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A total of 290 tree-ring samples, collected from six sites in the West Qinling Mountains of China, were used to develop six new standard tree-ring chronologies. In addition, 73 proxy records were assembled in collaboration with Chinese and international scholars, from 27 publically available proxy records and 40 tree-ring chronologies that are not available in public datasets. These records were used to reconstruct annual mean temperature variability in the West Qinling Mountains over the past 500 years (AD 1500–1995), using a modified point-by-point regression (hybrid PPR) method. The results demonstrate that the hybrid PPR method successfully integrates the temperature signals from different types of proxies, and that the method preserves a high degree of low-frequency variability. The reconstruction shows greater temperature variability in the West Qinling Mountains than has been found in previous studies. Our temperature reconstruction for this region shows: 1) five distinct cold periods, at approximately AD 1520–1535, AD 1560–1575, AD 1610–1620, AD 1850–1875 and AD 1965–1985, and four warm periods, at approximately AD 1645–1660, AD 1705–1725, AD 1785–1795 and AD 1920–1945; 2) that in this region, the 20th century was not the warmest period of the past 500 years; and 3) that a dominant and persistent oscillation of ca. 64 years is significantly identified in the 1640–1790 period. [ABSTRACT FROM AUTHOR]

Chinese microblogs have drawn global attention to this online application’s potential impact on the country’s social and political environment. However, representative and reliable statistics on Chinese microbloggers are limited. Using a random sampling approach, this study collected Chinese microblog data from the service provider, analyzing the profile and the pattern of usage for 29,998 microblog accounts. From our analysis, 57.4% (95% CI 56.9%,58.0%) of the accounts’ timelines were empty. Among the 12,774 non-zero statuses samples, 86.9% (95% CI 86.2%,87.4%) did not make original post in a 7-day study period. By contrast, 0.51% (95% CI 0.4%,0.65%) wrote twenty or more original posts and 0.45% (95% CI 0.35%,0.60%) reposted more than 40 unique messages within the 7-day period. A small group of microbloggers created a majority of contents and drew other users’ attention. About 4.8% (95% CI 4.4%,5.2%) of the 12,774 users contributed more than 80% (95% CI,78.6%,80.3%) of the original posts and about 4.8% (95% CI 4.5%,5.2%) managed to create posts that were reposted or received comments at least once. Moreover, a regression analysis revealed that volume of followers is a key determinant of creating original microblog posts, reposting messages, being reposted, and receiving comments. Volume of friends is found to be linked only with the number of reposts. Gender differences and regional disparities in using microblogs in China are also observed. [ABSTRACT FROM AUTHOR]

Objective: The objectives of this study were to forecast epidemic peaks of typhoid and paratyphoid fever in China using the grey disaster model, to evaluate its feasibility of predicting the epidemic tendency of notifiable diseases. Methods: According to epidemiological features, the GM(1,1) model and DGM model were used to build the grey disaster model based on the incidence data of typhoid and paratyphoid fever collected from the China Health Statistical Yearbook. Model fitting accuracy test was used to evaluate the performance of these two models. Then, the next catastrophe date was predicted by the better model. Results: The simulation results showed that DGM model was better than GM(1,1) model in our data set. Using the DGM model, we predicted the next epidemic peak time will occur between 2023 to 2025. Conclusion: The grey disaster model can predict the typhoid and paratyphoid fever epidemic time precisely, which may provide valuable information for disease prevention and control. [ABSTRACT FROM AUTHOR]

Objectives: This investigation was undertaken in response to an outbreak of suspected shellfish poisoning in Zhejiang Province, China. The objectives of this project were to confirm the outbreak and to identify the aetiology, source and mode of transmission. Methods: A probable case was defined as an individual with diarrhea (≥3 times/day) plus at least one of the following symptoms: fever (≥37.5°C), vomiting, or abdominal pain after consuming seafood between May 23rd and May 28th, 2011. Using a case-control study design, we compared exposures to suspected seafood items and cooking methods between 61 probable cases and 61 controls. Results: Over 220 suspected or probable cases of diarrhetic shellfish poisoning (DSP) were identified (incidence of 18 cases per 100,000). The case control study revealed that 100% of cases and 18% of controls had eaten mussels during the exposure period (OR = ∞, χ2 = 84.72,P = 0.000). The number of mussels consumed was related to DSP risk (P = 0.004, χ2 test for trend). Consumption of other seafood items was not associated with disease. The frequency of diarrhea and vomiting were positively correlated with the number of mussels consumed (r = 0.424 and r = 0.562, respectively). The frequency of vomiting and the incubation period were significantly correlated with the total time the mussels were boiled (r = 0.594 and r = −0.336, respectively). Mussels from 3 food markets and one family contained Okadaic acid (OA) and Dinophysistoxin-1 (DTX-1). Conclusions: This outbreak was attributed to the consumption of mussels contaminated by DSP-toxins (OA and DTX-1) which are produced by different species of dinoflagellates (toxic microalgae) from the genus Dinophysis or Prorocentrum. Suspension of mussel sales and early public announcements were highly effective in controlling the outbreak, although oversight of seafood quality should be a priority to prevent future contamination and outbreaks. [ABSTRACT FROM AUTHOR]

Several approaches have been proposed for near real-time detection and prediction of the spread of influenza. These include search query data for influenza-related terms, which has been explored as a tool for augmenting traditional surveillance methods. In this paper, we present a method that uses Internet search query data from Baidu to model and monitor influenza activity in China. The objectives of the study are to present a comprehensive technique for: (i) keyword selection, (ii) keyword filtering, (iii) index composition and (iv) modeling and detection of influenza activity in China. Sequential time-series for the selected composite keyword index is significantly correlated with Chinese influenza case data. In addition, one-month ahead prediction of influenza cases for the first eight months of 2012 has a mean absolute percent error less than 11%. To our knowledge, this is the first study on the use of search query data from Baidu in conjunction with this approach for estimation of influenza activity in China. [ABSTRACT FROM AUTHOR]

We develop an efficient learning strategy of Chinese characters based on the network of the hierarchical structural relations between Chinese characters. A more efficient strategy is that of learning the same number of useful Chinese characters in less effort or time. We construct a node-weighted network of Chinese characters, where character usage frequencies are used as node weights. Using this hierarchical node-weighted network, we propose a new learning method, the distributed node weight (DNW) strategy, which is based on a new measure of nodes' importance that considers both the weight of the nodes and its location in the network hierarchical structure. Chinese character learning strategies, particularly their learning order, are analyzed as dynamical processes over the network. We compare the efficiency of three theoretical learning methods and two commonly used methods from mainstream Chinese textbooks, one for Chinese elementary school students and the other for students learning Chinese as a second language. We find that the DNW method significantly outperforms the others, implying that the efficiency of current learning methods of major textbooks can be greatly improved. [ABSTRACT FROM AUTHOR]

Background: Cadmium (Cd) is a heavy metal that can cause renal tubular dysfunction in humans. Women are among the high-risk group for Cd health effects. Determining the thresholds of Cd-induced renal effects is important. Thus, in this article, we aimed to identify the benchmark dose (BMD) and its low limit (BMDL) levels as the Cd thresholds for Chinese women. Methods: Epidemiologic investigation was performed in county A and county B to obtain data on Cd exposure and its renal effect on respondents. Levels of Cd (UCd), β2-microglobulin (UB2M), and N-acetyl-β-D-glucosaminidase (UNAG) were measured in morning urine samples. The BMD approach was mainly performed. Results: Results of the BMD approach were similar whether the method was conducted for the two sets of data (collected in CA and CB, respectively) separately or cooperatively. The BMD/BMDL values of UCd for all subjects were 1.07/0.44 and 2.12/0.53 µg/g cr based on UB2M and UNAG, respectively, given a predetermined BMR of 0.05. Conclusions: The presented thresholds of Cd-induced renal effects (i.e., the BMDLs of UCd) are close to the counterpart values reported in Japan, Sweden and Belguim. [ABSTRACT FROM AUTHOR]

Background: Most maternal deaths occur in developing countries and most maternal deaths are avoidable. China has made a great effort to reduce MMR by three quarters to meet the fifth Millennium Development Goal (MDG5). Methods: This retrospective study reviewed and analyzed maternal death data in Wuhan from 2001 to 2012. Joinpoint regression and multivariate Poisson regression was conducted using the log-linear model to measure the association of the number of maternal deaths with time, cause of death, where the death occurred, and cognitive factors including knowledge, attitude, resource, and management stratified. Results: The MMR declined from 33.41 per 100,000 live births in 2001 to 10.63 per 100,000 live births in 2012, with a total decline of 68.18% and an average annual decline of 9.89%. From 2001–2012, the four major causes of maternal death were obstetric hemorrhage (35.16%), pregnancy complications (28.57%), amniotic fluid embolism (16.48%) and gestational hypertension (8.79%). Multivariate Poisson regression showed on average the MMR decreased by.17% each year from 2001–2006 and stayed stagnant since 2007–2012. Conclusions: With the reduction in MMR in obstetric death (e.g. obstetric hemorrhage), there had been a remarkable reduction in MMR in Wuhan in 2001–2012, which may be due to (1) the improvement in the obstetric quality of perinatal care service on prevention and treatment of obstetric hemorrhage and emergency care skills, and (2) the improvement in the maternal health management and quality of prenatal care. Interventions to further reduce the MMR include several efforts such as the following: (1) designing community-based interventions, (2) providing subsidies to rural women and/hospitals for hospital delivery, (3) screening for pregnancy complications, and (4) establishing an emergency rescue system for critically ill pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Internet use has become an increasingly common leisure time activity among Chinese citizens. The association between Internet use and engagement in leisure activities is especially unclear among China population. This study aims to investigate Internet usage and to determine whether active Internet use is a marker for low or high levels of leisure time activities. Methods/Principal Findings: With the use of a face-to-face structured questionnaire interview, a total of 2,400 respondents who met all screening requirements were surveyed to answer the questions in eight major cities in China. 66.2% (n = 1,589) of all respondents were identified as Internet users. Of these Internet users, 30.0%, 24.1%, 26.4%, and 19.6% were clustered as “informative or instrumental users,” “entertainment users,” “communication users,” and “advanced users,” respectively. Regarding time spent on Internet use in leisure time, more than 96% reported going online in non-work situations, and 26.2% (n = 416) were classified as “heavy Internet users.” A logistic regression analysis revealed that there were significant differences in some leisure activities between non-Internet users and Internet users, with an observed one-unit increase in the leisure time dependence category increasing the probability of engaging in mental or social activities. In contrast, Internet users were less engaged in physical exercise-related activities. In addition, advanced Internet users were generally more active in leisure time activities than non-Internet users and other types of users. Conclusion/Significance: Internet use is one of very common leisure activities in Chinese citizens, and age, gender, income, and education are the key factors affecting Internet access. According to different types of leisure activities, Internet usage has different impacts on leisure activity engagement. High Internet dependence has no significant negative influence on engagement in mental or social leisure activities, but this group respondent tended to be less engaged in physical activities. [ABSTRACT FROM AUTHOR]

Variation of streamflow and sediment load in the Yellow River basin has received considerable attention due to its drastic reduction during the past several decades. This paper presents a detailed investigation on the changes of streamflow and sediment load from 1952 to 2011 using monthly observations at four gauging stations along the Yellow River. The results show significant decreasing trends for both streamflow and sediment load at all four gauging stations over the past 60 years. The wavelet transform demonstrated discontinuous periodicities from 1969 to 1973 and after 1986 due to the construction of large reservoirs and implementation of numerous soil and water conservations practices. The sediment rating curves with the power-law function was applied to investigate the relationship between discharge and sediment load. The results indicate distinct variations of the relationship between streamflow and sediment and implied significant hydro-morphological changes within different periods. The reducing sediment supply from the source region and the increased erosive power of the river are detected at Lanzhou station, while the decrease of the transport capacity at Toudaoguai is caused by severe siltation. Significant changes in the relationship between streamflow and sediment load are found at Huayuankou and Gaocun stations, which are largely induced by evident sediment income and trapping effects of large reservoirs. It is estimated that numerous reservoirs have strongly altered the regime and magnitude of streamflow and trapped large amount of sediment, leading to severe siltation and evident reduction of their total volumes. A decrease in precipitation, incoming water from the upper reaches, soil and water conservation measures as well as water consumption contribute most to the significant reduction of streamflow. The decrease of sediment load mainly resulted from various soil and water conservation measures and trapping in reservoirs from 1986 to 2011. [ABSTRACT FROM AUTHOR]

Shigellosis is a major public health concern in China, where waterborne disease outbreaks are common. Shigellosis-containing strategies, mostly single or multiple interventions, are implemented by primary-level health departments. Systematic assessment of the effectiveness of these measures is scarce. To estimate the efficacy of commonly used intervention strategies, we developed a Susceptible–Exposed–Infectious/Asymptomatic–Recovered–Water model. No intervention was predicted to result in a total attack rate (TAR) of 90% of the affected population (95% confidence interval [CI]: 86.65–92.80) and duration of outbreak (DO) of 89 days, and the use of single-intervention strategies can be futile or even counter-productive. Prophylactics and water disinfection did not improve TAR or DO. School closure for up to 3 weeks did not help but only increased DO. Isolation alone significantly increased DO. Only antibiotics treatment could shorten the DO to 35 days with TAR unaffected. We observed that these intervention effects were additive when in combined usage under most circumstances. Combined intervention “Isolation+antibiotics+prophylactics+water disinfection” was predicted to result in the lowest TAR (41.9%, 95%CI: 36.97–47.04%) and shortest DO (28 days). Our actual Shigellosis control implementation that also included school closure for 1 week, attained comparable results and the modeling produced an epidemic curve of Shigellosis highly similar to our actual outbreak data. This lends a strong support to the reality of our model that provides a possible reference for public health professionals to evaluate their strategies towards Shigellosis control. [ABSTRACT FROM AUTHOR]

Objective: To determine whether the New Cooperative Medical Insurance Scheme (NCMS) is associated with decreased levels of catastrophic health expenditure and reduced impoverishment due to medical expenses in rural households of China. Methods: An analysis of a national representative sample of 38,945 rural households (129,635 people) from the 2008 National Health Service Survey was performed. Logistic regression models used binary indicator of catastrophic health expenditure as dependent variable, with household consumption, demographic characteristics, health insurance schemes, and chronic illness as independent variables. Results: Higher percentage of households experiencing catastrophic health expenditure and medical impoverishment correlates to increased health care need. While the higher socio-economic status households had similar levels of catastrophic health expenditure as compared with the lowest. Households covered by the NCMS had similar levels of catastrophic health expenditure and medical impoverishment as those without health insurance. Conclusion: Despite over 95% of coverage, the NCMS has failed to prevent catastrophic health expenditure and medical impoverishment. An upgrade of benefit packages is needed, and effective cost control mechanisms on the provider side needs to be considered. [ABSTRACT FROM AUTHOR]

This study used the latent class analysis (LCA) to identify and classify Chinese adolescent children's aggressive behaviors. It was found that (1) Adolescent children could be divided into four categories: general children, aggressive children, victimized children and aggressive victimized children. (2) There were significant gender differences among the aggressive victimized children, the aggressive children and the general children. Specifically, aggressive victimized children and aggressive children had greater probabilities of being boys; victimized children had equal probabilities of being boys or girls. (3) Significant differences in loneliness, depression, anxiety and academic achievement existed among the aggressive victims, the aggressor, the victims and the general children, in which the aggressive victims scored the worst in all questionnaires. (4) As protective factors, peer and teacher supports had important influences on children's aggressive and victimized behaviors. Relative to general children, aggressive victims, aggressive children and victimized children had lower probabilities of receiving peer supports. On the other hand, compared to general children, aggressive victims had lower probabilities of receiving teacher supports; while significant differences in the probability of receiving teacher supports did not exist between aggressive children and victimized children. [ABSTRACT FROM AUTHOR]

Introduction: Analysts estimating the costs or cost-effectiveness of health interventions requiring hospitalization often cut corners because they lack data and the costs of undertaking full step-down costing studies are high. They sometimes use the costs taken from a single hospital, sometimes use simple rules of thumb for allocating total hospital costs between general inpatient care and the outpatient department, and sometimes use the average cost of an inpatient bed-day instead of a ward-specific cost. Purpose: In this paper we explore for the first time the extent and the causes of variation in ward-specific costs across hospitals, using data from China. We then use the resulting model to show how ward-specific costs for hospitals outside the data set could be estimated using information on the determinants identified in the paper. Methodology: Ward-specific costs estimated using step-down costing methods from 41 hospitals in 12 provinces of China were used. We used seemingly unrelated regressions to identify the determinants of variability in the ratio of the costs of specific wards to that of the outpatient department, and explain how this can be used to generate ward-specific unit costs. Findings: Ward-specific unit costs varied considerably across hospitals, ranging from 1 to 24 times the unit cost in the outpatient department — average unit costs are not a good proxy for costs at specialty wards in general. The most important sources of variability were the number of staff and the level of capacity utilization. Practice Implications: More careful hospital costing studies are clearly needed. In the meantime, we have shown that in China it is possible to estimate ward-specific unit costs taking into account key determinants of variability in costs across wards. This might well be a better alternative than using simple rules of thumb or using estimates from a single study. [ABSTRACT FROM AUTHOR]

Future climates are likely to include extreme events, which in turn have great impacts on ecological systems. In this study, we investigated possible effects that could mitigate stem breakage caused by a rare and extreme ice storm in a Chinese subtropical forest across a gradient of forest diversity. We used Bayesian modeling to correct stem breakage for tree size and variance components analysis to quantify the influence of taxon, leaf and wood functional traits, and stand level properties on the probability of stem breakage. We show that the taxon explained four times more variance in individual stem breakage than did stand level properties; trees with higher specific leaf area (SLA) were less susceptible to breakage. However, a large part of the variation at the taxon scale remained unexplained, implying that unmeasured or undefined traits could be used to predict damage caused by ice storms. When aggregated at the plot level, functional diversity and wood density increased after the ice storm. We suggest that for the adaption of forest management to climate change, much can still be learned from looking at functional traits at the taxon level. [ABSTRACT FROM AUTHOR]

Aim: We performed a comprehensive meta-analysis to determine the association between P2X7 -762T/C polymorphism and pulmonary tuberculosis susceptibility. Methodology: Based on comprehensive searches of the PubMed, SCI, Elsevier, China National Knowledge Infrastructure (CNKI) and Wanfang Database, we identified eligible studies about the association between P2X7 -762T/C polymorphism and pulmonary tuberculosis risk. Pooled odds ratio (ORs) and 95% confidence intervals (95%CIs) were calculated in random-effects model. Results: A total of 2207 tuberculosis cases and 2220 controls in 8 case-control studies were included in this meta-analysis. Allele model (C vs. T: p = 0.15; OR = 0.83, 95% CI = 0.65–1.07), homozygous model (CC vs. TT: p = 0.23; OR = 0.73, 95% CI = 0.44 to 1.22), and heterozygous model (CT vs. TT: p = 0.57; OR = 0.92, 95% CI = 0.68 to 1.24) did not show increased risk of developing pulmonary tuberculosis. Similarly, dominant model (CC+CT vs. TT: p = 0.32; OR = 0.84, 95% CI = 0.59 to 1.19) and recessive model (CC vs. CT+TT: p = 0.08; OR = 0.77, 95% CI = 0.57 to 1.04) failed to show increased risk of developing pulmonary tuberculosis. Subgroup analysis by ethnicity did not detect any significant association between P2X7–762T/C polymorphism and pulmonary tuberculosis susceptibility. Conclusions: P2X7 -762T/C gene polymorphism is not associated with pulmonary tuberculosis susceptibility. [ABSTRACT FROM AUTHOR]

Objectives: To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and the metabolic syndrome (MetS), and evaluate the value of NAFLD as a marker for predicting the risk of MetS in a large scale prospective cohort from northern urban Han Chinese population. Materials and Methods: A total of 17,920 MetS-free at baseline cohort members was included in the current study between 2005 and 2011. The baseline characteristics of the cohort were compared by NAFLD status at baseline, MetS status after follow-up. Cox proportional hazards models were used to estimate the unadjusted or adjusted hazard ratios (HRs) for NAFLD at baseline predicting the risk of MetS. Results: 2,183 (12.18%) new cases of MetS occurred between 2005 and 2011. In unadjusted model, HRs (95% CIs) for NAFLD predicting MetS was 3.65 (3.35, 3.97). After adjusting the confounding factors of age, gender, the metabolic factors, smoke and exercise, the HRs (95% CIs) was 1.70 (1.55, 1.87). Gender difference was observed, adjusted HRs (95% CIs) of NAFLD for predicting MetS were 2.06(1.72, 2.46) and 1.55(1.39, 1.72) in female and male population, respectively. Moreover, 163 participants developed MetS among participants without any MetS component at baseline, and its adjusted HRs was still significant, 1.87 (1.12, 3.13). Conclusion: The present study indicates that NAFLD is an independent risk factor for predicting the risk of MetS in northern urban Han Chinese population, and the people with NAFLD should initiate weight and dietary control to prevent the occurrence of MetS. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes is often accompanied by altered cardiometabolic risk profiles, including abdominal obesity, hypertension, and dyslipidaemia. The association of altered cardiometabolic risk profiles with chronic complications of diabetes is not well investigated. Methods: We recruited 2954 type 2 diabetes patients with a body mass index ≥25 kg/m2 who visited the diabetes clinics of 62 hospitals in 21 cities in Guangdong province of China from August 2011 to March 2012. Demographic characteristics, personal and family medical histories, and data on chronic complications of diabetes were collected. Clinical examinations and laboratory assessment were conducted. Results: Abdominal obesity was found in 91.6% of the study population, elevated blood pressure in 78.3%; elevated serum triacylglycerols in 57.8%, and reduced serum HDL-C in 55.9%. Among the cardiometabolic risk factors, elevated blood pressure was significantly associated with almost all the chronic complications of diabetes. After adjusting for age, gender, duration of diabetes, and HbA1c, elevated blood pressure was significantly associated with diabetic retinopathy (OR 1.63, 95% CI: 1.22–2.19), diabetic nephropathy (OR 3.16, 95% CI: 2.25–4.46), cardiovascular disease (OR 2.71, 95% CI: 1.70–4.32), and stroke (OR 1.90, 95% CI: 1.15–3.12). Abdominal adiposity was significantly associated with diabetic nephropathy (OR 1.39, 95% CI: 1.11–1.74). Elevated triacylglycerols was significantly associated with diabetic retinopathy (OR 1.29, 95% CI: 1.05–1.58) and diabetic nephropathy (OR 1.30, 95% CI: 1.05–1.58). Reduced HDL-C was significantly associated with stroke (OR 1.41, 95% CI: 1.05–1.88). Conclusions: Altered cardiometabolic risk profiles, and elevated blood pressure in particular, were significantly associated with chronic complications in overweight and obese patients with type 2 diabetes. Future studies on the prevention of chronic complications of diabetes might make lowering blood pressure a primary target. [ABSTRACT FROM AUTHOR]

We investigate the economic hubs and authorities of the world trade network (WTN) from to , an era of rapid economic globalization. Using a well-defined weighted hyperlink-induced topic search (HITS) algorithm, we can calculate the values of the weighted HITS hub and authority for each country in a conjugate way. In the context of the WTN, authority values are large for countries with significant imports from large hub countries, and hub values are large for countries with significant exports to high-authority countries. The United States was the largest economic authority in the WTN from to . The authority value of the United States has declined since , and China has now become the largest hub in the WTN. At the same time, China's authority value has grown as China is transforming itself from the “factory of the world” to the “market of the world.” European countries show a tendency to trade mostly within the European Union, which has decreased Europe's hub and authority values. Japan's authority value has increased slowly, while its hub value has declined. These changes are consistent with Japan's transition from being an export-driven economy in its high economic growth era in the latter half of the twentieth century to being a more mature, economically balanced nation. [ABSTRACT FROM AUTHOR]

Chinese rare earth export policies currently result in accelerating its depletion. Thus adopting an optimal export trade selection strategy is crucial to determining and ultimately identifying the ideal trading partners. This paper introduces a multi-attribute decision-making methodology which is then used to select the optimal trading partner. In the method, an evaluation criteria system is established to assess the seven top trading partners based on three dimensions: political relationships, economic benefits and industrial security. Specifically, a simple additive weighing model derived from an additive utility function is utilized to calculate, rank and select alternatives. Results show that Japan would be the optimal trading partner for Chinese rare earths. The criteria evaluation method of trading partners for China's rare earth exports provides the Chinese government with a tool to enhance rare earth industrial policies. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of Functional abdominal bloating (FAB) and its impact on health-related quality of life (HRQoL) in Chinese people remains unclear. Methods: Randomised, stratified, multi-stage sampling methodology was used to select a representative sample of the general population from five cities in China (n = 16,078). All respondents completed the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form (SF-36). The associated factors of FAB were analyzed. The effects of FAB on HRQoL were estimated with gender stratification using propensity score techniques in 20% subsample. Results: Overall, 643 individuals (4.00%) had FAB and it was more prevalent in males than in females (4.87% vs. 3.04%, P<0.001). For males, self-reported history of dyspepsia was most strongly associated with FAB (OR = 2.78; 95% CI: 1.59, 4.72). However, the most strongly associated factor was self-reported health status for females (moderate health vs. good health: OR = 2.06, 95% CI: 1.07, 3.96. P = 0.030; poor health vs. good health: OR = 5.71, 95% CI: 2.06, 15.09). Concerning HRQoL, FAB was found to be related to two domains: role limitation due to physical problems (P = 0.030) and bodily pain (P<0.001) in females. While, in males, there were significant differences in multiple domains between those with and without FAB. Conclusion: The prevalence of FAB in China was lower than previous reports. Males who had ever been diagnosed with dyspepsia and females who were in a poor self-reported health status were correlated with a higher prevalence of FAB. FAB affected only physical health in females, but impaired both physical and mental health in males. [ABSTRACT FROM AUTHOR]

Background: About 1 million people worldwide commit suicide each year, and college students with suicidal ideation are at high risk of suicide. The prevalence of suicidal ideation in college students has been estimated extensively, but quantitative syntheses of overall prevalence are scarce, especially in China. Accurate estimates of prevalence are important for making public policy. In this paper, we aimed to determine the prevalence of suicidal ideation in Chinese college students. Objective and Methods: Databases including PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang (Chinese database) and Weipu (Chinese database) were systematically reviewed to identify articles published between 2004 to July 2013, in either English or Chinese, reporting prevalence estimates of suicidal ideation among Chinese college students. The strategy also included a secondary search of reference lists of records retrieved from databases. Then the prevalence estimates were summarized using a random effects model. The effects of moderator variables on the prevalence estimates were assessed using a meta-regression model. Results: A total of 41 studies involving 160339 college students were identified, and the prevalence ranged from 1.24% to 26.00%. The overall pooled prevalence of suicidal ideation among Chinese college students was 10.72% (95%CI: 8.41% to 13.28%). We noted substantial heterogeneity in prevalence estimates. Subgroup analyses showed that prevalence of suicidal ideation in females is higher than in males. Conclusions: The prevalence of suicidal ideation in Chinese college students is relatively high, although the suicide rate is lower compared with the entire society, suggesting the need for local surveys to inform the development of health services for college students. [ABSTRACT FROM AUTHOR]

Chinese fir (Cunninghamia lanceolata [Lamb.] Hook) is one of the most important plantation tree species in China with good timber quality and fast growth. It covers an area of 8.54 million hectare, which corresponds to 21% of the total plantation area and 32% of total plantation volume in China. With the increasing market demand, an accurate estimation and prediction of merchantable volume at tree- and stand-level is becoming important for plantation owners. Although there are many studies on the total tree volume estimation from allometric models, these allometric models cannot predict tree- and stand-level merchantable volume at any merchantable height, and the stand-level merchantable volume model was not seen yet in Chinese fir plantations. This study aimed to develop (1) a compatible taper function for tree-level merchantable volume estimation, and (2) a stand-level merchantable volume model for Chinese fir plantations. This “taper function system” consisted in a taper function, a merchantable volume equation and a total tree volume equation. 46 Chinese fir trees were felled to develop the taper function in Shitai County, Anhui province, China. A second-order continuous autoregressive error structure corrected the inherent serial autocorrelation of different observations in one tree. The taper function and volume equations were fitted simultaneously after autocorrelation correction. The compatible taper function fitted well to our data and had very good performances in diameter and total tree volume prediction. The stand-level merchantable volume equation based on the ratio approach was developed using basal area, dominant height, quadratic mean diameter and top diameter (ranging from 0 to 30 cm) as independent variables. At last, a total stand-level volume table using stand basal area and dominant height as variables was proposed for local forest managers to simplify the stand volume estimation. [ABSTRACT FROM AUTHOR]

Background: Hand, Foot, and Mouth Disease (HFMD) is a worldwide infectious disease. In China, many provinces have reported HFMD cases, especially the south and southwest provinces. Many studies have found a strong association between the incidence of HFMD and climatic factors such as temperature, rainfall, and relative humidity. However, few studies have analyzed cluster effects between various geographical units. Methods: The nonlinear relationships and lag effects between weekly HFMD cases and climatic variables were estimated for the period of 2008–2013 using a polynomial distributed lag model. The extra-Poisson multilevel spatial polynomial model was used to model the exact relationship between weekly HFMD incidence and climatic variables after considering cluster effects, provincial correlated structure of HFMD incidence and overdispersion. The smoothing spline methods were used to detect threshold effects between climatic factors and HFMD incidence. Results: The HFMD incidence spatial heterogeneity distributed among provinces, and the scale measurement of overdispersion was 548.077. After controlling for long-term trends, spatial heterogeneity and overdispersion, temperature was highly associated with HFMD incidence. Weekly average temperature and weekly temperature difference approximate inverse “V” shape and “V” shape relationships associated with HFMD incidence. The lag effects for weekly average temperature and weekly temperature difference were 3 weeks and 2 weeks. High spatial correlated HFMD incidence were detected in northern, central and southern province. Temperature can be used to explain most of variation of HFMD incidence in southern and northeastern provinces. After adjustment for temperature, eastern and Northern provinces still had high variation HFMD incidence. Conclusion: We found a relatively strong association between weekly HFMD incidence and weekly average temperature. The association between the HFMD incidence and climatic variables spatial heterogeneity distributed across provinces. Future research should explore the risk factors that cause spatial correlated structure or high variation of HFMD incidence which can be explained by temperature. When analyzing association between HFMD incidence and climatic variables, spatial heterogeneity among provinces should be evaluated. Moreover, the extra-Poisson multilevel model was capable of modeling the association between overdispersion of HFMD incidence and climatic variables. [ABSTRACT FROM AUTHOR]

Background: In recent years, drug resistant tuberculosis (DR-TB) particularly the emergence of multi-drug-resistant tuberculosis (MDR-TB) has become a major public health issue. The most recent study regarding the prevalence of drug-resistant tuberculosis in mainland China was a meta-analysis published in 2011, and the subjects from the included studies were mostly enrolled before 2008, thus making it now obsolete. Current data on the national prevalence of DR-TB is needed. This review aims to provide a comprehensive and up-to-date assessment of the status of DR-TB epidemic in mainland China. Methods: A systematic review and meta-analysis of studies regarding the prevalence of drug-resistant tuberculosis in mainland China was performed. Pubmed/MEDLINE, EMBASE, the Cochrane central database, the Chinese Biomedical Literature Database and the China National Knowledge Infrastructure Database were searched for studies relevant to drug-resistant tuberculosis that were published between January 1, 2012 and May 18, 2015. Comprehensive Meta-Analysis (V2.2, Biostat) software was used to analyse the data. Results: A total of fifty-nine articles, published from 2012 to 2015, were included in our review. The result of this meta-analysis demonstrated that among new cases, the rate of resistance to any drug was 20.1% (18.0%–22.3%; n/N = 7203/34314) and among retreatment cases, the rate was 49.8% (46.0%–53.6%; n/N = 4155/8291). Multi-drug resistance among new and retreatment cases was 4.8% (4.0%–5.7%; n/N = 2300/42946) and 26.3% (23.1%–29.7%; n/N = 3125/11589) respectively. The results were significantly heterogeneous (p<0.001, I2 tests). Resistance to isoniazid was the most common resistance observed, and HRSE (H: isoniazid; R: rifampicin; S: streptomycin; E: ethambutol) was the most common form for MDR among both new and retreatment cases. Different drug resistance patterns were found by subgroup analysis according to geographic areas, subject enrolment time, and methods of drug susceptibility test (DST). Conclusions: The prevalence of resistance to any drug evidently dropped for both new and retreatment cases, and multi-drug resistance declined among new cases but became more prevalent among retreatment cases compared to the data before 2008. Therefore, drug-resistant tuberculosis, particularly multi-drug-resistant tuberculosis among retreatment TB cases is a public health issue in China that requires a constant attention in order to prevent increase in MDR-TB cases. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) with a Chinese military population with the aim of finding a suitable instrument to quantify resilience in Chinese military service members. The confirmatory factor analysis results did not support the factorial structure of the original or the Chinese community version of the CD-RISC, but the exploratory factor analysis results revealed a three-factor model (composed of Competency, Toughness, and Adaptability) that seemed to fit. Moreover, the repeat confirmatory factory analysis replicated the three-factor model. Additionally, the CD-RISC with a Chinese military sample exhibited appropriate psychometric properties, including internal consistency, test-retest reliability, and structural and concurrent validity. The revised CD-RISC with a Chinese military sample provides insight into the resilience measurement framework and could be a reliable and valid measurement for evaluating resilience in a Chinese military population. [ABSTRACT FROM AUTHOR]

The present study was performed to assess the quality of Potentilla fruticosa L. sampled from distinct regions of China using high performance liquid chromatography (HPLC) fingerprinting coupled with a suite of chemometric methods. For this quantitative analysis, the main active phytochemical compositions and the antioxidant activity in P. fruticosa were also investigated. Considering the high percentages and antioxidant activities of phytochemicals, P. fruticosa samples from Kangding, Sichuan were selected as the most valuable raw materials. Similarity analysis (SA) of HPLC fingerprints, hierarchical cluster analysis (HCA), principle component analysis (PCA), and discriminant analysis (DA) were further employed to provide accurate classification and quality estimates of P. fruticosa. Two principal components (PCs) were collected by PCA. PC1 separated samples from Kangding, Sichuan, capturing 57.64% of the variance, whereas PC2 contributed to further separation, capturing 18.97% of the variance. Two kinds of discriminant functions with a 100% discrimination ratio were constructed. The results strongly supported the conclusion that the eight samples from different regions were clustered into three major groups, corresponding with their morphological classification, for which HPLC analysis confirmed the considerable variation in phytochemical compositions and that P. fruticosa samples from Kangding, Sichuan were of high quality. The results of SA, HCA, PCA, and DA were in agreement and performed well for the quality assessment of P. fruticosa. Consequently, HPLC fingerprinting coupled with chemometric techniques provides a highly flexible and reliable method for the quality evaluation of traditional Chinese medicines. [ABSTRACT FROM AUTHOR]

Shale has been considered as good gas reservoir due to its abundant interior nanoscale pores. Thus, the study of the pore structure of shale is of great significance for the evaluation and development of shale oil and gas. To date, the most widely used approaches for studying the shale pore structure include image analysis, radiation and fluid invasion methods. The detailed pore structures can be studied intuitively by image analysis and radiation methods, but the results obtained are quite sensitive to sample preparation, equipment performance and experimental operation. In contrast, the fluid invasion method can be used to obtain information on pore size distribution and pore structure, but the relative simple parameters derived cannot be used to evaluate the pore structure of shale comprehensively and quantitatively. To characterize the nanoscale pore structure of shale reservoir more effectively and expand the current research techniques, we proposed a new method based on gas adsorption experimental data and the method of moments to describe the pore structure parameters of shale reservoir. Combined with the geological mixture empirical distribution and the method of moments estimation principle, the new method calculates the characteristic parameters of shale, including the mean pore size (), standard deviation (σ), skewness (Sk) and variation coefficient (c). These values are found by reconstructing the grouping intervals of observation values and optimizing algorithms for eigenvalues. This approach assures a more effective description of the characteristics of nanoscale pore structures. Finally, the new method has been applied to analyze the Yanchang shale in the Ordos Basin (China) and Longmaxi shale from the Sichuan Basin (China). The results obtained well reveal the pore characteristics of shale, indicating the feasibility of this new method in the study of the pore structure of shale reservoir. [ABSTRACT FROM AUTHOR]

Background: Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system. Methods: Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed. Results: Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy. Conclusions: The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market. [ABSTRACT FROM AUTHOR]

Turbidity (T) has been widely used to detect the occurrence of pollutants in surface water. Using data collected from January 2013 to June 2014 at eleven sites along two rivers feeding the Taihu Basin, China, the relationship between the concentration of five metals (aluminum (Al), titanium (Ti), nickel (Ni), vanadium (V), lead (Pb)) and turbidity was investigated. Metal concentration was determined using inductively coupled plasma mass spectrometry (ICP-MS). The linear regression of metal concentration and turbidity provided a good fit, with R2 = 0.86–0.93 for 72 data sets collected in the industrial river and R2 = 0.60–0.85 for 60 data sets collected in the cleaner river. All the regression presented good linear relationship, leading to the conclusion that the occurrence of the five metals are directly related to suspended solids, and these metal concentration could be approximated using these regression equations. Thus, the linear regression equations were applied to estimate the metal concentration using online turbidity data from January 1 to June 30 in 2014. In the prediction, the WASP 7.5.2 (Water Quality Analysis Simulation Program) model was introduced to interpret the transport and fates of total suspended solids; in addition, metal concentration downstream of the two rivers was predicted. All the relative errors between the estimated and measured metal concentration were within 30%, and those between the predicted and measured values were within 40%. The estimation and prediction process of metals’ concentration indicated that exploring the relationship between metals and turbidity values might be one effective technique for efficient estimation and prediction of metal concentration to facilitate better long-term monitoring with high temporal and spatial density. [ABSTRACT FROM AUTHOR]

Estimating gross primary production (GPP) and net primary production (NPP) are significant important in studying carbon cycles. Using models driven by multi-source and multi-scale data is a promising approach to estimate GPP and NPP at regional and global scales. With a focus on data that are openly accessible, this paper presents a GPP and NPP model driven by remotely sensed data and meteorological data with spatial resolutions varying from 30 m to 0.25 degree and temporal resolutions ranging from 3 hours to 1 month, by integrating remote sensing techniques and eco-physiological process theories. Our model is also designed as part of the Multi-source data Synergized Quantitative (MuSyQ) Remote Sensing Production System. In the presented MuSyQ-NPP algorithm, daily GPP for a 10-day period was calculated as a product of incident photosynthetically active radiation (PAR) and its fraction absorbed by vegetation (FPAR) using a light use efficiency (LUE) model. The autotrophic respiration (Ra) was determined using eco-physiological process theories and the daily NPP was obtained as the balance between GPP and Ra. To test its feasibility at regional scales, our model was performed in an arid and semi-arid region of Heihe River Basin, China to generate daily GPP and NPP during the growing season of 2012. The results indicated that both GPP and NPP exhibit clear spatial and temporal patterns in their distribution over Heihe River Basin during the growing season due to the temperature, water and solar influx conditions. After validated against ground-based measurements, MODIS GPP product (MOD17A2H) and results reported in recent literature, we found the MuSyQ-NPP algorithm could yield an RMSE of 2.973 gC m-2 d-1 and an R of 0.842 when compared with ground-based GPP while an RMSE of 8.010 gC m-2 d-1 and an R of 0.682 can be achieved for MODIS GPP, the estimated NPP values were also well within the range of previous literature, which proved the reliability of our modelling results. This research suggested that the utilization of multi-source data with various scales would help to the establishment of an appropriate model for calculating GPP and NPP at regional scales with relatively high spatial and temporal resolution. [ABSTRACT FROM AUTHOR]

Objective: Team-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL. Methods: Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship. Results: In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students. Conclusion: The application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students. [ABSTRACT FROM AUTHOR]

The purpose of this study was to construct and validate a “Perceived Physical Literacy Instrument” (PPLI) for physical education teachers. Based on literature review and focus group interviews, an 18-item instrument was developed for the initial tests. This self-report measure, using a 5-point Likert scale, formed the PPLI and was administered to 336 physical education teachers in Hong Kong. The sample was randomly split, and exploratory and confirmatory factor analyses resulted in a 9-item, 3-factor scale. Exploratory factor analysis (EFA) item loadings ranged from 0.69 to 0.87, and Cronbach’s alpha ranged from 0.73 to 0.76. Confirmatory factor analysis (CFA) showed that the construct demonstrated good fit to the model. The PPLI thus appeared to be reliable and valid to measure the perceived physical literacy of physical education teachers. It is argued that the instrument can be used for both research and applied purposes and potential uses for the instrument in physical education, medical and health settings are discussed. [ABSTRACT FROM AUTHOR]

This study used the dynamic conditional correlations (DCC) method to identify the linkage effects of Chinese stock market, and further detected the influence of network linkage effects on magnitude of security returns across different industries. Applying two physics-derived techniques, the minimum spanning tree and the hierarchical tree, we analyzed the stock interdependence within the network of the China Securities Index (CSI) industry index basket. We observed that that obvious linkage effects existed among stock networks. CII and CCE, CAG and ITH as well as COU, CHA and REI were confirmed as the core nodes in the three different networks respectively. We also investigated the stability of linkage effects by estimating the mean correlations and mean distances, as well as the normalized tree length of these indices. In addition, using the GMM model approach, we found inter-node influence within the stock network had a pronounced effect on stock returns. Our results generally suggested that there appeared to be greater clustering effect among the indexes belonging to related industrial sectors than those of diverse sectors, and network comovement was significantly affected by impactive financial events in the reality. Besides, stocks that were more central within the network of stock market usually had higher returns for compensation because they endured greater exposure to correlation risk. [ABSTRACT FROM AUTHOR]

Background: Hepatitis is a serious public health problem with increasing cases and property damage in Heng County. It is necessary to develop a model to predict the hepatitis epidemic that could be useful for preventing this disease. Methods: The autoregressive integrated moving average (ARIMA) model and the generalized regression neural network (GRNN) model were used to fit the incidence data from the Heng County CDC (Center for Disease Control and Prevention) from January 2005 to December 2012. Then, the ARIMA-GRNN hybrid model was developed. The incidence data from January 2013 to December 2013 were used to validate the models. Several parameters, including mean absolute error (MAE), root mean square error (RMSE), mean absolute percentage error (MAPE) and mean square error (MSE), were used to compare the performance among the three models. Results: The morbidity of hepatitis from Jan 2005 to Dec 2012 has seasonal variation and slightly rising trend. The ARIMA(0,1,2)(1,1,1)12 model was the most appropriate one with the residual test showing a white noise sequence. The smoothing factor of the basic GRNN model and the combined model was 1.8 and 0.07, respectively. The four parameters of the hybrid model were lower than those of the two single models in the validation. The parameters values of the GRNN model were the lowest in the fitting of the three models. Conclusions: The hybrid ARIMA-GRNN model showed better hepatitis incidence forecasting in Heng County than the single ARIMA model and the basic GRNN model. It is a potential decision-supportive tool for controlling hepatitis in Heng County. [ABSTRACT FROM AUTHOR]

Objectives: Road traffic crashes that involve very high numbers of fatalities and injuries arouse public concern wherever they occur. In China, there are two categories of such crashes: a crash that results in 10–30 fatalities, 50–100 serious injuries or a total cost of 50–100 million RMB ($US8-16m) is a “serious road traffic crash” (SRTC), while a crash that is even more severe or costly is a “particularly serious road traffic crash” (PSRTC). The aim of this study is to identify the main factors affecting different types of these crashes (single-vehicle, head-on, rear-end and side impact) with the ultimate goal of informing prevention activities and policies. Methods: Detailed descriptions of the SRTCs and PSRTCs that occurred from 2007 to 2014 were collected from the database “In-depth Investigation and Analysis System for Major Road Traffic Crashes” (IIASMRTC), which is maintained by the Traffic Management Research Institute of the Ministry of Public Security of China (TMRI). 18 main risk factors, which were categorized into four areas (participant, vehicle, road and environment-related) were chosen as potential independent variables for the multinomial logistic regression analysis. Comparisons were made among the single-vehicle, head-on, rear-end and side impact crashes in terms of factors affecting crash occurrence. Findings: Five risk factors were significant for the six multinomial logistic regression models, which were location, vertical alignment, roadside safety rating, driver distraction and overloading of cargo. It was indicated that intersections were more likely to have side impact SRTCs and PSRTCs, especially with poor visibility at night. Overloaded freight vehicles were more likely to be involved in a rear-end crash than other freight vehicles. Driver distraction is an important risk factor for head-on crashes, while vertical alignment and roadside safety rating are positively associated with single-vehicle crashes. Conclusion: Based on the findings, promising measures were proposed to prevent each type of SRTC and PSRTC, which governmental or regulatory agencies could employ to plan strategies to reduce SRTCs and PSRTCs and support lifesaving policies. [ABSTRACT FROM AUTHOR]

We investigated the inter-day effects of price limits policies that are employed in agent-based simulations. To isolate the impact of price limits from the impact of other factors, we built an artificial stock market with higher frequency price limits hitting. The trading mechanisms in this market are the same as the trading mechanisms in China’s stock market. Then, we designed a series of simulations with and without price limits policy. The results of these simulations demonstrate that both upper and lower price limits can cause a volatility spillover effect and a trading interference effect. The process of price discovery will be delayed if upper price limits are imposed on a stock market; however, this phenomenon does not occur when lower price limits are imposed. [ABSTRACT FROM AUTHOR]

Colorectal Cancer (CRC) is becoming a major threat to people’s life in China. Screening methods adopted by many other countries as effective counter-cancer methods have not been explicitly explored for people there. Thus, we present a Markov model with detailed precancerous adenoma states and then evaluate various screening strategies in this paper. Different from current researches, our model considers the population’s heterogeneous risk of developing adenomas and observation-based screening strategies. Furthermore, we also give a new cost-effectiveness metric. After calibrating, the model is simulated using the Monte Carlo method. Numerical results show that there are threshold values of compliance rates below which strategy with every ten-year colonoscopy becomes the most cost-effective method; otherwise, an observation-based screening strategy is the most cost-effective. We also find that strategy with single colonoscopy for adenoma-free individuals and every three-year colonoscopy for those with adenoma is recommended when the observation-based strategy is not considered. Our findings give an explicit and complete instruction in CRC screening protocol in average-risk Chinese. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis E virus is one of new threats to blood safety which was usually considered to be transmitted via fecal-oral route. China is one of the hyperendemic regions where frequent outbreaks of hepatitis E are noted. However, the overall prevalence of HEV infection among mainland Chinese blood donors is not clear until now. Method: The peer-reviewed literatures reporting the prevalence of HEV in Chinese blood donors were identified by systematic searching of five electronic databases. The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement issued in 2009. Data manipulation and statistical analyses were performed by Stata 12.0. Results: Fourteen eligible articles involving 22 independent studies were included. Pooled prevalence of HEV infection biomarkers (anti-HEV IgG, anti-HEV IgM, RNA and antigen) among mainland Chinese blood donors were 29.2%, 1.1%, 0.1% and 0.1%, respectively which were higher than the data reported in other countries. The analysis of HEV genotypes indicated that the most prevalent strains in Chinese blood donors were genotype 1 and 4. Conclusions: Mainland China is indicated with a relatively higher risk of transmission of hepatitis E through transfusion and the screening of blood donors for HEV RNA, especially in HEV-endemic areas, might reduce the potential risk of HEV infection via transfusion. [ABSTRACT FROM AUTHOR]

Introduced predators have a global reputation for causing declines and extinctions of native species. Native prey naiveté towards novel predators is thought to be a key reason for predator impacts. However, naiveté is not necessarily forever: where coexistence establishes, it is likely that naiveté will be reduced through adaptation, and the once alien predator will eventually become recognised by prey. For example, native marsupial bandicoots in Sydney avoid backyards with domestic dogs (C. lupus familiaris), but not domestic cats (Felis catus), even though cats and dogs were both introduced about 200 years ago (Carthey and Banks 2012). The authors attributed bandicoots’ recognition of dogs to long-term exposure to a close relative of dogs, dingoes that arrived in Australia 4000 years ago. Here, we test a prediction of this hypothesis by taking the study to Tasmania, where dingoes have never been present but where domestic dogs also arrived about 200 years ago. We use a similar survey design to that of Carthey and Banks (2012): asking Hobart residents to report on pet-ownership, bandicoot sightings and scats within their backyards, as well as an array of yard characteristic control variables. We predicted that if long term experience with dingoes enabled mainland bandicoots to recognise domestic dogs, then Tasmanian bandicoots, which are inexperienced with dingoes, would not recognise domestic dogs. Our results indicate that Tasmanian bandicoots are naïve to both dogs and cats after only 200 years of coexistence, supporting our hypothesis and the notion that naiveté in native prey towards alien predators (as observed on the mainland) may eventually be overcome. [ABSTRACT FROM AUTHOR]

Although studies have increasingly linked air pollution to specific health outcomes, less well understood is how public perceptions of air quality respond to changing pollutant levels. The growing availability of air pollution measurements and the proliferation of social media provide an opportunity to gauge public discussion of air quality conditions. In this paper, we consider particulate matter (PM) measurements from four Chinese megacities (Beijing, Shanghai, Guangzhou, and Chengdu) together with 112 million posts on Weibo (a popular Chinese microblogging system) from corresponding days in 2011–2013 to identify terms whose frequency was most correlated with PM levels. These correlations are used to construct an Air Discussion Index (ADI) for estimating daily PM based on the content of Weibo posts. In Beijing, the Chinese city with the most PM as measured by U.S. Embassy monitor stations, we found a strong correlation (R = 0.88) between the ADI and measured PM. In other Chinese cities with lower pollution levels, the correlation was weaker. Nonetheless, our results show that social media may be a useful proxy measurement for pollution, particularly when traditional measurement stations are unavailable, censored or misreported. [ABSTRACT FROM AUTHOR]

Exact prediction of Hemorrhagic fever with renal syndrome (HFRS) epidemics must improve to establish effective preventive measures in China. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was applied to establish a highly predictive model of HFRS. Meteorological factors were considered external variables through a cross correlation analysis. Then, these factors were included in the SARIMA model to determine if they could improve the predictive ability of HFRS epidemics in the region. The optimal univariate SARIMA model was identified as (0,0,2)(1,1,1)12. The R2 of the prediction of HFRS cases from January 2014 to December 2014 was 0.857, and the Root mean square error (RMSE) was 2.708. However, the inclusion of meteorological variables as external regressors did not significantly improve the SARIMA model. This result is likely because seasonal variations in meteorological variables were included in the seasonal characteristics of the HFRS itself. [ABSTRACT FROM AUTHOR]

Objective: To estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China. Methods: The Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed. Results: The model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust. Conclusion: Dapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM. [ABSTRACT FROM AUTHOR]

In this study, university-industry collaborations in China and the USA are analyzed in terms of co-authored publications indexed in the Web of Science (WoS). Results show a wide gap between China and the USA: Chinese universities are much less active in collaborations with industry in terms of either publication productivity or collaboration intensity. In selecting local and foreign industrial partners, however, more variation exists among Chinese universities than among US universities. The US system is domestically oriented more than that of China. In the USA, the intensity of university-industry collaboration is determined by research quality, whereas in China this is not the case. In both China and the USA, distance is not critical for the establishment of domestic university-industry collaboration. A high correlation is found between productivity indicators including total publications and university-industry co-authored publications. However, the productivity indicators are less correlated with the intensity of university-industry collaboration. Large research universities with strong ties to domestic industry play critical roles in both national publication systems. [ABSTRACT FROM AUTHOR]

We examine the different effects of monetary policy actions and central bank communication on China’s stock market bubbles with a Time-varying Parameter SVAR model. We find that with negative responses of fundamental component and positive responses of bubble component of asset prices, contractionary monetary policy induces the observed stock prices to rise during periods of large bubbles. By contrast, central bank communication acts on the market through expectation guidance and has more significant effects on stock prices in the long run, which implies that central bank communication be used as an effective long-term instrument for the central bank’s policymaking. [ABSTRACT FROM AUTHOR]

Background: Around the world, regulatory bodies have taken the lead in determining the competencies required to become a physician. As a first step in addressing this project, it was decided to develop a set of core competencies that were unique to China and that might serve as a basis for medical education. The purpose of this paper was to construct a competency model for clinical physicians in China. Methods: Data was collected using a cross-sectional survey of 6247 clinicians from seven administrative regions (31 provinces, autonomous regions and municipalities directly under the central government) in China. The total sample was randomly divided into two sub-samples, an initial sample (Sample 1) and a replication sample (Sample 2). Independent exploratory factor analysis was conducted in each sample and the results were compared to determine the stability. After that the confirmatory factor analysis was used to ascertain the competency model for physicians. The reliability, convergent and discriminant validity of competency-based instrument were also examined. Results: 76 items with 8 dimensions were identified, accounting for 68.41% of the construct’s total variance in the initial sample and 67.47% in the replication sample. For the two samples, the overall scale reliability (Cronbach’s alpha) was both 0.985 with dimensions from 0.905 to 0.954 for the initial sample and from 0.902 to 0.955 for the replication sample after deleting the items. In confirmatory factor analysis, the result showed that all items had acceptable goodness of fit index. RMSEA and SRMR were less than 0.08 (RMSEA = 0.046, SRMR = 0.040), while GFI, NFI, IFI, and CFI were higher than 0.9 (GFI = 0.905, NFI = 0.903, IFI = 0.909, CFI = 0.909), leading to acceptable construct validity. All construct reliability values of the factors were higher than 0.70, and all average variance extracted values exceeded 0.50. Thus, we considered the reliability and validity of the 8 dimensions were acceptable. Conclusions: The instrument was shown to be both valid and reliable for measuring clinical physicians’ competency in China. The results of the competency-based instrument can be used by ministry of health and administrators of hospitals to assess physicians’ competencies, encourage and guide them to modify their behaviors according to the evaluation criteria, and also cultivate physicians with strong clinical practice, innovation and independent scientific research ability. Through these measurements and understandings, the overall level of clinical physicians will be increased in China. [ABSTRACT FROM AUTHOR]

Road and foliar dust samples from four land-use districts of Panzhihua City, a famous V-Ti magnetite production area of China, were collected to investigate the sources and distribution characteristics of 9 heavy metals (V, Pb, Cd, Cu, Zn, Ni, Cr, Fe, and Mn). The results suggest that foliar samples had smaller particle size and higher heavy metal contents than road dusts. The contamination assessments of heavy metals were as follows: Pb and V (significant enrichment) > Zn, Ni, Cr, Fe, and Mn (moderate enrichment) > Cd and Ni (minimal enrichment). Statistical analyses showed Pb, as the primary pollution element, originated from waste incineration and lead-fuel combustion. The sources of Zn, Ni, Cr, Fe, V, and Mn were fugitive dust and traffic activities. Potential origins of Cu were corrosion of alloys used in vehicle components, vehicle covers, or other metallic surfaces and materials. The sources of Cd were different from any other heavy metals. Traffic and industrial activities were the main anthropogenic origins of heavy metals in dusts of Panzhihua, and more attention should be paid to heavy metal pollution in agricultural area. [ABSTRACT FROM AUTHOR]

The success of a biological invasion relies on the environment and is closely linked to factors such as water and temperature. Invasive plant species display different seed characteristics, including shape. Field sandbur (Cenchrus pauciflorus) is a globally widespread invasive species capable of adapting to broad environmental conditions. However, its germination response to water and temperature still remains unclear. C. pauciflorus contains two seeds in the same bur that differ in size: big seeds (M) and small seeds (P). Separate greenhouse experiments were conducted under different temperature regimes (0/10°C, 5/15°C, 10/20°C, 15/25°C, 18/28°C, 20/30°C and 25/35°C) and water potentials (-1.50Mpa, -1.00Mpa, -0.75Mpa, -0.50Mpa, -0.25Mpa and 0Mpa) for M and P seeds. The results support the hypothesis that germination of C. pauciflorus is significantly influenced by seed type, temperature and water potential. M and P seeds responded differently to varied alternative temperatures and water potentials. However, M and P seeds were more sensitive to water potential than to temperature. Optimal conditions for M and P seed germination were measured at 25/35°C (night temperature/day temperature) and 20/30°C, respectively. In contrast, the highest germination rate was observed for the 0Mpa of the water potential treatment. Additionally, base temperature (Tbase) and base water potential (Wbase) were lower for M (7.7°C, -1.11Mpa at 10/20°C, and -1.07Mpa at 20/30°C) than for P (9.4°C, -0.92Mpa at 10/20°C, and -0.52Mpa at 20/30°C). These different germination strategies of M and P seeds with respect to temperature and water potential increased overall plant propagation. These results indicate that tropical and subtropical regions water potentials beyond -0.50Mpa (10/20°C) or -1.00Mpa (20/30°C) face a potential risk of C. pauciflorus invasion. [ABSTRACT FROM AUTHOR]

Background: Since Spartina alterniflora (simplified as Spartina) has strong ecological competitiveness and rapid growth, it has been introduced and living in the coastal wetland regions of China for more than 30 years. Taking coastal wetland in the Beibu Gulf of south China as an example, the effects of Spartina invasion on soil quality were investigated to provide scientific basis for soil management. Methodology: The soil quality of six different coastal wetlands, i.e. mangrove (vegetation coverage is above 95%), mangrove- Spartina ecotones (vegetation coverage is above 95%), sparse mangrove (vegetation coverage is 10%-20%), sparse mangrove- Spartina ecotones (vegetation coverage is about 80%), Spartina (vegetation coverage is about 80%) and bare beach (no plants), were analyzed using the following indicators: pH, cation exchange capacity, contents of total nitrogen, total phosphorus and organic carbon, microbial biomass carbon, microbial biomass nitrogen, microbial carbon / organic carbon, and activities of urease, acid phosphatase, invertase, polyphenol oxidase and catalase. Principal Findings: The results showed that compared to mangrove wetland, most indicators in the mangrove-Spartina wetland showed a decline tendency except pH value, and the contents of total phosphorus and organic carbon, microbial biomass carbon and soil microbial biomass nitrogen, and the activities of acid phosphatase and invertase were significantly reduced (P<0.05). Compared to sparse mangrove wetland and bare beach, the Spartina invasion wetland (sparse mangrove-Spartina wetland and Spartina wetland) had higher contents of total nitrogen, total phosphorus and organic carbon, microbial biomass carbon, microbial biomass nitrogen, cation exchange capacity and the activities of urease and acid phosphatase, so soil quality in the sparse mangrove wetland and bare beach was significantly improved. Factor Analysis and PCA also showed that: the quality of mangrove wetland soil is better than that of mangrove-Spartina ecotones wetland soil; the quality of sparse mangrove-Spartina ecotones wetland soil is better than that of sparse mangrove wetland soil; the quality of Spartina wetland soil is better than that of bare beach wetland soil. Conclusions/Significance: Therefore, in the invaded Beibu Gulf wetland ecosystems of south China, for the mangrove wetlands where the productivity of native plant was higher than that of Spartina, the Spartina invasion can cause soil degradation significantly and it must be strictly controlled, while for sparse mangrove wetland and bare beach where the productivity of native plant was lower than that of Spartina, Spartina invasion can improve the soil quality. Thus our study may help to better understand the effect of plant invasion. [ABSTRACT FROM AUTHOR]

The research on the grid size suitability is important to provide improvement in accuracies of gridded population distribution. It contributes to reveal the actual spatial distribution of population. However, currently little research has been done in this area. Many well-modeled gridded population dataset are basically built at a single grid scale. If the grid cell size is not appropriate, it will result in spatial information loss or data redundancy. Therefore, in order to capture the desired spatial variation of population within the area of interest, it is necessary to conduct research on grid size suitability. This study summarized three expressed levels to analyze grid size suitability, which include location expressed level, numeric information expressed level, and spatial relationship expressed level. This study elaborated the reasons for choosing the five indexes to explore expression suitability. These five indexes are consistency measure, shape index rate, standard deviation of population density, patches diversity index, and the average local variance. The suitable grid size was determined by constructing grid size-indicator value curves and suitable grid size scheme. Results revealed that the three expressed levels on 10m grid scale are satisfying. And the population distribution raster data with 10m grid size provide excellent accuracy without loss. The 10m grid size is recommended as the appropriate scale for generating a high-quality gridded population distribution in our study area. Based on this preliminary study, it indicates the five indexes are coordinated with each other and reasonable and effective to assess grid size suitability. We also suggest choosing these five indexes in three perspectives of expressed level to carry out the research on grid size suitability of gridded population distribution. [ABSTRACT FROM AUTHOR]