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Background Most international treatment guidelines recommend rapid initiation of antiretroviral therapy (ART) for people newly diagnosed with human immunodeficiency virus (HIV)-1 infection, but experiences with rapid ART initiation remain limited in China. We aimed to evaluate the efficacy and safety of efavirenz (400 mg) plus lamivudine and tenofovir disoproxil fumarate (EFV + 3TC + TDF) versus coformulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) in rapid ART initiation among men who have sex with men (MSM) who have been diagnosed with HIV. Methods This multicenter, open-label, randomized clinical trial enrolled MSM aged ≥18 years to start ART within 14 days of confirmed HIV diagnosis. The participants were randomly assigned in a 1:1 ratio to receive EFV (400 mg) + 3TC + TDF or BIC/FTC/TAF. The primary end point was viral suppression (<50 copies/mL) at 48 weeks per US Food and Drug Administration Snapshot analysis. Results Between March 2021 and July 2022, 300 participants were enrolled; 154 were assigned to receive EFV + 3TC + TDF (EFV group) and 146 BIC/FTC/TAF (BIC group). At week 48, 118 (79.2%) and 140 (95.9%) participants in the EFV and BIC group, respectively, were retained in care with viral suppression, and 24 (16.1%) and 1 (0.7%) participant in the EFV and BIC group (P <.001), respectively, discontinued treatment because of adverse effects, death, or lost to follow-up. The median increase of CD4 count was 181 and 223 cells/μL (P =.020), respectively, for the EFV and BIC group, at week 48. The overall incidence of adverse effects was significantly higher for the EFV group (65.8% vs 37.7%, P <.001). Conclusions BIC/FTC/TAF was more efficacious and safer than EFV (400 mg) + 3TC + TDF for rapid ART initiation among HIV-positive MSM in China. [ABSTRACT FROM AUTHOR]

Mucopolysaccharidosis type IIIC (MPS IIIC) is one of inherited lysosomal storage disorders, caused by deficiencies in lysosomal hydrolases degrading acidic mucopolysaccharides. The gene responsible for MPS IIIC is HGSNAT, which encodes an enzyme that catalyses the acetylation of the terminal glucosamine residues of heparan sulfate. So far, few studies have focused on the genetic landscape of MPS IIIC in China, where IIIA and IIIB were the major subtypes. In this study, we utilized whole‐exome sequencing (WES) to identify novel compound heterozygous variants in the HGSNAT gene from a Chinese patient with typical MPS IIIC symptoms: c.743G>A; p.Gly248Glu and c.1030C>T; p.Arg344Cys. We performed in silico analysis and experimental validation, which confirmed the deleterious pathogenic nature of both variants, as evidenced by the loss of HGSNAT activity and failure of lysosomal localization. To the best of our knowledge, the MPS IIIC is first confirmed by clinical, biochemical and molecular genetic findings in China. Our study thus expands the spectrum of MPS IIIC pathogenic variants, which is of importance to dissect the pathogenesis and to carry out clinical diagnosis of MPS IIIC. Moreover, this study helps to depict the natural history of Chinese MPS IIIC populations. [ABSTRACT FROM AUTHOR]

Despite the proven virological advantages, there remains some controversy regarding whether first-line integrase strand transfer inhibitors (INSTIs)-based antiretroviral therapy (ART) contributes to reducing mortality of people living with HIV (PLHIV) in clinical practice. Here we report a retrospective study comparing all-cause mortality among PLHIV in China who were on different initial ART regimens (nevirapine, efavirenz, dolutegravir, lopinavir, and others [including darunavir, raltegravie, elvitegravir and rilpivirine]) between 2017 and 2019. A total of 41,018 individuals were included across China, representing 21.3% of newly reported HIV/AIDS cases collectively in the country during this period. Only the differences in all-cause mortality of PLHIV between the efavirenz group and the nevirapine group, the dolutegravir group and the nevirapine group, and the lopinavir group and the nevirapine group, were observed in China. After stratifying the cause of mortality, we found that the differences in mortality between initial ART regimens were mainly observed in AIDS-related mortality. First-line integrase strand transfer inhibitors are commonly used for people with HIV. Here, Wu et al. report results from a multicenter cohort study in China observing significant differences in all-cause mortality among patients between various treatment groups. [ABSTRACT FROM AUTHOR]

Background: In 2003, China implemented free antiretroviral therapy (ART) for people living with HIV (PLHIV), establishing an eligibility threshold of CD4 < 200 cells/μl. Subsequently, the entry criteria were revised in 2012 (eligibility threshold: CD4 ≤ 350 cells/μl), 2014 (CD4 ≤ 500 cells/μl), and 2016 (treat-all). However, the impact of treat-all policy on HIV care and treatment indicators in China is unknown. We aimed to elucidate the immediate and long-term impact of the implementation of treat-all policy in China. Methods: Anonymized programmatic data on ART initiation and collection in PLHIV who newly started ART were retrieved between 1 January 2015 and 31 December 2019, from two provincial and municipal Centers for Disease Control and Prevention and ten major infectious disease hospitals specialized in HIV care in China. We used Poisson and quasi-Poisson segmented regression models to estimate the immediate and long-term impact of treat-all on three key indicators: monthly proportion of 30-day ART initiation, mean CD4 counts (cells/μl) at ART initiation, and mean estimated time from infection to diagnosis (year). We built separate models according to gender, age, route of transmission and region. Results: Monthly data on ART initiation and collection were available for 75,516 individuals [gender: 83.8% males; age: median 39 years, interquartile range (IQR): 28–53; region: 18.5% Northern China, 10.9% Northeastern China, 17.5% Southern China, 49.2% Southwestern China]. In the first month of treat-all, compared with the contemporaneous counterfactual, there was a significant increase in proportion of 30-day ART initiation [+ 12.6%, incidence rate ratio (IRR) = 1.126, 95% CI: 1.033–1.229; P = 0.007] and mean estimated time from infection to diagnosis (+ 7.0%, IRR = 1.070, 95% CI: 1.021–1.120; P = 0.004), while there was no significant change in mean CD4 at ART initiation (IRR = 0.990, 95% CI: 0.956–1.026; P = 0.585). By December 2019, the three outcomes were not significantly different from expected levels. In the stratified analysis, compared with the contemporaneous counterfactual, mean CD4 at ART initiation showed significant increases in Northern China (+ 3.3%, IRR = 1.033, 95% CI: 1.001–1.065; P = 0.041) and Northeastern China (+ 8.0%, IRR = 1.080, 95% CI: 1.003–1.164; P = 0.042) in the first month of treat-all; mean estimated time from infection to diagnosis showed significant increases in male (+ 5.6%, IRR = 1.056, 95% CI: 1.010–1.104; P = 0.016), female (+ 14.8%, IRR = 1.148, 95% CI: 1.062–1.240; P < 0.001), aged 26–35 (+ 5.3%, IRR = 1.053, 95% CI: 1.001–1.109; P = 0.048) and > 50 (+ 7.8%, IRR = 1.078, 95% CI: 1.000–1.161; P = 0.046), heterosexual transmission (+ 12.4%, IRR = 1.124, 95% CI: 1.042–1.213; P = 0.002) and Southwestern China (+ 12.9%, IRR = 1.129, 95% CI: 1.055–1.208; P < 0.001) in the first month of treat-all. Conclusions: The implementation of treat-all policy in China was associated with a positive effect on HIV care and treatment outcomes. To advance the work of rapid ART, efforts should be made to streamline the testing and ART initiation process, provide comprehensive support services, and address the issue of uneven distribution of medical resources. [ABSTRACT FROM AUTHOR]

The input of pollutants into the lake has ainfluence on the water quality of the lake. Detailing the contribution of water and nutrients from the inflow rivers are essential for lake water management. Major ions Na+ and Cl− were applied to trace contributions of water and total nitrogen (TN) from the inflow rivers to West Dongting Lake. By using the two-source mixing model and the two-component TN mixing model, the results showed that water and TN in West Dongting Lake were mainly contributed by local rivers rather than the three outfalls, in which the contribution of Yuan River was larger than that of Li River. However, the contribution rates of water and TN of the three outfalls to West Dongting Lake during the wet season reached above 20% and 30%, respectively, indicating that the contribution of the three outfalls to West Dongting Lake could not be ignored. Among them, the contributions of Songzi outfall were higher than those from Taiping and Ouchi outfalls. Therefore, we suggest that the relevant departments should identify key river management targets during different water periods, implement refined management over water pollution in West Dongting Lake, and prioritize the pollutant input of Yuran River and Songzi outfall (especially during the wet season). This study demonstrates that major ion tracing is suitable for estimating the contribution rates of different nutrient sources in the river-lake system, which will provide valuable information for protecting the water quality of West Dongting Lake in the future. [ABSTRACT FROM AUTHOR]

Background: Epidemiologic evidence suggests that physical activity benefits cognition, but results from randomized trials in sedentary individuals are limited and inconsistent.Objective: To evaluate the effects of physical activity on cognition among sedentary older adults.Objective: A systematic literature search for eligible studies published up to January 1, 2021, was performed on six international (PubMed, Cochrane Library, Web of Science, Sinomed, FMRS, and OVID) and three Chinese databases (Wanfang, China National Knowledge Infrastructure, and VIP). We estimated the effect of physical activity on the cognition of sedentary elderly by standardized mean differences (SMD) and 95% confidence intervals (CI) using a random-effects model. We evaluated publication bias using funnel plots and heterogeneity using I2 statistics. Subgroup analyses were conducted by baseline cognition, intervention duration, activity type, and country.Results: Seven randomized controlled trials (RCTs) comprising 321 (experimental group, 164; control group, 157) sedentary older adults were included in the meta-analysis. Physical activity significantly improved cognition in sedentary elderly adults compared with controls (SMD: 0.50, 95% CI:0.09-0.92). Subgroup analyses showed significant effects of baseline cognition impairment (SMD: 9.80, 95% CI: 5.81-13.80), intervention duration > 12 weeks (SMD: 2.85, 95% CI: 0.73-4.96), aerobic exercise (SMD: 0.74, CI: 0.19-1.29), and countries other than the United States (SMD: 10.50, 95% CI: 7.08-13.92).Conclusion: Physical activity might have a general positive effect on the cognition of sedentary older adults. Intervention > 12 weeks and aerobic exercise can effectively delay their cognitive decline; however, more rigorous RCTs are needed to support our findings. [ABSTRACT FROM AUTHOR]

Background: Several studies have reported that dietary and serum concentrations of vitamin D and cholesterol are correlated with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about whether 25 hydroxyvitamin D [25(OH)D], lipids, and oxysterols are related to cognitive function.Objective: This study sought to explore the relations between 25(OH)D, lipids, oxysterols, and cognitive function.Methods: In this study, about 209 MCI patients and 209 age- and gender-matched healthy controls were recruited from the Shanxi province of China (49.5% male; median [IQR] age: 63 [59-66] y). Serum concentrations of 25(OH)D, lipids, and oxysterols were measured using ultra-performance LC-MS. Cognitive performance was determined via comprehensive mental, verbal, and auditory cognitive tests. Dietary information was collected using a semiquantitative FFQ and 3 consecutive days of 24-h dietary recalls. Logistic regression analyses, Spearman's correlation, and partial correlation analyses were used to explore correlation between the variables.Results: Participants with vitamin D deficiency [serum 25(OH)D <20.0 ng/mL] were 3 times more likely to develop MCI compared to those with adequate vitamin D (≥30 ng/mL) concentrations. The AUC of 25(OH)D was 0.72 and the cut-off was 16.5 ng/mL (sensitivity:  50.3%,  specificity: 84.4%). Serum 25(OH)D concentrations were negatively correlated with total cholesterol (TC) (r = -0.19, P = 0.02), LDL-cholesterol (r = -0.17, P = 0.04), and 24S,25-epoxycholesterol (24S,25-epoxy-CHO) (r = -0.21, P = 0.01). Conversely, the Montreal Cognitive Assessment (MoCA) (r = 0.185, P < 0.001) and symbol digit modalities test (SDMT) (r = 0.11, P = 0.03) scores were positively correlated with serum 25(OH)D concentrations.Conclusion: The study identified significant differences in serum 25(OH)D concentrations between MCI patients and cognitive healthy controls, and there was a correlation between serum concentrations of 25(OH)D, lipids, and oxysterols and cognitive impairment among people. This study was registered at the Chinese Clinical Trial Registry as ChiCTR1900025452. [ABSTRACT FROM AUTHOR]

Background: Nutrients are associated with cognitive function, but limited research studies have systematically evaluated on multi-domain cognitive function. The aim of this study was to investigate the effect and mechanism of specific nutrient on multi-domain cognitive function, and provide nutrition guidance for improving cognitive function. Methods: Participants were selected based on a multicenter prospective study on middle-aged and older adults in China. Global cognitive function was evaluated by the Mini-Mental State Examination (MMSE). Nutrients intake was assessed according to food frequency questionnaire and China Food Composition Database, and principal component analysis was performed to extract nutrient patterns. Associations between specific nutrients and cognitive function were assessed using log-binomial regression. Restricted cubic spline was used to illustrate the dose-response relationship of nutrients with multi-domain cognitive function. Mediation analysis was used to determine the mechanism of nutrients in cognitive function. Results: Four nutrient patterns were identified (vitamin-mineral, protein-carbohydrate, fatty acid-vitamin E, and cholesterol-vitamin B12), and only a nutrient pattern rich in cholesterol and vitamin B12 was found associated with cognitive function (RR = 0.891, 95%CI = 0.794–0.999). In multi-domain cognitive function, dietary cholesterol and vitamin B12 were related to better performance of visual memory function (P = 0.034, P = 0.02). In dose-response relationship, it suggested a U-shaped association between vitamin B12 and MMSE (P = 0.02) within a certain range. Conclusions: Dietary intake rich in cholesterol and vitamin B12 was associated with better cognitive function, and vitamin B12 had a U-shaped dose-response relation with MMSE. Thus, ensuring moderate cholesterol and vitamin B12intake may be an advisable strategy to improve cognitive function in middle-aged and older adults. Clinical Trial Registration: EMCOA, ChiCTR-OOC-17011882, Registered 5th, July 2017-Retrospectively registered, http://www.medresman.org/uc/project/projectedit.aspx?proj=2610 [ABSTRACT FROM AUTHOR]

Purpose: To compare the effectiveness of the Cook vaginal cervical ripening balloon (CCRB) with prostaglandin E2 (PGE2) insert for induction of labor in late pregnancy in primipara.Methods: We evaluated the effectiveness and safety of induction of labor using the improved Bishop score after CCRB or PGE2 administration, total stage of labor, hours until delivery (hours from placement of CCRB or PGE2 insert to parturition and delivery), delivery rate within 24 h, spontaneous delivery rate, successful induction rate, overstimulation syndrome, urgent delivery rate, pain scores, cesarean section rate, and outcomes related to delivery and perinatal morbidity, such as puerperal infection rate, total cost, satisfaction survey, and so on.Results: The improved Bishop Score and delivery rate within 24 h in the CCRB group were significantly higher than in the PGE2 group. The total stage of labor and hours until delivery in the CCRB group were significantly shorter than that in the PGE2 group. Rate of overstimulation syndrome and pain scores in the CCRB group were significantly lower than in the PGE2 group. Compared with the PGE2 group, the mean duration of hospitalization in the CCRB group was shorter and the total cost was less. No difference in satisfaction between the PGE2 and CCRB groups was observed.Conclusions: Compared with PGE2, CCRB reduced the total stage of labor, hours until delivery, pain scores, mean length of hospitalization, and total cost. CCRB increased the rate of delivery within 24 h with similar safety and maternal satisfaction compared with PGE2. [ABSTRACT FROM AUTHOR]

The population is commonly susceptible to the 2019 novel coronavirus (2019‐nCoV), especially the elderly with comorbidities. Elderly patients infected with 2019‐nCoV tend to have higher rates of severe illness and mortality. Immunosenescence is an important cause of severe novel coronavirus pneumonia (NCP) in the elderly. Due to the combination of underlying diseases, elderly patients may exhibit atypical manifestations in clinical symptoms, supplementary examinations, and pulmonary imaging, deserving particular attention. The general condition of the elderly should be considered during diagnosis and treatment. In addition to routine care and measures—such as oxygen therapy, antiviral therapy, and respiratory support—treatment of underlying disease, nutritional support, sputum expectoration complication prevention, and psychological support should also be considered for elderly patients. Based on a literature review and expert panel discussion, we drafted the "Recommendations for the Prevention and Treatment of the Novel Coronavirus Pneumonia in the elderly in China," aiming to provide help with the prevention and treatment of NCP and the reduction of harm to the elderly population. [ABSTRACT FROM AUTHOR]

Influenza and pneumonia can be prevented by vaccination, but they remain major causes of morbidity and mortality in age‐related diseases. In most areas of China, the rates of influenza and pneumococcal vaccination are relatively low and public awareness of vaccination remains insufficient. Thus, it is essential to recommend influenza and Streptococcus pneumoniae vaccination to elderly people in clinical practice. Based on recently published studies and related documents issued by several vaccination authorities, such as the World Health Organization, the National Health and Wellness Committee, the Chinese Center for Disease Control and Prevention, the US Centers for Disease Control and Prevention, and the US Advisory Committee on Immunization Practices, we propose official recommendations for influenza and S pneumoniae vaccination in elderly people in China. [ABSTRACT FROM AUTHOR]

This study investigated the effect of migrant children's perceived discrimination on their social adaptation and the moderating effect of their city identity. In addition, differences in the relationships among the aforementioned variables were compared across two school types in terms of public schools and privately operated migrant schools. A cluster sampling method was used to survey 410 junior high school students in China using the Social Adaptation Assessment Questionnaire, the Perceived Discrimination Questionnaire for Individuals, and the City Identity Questionnaire as measures. Results showed that perceived discrimination significantly and negatively affected the social adaptation of migrant children. The relationship between perceived discrimination and social adaptation was moderated by the city identity of migrant children in private schools but not by those in public schools. Under the condition of high or medium city identity, discrimination negatively predicts social adaptation; under the condition of low city identity, however, discrimination does not predict social adaptation. In conclusion, perceived discrimination is an important factor regarding the social adaptation of migrant children, and their relationships vary by different types of city identity and schools. [ABSTRACT FROM AUTHOR]

As a large river connected lake, Dongting Lake is influenced by anthropogenic activities and the discharge from its upstream tributaries in the lake basin and by the water recharge via a connection to the Yangtze River (YR) outside the basin. This makes the lake phosphorous cycle more complex than that in other disconnected lakes. Here, we calculated section fluxes and ran a hydrodynamic model to investigate the phosphorus (P) variations in response to the changing interactions in the water and sediment between the YR, four tributaries, and the lake. Results show that particulate P was the dominant form with a significant linear relationship with suspended sediment ( r = 0.906). The sediment input reduction from the YR through three water inlets, which is closely related to the Three Gorges Reservoir operation since 2003, led to a decrease in the total P (TP) concentration in the western Dongting Lake. However, the impact and range of this decrease were fairly limited. Compared with the limited effect of the YR, the raised TP flux from the Yuanjiang tributary controlled the TP concentration at the outlet of the western Dongting Lake. Apart from the influence of the YR and the tributaries, anthropogenic activities (sand dredging) in the eastern Dongting Lake also contributed to a high TP concentration around the S10 area through sediment resuspension. We suggest that, compared with the reduction in TP flux and sediment load from the connected Yangtze River outside the basin, the elements within the basin (increased TP input from tributaries and sand dredging) have a greater effect on the variations of TP in Dongting Lake. [ABSTRACT FROM AUTHOR]

Objective. To assess the value of bronchoscopy in the diagnosis and treatment of primary tracheobronchial amyloidosis (TBA), in order to reduce misdiagnosis rates and improve prognosis. Methods. Clinical data of 107 patients with TBA reported from 1981 to 2015 in China were retrospectively analyzed for clinical features, bronchoscopic manifestations, pathologies, treatments, and outcomes. Results. 105 of 107 TBA patients were pathologically confirmed by bronchoscopy. Main bronchoscopic manifestations of TBA were single or multiple nodules and masses within tracheobronchial lumens; local or diffuse luminal stenosis and obstruction; luminal wall thickening and rigidity; rough or uneven inner luminal walls; congestion and edema of mucosa, which was friable and prone to bleeding upon touch; and so forth. 53 patients were treated with bronchoscopic interventions, like Nd-YAG laser, high-frequency electrotome cautery, freezing, resection, clamping, argon plasma coagulation (APC), microwaving, stent implantation, drug spraying, and other treatments. 51 patients improved, 1 patient worsened, and 1 died. Conclusion. Bronchoscopic biopsy is the primary means of diagnosing TBA. A variety of bronchoscopic interventions have good short-term effects on TBA. Bronchoscopy has important value in the diagnosis, severity assessment, treatment, efficacy evaluation, and prognosis of TBA. [ABSTRACT FROM AUTHOR]

The assessment of spatial and temporal variation of water quality influenced by land use is necessary to manage the environment sustainably in basin scales. Understanding the correlations between land use and different formats of nonpoint source nutrients pollutants is a priority in order to assess pollutants loading and predicting the impact on surface water quality. Forest, upland, paddy field, and pasture are the dominant land use in the study area, and their land use pattern status has direct connection with nonpoint source (NPS) pollutant loading. In this study, two land use scenarios (1995 and 2010) were used to evaluate the impact of land use changes on NPS pollutants loading in basins upstream of Three Gorges Reservoir (TGR), using a calibrated and validated version of the soil and water assessment tool (SWAT) model. The Pengxi River is one of the largest tributaries of the Yangtze River upstream of the TGR, and the study area included the basins of the Dong and Puli Rivers, two major tributaries of the Pengxi River. The results indicated that the calibrated SWAT model could successfully reproduce the loading of NPS pollutants in the basins of the Dong and Puli Rivers. During the 16-year study period, the land use changed markedly with obvious increase of water body and construction. Average distance was used to measure relative distribution patterns of land use types to basin outlets. Forest was mainly distributed in upstream areas whereas other land use types, in particular, water bodies and construction areas were mainly distributed in downstream areas. The precipitation showed a non-significant influence on NPS pollutants loading; to the contrary, interaction between precipitation and land use were significant sources of variation. The different types of land use change were sensitive to NPS pollutants as well as land use pattern. The influence of background value of soil nutrient on NPS pollutants loading was evaluated in upland and paddy field. It was found that total nitrogen (TN) and total phosphorous (TP) in upland were more sensitive to NPS pollutants loading than in paddy fields. The results of this study have implications for management of the TGR to reduce the loading of NPS pollutants into downstream water bodies. [ABSTRACT FROM AUTHOR]

Harmful algal blooms (HABs), eutrophication, and internal pollutant sources from sediment, represent serious problems for public health, water quality, and ecological restoration worldwide. Previous studies have indicated that Modified Local Soil (MLS) technology is an efficient and cost-effective method to flocculate the HABs from water and settle them onto sediment. Additionally, MLS capping treatment can reduce the resuspension of algae flocs from the sediment, and convert the algal cells, along with any excessive nutrients in-situ into fertilisers for the restoration of submerged macrophytes in shallow water systems. Furthermore, the capping treatment using oxygen nanobubble-MLS materials can also mitigate sediment anoxia, causing a reduction in the release of internal pollutants, such as nutrients and greenhouse gases. This paper reviews and quantifies the main features of MLS by investigating the effect of MLS treatment in five pilot-scale whole-pond field experiments carried out in Lake Tai, South China, and in Cetian Reservoir in Datong city, North China. Data obtained from field monitoring showed that the algae-dominated waters transform into a macrophyte-dominated state within four months of MLS treatment in shallow water systems. The sediment-water nutrient fluxes were substantially reduced, whilst water quality (TN, TP, and transparency) and biodiversity were significantly improved in the treatment ponds, compared to the control ponds within a duration ranging from one day to three years. The sediment anoxia remediation effect by oxygen nanobubble-MLS treatment may further contribute to deep water hypoxia remediation and eutrophication control. Combined with the integrated management of external loads control, MLS technology can provide an environmentally friendly geo-engineering method to accelerate ecological restoration and control eutrophication. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the effect of gap environmental factors on the plant population regeneration pattern in the Castanopsis kawakamii natural forest. We used the detrended canonical correspondence analysis (DCCA) method to study coupling relationships between species distribution in the regeneration layer and environmental factors. The results showed that: (1) The main environmental factors that influenced species distribution in the forest gaps and non-gaps were different, and the highest explanation rate of environmental factors was the soil temperature below the surface 10 cm (ST10); (2) The relationships between species distribution in the regeneration layer of the forest gaps and non-gaps were mainly restricted by environmental factors, given the environmental factors complied with the ecological niche hypothesis; and (3) For the endangered C. kawakamii population, there were positive and negative relationships between the environmental factors and the various species in the forest gaps and non-gaps, whilst the effects of such relationships were varied. Some management operations, including the creation of artificial gaps and adequate fertilization in the non-gaps, could more effectively promote the growth and regeneration of the C. kawakamii population. [ABSTRACT FROM AUTHOR]

Suicide is a major public health concern, especially in prisoners. This study aims to investigate the prevalence of current suicidal ideation in a sample of Chinese female prisoners and examine the mediating role of negative emotions and social support in the link between childhood trauma and suicidal ideation. A cross-sectional study was conducted in five main jails of the district of Zhejiang province in China and a total of 626 female prisoners were surveyed by using cluster sampling. Childhood Trauma Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale and Multidimensional Scale of Perceived Social Support were applied. The estimated prevalence of current suicide ideation among Chinese female prisoners was 33.4%. Structural equation modeling analyses revealed that social support and negative emotions acted as chain mediators between childhood trauma and current suicidal ideation. Results emphasize the importance of stress-diathesis theory of suicidality in understanding the possible mechanisms underlying the relationship between childhood trauma and suicidal ideation among female prisoners. • Suicide ideation is much common among Chinese female prisoners. • Childhood trauma is positively associated to suicidal ideation. • This association is mediated by negative emotions and social support. [ABSTRACT FROM AUTHOR]

Objective: To investigate the characteristics of different Acute Gastrointestinal Injury (AGI) grading trajectories and examine their impact on prognosis in the Pediatric Intensive Care Unit (PICU)., Methods: This retrospective cohort study was conducted at a large children's hospital in China. The children admitted to the PICU were included. AGI grade was assessed every other day during the initial nine days following PICU admission., Results: A total of 642 children were included, of which 364 children (56.7%) exhibited varying degrees of gastrointestinal dysfunction (AGI grade ≥ 2). Based on the patterns of AGI grading over time, six groups were identified: low-stable group, low-fluctuating group, medium-decreasing group, medium-increasing group, high-decreasing group, high-persistent group. The high-persistent group accounted for approximately 90% of all recorded deaths. Compared to low-stable group, both the medium-increasing and high-persistent groups exhibited positive correlations with length of stay in PICU (PICU LOS) and length of stay (LOS). Compared to low-stable group, the five groups exhibited a negative correlation with the percentage of energy received by enteral nutrition (EN), as well as the protein received by EN., Conclusion: This study identified six distinct trajectory groups of AGI grade in critically ill children. The pattern of AGI grade trajectories over time were associated with EN delivery proportions and clinical outcomes., (© 2024. The Author(s).)

The number of individuals infected with HIV-1 among men who have sex with men (MSM) has risen rapidly in recent years in China, and the subtypes CRF01&#95;AE, CRF07&#95;BC, and B, as well as many novel unique recombinant forms (URFs) are prevalent among them. Co-circulation of strains among MSM populations allows the generation of circulating recombinant forms (CRFs) and URFs. In this study, we identified two new URFs from two HIV-1-positive subjects who were infected through homosexual contact in Hebei, China. Analysis of near-full-length genome sequences, using phylogenetic and recombination analysis showed that the two URFs originated from CRF01&#95;AE, CRF07&#95;BC, and B, and CRF01&#95;AE segments in the backbone of the URFs were derived from cluster 4 of CRF01&#95;AE. The CRF07&#95;BC segments of two URFs were clustered with 07BC&#95;N in a phylogenetic tree. The identification of novel URFs with complex genomic structures shows that it is necessary to strengthen surveillance of HIV-1 variants in MSM populations in this region., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Understanding and accurately measuring resilience among Chinese civil aviation pilots is imperative, especially concerning the psychological impact of distressing events on their well-being and aviation safety. Despite the necessity, a validated and tailored measurement tool specific to this demographic is absent. Addressing this gap, this study built on the widely used CD-RISC-25 to analyze and modify its applicability to Chinese civil aviation pilots. Utilizing CD-RISC-25 survey data from 231 Chinese pilots, correlational and differential analyses identified items 3 and 20 as incongruent with this population's resilience profile. Subsequently, factor analysis derived a distinct two-factor resilience psychological framework labeled "Decisiveness" and "Adaptability", which diverged from the structure found in American female pilots and the broader Chinese populace. Additionally, to further accurately identify the measurement characteristics of this 2-factor measurement model, this study introduced Generalized Theory and Item Response Theory, two modern measurement analysis theories, to comprehensively analyze the overall reliability of the measurement and issues with individual items. Results showed that the 2-factor model exhibited high reliability, with generalizability coefficient reaching 0.89503 and dependability coefficient reaching 0.88496, indicating the 2-factor measurement questionnaire can be effectively utilized for relative and absolute comparison of Chinese civil aviation pilot resilience. However, items in Factor 2 provided less information and have larger room for optimization than those in Factor 1, implying item option redesign may be beneficial. Consequently, this study culminates in the creation of a more accurate and reliable two-factor psychological resilience measurement tool tailored for Chinese civil aviation pilots, while exploring directions for optimization. By facilitating early identification of individuals with lower resilience and enabling the evaluation of intervention efficacy, this tool aims to positively impact pilot psychological health and aviation safety in the context of grief and trauma following distressing events., (© 2024. The Author(s).)

BACKGROUND The COVID-19 pandemic has caused varying degrees of psychological stress among medical students. This research explored the post-traumatic stress symptoms (PTSS) of medical students in China and their relationship with positive coping and social support. MATERIAL AND METHODS In the form of cross-sectional online survey, 2280 medical students locked down at home were selected by random cluster method to investigate social support, coping style, and PTSS using the Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire (SCSQ), and Post-traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), respectively. RESULTS This research found that the PTSS detection rate in medical students was 10.42% during the COVID-19 pandemic. The PTSS scores of females were significantly higher than that of the males. However, the PTSS detection rate in females (9.71%) was not significantly different from that in males (11.24%). Compared with those of the non-PTSS group, the total score and its all-factor score of social support, the total score of coping style and the positive coping score of the PTSS group were much lower, while the negative coping score of the PTSS group was much higher (P<0.01). Positive coping was positively correlated with social support, while positive coping and social support were negatively correlated with PTSS. The total effect of positive coping on PTSS was -0.310 (P<0.001), the direct effect was -0.128 (P<0.01), and the indirect effect was -0.182 (P<0.001). Social support played a mediating role between positive coping and PTSS, with the mediating effect accounting for 58.81% of the total effect. CONCLUSIONS Social support plays a mediating role between positive coping and post-traumatic stress symptoms. Objective support and positive coping are the 2 main protective factors of PTSS.

Objective: We explored the feasibility of app-based HIV testing services (AHTS) among men who have sex with men (MSM) according to the perspectives of testing service providers., Methods: Twenty-one current or previous AHTS providers participated in a semi-structured interview which explored the facilitators and barriers to AHTS. Ten participants originating from the Center for Disease Control and Prevention (CDC) and 11 from the non-governmental organization (NGO) in Shijiazhuang, China took part in this study. Interviews was transcribed verbatim, and the socioecological model (SEM) was applied to thematic analysis., Results: Twenty-one participants from AHTS services commented on the integration of online appointment schedules into HIV testing services. AHTS was deemed a convenient and efficient method for MSM and service providers to choose their preferred location and times. Moreover, it allowed for important HIV-related information to be accessed online and targeted toward at-risk individuals. Participants thought MSM may feel unsure about personal information security being stored within a privatized app and was considered a barrier to AHTS's usability. As such, they believed establishing a government-led national online platform for AHTS would allow for greater trust from MSM, rather than a social media app., Conclusion: By linking booking services to an online platform, AHTS was deemed a convenient and efficient method for HIV testing services, especially for young MSM who are familiar with smartphone applications. To improve the use of these services, AHTS apps should focus on ensuring the confidentiality of personal information and internet security to build trust between MSM and service providers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhao, Cao, Jiang, Bulloch, Qiu, Liu, Wang, Li, Jia, Guo and Wu.)

Purpose: To assess the prevalence of refractive errors (REs) in school children aged 6-18 years in urban and rural settings in Dalian, Northeast of China., Methods: This is a school-based cross-sectional survey using multi-stage randomization technique. Six- to eighteen-year-old school children from elementary schools, junior and senior high schools from a rural area and an urban area in Dalian were included in December 2018. All subjects underwent a comprehensive questionnaire and eye examination., Results: A total of 4,522 school children with 6-18 years of age were investigated. The age, gender-adjusted prevalence of myopia, and anisometropia were 82.71 and 7.27% among the urban students as compared to 71.76% and 5.41% among the rural ones (OR = 1.80, 95 % CI = 1.53 - 2.11, P < 0.001; OR = 1.29, 95 % CI = 1.00-1.67, P = 0.049), respectively. The hyperopia was less common in urban students than in rural ones (5.63 vs . 10.21%; OR = 0.54, 95 % CI: 0.43-0.67, P < 0.001). However, there was no significant difference in prevalence of astigmatism between urban (46.07%) and rural (44.69%) participants (OR = 0.96, 95 % CI: 0.84-1.10, P = 0.559). The differences on prevalence of REs were attributed to different social-demographic and physiologic factors., Conclusions: The students from urban settings are more likely to have myopia and anisometropia but less likely to have hyperopia than their rural counterparts. Although considerable attention had been paid to controlling REs, it is necessary to further consider the urban-rural differences in REs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Liu, Lu, Qu, Ren, Wang, Lu, Liang, Xin, Zhang, Jin, Wang, Song, Yu, Zhao, Ma and Zhang.)

Unique recombinant forms (URFs) are more likely developed among HIV-1 infections through men who have sex with men (MSM) because of cocirculation of multiple subtypes. In this study, two novel URFs deriving from two HIV-positive subjects (HB010014, HB010063) were identified in Shijiazhuang, Hebei province, China, and two sequences formed a distinct monophyletic cluster. Further recombination analysis showed that of two new URFs were consisted of circulating recombinant form (CRF)01&#95;AE and CRF07&#95;BC. The subregion phylogenetic analysis indicated that CRF01&#95;AE segments were traced back to cluster 4 of CRF01&#95;AE strains, which were prevalent among HIV-1 infections through MSM in China. New URFs being developing gradually and spreading released that more and more novel recombinant strains of HIV-1 could be developed, which means that the past prevention strategies need to be adjusted.

Homosexual contact is one of the main transmission routes of HIV-1 epidemic in Hebei, China. Several subtypes of HIV are prevalent simultaneously in the population, which always lead to the emergency of unique recombinant forms (URFs). In this study, we reported two new URFs from two HIV-1 positive subjects infected through homosexual contact route in Hebei, China. Phylogenetic and recombinant analyses based on the near full-length genome of the two URFs both revealed the two URFs are the second generation of recombinant strains originated from CRF01&#95;AE and CRF07&#95;BC. The CRF01&#95;AE segments of two URFs located in cluster 4 of CRF01&#95;AE strains in the phylogenetic tree. The emergence of the novel CRF01&#95;AE/CRF07&#95;BC recombinant forms with complicated genomic structures indicated the importance of the continuous monitoring of the HIV-1 epidemic and new URFs among the men who have sex with men populations.

The Three Gorges Reservoir (TGR) underwent staged impoundment of water from 135 m to 175 m between 2003 and 2010. Periodic water impoundment was divided into drainage (March to early June), low water level (June to August), impoundment (September to October), and high water level (November to February) period. However, the impact of the Three Gorges Dam (TGD) and staged impoundment on water quality, especially in the long term, remains unclear. Herein, hydrological, pollution load, nutrient, and biochemical indices were determined for the TGR during 1998-2018. The Canadian Council of Ministers of the Environment Water Quality Index, a K-means clustering algorithm, and the Mann-Kendall (MK) test were applied to this data to explore the spatial and temporal distribution of water quality. The results show that water quality was good overall, but it before the full impoundment stage (2010) was worse than after that. The low water level period had the worst water quality among the four periods, and spatially, midstream was worst. Among water quality indices, the median total nitrogen (TN) and total phosphorus (TP) were in the range of 1.505-2.303 and 0.071-0.176 mg/L, respectively, and these were the key pollution indices. In addition, due to differences in hydrological and hydrodynamic conditions, and the regional distribution of pollution sources, water quality in the TGR displayed temporal and spatial heterogeneity. TN, TP, potassium permanganate index (COD Mn ), five-day biochemical oxygen demand (BOD 5 ) and Escherichia coli (E. coli) were maximal during the low water level period, and TN, TP and E. coli were highest in midstream. MK test results revealed that nutrients pollution became worse midstream, and a gradual increase in TP caused severe algal blooms downstream. Therefore, nutritional water treatment and non-point source pollution control should be the focus of future work., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The Three Gorges Reservoir (TGR) underwent staged impoundment during 2003-2010. Periodic water impoundment included drainage (March to early June), low water level (June to August), impoundment (September to October), and high water level (November to February) periods. However, the impacts of the Three Gorges Dam (TGD) and impoundment on water quality of TGR tributaries remain poorly understood, especially in the long term and across the entire TGR drainage basin. Herein, water quality and hydrological indices of 27 tributaries, eutrophication of 38 tributaries, and pollution load of the TGR were determined during 2000-2015 to explore spatiotemporal variations in water quality. The results revealed slower flow velocity in tributaries and an extended residence time with the water level rising, and the water quality of tributaries was mainly affected by the mainstream backwater movement. Water quality was good in more than 60% of tested sites, had the best condition in the impoundment period, and it increased over time. Spatially, water quality in tributary upstream was better than in the backwater area, and worst in the tributary estuary. Among water quality indices, total nitrogen (TN) and total phosphorus (TP) were the key pollution indices, with median range of 1.619-2.739 and 0.088-0.277 mg/L, respectively. Additionally, water quality indices of TGR tributaries displayed temporal and spatial heterogeneity due to different hydrodynamic and pollution load conditions. A total of 38 tributaries displayed eutrophication, the frequency of blooms concentrated in spring and increased from the upper tributaries to the downstream area. These results expanded the theory of hydrodynamic variation and the associated evolution of the water environment after impoundment, could provide theoretical references for water quality management in river-type reservoir., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The Loess Plateau has one of the most vulnerable ecological environments in the world, but it also contains abundant oil and gas resources that are regularly exploited, which has resulted in serious environmental problems. Therefore, it is important to analyze the polycyclic aromatic hydrocarbons (PAHs) present in the topsoil of this region. The ∑16PAHs concentrations between 1980-1999 and 2000-2019 ranged from 1134.20-15871.04 and 1010.67-18,068.80 µg kg -1 , with average values of 5021.30 and 5662.82 µg kg -1 . All samples displayed heavy pollution levels according to European soil quality standards. In addition, among the measured physicochemical properties, the soil organic carbon (SOC) had the greatest influence on PAHs, while soil particle size distribution had the smallest effect. Source apportionment indicated that the two main sources were petroleum source (37.57%) and vehicular traffic source (25.88%). Lastly, an assessment of the carcinogenic risks illustrated that more focus should be placed on the dermal pathway in which the human body is exposed to soil PAHs. Overall, the carcinogenic risks in different populations did not exceed 10 -4 , but there was still a potential carcinogenic risk in some age groups, especially in adult women., Competing Interests: The authors declared they have no conflict of interest in this work.

This study investigated the effect of migrant children's perceived discrimination on their social adaptation and the moderating effect of their city identity. In addition, differences in the relationships among the aforementioned variables were compared across two school types in terms of public schools and privately operated migrant schools. A cluster sampling method was used to survey 410 junior high school students in China using the Social Adaptation Assessment Questionnaire, the Perceived Discrimination Questionnaire for Individuals, and the City Identity Questionnaire as measures. Results showed that perceived discrimination significantly and negatively affected the social adaptation of migrant children. The relationship between perceived discrimination and social adaptation was moderated by the city identity of migrant children in private schools but not by those in public schools. Under the condition of high or medium city identity, discrimination negatively predicts social adaptation; under the condition of low city identity, however, discrimination does not predict social adaptation. In conclusion, perceived discrimination is an important factor regarding the social adaptation of migrant children, and their relationships vary by different types of city identity and schools., (© 2019 John Wiley & Sons, Ltd.)

Understanding the spatial and temporal variation of nutrient concentrations, loads, and their distribution from upstream tributaries is important for the management of large lakes and reservoirs. The Three Gorges Dam was built on the Yangtze River in China, the world's third longest river, and impounded the famous Three Gorges Reservoir (TGR). In this study, we analyzed total nitrogen (TN) concentrations and inflow data from 2003 till 2010 for the main upstream tributaries of the TGR that contribute about 82% of the TGR's total inflow. We used time series analysis for seasonal decomposition of TN concentrations and used non-parametric statistical tests (Kruskal-Walli H, Mann-Whitney U) as well as base flow segmentation to analyze significant spatial and temporal patterns of TN pollution input into the TGR. Our results show that TN concentrations had significant spatial heterogeneity across the study area (Tuo River> Yangtze River> Wu River> Min River> Jialing River>Jinsha River). Furthermore, we derived apparent seasonal changes in three out of five upstream tributaries of the TGR rivers (Kruskal-Walli H ρ = 0.009, 0.030 and 0.029 for Tuo River, Jinsha River and Min River in sequence). TN pollution from non-point sources in the upstream tributaries accounted for 68.9% of the total TN input into the TGR. Non-point source pollution of TN revealed increasing trends for 4 out of five upstream tributaries of the TGR. Land use/cover and soil type were identified as the dominant driving factors for the spatial distribution of TN. Intensifying agriculture and increasing urbanization in the upstream catchments of the TGR were the main driving factors for non-point source pollution of TN increase from 2003 till 2010. Land use and land cover management as well as chemical fertilizer use restriction were needed to overcome the threats of increasing TN pollution.