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This study investigates the effect of public health education (PHE) on migrant workers' health status in China, using the data collected from the China Migrants Dynamic Survey project. The analysis employs a probit model, whose results suggest that, in general, PHE has a statistically significant and positive impact on migrant workers' self-rated health status and exerts a negative impact on their incidence rate of daily diseases. We also utilize the conditional mixed process method to address the potential endogenous issue. Further analyses reveal that there are significant differences in the impacts of different modes of PHE on migrant workers' health status, among which the mode of health knowledge lectures plays the most prominent role. Nonetheless, an additional analysis indicates that in addition to PHE, other public health services, such as the establishment of health records, also have a significant effect on the promotion of migrant workers' health status. A disaggregated analysis reveals that this impact is heterogeneous among different generations, genders as well as those with different income levels. The findings shed light on the importance of promoting equal access to public health services.

Background: People living with HIV (PLWH) are susceptible to social isolation as a result of stigma and discrimination, which not only diminishes adherence to antiretroviral therapy but also heightens the risks of hospital readmission, depression, and mortality. However, there is currently no systematic review addressing the occurrence and impact of social isolation in individuals with HIV. Therefore, this study undertook a comprehensive systematic review and meta-analysis of existing literature to examine the prevalence and influencing factors associated with social isolation among PLWH. Methods and analysis: PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Google Scholar, China Science and Technology Journal Database, The China National Knowledge Infrastructure, WanFang Data and Chinese Biomedicine Literature Database will be searched from the establishment of the database to the latest search date. Literature screening, data extraction and literature quality assessment will be done independently by two researchers and results will be cross-referenced. Data analysis will be performed using stata15.1 software. Risk of publication bias will be assessed using Begg's and Egger's methods. Heterogeneity between studies will then be assessed using the I2 index and its 95% CI and Q statistics. Sources of heterogeneity will be accounted for by subgroup and sensitivity analyses. Results: The results may reveal the prevalence of social isolation among PLWH and provide data support for understanding its etiology and prevention. Conclusion: By systematically reviewing the existing literature on social isolation among PLWH, this study aims to provide a comprehensive understanding of the prevalence of social isolation within this population, elucidate the detrimental effects it poses for people affected by HIV, and effectively inform targeted interventions for high-risk groups. Furthermore, these findings offer valuable insights to support evidence-based decision-making in public health policy. Systematic review registration: PROSPERO registration number: CRD42024499044 [ABSTRACT FROM AUTHOR]

Background: Rapidly progressive dementia (RPD), characterized by a rapid cognitive decline leading to dementia, comprises a diverse range of disorders. Despite advancements in diagnosis and treatment, research on RPD primarily focuses on Western populations. Objective: This study aims to explore the etiology and demographics of RPD in Chinese patients. Methods: We retrospectively analyzed 323 RPD inpatients at Huashan Hospital from May 2019 to March 2023. Data on sociodemographic factors, epidemiology, clinical presentation, and etiology were collected and analyzed. Results: The median onset age of RPD patients was 60.7 years. Two-thirds received a diagnosis within 6 months of symptom onset. Memory impairment was the most common initial symptom, followed by behavioral changes. Neurodegenerative diseases accounted for 47.4% of cases, with central nervous system inflammatory diseases at 30.96%. Autoimmune encephalitis was the leading cause (16.7%), followed by Alzheimer's disease (16.1%), neurosyphilis (11.8%), and Creutzfeldt-Jakob disease (9.0%). Alzheimer's disease, Creutzfeldt-Jakob disease, and frontotemporal dementia were the primary neurodegenerative causes, while autoimmune encephalitis, neurosyphilis, and vascular cognitive impairment were the main non-neurodegenerative causes. Conclusions: The etiology of RPD in Chinese patients is complex, with neurodegenerative and non-neurodegenerative diseases equally prevalent. Recognizing treatable conditions like autoimmune encephalitis and neurosyphilis requires careful consideration and differentiation. [ABSTRACT FROM AUTHOR]

Background: Immunization is a cornerstone of public health. Despite great success, China's National Immunization Program (NIP) faces challenges, such as the integration of several World Health Organization-recommended vaccines and other systemic issues. The Innovation Laboratory for Vaccine Delivery Research (VaxLab), supported by the Bill & Melinda Gates Foundation and established in 2021 at Duke Kunshan University, focuses on enhancing China's NIP through research and policy advocacy. This editorial aims to summarize the key findings of the manuscripts published in the collection contributed by VaxLab team and set the future research agenda. Key findings: The collection contains eleven manuscripts discussing China's immunization landscape and strategies to improve coverage, particularly for non-NIP vaccines like human papillomavirus vaccine (HPV), pneumococcal conjugate vaccine (PCV), Haemophilus influenzae type b vaccine (Hib), and rotavirus vaccines. Key findings include: (i) The COVID-19 vaccination campaign demonstrated China's capacity for rapid, large-scale immunization efforts, suggesting potential for broader vaccine coverage improvements; (ii) Efforts in combating cervical cancer through the HPV vaccine indicate progress but also highlight challenges like vaccine supply and equitable access; (iii) The lag in adopting higher-valent paediatric combination vaccines in China needs attention to address regulatory and health system hurdles; (iv) Disparities in access to non-NIP vaccines underscore the need for government initiatives to improve vaccine coverage, especially for remote areas and marginalized populations; (v) Original studies emphasize the influence of caregivers' knowledge, health workers' financial incentives, and concerns about vaccine efficacy on immunization rates; (vi) Case studies from the Weifang City of China and Indonesia to introduce PCV offer insights on successful vaccine introduction strategies and the impact of innovative financing and government support. Conclusion: The articles emphasize the need for government leadership, strategic policymaking, and public awareness to enhance vaccine coverage and equity. The VaxLab will continue strengthening China's NIP by focusing on vaccine financing, emphasizing diversity, equity, and inclusion, and improving maternal vaccination coverage. Research will extend to Southeast Asian and Western Pacific regions, especially in middle-income countries facing challenges in vaccine financing and delivery. The collective efforts outlined in this collection show a commitment to evolving and adapting immunization strategies to meet global health goals and to provide equitable access to vaccines for all. [ABSTRACT FROM AUTHOR]

The fungal diversity of five sweet fermented oats samples in China was studied by Illumina sequencing. The results showed that the abundance of Mucoromycota and Ascomycota peaked in the oats Tianpei samples, and a bit Basidiomycota were also included. As to genus, Rhizopus had the highest abundance, followed by unclassified_p_Ascomycota, Saccharomyces and Issatchenkia. Principal component analysis (PCA) indicated that five kinds of oats Tianpei samples formed their own fungal clusters. The biomarker taxa of oats Tianpei were identified by Lefse, including Mucor and Pichia. The fungal composition of oats Tianpei was significantlly related to the chemical composition of oats Tianpei (lactic acid, free fatty acid, amino acid, reducing sugar, etc). The fermentation effects of Rhizopus oryzae on the chemical composition of oats Tianpei were studied also. The fermentation of Rhizopus oryzae significantly increased the chemical composition in oats Tianpei. The research provided a theoretical basis for the study of microbial flora, the discovery of related microbial resources, the fermented modification grains, and the improvement of oats Tianpei quality. [ABSTRACT FROM AUTHOR]

Background: One anastomosis gastric bypass (OAGB) is a new recognized metabolic surgery, but the problem that we cannot screen the excluded stomach is a troubling issue in China. The emergence of sleeve gastrectomy plus one anastomosis bipartition (SG + OAB) makes us see a hope to solve this problem. Objectives: By comparing the efficacy of the two surgical methods, to evaluate whether SG + OAB surgery can solve the dilemma faced by OAGB that the excluded stomach cannot be screened. Methods: A retrospective study to compare the patients who underwent OAGB and SG + OAB was conducted. The main outcome measures were (1) operation risk, (2) weight loss, and (3) diabetes remission at 6 months. Results: This study was conducted in the bariatric/metabolic surgical center. From November 2021 to February 2022, a total of 30 patients with obesity who received SG + OAB surgery were recruited. Another matched 60 patients undergoing OAGB were recruited as control group. There was no difference in preoperative age (32.15 ± 9.02 vs. 34.47 ± 7.22; p =.224), female ratio (83% vs. 85%; p =.837), and BMI (36.18 ± 5.30 vs. 34.68 ± 5.58; p =.217) between the two groups. OAGB had a shorter mean operation time (121.67 ± 20.41 vs. 143.50 ± 25.07 min; p <.001) and a lower intraoperative blood loss (21.92 ± 12.35 vs. 32.43 ± 22.01 mL; p =.005), but a longer postoperative flatus passage (2.13 ± 0.43 vs. 1.87 ± 0.43 days; p =.007) compared with the SG + OAB group. Two patients (6.7%) developed major surgical complication in SG + OAB group but no major complication developed in OAGB group. At 6 months after surgery, SG + OAB had a higher %total weight loss than OAGB (31.05 ± 3.12 vs. 28.14 ± 5.43%; p =.015), but diabetes remission rate was similarly high in both groups. Conclusions: SG + OAB operation had a non‐inferior or even better weight loss than OAGB, with a similar glycemic control efficacy. However, the high complication rate of SG + OAB is the major drawback that needs attention. [ABSTRACT FROM AUTHOR]

Background: Non-National Immunization Program (NIP) vaccines have played an important role in controlling vaccine-preventable diseases (VPDs) in China. However, these vaccines are paid out of pocket and there is room to increase their coverage. We focused on four selected non-NIP vaccines in this study, namely Haemophilus influenzae type b (Hib) vaccine, human papillomavirus (HPV) vaccine, pneumococcal conjugate vaccine (PCV), and rotavirus vaccine. We aimed to conduct a scoping review of their vaccination rates and the major barriers faced by health systems, providers, and caregivers to increase coverage. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We searched five English databases (PubMed, Web of Science, EMBASE, Scopus, and WHO IRIS) and four Chinese databases using the search strategy developed by the study team. Two independent reviewers screened, selected studies, and examined their quality. We summarized the non-NIP vaccine coverage data by vaccine and applied the 5A framework (Access, Affordability, Acceptance, Awareness, Activation) to chart and analyze barriers to increasing coverage. Results: A total of 28 articles were included in the analysis (nine pertaining to vaccine coverage, and another 19 reporting challenges of increasing uptake). Among the four selected vaccines, coverage for the Hib vaccine was the highest (54.9–55.9% for 1 dose or more from two meta-analyses) in 2016, while the coverage of the other three vaccines was lower than 30%. Eight of the nine included articles mentioned the regional disparity of coverage, which was lower in under-developing regions. For example, the three-dose Hib vaccination rate in eastern provinces was 38.1%, whereas the rate in central and western provinces was 34.3% and 26.2%, respectively in 2017. Within the 5A framework, acceptance, awareness, and affordability stood out as the most prominent themes. Among the 12 identified sub-themes, high prices, low vaccine awareness, concerns about vaccine safety and efficacy were the most cited barriers to increasing the uptake. Conclusions: There is an urgent need to increase coverage of non-NIP vaccines and reduce disparities in access to these vaccines across regions. Concerted efforts from the government, the public, and society are required to tackle the barriers and challenges identified in this study, both on the demand and supply side, to ensure everybody has equal access to life-saving vaccines in China. Particularly, the government should take a prudent approach to gradually incorporate non-NIP vaccines into the NIP step by step, and make a prioritizing strategy based on key factors such as disease burden, financial resources, and market readiness, with special attention to high-risk populations and underdeveloped regions. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between fruit and vegetable intake and arterial stiffness. We conducted a cohort-based study comprising 6,628 participants with arterial stiffness information in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. A semi-quantitative food-frequency questionnaire was used to assess baseline (2007–2008) and recent (2018–2021) fruit and vegetable intake. We assessed changes in fruit and vegetable intake from 2007–2008 to 2018–2021 in 6,481 participants. Arterial stiffness was measured using the arterial velocity–pulse index (AVI) and arterial pressure-volume index (API). Elevated AVI and API values were defined according to diverse age reference ranges. Multivariable-adjusted linear regression models revealed that every 100 g/d increment in fruit and vegetable intake was associated with a 0.11 decrease in AVI (B = –0.11; 95% confidence interval [ CI ]: –0.20, –0.02) on average, rather than API (B = 0.02; 95% CI : –0.09, 0.13). The risk of elevated AVI (odds ratio [ OR ] = 0.82; 95% CI : 0.70, 0.97) is 18% lower in individuals with high intake (≥ 500 g/d) than in those with low intake (< 500 g/d). Furthermore, maintaining a high intake in the past median of 11.5 years of follow-up was associated with an even lower risk of elevated AVI compared with a low intake at both baseline and follow-up (OR = 0.64; 95% CI : 0.49, 0.83). Fruit and vegetable intake was negatively associated with arterial stiffness, emphasizing recommendations for adherence to fruit and vegetable intake for the prevention of arterial stiffness. [ABSTRACT FROM AUTHOR]

Practical abilities are important for students from majors including Computer Science and Engineering, and Electrical Engineering. Along with the popularity of ACM International Collegiate Programming Contest (ACM/ICPC) and other programming contests, online judge (OJ) websites achieve rapid development, thus providing a new kind of programming practice, i.e. online practice. Due to fair and timely feedback results from OJ websites, online practice outperforms traditional programming practice. In order to promote students' practical abilities in programming and algorithm designing, this article presents a novel teaching idea, online judge & practice oriented teaching (OJPOT). OJPOT is applied to "Programming Foundation" course. OJPOT cultivates students' practical abilities through various kinds of programming practice, such as programming contests, online practice and course project. To verify the effectiveness of this novel teaching idea, this study conducts empirical research. The experimental results show that OJPOT works effectively in enhancing students' practical abilities compared with the traditional teaching idea.

Background: The impact of multimorbidity on long-term care (LTC) use is understudied, despite its well-documented negative effects on functional disabilities. The current study aims to assess the association between multimorbidity and informal LTC use in China. We also explored the socioeconomic and regional disparities. Methods: The study included 10,831 community-dwelling respondents aged 45 years and older from the China Health and Retirement Longitudinal Study in 2011, 2015, and 2018 for analysis. We used a two-part model with random effects to estimate the association between multimorbidity and informal LTC use. Heterogeneity of the association by socioeconomic position (education and income) and region was explored via a subgroup analysis. We further converted the change of informal LTC hours associated with multimorbidity into monetary value and calculated the 95% uncertainty interval (UI). Results: The reported prevalence of multimorbidity was 60·0% (95% CI: 58·9%, 61·2%) in 2018. We found multimorbidity was associated with an increased likelihood of receiving informal LTC (OR = 2·13; 95% CI: 1·97, 2·30) and more hours of informal LTC received (IRR = 1·20; 95% CI: 1·06, 1·37), ceteris paribus. Participants in the highest income quintile received more hours of informal LTC care (IRR = 1·62; 95% CI: 1·31, 1·99). The estimated monetary value of increased informal LTC hours among participants with multimorbidity was equivalent to 3·7% (95% UI: 2·2%, 5·4%) of China's GDP in 2018. Conclusion: Our findings substantiate the threat of multimorbidity to LTC burden. It is imperative to strengthen LTC services provision, especially among older adults with multimorbidity and ensure equal access among those with lower income. [ABSTRACT FROM AUTHOR]

Traditional fermented milk from the western Sichuan plateau of China has a unique flavor and rich microbial diversity. This study explored the quality formation mechanism in fermented milk inoculated with Lactobacillus brevis NZ4 and Kluyveromyces marxianus SY11 (MFM), the dominant microorganisms isolated from traditional dairy products in western nan. The results indicated that MFM displayed better overall quality than the milk fermented with L. brevis NZ4 (LFM) and K. marxianus SY11 (KFM), respectively. MFM exhibited good sensory quality, more organic acid types, more free amino acids and esters, and moderate acidity and ethanol concentrations. Non-targeted metabolomics showed a total of 885 metabolites annotated in the samples, representing 204 differential metabolites between MFM and LFM and 163 between MFM and KFM. MFM displayed higher levels of N-acetyl-L-glutamic acid, cysteinyl serine, glaucarubin, and other substances. The differential metabolites were mainly enriched in pathways such as glycerophospholipid metabolism, arginine biosynthesis, and beta-alanine metabolism. This study speculated that L. brevis affected K. marxianus growth via its metabolites, while the mixed fermentation of these strains significantly changed the metabolism pathway of flavor-related substances, especially glycerophospholipid metabolism. Furthermore, mixed fermentation modified the flavor and quality of fermented milk by affecting cell growth and metabolic pathways. [ABSTRACT FROM AUTHOR]

COTE1 was recently described as an oncogene in hepatocellular carcinoma and gastric cancer. However, the roles of COTE1 in intrahepatic cholangiocarcinoma (ICC) are little known. Our study is aimed at clarifying novel functions of COTE1 in ICC progression, including proliferation, invasion, and autophagy. By using quantitative real-time PCR, immunohistochemistry staining, and western blotting, we found that COTE1 expression was frequently upregulated in ICC tissues, compared to paracarcinoma tissues. High COTE1 expression was significantly correlated with aggressive clinical features and predicted poor prognosis of ICC patients. Functional experiments revealed that ectopic COTE1 expression promoted ICC cell proliferation, colony formation, cellular invasion, migration, and in vivo tumorigenicity; in contrast, COTE1 knockdown resulted in the opposite effects. At molecular mechanism in vitro and vivo, our study revealed that COTE1 overexpression suppressed autophagy via Beclin1 transcription inhibition; conversely, COTE1 silencing facilitated autophagy through promoting Beclin1 expression. Furthermore, the suppression of COTE1 knockdown on cellular growth and invasion was rescued/aggravated by Beclin1 inhibition/accumulation. Our data, for the first time, illustrate that COTE1 is an oncogene in ICC pathogenesis, and the ectopic COTE1 expression promotes ICC proliferation and invasion via Beclin1-dependent autophagy inhibition. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cancer and the leading cause of cancer death among females worldwide. During the past 15 years, quality of life (QOL) has become an important aspect of breast cancer treatment. The purpose of this study was to evaluate QOL of breast cancer patients in China, and investigate its associations with sociodemographic and clinical variables. A cross-sectional study was conducted in 246 breast cancer patients in China. Recruited patients were surveyed for QOL using the QOL instruments for cancer patients-breast cancer QLICP-BR (V2.0). We assessed the associations between potential influencing factors and QOL using multiple linear regression models. The general mean QOL score for our population was 70.24 with SD = 8.70. Results indicated that medical insurance, drinking history, alkaline phosphatase, serum chloride ion level, serum calcium ion level, serum phosphorus ion level, mean corpuscular volume, mean corpuscular hemoglobin, red cell volume distribution width and platelet had significant associations with QOL of breast cancer patients. Our results emphasized that many factors are affecting QOL of breast cancer patients, which may provide a reference for targeted management or intervention strategies of breast cancer patients to improve their QOL. [ABSTRACT FROM AUTHOR]

Rural revitalization denotes the gathering of large populations in rural areas and the subsequent gradual urbanization. Rural environments have been deteriorated by heavy metals (HMs) over the last few years. Without the existence of large-scale industries, the accumulation of HMs in sediments due to population aggregation in rural environments needs to be scientifically confirmed. Therefore, in this study we first understand the sediment pollution in rural environments in China and across the globe, and subsequently investigate HMs in sediments in rural micro water. The study area, Sichuan Province, China, was divided into two areas, namely, sparsely populated areas (SPA) and densely populated areas (DPA). Eight typical HMs (As, Zn, Ni, Hg, Cd, Cr, Cu, and Pb) were selected to target in riverine sediments, and the content and spatial distribution characteristics were analyzed. The results indicate that As, Hg, Cd, and Pb concentrations in sediments were higher than background values (BVs), with high concentration sample sites located in the DPA. In addition, the geo-accumulation index (Igeo), pollution load index (PLI) and potential ecological risk index (RI) were used to quantitatively evaluate the pollution characteristics of HMs in sediments, revealing that the sediments exhibited high As and Hg pollution in the DPA (PLI = 1.09). In general, mild (RI = 48.76) and moderate (RI = 154.92) HM pollution was observed in the sediments of the SPA and DPA, respectively, based on the high PLI (> 1.0) and RI (> 150) values. Correlation analysis and principal component analysis (PCA) indicate that the Cd in the sediment generally originated from geogenic sources, while the other elements (Zn, As, Cu, Cr, Hg, Ni and Pb) were primarily linked to anthropogenic sources. Finally, the results demonstrate that population aggregation will lead to the enrichment of HMs. [ABSTRACT FROM AUTHOR]

Objective To investigate the contribution of early-life factors on intrinsic capacity of Chinese adults older than 45 years. Methods We used data on 21 783 participants from waves 1 (2011) and 2 (2013) of the China Health and Retirement Longitudinal Study (CHARLS), who also participated in the 2014 CHARLS Life History Survey to calculate a previously validated measure of intrinsic capacity. We considered 11 early-life factors and investigated their direct association with participants' intrinsic capacity later in life, as well as their indirect association through four current socioeconomic factors. We used multivariable linear regression and the decomposition of the concentration index to investigate the contribution of each determinant to intrinsic capacity inequalities. Findings Participants with a favourable environment in early life (that is, parental education, childhood health and neighbourhood environment) had a significantly higher intrinsic capacity score in later life. For example, participants with a literate father recorded a 0.040 (95% confidence interval, CI: 0.020 to 0.051) higher intrinsic capacity score than those with an illiterate father. This inequality was greater for cognitive, sensory and psychological capacities than locomotion and vitality. Overall, early-life factors directly explained 13.92% (95% CI: 12.07 to 15.77) of intrinsic capacity inequalities, and a further 28.57% (95% CI: 28.19 to 28.95) of these inequalities through their influence on current socioeconomic inequalities. Conclusion Unfavourable early-life factors appear to decrease late-life health status in China, particularly cognitive, sensory and psychological capacities, and these effects are exacerbated by cumulative socioeconomic inequalities over a person's life course. [ABSTRACT FROM AUTHOR]

Introduction: The development of inhibitors against factor FIX (FIX) is the most serious complication of FIX replacement therapy in haemophilia B (HB) patients. Currently, only few cohorts of HB inhibitor patients have been reported worldwide. Aim: This Chinese nationwide study of HB inhibitor patients explored their risk factors for FIX inhibitor development and experience on their management. Methods: We retrospectively analysed patient characteristics, F9 genotypes, treatment strategies and outcomes of HB inhibitor patients registered to the Chinese National Registry and Patient Organization Registry. Results: Forty‐four unique HB inhibitor patients were identified in 4485 unique HB patients registered by year 2021 to the two Registries. Inhibitor diagnosis were usually delayed and the low prevalence (.98%) may suggest some inhibitor patients were not identified. Their median age at inhibitor diagnosis was 7.5 (IQR, 3.0–14.8) years. Most patients (95.5%) had high‐titre inhibitors. Allergic/Anaphylactic reactions occurred in 59.1% patients. Large deletions and nonsense mutations were the most common F9 mutation types in our FIX inhibitor patients. Patients with large F9 gene deletions were more likely to develop inhibitors (p =.0002), while those with missense mutations had a low risk (p <.0001). Thirteen (29.5%) patients received immune tolerance induction (ITI) therapy using low‐dose prothrombin complex concentrate regimens. Twelve completed ITI with three (25.0%) achieving success. Nephrotic syndrome developed in two (16.7%) patients during ITI. Conclusion: This study reports the largest Chinese cohort of HB inhibitor patients. Large deletions were most significantly associated with inhibitor development. Low‐dose ITI might be feasible for FIX inhibitor eradication. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to investigate the clinical effects of targeted perioperative nursing combined with propofol and fentanyl in gynecological laparoscopic surgery. Methods. Patients who were admitted to our hospital for gynecological laparoscopic surgeries from October 1, 2019 to November 30, 2021 were included in this retrospective study. Patients in group A received routine propofol and fentanyl. Patients in group B received targeted perioperative nursing on the basis of interventions in group A. The anesthetic effects, clinical indicators, mental health status, and adverse reactions were compared between the two groups. Results. A total of 84 qualified patients were retrieved. The total effective anesthesia rate, extubation time, operation time, consciousness recovery time, intraoperative blood loss, hospital stay, SAS score, SDS score, health status indicators, and adverse events in group B were all significantly better than those in group A (P < 0.05 for all comparisons). Conclusion. Combined intervention (propofol + fentanyl + targeted perioperative care) for gynecological laparoscopic surgery patients has a significant anesthesia effect, which can effectively improve the patient's clinical indicators and mental health status and can also reduce the occurrence of adverse events. It has good safety and can be widely used in clinical practice. [ABSTRACT FROM AUTHOR]

This study investigates the effect of public health education (PHE) on migrant workers' health status in China, using the data collected from the China Migrants Dynamic Survey project. The analysis employs a probit model, whose results suggest that, in general, PHE has a statistically significant and positive impact on migrant workers' self-rated health status and exerts a negative impact on their incidence rate of daily diseases. We also utilize the conditional mixed process method to address the potential endogenous issue. Further analyses reveal that there are significant differences in the impacts of different modes of PHE on migrant workers' health status, among which the mode of health knowledge lectures plays the most prominent role. Nonetheless, an additional analysis indicates that in addition to PHE, other public health services, such as the establishment of health records, also have a significant effect on the promotion of migrant workers' health status. A disaggregated analysis reveals that this impact is heterogeneous among different generations, genders as well as those with different income levels. The findings shed light on the importance of promoting equal access to public health services. [ABSTRACT FROM AUTHOR]

In this study, the contents and associated soil properties of 6 metal elements (Pb, As, Cu, Zn, Ni, Cr) were measured in 63 topsoil samples in the affected areas of a typical non-ferrous metal slag field in Huili City, Sichuan Province, China. The associated soil properties of the 6 metals include Ammonium Nitrogen ( NH 4 + -N), Nitrate ( NO 3 − -N), Available Phosphorus (AP), Available Potassium (AK), Electrical Conductivity (EC), Cation Exchange Capacity (CEC), Soil Water Content (SWC), and pH. Multivariate statistics-spatial analysis-soil pollution comprehensive evaluation method was used to quantify the environmental pollution degree of heavy metals in the topsoil and divided (zone) the slag field based on the degree of pollution. Pearson correlation analysis and positive matrix factorization (PMF) were used to identify and quantitatively analyze pollution sources and their contributions. The results show that the average contents of Pb, As, Cu, Zn, Ni, and Cr were 13.27, 19.87, 6.91, 50.55, 25.06, and 77.71 mg·kg−1, respectively. Nemerow comprehensive evaluation results showed that the sites with Slight Pollution and Mild Pollution accounted for 26.98% and 3.17% of the total sampling sites, respectively. Approximately 70% of the sampling sites in the study area had no heavy metal pollution in the soil. Sites with No Pollution or Slight Pollution were mainly distributed in the forest areas with vegetation coverage, while sites with Moderate Pollution or Heavy Pollution were mainly distributed in crop planting areas and areas near slag fields. PMF model revealed four pollution sources: natural sources, mixed industrial and transportation sources, agricultural sources, and industrial river water. These results will provide theoretical references for the utilization and treatment of heavy metal-contaminated soil around the slag field in the dry-hot valley. [ABSTRACT FROM AUTHOR]

Background: One anastomosis gastric bypass (OAGB) is gradually accepted worldwide but still new in China. Materials and Methods: Retrospective review of the patients who received OAGB in a new bariatric/metabolic surgical center in China and compared the data with a center of excellence in Taiwan. All in-patient and outpatient follow-up data were analyzed. The main outcome measures were (1) operation risk (2) weight loss (3) diabetes remission. Results: Between August 2019 and October 2021, 100 consecutive patients who received OAGB in situ in China and 225 patients who received OAGB with the same technique were recruited from Taiwan. Taiwan patients were older (39.2 ± 10.6 vs. 33.3 ± 8.8 years old, p < 0.001), and to have more diabetes (32.4% vs. 20.0%, p = 0.022) comparing to the patients of China. Operation time was significantly longer for Taiwan patients (172.4 ± 36.9 vs. 128.5 ± 29.8, p < 0.001). Taiwan patients lost more blood during the operation (35.5 ± 25.2 vs. 22.4 ± 15.6, p < 0.001) but patients in China need more time to postoperative flatus passage (1.3 ± 0.5 vs. 2.0 ± 0.5, p < 0.001). There was no major surgical complication in this study, minor complication rates were similar low for both groups (1.0% vs. 1.8%, p = 0.891). At 1 year after surgery, %TWL and %EWL of both centers were similar (33.9 ± 7.43% vs. 32.6 ± 11.2%, p = 0.91; 81.9 vs. 19.8 vs. 85.4 ± 13.2, p = 0.798). T2DM remission (HbA1c < 6.5%) was 100% for patients of China and 95.9% for patients of Taiwan (p = 0.836). Conclusions: OAGB in situ is a safe and effective bariatric/metabolic surgery. With proper training and proctorship, these results are reproduceable in a new bariatric/metabolic surgical center in China. [ABSTRACT FROM AUTHOR]

Background: Fleas are the most economically significant blood-feeding ectoparasites worldwide. Ctenocephalides felis and Pulex irritans can parasitize various animals closely related to humans and are of high veterinary significance. Methods: In this study, 82 samples were collected from 7 provinces of China. Through studying the nuclear genes ITS1 and EF-1α and two different mitochondrial genes cox1 and cox2, the population genetics and genetic variation of C. felis and P. irritans in China were further investigated. Results: The intraspecies differences between C. felis and P. irritans ranged from 0 to 3.9%. The interspecific variance in the EF-1α, cox1, and cox2 sequences was 8.2–18.3%, while the ITS1 sequence was 50.1–52.2%. High genetic diversity was observed in both C. felis and P. irritans, and the nucleotide diversity of cox1 was higher than that of cox2. Moderate gene flow was detected in the C. felis and P. irritans populations. Both species possessed many haplotypes, but the haplotype distribution was uneven. Fu's Fs and Tajima's D tests showed that C. felis and P. irritans experienced a bottleneck effect in Guangxi Zhuang Autonomous Region and Henan province. Evolutionary analysis suggested that C. felis may have two geographical lineages in China, while no multiple lineages of P.irritans were found. Conclusions: Using sequence comparison and the construction of phylogenetic trees, we found a moderate amount of gene flow in the C. felis and P. irritans populations. Both species possessed many haplotypes, but the distribution of haplotypes varied among the provinces. Fu's Fs and Tajima's D tests indicated that both species had experienced a bottleneck effect in Guangxi and Henan provinces. Evolutionary analysis suggested that C. felis may have two geographical lineages in China, while no multiple lineages of P.irritans were found. This study will help better understand fleas' population genetics and evolutionary biology. [ABSTRACT FROM AUTHOR]

Intertidal wetlands are important carbon reservoirs that play a significant role in climate change mitigation. However, the lack of large‐scale quantification and source identification of sediment organic carbon (SOC) in different discharge estuaries hampers the assessment of the carbon storage potential in these systems. In this study, based on the elemental ratios and stable carbon isotopes of the core sediment from the intertidal wetlands along the east coast of China, we quantified the contribution of organic carbon (OC) derived from terrestrial/estuarine particulate organic matter (POM), marine phytoplankton, and local plants, such as mangrove and salt marsh plants in the study area. We explored the hydrological and plant drivers controlling the variation in the contribution of OC sources among different coastal environmental settings. We found that SOC in high discharge estuaries (river runoff more than 50 billion m3/a) originated predominantly from terrestrial/estuarine POM (45 ± 6%), whereas the primary source for low discharge estuaries was marine phytoplankton OC (51 ± 14%). Moreover, our estimates revealed a sharp increase in the contribution of OC from mangroves to deep sediments compared with surface sediments, owing to the infiltration of mangrove roots at greater depths and the slow degradation of roots contributing to the substantial refractory OC buried in the deep sediments. These findings indicate that carbon storage in the intertidal wetlands varies among contrasting coastal environmental conditions, which provides implications for intertidal wetlands as a critical carbon sink in the global carbon budget. Plain Language Summary: Better constraints on the sources of sediment organic carbon (SOC) in intertidal wetlands are very important for calculating the global carbon budget. Many researchers have studied the distribution, source, burial of SOC, but still, there is an obvious lack of quantification of the contributions of multiple SOC sources in different discharge estuaries across a large geographical area. Terrestrial/estuarine particulate organic matter (POM), marine phytoplankton, and local plants contribute organic carbon (OC) to sediments, varying in different places. In this study, by comparing the total organic carbon and total nitrogen content, δ13C values, and C/N ratios of the sediment cores, we quantified the relative contributions of three OC sources to sediments from 12 intertidal wetlands along the east coast of China. We found a higher percentage of terrestrial/estuarine POM input in high discharge estuaries (river runoff more than 50 billion m3/a). Results suggest that the contribution of terrestrial/estuarine POM increases with river runoff, whereas the contribution of marine phytoplankton OC decreases with runoff. Moreover, there was a sharp increase in the relative contribution of long‐term OC supplied by mangrove OC with depth. The large‐scale quantification of the contributions of SOC sources has important implications for better estimation of the potential of OC sequestration. Key Points: Organic carbon (OC) contribution was assessed in coastal wetlands of China by using MixSIARThe contribution of terrestrial/estuarine particulate organic matter rose with river runoff, while the contribution of marine OC decreasedThe infiltration of mangrove roots resulted in mangrove OC dominated in deeper sediments and preserved [ABSTRACT FROM AUTHOR]

This study examines preservice music teachers' multicultural personality level and characteristics in the context of multicultural music education in China, focusing on the factors that influence the teachers' multicultural personality traits. We surveyed 433 preservice music teachers who responded via the Multicultural Personality Questionnaire-Short Form survey instrument. The results indicated that the multicultural personality level of preservice music teachers was intermediate, mainly due to a deficiency in the Flexibility and Emotional Stability dimensions, which are necessary for dealing with cultural differences in the face of unknown multicultural conditions. In addition, we also found that the size of a teacher's hometown and the years of studying and teaching are significant factors in shaping preservice music teachers' multicultural personalities. Preservice music teachers whose hometowns are big cities have a higher multicultural personality level than those in rural areas. The more time a preservice music teacher spent studying and teaching, the higher the multicultural personality level. Gender, educational level, and experience playing musical instruments have no statistically significant effect on the multicultural personality of preservice music teachers. [ABSTRACT FROM AUTHOR]

Water quality evaluation is an important step in water environment control and management. The water quality index (WQI) is considered to be an effective method for water quality evaluation. However, when constructing the WQI, the contribution of the lower threshold limits of water quality parameters to water quality has received little attention. The principle of the modified integrated water quality index (IWQI) is that the concentration of any water quality parameter below the lower threshold limits as well as above the upper threshold limits will lead to an increase in the overall index value. Based on the concentration of water quality parameters, the modified IWQI classified water quality into five categories, i.e., bad (> 8), poor (5–8), medium (2–5), good (1–2), and excellent (< 1). Tuo River plays a crucial role in potable and irrigation water sources of Sichuan Province, and the assessment result of modified IWQI reveals that 67.8% of samples were classified as "medium," 29% "poor," and 3.2% "bad." The high concentrations of N and P from agricultural activities and industrial wastewater are the main contributors to the deterioration of water quality in the Tuo River. Additionally, the Tuo River presents the characteristics of worse water quality in the midstream. The evaluation results of the modified IWQI are consistent with that of the conventional WQI, which proves the accuracy of the modified IWQI as a surface water quality evaluation method. [ABSTRACT FROM AUTHOR]

Under the background of healthy China, health education has been brought into the national education system. To improve the health literacy level of PE normal students in primary schools, this study studies the health literacy status of PE normal students in the "six-year junior middle school starting point system" using the methods of literature review, questionnaire survey, mathematical statistics, and so on. The results show that the health literacy level of "six-year junior high school starting point" PE normal students is close to that of national college students, but the health literacy is overall low. The success rate of health literacy of six-year physical education normal students from high to low is health skills, health knowledge, healthy lifestyle, and behavior; six-year physical education normal students have a high level of health skills, but a low level of healthy lifestyle and behavior. Countermeasures are put forward: optimizing the curriculum structure and strengthening health education; paying attention to health literacy and improving learning awareness; cultivating health awareness; maintaining the law of life, etc. [ABSTRACT FROM AUTHOR]

This paper digests the influences of financial transparency and media coverage in the Chinese stock market. In China, media performs under a regulatory system and media information is regarded as the direction of news. In addition, the Chinese market is dominated by retail investors and financial information is always manipulated, so the reliability of financial information is quite intriguing. The effect of ostensible financial information on the stock market through the media hype is a crucial issue. We employ media and transparency to analyze over 3,000 stocks in China. First of all, the Chinese stock market is characterized by significantly negative momentum profit and thus exhibits price reversal. However, when high media coverage and high transparency jointly come into play, the significantly negative momentum profit turns to be significantly positive. This dramatic change alters the price reversal to be price momentum. By contrast, low media coverage and low transparency still result in price reversal. [ABSTRACT FROM AUTHOR]

Background: Attributed to the immunosuppression caused by malignancy itself and its treatments, cancer patients are vulnerable to developing nosocomial infections. This study aimed to develop a nomogram to predict the in-hospital death risk of these patients. Methods: This retrospective study was conducted at a medical center in Northwestern China. The univariate and multivariate logistic regression analyses were adopted to identify predictive factors for in-hospital mortality of nosocomial infections in cancer patients. A nomogram was developed to predict the in-hospital mortality of each patient, with receiver operating characteristic curves and calibration curves being generated to assess its predictive ability. Furthermore, decision curve analysis (DCA) was also performed to estimate the clinical utility of the nomogram. Results: A total of 1,008 nosocomial infection episodes were recognized from 14,695 cancer patients. Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (15.5%) was the most predominant causative pathogen. Besides, multidrug-resistant strains were discovered in 25.5% of cases. The multivariate analysis indicated that Eastern Cooperative Oncology Group Performance Status 3–4, mechanical ventilation, septic shock, hypoproteinemia, and length of antimicrobial treatment < 7 days were correlated with higher in-hospital mortality. Patients who received curative surgery were correlated with favorable survival outcomes. Ultimately, a nomogram was constructed to predict the in-hospital mortality of nosocomial infections in cancer patients. The area under the curve values of the nomogram were 0.811 and 0.795 in the training and validation cohorts. The calibration curve showed high consistency between the actual and predicted in-hospital mortality. DCA indicated that the nomogram was of good clinical utility and more credible net clinical benefits in predicting in-hospital mortality. Conclusions: Nosocomial infections stay conjoint in cancer patients, with gram-negative bacteria being the most frequent causative pathogens. We developed and verified a nomogram that could effectively predict the in-hospital death risk of nosocomial infections among these patients. Precise management of high-risk patients, early recognition of septic shock, rapid and adequate antimicrobial treatment, and dynamic monitoring of serum albumin levels may improve the prognosis of these individuals. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence of diabetes-associated autoantibodies in Chinese patients recently diagnosed with adult-onset diabetes and to evaluate the potential role of the autoantibody markers for characterization of disease phenotype in the patient population. Methods: The study included 1273 recent-onset adult patients with phenotypic type 2 diabetes mellitus (T2DM). Serum samples were tested using the 3-Screen ICA™ ELISA (3-Screen) designed for combined measurement of GADAb and/or IA-2Ab and/or ZnT8Ab. 3-Screen positive samples were then tested for individual diabetes-associated and other organ-specific autoantibodies. Clinical characteristics of patients positive and negative in 3-Screen were analysed. Results: Forty-four (3.5%) of the T2DM patients were positive in 3-Screen, and 38 (86%) of these were also positive for at least one of GADAb, IA-2Ab and ZnT8Ab in assays for the individual autoantibodies. 3-Screen positive patients had lower BMI, higher HbA1c, lower fasting insulin levels and lower fasting C-peptide levels compared to 3-Screen negative patients. Analysis using a homeostatic model assessment (HOMA2) indicated that HOMA2-β-cell function was significantly lower for the forty-four 3-Screen positive patients compared to 3-Screen negative patients. Twenty (45%) 3-Screen positive patients were also positive for at least one thyroid autoantibody. Conclusions: The 3-Screen ELISA has been used successfully for the first time in China to detect diabetes autoantibodies in patients with phenotypic T2DM. 3-Screen positive patients presented with poorer β cell function. [ABSTRACT FROM AUTHOR]

Nothotsuga is a monotypic genus of Pinaceae endemic to southern China today. Molecular data indicate that Nothotsuga split from Tsuga during the Palaeogene with the earliest fossils from the upper Eocene of North Europe. However, Nothotsuga fossil has not been reported from China. Here, we describe several well-preserved seed cones from the upper Miocene of Tiantai County, Zhejiang Province, China. The fossil cones are characterised by ovate to elliptic shapes, rhombic to suborbicular and auriculate scales, and exserted subspathulate bracts with dentate margin and acute or acuminate apical cusp. These cones are ascribed to a new species Nothotsuga sinogaia sp. nov. based on detailed comparisons with all extant genera of Pinaceae. The present discovery indicate that Nothotsuga had a more northern distribution during the late Miocene and the increased annual range of monthly-mean temperature might have restricted its modern distribution to several scattered and fragmental areas in southern China. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the prevalence and clinical characteristics of myelinated retinal nerve fibre (MRNF) in a large teleophthalmology system. Methods: All records between January 2015 and December 2015 from Daheng Prust teleophthalmology system were reviewed by 2 ophthalmologists independently. MRNF was classified into continuous group and discontinuous group according to the relationship between MRNF patches and optic disc. The number, total area and location of MRNF patches were analysed. Concomitant ocular diseases were documented. Results: Out of 51469 subjects, MRNF was detected in 304 eyes of 263 subjects with a prevalence rate of 0.51 ± 7.1% per subject and 0.30 ± 5.4% per eye. Among 304 eyes with MRNF, 239 (78.6%) eyes were in continuous group and 65 (21.4%) eyes were in discontinuous group. Single MRNF patch was found in 249 (81.9%) eyes and multiple MRNF patches were found in 55 (18.1%) eyes. MRNF of small size was found in 150 (49.3%) eyes. The ratios of multiple MRNF patches and small-sized MRNF in the continuous group were significantly higher than those in the discontinuous group (P =.014 and P <.001). In continuous group, the MRNF patches were located most frequently in the superior region (68.6%) of the optic disc; In discontinuous group, the MRNF patches were located most frequently in the inferotemporal region (38.5%) of the retina. Epiretinal membrane (12 eyes, 3.9%) was the most common concomitant ocular disease. Conclusion: MRNF is uncommon in China. MRNF usually presents unilaterally and as a single small whitish patch that is connected with optic disc. [ABSTRACT FROM AUTHOR]

Over recent decades, Chinese giant salamanders Andrias spp. have declined dramatically across much of their range. Overexploitation and habitat degradation have been widely cited as the cause of these declines. To investigate the relative contribution of each of these factors in driving the declines, we carried out standardized ecological and questionnaire surveys at 98 sites across the range of giant salamanders in China. We did not find any statistically significant differences between water parameters (temperature, dissolved oxygen, ammonia, nitrite, nitrate, salinity, alkalinity, hardness and flow rate) recorded at sites where giant salamanders were detected by survey teams and/or had been recently seen by local respondents, and sites where they were not detected and/or from which they had recently been extirpated. Additionally, we found direct and indirect evidence that the extraction of giant salamanders from the wild is ongoing, including within protected areas. Our results support the hypothesis that the decline of giant salamanders across China has been primarily driven by overexploitation. Data on water parameters may be informative for the establishment of conservation breeding programmes, an initiative recommended for the conservation of these species. [ABSTRACT FROM AUTHOR]

Introduction: Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years. Methods: The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure and Wanfang Data will be searched from the inception onwards for evidence of the treatment effects. We will include systematic reviews of randomised control trials evaluating the effects and safety of massage therapy in infants and children aged < 5 years. The primary outcomes will be any physical or psychological outcome, and adverse effects on children. Secondary outcomes will include any physical or psychological outcome on caregivers. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. A table will be used to summarise of information of the included studies, which includes the basic information, method and findings. The methodological quality of the included systematic reviews will be assessed by A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR 2). Extracted data from the included studies will be collected and presented using narrative approach. The pooled effect estimates for meta-analysed outcomes will be extracted when possible. If there is a discrepancy in results of two or more reviews on the same topic, then the causes of such discrepancy will be further explored. Discussion: This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention. Findings from this overview will be published in a peer-reviewed journal. Systematic review registration: CRD42020186003. [ABSTRACT FROM AUTHOR]

Public-Private Partnership (PPP) has been adopted extensively in public infrastructures in China. Numerous studies have explored development patterns for future PPP projects success based on either literature review or case studies. This paper aims to probe into the spatiotemporal dynamics of China's PPP and clarify regional differentiation by frequency analysis, coefficient of variation and cluster analysis. The result shows that the implementation rate has a slight increase along with time series although PPP projects gradually return to rational development. The fuzzy set is utilized to handle with ambiguity in some linguistic risk allocation criteria to lower the fuzziness and bias in knowledge expert which is qualitative that handles real time decision making. The municipal sector has been occupied the largest share of PPP projects while state-owned enterprises still dominate the biggest PPP marketed components. Local governments prefer viability gap subsidies although central government encourages user payment. Spatial difference coefficient is so high reflecting obvious regional differentiation of provincial PPP development. Recommendations are ultimately put forward to enhance China's future PPP promotion, which will provide a valuable direction for government to make PPP customized policies. [ABSTRACT FROM AUTHOR]

Determining the dynamics and sustainability of human interactions with threatened species is essential to inform evidence‐based conservation, but data can be challenging to collect across large areas and multiple user groups.Chinese giant salamanders Andrias spp. are critically depleted across China. Wild populations were exploited during the 20th century, and more recently to support a large‐scale farming industry. However, robust data remain largely unavailable on the timing of population declines in relation to changing human pressures, on primary drivers of exploitation, or on the effectiveness of conservation legislation.We conducted a series of large‐scale interview surveys across the range of giant salamanders in China, targeting potential rural and urban user groups, and stakeholders involved with giant salamander exploitation and policy management (comprising 2,932 rural households, 66 salamander farms, 115 county government officials and 835 urban consumers).Giant salamander populations were probably declining from at least the 1980s due to exploitation for food, and negative cultural values associated with these animals have not prevented rural consumption. There has been a major escalation in exploitation following the establishment of a large‐scale giant salamander farming industry in the 2000s. Our results demonstrate wide‐scale and largely unregulated illegal hunting to stock farms at a country‐wide scale in order to support demand by urban consumers for high‐prestige rare meat. We estimate there were at least 42,000 wild‐caught breeding adult giant salamanders and 164,000 wild‐caught subadults in farms across China at the time of our survey.Salamander farming probably poses unsustainable pressure on giant salamander populations. Existing legislation has clearly proved ineffective at preventing the stocking of farms with wild‐caught animals, and our findings highlight an important gap in the effectiveness of China's conservation protection for some of its highest‐priority threatened species. Tackling this problem will likely require multiple coordinated approaches, including enforcement of legislation, increased penalties for removing giant salamanders from the wild, permanent identification of captive‐bred giant salamanders, and consumer‐focused interventions to reduce urban demand. A free Plain Language Summary can be found within the Supporting Information of this article. A free Plain Language Summary can be found within the Supporting Information of this article. [ABSTRACT FROM AUTHOR]

Despite the large number of people with cancer who need hospice care, utilization rates at community hospice service in Shanghai are low. This study aimed to review the care provided in these hospice wards and examine the difficulties in delivering service. Fourteen hospice care providers were interviewed, and the data analyzed using qualitative content analysis. Three themes emerged from the interviews: (i) characteristics of hospice patients, mostly cancer patients at the end‐of‐life stage (within 3‐months of life expectancy) who were admitted without awareness of their condition; (ii) components of care, from physicians and nurses who focused mainly on physical problems as psycho‐spiritual care stagnated at a superficial level; and (iii) difficulties in care, including a lack of patients as well as inadequacies in service, along with suggestions for the future. Efforts at improvement should be made in both the health care system and society. To address the lack of patients, doctors in secondary/tertiary care hospitals need improved skills in discussing end‐of‐life care, while the general public needs better awareness and acceptance of hospice care. Solutions should respect the perspective of patients and their families, while hospice care providers must also enhance their skills of communication and psycho‐spiritual care. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus (DM), a common tuberculosis (TB) comorbidity, is associated with delayed bacillary clearance during anti-TB treatment and unfavorable outcomes. Bedaquiline (BDQ), when used as part of multidrug regimen for multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB), has been shown to be effective and safe although treatment outcome and risks for patients with MDR/XDR-TB and DM are unknown. A multicenter retrospective study was conducted to compared the safety and effectiveness of 24-week BDQ-containing anti-TB treatment for patients with MDR/XDR-TB with and without DM. Methods: The study of patients with MDR/XDR-TB with or without DM (enrolled February 2018–September 2019, 21 Chinese hospitals) was supervised by the New Drug Introduction and Protection Program (NDIP). Of 640 patients with MDR/XDR-TB receiving BDQ-containing anti-TB treatments, two propensity score-matched groups (107 DM/107 non-DM) were compared for cumulative culture conversion rate, time to culture conversion, adverse events, and corrected QT interval. Results: Body mass index was higher in patients with DM than patients without DM (23.29 ± 3.9 vs. 20.5 ± 3.6, P < 0.001); lung cavity prevalence (86.9% vs. 72.9%, P = 0.037) was also higher in patients with DM; the non-DM group had higher hepatitis prevalence (29.0% vs. 15.9%, P = 0.022). No significant intergroup differences were found for sputum culture conversion rate at week 8 (80.0% vs. 81.4%, P = 0.884), at week 24 (95.6% vs. 98.2%, P = 0.629), or for median time to sputum culture conversion [56 days (IQR 28–63) vs. 56 days (IQR 28–84) (P = 0.687)]. Favorable post-24-week treatment outcomes were presented by 90.7% and 93.5% in the DM group and non-DM group, respectively, without significant intergroup differences (P = 0.448). The DM adverse event rate exceeded non-DM rate (77.6% vs. 64.5%, P = 0.035). Conclusion: Despite some differences in baseline characteristics, Chinese patients with MDR/XDR-TB with or without DM had similar sputum culture conversion rates and favorable treatment outcomes post-24-week BDQ-containing anti-TB treatment. Low BMI but not DM is risk factor associated with unfavorable outcome of patients with MDR/XDR-TB. [ABSTRACT FROM AUTHOR]

The Hengduan mountain area, located in the upper reaches of the Yangtze River of China, is an important ecological barrier that significantly impacts the climate and ecological environment of the surrounding region and western China as a whole. This paper introduces the gravity center model used to analyze the spatial-temporal variation patterns of vegetation Net Primary Productivity (NPP) from 2000 to 2015, which were determined by the use of MOD17A3 NPP products. Additionally, the dominant driving factors of the spatial—temporal changes of vegetation NPP of the Hengduan Mountain area were quantitatively determined with a geographical detector over 2000–2015. The results revealed that: (1) From 2000 to 2015, there was an increasing trend of vegetation NPP in the Hengduan mountain area. Throughout the whole study region, the vegetation NPP with a mean value of 611.37 gC·m−2·a−1 indicated a decreasing trend from southeast to northwest in terms of spatial distribution. (2) The gravity centers of vegetation NPP in 2000–2015 were mainly concentrated in Zhongdian County. During the study period, the gravity center of vegetation NPP moved northward, which indicated that the increment and increasing rate of vegetation NPP in the northern parts were greater than that of the southern areas. (3) The vegetation NPP showed a moderately positive correlation with temperature, accumulated temperature (>10°C), and sunshine, while there was an overall negative relationship between NPP and precipitation. (4) The dominant factors and interactive dominant factors changed in different sub-regions over different segments of the study period. The dominant factors of most sub-regions in Hengduan mountain were natural factors, and the climate change factors played an increasingly greater role over the 16 years of the study period. [ABSTRACT FROM AUTHOR]

Tidal flats form around the estuarine and coastal zone by continuous terrigenous sediment transport and deposition processes. Now a large body of published carbon research work frame within the vegetated area (mangrove forests, sea grass bed, and salt marshes). Nonvegetated tidal flats, which are characterized by predominantly silts and clays sediment, were generally impressed with low carbon stock due to their meager primary productivity. However, these regions may be a potentially important carbon sink, given their high burial rate, expanding areal coverage, and detrial organic carbon derived from watershed and adjacent vegetated area. Low carbon densities (<0.01 g cm−3) were found in Chinese tidal flat sediments by the study, but the carbon sequestration rates ranged from 35 to 361 g C m−2 yr−1, which were comparable to rates of worldwide vegetated coastal areas. The high rates can be ascribed to rapid sedimentation rates (1–2 cm yr−1) during the past several decades. The highest areal carbon stocks were located at tidal flat sites proximal to mangrove forests. The majority of carbon stocks (100 cm) was found in the unvegetated tidal flats instead of in the vegetated tidal flats. The former occupied 87% of the entire tidal area, 6.7 times larger than the latter. Tidal flats in coastal China store 78.07 Tg C (100 cm), accounting for nearly 80% of the C deposited in entire coastal tidal area. The future carbon sequestration rates of Chinese tidal flats are facing uncertainties under the pressures of reduced fluvial sediment loads from major rivers. Key Points: Soil organic carbon density is lower in the Chinese unvegetated tidal flats than vegetated coastal area in the worldThe overall carbon sequestration rate of Chinese tidal flats is comparable to rates of global coastal marshesTidal flats account for nearly 80% of the C stored in the Chinese tidal area [ABSTRACT FROM AUTHOR]

Background: With the second largest tuberculosis (TB) burden globally, China is committed to actively engage in international TB clinical trials to contribute to global TB research. However, lack of research capacity among local sites has been identified as a barrier. Main text: The China Tuberculosis Clinical Trials Consortium (CTCTC) was initiated by Beijing Chest Hospital with investment from the US National Institutes of Health and technical support from Family Health International 360 in 2013, as a nationwide collaborative clinical trial network to strengthen selected clinical site research capacity and attract TB clinical trials. The program aims to: 1) recruit leading hospitals that care for TB patients; 2) conduct on-site assessment to identify capacity gaps and needs for improvement; 3) design and deliver capacity building activities; 4) attract and deliver high quality results for TB clinical trials. A total of 24 sites have joined CTCTC, covering 20 provinces in China. Twenty-two sites have been accredited by the National Medical Products Administration (NMPA) to be qualified to conduct TB clinical trials. The onsite assessment, extensive trainings among the CTCTC sites and young investigators have resulted in better understanding and improvement of the site capacity in conducting TB clinical trials. The establishment and growth of the CTCTC network has benefited from the good leadership, effective international cooperation and local commitment. Issues in human resources, regulatory environment and sustainability have been challenging the network from continuing growth. Clinical researchers have full-time clinical responsibilities in China and it is thus important to build a cadre of other human resources to assist. The regulatory environment is becoming friendlier in China to introduce international clinical trials to the CTCTC network. Conclusions: The CTCTC, with mature management structure and sustainable development model, which are distilled five key lessons for other developing countries or investigators of interest. They are the respectively using assessment-based approach to design tailored training package, understanding the availability of clinical researchers, providing solutions to maintain sustainability, understanding local regulatory environments and working with an international organization with local on-site team, respectively. Although, the experiences and capacity of China's TB hospitals in conducting clinical research vary. Considerable efforts to continue building the capacity are still needed, although the gap is smaller for a few top-tier hospitals. [ABSTRACT FROM AUTHOR]

Background: Only a small number of patients have utilized the home-based end-of-life care service in Shanghai that has been offered since 2012. This study explores how home-based end-of-life care is delivered in community health service centers in Shanghai and examines the difficulties in the delivery of the care. Methods: This was a qualitative study in which data were collected from interviews and analyzed using qualitative content analysis. Nineteen health care providers with experience in delivering home-based end-of-life care in 12 community health service centers were recruited. The interviews were conducted between August 2018 and February 2019. Results: Four themes emerged from the interviews: (i) Patients under home-based end-of-life care: Patients receiving the care were cancer patients with less than 1 year of life expectancy. The criteria for patients were broad. (ii) Service structure: The service was delivered regularly by the physicians and nurses using the approaches of home visits and/or telephone follow-ups. (iii) Service process: The service consisted of multiple components, including monitoring the patient's condition, managing the patient's symptoms, giving daily care instructions, performing nursing procedures, and giving psychological support. However, most of the care focused on monitoring the patients and managing their physical discomfort. (iv) Difficulties in delivering care: Being unable to provide the service and feeling powerless when facing psycho-spiritual problems were the two major difficulties. Three factors contributed to the suspension of the service: The gap between the service and the needs of the patients, a lack of patients, and low work motivation. The demand that the truth be concealed from the families and their attitude of avoiding talking about death were the key factors of the failure of psycho-spiritual care. Conclusions: Several issues should be addressed before the service can be further developed, including fully understanding the needs and preferences of local patients and their families, securing more financial support and a better supply of drugs, delivering better training for staff, and ensuring greater rewards for individuals and institutions providing the service. [ABSTRACT FROM AUTHOR]

Background: The Sustainable Development Goals (SDGs), adopted by all United Nations (UN) member states in 2015, established a set of bold and ambitious health-related targets to achieve by 2030. Understanding China's progress toward these targets is critical to improving population health for its 1.4 billion people.Methods and Findings: We used estimates from the Global Burden of Disease (GBD) Study 2016, national surveys and surveillance data from China, and qualitative data. Twenty-eight of the 37 indicators included in the GBD Study 2016 were analyzed. We developed an attainment index of health-related SDGs, a scale of 0-100 based on the values of indicators. The projection model is adjusted based on the one developed by the GBD Study 2016 SDG collaborators. We found that China has achieved several health-related SDG targets, including decreasing neonatal and under-5 mortality rates and the maternal mortality ratios and reducing wasting and stunting for children. However, China may only achieve 12 out of the 28 health-related SDG targets by 2030. The number of target indicators achieved varies among provinces and municipalities. In 2016, among the seven measured health domains, China performed best in child nutrition and maternal and child health and reproductive health, with the attainment index scores of 93.0 and 91.8, respectively, followed by noncommunicable diseases (NCDs) (69.4), road injuries (63.6), infectious diseases (63.0), environmental health (62.9), and universal health coverage (UHC) (54.4). There are daunting challenges to achieve the targets for child overweight, infectious diseases, NCD risk factors, and environmental exposure factors. China will also have a formidable challenge in achieving UHC, particularly in ensuring access to essential healthcare for all and providing adequate financial protection. The attainment index of child nutrition is projected to drop to 80.5 by 2025 because of worsening child overweight. The index of NCD risk factors is projected to drop to 38.8 by 2025. Regional disparities are substantial, with eastern provinces generally performing better than central and western provinces. Sex disparities are clear, with men at higher risk of excess mortality than women. The primary limitations of this study are the limited data availability and quality for several indicators and the adoption of "business-as-usual" projection methods.Conclusion: The study found that China has made good progress in improving population health, but challenges lie ahead. China has substantially improved the health of children and women and will continue to make good progress, although geographic disparities remain a great challenge. Meanwhile, China faced challenges in NCDs, mental health, and some infectious diseases. Poor control of health risk factors and worsening environmental threats have posed difficulties in further health improvement. Meanwhile, an inefficient health system is a barrier to tackling these challenges among such a rapidly aging population. The eastern provinces are predicted to perform better than the central and western provinces, and women are predicted to be more likely than men to achieve these targets by 2030. In order to make good progress, China must take a series of concerted actions, including more investments in public goods and services for health and redressing the intracountry inequities. [ABSTRACT FROM AUTHOR]

Background: As the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear. Aims: To investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects. Methods: 318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight® software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance. Results: We found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip. Conclusions: The reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects. [ABSTRACT FROM AUTHOR]

Holocene vegetation change is a complex process driven by climate and human activity, distinguishing their relative contributions is important to understand and adapt to the changing planet. Southeast China has a long history of human occupation and the evergreen broadleaved forests of the region have been strongly affected by human activity and replaced widely by anthropogenic vegetation in the last millennium. Pines exist both in natural and anthropogenic vegetation, therefore the interrelationship between pine and other species offers a means of differentiating natural from anthropogenic vegetation changes. Both climate and population in southeast China have undergone substantial change during the late Holocene, but the response of vegetation at centennial scale has not been fully resolved. In this study, we present a palynological analysis of a sediment core obtained from a high-elevation wetland on the Huangshan Mountain, which is known for its remarkably steep topography. The core provides evidence of vegetation history since the onset of the Little Ice Age. Results show that Huangshan vegetation shifted from montane mixed forest to upper montane grassland at the beginning of the Little Ice Age and that, although forest recovery thereafter was gradual, the coexistence of forest and grassland has been maintained since 1800 CE. Climate is shown to be the main driver of Huangshan vegetation change over the last six centuries as a whole, although the expansion of pines into broadleaved forests under the pressure of population growth, commonly reported at other sites in southeast China, is also observed in the Huangshan record from 1800 CE onward. Nevertheless, vegetation on the mountain appears to have been less impacted by human activity than in other parts of the region, possibly as result of the unique topography of Huangshan that restricts its accessibility. In conclusion, the study reveals climate still played an important role in driving last-millennium vegetation change. • Population growth over last six centuries created favorable conditions for pines to invade into broadleaved forests. • Climate was the main driver of the 600-year vegetation change at Huangshan. • Topography plays an important role in postponing human impact on vegetation. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) related tumours account for a significant proportion of head and neck squamous cell carcinomas (HNSCCs) in developed countries. They respond better to chemo- and radio-therapy, and have a better stage specific prognosis. To establish their prevalence in China, we assessed a series of histology confirmed HNSCCs collected in Zhejiang and Guangdong provinces by PCR for HPV DNA and by immunohistochemistry for p16 protein status. Among 303 HNSCCs, HPV DNA was detected in 26.4%, with HPV16 DNA in 71% of these. Of HNSCC located in the oropharynx, 38.55% (32/83) were HPV+ve. In this series, p16 status was a relatively poor predictor of HPV status as detected by PCR. The stage specific survival time of HPV+ HNSCCs was significantly longer than for HPV- HNSCC. HPV status should be assessed for oropharyngeal cancers in China to assist with appropriate management, and prophylaxis against HPV infection should be considered to reduce the incidence of this disease. [ABSTRACT FROM AUTHOR]

The presence of carbapenem-producing Klebsiella pneumoniae (CP-Kp) is a serious threat to the control of nosocomial infections. Plasmid-mediated horizontal transfer of the resistance gene makes it difficult to control hospital-acquired CP- Kp infections. Nine CP- Kp strains were isolated during an outbreak in the intensive care unit of Shanghai Huashan hospital in east China. We conducted a retrospective study to identify the origin and route of transmission of this CP-Kp outbreak. Whole-genome sequencing (WGS) analysis was performed on 9 clinical isolates obtained from 8 patients, and the results were compared to clinical and epidemiological records. All isolates were ST11 CP-Kp. Single-nucleotide polymorphisms and the presence and structure of plasmids indicated that this CP-Kp outbreak had different origins. These 9 isolates were partitioned into two clades according to genetic distance. Four plasmids, CP002474.1, CP006799.1, CP018455.1, and CP025459.1, were detected among the 9 isolates. The plasmid phylogeny and antibiotic resistance (AR) gene profile results were consistent with the sequencing results. We found that two clades of CP-Kp were responsible for this nosocomial outbreak and demonstrated the transmission route from two index patients. Plasmid carriage and phylogeny are a useful tool for identifying clades involved in disease transmission. [ABSTRACT FROM AUTHOR]

Five reanalysis datasets—National Centers for Environmental Prediction reanalysis II (NCEP-2), NCEP Climate Forecast System Reanalysis (CFSR), European Centre for Medium-Range Weather Forecasts (ECMWF) Interim Reanalysis (ERA-Interim), Japanese 55-year Reanalysis Project (JRA-55), and National Aeronautics and Space Administration (NASA) Modern Era Reanalysis for Research and Applications Version-2 (MERRA-2)—are selected to estimate meteorological droughts of China using three drought indices—the Palmer Drought Severity Index (PDSI), Standardized Precipitation Index (SPI), and Standardized Precipitation Evapotranspiration Index (SPEI). Drought indices, drought areas and drought severity estimated for China from these reanalysis datasets are assessed against corresponding results obtained from observed climate dataset of China using Nash–Sutcliffe efficiency (NSE), correlation coefficient, and the analysis of time series. Further, temperature, precipitation and potential evapotranspiration data of the five reanalysis datasets are also compared against the observed dataset. Drought indices and drought areas estimated from reanalysis datasets are generally more representative of historical droughts that had occurred in eastern China than in western China. However, the performance of these five reanalysis datasets in representing the drought severity is unsatisfactory in both western China and eastern China. SPEI is generally more representative than PDSI and SPI partly because temperature and potential evapotranspiration data of reanalysis datasets are generally better than precipitation data. PDSI is also based on a supply-and-demand model of soil moisture but estimating the demand of soil moisture is complicated. Therefore, SPEI is preferred over PDSI and SPI as the drought index to characterize the meteorological droughts of China. Climate data and meteorological drought characteristics of eastern China are best represented by JRA-55, while that of western China are best represented by MERRA-2. From 1980 to 2014, statistically significant increasing trends in annual drought areas and drought severity are detected from JRA-55 and observed climate datasets in eastern China, but they are only detected from observed dataset in western China. [ABSTRACT FROM AUTHOR]

Highlights • A couple-based interval-bistochastic programming method is proposed to address the regional water resources allocation under uncertainties. • An appropriate water allocation plan in Zhanghe Irrigation District is developed under uncertainties of reservoir inflow and local rainfall. • The independence hypothetical situation and linear relationship hypothetical situation are also discussed and compared. Abstract In regional water resources allcoation problems, the uncertainties of hydrological variables and socio-economic parameters are bringing huge challenges to water managers. So far, the stochastic programming models have difficulty in addressing uncertain problems, in which there are two correlated random variables. In order to address regional water resources allocation under two hydrological random variables and interval parameters, a couple-based interval-bistochastic programming (CIBSP) method is proposed. The CIBSP method includes several key steps: first, the marginal distributions of the two hydrological variables are analyzed and hydrological scenarios are set; then, the copula is chosen to analyze joint probability distribution of the two hydrological variables and the joint probabilities of scenarios are calculated; last, an interval-bistochastic model is formulated by incorporating two-stage stochastic programming, interval-parameter programming, and bivariate joint distribution. The CIBSP method can describe the probability of occurrence of a hydrological scenario and then make an optimized water allocation scheme under uncertainties. To demonstrate its applicability, the CIBSP method is applied to the Zhanghe Irrigation District located in China, to optimize available water allocation under the uncertainties of the annual inflow volume of the Zhanghe Reservoir and annual rainfall volume in the irrigated district. An appropriate water allocation plan can be obtained by the method, which provides a foundation to water managers for managing water resources in Zhanghe Irrigation District. Moreover, other two hypothetical situations named independence hypothetical situation and linear relationship hypothetical situation are discussed. The difference in the results between the two hypothetical situations and the case study indicates that an appropriate description of the joint probability of the annual inflow volume and annual rainfall volume by using CIBSP method is important for water resource allocation under uncertainties. [ABSTRACT FROM AUTHOR]