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Despite the wide usage of screen media among young children, less is known about the relationships between children's screen time and their social competence development as impacted by family-related factors. Here, we investigated parents' engagement, children's screen time, and their social competence among Taiwanese Chinese children's families at three time points as the children aged (Time 1: N = 2,037, including 991 girls, M = 3.00 years; Time 2: N = 1,785, including 868 girls, M = 4.00 years; Time 3: N = 1,749, including 842 girls, M = 5.01 years). "Research Findings": From ages 3 to 5 years, parental engagement positively predicted children's social competence, whereas children's screen time negatively predicted their social competence. Examination of the mechanism underlying these longitudinal relationships suggested that when parents engaged less frequently in interacting with children, their children tended to spend more time on screen media, and then developed a lower level of social competence during the early years. "Practice or Policy": Our findings indicate that young children's time spent on screen media should be monitored and restricted. Instead of keeping children occupied with screen media, parents and educators should engage more actively in interacting with children to promote their social competence.

Although children often believe an adult's claims, they may have opportunities to check these claims by gathering relevant empirical evidence themselves. Here, we examine whether children seize such opportunities, especially when the claim is counterintuitive. Chinese preschool and elementary schoolchildren were presented with five different-sized Russian dolls and asked to indicate the heaviest doll. Almost all children selected the biggest doll. Half of the children then heard a false, counterintuitive claim (i.e., smallest = heaviest). The remaining children heard a claim confirming their initial intuition (i.e., biggest = heaviest). Children in both age groups typically endorsed the experimenter's claim even when it was counterintuitive. However, during the experimenter's subsequent absence, elementary schoolchildren explored the dolls more if they had received counterintuitive rather than confirming testimony whereas preschool children rarely explored, no matter what testimony they had received. Thus, with increasing age, children seize opportunities to test counterintuitive claims. [Supplemental materials are located at: http://dx.doi.org/10.1037/dev0000455.supp.]

Deciding whose words to trust profoundly impacts children's knowledge acquisition. In evaluating informants' trustworthiness, children are attentive to their social dominance. Previous studies have shown that children's trust preferences may differ across cultures based on the dominance of the informant: children in Western cultures prefer to trust in testimony from dominant informants, whereas children in Eastern cultures prefer to trust subordinate informants (Bernard et al., 2016; Charafeddine et al., 2019). We aim to investigate the potential cultural difference in the trust preferences of European American children (in the United States) and Chinese children (in China) from informants of varying levels of dominance, using a more refined method to assess children's trust preferences. We propose that different levels of authoritarianism – advocacies to obey authorities – in Western and Eastern cultures may explain the potential difference in children's selective trust. Specifically, as impacted by societal cultures, Chinese parents may possess a higher level of authoritarianism than European American parents and may place a higher emphasis on obedience in their parenting. Consequently, Chinese children may show stronger trust preferences from subordinate informants over dominant informants than European American children. Our research will offer insights into the potential mechanism underlying children's different learning preferences across cultures. [ABSTRACT FROM AUTHOR]

During the Marinoan Ice Age (ca. 654–635 Ma), one of the 'Snowball Earth' events in the Cryogenian Period, continental icesheets reached the tropical oceans. Oceanic refugia must have existed for aerobic marine eukaryotes to survive this event, as evidenced by benthic phototrophic macroalgae of the Songluo Biota preserved in black shales interbedded with glacial diamictites of the late Cryogenian Nantuo Formation in South China. However, the environmental conditions that allowed these organisms to thrive are poorly known. Here, we report carbon-nitrogen-iron geochemical data from the fossiliferous black shales and adjacent diamictites of the Nantuo Formation. Iron-speciation data document dysoxic-anoxic conditions in bottom waters, whereas nitrogen isotopes record aerobic nitrogen cycling perhaps in surface waters. These findings indicate that habitable open-ocean conditions were more extensive than previously thought, extending into mid-latitude coastal oceans and providing refugia for eukaryotic organisms during the waning stage of the Marinoan Ice Age. Based on geochemical and paleontological data, this study shows that habitable open-oceans extended to mid-latitude coastal oceans during the waning stage of the Marinoan snowball Earth, offering refugia for benthic photosynthetic eukaryotes [ABSTRACT FROM AUTHOR]

Ocean temperature, redox state, circulation, and nutrient levels regulate the marine nitrogen (N) cycle, yet their specific impacts during greenhouse intervals remain poorly understood. Here, we examined the Smithian–Spathian hyperthermal event (∼250.5 Ma) during the Early Triassic greenhouse using stable N isotopes (δ15N) from sedimentary records in the Nanpanjiang Basin and Northern Yangtze Basin of South China. The δ15N profiles in both basins reveal consistent trends that correspond to fluctuations in temperature across the Smithian–Spathian transition. The Smithian hyperthermal interval exhibited low δ15N values (mostly <+2‰), indicating N deficiency and enhanced biological N 2 fixation. Bacterial blooms and the release of the potent greenhouse gas N 2 O, enhanced by high temperatures, may have triggered positive feedback mechanisms that sustained the warming and contributed to the late Smithian extinction. During subsequent cooling across the Smithian–Spathian transition, δ15N increased to a range of +3‰ to +7‰, likely reflecting signals of partial denitrification based on reconstruction of the NO 3 − inventory associated with oceanic cooling and oxygenation. The prevailing increases in sedimentary TOC/TN ratios signify heightened deamination (removal of amino groups) and N recycling across the Smithian–Spathian boundary. This transition is likely attributed to cooling-driven amelioration of seawater stratification and anoxia from the Smithian to the Spathian, which resulted in increased nitrate availability in the photic zone. Eukaryotic algae thrived while prokaryotes declined during the Spathian, evidenced by elevated δ15N and Δ13C carb-org (the difference between carbonate and organic carbon isotopes). The proliferation of eukaryotic algae had a positive impact on environmental conditions and facilitated biotic recovery due to more efficient burial of organic particles. A notable latitudinal gradient in the N cycle response was observed, with low-latitude regions showing a more pronounced response to cooling compared to mid-latitude areas. This significant gradient may suggest that the rapid recovery of nutrient cycles, despite relatively small decline in high temperature, was a key factor in the amelioration of climate and recovery of life in low latitudes. These findings highlight that the marine N cycle is highly sensitive to temperature changes, particularly in low-latitude regions, and that changes in N cycle under high-temperature conditions may be a critical life-limiting factor. [ABSTRACT FROM AUTHOR]

The Cryogenian period of the Neoproterozoic was marked by two Snowball Earth glaciations that bookended a non-glacial interval that lasted roughly 10 million years. The break-up of Rodinia in the early Neoproterozoic gave rise to numerous rift basins whose time-varying redox dynamics, linked to marine productivity and biogeochemical cycling, were likely controlled by varying degrees of basin restriction in response to sea-level change. Those drivers were associated with both global glaciations (Sturtian deglaciation and the possibly early onset of the Marinoan) and local tectonics (regional basin uplift/subsidence). To explore these relationships, we focus on the Datangpo Formation, an exceptional shale sequence deposited in a marginal rift basin in South China. The Datangpo succession comprises lower organic-rich black shales and upper organic-lean gray shales/siltstones. As elucidated by our integrated data, the former were deposited in H 2 S-rich, deep-water settings underlying highly productive surface waters. We attribute this productivity to elevated nutrient supplies replenished from the open ocean following a sea-level rise, as augmented by high terrestrial input of phosphate in the wake of the Sturtian deglaciation. By contrast, the gray shales/siltstones were associated with relatively shallow deposition in an oxic/suboxic water column with suppressed primary production. The major driver of this dramatic shift in water chemistry may lie with a greater extent of basin isolation and the corresponding reduction in nutrient fluxes from the global ocean due to a significant sea-level fall—possibly linked to regional basin uplift. At this time, the basin experienced an elevated influx of detrital clays and organic material, perhaps triggered by lower sea level. Surprisingly, we found that euxinic conditions prevailed in the water column for a substantial period following the onset of more isolated conditions. This relationship can be attributed to redox-dependent phosphorus cycling. Specifically, H 2 S-replete conditions facilitated regeneration of bioavailable phosphorus, initiating a positive feedback that allowed the persistence of anoxic waters. This study advances our understanding of nutrient cycling and biogeochemical evolution during the Cryogenian under the influence of large-scale sea-level fluctuations and associated time-varying connectivity to the open ocean that must have been common in many basins at this time. Furthermore, our study sheds novel light on the iron proxy and early sulfur cycling. Almost all of the terrestrial silicate-bound iron was likely converted into highly reactive phases due to strong chemical weathering, while sulfur data revealed isotopic stratification in the wake of Sturtian deglaciation, with important messages for interpretations of analogous data in the aftermath of other climate upheavals in Earth history. [ABSTRACT FROM AUTHOR]

Simple Summary: Infections caused by bacteria, fungi, or viruses possess serious threat to human health and life. This is well realized in the current COVID-19 pandemic scenario. Antimicrobial peptides (AMPs) are a natural line of defense in many organisms, especially insects which survive in extreme niches. Here we identified AMPs from red spotted apollo butterflies found at high altitudes in Russia, China, and Korea. The larval development stage occurs on the months of December to April, when there are very low temperatures. The insects natural defense mechanism might contribute to withstand this condition, which is our point of interest, and we utilized the genomic information to identify AMPs from red spotted butterflies. The obtained AMPs were tested against a list of pathogenic bacteria and fungi. Finally, we obtained one promising candidate active against Porphyromonas gingivalis, a causative organism for periodontitis. With further validations, this could be a lead antimicrobial agent in future. Classical antibiotics are the foremost treatment strategy against microbial infections. Overuse of this has led to the evolution of antimicrobial resistance. Antimicrobial peptides (AMPs) are natural defense elements present across many species including humans, insects, bacteria, and plants. Insect AMPs are our area of interest, because of their stronger abilities in host defense. We have deciphered AMPs from an endangered species Parnassius bremeri, commonly known as the red spotted apollo butterfly. It belongs to the second largest insect order Lepidoptera, comprised of butterflies and moths, and lives in the high altitudes of Russia, China, and Korea. We aimed at identifying the AMPs from the larvae stages. The rationale of choosing this stage is that the P. bremeri larvae development occurs at extremely low temperature conditions, which might serve as external stimuli for AMP production. RNA was isolated from larvae (L1 to L5) instar stages and subjected to next generation sequencing. The transcriptomes obtained were curated in in-silico pipelines. The peptides obtained were screened for requisite AMP physicochemical properties and in vitro antimicrobial activity. With the sequential screening and validation, we obtained fifteen candidate AMPs. One peptide TPS–032 showed promising antimicrobial activity against Porphyromonas gingivalis, a primary causative organism of periodontitis. [ABSTRACT FROM AUTHOR]

The linkages between nitrogen cycling, nitrogen isotopes, and environmental properties are fundamental for reconstructing nitrogen biogeochemistry. While the impact of ocean redox changes on nitrogen isotopes is relatively well understood, it is poorly known how nitrogen responds to changes in pH and salinity. To fill the knowledge gap, we explore the effects of these environmental parameters using a well-controlled set of samples from Carboniferous-Paleogene lake sediments in China. Our results show that the threshold of 10-12‰ in d15N works to distinguish alkaline (pH > 9) from circum-neutral conditions. Elevated Mo levels in the alkaline samples support the idea of NH3 volatilization from a reducing water column in an alkaline setting. For non-alkaline lakes, d15N values tend to be higher (up to +10‰) in more saline, anoxic settings, which is attributed to either the expansion of stagnant anoxic waters spurring water-column denitrification or a shift from plant-based toward more microbially dominated ecosystems or both. Our results imply that salinity-induced redox stratification and basicity can alter nitrogen biogeochemical cycling beyond what is shown by the marine nitrogen isotope record alone. This finding will result in an improved understanding of the dynamic controls of d15N in sediments and lead to better biogeochemical interpretations of paleo-environmental conditions from unknown environmental settings on Earth and beyond Earth. [ABSTRACT FROM AUTHOR]

Hyperalkaline waters display unusually high productivity, which makes them prime targets in the search for life elsewhere in the solar system. However, the formation mechanisms of alkaline waters are not well understood, because the response of biogeochemical proxies to these conditions is poorly constrained. To address this issue, we assessed the influence of hydrothermal fluids on the salinity and pH of alkaline lakes based on a case study of an early Permian paleo-alkaline lake (~290 Ma; Fengcheng Formation) in the Mahu Sag, northwestern Junggar Basin, China. Multiple proxies indicate that hydrothermal fluids in the central salt rock and marginal tuff–mudstone areas of the Fengcheng Formation were affected by deep and shallow hydrothermal fluids, respectively. A small part of the transitional area was affected by hydrothermal fluids with a hybrid nature. The hydrothermal fluid activity gradually weakened up-section in all areas while salinity (inferred from carbon and oxygen isotopes) increased and pH (inferred from nitrogen isotopes and mineralogy) decreased from hyperalkaline (>9.25) to moderately alkaline conditions. These trends suggest that hyperalkalinity was largely driven by hydrothermal processes. In contrast, evaporation, which dominated towards the end of the lake's lifetime, maintained an elevated pH but did evidently not have a similarly strong effect as hydrothermal fluids. Our data suggest that hydrothermal activity and evaporation in closed lacustrine basins have the potential to create extreme conditions for the formation of alkaline lakes. The evolution of salinity and pH may not necessarily be synchronized. [ABSTRACT FROM AUTHOR]

• Ferruginous to weakly euxinic conditions recorded in Mesoproterozoic Yanliao sea. • A stable and moderate nitrate pool likely developed in offshore waters. • Oceanic nitrate gradient may be a global feature in the Mesoproterozoic. • Moderate nitrate availability may have maintained low eukaryotic abundance. The Mesoproterozoic (1.6–1.0 Ga) is a particularly important interval in Earth history that witnessed the initial radiation of eukaryotic life. Ocean anoxia and nutrient limitation has been invoked to explain the delayed expansion of more complex, multicellular eukaryotes during the Mesoproterozoic. However, pulsed oxygenation events and elevated nitrate availability have been identified in shallow marine settings. In deeper waters, however, nitrate availability and potential links to eukaryotic evolution remain poorly constrained. Here, we report an integrated geochemical study based on multiple proxies conducted on two new drill-core sections from the ∼1460 Ma Hongshuizhuang Formation and the ∼1380 Ma Xiamaling Formation, North China. Iron speciation and redox-sensitive trace element systematics suggest dominantly ferruginous to weakly euxinic water column conditions during deposition of both units. Our data are consistent with previous inferences of persistently anoxic deep water conditions in Mesoproterozoic oceans. Exclusively positive δ15N (+3.1 ± 0.8 ‰) values reveal the operation of partial denitrification in the water column, implying a relatively stable and moderate nitrate pool in offshore surface waters. Furthermore, a compilation of the Mesoproterozoic sedimentary δ15N record suggests a global nearshore to offshore oceanic nitrate gradient, with minimal but still bioavailable nitrate in offshore environments. The overall size of the nitrate pool was therefore apparently smaller than that of eukaryote-dominated modern oceans. Coupling Mesoproterozoic sedimentary δ15N data with fossil and biomarker records, we propose that this moderate level of nitrate may have been able to sustain a relatively low abundance of eukaryotic primary producers in the marine ecosystem, but was still not sufficient to trigger eukaryotic diversification and the rise of eukaryotes to ecological dominance. [ABSTRACT FROM AUTHOR]

Purpose: This study explores whether economic instability or food insecurity moderates the changes in emotional abuse and neglect over time., Methods: We used data from the Global Early Adolescent Study, a longitudinal study among adolescents ages 13-18 years (10-14 during pre-COVID-19 round) from poor urban communities in China (n = 387), the Democratic Republic of Congo (DRC) (n = 285), Indonesia (n = 400), and Malawi (n = 320). Data were collected before (2017 to March 2020) and during the pandemic (June to November 2020). Generalized estimating equations, using inverse probability weights evaluated changes in emotional abuse and neglect pre- and during COVID-19 and tested whether these changes varied by economic instability and food insecurity experiences during COVID-19., Results: Pre-COVID-19, emotional abuse ranged from 37.2% in DRC to 65.3% in Indonesia, and emotional neglect from 10.9% in DRC to 50.3% in Indonesia. The odds of emotional neglect increased in all sites during COVID-19 except Indonesia (adjusted odds ratio (aOR) ranging from 1.7 in China to 4.1 in Malawi). In Indonesia, odds of abuse and neglect decreased significantly during COVID-19 (aOR ranging from 0.4 to 0.7); however, emotional abuse and/or neglect declines was less pronounced for those who experienced economic instability and/or food insecurity. In Malawi, adolescents who experienced food insecurity had a significant increase in odds of emotional neglect during COVID-19., Discussion: The COVID-19 pandemic exacerbated emotional neglect and emotional abuse among adolescents living in low- and middle-income countries, although this effect varies by place and population. In Malawi and Indonesia, adolescents who experienced economic instability and/or food insecurity had more unfavorable outcomes during COVID-19, highlighting the importance of social programs correcting inequities during pandemics., (Copyright © 2024. Published by Elsevier Inc.)

Objective: This article intends to reveal the long-term effects of physical maltreatment in childhood on depressive symptoms in later life in China. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). 8676 respondents aged 45 and older were included in the study. In this study, we use ordinary least squares (OLS) regression models to estimate the long-term impact on children of physical punishment from their parents. Results: We found that individuals who recalled being hit by their mother in early life reported more depressive symptoms than those who recalled being punished by their father. Difficult family contexts (e.g., comparative poverty, family violence, and parent's poor mental health) had a weak association with higher risk of reporting physical maltreatment and more depressive symptoms among respondents in later life. Conclusion: This article extended the exploration of the long-term impact of child physical maltreatment beyond adolescence and into until later adult life. Effective policies to protect children from maltreatment in the form of physical punishment require further attention to the challenges posed by tradition and culture., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: When selecting inhaled therapies, it is important to consider both the active molecules and the device. Extrafine formulation beclomethasone dipropionate plus formoterol fumarate (BDP/FF) has been available for some years delivered via pressurized metered-dose inhaler (pMDI). More recently, a breath-activated, multi-dose dry-powder inhaler (DPI), the NEXThaler, has been approved. The current study aimed to demonstrate the non-inferiority of BDP/FF delivered via the DPI vs. via the pMDI, in Chinese adults with asthma., Methods: After a four-week run-in period, when all patients received BDP/FF pMDI 100/6 µg, two inhalations twice daily (BID), patients were randomized equally to BDP/FF pMDI or DPI, both 100/6 µg, two inhalations BID for 12 weeks. The primary objective was to demonstrate non-inferiority of BDP/FF DPI vs. BDP/FF pMDI in terms of average pre-dose morning peak expiratory flow (PEF) over the entire treatment period., Results: Of 252 and 242 patients in the DPI and pMDI groups, respectively, 88.5% and 88.8% completed the study. The primary objective was met, with no statistically significant difference between the treatments in average pre-dose morning PEF, and with the lower limit of the 95% CI above the -15 L/min non-inferiority margin (adjusted mean difference: 5.25 L/min [95% CI: -0.56, 11.06]). Adverse events were reported by 48.4% and 49.6% patients in the DPI and pMDI groups, respectively, most mild or moderate., Conclusions: The NEXThaler DPI is a similarly effective device to the pMDI for the administration of BDP/FF in adults, so extending the options available for the management of asthma.

This study aims to analyse the risk to consumers given the presence of heavy metals and bromine in honey from different countries. A probabilistic approach was applied to assess carcinogenic risk. Concerning exposure, Al in Spain (3.3E-04 mg/kgBw/day), B in Dominican Republic and Mexico (2E-04 mg/kgBw/day in both cases) and Fe in Mexico and Mozambique had the highest values (5E-05 and 4.8E-05 mg/kgBw/day). In risk characterisation, the values were less than 1 for hazard index (HI), meaning that the consumption of honey represents a low level of concern for non-genotoxic effects. A combination of margin of exposure and probability of exceedance results that exposure to Pb pose no threat. The probability of suffering cancer for Br, Cd, Ni and Pb was lower than 1.0E-06 and, therefore, considered safe. However, the risk at the 95th percentile of Br in Dominican Republic was 1.18E-04 in adults and 2.45E-04 in children, exceeding 1.0E-04, and therefore, considered intolerable. Finally, the sensitivity analysis indicated that the most influential factor in the HI was the consumption in adults and the concentration of Ni in children, whereas for cancer risk, were the concentrations of Ni, Cd, Br and Pb, in both cases., 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 © 2023 Elsevier Ltd. All rights reserved.)

Exposure to heavy metals may cause the overproduction of reactive oxygen species, generating oxidative stress and consequently, various harms to human health. The soil surrounding the Ventanas Industrial Complex, in Puchuncaví and Quintero municipal districts on the central Chilean coast, contains heavy metal concentrations (As, Cu, Pb, Zn, among others) that far exceed the maximum permissible levels established by Italian soil standards (used as a reference). This study aimed to investigate the potential association between heavy metal exposure in humans and the levels of oxidative stress biomarkers in inhabitants of these locations. We took blood samples from 140 adults living in sites with high concentrations of heavy metals in the soil and compared them with blood samples from 140 adults living in areas with normal heavy metal concentrations. We assessed lipid peroxidation, damage to genetic material, and Total Antioxidant Capacity in these blood samples. Our results indicate an association between oxidative damage and heavy metal exposure, where the inhabitants living in exposed areas have a higher level of DNA damage compared with those living in control areas. Given that DNA damage is one of the main factors in carcinogenesis, these results are of interest, both for public health and for public policies aimed at limiting human exposure to environmental pollution., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Aquatic environments are often severely polluted with chemical substances of anthropogenic origin, which can pose a potential threat to aquatic organisms and human health. In this study, patterns and sources of heavy metals (HMs, 6 metals) and polycyclic aromatic hydrocarbons (PAHs, 16 hydrocarbons), contamination indicators, environmental genotoxicity measures and metrics of ecological status in lotic and lentic ecosystems were collated for the first time. Chemical analysis has confirmed previously reported long-term contamination at certain study sites. The sediments of Lake Talkša, located in a city and characterized by exclusive anthropogenic pressure, exhibited the highest levels of contamination by both HMs and PAHs. Through positive matrix factorization (PMF) analysis, vehicle and industrial emissions were identified as the primary sources of HMs and PAHs. Our results revealed that frequencies of genotoxic aberrations were higher in river sites compared to lakes, with the highest genotoxic risk observed in the Nemunas River below industrial cities Alytus and Kaunas. Surprisingly, even the severely contaminated Lake Talkša showed only a "moderate" grade of genotoxic risk, highlighting the potential for adaptation of biota to long-term contamination especially in lentic ecosystems. The ecological quality status assessed by macroinvertebrate metrics, which may be sensitive to observed high biological contamination, appeared to be unrelated to contamination patterns. Consequently, to obtain the robust information on anthropogenic contamination and its effects, a combination of various assessment methods and metrics should be employed., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Aleksandras Rybakovas reports financial support was provided by Research Council of Lithuania. Reda Nalivaikienė reports financial support was provided by Research Council of Lithuania. Giedre Višinskienė reports financial support was provided by Research Council of Lithuania. Kęstutis Arbačiauskas reports financial support was provided by Research Council of Lithuania., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Seafood consumption has become a potential exposure route towards high production volume chemicals (HPVs) due to the pathway of these compounds reaching the aquatic environment via industrial and domestic discharges. The present study focuses on the determination of phthalate esters (PAEs), organophosphate esters (OPEs), benzothiazoles (BTs), benzotriazoles (BTRs) and benzenesulfonamides (BSAs) in the ten most consumed fish species in Catalonia. A total of 120 commercially available seafood specimens were purchased throughout February 2019-February 2020 in three different stores (supermarket, local market, and local fishmonger) of the city of Tarragona, Spain, to cover the most typical places where seafood can be obtained. ΣOPEs, ΣBTs, ΣBSAs and ΣPAEs concentrations ranged between 5.99 and 139.45 ng g -1 w.w., 8.41-54.08 ng g -1 w.w., 8.38-304.47 ng g -1 w.w and 2.86-323.80 ng g -1 w.w., respectively. BTRs were not detected in any of the samples. PAEs and BSAs had similar contributions which combined represented nearly the 70% of detected compounds and sardine resulted as the species with the higher HPVs mean concentration. No considerable threat was posed due to the individual intake of these compounds via seafood consumption., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Authors report financial support was provided by Spain Ministry of Science and Innovation., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Disengagement from treatment is common in first episode schizophrenia (FES) and is associated with poor outcomes. Our aim was to determine whether hippocampal subfield volumes predict disengagement during maintenance treatment of FES., Methods: FES patients were recruited from sites in Boston, New York, Shanghai, and Changsha. After stabilization on antipsychotic medication, participants were randomized to add-on citalopram or placebo and followed for 12 months. Demographic, clinical and cognitive factors at baseline were compared between completers and disengagers in addition to volumes of hippocampal subfields., Results: Baseline data were available for 95 randomized participants. Disengagers (n = 38, 40%) differed from completers (n = 57, 60%) by race (more likely Black; less likely Asian) and in more alcohol use, parkinsonism, negative symptoms and more impairment in visual learning and working memory. Bilateral dentate gyrus (DG), CA1, CA2/3 and whole hippocampal volumes were significantly smaller in disengagers compared to completers. When all the eight volumes were entered into the model simultaneously, only left DG volume significantly predicted disengagement status and remained significant after adjusting for age, sex, race, intracranial volume, antipsychotic dose, duration of untreated psychosis, citalopram status, alcohol status, and smoking status (P < .01). Left DG volume predicted disengagement with 57% sensitivity and 83% specificity., Conclusions: Smaller left DG was significantly associated with disengagement status over 12 months of maintenance treatment in patients with FES participating in a randomized clinical trial. If replicated, these findings may provide a biomarker to identify patients at risk for disengagement and a potential target for interventions., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

Purpose: This research aimed to explore individuals' willingness to pay (WTP) and studied the role of family decision makers in WTP for COVID-19 vaccines., Methods: A self-administered online questionnaire evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China. The logistic regression model was performed to identify the factors associated with WTP for the COVID-19 vaccines, and all data were analysed by R software, version 4.1.0., Results: 44.2% and 43.7% of 824 community residents were willing to pay for the first two doses and the booster dose of the COVID-19 vaccine, respectively. Decision-makers were more willing to pay for both the first two doses and the boost dose of the COVID-19 vaccines, with OR (95%CI) being 1.75 (1.25-2.47) and 1.89 (1.34-2.67), respectively. Besides, participants' WTP for COVID-19 vaccines were also associated with their occupation and monthly household income., Conclusion: This study found that family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines in Taizhou, China. To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision makers in vaccination.Key MessagesA study evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China.Family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines.To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision-makers in vaccination.

Gene expression can be modified in people who are chronically exposed to high concentrations of heavy metals. The soil surrounding the Ventanas Industrial Complex, located on the coastal zone of Puchuncaví and Quintero townships (Chile), contain heavy metal concentrations (As, Cu, Pb, Zn, among others) that far exceed international standards. The aim of this study was to determine the potential association of the heavy metals in soils, especially arsenic, with the status of methylation of four tumor suppressor genes in permanent residents in those townships. To study the methylation status in genes p53, p16, APC, and RASSF1A, we took blood samples from adults living in areas near the industrial complex for at least 5 years and compared it to blood samples from adults living in areas with normal heavy metal concentrations of soils. Results indicated that inhabitants of an area with high levels of heavy metals in soil have a significantly higher proportion of methylation in the promoter region of the p53 tumor suppressor gene compared with control areas (p-value: 0.0035). This is the first study to consider associations between heavy metal exposure in humans and aberrant DNA methylation in Chile. Our results suggest more research to support consistent decision-making on processes of environmental remediation or prevention of exposure., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: An extrafine formulation of the inhaled corticosteroid beclometasone dipropionate (BDP) plus the long-acting β 2 -agonist formoterol fumarate (FF) has been available for years via a pressurised metered-dose inhaler for the management of asthma and chronic obstructive pulmonary disease. More recently, the same extrafine BDP/FF formulation has become available in a multidose dry-powder inhaler (DPI) called the NEXThaler. The pharmacokinetics (PK) of BDP/FF via this DPI have previously been evaluated in a Caucasian population. The current study aimed to evaluate the PK profile of BDP/FF via DPI in healthy Chinese volunteers. The results were then compared to previous Caucasian data., Methods: This open-label parallel group study randomised subjects to single-dose BDP/FF 200/12, 400/24, or 800/48 μg via DPI. Blood samples were taken up to 24 h post-dose for PK evaluation of BDP, beclometasone 17-monopropionate (B17MP, active metabolite of BDP) and formoterol. The primary objective of the study was to evaluate the PK of BDP/FF (BDP, B17MP and formoterol). The study is registered on the World Health Organization International Clinical Trials Registry Platform (ChiCTR1900021899)., Results: Of 36 subjects randomised, all completed the study. Following inhalation of all three doses, plasma concentration of formoterol and BDP increased rapidly, with peak mean values at the first post-dose timepoint (5 min), then rapidly decreasing; B17MP reached peak concentration slightly later. Plasma exposure to formoterol, BDP and B17MP increased broadly in a dose-proportional manner to BDP/FF dose, with t max values similar across the dose range. All BDP/FF doses were generally well tolerated., Conclusions: Therapeutic and supra-therapeutic doses of BDP/FF administered via DPI resulted in approximately dose-proportional plasma exposure in healthy Chinese subjects, with PK profiles that were comparable to previous data from Caucasian subjects., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Hepatitis B virus (HBV) infection has been associated with an increased risk for B-cell lymphomas. We previously showed that 20% of diffuse large B-cell lymphoma (DLBCL) patients from China, an endemic area of HBV infection, have chronic HBV infection (surface antigen-positive, HBsAg+) and are characterized by distinct clinical and genetic features. Here, we showed that 24% of follicular lymphoma (FL) Chinese patients are HBsAg+. Compared with the HBsAg- FL patients, HBsAg+ patients are younger, have a higher histological grade at diagnosis, and have a higher incidence of disease progression within 24 months. Moreover, by sequencing the genomes of 109 FL tumors, we observed enhanced mutagenesis and distinct genetic profile in HBsAg+ FLs, with a unique set of preferentially mutated genes (TNFAIP3, FAS, HIST1H1C, KLF2, TP53, PIM1, TMSB4X, DUSP2, TAGAP, LYN, and SETD2) but lack of the hallmark of HBsAg- FLs (ie, IGH/BCL2 translocations and CREBBP mutations). Transcriptomic analyses further showed that HBsAg+ FLs displayed gene-expression signatures resembling the activated B-cell-like subtype of diffuse large B-cell lymphoma, involving IRF4-targeted genes and NF-κB/MYD88 signaling pathways. Finally, we identified an increased infiltration of CD8+ memory T cells, CD4+ Th1 cells, and M1 macrophages and higher T-cell exhaustion gene signature in HBsAg+ FL samples. Taken together, we present new genetic/epigenetic evidence that links chronic HBV infection to B-cell lymphomagenesis, and HBV-associated FL is likely to have a distinct cell-of-origin and represent as a separate subtype of FL. Targetable genetic/epigenetic alterations identified in tumors and their associated tumor microenvironment may provide potential novel therapeutic approaches for this subgroup of patients., (© 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

Background: Moderate intraoperative hypothermia promotes myocardial injury, surgical site infections, and blood loss. Whether aggressive warming to a truly normothermic temperature near 37°C improves outcomes remains unknown. We aimed to test the hypothesis that aggressive intraoperative warming reduces major perioperative complications., Methods: In this multicentre, parallel group, superiority trial, patients at 12 sites in China and at the Cleveland Clinic in the USA were randomly assigned (1:1) to receive either aggressive warming to a target core temperature of 37°C (aggressively warmed group) or routine thermal management to a target of 35·5°C (routine thermal management group) during non-cardiac surgery. Randomisation was stratified by site, with computer-generated, randomly sized blocks. Eligible patients (aged ≥45 years) had at least one cardiovascular risk factor, were scheduled for inpatient non-cardiac surgery expected to last 2-6 h with general anaesthesia, and were expected to have at least half of the anterior skin surface available for warming. Patients requiring dialysis and those with a body-mass index exceeding 30 kg/m 2 were excluded. The primary outcome was a composite of myocardial injury (troponin elevation, apparently of ischaemic origin), non-fatal cardiac arrest, and all-cause mortality within 30 days of surgery, as assessed in the modified intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT03111875., Findings: Between March 27, 2017, and March 16, 2021, 5056 participants were enrolled, of whom 5013 were included in the intention-to-treat population (2507 in the aggressively warmed group and 2506 in the routine thermal management group). Patients assigned to aggressive warming had a mean final intraoperative core temperature of 37·1°C (SD 0·3) whereas the routine thermal management group averaged 35·6°C (SD 0·3). At least one of the primary outcome components (myocardial injury after non-cardiac surgery, cardiac arrest, or mortality) occurred in 246 (9·9%) of 2497 patients in the aggressively warmed group and in 239 (9·6%) of 2490 patients in the routine thermal management group. The common effect relative risk of aggressive versus routine thermal management was an estimated 1·04 (95% CI 0·87-1·24, p=0·69). There were 39 adverse events in patients assigned to aggressive warming (17 of which were serious) and 54 in those assigned to routine thermal management (30 of which were serious). One serious adverse event, in an aggressively warmed patient, was deemed to be possibly related to thermal management., Interpretation: The incidence of a 30-day composite of major cardiovascular outcomes did not differ significantly in patients randomised to 35·5°C and to 37°C. At least over a 1·5°C range from very mild hypothermia to full normothermia, there was no evidence that any substantive outcome varied. Keeping core temperature at least 35·5°C in surgical patients appears sufficient., Funding: 3M and the Health and Medical Research Fund, Food and Health Bureau, Hong Kong., Translation: For the Chinese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests DIS occasionally consults for various temperature-related companies; all fees are donated to charity. Unrelated to this trial, DIS is a consultant for Pacira Biosciences (Parsippany, NJ, USA). DIS also reports advisory board participation and equity interests in Calorint (Philadelphia, PA, USA), TransQtronics (Philadelphia, PA, USA), the Health Data Analytics Institute (Boston, MA, USA), Medasense (Tel Aviv, Israel), Serenno (Tel Aviv, Israel), Sensifree (Cupertino, CA, USA), Perceptive Medical (Newport Beach, CA, USA), and Neuroindex (Tel Aviv, Israel). All other authors declare no competing interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background and Objectives: With the extension of healthy life expectancy, promoting active aging has become a policy response to rapid population aging in China. Yet, it has been inconclusive about the relative importance of the determinants of active aging. By applying a machine learning approach, this study aims to identify the most important determinants of active aging in 3 domains, i.e., paid/unpaid work, caregiving, and social activities, among Chinese older adults., Research Design and Methods: Data were drawn from the first wave of the China Health and Retirement Longitudinal Study, which surveys a nationally representative sample of adults aged 60 years and older (N = 7,503). We estimated Random Forest and the least absolute shrinkage and selection operator regression models (LASSO) to determine the most important factors related to active aging., Results: Health has a generic effect on all outcomes of active aging. Our findings also identified the domain-specific determinants of active aging. Urban/rural residency is among the most important factors determining the likelihood of engaging in paid/unpaid work. Living in a multigenerational household is especially important in predicting caregiving activities. Neighborhood infrastructure and facilities have the strongest influence on older adults' participation in social activities., Discussion and Implications: The application of feature selection models provides a fruitful first step in identifying the most important determinants of active aging among Chinese older adults. These results provide evidence-based recommendations for policies and practices promoting active aging., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

In October 2019, a fire occurred in a tire-recycling facility in Alytus (Lithuania), where around 5000 t of tires had been stored. Only after 10 days was the fire completely extinguished, and the potential contamination of the surrounding environment has raised a large public concern. With an aim to assess the pollution level and pollutants distribution in the surrounding area, we conducted a study on polycyclic aromatic hydrocarbons (PAHs) and heavy metals. High concentrations of total PAHs were found inside the fire zone (315-5872 ng g -1 dw), whereas those detected in the surrounding soils were significantly lower (1.9-72 ng g -1 dw). Some areas with higher anthropogenic impact were found to contain PAH concentrations as high as 70198 ng g -1 dw. Concentrations of Cr, Zn, Ni, Cu, Pb were in the range of 1.1-93.9; 20.7-227.5; 0.2-35.7; 0.9-21.3; 0.9-102.9 μg g -1 , respectively. Zn was the prevailing metal in the fire zone, elevated concentrations of Cr, Ni and Cu were also detected in this area. Principal component analysis (PCA) revealed several locations affected by the fire. The one located the closest to the fire zone was found to be highly contaminated with the heavy metals, just like the whole fire zone. Increase of the carcinogenic risk was observed in the fire zone, but no significant risk was detected in the fire-affected stations. The highest carcinogenic risk was detected in the zones with high anthropogenic loading (traffic and urban activities)., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Dengue is a prioritized public health concern in China. Because of the larger scale, more frequent and wider spatial distribution, the challenge for dengue prevention and control has increased in recent years. While land use and land cover (LULC) change was suggested to be associated with dengue, relevant research has been quite limited. The "Open Door" policy introduced in 1978 led to significant LULC change in China. This systematic review is the first to review the studies on the impacts of LULC change on dengue dynamics in China. This review aims at identifying the research evidence, research gaps and provide insights for future research., Methods: A systematic literature review was conducted following the PRISMA protocol. The combinations of search terms on LULC, dengue and its vectors were searched in the databases PubMed, Web of Science, and Baidu Scholar. Research conducted on China published from 1978 to December 2019 and written in English or Chinese was selected for further screening. References listed in articles meeting the inclusion criteria were also reviewed and included if again inclusion criteria were met to minimize the probability of missing relevant research., Results: 28 studies published between 1978 and 2017 were included for the full review. Guangdong Province and southern Taiwan were the major regional foci in the literature. The majority of the reviewed studies observed associations between LULC change factors and dengue incidence and distribution. Conflictive evidence was shown in the studies about the impacts of green space and blue space on dengue in China. Transportation infrastructure and urbanization were repeatedly suggested to be positively associated with dengue incidence and spread. The majority of the studies reviewed considered meteorological and sociodemographic factors when they analyzed the effects of LULC change on dengue. Primary and secondary remote sensing (RS) data were the primary source for LULC variables. In 21 of 28 studies, a geographic information system (GIS) was used to process data of environmental variables and dengue cases and to perform spatial analysis of dengue., Conclusions: The effects of LULC change on the dynamics of dengue in China varied in different periods and regions. The application of RS and GIS enriches the means and dimensions to explore the relations between LULC change and dengue. Further comprehensive regional research is necessary to assess the influence of LULC change on local dengue transmission to provide practical advice for dengue prevention and control., Competing Interests: The authors have declared that no competing interests exist.

Swift degradation of the coral reef ecosystems urges the need to identify the reef decline drivers. Due to their widespread use, bioaccumulative and toxic characteristics, chlorinated organic compounds, such as chlorinated paraffins (CPs), are regarded as specific pollutants of concern. Yet little is known about the occurrence of CPs in the coral reef ecosystems. This study focuses on the short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs). Their distribution and congener pattern were investigated in the water-SPM-sediment system and in the corals of the Larak coral reef for the first time. Chlorinated paraffins were detected in all the coral species. Their total loadings ranged from 42.1 to 178 ng g -1 dw in coral tissue, from 6.0 to 144 ng g -1 dw in the skeleton, and from 55.0 to 240 ng g -1 dw in zooxanthellae. Soft corals were found to accumulate more CPs than Scleractinian corals. Zooxanthellae and mucus accumulated more CPs than tissue and skeleton. In most cases, congener group patterns were dominated by C 13 (for SCCPs) and C 17 (MCCPs) groups, respectively. The congener patterns of CPs altered to some extent between mucus and the remaining coral compartments. High loadings of CPs were detected in the skeleton of the bleached corals. Moreover, a significant negative correlation between the levels of CPs and the symbiodinium density was observed., Competing Interests: Declaration of competing interest Authors declare no conflicts of interest in this work., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The novel coronavirus disease (COVID-19) was first detected in Mainland China in December 2019, and soon it spread throughout the world, with multiple physical and psychological consequences across the affected populations., Aims: The aim of the current study was to analyze the impact of COVID-19 pandemic on older adults with mild cognitive impairment (MCI)/dementia and their caregivers as well., Materials and Methods: Two hundred and four caregivers took part in the study, completing a self-reported questionnaire about the person with MCI/dementia and their own, since the lockdown period which started in February and ended in May of 2020 in Greece., Results: Results indicated a significant overall decline of the people with MCI/dementia. Further, the domains in which people with MCI/dementia were mostly affected were: communication, mood, movement and compliance with the new measures. Caregivers also reported a great increase in their psychological and physical burden during this period, where the available support sources were limited., Discussion: The pandemic threatens to disrupt the basic routines that promote mental and physical health of both people with MCI/dementia and t heir caregivers., Conclusion: Further measures to protect and provide support to people who suffer and their families are needed., (© 2020 John Wiley & Sons Ltd.)

The aim of this study was to identify interventions targeting children and their caregivers to reduce psychosocial problems in the course of the COVID-19 pandemic and comparable outbreaks. The review was performed using systematic literature searches in MEDLINE, Embase, PsycINFO and COVID-19-specific databases, including the CDC COVID-19 Research Database, the World Health Organisation (WHO) Global Database on COVID-19 Research and the Cochrane COVID-19 Study Register, ClinicalTrials.gov, the EU Clinical Trials Register and the German Clinical Trials Register (DRKS) up to 25th September 2020. The search yielded 6657 unique citations. After title/abstract and full text screening, 11 study protocols reporting on trials planned in China, the US, Canada, the UK, and Hungary during the COVID-19 pandemic were included. Four interventions targeted children ≥10 years directly, seven system-based interventions targeted the parents and caregivers of younger children and adolescents. Outcome measures encompassed mainly anxiety and depressive symptoms, different dimensions of stress or psychosocial well-being, and quality of supportive relationships. In conclusion, this systematic review revealed a paucity of studies on psychosocial interventions for children during the COVID-19 pandemic. Further research should be encouraged in light of the expected demand for child mental health management.

Within the last two decades, several members of the Coronaviridae family demonstrated epidemic potential. In late 2019, an unnamed genetic relative, later named SARS-CoV-2 (COVID-19), erupted in the highly populous neighborhoods of Wuhan, China. Unchecked, COVID-19 spread rapidly among interconnected communities and related households before containment measures could be enacted. At present, the mortality rate of COVID-19 infection worldwide is 6.6%. In order to mitigate the number of infections, restrictions or recommendations on the number of people that can gather in a given area have been employed by governments worldwide. For governments to confidently lift these restrictions as well as counter a potential secondary wave of infections, alternative medications and diagnostic strategies against COVID-19 are urgently required. This review has focused on these issues.

This study examines the association between productive activity patterns and functional health trajectories of Chinese older adults and whether this association varies by urban/rural residence. Using three waves of the China Health and Retirement Longitudinal Study from a sample of 7,503 older adults, we first performed latent class analysis (LCA) to identify productive activity patterns based on four activities (work, caregiving, informal help, and formal volunteering). Next, multilevel regression analyses were conducted to assess the association between the identified productive activity patterns and functional health trajectories among older adults. Four productive activity patterns are identified from LCA: nonengagers, working-caregivers, workers, and helpers. We find that participation in productive activities is associated with slower functional health decline. The moderation effects of urban/rural differences are prominent across identified groups. Our findings highlight the importance of the urban/rural context in understanding productive aging and its health consequences among Chinese older adults.

Background: Optimal management of patients with cancer during COVID-19 pandemic is still pending., Methods: Our patients were advised to maintain their scheduled appointments, and planned cancer treatment was continued without unnecessary delays in an outpatient setting. Additional strict preventive infection measures were rapidly implemented at our outpatient department. When COVID-19 test became widely available, universal testing of healthcare workers and vigorous screening of all patients coming to our facility for COVID-19 infection were performed by SARS-CoV-2 real-time reverse transcription PCR on rhinopharyngeal swab., Results: As of the data cut-off on 9 April 2020, a total of 156 oncology patients with a median age of 67 (range 26-86) years and 63 haematology patients (median age 69 years, range 23-89) were screened for COVID-19 during active cancer treatment. Prevalence (1.8%; 4/219) of COVID-19 in patients with cancer was significantly higher compared with a respective control group of asymptomatic counterparts (p=0.018). Outcomes of COVID-19 positive patients were good, with only one observed death due to progression of advanced metastatic disease., Conclusion: Our data indicate that continuation of anticancer treatment in epidemic areas during the COVID-19 pandemic seems to be safe and feasible, if adequate and strict preventive measures are vigorously and successfully carried out., Competing Interests: Competing interests: DF declares travel, accommodation, expenses supported by Sanofi and Ipsen outside the submitted work. CP declares non-financial support from Innova outside the submitted work. EH declares travel, accommodation, expenses supported by Roche and received honoraria from Novartis, Boehringer Ingelheim and AstraZeneca outside the submitted work. MM declares travel, accommodation, expenses supported by Ipsen and Celgene and received honoraria from Janssen outside the submitted work., (© Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.)

Background : Since 2007, trivalent inactivated influenza vaccine (TIV) has been provided free-of-charge to primary, middle school and high school students in Beijing. However, there have been few school-based studies on influenza vaccine effectiveness (VE). In this report, we estimated influenza VE against laboratory-confirmed influenza illness among school children in Beijing, China during the 2016-2017 influenza season. Methods : The VE of 2016-2017 TIV against laboratory-confirmed influenza virus infection among school-age children was assessed through a case-control design. Conditional logistic regression was conducted on matched case-control sets to estimate VE. The effect of prior vaccination on current VE was also examined. Results : All 176 samples tested positive for influenza A virus with the positive rate of 55.5%. The average coverage rate of 2016-2017 TIV among students across the 37 schools was 30.6%. The fully adjusted VE of 2016-2017 TIV against laboratory-confirmed influenza was 69% (95% CI: 51 to 81): 60% (95% CI: -15 to 86) for influenza A(H1N1)pdm09 and 73% (95% CI: 52 to 84) for influenza A(H3N2). The overall VE for receipt of 2015-2016 vaccination only, 2016-2017 vaccination only, and vaccinations in both seasons was 46% (95% CI: -5 to 72), 77% (95% CI: 58 to 87), and 57% (95%CI: 17 to 78), respectively. Conclusions : Our study during school outbreaks found that VE of 2016-2017 TIV was moderate against influenza A(H3N2) as well as A(H1N1)pdm09 viruses.

Air pollution has recently been linked to central nervous system (CNS) diseases, possibly mediated by inflammation and oxidative stress. Hippocampal atrophy in individuals with first episode schizophrenia (FES) has also been associated with biomarkers of inflammation and oxidative stress, whereas hippocampal atrophy was not observed in matched healthy controls with similar biomarker levels of inflammation and oxidative stress. Fine particulate matter (PM2.5), one component of air pollution, is most strongly implicated in CNS disease. The present study examined the association between PM2.5 and hippocampal volume in individuals with FES who participated in a 52-week placebo-controlled clinical trial of citalopram added to clinician-determined antipsychotic treatment at four sites in the US and China. Left hippocampal volumetric integrity (LHVI; inversely related to atrophy) was measured at baseline and week 52 using an automated highly-reliable algorithm. Mean annual PM2.5 concentrations were obtained from records compiled by the World Health Organization. The relationships between baseline LHVI and PM2.5 and change in LHVI and PM2.5 were evaluated using regression analyses. 89 participants completed imaging at baseline and 46 participants completed imaging at week 52. Mean annual PM2.5 was significantly associated with both baseline LHVI and change in LHVI after controlling for age, sex, baseline LHVI, duration of untreated psychosis and baseline antipsychotic medication dose. Air pollution may contribute to the progression of hippocampal atrophy after a first episode of illness, but these findings should be considered preliminary since other unmeasured factors may have differed between cities and contributed to the observed effect., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2020. Published by Elsevier B.V.)

The Chinese old-old (80+) population has steadily increased in recent years; however, limited studies have examined how this group ages. The purpose of this study is to explore how the old-old in urban China define successful aging. Guided by grounded theory, we conducted semi-structured, in-depth interviews with community-dwelling old-old participants (N = 97). Participants identified self-reliance as the goal of successful aging, which was supported by four proactive behaviors: physical activity, financial security, community connectedness, and willing acceptance of reality. In our model, we conceptualized these four proactive behaviors to constitute the ribs of an umbrella, supporting a canopy to protect the pole of self-reliant successful aging. This study offers new understanding of the dynamic and nuanced ways that the old-old in urban China age successfully and of their valiant efforts to maintain self-reliance.

To investigate the effectiveness of the Clubhouse Model of Psychosocial Rehabilitation on psychosocial functions and recovery of native Chinese individuals with schizophrenia in a community sample. A randomized controlled design was used. A total of 56 participants were recruited from a community sample for a study lasting 6 months, but five participants dropped out. Twenty-eight participants attended the Clubhouse program, and twenty-three participants served as controls. Standardized assessments were performed on three areas at the baseline and the 6-month follow-up: 1. symptom reduction; 2. social function, self-determination, and quality of life; and 3. rehospitalization rate. Compared to the controls, the Clubhouse participants showed reductions in psychiatric symptoms and better social function, self-determination, and quality of life (p < .05), but with no difference in the rehospitalization rate between Clubhouse members and the controls. The Clubhouse Model demonstrates its effectiveness and shows its viability as a service delivery model in psychosocial rehabilitation for individuals with schizophrenia in mainland China.

A comprehensive study is carried out to determine (1) the annual historical demand and supply, (2) the annual prospective demand, and (3) the carrying capacity and future sustainability of copper resources in China. The results of the first analysis show that both the demand and the supply have substantially increased since 2000 after remaining relatively minute for the period from 1950 to 2000. By 2015, the per capita total and domestic demands had reached 7.6 and 5.4 kg, respectively. The annual demand prospects suggest that the copper demand will peak in 2030 and either stabilize or marginally drop thereafter. This was found to be the case for all population variants and demand growth rates that were considered herein, with the exception of the "stable scenario". Under the considered scenarios, the domestic demand in the year 2050 is predicted to fall by 6.7-15 million metric tons (Mt), while the total demand will likely fall by 9.4-21.2 Mt. The projected drastic increase in the cumulative primary demand suggests that China should pursue more industrially sustainable options. If the current trends continue, demand will likely surpass even the projected reserve base of 2050 sometime from 2025 to 2035 unless necessary actions to change the course are initiated as soon as possible. Chinese efforts to promote recycling in recent decades have been admirable but are not sufficient to meet the primary demand, thus leaving a large proportion of the demand to be met using imports. Thus, to reduce the primary copper imports, it is desirable to increase recycling rates to 60-70%. The shortcomings of the domestic recycling industry include poor end-of-life collection and an elastic policy framework. These issues merit attention in the short term to increase the long-term sustainability of copper resources in China.

Objectives: To develop a transferable, simple screening method to evaluate the effect of pH of oral care products on oral hard tissues., Methods: The method reported here is based on the assessment of oral hard surface changes produced by oral care products measured via Vickers Surface Microhardness (SMH). Two variations of this screening test method were developed, one including the use of salivary pellicle and human teeth and a second using bovine substrates with artificial saliva. The test method using bovine substrates and artificial saliva was replicated in a second laboratory in Beijing, China to verify reproducibility and transferability of the technique., Results: Both approaches confirmed changes on surface hardness with 1% citric acid. All tested marketed products, including those formulated at pH < 5.5, showed no significant %SMH difference from the positive control (water), and demonstrated a significant difference from the negative control (1% citric acid). The two laboratories produced similar results (pH effects, standard deviation, and statistical rank-ordering of treatments)., Conclusions: This simple screening method accurately assesses the influence of positive and negative controls, regardless of the source of hard tissue (human vs. bovine) and saliva (human vs. artificial). It correctly shows that marketed products with pH below 5.5 that demonstrate favorable in vivo safety profiles do not contribute to detrimental hard tissue changes. The method is easily transferable and shows potential as a tool for the safety profile assessment of oral care products., Competing Interests: All authors of this paper were employees of the Procter & Gamble Company at the time the work was done. Dr. White has since retired and is a consultant to the company., (Copyright© by the YES Group, Inc.)

The monozoic tapeworm Atractolytocestus huronensis Anthony, 1958 (Cestoda: Caryophyllidea), an intestinal parasite of the common carp, is characterized by its invasive character and potential to colonize new territories. It was initially described from North America and has also been found in several European countries. The most recent findings of A. huronensis originated from China and South Africa; however, no data on genetic relationships of these populations were available. The current study provides the first molecular characterisation of A. huronensis from South Africa and China using a partial sequence of mitochondrial cytochrome c oxidase subunit 1 (cox1) and a complete ribosomal ITS2 spacer. Ribosomal and mitochondrial data were applied for phylogenetic analyses in order to assess the genetic interrelationships among global A. huronensis populations. Divergent intragenomic copies of ribosomal ITS2 were detected in all analysed specimens; the structure and frequency of the ITS2 variants of tapeworms from China and South Africa corresponded with the data on ITS2 paralogues observed previously in A. huronensis from Slovakia, the United States and the United Kingdom. The phylogenetic analysis of cox1 indicated that A. huronensis exist in two slightly differentiated clusters; one cluster was supported by all phylogenetic approaches (NJ, ML, BI) and was represented by samples from China, the USA and the UK. A second cluster was represented by tapeworms from continental Europe (Slovakia, Hungary, Romania, Croatia) and South Africa. Haplotype network analysis revealed that the highest population diversity occurs in China. The results provide useful pilot information about the interrelationships of A. huronensis on four continents and indicate that China, or the eastern Palaearctic, served as the original source population for the global expansion of this invasive tapeworm. Data on the origin and distribution of the common carp, the only specific host of A. huronensis, are also discussed., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Stroke is the second leading cause of death in the world. It has multiple risk factors of which some, such as ambient temperature, are less well documented., Objective: We aimed to examine the association between diurnal temperature range (DTR) and stroke mortality, and to test the possible effect modification of this association according to gender, age and educational level., Methods: Daily data on weather and stroke mortality from 16 provincial capital cities in China for the years 2007-2013 were obtained, with a total of 788,783 deaths from stroke. A quasi-Poisson generalized linear regression combined with a distributed lag non-linear model was used to examine the city-specific DTR effect on stroke mortality. The pooled effects of DTR on stroke mortality were then obtained using a meta-analysis, which was based on restricted maximum likelihood estimation., Results: The DTR impacts were generally limited to a period of eight days, while significant effects during lag 0-8 days were only found in the cities of Beijing, Zhengzhou, Nanjing, Hefei, Chongqing and Changsha. The DTR effects were significantly and negatively associated with latitudes at lag 0-10 days (r s = - 0.640, P = 0.008). An increase of 1 °C in DTR was associated with pooled estimate of 0.66% (95%CI: 0.28-1.05%), 0.12% (- 0.26% to 0.51%) and 0.67% (0.26-1.07%) increases in stroke mortality at lag 0-10 days during the total, hot and cold days, respectively. The impact of DTR was much higher in southern China than in northern China [1.02% (0.62% to 1.43%) versus 0.10% (-0.27% to 0.47%) ]. For the individual characteristics, only females, the elderly aged ≥ 65 years, and those with lower educational attainment were vulnerable to DTR., Conclusions: DTR has considerable effects on risk of mortality from stroke in various cities in China, especially among the elderly, females, those with low educational level, and people living in southern China. The results can inform decisions on developing programs to protect vulnerable subpopulations from adverse impacts of DTR., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objectives: Self-determination is viewed as an important ingredient of successful recovery in psychiatric rehabilitation. The concept of autonomy, a key component of self-determination, may be of less importance in Chinese cultures, whereby an individual's choices may be in conflict with the family's expectations. This study aimed to develop an instrument to measure opinions about self-determination among Chinese consumers and their family members., Methods: A 27-item questionnaire, the Consumer and Family Decision Making Scale (CFDMS), was constructed to measure consumers' and family members' views of self-determination in various aspects of daily life. A total of 364 (182 consumers of psychiatric services with a diagnosis of schizophrenia and 182 of their family members) participated in the study., Results: The CFDMS was found to possess good psychometric properties and appears to be a reliable and valid instrument for assessment of consumers' decision making. (The Cronbach's alphas of psychiatric care and treatment factor, personal and social function factor, community and daily living factor, and money management factor were as follows: .86, .89, .87 and .76. The respective test-retest reliabilities were as follows: .81, .89, .80, and .88). Chinese consumers preferred autonomous decision making in regard to personal and social functioning and community and daily living but preferred to defer decisions regarding psychiatric care and treatment and money management to others. Family members and consumers had similar views., Conclusions: Deferring decisions to family members is common in Chinese families. The emphasis on autonomy in Western health care may need to be reconsidered in the treatment of Chinese consumers. Chinese families have a strong influence on treatment decisions, and providers must respect this style and remain nonjudgmental when dealing with situations or decisions that may be contradictory to their own culture and values.

This prospective, multicentre, phase III study (NCT02104804) evaluated the efficacy and safety of saxagliptin add-on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin ± metformin. Patients with glycated haemoglobin (HbA1c) 7.5% to 10.5% and fasting plasma glucose (FPG) <15 mmol/L (270 mg/dL) on stable insulin therapy (20-150 U/d) were randomized (1:1) to saxagliptin 5 mg once daily (N = 232) or placebo (N = 230) for 24 weeks, stratified by metformin use. The primary efficacy measure was change in HbA1c. Saxagliptin treatment resulted in a greater adjusted mean change in HbA1c from baseline to week 24 than placebo (-0.58%; P < .001), irrespective of metformin use, and a greater mean change in FPG (0.9 mmol/L [-15.9 mg/dL]; P < .001). More patients achieved HbA1c <7% with saxagliptin (11.4%) than with placebo (3.5%, P = .002). Adverse events and incidence of hypoglycaemia were similar in both groups. Overall, add-on saxagliptin 5 mg once daily significantly improved glycaemic control without increasing hypoglycaemia risk and was well tolerated in Chinese patients with type 2 diabetes inadequately controlled by insulin (± metformin)., (© 2017 John Wiley & Sons Ltd.)

The purpose of this study is to explore direct carers' work experience and formal caring relationships with older adults in a community-based eldercare program in Shanghai. Existing evidence has primarily focused on direct carers' work experience in residential care settings. However, direct carers' experiences of caring older adults in the community also deserve exploration. This qualitative study purposively sampled direct carers who worked in government-sponsored programs. Carers participated in semi-structured, in-depth interviews ( N = 37). Results reveal that despite occasional frustration, direct carers undertook demanding workloads and fostered strong emotional attachments with older adult clients. "Karma" was a critical cultural factor pertaining to their work ethic and motivated their care provision to benefit their future elderly selves. This study recognizes the cultural aspects of caring relationships that contribute to the quality of care of the community-based older adults in urban China.

Background and Aim: Approximately one-third of patients with hepatitis C virus (HCV) genotype (GT) 1 infection live in East Asia. This study evaluated the efficacy, pharmacokinetics, safety, and tolerability of simeprevir plus peginterferon alpha-2a and ribavirin (PR) in HCV GT1-infected, treatment-naïve, Asian patients with compensated liver disease., Methods: This phase III, randomized study (NCT01725529) was conducted in China and South Korea. Patients received simeprevir 150 mg once daily (QD), simeprevir 100 mg QD, or placebo, in combination with PR for 12 weeks. Patients in the simeprevir groups received PR alone for a further 12 or 36 weeks based on response-guided treatment criteria. Patients in the placebo group received a further 36 weeks of PR alone. The primary efficacy endpoint was sustained virologic response 12 weeks after planned end of treatment (SVR12). Secondary endpoints were safety, pharmacokinetics, tolerability, and patient-reported outcomes., Results: Overall, 457 patients were treated; the majority had GT1b infection (452/457 [99%]) and IL28B CC GT (364/457 [80%]). Of the 454 patients who had liver biopsy, 26 had cirrhosis (6%). SVR12 rates were superior for both the simeprevir 100 mg (89%; P = 0.003) and 150 mg (91%; P < 0.001) groups versus placebo (76%). Adverse events were mainly grade 1/2 and occurred at a similar incidence across all treatment groups. Overall, eight patients (2%) discontinued simeprevir or placebo treatment because of adverse events., Conclusions: Both simeprevir (100 mg and 150 mg QD) plus PR achieved superiority in SVR12 versus placebo plus PR in treatment-naïve, HCV GT1-infected, Asian patients and were well tolerated., (© 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Artificial neural networks are sophisticated modelling and prediction tools capable of extracting complex, non-linear relationships between predictor (input) and predicted (output) variables. This study explores this capacity by modelling non-linearities in the hardiness-modulated burnout process with a neural network. Specifically, two multi-layer feed-forward artificial neural networks are concatenated in an attempt to model the composite non-linear burnout process. Sensitivity analysis, a Monte Carlo-based global simulation technique, is then utilised to examine the first-order effects of the predictor variables on the burnout sub-dimensions and consequences. Results show that (1) this concatenated artificial neural network approach is feasible to model the burnout process, (2) sensitivity analysis is a prolific method to study the relative importance of predictor variables and (3) the relationships among variables involved in the development of burnout and its consequences are to different degrees non-linear., Practitioner Summary: Many relationships among variables (e.g., stressors and strains) are not linear, yet researchers use linear methods such as Pearson correlation or linear regression to analyse these relationships. Artificial neural network analysis is an innovative method to analyse non-linear relationships and in combination with sensitivity analysis superior to linear methods.

Stroke is a leading cause of adult disability and community re-integration is a priority for stroke rehabilitation. In North America, we have a growing population of individuals whose first language is not English. Little is known about the experiences of visible minorities living in North America as they re-integrate into the community post stroke or how these experiences change over time. Specifically, this research aimed to explore the experiences and needs of Chinese stroke survivors and family caregivers as they return to community living using the Timing it Right Framework as a conceptual guide. We recruited Cantonese-speaking stroke survivors and family caregivers from outpatient rehabilitation programmes. Using qualitative interviews conducted in Cantonese or English, we examined their experiences and needs as they return to community living and explored the influence of culture and time on their experiences. The interviews were transcribed and translated, and then analysed using framework analysis. Using framework analysis, we coded the data corresponding to the phases of the Timing it Right framework to determine the influence of time on the themes. We interviewed five Cantonese-speaking stroke survivors and 13 caregivers in 2009. We identified two main themes: (i) Participants' education and support needs change over time and (ii) Chinese resources are needed across care environments. These resources include access to care in their preferred language, traditional Chinese medicine, and Chinese food during their recovery and rehabilitation. To optimise Chinese stroke survivors' and caregivers' community re-integration, healthcare professionals should provide timely and accessible education and be aware of the role of Chinese diet and traditional medicine in stroke survivors' rehabilitation., (© 2014 John Wiley & Sons Ltd.)

As humans migrated around the world, they came to inhabit environments that differ widely in the soil levels of certain micronutrients, including selenium (Se). Coupled with cultural variation in dietary practices, these migrations have led to a wide range of Se intake levels in populations around the world. Both excess and deficiency of Se in the diet can have adverse health consequences in humans, with severe Se deficiency resulting in diseases of the bone and heart. Se is required by humans mainly due to its function in selenoproteins, which contain the amino acid selenocysteine as one of their constituent residues. To understand the evolution of the use of this micronutrient in humans, we surveyed the patterns of polymorphism in all selenoprotein genes and genes involved in their regulation in 50 human populations. We find that single nucleotide polymorphisms from populations in Asia, particularly in populations living in the extreme Se-deficient regions of China, have experienced concerted shifts in their allele frequencies. Such differentiation in allele frequencies across genes is not observed in other regions of the world and is not expected under neutral evolution, being better explained by the action of recent positive selection. Thus, recent changes in the use and regulation of Se may harbor the genetic adaptations that helped humans inhabit environments that do not provide adequate levels of Se in the diet., (© The Author 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Molecular phylogenetic analysis of an extensive collection of monozoic tapeworms of the genus Paracaryophyllaeus Kulakovskaya, 1961 (Cestoda: Caryophyllidea), parasites of loaches (Cypriniformes: Cobitidae) in Eurasia, has revealed cryptic species diversity within this long-time monotypic genus, especially in the Paracaryophyllaeus gotoi (Motomura, 1927) species complex [syn. Paracaryophyllaeus dubininorum (Kulakovskaya, 1961); type species]. Three independent, well-supported clades were discovered on the basis of molecular data: (i) specimens from Misgurnus anguillicaudatus and Cobitis lutheri from China, Russian Far East and Japan - called herein P. cf. gotoi 1, which may be conspecific with P. gotoi (Motomura, 1927), although in the absence of sequence data for P. gotoi from its type locality (basin of the River Kumkan in Korea), no certain inferences about their identity can currently be made; (ii) specimens from M. anguillicaudatus from China and Japan - P. cf. gotoi 2, which are morphologically indistinguishable from those of P. cf. gotoi 1; and (iii) morphologically distinct tapeworms from the endemic loach Cobitis bilseli from southwestern Turkey (Beyşehir Lake), which are described herein as a new species. Paracaryophyllaeus vladkae Scholz, Oros and Aydoğdu n. sp. differs from the remaining species of the genus in the following characteristics: the testes begin anterior to the first vitelline follicles (versus posterior), the body is short and robust (versus more elongate and slender), and the scolex is wide, rounded or apically tapered (versus claviform to truncate). Species composition of the genus, host specificity of species and geographical distribution are briefly discussed., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)