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Moving away from an individual and pathological framework and instead drawing on a social-relational model of disability, this article examines the experiences of mothers with autistic children in navigating between caregiving and working life in China. Conducting narrative analysis of 14 in-depth interviews with mothers of autistic children, we argue that their decisions to make adjustments to work are situated in social and relational dynamics of disabled and gendered cultural ideologies, inaccessibility to healthcare, education, and social services, as well as filial familial relationship. As a result, they have to adjust their careers and personal life, such as resigning from previous work and becoming full-time mothers. Although these women constantly experienced a strong sense of loss in terms of their personal and social identity, some developed new perspectives seeing disability, normality, and the meaning of 'good mother' in the process of negotiating their work life and motherhood role. Points of Interests: Mothers of autistic children in China experience social and relational barriers in caregiving and working life. Mothers adjust to their careers and personal life by quitting their previous jobs and becoming full-time mothers, changing positions, or switching to part-time employment. The unavailability of healthcare and social service, as well as the discrimination of the education system against children with autism, significantly affect their mothers' work and family life. Autistic children encounter exclusion in the filial family in China. Grandparents and fathers of autistic children often refuse to participate in childcare arrangements. As a result, mothers had to bear the care responsibility alone. Some mothers described their personal journey of 'walking out'. They rejected the idea that autism is a form of abnormality needed to be cured. They also organized to advocate for social inclusion and policy changes. [ABSTRACT FROM AUTHOR]

Introduction: Due to the widespread use of social media by young adults, the alcohol industry has been increasingly using social media marketing (SMM) to target potential customers. This study examines the prevalence and factors associated with past‐month exposure to alcohol SMM among young Chinese adults, a group with rapidly increasing uptake of alcohol consumption. Methods: An anonymous, random telephone survey was conducted between June and August 2021 on Hong Kong Chinese residents between 18 and 34 years old (n = 675). Results: Of respondents, 52.3% reported past‐month exposure to alcohol SMM (68.6% of past‐month drinkers and 48.0% of non‐past‐month drinkers, p < 0.05) while 71.6% reported exposure to non‐SMM alcohol marketing. Direct alcohol SMM exposure was reported by 40.9% (e.g., business‐to‐consumer postings, alcohol banner ads) while 27.4% of respondents reported exposure to indirect alcohol SMM marketing (e.g., shared/'liked' alcohol brand posts). Of those exposed to alcohol SMM, 13.7–15.5% reported that the various forms indirect alcohol SMM influenced them to drink more (vs. 6.2–8.9% for direct alcohol SMM). Being male, lower‐income, university educated and spirits/cocktail drinker were independently associated with exposure to direct alcohol SMM (ORmv 1.71–3.14). Past‐month exposure to indirect alcohol SMM was independently associated with lower income, not working full‐time and drinking any type of alcohol (ORmv 1.59–4.44). Discussion and Conclusion: The comparative effectiveness of indirect SMM on influencing young adults drinking intentions may be a form of peer endorsement of drinking. The pervasiveness of alcohol SMM and lack of alcohol SMM policies may indicate the need for greater alcohol marketing regulation in this region. [ABSTRACT FROM AUTHOR]

Engineering construction (such as water conservancy project, road engineering, and so on) in mountain areas bring mass of waste soil and rock fragment, whose stability is critical to the ecological environment and the safe operation of engineering facilities. The biggest waste dump of the Pumped Storage Power Station Project in Hunyuan County, Shanxi Province, China, with a volume of 7 million m³ and a maximum height of 240 m, is to be located at the origin of Mahua Valley. To assess the potential risk of the waste dump, reconnaissance, geomorphological analysis was undertaken to provide basic data. The potential failure area and volume was determined utilizing Flac3D depending on strength reduction method. The kinematic process and the potential hazards after failure was presented by Particle flow code. The results showed that the factor of safety of the waste dump under heavy precipitation was 1.15, less than the stability requirement of slope in hydropower station, and the potential failure volume was about 4.8 million m³. The scenario-based debris mass run-out paths indicated that, considering the worst cases scenario, the ground ventilation platform and ventilation tunnel exit on the right bank of the gully might be destroyed rapidly by landslide debris. Besides, the debris flow would accumulate at the gully mouth, and even run into the lower reservoir. Thus, more attention should be taken to increase the stability of the waste dump. These results are useful information for decision support and future hazard assessment of such engineering project. [ABSTRACT FROM AUTHOR]

Due to advancements in information technology and growing eco-tourism demand, National Park Network Attention (NPNA) has emerged as a novel indicator of tourism appeal and ecological value recognition. Utilizing Baidu search index (accessed in 2023) data from 2013 to 2022, this study employs time series analysis, index analysis, and spatial statistics to measure and differentiate the spatial and temporal aspects of NPNA across 31 provinces, regions, and municipalities in mainland China, while systematically assessing the impact of various factors from both source and destination perspectives. Over the period of 2013 to 2022, NPNA has increased annually, peaking around holidays and during spring and autumn, demonstrating pronounced seasonality and precursor effects, while exhibiting volatility due to external events. Influenced by factors from both source and destination perspectives, the spatial distribution of NPNA displays a trend of being "high in the east and low in the west" and "high in the south and low in the north", though regional disparities are diminishing. The population size in the source areas remains the dominant factor influencing NPNA, while the concept of national parks is not yet widely recognized. The destination's tourism resource endowment, media publicity, accessibility, and level of informatization are significant influences. An effective integration of resources and marketing is essential for boosting NPNA. The findings provide valuable insights for optimizing the spatial layout of national parks, enhancing the tourism service system, innovating communication and promotional strategies, and improving national park governance effectiveness. [ABSTRACT FROM AUTHOR]

Background. In patients with stage III melanoma carrying BRAF mutations, the risk of melanoma recurrence is relatively high even after complete resection of the primary melanoma and regional lymph nodes. Methods. We collected data from patients with stage III cutaneous and acral melanoma who received adjuvant trametinib combined with dabrafenib from three cancer centres in China between August 2019 and December 2022. Results. A total of 55 patients were included in this study. The one-year recurrence-free survival (RFS) rate was 79.8% (95% CI 73.6–86.0%). The one-year RFS rate was 79.8% (95% CI 72.8–86.8%) in the cutaneous melanoma subgroup, while the one-year RFS rate was 74.1% (95% CI 58.0–90.2%) in the acral melanoma subgroup. Six (46.2%) patients experienced recurrence during adjuvant therapy; 7 (53.9%) patients recurred after completion of the regimen. At the time of the first recurrence, distant metastasis occurred in 10 patients, local recurrence occurred in 2 patients, and one patient experienced both distant metastasis and local recurrence. Conclusions. This study confirmed the good tolerability and short-term benefits of adjuvant therapy with dabrafenib and trametinib in Chinese patients with stage III melanoma with BRAF V600 mutation. [ABSTRACT FROM AUTHOR]

Background: Myasthenia gravis (MG), a rare chronic neuromuscular disorder, is characterized by progressive physical decline and requires long-term pharmacological treatment. Due to the decline of physical and social abilities, MG patients are in great need of social support, including tangible and emotional support. This study aims to examine the association between social support and medication adherence and the possible mediating effects of mental health and self-efficacy among MG patients. Methods: A cross-sectional analysis of a nationwide MG registry was conducted on 865 patients under oral medication treatment in China between June and July 2022. Validated scales were used to measure the respondent's mental distress (Four-item Patient Health Questionnaire), social support (Modified Medical Outcomes Study Social Support Scale), self-efficacy for medication use (Self-efficacy for Appropriate Medication Use Scale), and medication adherence (Morisky Medication Adherence Scale, MMAS). Results: The association between social support and medication adherence and possible mediating effects of mental distress and self-efficacy were tested by structural equation model, with significant demographic and disease-related factors adjusted. The respondents showed a very low level of medication adherence (71.2% poor adherence; 1.4% high adherence; mean MMAS = 4.65). The level of social support was positively associated with medication adherence, and such association was fully mediated by two indirect pathways: through self-efficacy (β = 0.07, proportion mediated = 63.8%); and through mental distress and then self-efficacy (β = 0.01, proportion mediated = 6.7%). Conclusion: Provision of social support and interventions on mental health with emphasis on improving self-efficacy for medication use may effectively improve medication adherence among MG patients. [ABSTRACT FROM AUTHOR]

Many lines of evidence indicate that red jungle fowl (RJF) is the primary ancestor of domestic chickens. Although multiple versions of RJF (galgal2-galgal5 and GRCg6a) and commercial chickens (GRCg7b/w and Huxu) genomes have been assembled since 2004, no high-quality indigenous chicken genomes have been assembled, hampering the understanding of chicken domestication and evolution. To fill the gap, we sequenced the genomes of four indigenous chickens with distinct morphological traits in southwest China, using a combination of short, long and Hi-C reads. We assembled each genome (~1.0 Gb) into 42 chromosomes with chromosome N50 90.5–90.9 Mb, amongst the highest quality of chicken genome assemblies. To provide resources for gene annotation and functional analysis, we also sequenced transcriptomes of 10 tissues for each of the four chickens. Moreover, we corrected many mis-assemblies and assembled missing micro-chromosomes 29 and 34–39 for GRCg6a. Our assemblies, sequencing data and the correction of GRCg6a can be valuable resources for studying chicken domestication and evolution. [ABSTRACT FROM AUTHOR]

There are four species in the Crossoptilon genus inhibiting at from very low to very high altitudes across China, and they are in varying levels of danger of extinction. To better understand the genetic basis of adaptation to high altitudes and genetic changes due to bottleneck, we assembled the genome (~1.02 Gb) of a white eared pheasant (WT) (Crossoptilon crossoptilon) inhibiting at high altitudes (3,000~7,000 m) in northwest of Yunnan province, China, using a combination of Illumina short reads, PacBio long reads and Hi-C reads, with a contig N50 of 19.63 Mb and only six gaps. To further provide resources for gene annotation as well as functional and population genetics analyses, we sequenced transcriptomes of 20 major tissues of the WT individual and re-sequenced another 10 WT individuals and a blue eared pheasant (Crossoptilon auritum) individual inhabiting at intermediate altitudes (1,500~3,000 m). Our assembled WT genome, transcriptome data, and DNA sequencing data can be valuable resources for studying the biology, evolution and developing conservation strategies of these endangered species. [ABSTRACT FROM AUTHOR]

Ticks are important vectors of zoonotic diseases and play a major role in the circulation and transmission of many rickettsial species. The aim of this study was to investigate the carriage of Candidatus Rickettsia tarasevichiae (CRT) in a total of 1168 ticks collected in Inner Mongolia to elucidate the potential public health risk of this pathogen, provide a basis for infectious disease prevention, control and prediction and contribute diagnostic ideas for clinical diseases that present with fever in populations exposed to ticks. A total of four tick species, Haemaphysalis concinna (n = 21), Dermacentor nuttalli (n = 122), Hyalomma marginatum (n = 148), and Ixodes persulcatus (n = 877), were collected at nine sampling sites in Inner Mongolia, China, and identified by morphological and molecular biological methods. Reverse transcription PCR targeting the 16S ribosomal RNA (rrs), gltA, groEL, ompB and Sca4 genes was used to detect CRT DNA. Sequencing was used for pathogen species confirmation. The molecular epidemiological analysis showed that three species of ticks were infected with CRT, and the overall positive rate was as high as 42%. The positive rate of I. persulcatus collected in Hinggan League city was up to 96%, and that of I. persulcatus collected in Hulun Buir city was 50%. The pool positive rates of D. nuttalli and H. marginatum collected in Bayan Nur city and H. concinna collected in Hulun Buir city were 0%, 28% and 40%, respectively. This study revealed the high prevalence of CRT infection in ticks from Inner Mongolia and the first confirmation of CRT detected in H. marginatum in China. The wide host range and high infection rate in Inner Mongolia may dramatically increase the exposure of CRT to humans and other vertebrates. The role of H. marginatum in the transmission of rickettsiosis and its potential risk to public health should be further considered. [ABSTRACT FROM AUTHOR]

Introduction: Drinking expectancies, the perceived consequences of alcohol consumption, are noted to predict drinking behaviours. However, there is comparatively little research of drinking expectancies in non‐Western populations. This study aimed to develop and validate a Chinese Drinking Expectancy Questionnaire (CDEQ‐Adult) for Chinese young adults. Methods: Face and content validity were first assessed of items generated from literature review and previously conducted focus groups. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted with split‐half samples from a random telephone survey that was conducted on Hong Kong Chinese adults between the ages of 18–34 (n = 675). The instrument's convergent validity and internal reliability were also examined. Results: The preliminary instrument items showed good content validity (Item Content Validity Index range: 0.8–1.0). The EFA yielded a 31‐item, five‐factor model consisting of five domains: Negative Consequences, Interpersonal Benefits, Increased Confidence, Health Benefits and Tension/Stress Reduction (variance explained 63.7%). The CFA revealed that the fit indices for the five‐factor model using diagonal weighted least squares estimator were χ2 (256, N = 338) = 394.04, p < 0.001, comparative fit index 0.97, SRMR 0.07, RMSEA 0.06 (95% confidence interval 0.06, 0.08), suggesting a good fit of the model. The Cronbach's α coefficients were 0.94, 0.90, 0.86, 0.77 and 0.57, respectively for each of the five domains (n = 675). Significant associations with past month drinking behaviours and future drinking intentions give strong support for convergent validity. Discussion and Conclusions: The CDEQ‐Adult is a culturally relevant instrument for assessing drinking expectancies in Chinese young adults for use in future studies. [ABSTRACT FROM AUTHOR]

Background: Huntington's disease (HD) poses a significant socio-economic burden globally. Existing research on HD's economic burden predominantly comes from Western settings, leaving a gap in data from Asian countries. This study aimed to assess the economic burden of HD in China and identify cost-driving factors. Methods: This study used data from a 2019 nationwide cross-sectional survey of individuals affected by rare diseases in China. Data included socio-demographic characteristics, income, disease stage, health and social insurance coverage status, treatment-seeking behaviour, and costs. Logistic regression and linear regression were used to explore potential contributors to treatment-seeking behaviour and associated costs. Results: Of the 269 individuals with HD included in this study, 80.6% were actively seeking treatment. The average annual direct medical cost, direct non-medical cost, and indirect cost were 3,265.65, 805.82, and 801.97 Euros, respectively. Compared to participants with early-stage HD, those with middle- or advanced-stage HD reported higher direct medical costs (coefficient 1,612.70, 95% confidence interval [CI]: [141.92, 3,083.48] and 2,398.58, 95% CI: [791.16, 4,006.00], respectively). However, the disease stage was not significantly associated with direct non-medical costs or indirect costs. Conclusions: This study provides crucial insights into the economic burden of HD in China. It emphasises a need for targeted policies that better cater to the financial needs of HD patients. [ABSTRACT FROM AUTHOR]

Petrolisthes lamarckii (Leach, 1821) and P. haswelli Miers, 1884 are a pair of sister species of porcelain crabs, both of which are common in the intertidal zone of southern China, typically found under rocks and in the crevices of coral reefs. However, the distribution, genetic relationship and diversity of the two species in China have not been rigorously studied. Meanwhile, P. lamarckii is considered as a complex of cryptic species due to their diverse morphological features. In this study, we identified 127 specimens of the P. lamarckii–P. haswelli complex (LH complex) and recognised a new species through morphological and molecular analysis. Furthermore, we constructed a time-calibrated phylogeny of the LH complex using three mitochondrial and two nuclear genes from all three species, finding that the divergence of the LH complex can be traced back to the Miocene epoch, and that the genetic diversity increased during the Mid-Pleistocene transition period. Glacial refugia formed during the Pleistocene climatic oscillations has been regarded as one of the contributing factors to the diversification of marine organisms in the north-western Pacific. Petrolisthes haswelli demonstrates a wide distribution along the southern coast of China, while other lineages display more restricted distributions. The research on the demographic history and gene flow of P. haswelli revealed that the Chinese coastal populations experienced an expansion event approximately 12.5 thousand years ago (Kya) and the asymmetrical gene flows were observed between the two sides of the Taiwan Strait and Qiongzhou Strait, respectively, which is likely influenced by the restriction of ocean currents. [ABSTRACT FROM AUTHOR]

Background: Requirements of blood transfusions rise rapidly in China. Improving the efficiency of blood donation could help maintaining sufficient blood supplement. We conducted a pilot research to investigate the reliability and safety of collecting more units of red blood cell by apheresis. Methods: Thirty‐two healthy male volunteers were randomized into two groups: red blood cell apheresis (RA) (n = 16) and whole blood (WB) donation (n = 16). RA group donated individualized RBC volumes by apheresis according to the volunteers' basal total blood volumes and haematocrit levels, WB group donated 400 mL whole blood. All volunteers were scheduled seven visit times in 8 weeks' study period. The cardiovascular functions were assessed by laboratory examinations, echocardiography and cardiopulmonary functional tests. All results were compared between groups at the same visit time and compared between visit 1(before donation) and other visit times within the same group. Results: The average donated RBC volume in RA group and in WB group was 627.25 ± 109.74 mL and 175.28 ± 8.85 mL, respectively(p < 0.05); the RBC, haemoglobin and haematocrit levels changed significantly between times and between groups (p < 0.05). Cardiac biomarker levels such as NT‐proBNP, hs‐TnT and CK‐MB did not change significantly between times or between groups (p > 0.05). The echocardiographic and cardiopulmonary results did not change significantly between times or between groups during the whole study period(p > 0.05). Conclusions: We provided an efficient and secure method for RBC apheresis. By harvesting more RBC volumes at one single‐time, the cardiovascular functions did not change significantly compared with traditional whole blood donation. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is the third most common cancer worldwide. Colonoscopy is the gold standard for colorectal cancer screening. However, the colonoscopy participation rate in China is much lower than that in Europe and the United States. As only non-sedated colonoscopies are offered in colorectal cancer screening programs in China, the absence of sedation may contribute to this gap. Methods: To explore the effect of free and partially participant-paid sedated colonoscopy on improving colorectal screening participation, we conducted a cross-sectional study under the framework of the Cancer Screening Program in Urban China in Xuzhou from May 2017 to December 2020. The Quanshan district was set as the control group and provided free non-sedated colonoscopy, the Yunlong district was set as a partial cost coverage group and offered partially participant-paid sedated colonoscopy, and the Gulou district was set as the full cost coverage group and offered free sedation colonoscopies. Multivariate logistic regression was used for multivariate analysis of colonoscopy participation and colorectal lesion detection rates between the groups. Results: From May 2017 to May 2020, 81,358 participants were recruited and completed questionnaire, 7,868 subjects who met high-risk conditions for CRC were invited to undergo colonoscopy. The colonoscopy participation rates in the control group, partially cost coverage, and full cost coverage groups were 17.33% (594/3,428), 25.66% (542/2,112), and 34.41% (801/2,328), respectively. Subjects in the partial and full cost coverage groups had 1.66-fold (95% CI: 1.48-1.86) and 2.49-fold (95% CI: 2.23-2.76) increased rates compared with those in the control group. The adjusted PARs for the partially and the full cost coverage group was 9.08 (95% CI: 6.88-11.28) and 18.97 (95% CI: 16.51-21.42), respectively. The detection rates of CAN in the control, partial-cost coverage, and full-cost coverage groups were 3.54% (21/594), 2.95% (16/542), and 5.12% (41/801), respectively. There were no significant differences in the detection rates between the group. However, sedated colonoscopy increases costs. Conclusion: Sedated colonoscopy increased colonoscopy participation rates in both the partial and full cost-covered groups. A partial cost coverage strategy may be a good way to increase colorectal cancer participation rates and quickly establish a colorectal cancer screening strategy in underfunded areas. [ABSTRACT FROM AUTHOR]

Objective: This study assesses the association between health-related quality of life (HRQoL) for pediatric patients with osteogenesis imperfecta (OI) and their caregivers' eHealth literacy (eHL), financial well-being, and mental health along with the impact of eHealth literacy on the financial well-being and mental health of OI caregivers. Methods: Participants were recruited from a member pool of two OI patient organizations in China. Information about patients' HRQoL and their caregivers' eHL, financial well-being, and mental health was collected. Structure equation modeling (SEM) was used to estimate the relationship between the measures. The robust weighted least square mean and variance adjusted estimator was used. Three criteria, the comparative fit index, the Tucker-Lewis index, and the root mean square error of approximation, were used to evaluate the goodness-of-fit of the model. Results: A total of 166 caregivers completed the questionnaires. Around 28.3% indicated that pediatric OI patients experienced problems related to mobility, and 25.3% reported difficulty doing usual activities. Around 52.4% of caregivers reported that their care receivers have some emotional problems while 8.4% reported that their care receivers have "a lot of" emotional problems. 'Some problems' on all dimensions on EQ-5D-Y was the most frequently reported health state (13.9%), and around 10.0% have no problems on all dimensions on EQ-5D-Y. Caregivers tended to show a significantly high eHL, financial well-being, and mental health when their care receivers reported no problems with usual activities and emotions. The SEM demonstrated a significant and positive relationship between eHL, financial well-being, and mental health. Conclusion: OI caregivers with high eHL reported satisfactory financial well-being and mental health; their care receivers rarely reported living with poor HRQoL. Providing multicomponent and easy-to-learn training to improve caregivers' eHL should be highly encouraged. [ABSTRACT FROM AUTHOR]

Summary: The majority of melanoma patients experience relapse during adjuvant therapy or after the end of therapy. Sixty-one patients from 3 melanoma centres who experienced recurrence and received adjuvant pembrolizumab for resected stage III/IV melanoma were enrolled. Disease characteristics, recurrence characteristics, subsequent management and outcomes were retrospectively analysed. Sixty-one patients were enrolled in this study. The median time to first relapse from the commencement of adjuvant pembrolizumab was 8 months (1–22 months). The first recurrences were locoregional alone in 25 patients (41%), distant alone in 29 (47.5%) and concurrent locoregional and distant relapse in 7 (11.5%). At the first recurrence, 4 patients (80%) who underwent resection alone experienced further relapse of disease. Three (60%) patients who were treated with adjuvant pembrolizumab following surgery, 2 (100%) patients who were treated with adjuvant chemotherapy, 2 (66.7%) patients who were treated with adjuvant chemotherapy and pembrolizumab combined and 3 (100%) patients who were treated with adjuvant radiotherapy and pembrolizumab combined had further recurrence. Of the three patients treated with adjuvant BRAF/MEKi following the first relapse, none had yet recurred. Of the 8 patients treated with pembrolizumab alone, only one patient (12.5%) who recurred after ceasing adjuvant PD1 had a partial response. The overall response rate to BRAF/MEKi was 75%, 3/4; to pembrolizumab in combination with an oral multitargeted receptor tyrosine kinase inhibitor, it was 22.2%, 2/9; to chemotherapeutic agents alone, it was 33.3%, 1/3; and to chemotherapeutic agents combined with pembrolizumab, it was 37.5%, 3/8. The patient treated with imatinib had progressive disease after 3 months of treatment. Of the 6 patients who received temozolomide combined with pembrolizumab, 3 (3/6, 50%) had a partial response. The median OS of the patients who relapsed locoregionally only was longer than that of the patients who relapsed distally at the first recurrence (35 months and 14 months, respectively; P < 0.01). The outcomes of the patients with disease recurrence during or after the completion of 1 year of adjuvant anti-PD1 therapy were poor despite multimodality treatment. [ABSTRACT FROM AUTHOR]

Background: Among six extant tiger subspecies, the South China tiger (Panthera tigris amoyensis) once was widely distributed but is now the rarest one and extinct in the wild. All living South China tigers are descendants of only two male and four female wild-caught tigers and they survive solely in zoos after 60 years of effective conservation efforts. Inbreeding depression and hybridization with other tiger subspecies were believed to have occurred within the small, captive South China tiger population. It is therefore urgently needed to examine the genomic landscape of existing genetic variation among the South China tigers. Results: In this study, we assembled a high-quality chromosome-level genome using long-read sequences and re-sequenced 29 high-depth genomes of the South China tigers. By combining and comparing our data with the other 40 genomes of six tiger subspecies, we identified two significantly differentiated genomic lineages among the South China tigers, which harbored some rare genetic variants introgressed from other tiger subspecies and thus maintained a moderate genetic diversity. We noticed that the South China tiger had higher FROH values for longer runs of homozygosity (ROH > 1 Mb), an indication of recent inbreeding/founder events. We also observed that the South China tiger had the least frequent homozygous genotypes of both high- and moderate-impact deleterious mutations, and lower mutation loads than both Amur and Sumatran tigers. Altogether, our analyses indicated an effective genetic purging of deleterious mutations in homozygous states from the South China tiger, following its population contraction with a controlled increase in inbreeding based on its pedigree records. Conclusions: The identification of two unique founder/genomic lineages coupled with active genetic purging of deleterious mutations in homozygous states and the genomic resources generated in our study pave the way for a genomics-informed conservation, following the real-time monitoring and rational exchange of reproductive South China tigers among zoos. [ABSTRACT FROM AUTHOR]

A new species of the spionid genus Lindaspio Blake & Maciolek, 1992 was collected from a cold seep near the Hainan Island at a depth of 1758 m. Morphologically, Lindaspio polybranchiata sp. nov. differs from the congeners in having a narrow, folded caruncle and more neuropodial branchiae (from chaetiger 20). The 18S, COI, and 16S sequences of the new species have been submitted to GenBank. It is the first record of the genus Lindaspio from Chinese waters. A key to all species of Lindaspio is given. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to develop the Chinese version of the biopsychosocial impact scale (BPIm-S) to assess functional limitation and psychosocial distress in orofacial pain (OFP) patients in mainland China, and investigate the factor structure, reliability and validity, measurement invariance, as well as scores differences across genders, age and educational status among OFP patients. Methods: The BPIm-S was developed and evaluated in four stages: (1) concept selection and item generation; (2) a pilot study assessing face and content validity; (3) the factors structure, reliability, convergent validity, and measurement invariance; and (4) concurrent validity and clinical responsiveness. Exploratory (EFA) and confirmatory factor analyses (CFA) were performed on data gathered from 406 OFP patients to assess construct validity. Composite Reliability (CR) and the Average Variance Extracted (AVE) were used to assess internal convergent validity. CR, internal consistency, and split-half reliability were also performed to determine the reliability. Multigroup CFA (MGCFA) was used to assess measurement invariance across genders, age and educational status. Mann-Whitney test compared scores across different genders, age and educational status. Participants completed the BPIm-S, visual analog scale (VAS), brief pain inventory facial (BPI-F), General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), and spearman 's correlation coefficient was used to evaluate the concurrent validity and item-total correlations. A total of 12 patients with OFP completed the BPIm-S twice to test clinical responsiveness. To conduct the CFA and measurement invariance analysis, Mplus 8.4 was used. IBM SPSS Statistics 21 software and SPSSAU, a web-based data science algorithm platform tool, were used for all additional studies. Results: For the preliminary version, 17 items were chosen. A total of four items were removed following the pilot research. The remaining 13 items of the BPIm-S comprised an overall summary scale. Excellent reliability (Item-to-total correlations ranged from 0.763 to 0.912) and strong internal consistency (Cronbach's α = 0.970, functional limitation, 0.962, and psychosocial distress, 0.977) were discovered. CFA also validated the structural validity of the 13-item scale. EFA was performed and a two-factor structure was investigated. In addition, MGCFA corroborated the measurement invariance of the BPIm-S across gender, age, and educational status. Patients over the age of 30, those with a medium level of education, and those with a low level of education showed substantially greater levels of functional limitation and psychological distress (Wilcoxon test, p < 0.001). Both concurrent validity and clinical responsiveness were assessed to be of good quality. Conclusion: The BPIm-S demonstrated good psychometric qualities and is a reliable tool that can now be used by clinicians to evaluate functional limitation and psychosocial distress among OFP patient. [ABSTRACT FROM AUTHOR]

The effects of wet brewers grains (WBG) on fermentation quality, chemical composition and in vitro ruminal digestibility of mixed silages prepared with corn stalk, dried apple pomace and sweet potato peel were evaluated. A mixture of corn stalk, sweet potato peel and dried apple pomace (50/30/20) was ensiled with 0, 10%, 20% and 30% WBG on a fresh weight (FW) basis for 1, 3, 5, 7, 14 and 30 days respectively. The results showed that the application of WBG increased (p < 0.05) lactic acid, acetic acid and total volatile fatty acids contents, and decreased (p < 0.05) pH, dry matter, water‐soluble carbohydrates content and ammonia‐nitrogen/total nitrogen during ensiling. The pH in all silages was below 4.03 during ensiling. Treating with WBG increased (p < 0.05) crude protein content, and decreased (p < 0.05) neutral detergent fibre, acid detergent fibre, cellulose and hemicellulose content after 30 days of ensiling. After 72 h of incubation, cumulative gas production, potential gas production and in vitro crude protein digestibility increased (p < 0.05) with the increasing proportions of WBG. However, in vitro digestibility of dry matter and neutral detergent fibre, and metabolisable energy were similar in all silages. The 20% and 30% WBG‐treated silages showed better fermentation quality and greater or higher in vitro digestibility, which were indicated by greater or higher (p < 0.05) lactic acid content, in vitro crude protein digestibility, and lower (p < 0.05) pH, ammonia‐nitrogen/total nitrogen ratio as compared with the control. Therefore, ensiling agro‐food by‐products with at least 20% WBG were recommended for improving fermentation quality. [ABSTRACT FROM AUTHOR]

Background: The economic burden of Pompe disease (PD) is under-researched. This study aimed to fill this gap and provide evidence-based suggestions for policy improvement based on policy simulation. Methods: Data were derived from a nationally based cross-sectional survey on rare diseases in early 2018. Answers from 92 PD patients were used for data analysis and simulation. Catastrophic health expenditure (CHE) and impoverishment due to illness (IDI) were adopted to measure PD patients' economic burden. Two typical reimbursement patterns, a dosage-based model and a cost-based model, in China were simulated. Results: Twenty-four pediatric and 68 adult PD patients were investigated. Families with pediatric PD patients on average had lower annual household incomes than families with adult PD patients (RMB 37 890 vs. RMB 66 120). The direct medical expense and out-of-pocket expenses were almost double for pediatric patients compared with adult patients (RMB 120 050 vs. RMB 66 350; RMB 112 710 vs. RMB 57 940, respectively). The direct non-medical expense for patients was almost six times the expense of adult patients (RMB 73 790 vs. RMB 13 080, respectively). About 88.24% of families with pediatric PD patients and 67.21% of families with adult PD patients suffered from CHE. Around 84.21% of families with pediatric PD patients and 45.90% of families with adult PD patients were forced to live in poverty due to illness. The simulation indicated that, although the two current reimbursement schemes helped reduce CHE, they almost had no effect on reducing IDI; the dosage-based model was more sensitive to changes in policy parameters. Conclusion: Our study highlighted the alarmingly high disease burden faced by PD patients with first-hand patientreported evidence. Our series of simulations could be a good reference for China and other countries to improve their reimbursement policy regarding PD. [ABSTRACT FROM AUTHOR]

Chemical additives have been widely used to restrain the growth of undesirable microorganisms, and they were ideal additives to well preserve silages. The work aimed at evaluating the effects of four chemical additives on fermentation quality, aerobic stability and in vitro ruminal digestibility of the fermented total mixed ration (FTMR). The TMR was treated with: (1) no additive (control); (2) sodium diacetate; (3) calcium propionate; (4) sodium benzoate (SB); (5) potassium sorbate (PS) on a fresh weight (FW) basis. After 60 days of ensiling, the silos were opened and sampled to determine fermentation quality, in vitro rumen parameters, and then the 60-day FTMR were subjected to a 9-day aerobic stability test. Chemical additives significantly (p < 0.05) increased dry matter, crude protein, and water-soluble carbohydrates contents, and decreased ammonia nitrogen, ethanol contents, aerobic bacteria and yeast counts after 60 days of ensiling. During aerobic exposure, chemical additives obviously improved aerobic stability as indicated by higher lactic acid, water-soluble carbohydrates contents and lactic acid bacteria counts, and lower pH, ethanol, ammonia nitrogen contents, aerobic bacteria and yeast counts. Treatments with SB and PS had higher (p < 0.05) lactic acid content, and lower (p < 0.05) pH, ammonia nitrogen content, aerobic bacteria and yeast counts than other FTMR. After 72 h of incubation, chemical additives significantly (p < 0.05) increased cumulative gas production, in vitro digestibility of dry matter and crude protein. The SB and PS-treated FTMR had higher (p < 0.05) cumulative gas production and in vitro dry matter digestibility than other FTMR. These results indicated that SB and PS were more effective to improve aerobic stability and in vitro ruminal parameters, and they were recommended as optimal additives for FTMR. Four chemical additives were served as additives for fermentation total mixed ration Chemical additives markedly improved fermentation quality, aerobic stability and in vitro ruminal parameters Sodium benzoate and potassium sorbate were optimal for improving aerobic stability and in vitro parameters [ABSTRACT FROM AUTHOR]

To evaluate the psychometric properties of the Chinese Fear of Cancer Recurrence Inventory (FCRI-C) in follicular lymphoma (FL) survivors. A nationwide cross-sectional study was conducted online between July and September 2020. The following psychometric properties of the FCRI-C were evaluated: construct, convergent, and discriminant validity, and reliability. Item variance was assessed using differential item functioning (DIF). A short version of the FCRI-C was developed using a two-parameter item response theory (IRT) model. The patterns of response scale, item fit, and item information were assessed. The receiver operating characteristic (ROC) curve was used to determine the clinical cut-off point for the FCRI-C. A total of 326 FL survivors completed the questionnaire. The confirmatory factor analysis supported the bi-factor structure of the FCRI-C. The IRT analysis confirmed a 10-item short version of the FCRI-C. Satisfactory convergent and discriminant validity were underpinned by a priori hypotheses. Cronbach's alpha of 0.95 and intraclass correlation coefficient of 0.82 indicated good internal consistency and test–retest reliability. The ROC curve determined a cut-off point of 83 and 20 for the full and short versions, respectively. The FCRI-C used to measure and screen the levels of FCR in Chinese FL survivors was found to be valid and reliable. The Chinese Fear of Cancer Recurrence Inventory (FCRI-C) is a reliable and valid measure to evaluate the fear of cancer recurrence (FCR) in follicular lymphoma survivors. The short version of the FCRI-C provides a rapid screening tool for the clinical detection of FCR in patients. The cut-off point of the FCRI-C could differentiate patients between "high" and "low" levels of FCR in clinical practice. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the association between dietary patterns in abdominal obesity obtained by reduced-rank regression (RRR) with visceral fat index (VFI) as a dependent variable and dyslipidemia in rural adults in Henan, China. A total of 29538 people aged 18–79 were selected from the Henan Rural Cohort Study. RRR analysis was used to identify dietary patterns; logistic regression analysis and restricted cubic spline regression models were applied to analyze the association between dietary patterns in abdominal obesity and dyslipidemia. VFI was used as a mediator to estimate the mediation effect. The dietary pattern in abdominal obesity was characterized by high carbohydrate and red meat intake and low consumption of fresh fruits, vegetables, milk, etc. After full adjustment, the highest quartile of dietary pattern scores was significantly associated with an increased risk of dyslipidemia (OR: 1·33, 95 % CI 1·23–1·44, Ptrend < 0·001), there was a non-linear dose–response relationship between them (Poverall-association < 0·001, Pnon-lin-association = 0·022). The result was similar in dose-response between the dietary pattern scores and VFI. The indirect effect partially mediated by VFI was significant (OR: 1·07, 95 % CI 1·06–1·08). VIF explained approximately 53·3 % of odds of dyslipidemia related to the dietary pattern. Abdominal obesity dietary pattern scores positively affected VFI and dyslipidemia; there was a dose-response in both relationships. Dyslipidemia progression increased with higher abdominal obesity dietary pattern scores. In addition, VFI played a partial mediating role in relationship between abdominal obesity dietary pattern and dyslipidemia. [ABSTRACT FROM AUTHOR]

Objective: To explore the factors associated with the psychosocial quality of life (QoL) among adolescents with rare diseases (RDs). Methods: We used cross-sectional design to collect data in February 2016 and February 2018, respectively, in China through a structured questionnaire. Those included in the study were adolescents aged between 10 and 18 who had a doctor-diagnosed RD. Multivariable linear regression was used to identify the predictors associated with psychosocial QoL among adolescents with RDs. Results: The study included 737 adolescents (28.4% girls). The mean score of their psychological QoL was 43.79 (SD = 20.44). Multivariable linear regression analysis suggests that girls had a lower psychological QoL than boys (adjusted coefficient = −1.87, 95% CI = [−3.53, −0.21]); and receiving an education (adjusted coefficient = 6.53, 95% CI = [4.47, 8.33]), living with parents (adjusted coefficient = 6.45, 95% CI = [3.94, 8.97]), and physical function (adjusted coefficient = 0.53, 95% CI = [0.49, 0.56]) were positively associated with psychological QoL. Conclusion: This study reveals the status of psychological QoL among adolescents with RDs. The evidence provided can increase our understanding of the factors associated with psychological QoL among adolescents with RDs and can help formulate policies and put concrete actions into practice. [ABSTRACT FROM AUTHOR]

The Cretaceous has been considered a "high-fire" world accompanied by widespread by-products of combustion in the rock record. The mid-Cretaceous oceanic anoxic event 1b (OAE1b) is marked by one of the major perturbations in the global carbon cycle characterized by deposition of organic-rich sediments in both marine and terrestrial settings. However, our understanding is still limited on changes in wildfire activity during OAE1b period. Here, we carried out a comprehensive analysis, including organic carbon isotope (δ13C org), total organic carbon (TOC), coal petrology, trace elements, and pyrolytic polycyclic aromatic hydrocarbons (pyroPAHs), of coal seams of the middle Aptian to early Albian Shahezi Formation from borehole SK-2 in Songliao Basin, Northeast China. Two negative δ13C org excursions in the Shahezi Formation can be corresponded with the 113/Jacob and Kilian sub-events of OAE1b. Moreover, the intensive peatland wildfires have been identified during the sub-event periods of OAE1b based on the co-occurrence of high abundance of charcoal and pyroPAHs at that time. In addition, Sr/Ba, Sr/Cu and Sr/Rb ratios demonstrate that enhanced peatland wildfires were controlled by dryer climate conditions owing to episodic northward migration of arid zones in East Asia related with rising global temperature during the sub-events of OAE1b. The climate-driven extensive wildfire activity in the mid-latitude terrestrial ecosystems can be a contributing factor for OAE1b through the increased flux of nutrients fuelling primary producers in the lake and marine environments and leading to more speculative anoxia to allow the deposition of organic-rich sediments. Our results provide essential understanding of the importance of wildfires in driving mechanism of oceanic anoxic events (OAEs) in Earth's history. [ABSTRACT FROM AUTHOR]

The real-time quaking-induced conversion (RT-QuIC) assay has been developed and used as an in vitro diagnostic tool for Parkinson's disease (PD). In this study, we established α-Syn RT-QuIC using recombinant human α-Syn as the substrate. All 5 brain homogenates of neuropathological PD cases and 13 skin homogenates of clinical PD cases showed positive results, whereas all the samples of negative controls remain negative. Meantime, randomly selected 6 skin samples of PD cases and 6 skin samples of sCJD cases showed negative in opposite prion RT-QuIC and α-Syn RT-QuIC. Our α-Syn RT-QuIC showed dose-dependent manner between the lag times and peak ThT fluorescent values. Additionally, the detecting limitation was about 10-7 dilution for brain tissues and 10-6 for skins. Those data indicate a reliable specificity and good sensitivity of the established a-Syn RT-QuIC in identifying and amplifying the misfolded α-Syn in brain and skin tissues of patients with PD. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) poses a serious threat to urban health with the development of urbanization. There are multifaceted and comprehensive influencing factors for CVD, so clarifying the spatial distribution characteristics of CVD and multiple environmental influencing factors is conducive to improving the active health intervention of urban environment and promoting the sustainable development of cities The spatial distribution characteristics of CVD deaths in a certain district, Bengbu City, Huaihe River Basin, China, in 2019 were explored, and the correlation between multiple environmental factors and CVD mortality was investigated in this study, to reveal the action mechanism of multiple environmental factors affecting the risk of mortality. Relevant studies have shown that (1) CVD deaths are characterized as follows: male deaths are more than females; the mortality is higher in those of higher age; most of them are unemployed; cardiocerebral infarction is the main cause of death; and the deaths are mainly distributed in the central city and near the old urban area. (2) The increased CVD mortality can be attributed to the increased density of restaurants and cigarette and wine shops around the residential area, the increased traffic volume, the dense residential and spatial forms, the low green space coverage, and the distance from rivers. Therefore, appropriate urban planning and policies can improve the active health interventions in cities and reduce CVD mortality. [ABSTRACT FROM AUTHOR]

Background: Rare disease patients often experience diagnosis delays or misdiagnosis, which may be due to lack of knowledge on rare diseases among physicians.Objective: To assess Chinese physicians' knowledge on specific rare diseases and identify its associated factors.Methods: Thirty-four patient organizations with a unique disease of interest were invited to develop 3 knowledge questions for each rare disease to assess physicians' knowledge on the disease that they felt most experienced in. The total knowledge score for each participant ranged from a score of 0 to 3. A national cross-sectional study conducted in a cohort of 3197 physicians from 6 provinces across western, central and eastern China. The demographic information of the participants was collected including gender, age, birthplace, income, education, hospital class, working title, working years, and specialty. A multiple linear regression analysis was performed to assess the independent associations between the physician variables and the total knowledge score.Results: Two thousand, one hundred and fifteen (66.16%) of the involved physicians obtained a total knowledge score of 2 or 3. The median knowledge scores of 10 (29.4%) rare diseases were a score of 1.5 or below. Physicians with female gender (β = 0.08, p < 0.05 for females vs. males), and a monthly income of 5000-10,000 RMB (β = 0.11, p < 0.01 for 5000-10,000 vs. < 5000) and 10,000-30,000 RMB (β = 0.14, p < 0.05) were associated with a higher score. Specialties of physicians who received a relatively higher score included internal medicine, obstetrics and gynecology, radiology, intensive care unit, and surgery.Conclusions: Almost two thirds of the participants had an average or good level of knowledge on the specific rare disease that they felt most experienced in. Physicians with female gender, a monthly income of 5000-10,000 RMB and 10,000-30000 RMB, and specialties of internal medicine, obstetrics and gynecology, radiology, intensive care unit, and surgery, were associated with a relatively higher knowledge score. [ABSTRACT FROM AUTHOR]

In November 2018, a scientific scandal broke when news emerged that the world's first gene edited babies had been born in China on the eve of the 2nd International Summit on Human Genome Editing in Hong Kong. He Jiankui had recruited a total of seven couples who were in need of fertility treatment to participate in an effort to clinically apply human embryo editing with the promise that, if successful, their future children would be protected from HIV. While He Jiankui has since been jailed for illegal medical practice and much has been written about his unethical and flawed "experiment," in this article we suggest that the Hong Kong summit nevertheless marked the moment when human embryo editing came to be platformed. Human embryo editing brings together a complete set of new reproductive and genetic technologies into a total bio-reproductive platform shaped by socio-technical "disease free" imaginaries. [ABSTRACT FROM AUTHOR]

A large landslide occurred on May 2, 2014, on the south bank of the Yellow River in Huaipa village, Mianchi County, Henan Province, China. The total volume of the slide was about 4 million m3. The landslide caused serious damage to the water-conveying pipeline at the foot of the slope, which was for water supply from the Yellow River to Manchi County and Yima City. After the event, the engineering geological characteristics, influencing factors and failure mechanism were investigated by field investigation and geological mapping. Then, the failure process and the effect of anti-tipping locked segment were presented by three-dimensional (3D) numerical simulation. The results showed that the destruction of the anti-tipping locked segment in the front edge due to open-pit mining was the main factor of slope failure. The sliding mass, composed of loose silty clay and heavily weathered sandstone and mudstone, and rainfall infiltration were other factors triggering the slide. According to 3D numerical simulation, the stability coefficient of the landslide was 1.35 in natural condition and 1.26 when the sliding body was saturated by continuous rainfall, before the anti-tipping locked segment was destroyed, while the stability coefficient decreased significantly to 1.04 after the anti-tipping strata were destroyed. The whole failure occurred when the sliding mass was saturated by continuous rainfall (the stability coefficient is 0.88). This paper can provide an insight into the effect of anti-tipping locked segment on the failure mechanism of landslide associated with open-pit mining and rainfall. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the psychometric properties of the EQ-5D-5L and SF-6D, and to compare their performance among patients living with haemophilia in China.Methods: A total of 875 Chinese patients completed the EQ-5D-5L, SF-6D, and Haem-A-QoL questionnaires. Construct validity of the EQ-5D-5L and SF-6D dimensions and indices was assessed by testing hypotheses relating these measures to Haem-A-QoL and clinical measures. The Spearman correlation coefficient was used to assess convergent validity, and one-way analysis of variance (F statistic) was used to assess the known-groups validity (discriminatory power). The agreement between EQ-5D-5L and SF-6D indices was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot.Results: Both the EQ-5D-5L and SF-6D indices showed acceptable ceiling and floor effects. As hypothesised, both EQ-5D-5L and SF-6D were significantly correlated with Haem-A-QoL (both dimensions and overall score). EQ-5D-5L and SF-6D indices as well as EQ-VAS differentiated patients are known to differ in severity of haemophilia, bleeding status, disabling levels, and comorbidity. The F statistics in the known-groups comparisons suggested that the EQ-5D-5L was slightly more discriminative than the SF-6D. ICC (0.41) and Bland-Altman plot confirmed that the agreement between the EQ-5D-5L and SF-6D indices was poor.Conclusion: Both EQ-5D-5L and SF-6D showed satisfactory construct validity in the measurement of the HRQoL among patients with haemophilia. However, the two instruments may not be used interchangeably in this patient population due to their poor agreement and differing discriminatory power. [ABSTRACT FROM AUTHOR]

Coal, especially the inertinite in it, is highly sensitive to climate changes, showing an obvious response to paleoclimate conditions, in particular, to paleo-oxygen concentration (pO2). In this study, the inertinite abundance data of typical coal-forming periods in China were systematically collected and analyzed. Its characteristics and control factors were studied, and its evolution was established. Based on inertinite abundance data, pO2 evolution curves of various coal-forming periods in China were established, which fluctuated between 15% and 30% during the entire Phanerozoic. The inertinite abundance in coal deposits during Paleozoic in China was basically consistent with that of other areas of the world, while it was quite different globally from the Mesozoic to the Cenozoic. The results show that the inertinite abundance in coal deposits is controlled by pO2 and other factors including climatic zones, plant differentiation, sedimentary environments, and tectonic activities. The inertinite abundance in coal deposits in China during the Jurassic was high, suggesting dry paleoclimate of inland China. [ABSTRACT FROM AUTHOR]

Background: Pompe disease (PD) is a rare inherited disorder caused by the deficiency of acid-α glucosidase, which leads to the impairment of organ and tissue functions and causes disabilities. As the first national survey on patients with late-onset PD (LOPD) in China, this study investigated the quality of life (QOL) of adult patients with LOPD in China and explored its contributors.Methods: Data were derived from a nation-based, cross-sectional, self-response survey on rare diseases (RDs) in early 2018. Answers from 68 adult Chinese patients with LOPD were used for data analysis. QOL was measured using the World Health Organization Quality of Life: Brief Version. Covariates included age, gender, education, employment, reliance on assistive devices, medication history, social support, and disease economic burden. Data were analyzed using linear regression in R.Results: For adult patients with LOPD, the average scores and standard deviations (SD) of the four dimensions of QOL were physical health = 33.77 (SD = 18.28), psychological health = 43.81 (SD = 21.70), environmental health = 39.43 (SD = 16.93), and social relationship = 46.20 (SD = 19.76); the scoring for each dimension was evaluated on a scale of 0 to 100. At the significance level of p < 0.05, with increasing age, the patients experienced a significant decrease in physical health QOL (β = - 0.75) and environmental health QOL (β = - 0.79). Those who relied heavily on assistive devices had lower perceived physical health (β = - 17.8), psychological health (β = - 22.76), environmental health (β = - 17.8), and social relationships (β = - 22.12) than those who did not. A one-unit increase in the amount of social support, as a form of social interaction, led to a significant increase in physical health (β = 0.28), psychological health (β = 0.71), environmental health (β = 0.72), and social relationships (β = 0.70).Conclusion: Adult Chinese patients with LOPD had a lower physical health and QOL compared to their counterparts with other RDs. Being employed was found to affect the QOL of adult Chinese patients with LOPD in almost all dimensions. Encouraging adult Chinese patients with LOPD to be socially active and help them become more involved in social life might improve their QOL. [ABSTRACT FROM AUTHOR]

Objective To summarize the dynamic changes of cerebrospinal fluid (CSF) cytology in drug resistant tuberculous meningitis (TBM), and to explore its value in drug resistance and efficacy evaluation of TBM. Methods Seventy-nine patients with TBM who were diagnosed and treated in Jiangxi Chest Hospital from January 2013 to December 2020 were included in this study. H(S)REZ(V) scheme [isoniazid (or streptomycin), rifampicin, ethambutol, plus pyrazinamide (or levofloxacin)] regimen was adopted before the return of drug sensitivity test results. After the return of results, individualized anti - tuberculosis regimen was formulated according to drug resistance. Results According to the drug sensitivity test results of CSF, 37 cases were drug resistant TBM, of which 29 cases (78.38%) were multidrug resistant. The drug resistance spectrum was isoniazid + rifampicin + streptomycin [35.14% (13/37)], isoniazid + rifampicin + streptomycin + fluoroquinolone [18.92% (7/37)], isoniazid + rifampicin + ethambutol + streptomycin [16.22% (6/37)], isoniazid and rifampicin [10.81% each, (4/37)], Isoniazid + rifampicin, isoniazid + rifampicin + ethambutol + streptomycin + fluoroquinolone, isoniazid + rifampicin + ethambutol + streptomycin + amikacin/capreomycin [2.70% each, (1/37)]. After 2 and 4 weeks of antituberculosis treatment, the number of nucleated cells in CSF of non drug resistant group (t = 5.050, P = 0.000; t = 11.100, P = 0.000) and neutrophil ratio (t = 15.268, P = 0.000; t = 17.048, P = 0.000) were lower than drug resistant group. CSF cytology showed that the drug resistant group showed mixed cell inflammatory reaction lasting more than 4 weeks, and the non drug resistant group transformed into significant lymphocyte reaction. After 6 months of follow-up, the total effective rate of drug resistant group was lower than that of non drug resistant group [45.71% (16/35) vs. 90% (36/40); χ² = 17.218, P = 0.000]. Conclusions The cytological characteristics of CSF in patients with TBM are mainly characterized by mixed cell inflammatory reaction in the early stage, the delayed mixed cell inflammatory reaction lasting more than 4 weeks during treatment is the characteristic of drug resistant TBM, which may be the basis for indicating that the treatment plan is invalid. When limited by the time limit and conditions of drug sensitivity test, monitoring the dynamic changes of CSF cytology may become an auxiliary judgment method for drug resistant TBM, which can provide reference for clinical efficacy evaluation and antituberculosis treatment plan adjustment. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to estimate the health preference–based index scores of the population of patients with lymphoma using the EQ-5D in China. Methods: A cross-sectional online survey was conducted to examine the health and well-being of patients with lymphoma in China. Their health-related quality of life (HRQoL; using the EQ-5D), demographic and socioeconomic characteristics, and health conditions were assessed. The data were analyzed using Pearson's χ2 test, analysis of variance, and binary logistic and Tobit regression models. Results: A total of 3261 patients (sex: men = 58.5%, age: < 30 years = 9.5% and > 60 years = 24.6%) participated in the study. The mean EQ-5D-5L index and EQ-VAS scores were 0.83 and 68.8, respectively. Binary logistic regression analysis revealed that women reported more pain-related problems than men did. Unemployed participants were substantially more likely to report health problems on all the five dimensions of the EQ-5D than their employed counterparts. The Tobit regression model revealed that respondents who were older, unemployed, with low income, received chemotherapy, and with short durations reported a low index score. Conclusion: Using the EQ-5D, the preference-based scores of different subpopulations of patients with lymphoma may support economic evaluation by promoting the simultaneous consideration of both the reasonable use of resources and satisfactory achievement of health outcomes. [ABSTRACT FROM AUTHOR]

Patient advocacy and media coverage are important strategies for changing health policies. China is no exception. Through 31 interviews and content analysis of 1,136 news stories related to hepatitis B, this study revealed how members of Chinese health advocacy groups strategically built a coalition with the news media, actively played the role of 'policy entrepreneurs', and successfully affected the framing of hepatitis B. As a result, China's grassroots civil societies not only successfully attracted public attention to the previously ignored problem of discrimination against people affected by hepatitis B but also impacted on the state's rewriting of public policies on this disease. [ABSTRACT FROM AUTHOR]

Objective. Although increasing evidence reveals the efficacy of traditional Chinese medicine (TCM) and its safety on Tourette Syndrome (TS) patients, whether TCM is indeed improving TS remains unclear. The purpose of the current study is to perform a meta-analysis to evaluate the efficacy and safety of TCM on treating TS patients. Method. An elaborate search strategy was conducted based on several databases including Medline, Embase, Cochrane, Web of Science, CINAHL, CBM, VIP, CNKI, and Wanfang Data in order to identify the relevant randomized controlled trials (RCTs) from their inception to as late as May 1st, 2020. General information and data needing analysis were extracted simultaneously for the necessity of various analyses such as descriptive analysis and metaquantitative analysis. Results. Forty-seven trials with 5437 TS patients in total were eventually included according to our criteria. All trials were conducted in China, and the publication years ranged from 2004 to 2017. In terms of clinical efficacy, clinical symptoms of patients with TCM were more likely to be improved compared with the control group (odds ratio, OR = − 1.29 , 95% confidence interval, CI: -2.54 to -0.06, I 2 = 0.00 %). As to the outcome of recurrence rate, the pooled results revealed that the TCM group was more inclined to stabilize the recurrence (OR = 0.44 , 95% CI: 0.24 to 0.78, I 2 = 0.00 %). Similar results were observed in adverse reaction (OR = 0.32 , 95% CI: 0.24 to 0.43, I 2 = 32.90 %). Conclusion. The results of our study recommend applying TCM to treat TS patients for better efficacy and safety. Results need to be interpreted cautiously due to certain limitations in our study. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical value of intraoperative ultrasound and endoscopy technique on the surgery of spontaneous intracerebral hematoma. Methods A total of 17 patients who underwent ultrasound - guided endoscopic evacuation of spontaneous intracerebral hematoma from October 2016 to October 2019 in Department of Neurosurgery of the First Medical Center of PLA General Hospital and Hainan Hospital were selected. All hematomas were located by ultrasound during operation. At the same time, feedback the degree of hematoma clearance and calculate the hematoma removal rate. Record ultrasound and endoscopy - related complications or adverse events. Use Karnofsky Performance Status (KPS) to evaluate postoperative neurological function improvement. Results Intraoperative ultrasound and endoscopic technique were conducted in all 17 patients with a success rate of 100%, and no ultrasound and endoscopic-related complications or adverse events occurred. In all cases, endoscopic working sheath was once accurately introduced into the center of hematoma. Preoperative median volume of hematoma was 44.40 (31.20, 54.35) ml, and postoperative median volume was 3.00 (1.80, 5.10) ml, and the extent of hematoma removal rate was 94.01% (87.11, 96.08)%. Preoperative median KPS score was 20 (15, 30), and median KPS score was 40 (35, 50) 2 weeks after operation, which was significantly improved (Z = - 3.671, P = 0.000). Conclusions These results suggest that intraoperative ultrasound-guided endoscopic surgery is a safe and feasible surgical modality for spontaneous intracerebral hematoma. This combined technique may help to localize the hematoma more accurately, enhance the extent of hematoma removal, and reduce complications and facilitate neurological recovery. [ABSTRACT FROM AUTHOR]

The Yumenkou tunnel is located on the left bank of the Yellow River on the border between Shanxi and Shaanxi provinces, China. It is connected to the Longmen Yellow River Bridge of the Menghua railway. Many unstable rock masses have developed on the cliff above the tunnel entrance, threatening the construction and operation of the tunnel and the bridge. Based on a high-precision three-dimensional (3D) digital terrain model obtained by unmanned air vehicle (UAV) photogrammetry, information of the structural surface which controls the stability of the rock mass in the study area was obtained by manual identification and extraction. We combined the UAV imaging with field survey data to obtain the spatial distribution, shape, scale, and potential failure modes of the unstable rock masses. A 3D numerical model of the unstable rock mass and surface morphology was constructed using a 3D discrete element method. The 3D path and impact energy of the moving unstable rock mass were analyzed. Based on the lithology, topography, structural surface, and other factors, three types of potential rock failure modes were identified in the study area: sliding, toppling, and falling. Differential weathering and the structure plane and stress-unloading cracks are two main factors affecting the stability of the unstable rock mass. According to the result of 3D discrete element method, once the unstable rock masses fail, about 50% of which might hit the portal of the tunnel, and the maximum rebound height at the portal would be about 1.2 m. To prevent such catastrophic failure, active protective net was recommend at each unstable rock zone, and retaining wall with a height of 5 m behind the portal. The results of this study confirm the effectiveness of a UAV photogrammetry-based method for reliable and cost-effective engineering geological surveying of unstable rock mass in complex terrain. [ABSTRACT FROM AUTHOR]

Context: Quality of life (QoL) continues to be impaired in acromegaly after treatment.Objective: We conducted the first nationwide survey assessing QoL status among Chinese patients with treated acromegaly and explored correlations with clinical parameters, treatment modalities, and outcomes.Design: Cross-sectional study.Setting: Survey via Chinese Association of Patients with Acromegaly (CAPA) online platform.Patients: Treated patients from CAPA.Main Outcome Measures: QoL was assessed using acromegaly QoL questionnaire (AcroQoL), 5-level EuroQoL five-dimensional questionnaire (EQ-5D-5L), and 12-item short-form health survey questionnaire (SF-12).Results: Complete, valid questionnaires from 327 patients (mean age: 39.2 years, 61.5% females) at a mean of 10 years after treatment were included. Biochemical control was satisfied in 52.9% of these patients. The controlled patients had significantly better QoL than the uncontrolled patients in all AcroQoL dimensions, most SF-12 dimensions, and pain/discomfort and anxiety/depression dimensions of the EQ-5D-5L. Patients with either controlled or uncontrolled acromegaly had significantly worse QoL than the age- and sex-adjusted population reference in most SF-12 dimensions except for physical functioning. More acromegaly-associated symptoms and comorbidities at follow-up were independent risk factors for decreased QoL across all questionnaires. Medical treatment, especially with somatostatin analogs (SSAs), and radiotherapy were predictors of worse QoL. Female patients had lower scores of physical-related QoL than male patients.Conclusions: Our study suggests that biochemical control improved but did not normalize QoL in acromegaly. Numbers of symptoms and comorbidities at follow-up, sex, radiotherapy, and medical treatment with SSAs were factors determining QoL of patients with treated acromegaly. [ABSTRACT FROM AUTHOR]

Background: As the coronavirus disease 2019 (COVID‐19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public's preference for the uptake of the COVID‐19 vaccine in China. Methods: An online discrete choice experiment (DCE) survey was administered to a sample of China's general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated. Results: Data of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID‐19 vaccine. Conclusions: The strong public preferences detected in this study should be considered when developing COVID‐19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy. Patient or Public Contribution: The design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio‐economic backgrounds. Without their participation, the study would not be possible. [ABSTRACT FROM AUTHOR]

Purpose: Acromegaly is a rare, intractable endocrine disease. We aimed to describe the patient characteristics, diagnostic delays, treatment patterns, treatment outcomes, comorbidities and treatment costs of acromegaly in China. Methods: This is a nationwide cross-sectional study. Patients diagnosed with and treated for acromegaly between 1996 and 2019 across China were surveyed via the Chinese Association of Patients with Acromegaly platform. Results: In total, 473 patients (58.8% females, mean age at diagnosis: 39.4±9.5 years) were included. The median disease duration was 3 years. The most common symptoms were extremity enlargement (91.8%) and facial changes (90.1%). Overall, 63.0% of patients experienced diagnostic delays within healthcare systems; 63.8% of the delays were <1 year. The most common first-line therapy was surgery with a transsphenoidal (76.1%) or transcranial approach (3.2%). Somatostatin analogues or dopamine agonists were administered in 20.5% of the patients as first-line therapies and in 41.7% as adjuvant therapies. Radiotherapy was performed in 32.1% of patients, 99.3% of whom received radiotherapy as an adjuvant therapy. After a median 5-year follow-up, 46.2% achieved biochemical control. Comorbidities were reported in 88.2% of the patients at follow-up; memory deterioration and thyroid nodules were the most common. Controlled patients had greater improvements in symptoms and comorbidities during follow-up than uncontrolled patients. The annual per-capita cost-of-treatment was $11013 in 2018, with medical treatments being the largest contributor (67%). Medical insurance covered 47.2% of all treatment costs. Conclusion: This study provides the first comprehensive description of real-world acromegaly data in China, serving as a basis for future population-based studies. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to develop algorithms to map the EORTC QLQ-C30 (QLQ-C30) onto EQ-5D-5L in a sample of patients with lymphomas. Methods: An online nationwide survey of patients with lymphoma was carried out in China. Ordinary least squares (OLS), beta-based mixture, adjusted limited dependent variable mixture regression, and a Tobit regression model were used to develop the mapping algorithms. The QLQ-C30 subscales/items, their squared and interaction terms, and respondents' demographic variables were used as independent variables. The root mean square error (RMSE), mean absolute error (MAE), and R-squared (R2) were estimated based on tenfold cross-validation to assess the predictive ability of the selected models. Results: Data of 2222/4068 respondents who self-completed the online survey were elicited for analyses. The mean EQ-5D-5L index score was 0.81 (SD 0.21, range − 0.81–1.0). 19.98% of respondents reported an index score at 1.0. In total, 72 models were generated based on four regression methods. According to the RMSE, MAE and R2, the OLS model including QLQ-C30 subscales, squared terms, interaction terms, and demographic variables showed the best fit for overall and the Non-Hodgkin's lymphoma sample; for Hodgkin's lymphoma, the ALDVMM with 1-component model, including QLQ-C30 subscales, squared terms, interaction terms, and demographic variables, showed a better fit than the other models. Conclusion: The mapping algorithms enable the EQ-5D-5L index scores to be predicted by QLQ-C30 subscale/item scores with good precision in patients living with lymphomas. [ABSTRACT FROM AUTHOR]

Oreocharis flavovirens is a new species of Gesneriaceae from Gansu, China and is described and illustrated here. It is morphologically similar to O. glandulosa, O. humilis and O. farreri, but those congeners of this new taxon can be distinguished by several salient characters. A description of O. flavovirens, together with illustrations and photos, are presented. [ABSTRACT FROM AUTHOR]

Antibiotic resistance of bacterial pathogens isolated in China is a major concern. Omadacycline is a novel tetracycline derivative that has been approved for use in skin infections and community-acquired pneumonia. This study was conducted to determine the in vitro activity of omadacycline against a large collection of patient isolate medical centers across Mainland China. A total of 1041 recent clinical isolates are obtained from patients hospitalized in 29 provinces and municipalities across China. The in vitro activity of omadacycline and comparator agents was assessed using the microbroth dilution methodology. Omadacycline was active against methicillin-susceptible and -resistant Staphylococcus aureus with MIC90 values of 0.25 and 1 mg/L, respectively. All isolates of Enterococcus faecalis and Enterococcus faecium, including vancomycin-resistant isolates, were inhibited by ≤ 0.25 mg/L of omadacycline. It was active against Streptococcus pneumoniae irrespective of susceptibility to penicillin or macrolides (MIC90 =0.12 mg/L). The minimum inhibitory concentration (MIC) distribution of omadacycline was nearly identical against (extended-spectrum beta-lactamases) ESBL-positive, ESBL-negative, and carbapenemase-producing Escherichia coli (MIC90 = 4 mg/L). Omadacycline also showed good activity against Acinetobacter baumannii, inhibiting all isolates at ≤ 8 mg/L. Against Hemophilus influenzae and Moraxella catarrhalis, the MICs of omadacycline were low and not influenced by the presence of β-lactamase. Overall, the activity of omadacycline was very good against isolates commonly associated with skin infections and pneumonia, and the susceptibility of Chinese isolates was similar to that reported for these pathogens from large surveillance studies outside China. This suggests that omadacycline could be an option for treatment of these infections in Chinese patients. [ABSTRACT FROM AUTHOR]

Background: Body size is considered as one of the most fundamental properties of an organism. Due to intensive breeding and artificial selection throughout the domestication history, horses exhibit striking variations for heights at withers and body sizes. Debao pony (DBP), a famous Chinese horse, is known for its small body size and lives in Guangxi mountains of southern China. In this study, we employed comparative population genomics to study the genetic basis underlying the small body size of DBP breed based on the whole genome sequencing data. To detect genomic signatures of positive selection, we applied three methods based on population comparison, fixation index (FST), cross population composite likelihood ratio (XP-CLR) and nucleotide diversity (θπ), and further analyzed the results to find genomic regions under selection for body size-related traits. Results: A number of protein-coding genes in windows with the top 1% values of FST (367 genes), XP-CLR (681 genes), and log2 (θπ ratio) (332 genes) were identified. The most significant signal of positive selection was mapped to the NELL1 gene, probably underlies the body size and development traits, and may also have been selected for short stature in the DBP population. In addition, some other loci on different chromosomes were identified to be potentially involved in the development of body size. Conclusions: Results of our study identified some positively selected genes across the horse genome, which are possibly involved in body size traits. These novel candidate genes may be useful targets for clarifying our understanding of the molecular basis of body size and as such they should be of great interest for future research into the genetic architecture of relevant traits in horse breeding program. [ABSTRACT FROM AUTHOR]

Purpose: The association of chronic lymphocytic leukemia (CLL) with health-related quality of life (HRQoL) is rarely studied globally. This study evaluated the psychometric properties of the EORTC-Chronic Lymphocytic Leukaemia (CLL17 [phase III]) module, a newly developed assessment on CLL patients' HRQoL, among Chinese CLL patients.Methods: The Chinese CLL17, comprised of three subscales (symptom burden [SB], physical condition [PC] and worries/fears [WF]), was provided by the developer team through EORTC. A cross-sectional online survey was conducted to collect data. The classical traditional theory (CTT) and the item response theory (IRT) were used to evaluate the psychometric properties of CLL17. Internal consistency reliability was determined by the Cronbach's alpha and item-total correlation. Dimensionality was verified through confirmatory factor analysis (CFA). Convergent validity was also assessed. The generalized partial credit model was used for the IRT. The difficulty, discrimination, item fit, and differential item functioning (DIF) were calculated to assess the instrument's psychometric properties.Results: In all, 318 patients, aged between 26 and 82 years, completed the questionnaire. A good level of internal reliability was achieved (Cronbach's alpha = 0.92). The item-total correlation coefficient ranged from 0.46 to 0.72. There was a mid-to-high correlation between CLL17 and domains of EQ-5D and QLQ-C30. The IRT model showed a satisfactory homogeneity, item fit and good discrimination of items, except for item 4, 6 and 16 (< 1.0). low information provided by item 16 and 17. SB and PC provided more information with theta > 0, whereas WF provided more information with theta < 0. Item 17 perform inconsistently for respondents from different age groups (DIF).Conclusion: The EORTC-CLL17 Chinese version shows acceptable reliability and validity, making it a valuable instrument to evaluate the impact on the HRQoL of Chinese CLL patients. [ABSTRACT FROM AUTHOR]

Background: Aging and the chronic non-communicable diseases (NCDs) challenge the Chinese government in the process of providing hospitalization services fairly and reasonably. The Chinese government has developed the basic medical insurance system to solve the problem of "expensive medical cost and difficult medical services" for vulnerable groups and alleviate the unfair phenomenon. However, few studies have confirmed its effect through longitudinal comparison. This study aimed to explore the trend in the inequity of inpatient use among middle-aged and elderly individuals with NCDs in China. Methods: This longitudinal comparative study was based on CHARLS data in 2011, 2013 and 2015. Concentration index (CI) was used to measure the variation trend of inequity of inpatient services utilization, while the decomposition method of the CI was applied to measure the factors contributing to inequity in inpatient services utilization. The effect of each factor on the change of inequity in inpatient services utilization was divided into the change of the elasticity and the change of inequality using the Oaxaca-type decomposition method. Results: The affluent middle-aged and elderly patients with NCDs used more inpatient services than poor groups. The per capita household consumption expenditure (PCE) and Urban Employee Basic Medical Insurance (UEBMI) contributed to the decline in pro-rich inequality of inpatient use, while the New Rural Cooperative Medical Scheme (NRCMS) contributed to the decline in pro-poor inequality of inpatient use. Conclusions: There was a certain degree of pro-rich unfairness in the probability and frequency of inpatient services utilization for middle-aged and elderly individuals with NCDs in China. The decrease of pro-wealth contribution of PCE and UEBMI offset the decrease of pro-poor contribution of NRCMS, and improved the equity of inpatient services utilization, favoring poor people. [ABSTRACT FROM AUTHOR]