input parameters for modeling CO2 emissions. Finally, 18 out of 31 predictor variables were selected to establish prediction models of CO2 emissions. We found that the statistical indicators of urban environment pollution (such as industrial SO2 and dust emissions per capita) are the most important variables for predicting the city-level CO2 emissions in China. The XGBoost models obtained the highest estimation accuracy with R2 > 0.98 and lower relative error (about 0.8%) than other methods. The CO2 emissions predictive accuracy can be improved modestly by combing geospatial and meteorological interpolation predictor variables (e.g., DEM, annual average precipitation, and air temperature). We also observed an S-shape relationship between urban CO2 emissions per capita and urban economic growth when the rest variables were held constant, rather than a U-shaped one. The findings presented herein provide a first proof of concept that easily available socioeconomic statistical records and geospatial data at urban areas have the potential to accurately predict city-level CO2 emissions with the aid of machine learning algorithms. Our approach can be used to generate carbon footprint maps frequently for the undeveloped regions with scarce detailed energy-related statistical data, to assist policy-makers in designing specific measures of reducing and allocating carbon emissions reduction goal. [ABSTRACT FROM AUTHOR]

Purpose: Developing countries need effective and efficient training curriculum for the point-of-care ultrasound (POCUS) in the emergency department (ED). We have developed a new goal-directed training curriculum focusing on critical POCUS procedures used in ED. Methods: To evaluate the impact of the new POCUS curriculum on ED physicians' performance/self-confidence, we carried out a quasi-experimental trial at ED training center of Peking Union Medical College Hospital, in which we trained two groups of physicians using either traditional curriculum or the new goal-directed curriculum. We measured the confidence in performing Focused Assessment with Sonography in Trauma, thoracic, vascular, ultrasound-guided puncture, echocardiography and undifferentiated shock diagnostic ultrasound at baseline, training completion and 1 month after training. We also measured the performance skills at the time of training completion. The relative value of the new curriculum was evaluated by differences in the confidence and performance measurements, with control for baseline measurements and confounding characteristics in univariate analyses and multivariate linear regression models. Results: After training, both groups of trainees reported significantly increased self-confidence in performing POCUS as compared with baseline. Trainees with the new curriculum had statistically significant higher self-confidence increase and performance scores (p < 0.05), e.g., increase in confidence for diagnosis of undifferentiated shock at training completion = 3.14 vs. 1.85, 1 month after training = 2.22 vs. 1.56, for new and traditional curriculum, respectively. The new curriculum also resulted in a higher number of shock POCUS done within 1 month after training: 1.73 vs. 0, and higher overall performance scores: 165 vs. 113. The findings were robust when controlling for imbalanced baseline characteristics in multivariate regression models. Conclusion: We conclude that a goal-directed, intensive but brief ED POCUS curriculum significantly increases trainee self-confidence, performance, and promote trainees to perform more procedures. [ABSTRACT FROM AUTHOR]

Objectives: To compare the ability of Frailty Phenotype (FP), FRAIL and Frailty Index (FI) to predict adverse outcomes. Design: A prospective cohort study. Setting: A senior community in Beijing, China. Participants: A total of 188 older adults aged 65 years or older (mean age 84.0 ± 4.4 years, 58.5% female). Measurements: Frailty was evaluated by FP, FRAIL and FI. The agreement between scales was assessed by Cohen kappa coefficient. The predictive value of the three scales for adverse outcomes during one-year follow-up period were analyzed using decision curve analysis(DCA) and receiver operating characteristic curve (ROC) analysis. Results: Frailty ranged from 25% (FRAIL) to 42.6% (FI). The agreement between scales was moderate to good (Cohen's kappa coefficient 0.44∼0.61). DCA showed though the curves of the scales overlapped across all relevant risk thresholds, clinical treating had a higher net benefit than "treat all" and "treat none" when risk of unplanned hospital visits ≥30%, risk of functional decline or falls ≥15%. The three scales had similar predictive value for unplanned hospital visits (area under ROC, AUC 0.63, 0.64 and 0.69). FRAIL and FI had similar predictive value for functional decline (AUC 0.63,0.65). FI had predictive value for falls (AUC 0.65). Conclusions: All three scales showed clinical utility but FRAIL may be best in practice because it is simple. Multidimensional measures of frailty are better than unidimensional for prediction of adverse outcomes among older adults. [ABSTRACT FROM AUTHOR]

Hydrochemistry of groundwater is important in coal mines because it can be used for understanding water–rock interaction and inrush water source identification. In this study, major ion concentrations of groundwater samples from the loose layer aquifer (LA), coal-bearing aquifer (CA) and Taiyuan Formation limestone aquifer (TA) in the Qingdong coal mine, northern Anhui province, China, have been analyzed by a series of statistical methods for identifying the source of chemical constituents in groundwater and the source of inrush water. The results indicate that the mean concentration of the major ions in the LA were ordered as follows: HCO3− > SO42− > Na+ + K+ > Cl− > Ca2+ > Mg2+ > CO32−, whereas average values of the CA in decreasing order are SO42−, Na+ + K+, HCO3−, Cl−, Ca2+, Mg2+ and CO32−, and the major ion concentrations of the TA have the following order: SO42− > Na+ + K+ > Ca2+ > HCO3− > Cl− > Mg2+ > CO32−, and most of the samples are Na-SO4 and Ca-SO4 types. TDS content in water increases with aquifer depth, whereas the pH values ranged from 7.1 to 8.9, indicating a weak alkaline environment. Two sources (weathering of silicate minerals and dissolution of evaporate minerals) have been identified by principal component analysis responsible for the chemical variations of the groundwater, and their contribution ratios have been quantified by Unmix model. Moreover, based on the Q-mode cluster and discriminant analyses, the samples with known sources have been identified correctly to be 95.7% and 97.6%, respectively, and the samples with unknown sources have been determined with high probability (78–100%). [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the feasibility of the Clinical Frailty Scale (CFS) and clinical biomarkers in assessing the frailty in elder inpatients in China. Design: The study was a cross-sectional study. Setting and Participants: The study included 642 elder inpatients (295 females and 347 males) aged ≥65 years, from the Department of Geriatrics of Zhejiang Hospital between January 2018 and December 2019. Measurements: All participants underwent a comprehensive geriatric assessment and blood tests. Univariate and multivariate logistic regression was used to analyze the association between risk factors and frailty. Results: The average age of the participants was 82.72±8.06 years (range: 65–95 years) and the prevalence of frailty was 39.1% according to the CFS. Frail participants showed significantly lower short physical performance battery (SPPB), basic activities of daily living (ADL) and instrumental activities of daily living (IADL) scores (all p<0.001), and lower hemoglobin, total protein and albumin levels (all P<0.05) than nonfrail participants. Frail participants had higher CRP, D-dimer and fibrinogen levels than nonfrail participants (all p<0.05). Univariate logistic regression analysis showed a significant association between frailty and age, comorbidity, polypharmacy, fall history, SPPB, ADL, and IADL scores, D-dimer, fibrinogen, hemoglobin, total protein and albumin levels (all P<0.05). Multivariate logistic regression analysis indicated that age (odds ratio (OR), 95% confidence interval (CI)= 1.151(1.042–1.272), P=0.006), SPPB scores (OR, 95% CI=0.901(0.601–1.350), P<0.001), and D-dimer (OR, 95% CI=4.857(2.182–6.983), P<0.001), fibrinogen (OR, 95% CI=2.665(0.977–4.254), P<0.001), hemoglobin (OR, 95% CI=0.837(0.725–0.963), P= 0.044), and albumin (OR, 95% CI=0.860 (0.776–1.188), P<0.001) levels were independently associated with frailty in all participants. Conclusion: Frailty in elder inpatients in China is characterized by older age, a lower SPPB scores, higher D-dimer and fibrinogen levels and lower hemoglobin and albumin levels. Functional decline and malnutrition may be the targets of frailty interventions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application status of Chinese medicine (CM) in cancer rehabilitation, so as to provide references for improving the level of CM cancer rehabilitation. Methods: A survey questionnaire regarding "application status of CM rehabilitation in cancer patients" for oncologists (doctor version) and cancer patients (patient version) were developed, respectively. From September 2014 to November 2016, a total of 1,000 doctors from oncology department in 48 hospitals and 2,000 cancer patients from CM oncology department from 8 hospitals in China were recruited in this survey. The psychological, nutrition and exercise rehabilitation guidance for cancer patients provided by doctors, their mastery conditions regarding cancer staging treatment and CM syndrome differentiation, and recommendation from doctors on CM rehabilitation were investigated. Cancer patients' awareness on the importance of psychological, nutrition and exercise rehabilitation, as well as their knowledge and needs for rehabilitation were also analyzed. The impact of gender, age, professional title, hospitals grades of physicians on their knowledge of cancer staging treatment and CM syndrome differentiation, and the relationship between gender, age, education level and economic conditions and patient's knowledge along with the needs of CM rehabilitation were further analyzed. Results: Totally 1,000 questionnaires were issued to doctors and 963 questionnaires returned, among which 948 were valid representing a response rate of 94.80%. A total of 2,000 questionnaires were issued to patients and 1,705 valid data finally returned with a response rate of 85.25%. The survey showed that cancer patients generally paid much attention to psychological, nutritional and sports rehabilitation, and had a strong demand for CM rehabilitation. Knowledge of CM rehabilitation was not well provided by oncologists, and the rehabilitation guidance as well as CM rehabilitation measures were obviously insufficient in cancer patients. Educational and economic levels were positively correlated with cognition level of CM rehabilitation knowledge among cancer patients (Kendall-tau_b correlation coefficients=0.130, 0.057, respectively; P<0.05). Gender and education level were positively correlated with the patients' willingness for taking CM measures (Kendall-tau_b correlation coefficient=0.057, 0.105, respectively; P<0.05). Age was negatively correlated with intention of applying CM measures (kendall-taub correlation coefficient=–0.105, P<0.05). Conclusions: Health education and professional training for both cancer patients and oncologists should be strengthened and CM rehabilitation knowledge among cancer patients and oncologists should be improved, so as to give full play to CM in cancer rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Silent new ischemic cerebral lesions (sNICL) detected by diffusion-weighted imaging (DWI) are common after carotid artery stenting (CAS). As part of the Revascularization of Extracranial Carotid Artery Stenosis (RECAS) study, this work aimed to determine predictors of sNICL detected by DWI following CAS. Methods: A total of 694 patients eligible for the RECAS study treated in Xuanwu Hospital, Capital Medical University, with complete imaging data were included in this retrospective study. The patients were asymptomatic after CAS, and those with stroke, transient ischemic attack (TIA), or death were excluded. The RECAS protocol specified that DWI was completed 1–7 days before the procedure and within 3 days after CAS. Several parameters were assessed for associations with sNICL occurrence after CAS in univariate analysis. Finally, multivariate analysis was performed to determine risk factors for sNICL. Results: The rate of post-procedural sNICL in CAS was 51.3% (356/694 patients with sNICL). All patients underwent stenting with embolic protection devices. Univariate analysis showed that diabetes mellitus (P = 0.008), ipsilateral calcified plaques (P = 0.036), ipsilateral ulcerated plaques (P = 0.026), pre-dilatation (P = 0.003), and open-cell stent use (P < 0.001) were significantly associated with sNICL occurrence in CAS. Multivariate analysis revealed that diabetes mellitus (P = 0.006), ipsilateral calcified plaques (P = 0.024), ipsilateral ulcerated plaques (P = 0.021), and open-cell stent use (P < 0.001) were independent risk factors for sNICL. Conclusions: Patients with diabetes, calcified or ulcerated plaques who undergo CAS with open-cell stent application, are at high risk of sNICL. Large-scale prospective randomized controlled trials are needed to confirm these findings. [ABSTRACT FROM AUTHOR]