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Background: Rapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics. Method: This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal–Wallis H tests, Chi-square or Fisher's exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD. Results: Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472). Conclusion: This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013. [ABSTRACT FROM AUTHOR]

Cryptomeria japonica var. sinensis Miquel in south China is currently overwhelmingly infested by a native caterpillar species, Dendrolimus houi (Lepidoptera), which is causing severe economic losses and ecological disasters in both planted and natural forests. Our results include report of five parasitoid species and eight parasitoid flies within D. houi and a dominant endoparasitoid species Kriechbaumerella dendrolimi, which attacks pupae of D. houi with a high parasitism rate. This result might be helpful to improve better identification and application in the future for potential biological control of D. houi in the forests of east Asia. [ABSTRACT FROM AUTHOR]

With the increase in extremely low birth weight (ELBW) infants, their outcome attracted worldwide attention. However, in China, the related studies are rare. The hospitalized records of ELBW infants discharged from twenty-six neonatal intensive care units in Guangdong Province of China during 2008–2017 were analyzed. A total of 2575 ELBW infants were enrolled and the overall survival rate was 55.11%. From 2008 to 2017, the number of ELBW infants increased rapidly from 91 to 466, and the survival rate improved steadily from 41.76% to 62.02%. Increased survival is closely related to birth weight (BW), regional economic development, and specialized hospital. The incidence of complications was neonatal respiratory distress syndrome (85.2%), oxygen dependency at 28 days (63.7%), retinopathy of prematurity (39.3%), intraventricular hemorrhage (29.4%), necrotizing enterocolitis (12.0%), and periventricular leukomalacia (8.0%). Among the 1156 nonsurvivors, 90.0% of infants died during the neonatal period (≤ 28 days). A total of 768 ELBW infants died after treatment withdrawal, for reasons of economic and/or poor outcome. The number of ELBW infants is increasing in Guangdong Province of China, and the overall survival rate is improving steadily. [ABSTRACT FROM AUTHOR]

Landslides are one of the most widespread natural hazards that cause damage to both property and life every year. Therefore, the landslide susceptibility evaluation is necessary for land hazard assessment and mitigation of landslide-related losses. Selecting an appropriate mapping unit is an essential step for landslide susceptibility evaluation. This study tested the back propagation (BP) neural network technique to develop a landslide susceptibility map in Qingchuan County, Sichuan Province, China. It compared the results of applying six different slope unit scales for landslide susceptibility maps obtained using hydrological analysis. We prepared a dataset comprising 973 historical landslide locations and six conditioning factors (elevation, slope degree, aspect, lithology, distance to fault lines, and distance to drainage network) to construct a geospatial database and divided the data into the training and testing datasets. We based on the BP learning algorithm to generate landslide susceptibility maps using the training dataset. We divided Qingchuan County into six different scales of slope unit: 4,401, 13,146, 39,251, 46,504, 56,570, and 69,013, then calculated the receiver operating characteristic (ROC) curve, and used the area under the curve (AUC) for the quantitative evaluation of 6 different slope unit scales of landslide susceptibility maps using the testing dataset. The verification results indicated that the evaluation generated by 56,570 slope units had the highest accuracy with a ROC curve of 0.9424. Overelaborate and rough division of slope units may not get the best evaluation results, and it is necessary to obtain the slope units most consistent with the actual situation through debugging. The results of this study will be useful for the development of landslide hazard mitigation strategies. [ABSTRACT FROM AUTHOR]

Based on China's monthly data from January 2006 to June 2018, this paper uses the symmetric regressive distributed lag model (ARDL) and nonlinear asymmetric regressive distributed lag model (NARDL) to examine the impact of the real interest rate, products' shortage costs and products' selling prices on China's overall inventory investment, and focuses on the asymmetric impact of the three factors on inventory investment. The empirical results show that the real interest rate has a negative impact on inventory investment, and its inhibition effect is stronger than the pulling effect. The products' shortage costs have the positive effect on inventory investment, and the effect of increasing shortage costs are greater than that of decreasing the shortage costs. The products' selling prices are also positively correlated with inventory investment, but the decline of the products' selling prices has the greater impact than the increase of the products' selling prices. [ABSTRACT FROM AUTHOR]

The continuous development of urbanization has dramatically changed people's living environment and lifestyle, accompanied by the increased prevalence of chronic diseases. However, there is little research on the effect of urbanization on gut microbiome in residents. Here we investigated the relation between living environment and gut microbiota in a homogenous population along an urban-rural gradient in Ningxia China. According to the degree of urbanization, the population is divided into four groups: mountainous rural (MR) represents non-urbanized areas, mountainous urban (MU) and plain rural (PR) represent preliminary urbanization, and plain urban (PU) is a representative of complete urbanization. Studies have found that with the deepening of urbanization, the prevalence of chronic diseases, such as diabetes, dyslipidemia, fatty liver, gallstones, and renal cysts, have gradually increased. The intestinal richness and diversity of the microbial community were significantly reduced in the PR and the PU groups compared with the MR and the MU groups. Based on linear discriminant analysis selection, the significantly enriched genera Faecalibacterium, Prevotella, and Pseudobutyrivibrio in the MR group gradually decreased in the MU, the PR, and the PU groups. Effect size results revealed that both residence and diet had an effect on intestinal microbiota. Our results suggested that the disparate patterns of gut microbiota composition were revealed at different levels of urbanization, providing an opportunity to understand the pathogenesis of chronic diseases and the contribution of the "rural microbiome" in potential protection against the occurrence of chronic diseases. [ABSTRACT FROM AUTHOR]

Elatostema stewardii is an important medicinal plant endemic to China. In this study, the complete chloroplast genome of E. stewardii was sequenced and assembled using next-generation sequencing technology. The complete chloroplast genome length of E. stewardii was 150,263 bp, including two inverted repeats (IRs) of 24,681 bp, which are separated by LSC and SSC of 83,791 bp and 17,110 bp, respectively. A total of 129 genes were included in the genome, consisting 85 protein-coding genes, eight rRNA genes, and 36 tRNA genes, the overall GC content of this genome was 36.3%. There are few studies on the genus Elatostema of Urticaceae, this chloroplast genome sequence will provide useful data for further research on solving the generic and familial relationships in Urticaceae. [ABSTRACT FROM AUTHOR]

Since the end of the Cold War, establishing partnerships has been part and parcel of the grand strategy of great powers. The partners that great powers seek fall under the two categories of security partners and political-economic partners. Statistics show a significant variation in the proportions of great powers' security partners. The authors argue that such variation is mainly determined by two factors, namely, great powers' strategic threats, and their ways of maintaining national security [self-help or security-dependent (on the United States)]. Specifically, both the security-dependent great powers that are under China's strategic threat and the self-help great powers that are under the US's strategic threat have a higher proportion of security partners than the security-dependent great powers that are not under China's strategic threat and the self-help great powers that are under China's strategic threat. These findings will help to refine the current theories of great power politics. [ABSTRACT FROM AUTHOR]

Nominal grid data of geostationary remote sensing satellites are fundamental for generating the subsequent products. It can be obtained by normalized projection models, mainly based on the imaging mode. However, there are only definitions and primary descriptive equations for the normalized geostationary projection (NGP) model in the existing literature, while the corresponding imaging mode and the physical interpretation are missing, thus hindering the understanding of the produced nominal grid dataset as well as the subsequent products based on the grid. This paper first derived the imaging mode for NGP based on the limited literature. In addition, another new imaging mode was introduced and analyzed based on NGP. The corresponding projection model [nonstandard normalized geostationary projection (NNGP)] was proposed, which is entirely consistent with the situation of America’s Geostationary Operational Environmental Satellite-R Series (GOES-R) and Chinese Fengyun-4A (FY-4A). Furthermore, this paper proposed a novel nominal projection model for frame imaging, which is consistent with the imaging mode of China’s Gaofen-4. Finally, extensive experiments were designed to comparatively analyze the three nominal grids and demonstrate a detailed difference. By providing a theoretical basis for nominal grid selection, this research is highly significant for the efficient near-real-time production and further applications of geostationary images, as well as the conversion between different datasets resulting from different nominal grid data. In addition, our models are sufficiently tested during the on-orbit running of FY-4A, the first satellite of China’s second-generation three-axis stabilized geostationary meteorological satellite series. The algorithms provide the technical support for the high-precision image navigation and registration and play a significant role in robustly producing the meteorological data with similar quality to those from GOES-R. [ABSTRACT FROM AUTHOR]

Shengxuening (SXN) tablet is extracted from the excrement of the silkworm and has effects on hematopoiesis. The main components of SXN are chlorophyll derivatives and sodium iron chlorophyllin (SIC). The present study aims to investigate the efficiency and safety of SXN on iron deficiency anemia. This phase IV, multicenter, open-label, randomized clinical trial was conducted in 31 hospitals in China from June 2001 to April 2002. Adults and children were randomly divided into low-dose (L-SXN), medium-dose (M-SXN), and high-dose (H-SXN) groups, respectively. The course of treatment was 1 month. Peripheral hemogram levels and iron status were examined before and after treatment. Adults in all three dose groups demonstrated a significant increase in hemoglobin (HGB) concentration. Children who received SXN treatment in medium and high doses also demonstrated increased HGB concentration. Reticulocyte counts increased at the end of treatment in the M-SXN and H-SXN adult groups and in the M-SXN child group. For both children and adults, SXN in the three dose groups was found to significantly elevate red blood cell level, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The total effective rate in the SXN-treated group reached 84.8%. The incidence of adverse events was 4.07%. The most common side effects were nausea (2.83%), diarrhea (0.74%), and rash (0.25%). SXN was proved to be efficient and safe for adults and children with iron deficiency anemia. [ABSTRACT FROM AUTHOR]

In this paper, the framework macroscopic construction is made for teleological interpretation of self-organizing sports in colleges and universities. By analyzing the purpose of the traditional sports teaching, as well as taking the concept of self-organization as the starting point, this paper constructs the framework of self interpretation. At the same time, based on the theory of dissipative structure, this paper first presents the criteria of several self-organizing systems, such as openness, non-linearity and fluctuation mechanism, and then discusses the relationship between self-organization and other organizations in physical education teaching system relationship. Finally, the paper deals with the theory of self-organization teaching, and explores the motivation and mechanism of self-organization sports teleology in colleges and universities, as well as the mechanism of competition and synergy. It establishes a positive relationship between the new teachers and students based on equality, dialogue, cooperation and exchange metaphor. [ABSTRACT FROM AUTHOR]

The trade-off between plant community structure and function is an important issue during grassland restoration. It is essential to assess changes of structure and function after converting farmland to grassland. Three restoration stages (5, 15, and 30 years) were studied to determine the optimum time when the trade-off between diversity and productivity occurs. The results showed that the vegetation coverage, height, and productivity significantly increased, but the species richness, diversity, and density significantly decreased along the restoration time. Grassland community presented a succession from small individuals and high density to larger individuals and lower density. The community changed from being dominated by grass and forb functional groups to being dominated only by the grass functional group. The dominant grass functional group plays a decisive role on community structure and function (productivity, diversity, and density) during grassland succession. Our results suggest that community structure and function were mainly driven by the dominant grass functional group during the long-term succession. Grassland should be utilized to suppress the leading role of the dominant functional groups in the 20th year for keeping the trade-off of diversity and productivity. We suggest that the restoration grassland should be considered to use appropriately in the 20th year. Our study could provide a key guidance for maintaining the community structure and function trade-off for cropland-converted grassland management in the semi-arid areas. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

After decades of hyper growth, China's economy has slowed significantly in recent years, causing widespread anxiety both within and outside the country. Although economists have not reached a consensus about China's growth potential, it is undeniable that the country has switched gears toward a "new normal" of moderate growth amidst ongoing structural change. To assess China's growth performance and prospects, this study modifies Masahiko Aoki's analytical framework of a unified growth theory into a multi-sector model and applies it to identify the sources of China's per capita income growth in recent decades. The analysis confirms Aoki's early observation that China entered the socalled "Kuznets phase" of development in the 1980s, which then became overlapped by the H-phase, in which human capital-based growth is characterized by high labor productivity growth. This study provides evidence that China's labor productivity growth has been predominantly driven by fixed capital formation. It also reveals that the Kuznets effect (with its labor reallocation effect) has now passed its peak and is fading away. The most alarming finding is that net total factor productivity (TFP) growth in the latest period has slowed to a near halt. This trend is particularly worrisome given that China has exhausted its past demographic dividend and its industrial structure has evolved to the end of industrialization stage. Meanwhile, demographic projections clearly indicate that China has entered what Aoki defined as the development phase of "post demographic transition."Whether China can reverse the downward trend of TFP growth will determine how soon it can achieve the goal of becoming a high-income developed economy. [ABSTRACT FROM AUTHOR]

China's rise as a global economic power in recent decades has been achieved with tremendous environmental costs. Has China been an abnormally heavier polluter in its development path? How has pollution accounted for China's hyper economic growth? This study answers these questions by evaluating the environmental effects of China's growth using a data set of 61 countries over a period of four decades. The analysis is focused on two pollutant emissions: CO2 emissions, which carry global externalities, and particulate emissions, of which the environmental cost is more domestic. A fractional polynomial (FP) regression model is estimated to project emissions levels per worker based on lagged values of per capita GDP and other variables. It reveals that China's CO2 emissions have been higher than the projection for most years with an average margin of over 5.3% while its particulate emissions have exceeded projection by an average margin of more than 7.5%. The excessive emissions levels of both pollutants confirm the severity of China's environmental challenges and indicate great potential for the economy to work for a greener growth pattern. On the other hand, contributions of emissions to multi-factor productivity (MFP) growth are estimated by FP regressions based on a human-capital augmented growth model. The results show opposing trends of CO2 and particulates in their "contributions" to GDP growth, which imply asymmetric incentives to abate the two types of pollution. These findings have important implications for China's environmental policy making. [ABSTRACT FROM AUTHOR]

Objective: To report the cytogenetic and molecular genetic analysis of the first two cases of non-chimerism and chimerism karyotype in Chinese male patients who suffer from azoospermia, which may be caused by pseudo dicentric Y chromosomes. Design: Case study. Setting: Academic reproductive medicine center. Patients: Two male patients with azoospermia, carrying pseudo dicentric Y chromosome. Interventions: Review the records of inquiry, testicular biopsy, pathological examination, semen routine examination, endocrine evaluation, cytogenetic chromosomal analysis, and FISH detection of peripheral blood to evaluate Y chromosome deletion. Main outcome measures: To investigate the possible association among pseudo dicentric Y, chimeric status and azoospermia. Results: Two patients were both diagnosed with azoospermia by a variety of andrology inspections. Further chromosomal analysis and FISH indicated their pseudo dicentric Y chromosome and different chimerism status. PCR confirmed simultaneous deletions of AZFb and AZFc regions in the Y chromosome of both patients. Conclusions: Pseudodicentric Y chromosome affecting the long arm may lead to a male phenotype by duplicating the sex-determining region of Y chromosome (SRY) fragment and chimeric status may further impact patient's hormone levels, which obstruct spermatogenesis. However, the deletion of the azoospermia factor (AZF) is likely the key factor that causes azoospermia. [ABSTRACT FROM AUTHOR]

Factor mobility plays an important role in the convergence of regional income levels. This paper examines the role of labor mobility in China's regional economic development in the context of phases of demographic transition and the existence of institutional barriers. Our findings show that the two most important sources of interregional income disparity are per worker capital stock and technology level. The fact that the richest provincial economies are at the later phase of demographic transition provides a major reason for why those economies have accumulated higher per worker capital stock and achieved higher productivity levels. We also discover that regional per capita income levels have not displayed convergence since the mid 1990s. Two observations explain this phenomenon. One observation is that capital and labor movements have played only a limited role in equalizing their marginal returns across regions despite the fact that labor mobility has substantially strengthened this role since 2000. The other observation is that the impact of demographic changes on income growth has been distinctly uneven between the rich and poor regions. This phenomenon can be attributed to some particular features of China's interregional labor migration. [ABSTRACT FROM AUTHOR]

Using data on China's provincial economies for the period 1978–2005, we decomposed the causes and factors that have contributed to inter-regional per capita income disparity. Variance in capital per employee and variance in capital elasticity are found to be the two main sources of income disparity while the employment–labour force ratio is shown to be an important factor in containing the rise of income disparity. An analysis on inter-regional factor reallocation effects reveals their relatively small and insignificant contributions to overall growth performance. It is also discovered that capital has in most years flowed in the right direction to pursue higher marginal productivity across provincial economies. Inter-provincial labour movement, on the other hand, had not displayed significant equilibrating effects until institutional reforms started to allow freer inter-regional labour mobility in later years. Generally, we conclude that market-oriented factor mobility has played a crucial role in equalizing factor returns as well as enhancing growth efficiency across regions. [ABSTRACT FROM AUTHOR]

Parallel to the rise of the Chinese economy has been the worldwide growth in economic scholarship on China. This paper examines the trends in the literature on the Chinese economy across journals, authors and research fields and, where possible, identifies events contributing to these trends. It is hoped that identification of these trends will provide useful references for researchers, not only in sourcing information but also in considering channels for publication in the field of Chinese economic studies. [ABSTRACT FROM AUTHOR]

Examines the impact of sectoral factor reallocation on productivity growth for the period 1986 to 2000 in China. Reforms of state-owned business enterprises; Differences in productivity growth performance between industrial sectors; Conformity of industrial policy to inter-sector factor mobility.

Feline calicivirus (FCV) is an important pathogen of cats that has two genogroups (GI and GII). To investigate the prevalence and molecular characteristics of FCVs in southwestern China, 162 nasal swab samples were collected from cats in animal shelters and pet hospitals. In total, 38 of the clinical samples (23.46%) were identified as FCV positive using nested RT-PCR. Phylogenetic analyses using 10 capsid protein VP1 sequences revealed that 8 GI and 2 GII strains formed two independent clusters. Additionally, three separated FCVs that were not clustered phylogenetically (two GI and one GII strains) were successfully isolated from clinical samples and their full-length genomes were obtained. Phylogenetic and recombinant analyses of a GI FCV revealed genomic breakpoints in ORF1 and ORF2 regions with evidence for recombinant events between GI sub-genogroups, which is reported in China for the first time. Furthermore, sera obtained from mice immunized independently with the three FCV isolates and a commercial vaccine were used to evaluate the cross-reactivity of neutralizing antibodies. The three separate FCVs were neutralized by each other at a 1:19 to 1:775 titer range, whereas the triple-inactivated vaccine was at a titer of 1:16, which suggested that different genogroup/sub-genogroup FCV strains exhibit significantly different titers of neutralizing antibodies, including the commercial FCV vaccine. Thus, our study revealed the genetic diversity and complex cross-reactivity levels of FCVs in southwestern China, which provides new insights for application in vaccination strategies. [ABSTRACT FROM AUTHOR]

Five years have passed since China's foreign exchange regime entered the era of current account convertibility in 1994. During the turbulent Asian currency crisis, China's foreign exchange management has met tests and challenges. To fight capital flight and defend the stability of the renminbi, the Chinese monetary authorities tightened foreign exchange controls in 1998. In this context, this paper reviews the evolution of China's foreign exchange management regime and reveals the features of the current regime's functional mechanisms. By critically assessing the successes and failures of the system, the paper examines the nature of foreign exchange policy changes in 1998. The paper concludes that, in the near future, Beijing is likely to consolidate the framework of the current foreign exchange regime by ensuring current account convertibility and keeping its grip over cross-border capital flows. [ABSTRACT FROM AUTHOR]

The author criticizes the study "Zombie Firms and the Crowding-Out of Private Investment in China." Topics discussed include the impact of the state-led investment on the Chinese economic efficiency, the extraordinary success achieved by China in economic development, and the implications of the study on the policy agenda of the country.

1-Aminopyrene@ZIF-8 composite was synthesized as the fluorescent probe for picric acid (PA) based on inner filter effect. The probe displayed selective response toward PA within 10 s, and a linear range was obtained from 1 to 150 μM with detection limit of 0.3 μM, which is much lower than the permissible level of PA in drinking water reservoir (0.5 mg L−1/2.2 μM) set by China's State Environmental Protection Administration (GB3838-2002). Most importantly, the probe possessed excellent recyclability and could be recycled for at least six times. It was further applied to the detection of PA in water samples, and satisfactory recoveries were obtained in the range of 96.0–104.0%. Image 1 • 1-Aminopyrene was loaded in zeolitic imidazolate framework-8. • The obtained composite could act as the fluorescent probe for picric acid. • The response of the probe toward picric acid was based on inner filter effect. • The probe was facilely separated thereby exhibited excellent recyclability. • The probe was finally applied to picric acid detection in water samples. [ABSTRACT FROM AUTHOR]

Objective: To investigate dynein, axonemal, heavy chain 1 (DNAH1) gene mutations that may be associated with dysplasia of the sperm fibrous sheath (DFS) and infertility in the Han Chinese population.Design: Dysfunction of DNAH1 is known to cause multiple morphologic abnormalities of the flagella (MMAF), DFS, and infertility. Whole-exome sequencing was performed in DFS subjects and the healthy control subjects.Setting: Not applicable.Patient(s): Twenty-one patients of Han ethnicity with primary infertility and diagnosed with asthenozoospermia and MMAF, but without primary ciliary dyskinesia. Fifty healthy men with normal fertility served as control subjects.Main Outcome Measure(s): Whole-exome sequencing, polymerase chain reaction and sequencing, pedigree analysis, Western blotting, and immunofluorescence assay.Interventions(s): None.Result(s): A total of 17 mutations in the DNAH1 gene were identified in 12 of the 21 patients. These included one homozygous mutation at the splice site and 16 complex heterozygous mutations at the splice sites and exons. These mutations may cause deletion, replacement of amino acids in the peptide, or introduction of a stop codon in the coding sequence according to bioinformatic prediction. Of note, 52430998CCT>C deletion at exon 73, which may result in c.11726_11727del:p.P3909fs, was found in six patients, which suggests that this mutation may be an etiologic factor for MMAF. Although these DNAH1 gene mutations were found in Exome Aggregation Consortium (ExAC) databases, none were found in the Han healthy control subjects. The expression of DNAH1 protein in the sperm of patient P10, with 52409336C>T in exon 45 and 52430998CCT>C in exon 73 mutations, and patient P12, with 52402755A>G in exon 37 and 52428484G>T in exon 67 mutations, was missing or very weak compared with the sperm of healthy control subjects. The peptide phenotypes of 52409336C>T, 52402755A>G, and 52428484G>T were R2356W, nonsense, and E3544X, respectively. The sperm tails were short or coiled in P10 and P12 compared with healthy control subjects. Pedigree analysis supported the notion that the combination of DNAH1 gene mutations 52430998CCT>C and 52409336C>T and 52428484G>T alone were associated with MMAF.Conclusion(s): These DNAH1 gene mutations may be associated with DFS and infertility in the Han population. [ABSTRACT FROM AUTHOR]

Introduction: Preterm birth complications and neonatal asphyxia are the leading causes of neonatal mortality worldwide. Surviving preterm and asphyxiated newborns can develop neurological sequelae; therefore, timely and appropriate neonatal resuscitation is important to decrease neonatal mortality and disability rates. There are very few systematic studies on neonatal resuscitation in China, and its prognosis remains unclear. We established an online registry for neonatal resuscitation in Shenzhen based on Utstein's model and designed a prospective, multicentre, open, observational cohort study to address many of the limitations of existing studies. The aim of this study is to explore the implementation and management, risk factors and outcomes of neonatal resuscitation in Shenzhen., Methods and Analysis: This prospective, multicentre, open, observational cohort study will be conducted between January 2024 and December 2026 and will include >1500 newborns resuscitated at birth by positive pressure ventilation at five hospitals in Shenzhen, located in the south-central coastal area of Guangdong province, China. Maternal and infant information, resuscitation information, hospitalisation information and follow-up information will be collected. Maternal and infant information, resuscitation information and hospitalisation information will be collected from the clinical records of the patients. Follow-up information will include the results of follow-up examinations and outcomes, which will be recorded using the WeChat applet 'Resuscitation Follow-up'. These data will be provided by the neonatal guardians through the applet on their mobile phones. This study will provide a more comprehensive understanding of the implementation and management, risk factors and outcomes of neonatal resuscitation in Shenzhen; the findings will ultimately contribute to the reduction of neonatal mortality and disability rates in Shenzhen., Ethics and Dissemination: Our protocol has been approved by the Medical Ethics Committee of Shenzhen Luohu People's Hospital (2023-LHQRMYY-KYLL-048). We will present the study results at academic conferences and peer-reviewed paediatrics journals., Trial Registration Number: ChiCTR2300077368., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Current human health risk assessments of soil arsenic (As) contamination rarely consider bioaccessibility (IVBA), which may overestimate the health risks of soil As. The IVBA of As (As-IVBA) may differ among various soil types. This investigation of As-IVBA focused As from geological origin in a typical subtropical soil, lateritic red soil, and its risk control values. The study used the SBRC gastric phase in vitro digestion method and As speciation sequential extraction based upon phosphorus speciation extraction method. Two construction land sites (CH and HD sites) in the Pearl River Delta region were surveyed. The results revealed a high content of residual As (including scorodite, mansfieldite, orpiment, realgar, and aluminum arsenite) in the lateritic red soils at both sites (CH: 84.9%, HD: 91.7%). The content of adsorbed aluminum arsenate (CH: 3.24%, HD: 0.228%), adsorbed ferrum arsenate (CH: 8.55%, HD: 5.01%), and calcium arsenate (CH: 7.33%, HD: 3.01%) were found to be low. The bioaccessible As content was significantly positively correlated with the As content in adsorbed aluminum arsenate, adsorbed ferrum arsenate, and calcium arsenate. A small portion of these sequential extractable As speciation could be absorbed by the human body (CH: 14.9%, HD: 3.16%), posing a certain health risk. Adsorbed aluminum arsenate had the highest IVBA, followed by calcium arsenate, and adsorbed ferrum arsenate had the lowest IVBA. The aforementioned speciation characteristics of As from geological origin in lateritic red soil contributed to its lower IVBA compared to other soils. The oxidation state of As did not significantly affect As-IVBA. Based on As-IVBA, the carcinogenic and non-carcinogenic risks of soil As in the CH and HD sites decreased greatly in human health risk assessment. The results suggest that As-IVBA in lateritic red soil should be considered when assessing human health risks on construction land., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The classification and phylogenetic relationships within the Phaseoleae tribe (Leguminosae) have consistently posed challenges to botanists. This study addresses these taxonomic intricacies, with a specific focus on the Glycininae subtribe, by conducting a comprehensive analysis of the highly conserved plastome in Amphicarpaea edgeworthii Benth., a critical species within this subtribe. Through meticulous genomic sequencing, we identified a plastome size of 148,650 bp, composed of 128 genes, including 84 protein-coding genes, 36 tRNA genes, and 8 rRNA genes. Comparative genomic analysis across seven Glycininae species illuminated a universally conserved circular and quadripartite structure, with nine genes exhibiting notable nucleotide diversity, signifying a remarkable genomic variability. Phylogenetic reconstruction of 35 Phaseoleae species underscores the affinity of Amphicarpaea with Glycine , placing Apios as a sister lineage to all other Phaseoleae species, excluding Clitorinae and Diocleinae subtribes. Intriguingly, Apios , Butea , Erythrina , and Spatholobus , traditionally clumped together in the Erythrininae subtribe, display paraphyletic divergence, thereby contesting their taxonomic coherence. The pronounced structural differences in the quadripartite boundary genes among taxa with unresolved subtribal affiliations demand a reevaluation of Erythrininae's taxonomic classification, potentially refining the phylogenetic contours of the tribe.

Introduction: Fungemia in preterm infants results in high mortality and morbidity. The genotypes, drug susceptibilities of Candida pelliculosa strains, and clinical features of two outbreaks of neonatal candidemia caused by C. pelliculosa were analyzed, in order to provide evidence for the outbreaks and characteristics of C. pelliculosa neonatal candidemia., Methodology: The strains were genotyped by pulsed-field gel electrophoresis to investigate their genetic relatedness. The broth microdilution method was used to determine in vitro susceptibility of the isolates to antifungal drugs. Clinical features of the infected patients were collected to analyze the risks for C. pelliculosa infection., Results: Fourteen neonates, hospitalized in the neonatal intensive care unit from November 2012 to October 2013, were infected by C. pelliculosa. All 14 patients were cured after treatment with fluconazole and discharged without any complications. The C. pelliculosa isolates from the 14 patients were clustered into two groups, indicating that the outbreaks were caused by two types of strains. Eight of nine strains isolated from the 2013 outbreak were clustered into the same group, while one isolate was grouped together with five isolates from the 2012 outbreak. In vitro experiments demonstrated high antifungal activity of fluconazole, voriconazole, amphotericin B, and 5-fluorocytosine to C. pelliculosa. The common symptoms of C. pelliculosa candidaemia were fever, cyanosis, polypnea, hypoactivity, and apnea., Conclusions: The current study revealed high in vitro susceptibility of C. pelliculosa to antifungals. As C. pelliculosa candidaemia cannot be characterized by clinical symptoms and routine blood testing alone, monitoring unusual strains isolated from immunodeficient hosts is very important to prevent possible outbreaks., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2021 Yulan Yang, Weiyuan Wu, Lu Ding, Lin Yang, Jinzhen Su, Benqing Wu.)

Background: The incidence of patient dissatisfaction due to anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA) remains a concern. However, it has been shown that improvements in the femoral component of traditional prostheses could reduce these instances of pain in the case of TKA performed with patellar resurfacing. This study aims to investigate whether TKA without patellar resurfacing can also benefit from the aforementioned femoral component modification in reducing AKP and patellar crepitus post-TKA., Methods: Sixty-two patients (85 knees) who underwent TKA using the modern prosthesis and 62 age- and sex-matched patients (90 knees) fitted with the traditional prosthesis were enrolled in this study. The occurrence of AKP and patellar crepitus as well as the Knee Society Score (KSS) were consequently recorded, and the data was analyzed in order to determine whether there was a statistically significant difference between the two groups., Results: The incidence of AKP was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (4.7% vs. 13.3% [p = 0.048] and 3.5% vs. 13.3% [p = 0.021], respectively). In addition, the incidence of patellar crepitus was also significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (15.3% vs. 34.4% [p = 0.004] and 10.6% vs. 28.9% [p = 0.002], respectively). There was no significant difference in the KSS between the two groups., Conclusions: These results revealed that TKA without patellar resurfacing will indeed benefit from the modified femoral implant design in reducing AKP and patellar crepitus, a finding that may be beneficial to surgeons who select implants for their patients when patellar resurfacing is not planned or not possible due to other reasons.

Background: An increasing number of extremely preterm (EP) infants have survived worldwide. However, few data have been reported from China. This study was designed to investigate the short-term outcomes of EP infants at discharge in Guangdong province., Methods: A total of 2051 EP infants discharged from 26 neonatal intensive care units during 2008-2017 were enrolled. The data from 2008 to 2012 were collected retrospectively, and from 2013 to 2017 were collected prospectively. Their hospitalization records were reviewed., Results: During 2008-2017, the mean gestational age (GA) was 26.68 ± 1.00 weeks and the mean birth weight (BW) was 935 ± 179 g. The overall survival rate at discharge was 52.5%. There were 321 infants (15.7%) died despite active treatment, and 654 infants (31.9%) died after medical care withdrawal. The survival rates increased with advancing GA and BW (p < 0.001). The annual survival rate improved from 36.2% in 2008 to 59.3% in 2017 (p < 0.001). EP infants discharged from hospitals in Guangzhou and Shenzhen cities had a higher survival rate than in others (p < 0.001). The survival rate of EP infants discharged from general hospitals was lower than in specialist hospitals (p < 0.001). The major complications were neonatal respiratory distress syndrome, 88.0% (1804 of 2051), bronchopulmonary dysplasia, 32.3% (374 of 1158), retinopathy of prematurity (any grade), 45.1% (504 of 1117), necrotizing enterocolitis (any stage), 10.1% (160 of 1588), intraventricular hemorrhages (any grade), 37.4% (535 of 1431), and blood culture-positive nosocomial sepsis, 15.7% (250 of 1588). The multivariate logistic regression analysis indicated that improved survival of EP infants was associated with discharged from specialist hospitals, hospitals located in high-level economic development region, increasing gestational age, increasing birth weight, antenatal steroids use and a history of premature rupture of membranes. However, twins or multiple births, Apgar ≤7 at 5 min, cervical incompetence, and decision to withdraw care were associated with decreased survival., Conclusions: Our study revealed the short-term outcomes of EP infants at discharge in China. The overall survival rate was lower than the developed countries, and medical care withdrawal was a serious problem. Nonetheless, improvements in care and outcomes have been made annually.

Objective: To understand the current distribution of Oncomelania snails in Sichuan Province, so as to provide scientific evidence for formulating the schistosomiasis elimination strategy and implementing the precision schistosomiasis control measures in the province., Methods: According to the National Scheme on Oncomelania hupensis Snails in China and the Scheme on Oncomelania hupensis Snails in Sichuan Province , snail surveys were performed in current snail habitats, historical snail habitats and suspected snail habitats using systematic sampling in Sichuan Province from 2016 to 2017, and the survey results were analyzed., Results: From 2016 to 2017, a total of 88 346 settings were surveyed in schistosomiasis-endemic areas of Sichuan Province, and 19 314 settings were detected with snails, covering an area of 4 829.25 hm 2 , with no Schistosoma japonicum infection identified in snails. A total of 3 017 915 frames were investigated in Sichuan Province, and 1 041 417 frames were found to have living snails, with totally 1 791 115 living snails captured. The mean density of living snails was 0.59 snails/0.1 m 2 , and the mean percentage of frames with living snails was 34.51% in Sichuan Province. The current snail habitats were mainly distributed in 1 704 villages, 377 townships, 54 counties (districts) of 9 cities (prefectures) across the schistosomiasis-endemic areas of Sichuan Province. Snail habitats were mainly found in ditches (70.22%), and weeds were the predominant vegetation in snail habitats (66.45%). Snails were firstly discovered in Sichuan Province in 1913, and S. japonicum -infected snails were firstly identified in 1956, with the latest identification of S. japonicum -infected snails in 2008., Conclusions: There are many settings suitable for snail breeding in Sichuan Province, and snail monitoring and control should be intensified in the future.

Objective: To explore the integrated schistosomiasis control model in mountainous and hilly endemic regions, so as to provide insights into the development of the schistosomiasis elimination strategy., Methods: Five hilly and mountainous areas endemic for schistosomiasis were selected as the integrated control demonstration areas in Sichuan Province from 2011 to 2015. According to the epidemic characteristics, economic levels and overall development planning of the demonstration areas, the goals, strategies and measures were developed, and the effectiveness of schistosomiasis control was evaluated following implementation of the integrated control., Results: The support system of the integrated schistosomiasis control model was built in the integrated control demonstration areas in Sichuan Province from 2011 to 2015, and five ecological, industrialized and sustainable development models of integrated schistosomiasis control were developed, including integration of balancing rural and urban development, systematic ecological improvement, intensified ecological agriculture, scientific management and health education of schistosomiasis control and ecological ethnic circular economy. Since the implementation of the integrated schistosomiasis control model, the snail habitats were completely changed. Until 2015, 92.0% of all historical areas with snails were managed, the coverage of safe drinking water was 100.0%, and more than 95.0% of the livestock were fenced. The coverage of sanitary toilets increased by 93.0%, 96.8%, 78.8%, 87.1% and 82.0% from 2011 to 2015, respectively, and the farmers'mean yearly income increased by 32.7% in the demonstration areas. From 2011 to 2015, the seroprevalence of human Schistosoma japonicum infections reduced from 3.1% in 2011 to 1.6% in 2015 in the demonstration areas, and no egg-positives were identified. In addition, the number of fenced bovines reduced year by year, and no egg-positives were detected. The areas of snail habitats were 398.7, 108.2 hm 2 and 52.9 hm 2 in the demonstration areas from 2011 to 2013, with no infected snails found, and no snails were detected since 2014. The awareness of schistosomiasis control knowledge and percentage of correct behavior formation increased year by year among residents in the demonstration areas from 2011 to 2015., Conclusions: The five integrated schistosomiasis control models meet the needs of the current schistosomiasis control activities in mountainous and hilly endemic areas of Sichuan Province, and achieve the goals of controlling the sources of S. japonicum infections, economic development, social progress and improving the ecological environment, which provides new insights into schistosomiasis elimination in the country.

Transmission control and interruption of schistosomiasis has been gradually achieved in the mountainous and hilly endemic areas with the implementation of the schistosomiasis control programmes, which are moving towards the progress of schistosomiasis elimination. As an important measure of schistosomiasis control, health education is experiencing new challenges and problems in the new situation, and conventional health education of schistosomiasis control has already failed to meet the needs of socioeconomic and cultural development and the increasing changes of human production and life styles in the endemic areas. Therefore, a precision health education model for schistosomiasis control is of great need to be established to highly effectively promote the implementation of schistosomiasis control measures. This review summarizes the important role of health education in schistosomiasis control in mountainous and hilly endemic areas, and describes the new health education model based on optimization of the policy environment and creation of the community atmosphere according to the changes in the endemic situation of schistosomiasis and requirements of the schistosomiasis control target, so as to promote the precision and sustainable implementation of health education and health promotion in schistosomiasis control.

Competing Interests: Competing interests: None declared.

Objective: We conducted a case-control study to investigate the associations of functional single-nucleotide polymorphisms in the purinergic P2X7 receptor (P2X7R) gene (rs2393799, rs7958311, rs1718119, rs2230911, and rs3751143) with obesity and overweight in a population of Chinese postmenopausal women., Methods: Our study included 180 obese women, 179 overweight women, and 204 controls. All participants were genotyped at the P2X7R rs2393799, rs7958311, rs1718119, rs2230911, and rs3751143 loci via allele-specific polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism procedures. The relationships between P2X7R genetic polymorphisms and their associated haplotypes with obesity (body mass index [BMI] ≥30 kg/m] and overweight (25 kg/m ≤ BMI < 30 kg/m) were evaluated., Results: Our results showed that P2X7R rs2230911G and rs1718119A were associated with an increased risk of obesity; in particular, both carriers of the rs2230911G allele and GG/(CG + GG) genotypes (G vs C, P < 0.001, odds ratio [OR] 2.87, 95% confidence interval [CI] 1.98-4.16; GG vs CC, P < 0.001, OR 8.76, 95% CI 3.29-23.35; CG + GG vs CC, P < 0.001, OR 2.54, 95% CI 1.63-3.95) and carriers of the rs17181191A allele and GA/(GA + AA) genotypes (A vs G, P < 0.001, OR 2.97, 95% CI 1.86-4.74; GA vs GG, P = 0.001, OR 2.72, 95% CI 1.55-4.79; GA + AA vs GG, P < 0.001, OR 3.05, 95% CI 1.79-5.19) were at a higher risk of obesity. No association with obesity or overweight was observed for the other three P2X7R polymorphisms (rs2393799, rs7958311, and rs3751143). Haplotype analysis indicated that P2X7R rs1718119A-rs2230911G-rs3751143C appeared to be a significant risk haplotype with obesity (P = 0.0005, OR 2.37, 95% CI 1.45-3.90)., Conclusions: P2X7R functional genetic polymorphisms and their estimated haplotypes are associated with obesity in Chinese postmenopausal women.

Context: Acute or chronic exposure of N,N-dimethylacetamide (DMAc) is responsible for abnormal liver function. It appears that DMAc is mainly metabolized by cytochrome P450 in the liver and thereby produces reactive oxygen species (ROS). The elimination of ROS and the repairing of ROS-induced DNA damage are relevant to the ultimate toxicity of DMAc., Objective: To investigate whether the polymorphisms in the CAT (rs564250, rs769214 and rs7943316), hOGG1 (rs2072668 and rs159153) and XRCC1 (rs25487 and rs1799782) genes are associated with susceptibility to DMAc-induced abnormal liver function in Chinese population., Methods: Samples were obtained from 108 workers with DMAc-induced abnormal liver function and 108 workers with normal liver function., Results: Subjects with the CAT rs769214 GA/GG genotypes had a reducing risk of abnormal liver function, which was more evident in the subgroups exposed to DMAc <10 years, exposed to DMAc <5 mg/m 3 , never smoked and never drank., Conclusions: CAT rs769214 (-844 G > A) polymorphism may be associated with DMAc-induced abnormal liver function in Chinese population.

Background: Lung cancer has been a major health problem in developed countries for several decades, and has emerged recently as the leading cause of cancer death in many developing countries. The incidence of lung cancer appears to be increasing more rapidly in rural than in urban areas of China. This paper presents the trends of lung cancer incidence and survival derived from a 40-year population-based cancer monitoring program in a rural area, Qidong, China., Materials and Methods: The Qidong cancer registration data of 1972- 2011 were used to calculate the crude rate, age-standardized rate by Chinese population (CASR) and by world population (WASR), birth cohort rates, and other descriptive features. Active and passive methods were used to construct the data set, with a deadline of the latest follow-up of April 30, 2012., Results: The total number of lung cancer cases was 15,340, accounting for 16.5% of all sites combined. The crude incidence rate, CASR and WASR of this cancer were 34.1, 15.7 and 25.4 per 100,000, respectively. Males had higher crude rates than females (49.7 vs 19.0). Rapidly increasing trends were found in annual percent change resulting in lung cancer being a number one cancer site after year 2010 in Qidong. Birth cohort analysis showed incidence rates have increased for all age groups over 24 years old. The 5 year observed survival rates were 3.55% in 1973-1977, 3.92 in 1983-1987, 3.69% in 1993-1997, and 6.32% in 2003-2007. Males experienced poorer survival than did females., Conclusions: Lung cancer has become a major cancer-related health problem in this rural area. The rapid increases in incidence likely result from an increased cigarette smoking rate and evolving environmental risk factors. Lung cancer survival, while showing some improvement in prognosis, still remains well below that observed in the developed areas of the world.

Background: Based on data from the population-based Qidong Cancer Registry, we report a survival analysis for female breast cancer patients diagnosed during 1972-2011 in order to assess the long-term trends for the prognosis of this cancer., Methods: The last follow-up for survival status of the 3,398 registered female breast cancer cases was April, 2012. Cumulative observed survival (OS) and relative survival (RS) rates were calculated using Hakulinen's method performed by the SURV3.01 Software developed at the Finnish Cancer Registry., Results: The one-, three-, five-, ten-, fifteen-, twenty-, thirty-, and forty- year OS rates were 83.61%, 67.53%, 58.75%, 48.56%, 42.57%, 38.30%, 29.19%, 19.35%; and the RS rates were 84.76%, 70.45%, 63.12%, 56.81%, 55.26%, 56.36%, 62.59%, 84.00%, respectively. Five-year RS rates of age groups 15-34, 35-44, 45-54, 55-64, 65-74, and 75+ were 60.17%, 68.27%, 67.79%, 56.03%, 55.50%, and 57.28%; 10-year RS rates were 54.16%, 59.59%, 61.34%, 47.78%, 51.30%, and 59.28%, respectively. There were statistical differences among the age groups (RS: χ2 = 152.15, P = 0.000). Remarkable improvement could be seen for the 5-year RS rates from 52.08% in 1972 to 69.26% in 2003-2007, and the 10-year RS rates from 43.16% in 1972 to 60.85% in 1998-2002, respectively., Conclusions: Survival outcomes from Qidong registered cases with breast cancer have shown gradual progress during the past 40 years. The disparities between survival rates of this area and developed countries are getting narrower, but there is still great need for improving survival in Qidong.

Objective: To study the trend of mortality changes on lung cancer during the period 1972 to 2011 in Qidong., Methods: Cancer registration data from 1972 - 2011 in Qidong was used to analyze the following information as: crude mortality rate (CR) of lung cancer, the age-standardized rates by China population (CASR) and the World population (WASR), the truncated mortality rate of 35 - 64, the accumulative rate of age from 0 to 74 years old, the accumulative risk, and the total percentage over all sites of cancers. The changes on the trend of mortality by gender, age and period were analyzed., Results: The CR of lung cancer was 31.15 per 100 000 (males: 45.68, females: 16.95). While CASR and WASR were 14.04, and 22.95 per 100 000, respectively. The truncated rate was 31.82 per 100 000. Accumulative rate, accumulative risk, and total percentage were 2.93%, 2.89%, and 20.50% respectively. The mortality rate of lung cancer in males was significantly higher than that in females, with a sex ratio of 2.69:1. CRs increased remarkably with age among those 30-year-olds, with P value being 0.000. When compared with 9 periods of 1972, 1973 - 1977, 1978 - 1982, 1983 - 1987, 1988 - 1992, 1993 - 1997, 1998 - 2002, 2003 - 2007, and 2008 - 2011, the CRs, CASRs and WASRs increased 6.78-folds, 1.60-folds and 1.92-folds, respectively, with the average annual percentage changes (APC) as 4.78%, 1.86% and 2.04%, respectively., Conclusion: The mortality rate of lung cancer among residents during the last four decades in Qidong had been increasing remarkably, suggesting that special attention on lung cancer trend should be highly paid.

Objective: To describe and analyze the charecteristics and trends of liver cancer mortality during the past fifty years in Qidong, China., Methods: Retrospective mortality survey was conducted to get the data on liver cancer death in the period of 1958-1971, and the data from 1972 to 2007 were obtained from the records of cancer registration in Qidong. The crude mortality rate (CR) of liver cancer, and age-standardized rate by Chinese population (CASR) and by world population (WASR) were calculated and analyzed. The total percent changes (PC) and annual percent changes (APC) were used for evaluating the increasing trends of the mortality. The sex-specific rate, age-specific rate, truncated rate of the age group 35 - 64, cumulative rate of the age group 0-74, cumulative risk, period-rate, and the rate for age-birth cohort were compared., Results: The natural death rate in Qidong residents for the past five-decade period experienced a wave interval of 8.62‰ in 1958 down to 5.37‰ in 1979, and up to 7.75‰ in 2007. The mortality rate for all-site cancers was increased from 56.69 per 100, 000 to 234.97 per 100, 000. The mortality rate of liver cancer, being 20.45 per 100, 100 in 1958 was increased to 49.04 per 100, 000 in 1972, and up to 69.29 per 100, 000 in 2007. According to the registration data of 1972 - 2007, the death from liver cancer was accounted for 34.88% of all deaths due to cancers, with a CR of 58.86 per 100, 000, CASR of 38.36 per 100, 000, and WASR, 49.37 Per 100, 000 in Qidong. The truncated rate for the age group 35 - 64 was 117.08 per 100, 000, and the cumulative rate for the age group 0-74 and the cumulative risk were 5.15% and 5.02%, respectively. The CRs for males was 90.52 per 100, 000 and for females was 27.93 per 100, 000, with a sex ratio of 3.24:1. For the period of 1972 - 2007, the PC for CR was 49.71%, and APC was +1.41%, showing an increasing variation tendency. The APCs for CASR and WASR, however, were decreasing, with a percentage of -1.11%, and -0.84%, respectively. The age-specific mortality rates by period showed a decreasing trend for those under age of 44. Moreover, age-birth cohort analysis showed a more rapid lowering mortality in the age groups 35-, 30-, 25-, and 15-, that is, those born after 1950's., Conclusions: Liver cancer remains the leading death cause due to cancers in Qidong, with a continuing higher crude mortality rate. Yet the age-standardized mortality rate has presented a declining posture. The liver cancer mortality in young people in Qidong demonstrates a continuously falling trend. The campaign for the control of liver cancer in Qidong has achieved initial success.

The sustained transmission and spread of environmentally mediated infectious diseases is governed in part by the dispersal of parasites, disease vectors and intermediate hosts between sites of transmission. Functional geospatial models can be used to quantify and predict the degree to which environmental features facilitate or limit connectivity between target populations, yet typical models are limited in their geographical and analytical approach, providing simplistic, global measures of connectivity and lacking methods to assess the epidemiological implications of fine-scale heterogeneous landscapes. Here, functional spatial models are applied to problems of surveillance and control of the parasitic blood fluke Schistosoma japonicum and its intermediate snail host Oncomelania haupensis in western China. We advance functional connectivity methods by providing an analytical framework to (i) identify nodes of transmission where the degree of connectedness to other villages, and thus the potential for disease spread, is higher than is estimated using Euclidean distance alone and (ii) (re)organize transmission sites into disease surveillance units based on second-order relationships among nodes using non-Euclidean distance measures, termed effective geographical distance (EGD). Functional environmental models are parametrized using ecological information on the target organisms, and pair-wise distributions of inter-node EGD are estimated. A Monte Carlo rank product analysis is presented to identify nearby nodes under alternative distance models. Nodes are then iteratively embedded into EGD space and clustered using a k-means algorithm to group villages into ecologically meaningful surveillance groups. A consensus clustering approach is taken to derive the most stable cluster structure. The results indicate that novel relationships between nodes are revealed when non-Euclidean, ecologically determined distance measures are used to quantify connectivity in heterogeneous landscapes. These connections are not evident when analysing nodes in Euclidean space, and thus surveillance and control activities planned using Euclidean distance measures may be suboptimal. The methods developed here provide a quantitative framework for assessing the effectiveness of ecologically grounded surveillance systems and of control and prevention strategies for environmentally mediated diseases.