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We conducted a phase I, randomized, double-blind, placebo-controlled trial including healthy adults in Sui County, Henan Province, China. Ninety-six adults were randomly assigned to one of three groups (high-dose, medium-dose, and low-dose) at a 3:1 ratio to receive one vaccine dose or placebo. Adverse events up to 28 days after each dose and serious adverse events up to 6 months after all doses were reported. Geometric mean titers and seroconversion rates were measured for anti-rotavirus neutralizing antibodies using microneutralization tests. The rates of total adverse events in the placebo group, low-dose group, medium-dose group, and high-dose group were 29.17 % (12.62 %–51.09 %), 12.50 % (2.66 %–32.36 %), 50.00 % (29.12 %–70.88 %), and 41.67 % (22.11 %–63.36 %), respectively, with no significant difference in the experimental groups compared with the placebo group. The results of the neutralizing antibody assay showed that in the adult group, the neutralizing antibody geometric mean titer at 28 days after full immunization in the low-dose group was 583.01 (95 % confidence interval [CI]: 447.12–760.20), that in the medium-dose group was 899.34 (95 % CI: 601.73–1344.14), and that in the high-dose group was 1055.24 (95 % CI: 876.28–1270.75). The GMT of serum-specific IgG at 28 days after full immunization in the low-dose group was 3444.26 (95 % CI: 2292.35–5175.02), that in the medium-dose group was 6888.55 (95 % CI: 4426.67–10719.6), and that in the high-dose group was 7511.99 (95 % CI: 3988.27–14149.0). The GMT of serum-specific IgA at 28 days after full immunization in the low-dose group was 2332.14 (95 % CI: 1538.82–3534.45), that in the medium-dose group was 4800.98 (95 % CI: 2986.64–7717.50), and that in the high-dose group was 3204.30 (95 % CI: 2175.66–4719.27). In terms of safety, adverse events were mainly Grades 1 and 2, indicating that the safety of the vaccine is within the acceptable range in the healthy adult population. Considering the GMT and positive transfer rate of neutralizing antibodies for the main immunogenicity endpoints in the experimental groups, it was initially observed that the high-dose group had higher levels of neutralizing antibodies than the medium- and low-dose groups in adults aged 18–49 years. This novel inactivated rotavirus vaccine was generally well-tolerated in adults, and the vaccine was immunogenic in adults (ClinicalTrials.gov number, NCT04626856). [ABSTRACT FROM AUTHOR]

Despite some progress in pneumococcal immunization, the global burden of pneumococcal infection remains high, and pneumococcal disease remains a public health concern. Studies in China and abroad have found that 23-valent pneumococcal polysaccharide vaccine (PPV23) vaccination can effectively prevent invasive pneumococcal disease. This phase Ⅰ clinical study assessed the safety and immunogenicity of a PPV23 vaccine candidate. All subjects were randomly assigned to receive one dose intramuscular injection of experimental vaccine or control vaccine at a ratio of 1:1. The incidence of any adverse events was observed within 30 min, 0–7 days and 8–28 days post vaccination and the incidence of abnormal blood biochemical and blood routine indicators were tested on the 4th day post vaccination, the incidence of serious adverse events (SAEs) at 6 months post vaccination was recorded. Blood samples were collected prior to vaccination and on the 28th day post vaccination, and serum antibodies were detected by enzyme linked immunosorbent assay (ELISA). The most common adverse reaction was pain at the injection site, followed by erythema. There was no significant difference of the incidence of systemic adverse reactions between the two vaccine groups. The adverse reactions observed in the trial were all common vaccination-related reactions, and no serious adverse reactions were observed. Compared to pre-vaccination, the (geometric mean concentrations) GMCs of IgG (immunoglobulin G) specific antibody against each serotype were all increased in the experimental group and the control group, there were statistical differences in seroconversion rates of serotypes 4 and 20 between the two vaccine groups. This clinical study showed good safety of the PPV23 vaccine candidate produced by Ab&b Biotechnology Co., Ltd.JS had good safety after vaccination in people aged 2 years and older. At the same time, good immunogenicity was also demonstrated. [ABSTRACT FROM AUTHOR]

• VarV reached non-inferior criteria of immunogenicity in population ≥ 13 years. • VarV offered a more flexible immunization schedule, with an interval of 4–10 weeks between the two doses. • VarV could induce good immune response in both adolescents and adults. • Vaccination with VarV did not increase additional safety risk. Vaccines for prevention against varicella are important for adolescents and adults, who have an increased risk of severe varicella. This study aimed to evaluate the immunogenicity and safety of a two-dose immunization schedule of a live-attenuated varicella vaccine (VarV) manufactured by Sinovac (Dalian) in healthy adolescents and adults. A randomized, double-blind, controlled clinical trial was conducted in healthy population aged ≥ 13 years old in China. Participants in block 1 were randomly assigned (1:1) to receive two doses of either the test vaccine or an active control vaccine, administered 4, 6 or 8 weeks apart. Participants in block 2 were randomly assigned (2:1) to receive two doses of test vaccine or placebo, administered 10 weeks apart. The primary immunogenicity endpoint was the seroconversion rates and GMTs of varicella zoster virus (VZV) antibodies measured by fluorescent-antibody-to-membrane-antigen (FAMA) 4 weeks post-immunization. The primary safety endpoint was the incidence of adverse reactions within 4 weeks after each dose. A total of 2398 participants were enrolled. The seroconversion rates of VZV antibodies were 79.55 % in the test group and 76.41 % in the active control group respectively 4 weeks after two doses of pooled schedule, with the difference of 3.14 % (95 %CI: −0.69 %, 6.97 %). The GMTs were 1:162.07 and 1:160.04 respectively, with the ratio of 1.013 (95 %CI: 0.910, 1.127). Both the seroconversion rates and GMTs reached the prespecified non-inferiority criteria. Two-dose schedule with an interval of 10 weeks could also induce high immune responses, with a seroconversion rate of 83.22 % and a GMT of 1:160.38 in the test group. Safety profiles were similar among the test group, active control group and placebo group. VarV, manufactured by Sinovac (Dalian), demonstrated higher immune response and better flexibility in the immunization schedule among heathy population aged 13 years and older, without increased safety risk. [ABSTRACT FROM AUTHOR]

• The immunogenicity and safety of concomitant administration of three vaccines are unclear in Chinese infants. • Concomitant administration can alleviate the burden on healthcare systems. • Concomitant administration can minimize discomfort in children. • Simultaneous vaccination is suitable for developing countries. During the COVID-19 pandemic, there was a decline in vaccine coverage, and the implementation of combined vaccines and co-administration strategies emerged as potential solutions to alleviate this predicament. Our objective is to delve into the concurrent administration of the sabin-strain-based inactivated poliovirus vaccine (sIPV), the diphtheria-tetanus-acellular pertussis vaccine (DTaP), and measles-mumps-rubella vaccine (MMR), with the intention of bridging the evidentiary gap pertaining to vaccine co-administration in Chinese infants, and to ensure a safe and effective vaccination strategy, ultimately leading to an augmentation in immunization coverage. This study was a follow-up trial of the "Immunogenicity and safety of concomitant administration of the sIPV with the DTaP vaccine in children: a multicenter, randomized, non-inferiority, controlled trial." Blood samples were collected on day 0 and day 30, and serum antibody levels were detected to measure antibody responses to each of the antigens. Local and systemic adverse events were monitored and compared among groups. This study is the first to fill the knowledge gap in China regarding the safe and effective combined vaccination of sIPV, DTaP, and MMR vaccines. The geometric mean titer of the poliovirus types I, II, and III neutralizing antibodies were 1060.22 (95% CI: 865.73-1298.39), 1537.06 (95% CI: 1324.27-1784.05), and 1539.10 (95% CI: 1296.37-1827.29) in group I on day 30; geometric mean titer of antibodies against DTaP and MMR in the simultaneous vaccination group was non-inferior to those in the DTaP alone and MMR alone group. Reporting rates of local and systemic adverse reactions were similar between groups and no serious adverse events were reported throughout the clinical study period. Co-administration of the sIPV, DTaP, and MMR was safe and did not impact immunogenicity, which would help to mitigate administrative costs and enhance vaccine coverage rates. [ABSTRACT FROM AUTHOR]

• Evaluating the safety of inactivated COVID-19 vaccines during the peri-pregnancy period for pregnant women and neonates. • No significant difference in the incidence of premature rupture of membranes or neonatal adverse events between groups. • IPTW method is employed prior to regression analysis, which can mitigate the bias in the observational study. • Robust evidences provide reference for the use of inactivated COVID-19 vaccines for pregnant women in clinical practice. Pregnant women have been excluded from vaccination of COVID-19 due to the lack of strong clinical evidence, which may place pregnant women at greater risk of contracting COVID-19. We conducted this study in China to investigate the maternal and neonatal safety of inactivated COVID-19 vaccination administered during the peri-pregnancy period. This prospective observational cohort study enrolled pregnant women who received pregnancy care between January 1, 2021, and December 31, 2021. Pregnant women were categorized into vaccine group (n = 60) and control group (n = 60) based on whether they had received an inactivated COVID-19 vaccine within peri-pregnancy period. The primary outcomes were the incidence of maternal premature rupture of membranes (PROM) and neonatal adverse events, including induced labor/death, premature birth, low birth weight, and neonatal intensive care unit (NICU) admission and several secondary outcomes related to pregnant women and neonates. Inverse probability treatment weighting (IPTW) was employed to adjust for baseline covariates. Linear and logistic regression models were established after IPTW for continuous and binary outcomes, respectively. In sensitivity analysis, E-values were calculated and propensity score matching analysis and multivariate regression analysis used to demonstrate the robustness of IPTW results. Moreover, vaccination time subgroup analysis and medication subgroup analysis were conducted. Out of 120 neonates delivered, there was no significant difference in PROM (25.42 % vs. 19.67 %, p = 0.438) or neonatal adverse events (11.86 % vs. 4.92 %, p = 0.148) between the vaccine and control groups. Moreover, among the secondary outcomes only serum alanine transaminase (ALT) at first trimester had a statistically significant difference between the groups, ALT levels were significantly higher in the vaccine group during the first trimester (20.67 ± 20.34 vs. 13.05 ± 9.43; RR: 5.38; p = 0.04). In sensitivity analysis, the E-values calculated for the primary outcomes PROM and neonatal adverse events are 2.04 and 5.00 respectively. PSM analysis and multivariate regression analysis reached the same conclusion. The results of primary outcomes are both consistent across the vaccination time subgroup and medication subgroup. The sensitivity analysis illustrates the robustness of our results, so we can conclude that the vaccination of inactivated COVID-19 vaccine during the peri-pregnancy period is safe for both the pregnant woman and neonates no matter what time of vaccination and the use of medication. In addition, it is recommended to monitor ALT levels throughout the first trimester of pregnancy. [ABSTRACT FROM AUTHOR]

We assessed the safety, immunogenicity and antibody persistence of two- and three-dose schedules of the novel bivalent HPV16/18 vaccine (HPV-2, Walrinvax) in the per-protocol target population of initially seronegative 9–14 year-old girls, including a non-inferiority comparison with the three-dose schedule in 18–26 year-old women. This randomized phase 3b trial in Guangxi Zhuang Autonomous Region, China, involved healthy Chinese females in two age cohorts; 600 girls aged 9–14 years and 300 women aged 18–26 years. Girls were randomly assigned (1:1) to receive either two (Months 0,6) or three (Months 0,2,6) intramuscular doses of HPV-2. All participants were monitored for immunogenicity as neutralizing antibodies up to 36 months. Primary objectives were non-inferiority analyses of immunogenicity between two- and three-dose girl groups and adult women at Month 7; safety assessments were based on participant-completed diary cards. All groups demonstrated marked increases in neutralizing antibodies against HPV 16 and 18 that persisted above baseline to 36 months. Month 7 responses in both girl groups were non-inferior to those in the women and were statistically higher after two-doses than girls or women who received three doses. GMTs waned after month 7, but then maintained a plateau level until month 36. Vaccination was well tolerated in all groups with no serious adverse events reported. Immune responses to two doses of HPV-2 vaccine in adolescent girls were non-inferior to those after three doses in young women, an age cohort in which clinical efficacy of HPV-2 against cervical cancer has been demonstrated. [ABSTRACT FROM AUTHOR]

• Three new multidrug-resistant tuberculosis (MDR-TB)/ pre-extensive drug-resistant tuberculosis (pre-XDR-TB) regimens, five drugs for 9 months. • The first cohort of short-course regimens for MDR-TB in China. • Of 99 assessable participants, 92.9% had a favorable outcome. • Culture conversion was 82.5% at month 2 and 97.9% at month 6. • Majority of adverse effects were manageable and reversible. Long, ineffective, and toxic regimens hinder the treatment of patients with multidrug-resistant tuberculosis (MDR-TB) and pre-extensive drug-resistant tuberculosis (pre-XDR-TB). We conducted a multicenter cohort study to prospectively evaluate the safety and efficacy of three 9-month, all-oral, 5-drug regimens. Regimen A (bedaquiline [Bdq]+linezolid [Lzd]+moxifloxacin [Mfx]+cycloserine [Cs]+pyrazinamide [Pza]) and Regimen B (Lzd+Mfx+Cs+clofazimine [Cfz]+Pza) were used to treat MDR-TB patients (Groups A and B, respectively, assigned according to the patient's treatment preference), while Regimen C (Bdq+Lzd+Cs+Cfz+Pza) was used to treat pre-XDR-TB patients (Group C). The primary endpoint was the occurrence of an unfavorable outcome within 12 months of treatment completion, regardless of regimen. A total of 104 patients (34 in Group A, 46 in Group B, and 24 in Group C), with a median age of 35.5 (29.0-54.0) years, were included in the analysis population. At 12 months after treatment completion, five patients were deemed non-assessable. Of the remaining 99 participants, seven (7.1%) had an unfavorable outcome (including two deaths from any cause, four with treatment failure, and one loss to follow-up) and 92 (92.9%) had a favorable outcome. Culture conversion was achieved in 82.5% (80/97) of participants at month 2 and in 97.9% (94/97) of participants at month 6. Adverse events (AEs) resulting in drug adjustment occurred in 69.2% (72/104) of participants, mainly due to Lzd and Pza use. A QT interval prolongation of ≥ 500 ms occurred in 5.8% (6/104) of participants. The primary outcome of the three tailored, 9-month, all-oral, 5-drug regimens was satisfactory in the vast majority of MDR-TB and pre-XDR-TB patients, with manageable and reversible AEs. [Display omitted] [ABSTRACT FROM AUTHOR]

• rFSAV is a novel recombinant five-antigen Staphylococcus aureus vaccine. • rFSAV was assessed in patients undergoing elective surgery for closed fractures for the first time. • rFSAV is safe, well tolerated in patients undergoing elective surgery for closed fractures. • rFSAV elicits rapid and robust specific humoral immune responses in targeted population. • rFSAV is worth further evaluation in in phase 3 studies in a larger number of individuals. Vaccines are urgently required to control Staphylococcus aureus hospital and community infections and reduce the use of antibiotics. Here, we report the safety and immunogenicity of a recombinant five-antigen Staphylococcus aureus vaccine (rFSAV) in patients undergoing elective surgery for closed fractures. A randomized, double-blind, placebo-controlled, multicenter phase 2 clinical trial was carried out in 10 clinical research centers in China. Patients undergoing elective surgery for closed fractures, aged 18–70 years, were randomly allocated at a ratio of 1:1 to receive the rFSAV or placebo at a regimen of two doses on day 0 and another dose on day 7. All participants and investigators remained blinded during the study period. The safety endpoint was the incidence of adverse events within 180 days. The immunogenicity endpoints included the level of specific antibodies to five antigens after vaccination, as well as opsonophagocytic antibodies. A total of 348 eligible participants were randomized to the rFSAV (n = 174) and placebo (n = 174) groups. No grade 3 local adverse events occurred. There was no significant difference in the incidence of overall systemic adverse events between the experimental (40.24 %) and control groups (33.72 %) within 180 days after the first immunization. The antigen-specific binding antibodies started to increase at days 7 and reached their peaks at 10–14 days after the first immunization. The rapid and potent opsonophagocytic antibodies were also substantially above the background levels. rFSAV is safe and well-tolerated in patients undergoing elective surgery for closed fractures. It elicited rapid and robust specific humoral immune responses using the perioperative immunization procedure. These results provide evidence for further clinical trials to confirm the vaccine efficacy. China's Drug Clinical Trials Registration and Information Publicity Platform registration number: CTR20181788. WHO International Clinical Trial Registry Platform identifier: ChiCTR2200066259. [ABSTRACT FROM AUTHOR]

As an important consideration in the chemical industry, chemical process safety has received notable attention in China. However, catastrophic chemical accidents still occur. To better understand why accidents continue to occur, this paper presented a diagnostic analysis of 14 major chemical accidents in China from 2012 to 2022 based on VOSviewer software. The authors analysed the correlation between the accident causation and their relationship with the safety management elements. The study observed that inferior process safety culture, intentional violation (rule-breaking) of procedure, inadequate safety training, and illegal operations were the most frequent causes of accidents. These causes highlighted the prominent gaps in PSM in China in the process safety culture, compliance with standards, the conduct of operations, process safety competency, and training & performance assurance. The results based on co-occurrence analysis indicated a strong correlation between these gaps in PSM. Enterprises should pay attention to collaborative management among them. These deficiencies in the enterprise's PSM system showed that the essential defects in China's chemical industry are a poor safety culture, inadequate accident investigation, inadequate training, and a lack of chemical safety personnel. The study recommended that the chemical industry establish superior process safety culture and competency for all personnel, monitor leading and lagging process safety indicators, apply inherent safety, and practice advanced safety management concepts. We hope that the findings can provide China's perspectives and strengths for global chemical safety. [ABSTRACT FROM AUTHOR]

The development of intelligence and informatization is the inevitable trend of safety production in coal enterprises. Data mining technology plays an important role in promoting the development of coal mine safety management. This paper uses natural language processing technology and the Bi-LSTM model to automatically classify the hidden danger information and extract the theme of the coal mine. Then, taking the risk of a coal mine gas explosion as the starting point, the gas safety situation prediction model is constructed. Finally, an accurate management and control information system based on data mining technology and intelligent technology is developed, which realizes the information analysis of a large visual screen and the intelligent information processing of the APP. The system has been applied in the Luxi coal mine, and the application effect is good, which significantly improves the safety management ability and efficiency of the coal mine. This study can provide new ideas and methods for the dual pre-control construction of coal mines, strengthen the information processing capacity of the existing pre-control system, and promote the healthy development of the coal industry. [ABSTRACT FROM AUTHOR]

This was a single-center, randomized, double-blind, parallel control study evaluating the immunogenicity and safety of a two-dose schedule of serogroups ACYW meningococcal polysaccharide conjugate vaccine with tetanus toxoid (TT) conjugate protein, in infants and toddlers of 3–35 months old. 720 participants were stratified according to the age of 3–5 months old, 6–11 months old, and 12–35 months old and randomly assigned with an equal ratio to two different dose groups, i.e., 40- and 20-μg doses. Blood samples were taken from all participants before the first vaccination and 30 days after the full-course vaccination to detect the serogroups ACYW meningococcal antibodies. All adverse events occurred within 30 days after vaccination of each dose, and serious adverse events occurred within six months after full-course vaccination were collected for safety evaluation. This study was registered at the China drug trial registration with the identifier CTR 20182031. After 30 days of full-course vaccination, 92.78 % (95 % CI: 85.70 %-100.00 %) showed the immune response against all serogroups in both high-dose and low-dose groups by rabbit serum bactericidal antibody assay (rSBA) and the geometric mean titer (GMT) of all serogroups showed a high level (74.6–505.8, 95 % CI: 56.4–615.7). However, no significant difference between different dose groups was observed (P > 0.05). The common local and systemic adverse events in both groups were redness (3 %-7%), and fever (26 %-65 %), respectively. In addition, the grade 3 adverse event related to the vaccine was fever (1.67 %-12.50 %). No serious adverse event was reported to be associate with the vaccination. The serogroups ACYW meningococcal polysaccharide conjugate vaccine was safe and effective in the population aged 3–35 months. The vaccine efficacy and safety of the 20-μg dose group were not less than that of the 40-μg dose group. [ABSTRACT FROM AUTHOR]

• Ormutivimab is the third recombinant human anti-rabies monoclonal antibody marketed in the world. In China, it is the first. • The study reported in this paper is the first phase IIb clinical study carried out in China. It further evaluates the activity, safety and immunogenicity of Ormutivimab combined with rabies vaccine, and recommends a reasonable dosage for phase III confirmatory clinical study. • In this study, the activity and safety of Ormutivimab combined with rabies vaccine were compared with that of commercial HRIG combined with vaccine and vaccinated alone. • In this study, the effects of different doses of Ormutivimab on active immunization of rabies vaccine were evaluated and compared with that of commercially available HRIG. • This study evaluated the dose correlation of Ormutivimab immunogenicity (anti-antibody) and the effect of anti-antibody on the activity. This study was a randomized, double-blind, parallel-controlled trail to evaluate the rabies virus neutralizing activity（RVNA）, safety and immunogenicity of Ormutivimab + rabies vaccine in Chinese healthy adults. Subjects were randomly and equally assigned to 4 groups (20 IU/kg Omtv + vaccine, 40 IU/kg Omtv + vaccine, 20 IU/kg HRIG + vaccine, and placebo + vaccine). Subjects received vaccine as the WHO Essen regime combined with Omutivimab、HRIG or placebo on Day 0. The study lasted for 43 days. A total of 240 subjects were simultaneously assigned to both FAS and SS. Fifty subjects with baseline RVNA > 0.05 IU/ml (detection limit) were excluded, 190 were included into mITT. All the subjects from 40 IU/kg Omtv + vaccine group had a protection level of RNVA (≥0.5 IU/ml, WHO) on Day 14, and those in 20 IU/kg Omtv + vaccine group and placebo + vaccine group converted positive 100 % on Day 28. In contrast to 20 IU/kg HRIG + vaccine and placebo + vaccine, Ormutivimab + vaccine provided a higher RVNA during Days 0 to 7. And RVNA in 40 IU/kg Omtv + vaccine and 20 IU/kg Omtv + vaccine groups were always higher than 20 IU/kg HRIG + vaccine group during the whole study. Although anti-Omtv antibody were detected in some subjects, it did not influence the RVNA. The incidence of adverse reactions was significantly lower in 20 IU/kg Omtv + vaccine group (17.2 %) than in 40 IU/kg Omtv + vaccine (36.7 %) and 20 IU/kg HRIG + vaccine groups (40.3 %). Compared with HRIG + vaccine and placebo + vaccine, Omtv + vaccine provided higher RNVA for earlier immune protection. The interference of Ormutivimab on the long-term immune protection induced by rabies vaccine is weaker than HRIG. At the same dose, the adverse reactions of Omtv + vaccine group were less than HRIG + vaccine group. Registration: ClinicalTrials.gov #NCT02559921. [ABSTRACT FROM AUTHOR]

To mitigate a national shortage of WIBP-CorV COVID-19 vaccine, China's regulator approved administering BBIBP-CorV after WIBP-CorV for completion of a primary series. In a pragmatic observational study, we compared immunogenicity and safety of a primary series of WIBP-CorV followed by BBIBP-CorV with a primary series of two doses of BBIBP-CorV. We invited healthy 18–59-years-old adults who had already received either WIBP-CorV or BBIBP-CorV as their first dose in a primary series to participate in this observational cohort study. Subjects who had received WIBP-CorV as their first dose became the observation group; subjects who had received BBIBP-CorV as their first dose became the control group. All participants received BBIBP-CorV as their second dose. We obtained sera 1, 2, and 6 months after second doses for nAb titer measurement by micro-neutralization cytopathic effect assay with SARS-CoV-2 strain HB01, standardized with WHO International Standard for anti-SARS-CoV-2 immunoglobulin. Safety was assessed for the 7 days after administration of second doses. Between March and December 2021, 275 subjects were included in the observation group and 133 in the control group. Neutralizing seropositivity (≥1:4) rates were 98.91 % and 99.25 % at 1 month and 53.16 % and 70.69 % at 6 months. One-month geometric mean titers (GMTs) were 21.33 and 22.45; one-month geometric mean concentrations (GMCs) were 227.71 IU/mL and 273.27 IU/mL. One to two months after vaccination, observation group seropositivity rates and titers were not significantly different to the control group's. Adverse reaction rates were 11.27 % and 18.80 %, all mild or moderate in severity. Both primary series were immunogenic; immunogenicity of WIBP-CorV followed by BBIBP-CorV was not different than immunogenicity following two doses of BBIBP-CorV for two months after vaccination; safety profiles were acceptable for both regimens. BBIBP-CorV can be used to complete a primary series that started with WIBP-CorV. [ABSTRACT FROM AUTHOR]

Work stress has a significant impact on unsafe behaviors. However, there has been limited exploration of the relationship between work stress and unsafe behaviors. The aim of this research was to examine the effect of work stress on unsafe behaviors, while incorporating the mediating effect of fatigue and the moderating role of safety climate. Data were collected from 1224 front-line oil workers in China. The findings showed that work stress had a significant effect on unsafe behaviors, and that fatigue and safety climate played partial mediating and moderating roles in the relationship respectively. In terms of their sub-dimensions, (1) job certainty and job control had positive influences on unsafe behaviors, while only social support was negatively associated with unsafe behaviors. (2) Five sub-dimensions of safety climate moderated the effect of work stress on unsafe behaviors. This research contributes to the study on the mechanism of unsafe behaviors by demonstrating differential effects of work stress, fatigue and safety climate and by considering their combined effects. Measures for reducing unsafe behaviors from the perspective of work stress and safety climate are discussed. [ABSTRACT FROM AUTHOR]

Smart safety management (SSM) in organizations is an inevitable trend in a more intelligent era. However, the adoption of safety science theory lags behind the application of intelligent technology in SSM, posing several challenges (functional dispersion, low-quality data, and lack of versatility). Thus, the accident causation theory (ACT) is adopted to address the existing problem. This study develops a conceptual framework for SSM using the 24Model, a popular ACT in China. The main work conducted in this study is summarized as follows: (a) the description of 24Model and its characteristics, as well as an analysis of its feasibility and applicability in SSM; (b) a detailed presentation of the functions, operation principle, and control paths of unsafe acts in the 24Model-based SSM framework; and (c) a discussion of the framework's advantages, limitations in this research, and suggestions for future research. Research shows that the SSM framework based on the ACT can integrate the functions of the current SSM, establish management sustainability, enhance data quality, and ensure the versatility of the industry, which are the key factors that facilitate SSM. This study can offer a theoretical and practical basis for safety management in the intelligent era and provide implications for the application of the ACT. [ABSTRACT FROM AUTHOR]

• The 9vHPV vaccine is currently approved for use in Chinese women aged 16–26 years. • Immunogenicity was compared: 9–19- and 27–45- vs. 20–26-year-old Chinese females. • Antibody responses were non-inferior in 9–19- and 27–45- vs. 20–26-year-olds. • Data support bridging of efficacy to Chinese females aged 9–19 years and 27–45 years. • The 9vHPV vaccine was generally well tolerated in Chinese females aged 9–45 years. The 9-valent human papillomavirus (9vHPV; HPV6/11/16/18/31/33/45/52/58) vaccine was approved for use in Chinese women aged 16–26 years in 2018. This phase 3, open-label study (NCT03903562) compared 9vHPV vaccine immunogenicity and safety in Chinese females aged 9–19 years and 27–45 years with Chinese females aged 20–26 years; we report results from day 1 through 1 month post-Dose 3. The study will continue through 54 months post-Dose 3 to assess antibody persistence in Chinese girls aged 9–19 years. Participants aged 9–45 years received three doses of the 9vHPV vaccine. Geometric mean titers (GMTs) and seroconversion percentages for anti-HPV6/11/16/18/31/33/45/52/58 antibodies were determined by competitive Luminex immunoassay in serum samples obtained at day 1 and 1 month post-Dose 3. Adverse events (AEs) within 30 days post-vaccination and serious AEs (SAEs) occurring at any time were recorded. In total, 1990 participants (690 aged 9–19 years; 650 aged 20–26 years; 650 aged 27–45 years) were enrolled. At 1 month post-Dose 3, >99% of participants in the per-protocol immunogenicity population seroconverted to each vaccine HPV type. Anti-HPV6/11/16/18/31/33/45/52/58 antibody GMTs in the 9–19-year age group were non-inferior to those in participants aged 20–26 years. Anti-HPV6/11/16/18/31/33/45/52/58 seroconversion percentages in the 27–45-year age group were non-inferior to those in participants aged 20–26 years. Injection-site and systemic AEs were reported by 43.3% and 50.9%, 50.5% and 57.1%, and 43.8% and 43.4% of participants aged 9–19, 20–26, and 27–45 years, respectively. There were no vaccine-related SAEs, discontinuations due to AEs, and deaths. Antibody responses induced by 9vHPV vaccination in Chinese females aged 9–19 years and 27–45 years were non-inferior to those in Chinese females aged 20–26 years. The vaccine was generally well tolerated. ClinicalTrials.gov Identifier: NCT03903562. [ABSTRACT FROM AUTHOR]

Systematic accident analysis is a significantly important and necessary phase for reactor primary heat transfer system (PHTS) design. Over the past several decades, many systematic accident analysis software and modules, such as RELAP5, CHATHARE, MELCOR, etc., have been developed to be applied on fission reactor accident simulation. However, there is no dedicated systematic safety analysis software for fusion reactor at present, although some methodologies and code modification for adapting fission system code to fusion condition have been applied, the discussion of pros and cons of these need to be addressed and still some special characteristics weren't brought into consideration, which could cause deviation between real situation and simulation result. Therefore, it is essential to develop a dedicated fusion reactor systematic safety analysis software. At the moment, a nuclear system safety code is being developed with the support of Chinese fusion community. The baseline version of the code was extracted from COSINE, which is the software platform for fission power plant design and safety analysis being developed in China. To develop this software, the adaptability analysis of this software for the fusion reactor is needed in the initial phase. In this paper, the different characteristics of PHTS accident between fission and fusion reactor is analyzed, and the related modules to be modified or developed were then sorted out, including heat transfer and material properties module, etc. This part of work will provide demands for the following development of the software and references for the fusion reactor safety analysis. [ABSTRACT FROM AUTHOR]

Road traffic safety is confronted with unique challenges worldwide due to the varied road network, high population density, and the rapid increase in vehicle numbers. This necessitates an effective evaluation of traffic safety at the road segment level to improve traffic safety management. Existing safety indicators, such as crash frequency (which lacks real-time availability) and Surrogate Safety Measures (focused on micro-level interactions), fall short in quantifying the overall safety status of road segments. To overcome these limitations, we introduce the concept of entropy, typically used to measure disorder in complex systems, into road traffic safety assessment. Our research presents a novel macroscopic safety indicator named 'velocity entropy,' along with its calculation method, which involves discretization and the Parzen window technique. The efficacy of velocity entropy is validated using the UTE dataset, a high-fidelity trajectory dataset from China, showing a more significant correlation with traffic conflicts than other macroscopic traffic properties. Notably, velocity entropy can track the temporal and spatial evolution of traffic safety, providing insights into the dynamic development of traffic risks. Overall, velocity entropy offers an innovative, practical, and theoretically meaningful tool for assessing and predicting road safety. [ABSTRACT FROM AUTHOR]

Compared to liquid/gas hydrogen tank, the pipeline is an economical way for hydrogen transportation. With the quick development of utility tunnel in China, hydrogen pipeline enters the gas compartment can be expected soon. However, all the safety requirements of the gas compartment in the current standards are designed for natural gas, and the applicability for hydrogen is unknown. Therefore, a series of studies were started to investigate the safety of hydrogen in utility tunnel. In this work, a real utility tunnel locates at Shanghai was selected as the physical object. A 3D numerical model was built and successfully validated by a scaled tunnel test. The model has the maximum deviation of +9.5%. After that, a comparatively study of the dispersion behavior of CH 4 and H 2 was conducted. The assumed scenario was a 20 mm small-hole leaks with gauge pressure of 1.0 MPa in the middle of the tunnel. Numerical results shown that, H 2 has a larger dispersion velocity and higher concentration, and is more dangerous compared to CH 4. The current emergency ventilation strategy of air change rate of 12 times/h is not effective enough to dilute the H 2 flammable cloud. The alarm time of the testing points shown strong linear law. There was a sharp variation in the range of 20%–100% LFL (Lower Flammable Limit), so the alarm strategy in the tunnel standards is too ideal for both CH 4 and H 2. The numerical results in the present study could provide a guidance for the design and safety management of the hydrogen tunnel. • Dispersion behavior of H 2 and CH 4 in a real utility tunnel was studied. • The dispersion characteristics both in length and lateral direction were focused. • The evolution of the concentration stratification was characterized by four phases. • The alarm time law of the testing points in the sensor line was fitted. • The applicability of CH 4 safety requirements for H 2 was explored. [ABSTRACT FROM AUTHOR]

• The first trial to explore all-oral short regimens for MDR-TB in China. • Two optimized regimens, designed according to local conditions. • Similar high culture conversion in the early stage in both regimens. • High treatment success rate for patients who completed the treatment. • Good adherence in the pandemic of COVID-19. Multidrug-resistant tuberculosis (MDR-TB) patients have been suffering long, ineffective, and toxic treatment until short-course injectable-free regimens emerged. However, the new WHO-recommended regimens might be less feasible in the real-world setting. Here, we evaluated two optimized all-oral short-course regimens in China. From April 2019 to August 2020, we conducted a prospective nonrandomized controlled trial and consecutively included 103 MDR-TB patients diagnosed with pulmonary MDR-TB in Shenzhen, China. A 4-5 drug regimen of 9-12 months was tailored to the strain's resistance patterns, patients' affordability, and tolerance to drugs. This was an interim analysis, focusing on the early treatment period. 53.4% (55/103) of patients were prescribed linezolid, fluoroquinolone (FQ), clofazimine, cycloserine, and pyrazinamide, followed by a regimen in which clofazimine was replaced by bedaquiline (35/103, 34.0%). The culture conversion rate was 83.1% and 94.4% at two and four months, respectively, with no significant difference between bedaquiline-free and bedaquiline-containing cases and between FQ-susceptible and FQ-resistant cases. Among 41 patients who completed treatment, 40 (97.6%) patients had a favorable outcome and no relapse was observed. Peripheral neuropathy and arthralgia/myalgia were the most frequent AEs (56.3%, 58/103). 18 AEs caused permanent discontinuation of drugs, mostly due to pyrazinamide and linezolid. Optimized all-oral short-course regimens showed satisfactory efficacy and safety in early treatment stage. Further research is needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Although sedation during gastrointestinal endoscopy is widely used in China, the characteristics of sedation use, including regional distribution, personnel composition, equipment used, and drug selection, remain unclear. The present study aimed to provide insights into the current practice and regional distribution of sedation for gastrointestinal endoscopy in China.Methods: A questionnaire consisting of 19 items was distributed to directors of anaesthesiology departments and anaesthesiologists in charge of endoscopic sedation units in mainland China through WeChat.Results: The results from 2758 participating hospitals (36.7% of the total) showed that 9 808 182 gastroscopies (69.3%) and 4 353 950 colonoscopies (30.7%), with a gastroscopy-to-colonoscopy ratio of 2.3, were conducted from January to December 2016. Sedation was used with 4 696 648 gastroscopies (47.9%) and 2 148 316 colonoscopies (49.3%), for a ratio of 2.2. The most commonly used sedative was propofol (61.0% for gastroscopies and 60.4% for colonoscopies). Haemoglobin oxygen saturation (SpO2) was monitored in most patients (96.1%). Supplemental oxygen was routinely administered, but the availability of other equipment was variable (anaesthesia machine in 64.9%, physiological monitor in 84.4%, suction device in 72.3%, airway equipment in 75.5%, defibrillator in 32.7%, emergency kit in 57.0%, and difficult airway kit in 20.8% of centres responding).Conclusions: The sedation rate for gastrointestinal endoscopy is much lower in China than in the USA and in Europe. The most commonly used combination of sedatives was propofol plus an opioid (either fentanyl or sufentanil). Emergency support devices, such as difficult airway devices and defibrillators, were not usually available. [ABSTRACT FROM AUTHOR]

• We assessed the safety/immunogenicity of full-/half-dose subunit NAIIV4 in 6–35 months subjects. • We compared the safety/immunogenicity of this subunit vs. a licensed split-virion NAIIV4 in ≥ 3 years subjects. • We assessed the effect of the dose of subunit NAIIV4 in 6–35 months toddlers. • The full-dose subunit NAIIV4 is safe and can elicit robust immune response in ≥ 6 months subjects. Quadrivalent influenza inactivated vaccine (IIV4) is more likely to provide wider protection against yearly circulating influenza viruses than trivalent inactivated influenza vaccine (IIV3). In this study, a total of 320 participants were allocated to four age cohorts (6–35 months, 3–8 years, 9–17 years, and ≥ 18 years; 80 participants/cohort) according to their actual date of birth. Participants in each cohort were randomly assigned to two groups to receive intramuscular injection of the trial vaccine or the comparative vaccine in a one-dose (3–8 years, 9–17 years,and ≥ 18 years) schedule on day 0 or two-dose (6–35 months cohort) schedule on day 0 and 28. The first objective is to evaluate the safety and immunogenicity of the full-dose subunit non-adjuvanted IIV4 (FD-subunit NAIIV4) we developed versus an active-control, China-licensed split-virion NAIIV4, in people ≥ 3 years. The second objective is to evaluate the safety and immunogenicity of FD-subunit NAIIV4 versus the half-dose (HD-subunit NAIIV4) in toddlers aged 6–35 months. Results showed that all adverse reactions noted were rare, mild, and self-limited. In ≥ 3 years cohorts, systemic adverse reactions in FD-subunit NAIIV4 groups were less than the active control split-virion NAIIV4 groups ([Systemic adverse reaction rates (95%CI)], 15.0 (8.6–21.4) versus 19.2(12.1–26.2), p = 0.391). The overall seroprotection efficacy after vaccination were comparable between FD-subunit NAIIV4 and the active control split-virion NAIIV4([Seroprotection rates (95%CI)], H1N1, 99.2(81.3–100.0) versus 94.9(90.9–98.9), p = 0.117; H3N2, 81.7(74.7–88.6) versus 82.1(75.1–89.0), p = 0.939; BV, 75.8(68.2–83.5) versus 74.4(66.4–82.3), p = 0.793; BY, 94.2(90.0–98.4) versus 92.3(87.5–97.1), p = 0.568). Additionally, FD-subunit NAIIV4 has comparable safety and better seroprotection versus that of the half-dose in 6–35 months toddlers groups ([Total adverse reaction rates (95%CI)], 37.5(18.5–56.5) versus 47.5(26.1–68.9), p = 0.366) ([Seroprotection rates (95%CI)], H1N1, 85(56.4–100.0) versus 75.7(47.6–100.0), p = 0.117; H3N2, 50(28.1–71.9) versus 29.7(12.2–47.3), p = 0.070; BV, 75(48.2–100.0) versus 29.7(12.2–47.3), p < 0.001; BY, 75(48.2–100.0) versus 56.8(32.5–81.0), p = 0.091). As a result, the FD-subunit NAIIV4 we developed is safe and effective to provide broader and adequate protection against the circulating influenza viruses during 2018–2019, which could be an essential component of the global preventive strategy for influenza pandemic. [ABSTRACT FROM AUTHOR]

• We investigated the toxicity and adverse reactions of the combined HAV-EV71 vaccine. • SD rats that received one dose of the HAV-EV71 combined vaccine showed no toxicity. • Restored phagocytosis of basophilic granules was observed with three doses. • Guinea pigs showed no allergic reactions following multiple intramuscular injection. Since 2007, Hepatitis A (HAV) vaccination has been a part of the National Immunization Program of China. Recognizing enterovirus 71 (EV71) as the most important pathogen in severe hand, foot and mouth disease, an inactivated EV71 vaccine was successfully marketed in 2015. Based on the concept of one vaccine preventing two diseases and owing to similarities in vaccine preparation and the overlap of the eligible population, a combination of the inactivated HAV vaccine and inactivated EV71 vaccine is theoretically feasible and desirable. However, the optimal vaccination schedule for this combination vaccine has yet to be optimized. Use of this combined vaccine would not only decrease the number of vaccinations, but also lower associated cost. This study aimed to investigate the toxicity and adverse reactions of the combined HAV-EV71 vaccine under Good Laboratory Practice conditions to provide a reference for clinical studies/applications in the future. CD®(Sprague Dawley) IGS rats were employed for single-dose toxicity testing using a high dose, and repeated-dose toxicity testing using high, as well as low doses. Animals that received only a single dose showed no obvious clinical symptoms nor abnormal body weight, and no significant gross pathological change at the experimental endpoint at necropsy. In the rats injected with three doses, phagocytosis of basophilic granules by macrophages was observed in the inguinal, mesenteric, and local lymph nodes, besides irritation at the administration site. At 56 days after the last dose, no significant histopathological change was observed in the lymph nodes, and local irritation gradually faded. Further, systematic allergy testing was performed in guinea pigs. After systemic sensitization and challenge with the HAV-EV71 vaccine, animals showed normal weight gain and no allergic reactions. This study, therefore, confirmed a good safety profile of the inactivated HAV and EV71 combined vaccine. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection remains a global public health challenge. Patients with diabetes are at greater risk of HBV infection than healthy people. The immunogenicity and safety of two major hepatitis B vaccines were evaluated in Chinese patients with diabetes. In this phase IV, open-label, randomized, controlled study, participants with diabetes were randomly recruited from 6 township health centers in Gansu Province and received either a 3-dose Saccharomyces cerevisiae recombinant hepatitis B vaccine (Group D20SC 0-1-6, n = 113) or a 3-dose Chinese hamster ovary cell (CHO) recombinant hepatitis B vaccine (Group D20CHO 0-1-6, n = 119). Healthy control groups were randomly recruited from the same 6 health centers and received 3 doses of the saccharomyces cerevisiae recombinant hepatitis B vaccine (Group ND20SC 0-1-6, n = 77). Immunogenicity, including seroconversion rate and geometric mean concentration (GMC) at 1 month after three doses of vaccination, and safety were assessed. The seroconversion rate was defined as the concentration of HBsAb ≥ 10 mIU/mL. The seroconversion rates of Group D20SC 0-1-6, Group D20CHO 0-1-6 and Group ND20SC 0-1-6 were 89.6%, 91.4% and 97.1%, respectively, in the per-protocol analysis, and these differences were not statistically significant. The antibody concentration in Group D20SC 0-1-6 (GMC = 601 mIU/mL) was lower than that of the healthy control group (GMC = 1465 mIU/mL), but no significant difference was found in the GMC between the Group D20CHO 0-1-6 (GMC = 778 mIU/mL) and Group D20SC 0-1-6. Adverse events (AEs) were comparable between groups, and no serious AEs were found in these three groups. The Saccharomyces cerevisiae recombinant and CHO recombinant hepatitis B vaccines in China can induce good immunogenicity in a diabetic population, although the antibody concentration may be lower, indicating the feasibility of vaccinating a large number of diabetic patients in China with these vaccines. [ABSTRACT FROM AUTHOR]

Bedaquiline treatment significantly improves multidrug-resistant tuberculosis (MDR-TB) patient treatment outcomes. However, safety and efficacy data are lacking for bedaquiline used with background regimens to treat Chinese TB patients. Here, we describe our initial clinical experience for bedaquiline treatment of a large multicentre cohort of MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patients in China. Patients (177) received 24-week bedaquiline treatment combined with personalized anti-TB drug background regimens. As primary efficacy endpoints, times to initial sputum culture conversion were measured. Of 177 MDR-TB patients completing the 24-week treatment course, sputum culture conversion occurred for 151/177 (85.3%), while 26 had unfavourable outcomes, including 3/177 (1.7%) deaths and 23/177 (13.0%) non-responders at treatment completion. The median time to sputum culture conversion was 4 (interquartile range 2–8) weeks. Conversion rates were 33/39 (84.6%, 95% confidence interval (CI) 73.3–95.9) for MDR-TB patients, 47/56 (83.9%, 95% CI 74.3–93.6) for pre-XDR-TB patients and 71/82 (86.6%, 95% CI 79.2–94.0) for XDR-TB patients. Multivariate analysis demonstrated that patients with low body mass index (odds ratio 7.356; 95% CI 2.652–20.401) were at significantly high risk of unfavourable outcomes, with serious adverse events noted in 15 (8.5%) patients, including six with corrected QT interval (QTc) prolongation times (>500 ms). Bedaquiline, when included in background regimens for treatment of MDR-TB and XDR-TB patients in China, was safe and associated with a high rate of culture conversion. [ABSTRACT FROM AUTHOR]

Objectives: Polymyxin B is a last-line antibiotic for multidrug-resistant gram-negative bacterial infections. However, limited safety and pharmacokinetic information is available. We investigated the safety and pharmacokinetics of intravenous polymyxin B in healthy subjects.Methods: An open-label, single-dose clinical trial was conducted in healthy Chinese subjects. Polymyxin B (sulphate) was administered intravenously at 0.75 or 1.5 mg/kg (n = 10 per dose, 5 males and 5 females) to examine the safety and pharmacokinetics.Results: One female subject in the 1.5-mg/kg group discontinued due to abdominal pain during administration. The most frequently reported adverse events were perioral paraesthesia, dizziness, and numbness of extremities (7/10 subjects in the 0.75-mg/kg group, all subjects in the 1.5-mg/kg group). All neurotoxicity-related events dissipated without treatment within a maximum of 23 h. Notably, abdominal pain (3/5) and vulvar pruritus (2/5), colpitis (2/5) or abnormal uterine bleeding (1/5) were reported in female subjects receiving the 1.5-mg/kg dose. In the 0.75-mg/kg group, the total clearance, volume of distribution and half-life of polymyxin B were 0.028±0.002 L/h/kg, 0.219±0.023 L/kg and 5.44±0.741 h, respectively; similar values were observed in the 1.5-mg/kg group. Urinary recovery was 3.7 ± 1.1% and 8.1 ± 1.3% in the 0.75- and 1.5-mg/kg groups, respectively. Population pharmacokinetics of polymyxin B was consistent with a three-compartment model. The clearance and distribution of the central compartment were 0.027 L/h/kg and 0.071 L/kg, respectively.Conclusions: This study is the first to examine the safety and pharmacokinetics of polymyxin B in healthy subjects. Our results highlight that acute toxicity is a dose-limiting factor for intravenous polymyxin B. [ABSTRACT FROM AUTHOR]

• We assessed qHPV vaccine immunogenicity/safety in Chinese females aged 9–26 years (83/85). • The qHPV vaccine elicited robust anti-HPV6/11/16/18 responses in Chinese females (82/85). • Non-inferior immunogenicity was observed in younger versus older Chinese females (82/85). • The qHPV vaccine was generally well tolerated in Chinese females aged 9–26 years (82/85). The quadrivalent human papillomavirus (qHPV; HPV6/11/16/18) vaccine was approved for use in Chinese women aged 20–45 years in 2017. This Phase 3, open-label study (NCT03493542) aimed to assess immunogenicity and safety of the qHPV vaccine in Chinese girls aged 9–19 years versus Chinese young women aged 20–26 years; we report results from Day 1 through Month 7. The study will continue through Month 60 to assess antibody persistence in Chinese girls aged 9–19 years. Participants aged 9–26 years received three doses of the qHPV vaccine (Day 1, Month 2, Month 6). Geometric mean titers (GMTs) and seroconversion percentages for anti-HPV6/11/16/18 antibodies were determined by competitive Luminex immunoassay (cLIA) in serum samples obtained on Day 1 and at Month 7. Injection-site adverse events (AEs) and systemic AEs within 30 days post-vaccination, and serious AEs (SAEs) occurring at any time during the study, were recorded. In total, 766 participants (383 aged 9–19 years; 383 aged 20–26 years) were enrolled and received ≥1 vaccine dose. All participants in the per-protocol immunogenicity population of both age groups seroconverted to each of the vaccine HPV types at Month 7. Anti-HPV6/11/16/18 antibody GMTs at Month 7 in participants aged 9–19 years were non-inferior to those in participants aged 20–26 years. Injection-site AEs and systemic AEs were reported by 36.6% and 49.3% of 9–19-year-olds, and 40.7% and 54.8% of 20–26-year-olds, respectively. There were no vaccine-related SAEs. No participants discontinued the vaccine due to an AE and no deaths were reported. Antibody responses induced by the 3-dose qHPV vaccination regimen in Chinese girls aged 9–19 years were non-inferior to those in Chinese young women aged 20–26 years. The vaccine was generally well tolerated in the study population. ClinicalTrials.gov Identifier: NCT03493542. [ABSTRACT FROM AUTHOR]

• Live, attenuated and inactivated hepatitis A vaccines are both immunogenic and show long-term duration of protection. • Live, attenuated and inactivated hepatitis A vaccines have similar per-dose safety profiles. • Use of either vaccine results in similar population immunity and low incidence of hepatitis A. In 2008, China introduced live, attenuated hepatitis A vaccine (L-HepA, licensed in 1992) and inactivated hepatitis A vaccine (I-HepA, licensed in 2002) nationwide, and is currently the only country using L-HepA in routine immunization. We assessed seropositivity and its duration following vaccination, safety, and association with hepatitis A incidence and population seroprevalence for I-HepA and L-HepA. We obtained seroprevalence data from two nationwide serosurveys (in 1992 and 2014), vaccination status from the 2014 serosurvey, and vaccine safety and disease incidence data from the national surveillance system. We compared long-term HAV seropositivity among vaccine recipients and described safety profiles of both vaccines. We categorized the 31 provinces into those predominately using I-HepA and achieving high coverage (n = 4), those predominately using L-HepA achieving high coverage (n = 4), and those predominately using L-HepA achieving lower coverage (n = 23). We compared population HAV seropositivity, coverage, and disease incidence among the three groups. One year after vaccination, seropositivity from I-HepA was significantly higher than from L-HepA (97.8% vs 90.7%), and seropositivity declined to 73.5% for L-HepA and 75.4% for I-HepA after 10 years – not significantly different by vaccine. The annual incidence of serious AEFI was <0.5/100 000 for both vaccines. Prior to licensure of either HepA vaccine, provinces that would go on to predominantly use I-HepA had lower incidences of hepatitis A and lower seropositivity levels to HAV than provinces that would go on to use L-HepA. By 2014, these differences were significantly diminished. Regardless of vaccine selection, all three province groups had lower immunity to HAV among individuals born during the 10 years prior to nationwide vaccine introduction – individuals who were 10 to 24 years old in 2014. Evidence of good immunogenicity, safety, and impact on incidence supports continued use of both I-HepA and L-HepA in the EPI system. These results may be useful for countries considering integrating HepA vaccines into their routine programs. [ABSTRACT FROM AUTHOR]

• We found a feasible way to attenuate DHAV-3. • SD70 strain was developed as a live attenuated DHAV-3 vaccine candidate. • This vaccine candidate exhibited safety, good stability and excellent protection. • One dose of SD70 vaccine is sufficient to protect ducklings from DHAV-3 infection. Duck hepatitis A virus type 3 (DHAV-3) is an important pathogen that causes substantial losses in the Chinese duck industry. DHAV-3 is highly fatal to ducklings and there is no licensed vaccine in China available to reduce DHAV-3 infection. Our goal was to develop a live attenuated vaccine candidate against DHAV-3. A field isolated strain, SD, was attenuated by serially passaging in specific-pathogen-free (SPF) chicken embryos, and it lost its pathogenicity after 40 passages. The 70th passaged strain (SD70), which achieved good growth capacity in chicken embryos with a viral titer of 107.5 ELD 50 /mL, was chosen to be the live attenuated vaccine candidate. The SD70 strain did not cause clinical signs of disease or mortality in 1-day-old ducklings and showed no virulence reversion after seven rounds of in vivo back passages. The minimum effective dose of SD70 was determined to be 102.5 ELD 50 via the vaccination route of subcutaneous inoculation. A single dose of the SD70 provided good protection to susceptible ducklings against the lethal DHAV-3 strain. Compared with the genomic sequence of the parent SD strain, the SD70 had 12 amino acid substitutions, some of which may play a role in virulence attenuation. This study demonstrated that the attenuated SD70 strain is a promising vaccine candidate for the prevention of DHAV-3 infection in China. It exhibited safety, good stability and excellent protection. [ABSTRACT FROM AUTHOR]

• Totally 155 patients from three medical centers in East China were recruited, including 108 patients in standard-dose group and 47 patients in high-dose group. • This study was a retrospective study, and established strict inclusion criteria. Furthermore, two experienced infectious experts reviewed the cases which met the cSSTIs diagnosis, and excluded the doubtful cases. • The results of multivariate analysis indicated that high-dose daptomycin was an independent effector for early clinical stabilization. • Compared with standard-dose daptomycin, high-dose daptomycin increased the rate of early clinical stabilization in Asian patients with cSSTIs, whereas the incidence of adverse events did not increase. To compare the efficacy and safety of standard-dose (SD) daptomycin with those of high-dose (HD) daptomycin in complicated skin and soft tissue infections (cSSTIs) in an Asian population. Patients from three medical centers diagnosed with cSSTIs were screened in the clinical information system. Patients included in the analysis were divided into two groups: those who received daptomycin at doses ≥ 6 mg/kg (HD group) and those receiving 4 mg/kg (SD group). The demographics and clinical treatment information were analyzed. Overall, 155 patients were recruited, including 108 patients in the SD group and 47 patients in the HD group. The rate of healthcare-associated infections was higher in the HD group (61.70% vs. 37.04%), demonstrating a statistically significant difference (P = 0.005). Compared with the SD group, the HD group had statistically significant early clinical stabilization (72.34% vs 52.78%, P = 0.023). The results of the multivariate analysis indicated that HD daptomycin was an independent effector for early clinical stabilization (HR=0.394, P < 0.001). The rate of drug-related adverse events was equally distributed in the HD and SD groups (36.17% vs. 26.85%, P = 0.243). Compared with SD daptomycin, HD daptomycin increased the rate of early clinical stabilization in Asian patients with cSSTIs, whereas the incidence of adverse events did not increase. [ABSTRACT FROM AUTHOR]

In recent years, the frequent occurrence of bus fire accidents has caused public concern in China, impacting the safe operation of urban transportation seriously. A cross-sectional survey was conducted to evaluate the safety & security (S&S) level of attitude and knowledge in relation to bus fires among residents in Fuzhou city, Fujian Province. 200 passengers from 6 bus terminals and 10 bus stations were selected as study subject. The results show that the S&S attitude and knowledge differ by gender, age, education background, occupation, and the frequency of taking a bus. The educational level significantly influences the S&S attitude and knowledge of the respondents, showing a positive correlation. Similarly, the passengers who take a bus frequently are more likely to display higher S&S attitude and knowledge scores. The participants working in governments and serving as managers in companies scored higher in attitude than the staff and students. A minority of respondents are concerned with bus fire S&S in their daily lives. Many passengers pay not much attention to the safety instructions when taking a bus. Some suggestions are given to improve S&S situation of bus transportation. The research results can lay the foundation for local governments, bus transport operators, and relevant safety organizations to establish a series of safety policies or regulations with respect to bus fires. [ABSTRACT FROM AUTHOR]

• Multiple safety investment indices with set theory and use in coal mines safety. • Multivariate safety investment with accident control and gray forecasting theory. • Using coupling model to improve the safety production level by a case study. Mechanization and automation of the coal industry as well as increasing the government support for safety in coal mines in China resulted in a significant decrease in the death rate per million tons of coal produced. Nonetheless, major accidents still occur. As one of the five factors of safe production, safety investment plays a key role in ensuring the safe production of coal in mining enterprises. Coal mining enterprises can ensure safe production in the mines and maximize profits through optimum safety investment. In this study, safety system engineering principles and subsets in set theory were combined to develop a novel safety investment index system. The safety investment indices were categorized into human, machine, environment, and the intersection of these three indices. The elements in each investment set were examined, and a multivariate model of safety investment and accident control was created using gray forecasting theory. In addition, a case study was conducted to validate the reliability of the model. The results indicated that the proposed model can provide theoretical evidence and guidance for safety investment decision making in coal mining enterprises. [ABSTRACT FROM AUTHOR]

• Upward counterfactual thinking (CFT) was positively related to safety behavior. • Safety knowledge mediated the upward CFT-safety behavior relationships. • Locus of control strengthened the mediations of safety knowledge on such relationships. • Upward CFT has a stronger relationship with safety behavior than downward CFT. Introduction: Information processing theories of workplace safety suggest that cognition is an antecedent of safety behavior. However, little research has directly tested cognitive factors as predictors of workplace safety within organizational psychology and behavior research. Counterfactuals (cognitions about "what might have been") can be functional when they consist of characteristics (e.g., "upward' – focusing on better outcomes) that alter behavior in a manner consistent with those outcomes. This field study aimed to examine the influence of counterfactual thinking on safety behavior and explanatory mechanisms and boundary conditions of that relationship. Method: A sample of 240 medical providers from a hospital in China responded to three surveys over a four-month time frame. Results: Results showed that upward counterfactuals were positively related to supervisor ratings of safety compliance and participation. These relationships were mediated by safety knowledge but not by safety motivation. Upward counterfactuals were more strongly related to safety behavior and knowledge than downward counterfactuals. As expected, safety locus of control strengthened the mediating effects of safety knowledge on the relationship between upward counterfactuals and safety behavior. Conclusions and Practical Applications: The findings demonstrated that counterfactual thinking is positively associated with safety behavior and knowledge, thus expanding the variables related to workplace safety and laying some initial groundwork for new safety interventions incorporating counterfactual thinking. [ABSTRACT FROM AUTHOR]

Construction workers face a work environment of high risk and mental stress. Psychological capital (PsyCap) could influence employee's mental health and work performance. It would be helpful to determine whether PsyCap affects worker safety behavior. However, few studies empirically examined the impacts of the sub-dimensions of PsyCap on the safety behavior in construction settings, reducing the potential practicability of PsyCap to improve workplace safety performance. Thus, this study tested the relationship between sub-dimensions of PsyCap (self-efficacy, hope, resilience, optimism) and safety behaviors (safety compliance, safety participation), while the mediating role of communication competence was also explored. Method: Data were collected from 655 construction workers in China using a psychological capital questionnaire (PCQ). The theoretical model were tested with confirmatory factor analyses (CFA) and structural equation modeling (SEM) techniques. Results: Results show that: (a) the self-efficacy dimension of PsyCap positively affected safety compliance and safety participation, while the resilience dimension positively impacted safety participation; (b) the hope dimension was not directly related to safety behaviors, while the optimism dimension negatively associated with safety participation; and (c) communication competence mediated the relationships between the hope and optimism dimensions of PsyCap and safety participation. Conclusions: A multidimensional perspective on PsyCap should be taken while examining its effects on safety behavior and the individual communication competence helps to enhance construction safety. Findings of this study shed lights on safety behavior promotion practices based on the multidimensional model. Initiating flexible psychological capital training and intervention, and strengthening communication skills of construction employees are suggested to improve safety performance in the construction industry. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy, safety and immunogenicity of a human diploid cell SV-1 strain–based live attenuated varicella vaccine in children aged 1 to 12 years. We conducted a randomized, double-blind, placebo-controlled trial in China in which healthy children were randomly assigned in a 1:1 ratio to receive one dose of varicella vaccine or placebo. The efficacy monitoring period was 6 to 7 months for each subject. The primary endpoint was the occurrence of laboratory-confirmed varicella. Efficacy and immunity were assessed in the per-protocol cohort, and safety was assessed in the total vaccinated cohort. The file was registered with ClinicalTrials.gov (NCT02981836). Between 22 August 2016 and 19 September 2016, a total of 5997 children (2997 in the varicella vaccine group and 3000 in the placebo group) were vaccinated, and 5991 children (2995 in the varicella vaccine group and 2996 in the placebo group) were included in the per-protocol efficacy cohort. The efficacy of the vaccine was 87.1% (95% confidence interval, 69.7–94.5) against varicella (six cases vs. 46 cases) and 89.2% (95% confidence interval, 72.9–95.7) breakthrough varicella (five cases vs. 46 cases). No significant difference in solicited adverse reactions was found between the two groups. Serious advent events occurred among 0.8% (25/2998) children in the vaccine group and 0.7% (22/2999) in the placebo group. In the immunogenicity subgroup, the seroconversion rate was 97.1% (339/349) in the vaccine group. An antibody titre of 1:8 was associated with protection against varicella. The varicella vaccine was effective in the prevention of varicella in children. [ABSTRACT FROM AUTHOR]

• 96.7% of the elderly people aged >65 y seroconverted at month 7. • Hecolin® was very well tolerated in elderly people aged >65 y. • No vaccine related SAE was reported. • This trial provided new data of the Hecolin® applied in elderly people aged >65 y. Hepatitis E virus (HEV) infection is a leading cause of acute hepatitis worldwide, and results in high morbidity and mortality rates among elderly people in China. The hepatitis E vaccine, Hecolin®, has been shown to be safe and highly efficacious among healthy adults aged 16–65 years old. However, there is no data about Hecolin® vaccination in elderly people older than 65 years (y). An open-labeled, controlled trial was conducted to evaluate the safety and immunogenicity of Hecolin® among the elderly aged >65 y. A total of 601 eligible participants were enrolled. Among them, 200 elderly people aged >65 y and 201 adults aged 18–65 y were assigned to the Hecolin® groups and vaccinated at day 0, month 1 and month 6. Serum samples were collected for anti-HEV IgG determination at day 0 prior to immunization and at month 7. The remaining 200 elderly people aged >65 y were assigned to the safety control group and received no intervention but were instructed to report any adverse events that occurred during the whole study period in the same way as those in the Hecolin® groups. After receiving 3 doses of Hecolin® with the standard schedule, most (96.7%) of the vaccinated elderly people aged >65 y seroconverted at one month after the final dose (month 7). At month 7, the geometric mean concentrations of anti-HEV IgG were 5.36 (95% CI, 3.88–7.41) and 19.65 (95% CI, 16.81–22.98) among the baseline seronegative and seropositive elderly, respectively. Of the vaccinated elderly, 97.3% (177/182) had anti-HEV IgG levels higher than 1.0 WU/ml at month 7. Hecolin® was very well tolerated in this population. No vaccine-related SAEs were reported. Hecolin® is immunogenic and well tolerated in elderly people aged greater than 65 years. [ABSTRACT FROM AUTHOR]

Social innovation has increasingly become a hot topic in China, a process in which multiple sectors collaborate with each other, aiming to change the status quo through creative, effective, efficient and sustainable ways. InterBoxes is an innovative project in the form of a social enterprise that commits to improving physical school conditions by building libraries, classrooms, schools and dormitories with refurbished cargo shipping containers called "Boxes". Within the scope of this project the word "Inter" signifies that each Box is equipped with an Internet connection to the outside world. Conceptually, as a social enterprise, the for-profit, business arm of InterBoxes is projected to operate within metropolitan areas, building structures such as cafés, gyms, bookstores, etc., all which will generate revenue to support the nonprofit operation in rural areas. This descriptive case study examines the implementation and use of InterBoxes as a library in a rural primary school and addresses the promises and challenges facing the project. The findings indicate that InterBoxes demonstrates much potential as a social innovation to improve physical school conditions and other rural education issues through the creative use of space and place. Recommendations for scaling up its operation in connection with a larger global network of innovation using shipping containers are discussed. [ABSTRACT FROM AUTHOR]

As the annual number of reported difficulties with LBC increases in rural China, the need to find innovative and different interventions grows. In this study, the outcomes of a whole-community intervention program targeted at improving the well-being of LBC and other rural children ages 7–18 were examined through a quasi-experimental evaluation. Our evidence suggests that the implementation of the Children's Companion Mother Program benefitted LBC in several dimensions of their well-being: their resilience, physical health, academic performance, safety, guardianship and communicative competence. This study also examined intervention effects among different populations. The 'Whole Community and Whole Child' approach, containing pluralistic engagement, activated endogenous resources, and para-professional social service workers, should be employed in order to build up a systematic and effective rural child well-being framework. • The implementation of the Children's Companion Mother Program benefitted LBC in several dimensions of their well-being. • The intervention effects vary among different populations. • The Whole-Community approach, should be employed to built up a systematic rural child well-being framework. [ABSTRACT FROM AUTHOR]

Objectives: Research suggests the efficacy of progesterone for luteal phase support in assisted reproduction cycles using gonadotropin-releasing hormone analogues. Our study objective was to compare the efficacy of two available preparations of progesterone, vaginal gel and intramuscular injection, for luteal phase support in assisted reproduction cycles.Study Design: This study included data gathered from 18 reproductive centers in China. Subjects were randomly allocated to receive progesterone gel or intramuscular progesterone (IMP). The progesterone gel group received micronized progesterone in gel (8%, 90 mg) once daily; the IMP group received IMP (progesterone oil) once daily. The ongoing pregnancy rate was calculated (number of women with a viable pregnancy at 12 weeks divided by the number of women who had undergone an oocyte pickup cycle).Results: A total of 1313 patients were enrolled in the study, 1248 of whom began treatment. The intention-to-treat set included 527 and 531 patients in the gel and IMP groups, respectively. The ongoing pregnancy rate in the progesterone gel group was non-inferior to that in the IMP group (48.4% [95% confidence interval (CI): 44.0, 52.8] vs. 46.3% [95% CI: 42.0, 50.7]); the between-group rate difference was 2.1% (-4.0, 8.1). There was no difference between the gel group and IMP group on most secondary endpoints, including implantation rate, biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, early abortion rate, and vaginal bleeding rate, but there was a between-group difference in luteal phase bleeding rate. The safety analysis showed no difference in the incidence of total adverse events.Conclusions: Progesterone gel showed good efficacy and safety outcomes and therefore provides an alternative method of luteal support in Chinese in vitro fertilization patients. [ABSTRACT FROM AUTHOR]

Applications of CRISPR in human health and in gene drives are at the forefront of biological research as tools. This technology will affect humankind and our environment, so as this technology pushes forward, the design and implementation of safety measures is imperative. Novel technologies and forethought in various applications of CRISPR are essential for using this technology safely. Here, we review environmental and health-related safety concerns associated with using CRISPR and ways proposed to minimize risk. Highlights It is becoming possible, with high resolution, to control when, where, and how genomic edits can be created and perhaps reversed. There is a need for continued evaluation of CRISPR-based gene drives for field trials within the context of a population's ecological and evolutionary dynamics. CRISPR clinical trials have begun within the United States and China using both ex vivo and in vivo therapeutics. Attention to the ethical, legal, and social implications of CRISPR-based gene editing is critical to the safe and proper usage of CRISPR technologies. [ABSTRACT FROM AUTHOR]

Highlights • The DTMUV virus strain was attenuated via passaging serially in chicken embryos and duck embryos alternately for 100 passages. • The 70th adapted strain, designated SDS-70, was used as the live attenuated vaccine candidate. • After immunization with SDS-70 strain, the ducklings obtained the protection of 100% against the attack of the SDS-10 virulent strain. • Substitutions of 33 base were present in the SDS-20/40/60/80/100 sequence, which included 15 neutral mutations and 18 amino acid mutations. Abstract Infection with duck Tembusu virus (DTMUV) can cause large economic losses to the duck-rearing industry in China. In this study, we isolated a virulent strain of DTMUV (SDS) from sparrows near a duck farm and attenuated it via serially passaging (alternately for 100 passages) in specific pathogen-free chicken and duck embryos. We attenuated the virus after the 60th passage (SDS-60), based on the production of embryos that were free of visible lesions and still alive. The 70th adapted strain (SDS-70), obtained with a virus titer of 10−2.46 EID 50 was chosen to be the live attenuated vaccine. After immunizing ducklings with the SDS-70 strain, they obtained 100% protection against infection by the SDS-10 virulent strain. Our data demonstrate that the vaccine can protect ducks from becoming infected with TMUV. Our study also shows that this newly developed attenuated vaccine candidate provides excellent immunogenicity, is safe, and has the potential to control DTMUV infections in ducks. [ABSTRACT FROM AUTHOR]

Highlights • Analysis of accident severity in waterborne transportation. • Collection and statistical analysis of maritime accident data over 30 years. • Identification of key factors influencing maritime accident severity using data-driven BN and expert verification. • Dynamic prediction of maritime accident severity under high uncertainties. Abstract The rapid development of the shipping industry requires the use of large vessels carrying high-volume cargoes. Accidents incurred by these vessels can lead to a heavy loss of life and damage to the environment and property. As a leading country in international trade, China has developed its waterway transport systems, including inland waterways and coastal shipping, in the past decades. A few catastrophic shipping accidents have occurred during this period. This paper aims to develop a new risk analysis approach based on Bayesian networks (BNs) to enable the analysis of accident severity in waterborne transportation. Although the risk data are derived from accidents that occurred in China's waters, the risk factors influencing accident severity and the risk modelling methodology are generic and capable of generating useful insights on waterway risk analysis in a broad sense. To develop the BN-based risk model, waterway accident data are first collected from all accident investigation reports by China's Maritime Safety Administration (MSA) from 1979 to 2015. Based on the derived quantitative data, we identify the factors related to the severity of waterway accidents and use them as nodes of the risk model. Second, based on a receiver operating characteristic (ROC) curve, an augmented naïve BN (ABN) model is selected through a comparative study with a naïve BN (NBN) model to analyse the key risk factors influencing waterway accident severity. The results show that the key factors influencing waterway safety include the type and location of the accident and the type and age of the ship. Moreover, a novel scenario analysis is conducted to predict accident severity in various situations by combining different states (e.g., high risk) of the key factors to generate useful insights for accident prevention. More specifically, the findings can aid transport authorities, ship owners and other stakeholders in improving waterborne transportation safety under uncertainty. [ABSTRACT FROM AUTHOR]

The freeway system of China is the longest in the world and planned to expand in the following years. However, the safety conditions of freeways are drawing increasing concerns both from the authorities and the public in the country. The safety design and management for freeways are urgently needed considering the current safety situation and great demands of new freeways. The study presented in this paper thoroughly investigated factors affecting safety using detailed data of crashes, traffic characteristics and freeway geometry. A random effects negative binomial (RENB) model was applied to account for spatial variations within groups together with a negative binomial (NB) model. The results indicated a better goodness of fit of RENB model than the NB model. In addition, a good number of factors significantly contributed to crash, such as truck proportion, presence of climbing lane, median barrier offset, curvature and longitudinal grade, were identified. This study was expected to provide a better understanding of how traffic condition and freeway design affect safety and should be useful to freeway engineers to design safe freeways, or develop effective safety countermeasures. [ABSTRACT FROM AUTHOR]

• This study evaluated the long-term benefits of atezolizumab in NSCLC in China. • Clinically meaningful benefits and no new safety concerns were observed. • Gene mutations that were enriched in atezolizumab responders were identified. • Patient subgroups with higher rates of atezolizumab-related SAEs were identified. To evaluate the long-term safety and efficacy of atezolizumab monotherapy in Chinese patients with previously treated, locally advanced or metastatic non-small cell lung cancer (NSCLC). In this open-label, single-arm, multicenter study, patients received atezolizumab 1200 mg intravenously on Day 1 of each 21-day cycle. The primary endpoint was incidence of atezolizumab-related serious adverse events (SAEs). Secondary endpoints included other safety and efficacy measures. Patients with available tumor tissue and blood samples underwent biomarker analyses. Patients with available tumor biopsies underwent exome sequencing. The safety and evaluable populations included 101 and 97 patients, respectively. Exome sequencing data were available for 31 patients. Median follow-up time was 27.43 months. Atezolizumab-related SAEs and immune-related adverse events occurred in 25.7% and 47.5% of the safety population, respectively, and in the following subgroups: central nervous system metastases (n = 14), 35.7% and 35.7%; squamous NSCLC (n = 39), 33.3% and 53.8%. The 24-month overall survival rate was 37.4%. Median overall survival and progression-free survival by RECIST v1.1 were 15.31 and 2.86 months, respectively; objective response rate was 16.5% in the evaluable population. PRRC2C (odds ratio: 12.780, P = 0.014) and ZMYND8 (odds ratio: 19.963, P = 0.016) gene mutations were significantly enriched in atezolizumab responders vs non-responders. Patients with CD8+ TILs > 10% vs ≤ 10% were significantly more likely to be atezolizumab responders. No new safety concerns were raised, and clinically meaningful benefits of atezolizumab monotherapy were shown. The results of the biomarker analyses may guide future therapeutic strategies. [ABSTRACT FROM AUTHOR]

Drawing on Schwartz's basic individual values theory and the expectancy theory, we contend that conformity values have a widespread role in explaining pandemic prevention behaviors, and perceived impact of such behaviors would amplify or mitigate the value-behavior relation. Moreover, we also examined whether these effects are different in Chinese and American cultural contexts. We conducted three studies with different designs and samples (N = 1341). The results suggested that the conformity-rules values were associated with pandemic prevention behaviors, and these effects were negatively moderated by perceived egoistic impact, but positively moderated by perceived altruistic impact. It also found that Chinese individuals had higher levels of conformity-rules values but lower levels of conformity-interpersonal values than American individuals. Finally, the predictive power of two types of conformity values on prevention behaviors were similar in China and U.S., while there are some differences in the moderating effects of perceived egoistic/altruistic impact between the two countries. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Herbal teas have long been consumed by Chinese people for preventive and/or therapeutic healthcare. Although herbal teas are widely consumed by many cultural groups in different regions of China, no thorough review has been undertaken to assess the diversity of the country's herbal tea usage. This literature review, complemented by a quantitative survey in an important tea market in Kunming, begins to fill this knowledge gap. Aims of the study The study aims to summarize the current knowledge of plant species used as herbal teas by different cultural groups in different regions of China, with a focus on the teas’ perceived traditional healthcare functions, related phytochemical/pharmaceutical research, and safety issues. Materials and methods The study involved a comprehensive literature review and a market survey. The literature review was based on published ethnobotanical studies of herbal teas in China. We searched the Web of Science™, ELSEVIER, the China National Knowledge Infrastructure (CNKI) and the China Science and Technology Journal Database to locate relevant studies (including journal articles, Masters/PhD dissertations and books) that were published before March 2017. A species list was compiled based on the review and supplemented with information retrieved from the Scifinder database ( https://scifinder.cas.org ) and the Chinese Pharmacopoeia (2010). A Use Value Index was employed for ranking the most cited species. Based on the 29 most cited species, we discussed the current research status in relation to healthcare benefits and safety concerns of herbal teas in China. To better understand the current status of the herbal tea market in China, we also surveyed 136 tea vendors at the Xiongda Tea Market in Kunming. Information gathered from the survey included the species sold, the sale prices and the form of the herbal tea product. Results The literature identified 759 plant species used as herbal tea in China and the market survey identified an additional 23 species. Most of the species used were from the Leguminosae, Compositae and Lamiaceae families. Twenty two provinces and fourteen ethnic minority groups have records on the consumption of herbal teas. Southern China uses up to 82% of the total species, and 211 out of 759 species are used by minority groups. Thirty categories of traditional healthcare functions are linked with herbal teas, with clearing away heat, relieving toxicity and suppressing cough being the most important functions. There is phytochemical/pharmaceutical evidence to support the claimed healthcare benefits of some Chinese herbal teas. Although Chinese herbal teas are generally safe to consume, overdoses of some herbal teas and some unapproved mixtures of species may cause health risks. Based on our market survey, the prices of most herbal teas range between 100 and 200 RMB (US$15–30) per kg. Conclusions A rich array of herbal tea species with various traditional healthcare functions have long been used in China, and as such there is a huge market potential for Chinese herbal teas. More pharmaceutical/phytochemical research is needed to assess a wide range of perceived healthcare benefits of Chinese herbal teas. Our research highlights the need to study herbal teas through an ethnopharmacological perspective and by employing a holistic approach, which requires greater consideration of traditional knowledge in the pharmacological research design. Product safety and sustainability issues should also be considered, so the traditional applications of herbal teas can be transformed to efficient health boosting functional products. [ABSTRACT FROM AUTHOR]

Introduction: Individual safety performance (behavior) critically influences safety outcomes in high-risk workplaces. Compared to the study of generic work performance on different measurements, few studies have investigated different measurements of safety performance, typically relying on employees' self-reflection of their safety behavior. This research aims to address this limitation by including worker self-reflection and other (i.e., supervisor) assessment of two worker safety performance dimensions, safety compliance and safety participation. Method: A sample of 105 workers and 17 supervisors in 17 groups in the Chinese construction industry participated in this study. Comparisons were made between worker compliance and participation in each measurement, and between workers' and supervisors' assessment of workers' compliance and participation. Multilevel modeling was adopted to test the moderating effects on the worker self-reflection and supervisor-assessment relationship by group safety climate and the work experience of supervisors. Results: Higher levels of safety compliance than participation were found for self-reflection and supervisor assessment. The discrepancy between the two measurements in each safety performance dimension was significant. The work experience of supervisors attenuated the discrepancy between self- and supervisor-assessment of compliance. Contrary to our expectations, the moderating effect of group safety climate was not supported. Conclusions: The discrepancy between worker self- and supervisor-assessment of worker safety performance, thus, suggests the importance of including alternative measurements of safety performance in addition to self-reflection. Lower levels of participation behavior in both raters suggest more research on the motivators of participatory behavior. Practical applications The discrepancy between different raters can lead to negative reactions of ratees, suggesting that managers should be aware of that difference. Assigning experienced supervisors as raters can be effective at mitigating interrater discrepancy and conflicts in the assessment of compliance behavior. [ABSTRACT FROM AUTHOR]

The construction industry in Hong Kong has been exposed to serious housing production issues such as insufficient manpower, safety, environmental concerns and inefficient housing supply. Prefabrication housing production has shown as efficient construction model which enables to overcome these issues and it is applied in construction industry in Hong Kong. In this paper, hybrid modeling techniques that combine system dynamics and discrete event simulation are used to analyze the interrelationships of schedule risks within the six-day cycle assembly of prefabrication housing production. Moreover, a hybrid dynamic model is developed to simulate and evaluate the impact of schedule risks on the schedule performance of the six-day cycle assembly of PHP via the Anylogic software package. The resulting model is validated by data which is collected from a PHP project in Hong Kong. Based on the simulation results, the first most influential level contains five schedule risks, namely, inefficient verification of precast components because of ambiguous labels, misplacement on the storage site because of carelessness, owner crane breakdown and maintenance, slow quality inspection procedures, and inefficient design data transition that cause average schedule delays of more than 300 min. The second most influential level includes delay of the delivery of precast element to site, design information gap between designer and manufacturer, installation error of precast elements, and logistics information inconsistency because of human errors, with average schedule delays less than 300 min and greater than 200 min. Design change, low information interoperability between different enterprise resource planning systems, and inefficiency of design approval belong to the third level that imposes the least influence on the schedule delay of the assembly. This research contributes to the current knowledge of the management of prefabrication construction by developing an effective model that offers an in-depth understanding of how schedule performance of PHP is dynamically influenced by interrelationships of various risk variables. Also, it provides an experimental platform for simulating and analyzing schedule risks that significantly affect the schedule performance of the six-day cycle assembly of prefabrication housing production. Such critical schedule risks could be identified and managed prior to the implement of prefabrication housing production projects. Compared with traditional techniques, the hybrid dynamic model simultaneously considers macro and micro levels, thereby enabling project managers to gain a deeper insight into schedule management and acquire a multidimensional understanding of schedule delay. [ABSTRACT FROM AUTHOR]