Search

Recently, Chinese medical education has exhibited a shifting trend from teacher-centered instruction to student-centered learning, which usually includes a self-directed learning process. Providing students with high-quality and appropriate supplemental resources is necessary for their self-directed learning. This study aimed to investigate the appropriateness of AccessMedicine, an online medical resource, for first-year medical students at Tongji University in China. In the randomized controlled trial, 42 students were stratified by gender and grade point average (GPA) and randomly assigned to either the control group or AccessMedicine group. The students' learning outcomes were assessed with quizzes, including tests before and after learning and a final examination. Paired "t"-tests and two-way analysis of variance were performed for statistical analysis. We found that AccessMedicine-assisted learning improved student performance on tests and decreased the overall failure rate in the final examination. Further analysis showed that the final examination score of the subgroup with high GPAs in the AccessMedicine group significantly increased, but not that of the subgroup with low GPAs, indicating that AccessMedicine-assisted learning was more beneficial for good students than for poor students. A survey showed that professional vocabularies were the greatest obstacles to learning with AccessMedicine. Moreover, English language skills greatly affected the students' learning outcomes for the English resource but not those for the Chinese resource. Taken together, our results demonstrated that AccessMedicine was appropriate for Chinese medical education and improved the learning outcomes of students, especially students with high GPAs and a good command over the English language.

Double-story high-speed railway stations have become increasingly popular due to their smaller footprint and improved operational efficiency. However, ensuring passenger comfort in such stations requires careful consideration of train-induced vibrations. This study investigates the train-induced vibrations in Beijing Fengtai Railway Station, which is Asia's largest and China's first double-story high-speed railway station. To carry out this work, a vibration source load model and the finite-element model of the station were first established, where the model was verified using field-measured data. Following these, the vibration characteristics of the station under various train passing conditions, including different track positions and train speeds, were investigated numerically in both time and frequency domains. The findings of this study provide valuable insights for the vibration control of the railway stations of the similar modes and scales. [ABSTRACT FROM AUTHOR]

Landslide susceptibility assessment is an essential tool for disaster prevention and management. In areas with multiple fault zones, the impact of fault zone on slope stability cannot be disregarded. This study performed qualitative analysis of fault zones and proposed a zoning method to assess the landslide susceptibility in Chengkou County, Chongqing Municipality, China. The region within a distance of 1 km from the faults was designated as sub-zone A, while the remaining area was labeled as sub-zone B. To accomplish the assessment, a dataset comprising 388 historical landslides and 388 non-landslide points was used to train the random forest model. 10-fold cross-validation was utilized to select the training and testing datasets for the model. The results of the models were analyzed and discussed, with a focus on model performance and prediction uncertainty. By implementing the proposed division strategy based on fault zone, the accuracy, precision, recall, F-score, and AUC of both two sub-zones surpassed those of the whole region. In comparison to the results obtained for the whole region, sub-zone B exhibited an increase in AUC by 6.15%, while sub-zone A demonstrated a corresponding increase of 1.66%. Moreover, the results of 100 random realizations indicated that the division strategy has little effect on the prediction uncertainty. This study introduces a novel approach to enhance the prediction accuracy of the landslide susceptibility mapping model in areas with multiple fault zones. [ABSTRACT FROM AUTHOR]

Evidence on the potential causal links of long‐term air pollution exposure with lung cancer incidence (reflected by mortality and hospital admission) was limited, especially based on large cohorts. We examined the relationship between lung cancer and long‐term exposure to particulate matter (PM, including PM2.5, PM10 and PM10‐2.5) and nitrogen dioxide (NO2) among a large cohort of general Chinese adults using causal inference approaches. The study included 575 592 participants who were followed up for an average of 8.2 years. The yearly exposure of PM and NO2 was estimated through satellite‐based random forest approaches and the ordinary kriging method, respectively. Marginal structural Cox models were used to examine hazard ratios (HRs) of mortality and hospital admission due to lung cancer following air pollution exposure, adjusting for potential confounders. The HRs of mortality due to lung cancer were 1.042 (95% confidence interval [CI]: 1.033‐1.052), 1.032 (95% CI:1.024‐1.041) and 1.052 (95% CI:1.041‐1.063) for each 1 μg/m3 increase in PM2.5, PM10 and NO2, respectively. In addition, we observed statistically significant effects of PMs on hospital admission due to lung cancer. The HRs (95%CI) were 1.110 (1.027‐1.201), 1.067 (1.020‐1.115) and 1.079 (1.010‐1.153) for every 1 μg/m3 increase in PM2.5, PM10, PM10‐2.5, respectively. Furthermore, we found larger effect estimates among the elderly and those who exercised more frequently. We provided the most comprehensive evidence of the potential causal links between two outcomes of lung cancer and long‐term air pollution exposure. Relevant policies should be developed, with special attention to protecting the vulnerable groups of the population. [ABSTRACT FROM AUTHOR]

Various disturbances like extreme climate events, fires, and insect outbreak severely impact forest ecosystems, and differences are expected between planted and natural forests. However, there is little information on the spatio-temporal dynamics of the disturbances in terms of both forest types. In this study, we used the LandTrendr algorithm to detect disturbances in planted and natural forests in a temperate region of Northern China from 1985 to 2020 using Landsat and Sentinel 2 satellite data. The planted and natural forests suffered severe disturbances in 1994 in the south (park establishment) and in 2012 in the north (severe drought). More than one third of the area of planted (37.5%) or natural (35.8%) forests was highly disturbed. The duration of forest disturbances was mostly 1 to 3 years in terms of planted or natural forests. The NDVI anomaly of the planted forests decreased from 0.24 to −0.08 after drought events, while the reduction was from 0.22 to −0.06 for natural forests. Afterwards, the NDVI anomaly of the planted forests showed a slow upward variation but not for the natural forests. This study allows us to evaluate the response of various forest types to disturbance regimes. [ABSTRACT FROM AUTHOR]

Today's doctor is as much a humanist as a scientist. Medical schools have responded to this change by introducing a variety of courses, most notably those concerning the humanities and ethics. Thus far, no one has examined the extent of use of these subjects in Chinese medical schools. The goal of this study is to determine how many and in what way Chinese medical schools use the humanities and ethics in training future physicians. We surveyed thirty-two Chinese medical schools covering each geographic region of China at the Twelfth Medical Education Conference for China Mainland, Hong Kong, and Taiwan on a variety of topics related to the humanities and ethics. Thirty-one (96.9 percent) Chinese medical schools offer courses in the humanities, and all thirty-two (100.0 percent) Chinese medical schools surveyed offer courses on ethics. Of the thirty-one universities offering humanities courses, twenty-six (83.9 percent) have five or more humanities courses, and of the thirty-two universities offering ethics courses, twenty-six (81.3 percent) have five or more ethics courses. At ten (32.3 percent) universities, all humanities courses are compulsory, at one (3.2 percent) university, all humanities courses are elective, and eighteen (58.1 percent) universities have both compulsory and elective humanities courses. At eighteen (56.3 percent) universities, all medical ethics courses are compulsory, at one (3.1 percent) university all medical ethics courses are elective, and thirteen (40.6 percent) universities have both compulsory and elective medical ethics courses. Educators at Chinese medical schools have embraced the humanities and medical ethics as fundamental components of their curricula as well as for elective study.

Background. Narrative medicine has been applied as a model for humane medical practice in many countries. However, it was not introduced in China until 2011 and there has been no standardized assessment of Chinese medical personnel regarding their perception and application of narrative medicine-related theories. This study is aimed at investigating Chinese medical personnel's knowledge, attitude, and practice regarding narrative medicine and the factors that influence it. Methods. An online questionnaire based on the knowledge, attitude, and practice model was distributed among Chinese medical personnel from December 2021 to March 2022. All in-service medical personnel across China who had access to the Internet were eligible. Two independent samples t -tests, one-way analysis of variance, Pearson's correlation analysis, and multivariate linear regression were conducted for data analyses. Results. The participants' scoring rates for knowledge, attitude, and practice were 49.62%, 47.18%, and 41.43%, respectively. Significant influencing factors for knowledge were education level, religious belief, professional role, title, working years, and institution categories; those for attitude were education level, religious belief, professional role, and working years; and those for practice were professional title, religious belief, working years, and institution categories. Conclusions. Chinese medical personnel have generally good knowledge of, attitudes towards, and practice of narrative medicine; however, there remain deficiencies in their understanding of certain important concepts, their attitude towards narrative medicine, and the application of narrative skills in their daily work. Thus, to improve narrative medicine practice in China, the application of strategies based on theoretical, educational, and institutional aspects is warranted. [ABSTRACT FROM AUTHOR]

Evidence of a potential causal link between long-term exposure to particulate matter (PM) and all-site cancer mortality from large population cohorts remained limited and suffered from residual confounding issues with traditional statistical methods. We aimed to examine the potential causal relationship between long-term PM exposure and all-site cancer mortality in South China using causal inference methods. We used a cohort in southern China that recruited 580,757 participants from 2009 through 2015 and tracked until 2020. Annual averages of PM 1 , PM 2.5, and PM 10 concentrations were generated with validated spatiotemporal models. We employed a causal inference approach, the Marginal Structural Cox model, based on observational data to evaluate the association between long-term exposure to PM and all-site cancer mortality. With an increase of 1 µg/m³ in PM 1 , PM 2.5, and PM 10 , the hazard ratios (HRs) and 95% confidence interval (CI) for all-site cancer were 1.033 (95% CI : 1.025–1.041), 1.032 (95% CI : 1.027–1.038), and 1.020 (95% CI : 1.016–1.025), respectively. The HRs (95% CI) for digestive system and respiratory system cancer mortality associated with each 1 µg/m³ increase in PM 1 were 1.022 (1.009–1.035) and 1.053 (1.038–1.068), respectively. In addition, inactive participants, who never smoked, or who lived in areas of low surrounding greenness were more susceptible to the effects of PM exposure, the HRs (95% CI) for all-site cancer mortality were 1.042 (1.031–1.053), 1.041 (1.032–1.050), and 1.0473 (1.025–1.070) for every 1 µg/m³ increase in PM 1 , respectively. The effect of PM 1 tended to be more pronounced in the low-exposure group than in the general population, and multiple sensitivity analyses confirmed the robustness of the results. This study provided evidence that long-term exposure to PM may elevate the risk of all-site cancer mortality, emphasizing the potential health benefits of improving air quality for cancer prevention. [Display omitted] • All-site cancer mortality was elevated by 3.3% following each 1 µg/m³ increase in PM 1 exposure. • Cancer mortality risk for PM 1 and PM 2.5 were generally higher than that for PM 10. • Non-smokers, those inactive or with less residential greenness were more vulnerable. [ABSTRACT FROM AUTHOR]

Evidence of the potential causal links between long-term exposure to particulate matters (PM, i.e., PM 1 , PM 2.5 , and PM 1–2.5) and T2DM mortality based on large cohorts is limited. In contrast, the existing evidence usually suffers from inherent bias with the traditional a ssociation assessment. A prospective cohort of 580,757 participants in the southern region of China were recruited during 2009 and 2015 and followed up through December 2020. PM exposure at each residential address was estimated by linking to the well-established high-resolution simulation dataset. Hazard ratios (HR s) were calculated using time-varying marginal structural Cox models, an established causal inference approach, after adjusting for potential confounders. During follow-up, a total of 717 subjects died from T2DM. For every 1 μg/m3 increase in PM 2.5 , the adjusted HRs and 95% confidence interval (CI) for T2DM mortality was 1.036 (1.019–1.053). Similarly, for every 1 μg/m3 increase in PM 1 and PM 1–2.5 , the adjusted HR s and 95% CI s were 1.032 (1.003–1.062) and 1.085 (1.054–1.116), respectively. Additionally, we observed a generally more pronounced impact among individuals with lower levels of education or lower residential greenness which as measured by the Normalized Difference Vegetation Index (NDVI). We identified substantial interactions between NDVI and PM 1 (P -interaction = 0.003), NDVI and PM 2.5 (P -interaction = 0.019), as well as education levels and PM 1 (P -interaction = 0.049). The study emphasizes the need to consider environmental and socio-economic factors in strategies to reduce T2DM mortality. We found that PM 1 , PM 2.5 , and PM 1–2.5 heighten the peril of T2DM mortality, with education and green space exposure roles in modifying it. • PM 1 , PM 2.5 , and PM 1–2.5 may significantly impact the mortality rate of T2DM. • We applied causal inference to explore the association between PM and T2DM mortality. • People with less education or less residential greenness are at a higher risk. • This is the first large cohort study in China on PM 1 and T2DM mortality. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the clinical phenomenology and characteristics of prodromal symptoms in Chinese patients with bipolar disorder (BPD) prior to their index mood episode.Methods: Semi-structured interviews [Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R)] were administered to patients within 3 years of BPD (I and II) onset.Results: 120 stable inpatients and outpatients were included (65% males, mean age: 26.5±10.0 years). Feeling extremely energetic (61.8%), overly cheerful (49.1%), racing thoughts (48.2%), overly talkative (47.3%), and decreased need for sleep (43.6%) most frequently preceded the first (hypo)manic episode, whereas depressed mood (78.5%), tiredness (53.9%), reduction of enjoyment (52.3%), trouble concentrating (49.2%) and insomnia (47.7%) often occurred prior to the index depressive episode. The prevalence of anxiety or nervousness (p = 0.009), social isolation (p = 0.004), and losing temper (p < 0.001) differed significantly depending on the different episodes. Prior to any depressive episode, insomnia (p = 0.035) lasted significantly longer and sleeping too much (p = 0.033) was more severe, whereas oppositionality (p < 0.001), hallucinations (p = 0.024) and psychosis index score (p = 0.044) were more severe before any (hypo) manic episode. Furthermore, depressed mood (p = 0.006) was more frequent prior to depression, while anxiety or nervousness (p = 0.018), oppositionality (p = 0.001), and psychosis index score (p = 0.009) were more frequent before any (hypo) manic episode.Conclusions: Characteristic affective and psychotic symptoms, including depressed mood and subthreshold hypo (manic) symptoms occurred in the prodromal phase. The pre-depression prodromal symptoms lasted longer than the pre-(hypo) mania prodromal symptoms. Our findings indicated that identifying prodromal symptoms of BPD may be beneficial for early diagnosis and intervention before the development of full episodes. [ABSTRACT FROM AUTHOR]

In the field of optical microscopy, height valuations, or calibrations, are critical to ensure accuracy and traceability. Height assessment, however, may be controversial, particularly for measurements on large steps or narrow grooves. Thus, standard setting and instrument operations are essential. In this paper, the limited energy lost (LEL) method, which is a Chinese solution, and the well-known ISO W/3 method were both applied in a two-year round robin test to verify their theoretical compatibility and promote their corresponding applications throughout China. The results show that the LEL method successfully predicted outlier growth for progressively narrowing grooves. In addition, compared with the W/3 method, 71% of the results from 24 measurements showed improved repeatability when applying the LEL method. This paper supports the LEL method with evidence from a large sample, after its original publishing in 2016 and the subsequent publication, as a key part of China's standard on confocal microscopy, in 2017. These results indicate that dynamic model-based valuation might be the future trend for 3D optical micro-nano metrology. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak is impacting clinical trials in many ways, such as patient recruitment, data collection and data analysis. To proceed in this difficult time, the adoption of new technologies and new approaches for conducting clinical trials needs to be accelerated. Simultaneously, regulatory agencies such as the US FDA and EMA have issued guidance to help the pharmaceutical industry conduct clinical trials of medical products during the COVID-19 pandemic. In this article, we will address some statistical issues and operational experiences in the conduction of clinical trials during the COVID-19 pandemic. Specifically, we will share experiences in the applications of remote clinical trials in China. Statistical issues related to protocol modifications caused by COVID-19 will be raised. [ABSTRACT FROM AUTHOR]

In recent years, bike-sharing systems have been widely deployed in many big cities, which provide an economical and healthy lifestyle. With the prevalence of bike-sharing systems, a lot of companies join the bike-sharing market, leading to increasingly fierce competition. To be competitive, bike-sharing companies and app developers need to make strategic decisions and predict the popularity of bike-sharing apps. However, existing works mostly focus on predicting the popularity of a single app, the popularity contest among different apps has not been explored yet. In this paper, we aim to forecast the popularity contest between Mobike and Ofo, two most popular bike-sharing apps in China. We develop CompetitiveBike, a system to predict the popularity contest among bike-sharing apps leveraging multi-source data. We extract two novel types of features: coarse-grained and fine-grained competitive features, and utilize Random Forest model to forecast the future competitiveness. In addition, we view mobile apps competition as a long-term event and generate the event storyline to enrich our competitive analysis. We collect data about two bike-sharing apps and two food ordering & delivery apps from 11 app stores and Sina Weibo, implement extensive experimental studies, and the results demonstrate the effectiveness and generality of our approach. [ABSTRACT FROM AUTHOR]

Recently, Chinese medical education has exhibited a shifting trend from teacher‐centered instruction to student‐centered learning, which usually includes a self‐directed learning process. Providing students with high‐quality and appropriate supplemental resources is necessary for their self‐directed learning. This study aimed to investigate the appropriateness of AccessMedicine, an online medical resource, for first‐year medical students at Tongji University in China. In the randomized controlled trial, 42 students were stratified by gender and grade point average (GPA) and randomly assigned to either the control group or AccessMedicine group. The students' learning outcomes were assessed with quizzes, including tests before and after learning and a final examination. Paired t‐tests and two‐way analysis of variance were performed for statistical analysis. We found that AccessMedicine‐assisted learning improved student performance on tests and decreased the overall failure rate in the final examination. Further analysis showed that the final examination score of the subgroup with high GPAs in the AccessMedicine group significantly increased, but not that of the subgroup with low GPAs, indicating that AccessMedicine‐assisted learning was more beneficial for good students than for poor students. A survey showed that professional vocabularies were the greatest obstacles to learning with AccessMedicine. Moreover, English language skills greatly affected the students' learning outcomes for the English resource but not those for the Chinese resource. Taken together, our results demonstrated that AccessMedicine was appropriate for Chinese medical education and improved the learning outcomes of students, especially students with high GPAs and a good command over the English language. © 2019 International Union of Biochemistry and Molecular Biology, 47(3):272–278, 2019. [ABSTRACT FROM AUTHOR]

Long-term ambient particulate matter (PM) exposure has been found associated with chronic obstructive pulmonary disease (COPD) mortality in an increasing body of research. However, limited evidence was available on the potential causal links between PM 1 and COPD mortality, especially in highly exposed areas. To examine the COPD mortality risk following long-term ambient PM 1 exposure in south China. The cohort included 580,757 participants recruited during 2009–2015. Satellite-based annual concentrations of PM 1 were estimated at a spatial resolution of 1 km × 1 km and assigned to each participant based on their residential addresses. We analyzed the potential causal links between time-varying PM 1 exposure and COPD mortality using marginal structural cox models within causal frameworks. Stratified analyses were also performed to identify the potential susceptible groups. The annual average PM 1 concentration continuously decreased over time. After adjusting for confounders, each 1 μg/m3 increase in PM 1 concentration corresponded to an 8.1 % (95% confidence interval: 6.4–9.9 %) increment in the risk of COPD mortality. The impact of PM 1 was more pronounced among the elderly and those with low exercise frequency, with a 1.9–6.9 % higher risk than their counterparts. We further observed a 0.1–9.7 % greater risk among those who lived in lower greenness settings. Additionally, we observed higher effect estimates in participants with long-term low PM 1 exposure compared to the general population. COPD mortality risk significantly increased following long term ambient PM 1 exposure, particularly among groups with certain demographics or long-term low exposure. • COPD mortality elevated by 8.1 % following each 1 μg/m3 increase in PM 1 exposure. • Elderly and those with less exercise or residential greenness were more vulnerable. • COPD mortality risk was higher among participants generally at low PM 1 exposure. [ABSTRACT FROM AUTHOR]

Cohort studies conducted in North America and Europe have linked cerebrovascular mortality to long-term exposure to particulate matter (PM). However, limited evidence from large cohorts in high-exposure areas and the traditional approach of association assessment may cause residual confounding issues. In this study, we aimed to investigate the causal links between cerebrovascular mortality and long-term exposure to PM 2.5 , PM 10 , and PM 2.5-10 in an ongoing cohort study with 580,757 participants in southern China. Using satellite-based estimates of PM concentration at a 1-km2 spatial resolution, we assigned exposure levels to each participant and used the marginal structural Cox model to assess the association between PM exposure and cerebrovascular mortality while accounting for time-varying covariates. We also explored the potential modification effects of sociodemographic and behavioral factors on the PM-health associations. Adjusted hazard ratios (HR) for overall cerebrovascular mortality were 1.041 (95% confidence interval (CI): 1.034–1.049) and 1.032 (95% CI : 1.026–1.038) for each 1 μg/m3 increase in PM 2.5 , and PM 10 , respectively. Similar trends were observed in the mortality risk from stroke and ischemic stroke, with HRs ranging from 1.040 to 1.069 and 1.025 to 1.052, respectively, across 2 p.m. exposures. The impact of PM exposure was generally more apparent among women, participants with primary school diplomas and below, and the subgroup under low-exposure. Multiple sensitivity analyses confirmed the robustness of the results. In conclusion, this sizable prospective cohort study hypothesizes causal links between long-term PM exposure and cerebrovascular mortality, particularly among vulnerable participants, supporting the rationale for reducing PM concentration in China to reduce cerebrovascular mortality. [Display omitted] • Cerebrovascular disease mortality increased with long-term PM exposures. • The hazard ratios of PM 2.5 are 0.01 greater than that of PM 10 in cerebrovascular mortality. • The low-exposure group was more sensitive to PM exposure than the general population. [ABSTRACT FROM AUTHOR]

• Meteorological factors were significantly associated with unintentional injury. • The excess risk for precipitation and temperature was positive from lag 0–1 day onward. • Overall excess risk for relative humidity (RH) was negative from lag 0-2 days onward. • Workers, males, and patients injured by falls or with fractures were more vulnerable. • High temperature and wind speed, with low precipitation and RH posed the highest risk. Meteorological factors are a critical component of a sustainable society, especially in the context of climate change. Although studies have linked key meteorological factors to unintentional injuries, their joint effects on the occurrence of unintentional injuries remain unclear. We conducted a case-crossover study using a sentinel-based injury database in a mega-city in China and identified the vulnerable subgroups by demographic and injury characteristics. We observed significantly increased cumulative risk associated with each interquartile range increase in temperature (excess risk [ER] range=4.78–7.05%) and precipitation (ER range=1.00–2.09%) from lag 0–1 day onwards. Conversely, there was a significantly decreased risk with relative humidity (RH) from lag 0–2 days onwards (ER range=-2.83 to -2.10%). The link between meteorological factors and unintentional injuries was worthy of particular attention for the working-age groups, males, and those with fall-related injuries, road-related injuries, or fractures. Climate conditions with high wind speed (WS) and temperature combined with low precipitation and RH exhibited the greatest ER. The ER of high WS and RH, combined with low precipitation and temperature, was also significant. These key factors may jointly contribute to unintentional injury, which is important for evidence-based climate mitigation and injury prevention. [ABSTRACT FROM AUTHOR]

Introduction: Curriculum reform at Chinese medical schools has attracted a lot of attention recently. Several leading medical schools in China have undergone exploratory reforms and in so doing, have accumulated significant experience and have made considerable progress. Methods: An analysis of the reforms conducted by 38 Chinese medical colleges that were targeted by the government for upgrade was performed. Drawing from both domestic and international literature, we designed a questionnaire to determine what types of curricular reforms have occurred at these institutions and how they were implemented. Major questions touched upon the purpose of the reforms, curricular patterns, improvements in teaching methods post-reform, changes made to evaluation systems post-reform, intra-university reform assessment, and what difficulties the schools faced when instituting the reforms. Besides the questionnaire, relevant administrators from each medical school were also interviewed to obtain more qualitative data. Results: Out of the 38 included universities, twenty-five have undergone major curricular reforms. Among them, 60.0% adopted an organ system-based curriculum model, 32.0% adopted a problem-based curriculum model, and 8.0% adopted a hybrid curriculum model. About 60.0% of the schools' reforms involved both the 'pre-clinical' and the 'clinical' curricula, 32.0% of the schools' reforms were limited to the 'pre-clinical' curricula, and 8.0% of the schools' reforms only involved the 'clinical' curricula. Following curricular reform, 60.0% of medical schools experienced an overall reduction in teaching hours, 76.0% reported an increase in their students' clinical skills, and 60.0% reported an increase in their students' research skills. Discussion: Medical curricular reform is still in its infancy in China. The republic's leading medical schools have engaged in various approaches to bring innovative teaching methods to their respective institutions. However, due to limited resources and the shackle of traditional pedagogical beliefs among many faculty and administrators, progress has been significantly hindered. Despite these and other challenges, many medical schools report positive initial results from the reforms that they have enacted. Although the long term effects of such reforms remain unclear, curricular reform appears to be the inevitable solution to China's growing need for high-quality medical doctors. [ABSTRACT FROM AUTHOR]

Background: A comprehensive search of the literature published between 2001 and 2010 was performed to gain a greater understanding of curricular reform practices at Chinese medical schools.Summary: There were 10,948 studies published between 2001 and 2010 that were retrieved from the database. Following preliminary screening, 76 publications from 49 different medical schools were selected. Thirty-one publications regarding clinical medicine curricular reforms were analyzed further. Of the 76 studies, 53 described curricular reforms that were instituted in theoretical courses, 22 described curricular reforms that were instituted in experimental courses, and 1 described curricular reforms that were instituted in a clinical skills training course. Of the 31 clinical medicine publications, 2 described reforms that were implemented for 3-year program medical students, 12 described reforms that were implemented for 5-year program medical students, 6 described reforms that were implemented for 7-year program medical students, and 2 described reforms that were implemented for 8-year program medical students. Currently, the majority of medical schools in China use the discipline-based curriculum model. Thirteen studies described transition to an organ-system-based curriculum model, 1 study described transition to a problem-based curriculum model, and 3 studies described transition to a clinical presentation-based curriculum model. In 7 studies educators decided to retain the discipline-based curriculum model while integrating 1 or several new courses to remedy the weaker aspects of the traditional curriculum, in 7 studies educators decided to integrate the preclinical courses with the clinical courses by using the systemic-integrating curricular system that dilutes classical disciplines and integrates material based on organ systems, and in 2 studies educators limited reforms to clinical courses only. Eight studies discussed the implementation of a formative evaluation system, 4 studies discussed faculty training, and 15 studies discussed the application of various instructional methods. Other issues that were also addressed include enhancing research, improving patient–doctor communication, developing interpersonal and teamwork skills, cultivating independent lifelong learning habits, and improving problem-solving capabilities.Conclusions: The medical schools in our study have adopted various comprehensive curricular changes, moving from a knowledge-based to a competency-based model, and from traditional standards to international standards. Many institutions face challenges when implementing curricular reforms, such as what to integrate and how to do so, the unintended omission of important material, ensuring coordination between different organizations and departments, and the training of faculty. [ABSTRACT FROM AUTHOR]

Introduction: In North America, where it was born, problem-based learning (PBL) has seen dips and rises in its popularity, but its inherent strengths have led to its spread to medical schools all over the world. Although its use at medical schools in some Western countries has already been examined, no one has looked at its status in many other countries, including China. The aim of this study is to determine the number of schools currently using PBL in China, the degree to which they use it, and the reasoning behind such usage. Methods: We used survey and internet search to examine PBL usage at Chinese medical schools. We were able to collect data from 43 first-class Chinese medical schools that are geographically diverse and thus representative of medical schools all across China. Results: 34 (79.1%) of the 43 medical schools use PBL in the preclinical curriculum. Of the 34, data were collected from 24 (70.6%) medical schools regarding the extent of their PBL usage. Nine (37.5%) schools use PBL for less than 10% of preclinical hours, 14 (58.3%) schools use PBL for 10-50% of preclinical hours, and one (4.2%) school uses PBL for more than 50% of preclinical hours. Conclusion: In our sample of Chinese medical institutions, a large majority of schools use PBL, however, most schools use it for less than 50% of total preclinical curricular hours. Our results suggest that schools are interested in increasing the number of curricular hours devoted to PBL but are constrained by resources. [ABSTRACT FROM AUTHOR]

Today's doctor is as much a humanist as a scientist. Medical schools have responded to this change by introducing a variety of courses, most notably those concerning the humanities and ethics. Thus far, no one has examined the extent of use of these subjects in Chinese medical schools. The goal of this study is to determine how many and in what way Chinese medical schools use the humanities and ethics in training future physicians. We surveyed thirty-two Chinese medical schools covering each geographic region of China at the Twelfth Medical Education Conference for China Mainland, Hong Kong, and Taiwan on a variety of topics related to the humanities and ethics. Thirty-one (96.9 percent) Chinese medical schools offer courses in the humanities, and all thirty-two (100.0 percent) Chinese medical schools surveyed offer courses on ethics. Of the thirty-one universities offering humanities courses, twenty-six (83.9 percent) have five or more humanities courses, and of the thirty-two universities offering ethics courses, twenty-six (81.3 percent) have five or more ethics courses. At ten (32.3 percent) universities, all humanities courses are compulsory, at one (3.2 percent) university, all humanities courses are elective, and eighteen (58.1 percent) universities have both compulsory and elective humanities courses. At eighteen (56.3 percent) universities, all medical ethics courses are compulsory, at one (3.1 percent) university all medical ethics courses are elective, and thirteen (40.6 percent) universities have both compulsory and elective medical ethics courses. Educators at Chinese medical schools have embraced the humanities and medical ethics as fundamental components of their curricula as well as for elective study. [ABSTRACT FROM AUTHOR]

Recent large earthquakes in China (e.g., Wenchuan earthquake and Yushu earthquake) resulted in enormous damage to school buildings and took many students' lives. Recognizing the seismic vulnerability of existing school buildings, the Chinese government started a nationwide mission in 2009, aiming at increasing the seismic capacity of school buildings through inspection and retrofit activities. This paper presents the experiences of the authors in the retrofits of school buildings in which seismic isolation by using rubber and/or sliding bearings was adopted as a new and efficient retrofit technique, as compared with conventional ones. The retrofitted school buildings include masonry buildings, RC frame buildings, and a mixture of both. Design methods and the corresponding requirements in the modified seismic design code are presented, and typical construction procedures of the seismic retrofit are summarized from an engineer's point of view. Procedures regarding the contract and review of the retrofit projects are also introduced. To this end, a case study is made to demonstrate the proposed design and construction methods. The presented work provides references to the seismic retrofit of existing buildings. [ABSTRACT FROM AUTHOR]

This case study presents the horizontal translocation of the Hongxing Mansion, a high-rise building in China, which was moved transversally for 26 m because of modifications in urban planning. The 13-story RC frame-wall structure was built in 2002 with a total height of 63.2 m and a total weight of 109,881 kN, making the project unique as compared with other similar cases. The executive process of this project is introduced, including the initial planning, design, and construction procedures. A load underpinning system was proposed that can transfer the vertical loads uniformly to the rails and distribute the propelling loads from the loaded end to the other end of the building. Anchor-jacked piles were used at the original foundation from the limited indoor clear height so that rails in the original basement can be well supported without the need of large piling machines. A special moving system was proposed and successfully applied, which combined the advantages of pull and push, so that the efficiency and stability of moving were guaranteed. The removable reaction frames were used to alleviate the energy accumulation in tendons and the sudden energy release when the building started to move. Finally, the columns and walls were connected with the new foundation without diminishing their seismic capacities. The design and construction methods in this project provide references to buildings in need of translocation. [ABSTRACT FROM AUTHOR]

A high-speed railway (HSR) construction boom has been observed in China during the past few years, in which prestressed concrete (PSC) box-girders are widely used for HSR bridges. Concerns have been raised regarding the long-term deflection of girders under the combined actions of concrete creep, shrinkage, and tendon relaxation, since the time-variant deflection significantly undermines the safety of high-speed trains. This paper presents the time-variant deflection reliability analysis of an existing HSR PSC box-girder bridge, in which a hybrid method, consisting of the response surface (RS) method, the finite element (FE) method and the checking point method (i.e., the JC method), is used. The pre-and post-cracking behaviors of the thin-walled box girder are described by using composite degenerated shell elements with the smeared cracking model and the Hordijk's tension softening relation. In particular, the CEB-FIP model for creep and shrinkage is applied in the finite-element (FE) analyses. By using the probabilistic sensitivity analyses, random variables that significantly affect the time-variant deflection are selected for the reliability calculation. It is found that the deflection reliabilities are high in the early stage of bridge service but decrease rapidly during the first 10 to 20 service years. Higher speed limits result in a significant decrease in deflection reliability indices, which may fall below the target value prior to the expected service life. The proposed methodologies can be used in the design optimization, speed control and making rational maintenance or repair strategies for HSR PSC bridges. [ABSTRACT FROM AUTHOR]

Field inspections on long-span steel suspension bridges in China reveal that the pavements undergo a fast deterioration process attributed to the flexibility of suspension bridges and the heavy traffic loads. Such extensive damage and enormous repair costs call for a cost-effective rehabilitation strategy for these bridges. In this paper, the pavement rehabilitation strategy is investigated for the Runyang Suspension Bridge in China with the aid of the life-cycle cost analysis (LCCA). Three alternatives are compared for their economic efficiency, and both agency costs and user costs are taken into account. To consider the uncertainties that abound in the LCCA, probabilistic analyses are made in which the Latin hypercube method is used to provide samples of random variables. According to the LCCA results, the user costs are a considerable proportion of the total costs so that the selection of rehabilitation strategies is significantly influenced by the user costs. In this regard, the second alternative, the double-layer pavement (guss asphalt plus stone matrix asphalt) is the most cost-effective rehabilitation strategy for the bridge. Additionally, sensitivity analyses show that the traffic growth rates, the discount rate, the work zone duration, and the delay cost rate for passenger cars are the most sensitive variables in the user costs. The methodologies and approaches introduced herein can be easily implemented by practitioners and would be of benefit to pavement rehabilitations for steel suspension bridges. [ABSTRACT FROM AUTHOR]

The Hilbert-Huang transform (HHT) is a new analysis method suitable for nonlinear and non-stationary signals. It is very appropriate to seismic signals because they show both non-stationary and nonlinear characteristics. We first introduce the realization of HHT empirical mode decomposition (EMD) and then comparatively analyze three instantaneous frequency algorithms based on intrinsic mode functions (IMF) resulting from EMD, of which one uses the average instantaneous frequency of two sample intervals having higher resolution which can determine that the signal frequency components change with time. The method is used with 3-D poststack migrated seismic data of marine carbonate strata in southern China to effectively extract the three instantaneous attributes. The instantaneous phase attributes of the second intrinsic mode functions (IMF2) better describe the reef facies of the platform margin and the IMF2 instantaneous frequency attribute has better zoning. Combining analysis of the three IMF2 instantaneous seismic attributes and drilling data can identify the distribution of sedimentary facies well. [ABSTRACT FROM AUTHOR]

Background: Internet addiction (IA) is associated with mental health problems but its impact on quality of life (QOL) is understudied. We examined the prevalence of IA and its association with QOL in clinically stable patients with major depressive disorder (MDD).Methods: In a cross-sectional survey between September 2020 and July 2021, the Young's Internet Addiction Test (IAT), the Patient Health Questionnaire-2 (PHQ-2) and the World Health Organization Quality of Life Brief version scale (WHOQOL-BREF) were administered to 1267 patients with MDD. Logistic regression was used to examine the correlates of IA, while analysis of covariance (ANCOVA) was used to examine the association between IA and QOL."Results: The prevalence of IA (IAT total scores ≥50) was 27.2 % (95 % CI: 24.7 %-29.6 %) in MDD patients. Compared to patients without IA, those with IA had lower QOL (F(1, 1267) = 19.1, P < 0.001). Logistic regression revealed that higher education (senior high school and above; OR = 1.85, 95 % CI: 1.13-3.03), family history of psychiatric disorders (OR = 1.72, 95 % CI: 1.08-2.73), and higher PHQ-2 total score (OR = 1.23, 95 % CI: 1.14-1.32) were positively associated with IA while older age (OR = 0.93, 95 % CI: 0.91-0.96) was inversely related to IA.Conclusion: IA is much more common in clinically stable patients with MDD compared to the reported figures in the general population. It would be prudent to screen and monitor internet use in MDD patients and treat those with IA. [ABSTRACT FROM AUTHOR]

• Cyclic tests of ten corroded beam-column joints of SCOPE system were conducted. • Corrosion of steel bars significantly affected seismic behaviors of the structure. • Key slot length affects the seismic performance and should be carefully determined. A frame Structure Comprised of Precast Prestressed Concrete Components (SCOPE) has been widely used in China. According to previous research, the length of non-contact lapped splice between U-shape bars and the steel strands plays an important role in seismic performance of the beam column joint. However, the splice may deteriorate due to corrosion when the frame is used in coastal region. This paper presents an experimental investigation on seismic behaviors of the corroded beam-column joints of the SCOPE system. Ten specimens with different key slot lengths and different corrosion levels were tested under cyclic loading, and their hysteretic loops, envelop curves, bearing capacity, and energy dissipation were compared and analyzed. It is observed that the corrosion of steel bars would significantly affect seismic behaviors of the structure, and most specimens showed flexural failure, while for the seriously corroded specimens with long key slots, failure might occur at the interface between the precast beam and the key slot due to severe corrosion and bond failure of the lapped splice. In general, the energy dissipation of specimens with shorter slot length was greater than that of specimens with the longer key slot under the same corrosion level. However, as the corrosion level increases, the difference became smaller. [ABSTRACT FROM AUTHOR]

COVID-19 caused by SARS-CoV-2 is a great threat to public health. We present the safety and immunogenicity data from a phase I trial in China of an mRNA vaccine (LVRNA009). In the single-centre, double-blind, placebo-controlled and dose-escalation study, 72 healthy unvaccinated adults aged 18–59 years were randomized (3:1) to receive LVRNA009 with one of three vaccine dosage (25, 50 and 100 μg) or placebo, to evaluate for the safety, tolerability and immunogenicity of LVRNA009. All these participants received two injections 28 days apart. No adverse events higher than grade 2 were reported during the study. A total of 30 participants (42 %) reported solicited adverse reactions during the first 14 days after vaccinations. Of the events reported, fever (n = 11, 15 %) was the most common systemic adverse reaction, and pain at the injection site (n = 17, 24 %) was the most frequent solicited local adverse reaction. Anti-S-protein IgG and neutralising antibodies were observed to have been induced 14 days after the first dose, significantly increased 7 days after the second dose, and remained at a high level 28 days after the second dose. Specific T-cell responses peaked 7 days and persisted 28 days after second vaccination. LVRNA009 has demonstrated promising results in safety and tolerability at all three dose levels among Chinese adults. LVRNA009 at three dose levels could rapidly induce strong humoral and cellular immune responses, including binding and neutralising antibody production and IFN- γ secretion, which showed good immunogenicity. Clinical trial registration number: Clinicaltrials.gov NCT05364047; Chictr.org.cn ChiCTR2100049349. [ABSTRACT FROM AUTHOR]

The participation of wind farms in the bidding of the energy and frequency regulation (FR) markets does not only improve the revenues of wind farms, but is also beneficial to the stable operation of grid dispatching. An optimization model for the bidding plan of a wind farm in the energy and FR markets (E&FR) considering wind power uncertainty is proposed. The wind power uncertainty is described by the probability density function (PDF) prediction model. It integrates the improved extreme learning machine (KELM), a PSO algorithm, and kernel density estimation (KELM-PSO-KDE). The model combines the strong fitting ability of KELM and the non-parametric KDE method, making the PDF prediction results more accurately. Based on the PDF prediction results and the goal to maximize the wind farm revenue, the optimal bidding plan is obtained by particle swarm optimization (PSO). A case study is conducted by using the operating data of a wind farm. The results show that the bidding plan for the wind farm participating in the E&FR markets achieves the maximum revenue and reduces the waste of wind resources, unlike the wind farm that only participates in the energy market. Comparisons with different methods demonstrate the excellent performance of the KELM-PSO-KDE model and the PSO algorithm. This study provides a new method for wind farms to participate in the FR of China's electricity system. [ABSTRACT FROM AUTHOR]

With limited evidence on the neurological impact of particulate matter (PM) exposure in China, particularly for PM 1 which is smaller but more toxic, we conducted a large Chinese cohort study using causal inference approaches to comprehensively clarify such impact. A total of 36,271 participants in southern China were recruited in 2015 and followed up through 2020. We obtained the neurological hospitalizations records by linking the cohort data to the electronic reports from 418 medical institutions across the study area. By using high-resolution PM concentrations from satellite-based spatiotemporal models and the cohort data, we performed marginal structural Cox models under causal assumptions to assess the potential causal links between time-varying PM exposure and neurological hospitalizations. Our findings indicated that increasing PM 1 , PM 2.5 , and PM 10 concentrations by 1 μg/m³ were associated with higher overall neurological hospitalization risks, with hazard ratios (HRs) of 1.10 (95% confidence interval (CI) 1.04–1.16), 1.09 (95% CI 1.04–1.14), and 1.03 (95% CI 1.00–1.06), respectively. PM 1 appeared to have a stronger effect on neurological hospitalization, with a 1% and 7% higher impact compared to PM 2.5 and PM 10 , respectively. Additionally, each 1-μg/m3 increase in the annual PM 1 concentration was associated with an elevated risk of hospitalizations for ischemic stroke (HR : 1.15; 95% CI , 1.06–1.26), which tended to be larger than the estimates for PM 2.5 (HR : 1.13, 95% CI , 1.04–1.23) and PM 10 (HR : 1.05, 95% CI , 1.00–1.09). Furthermore, never-married or female individuals tended be at a greater risk compared with their counterparts. Our study provides important insights into the health impact of particles, particularly smaller particles, on neurological hospitalization risk and highlights the need for clean-air policies that specifically target these particles. [Display omitted] • Long-term exposure to PMs increased the risk of neurological hospitalizations. • The hazard ratio for PM 1 tends to be greater on neurological hospitalization. • Long-term exposure to PMs enhanced the risk of ischemic stroke hospitalization. • Unmarried residents might be more vulnerable than their counterparts. • Causal inference models with time-varying exposure minimized confounding bias. [ABSTRACT FROM AUTHOR]

• Higher all-cause mortality was attributed to greater PM 1 , PM 2.5 and PM 10 exposure. • The risk from PM 1 tends to be 1.1% and 1.3% greater than that from PM 2.5 and PM 10. • The elderly, unmarried and less educated ones were more vulnerable to the impact of PMs. • Participants generally at low PM exposures were more susceptible than others. The association between long-term particulate matter (PM) exposure and all-cause mortality has been well-documented. However, evidence is still limited from high-exposed cohorts, especially for PM 1 which is smaller while more toxic than other commonly investigated particles. We aimed to examine the potential casual links of long-term PMs exposure with all-cause mortality in high-exposed areas. A total of 580,757 participants in southern China were enrolled during 2009–2015 and followed up to 2020. The annual average concentration of PM 1 , PM 2.5 , and PM 10 at 1 km2 spatial resolution was assessed for each residential address through validated spatiotemporal models. We used marginal structural Cox models to estimate the PM-mortality associations which were further stratified by sociodemographic, lifestyle factors and general exposure levels. 37,578 deaths were totally identified during averagely 8.0 years of follow-up. Increased exposure to all 3 PM size fractions were significantly associated with increased risk of all-cause mortality, with hazard ratios (HRs) of 1.042 (95 % confidence interval (CI): 1.037–1.046), 1.031 (95 % CI: 1.028–1.033), and 1.029 (95 % CI: 1.027–1.031) per 1 μg/m3 increase in PM 1 , PM 2.5 , and PM 10 concentrations, respectively. We observed greater effect estimates among the elderly (age ≥ 65 years), unmarried participants, and those with low education attainment. Additionally, the effect of PM 1 , PM 2.5 , and PM 10 tend to be higher in the low-exposure group than in the general population. We provided comprehensive evidence for the potential causal links between long-term PM exposure and all-cause mortality, and suggested stronger links for PM 1 compared to large particles and among certain vulnerable subgroups. [ABSTRACT FROM AUTHOR]

The E-proteinoid 3 receptor (PTGER3), a member of the prostaglandin E2 (PGE2) subtype receptor, belongs to the G-protein-coupled superfamily of receptors. Animal studies have demonstrated its involvement in salt sensitivity by regulating sodium reabsorption. This study aimed to investigate the association between genetic variants of PTGER3 and salt sensitivity, longitudinal blood pressure (BP) changes, and the incidence of hypertension in Chinese adults. A chronic salt intake intervention was conducted involving 514 adults from 124 families in the 2004 Baoji Salt-Sensitivity Study Cohort in northern China. These participants followed a 3-day regular baseline diet, followed by a 7-day low-salt diet (3.0 g/d) and a 7-day high-salt diet (18 g/d), and were subsequently followed for 14 years. The findings revealed a significant relationship between the single nucleotide polymorphism (SNP) rs17482751 of PTGER3 and diastolic blood pressure (DBP) response to high salt intervention. Additionally, SNPs rs11209733, rs3765894, and rs2268062 were significantly associated with longitudinal changes in systolic blood pressure (SBP), DBP, and mean arterial pressure (MAP) during the 14-year follow-up period. SNP rs6424414 was significantly associated with longitudinal changes in DBP over 14 years. Finally, SNP rs17482751 showed a significant correlation with the incidence of hypertension over 14 years. These results emphasize the significant role of PTGER3 gene polymorphism in salt sensitivity, longitudinal BP changes, and the development of hypertension in the Chinese population., (© 2024 The Author(s). The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

Background: Data on the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in China are very limited. Our aim was to determine the prevalence and clinical characteristics of MGUS in a large Chinese population., Methods: This study included 49,220 healthy people who received serum immunofixation electrophoresis (sIFE) and serum protein electrophoresis (SPE) tests. Serum free light chain ratio, immunoglobulin quantification, and other clinically correlates of MGUS were performed for all patients with M-protein., Results: A total of 576 MGUS patients were identified by sIFE, with a median age of 58 years and an overall prevalence of 1.17% (95% CI, 1.08-1.27). Among those aged 50 years and older, the prevalence of MGUS was 2.26% (95% CI, 2.04-2.50). The prevalence of MGUS was significantly higher in males than in females ( P  < 0.05). The median concentration of M-protein was 3.1 g/L, ranging from 0.5 g/L to 25.1 g/L. The M-protein type was IgG in 55.4% of MGUS patients, followed by IgA (31.1%), IgM (9.5%), IgD (0.5%), biclonal (2.3%), and light chain (1.2%). Abnormalities in SPE, FLC ratios, and immunoglobulin levels were observed in 78.3%, 31.1%, and 38.4% of MGUS patients, respectively., Conclusions: The prevalence of MGUS is substantially lower in southern China than in whites and blacks.

Background: China has a serious air pollution problem and a high prevalence of obesity. The interaction between the two and its impact on all-cause mortality is a public health issue of great concern., Objectives: This study aimed to investigate the association between long-term exposure to particulate matter with aerodynamic diameter ≤ 1 μm (PM 1 ) and all-cause mortality, as well as the interaction effect of body mass index (BMI) in the association., Methods: A total of 33,087 participants from 162 counties in 25 provinces in China were included, with annual average PM 1 exposure being estimated based on the county address. The PM 1 -mortality relation was evaluated using the time-varying Cox proportional hazards models, with the dose-response relationship being fitted using the penalized splines. Besides, the potential interaction effect of BMI in the PM 1 -mortality relation was evaluated., Results: The incidence of all-cause deaths was 76.99 per 10,000 person-years over a median of 8.2 years of follow-up. After controlling for potential confounders, the PM 1 -mortality relation was approximately J-shaped. The full-adjustment analysis observed the hazard ratio (HR) of all-cause mortality was 1.114 [95 % confidence interval (CI): 1.017-1.220] corresponding to a 10 μg/m 3 rise in PM 1 concentration. Further stratified analyses suggested the adverse effects of PM 1 might be more pronounced among the underweight., Discussion: Higher PM 1 concentrations were associated with an increase in all-cause mortality. The BMI might further alter the relation, and the underweight population was the sensitive subgroup of the population that needed to be protected., 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 B.V. All rights reserved.)

Vaccination plays a key role in preventing morbidity and mortality caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate the safety and immunogenicity of a SARS-CoV-2 messenger ribonucleic acid (mRNA) vaccine SYS6006. In the two randomized, observer-blinded, placebo-controlled phase 1 trials, 40 adult participants aged 18-59 years and 40 elderly participants aged 60 years or more were randomized to receive two doses of SYS6006 or placebo (saline). Adverse events (AEs) were collected through 30 days post the second vaccination. Immunogenicity was assessed by live-virus neutralizing antibody (Nab), spike protein (S1) binding antibody (S1-IgG), and cellular immunity. The result showed that 7/15, 9/15 and 4/10 adult participants, and 9/15, 8/15 and 4/10 elderly participants reported at least one AE in the 20-µg, 30-µg and placebo groups, respectively. Most AEs were grade 1. Injection-site pain was the most common AE. Two adults and one elder reported fever. No vaccination-related serious AE was reported. SYS6006 elicited wild-type Nab response with a peak geometric mean titer of 232.1 and 130.6 (adults), and 48.7 and 66.7 (elders), in the 20-µg and 30-µg groups, respectively. SYS6006 induced moderate-to-robust Nab response against Delta, and slight Nab response against Omicron BA.2 and BA.5. Robust IgG response against wild type and BA.2 was observed. Cellular immune response was induced. In conclusion, two-dose primary vaccination with SYS6006 demonstrated good safety and immunogenicity during a follow-up period of 51 days in immunologically naive population aged 18 years or more. (Trial registry: Chictr.org.cn ChiCTR2200059103 and ChiCTR2200059104).

Background: Long-term ambient particulate matter (PM) exposure has been found associated with chronic obstructive pulmonary disease (COPD) mortality in an increasing body of research. However, limited evidence was available on the potential causal links between PM 1 and COPD mortality, especially in highly exposed areas., Objectives: To examine the COPD mortality risk following long-term ambient PM 1 exposure in south China., Methods: The cohort included 580,757 participants recruited during 2009-2015. Satellite-based annual concentrations of PM 1 were estimated at a spatial resolution of 1 km × 1 km and assigned to each participant based on their residential addresses. We analyzed the potential causal links between time-varying PM 1 exposure and COPD mortality using marginal structural cox models within causal frameworks. Stratified analyses were also performed to identify the potential susceptible groups., Results: The annual average PM 1 concentration continuously decreased over time. After adjusting for confounders, each 1 μg/m 3 increase in PM 1 concentration corresponded to an 8.1 % (95% confidence interval: 6.4-9.9 %) increment in the risk of COPD mortality. The impact of PM 1 was more pronounced among the elderly and those with low exercise frequency, with a 1.9-6.9 % higher risk than their counterparts. We further observed a 0.1-9.7 % greater risk among those who lived in lower greenness settings. Additionally, we observed higher effect estimates in participants with long-term low PM 1 exposure compared to the general population., Conclusions: COPD mortality risk significantly increased following long term ambient PM 1 exposure, particularly among groups with certain demographics or long-term low exposure., 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. Published by Elsevier Inc.)

Background: Various populations have experienced significant increases in depression and decreased quality of life (QOL) during the coronavirus disease 2019 (COVID-19) pandemic. This network analysis study was designed to elucidate interconnections between particular depressive symptoms and different aspects of QOL and identify the most clinically important symptoms in this network among adults in Wuhan China, the initial epicenter of the COVID-19 pandemic., Methods: This cross-sectional, convenience-sampling study (N = 2459) was conducted between May 25 to June 18, 2020, after the lockdown policy had been lifted in Wuhan. Depressive symptoms and QOL were measured with the Patient Health Questionnaire-9 (PHQ-9) and first two items of the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. A network structure was constructed from the extended Bayesian Information Criterion (EBIC) model. Network centrality strength and bridge strength were evaluated along with the stability of the derived network model., Results: Loss of energy (DEP-4) and Guilt feelings (DEP-6) were the two central symptoms with the highest strength as well as the two most prominent bridge symptoms connecting the clusters of depression and quality of life (QOL) in tandem with the two nodes from the QOL cluster. Network structure and bridge strengths remained stable after randomly dropping 75 % of the sample., Conclusion: Interventions targeting "Loss of energy" and "Guilt feelings" should be evaluated as strategies for reducing depressive symptoms and promoting improved QOL in COVID-19-affected populations., Competing Interests: Conflict of interest The authors have no conflicts of interest to declare., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The novel coronavirus disease (COVID-19) pandemic is emerging as a global health threat and shows a higher risk for men than women. Thus far, the studies on andrological consequences of COVID-19 are limited. To ascertain the consequences of COVID-19 on sperm parameters after recovery, we recruited 41 reproductive-aged male patients who had recovered from COVID-19, and analyzed their semen parameters and serum sex hormones at a median time of 56 days after hospital discharge. For longitudinal analysis, a second sampling was obtained from 22 of the 41 patients after a median time interval of 29 days from first sampling. Compared with controls who had not suffered from COVID-19, the total sperm count, sperm concentration, and percentages of motile and progressively motile spermatozoa in the patients were significantly lower at first sampling, while sperm vitality and morphology were not affected. The total sperm count, sperm concentration, and number of motile spermatozoa per ejaculate were significantly increased and the percentage of morphologically abnormal sperm was reduced at the second sampling compared with those at first in the 22 patients examined. Though there were higher prolactin and lower progesterone levels in patients at first sampling than those in controls, no significant alterations were detected for any sex hormones examined over time following COVID-19 recovery in the 22 patients. Although it should be interpreted carefully, these findings indicate an adverse but potentially reversible consequence of COVID-19 on sperm quality., Competing Interests: None

Purpose: The aim of this study was to analyse 69 Chinese patients with USH2A mutations and to assess the genotype-phenotype correlation., Methods: All 36 Usher syndrome type IIA patients and 33 nonsyndromic RP (retinitis pigmentosa) patients underwent clinical examinations. Eye examinations included best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination with dilated pupils, fundus fluorescent angiography, visual field test, full-field electroretinography and optic coherence tomography; audiological assessment included pure tone audiometry and hearing thresholds. The molecular diagnosis of genotype combined the single-gene Sanger sequencing and next-generation sequencing. This study is a retrospective study., Results: The mean age of first symptoms with Usher syndrome type IIa and nonsyndromic RP patients was 13.7 versus 29.8 years (ocular phenotypes, p < 0.001); 17.7 versus 29.9 years (nyctalopia, p < 0.001); 44.7 versus 54.8 years (low vision based on VF, p < 0.001); 41.7 versus 54.7 years (low vision based on VA, p < 0.001); and 46.0 versus 56.7 years (legal blindness based on VF, p < 0.001). There was significant difference in variants in the two groups (p < 0.05). Among patients with mutation c.2802T > G (p.Cys934Trp), more (66.7%) presented with normal hearing. All patients (3/3, 100%) with the variant c.8232G > C (p.Trp2744Cys) had hearing loss. Furthermore, we identified 23 novel variants in USH2A., Conclusions: Patients with Usher syndrome type IIa had an earlier onset of the disease, inferior visual function and presented with more truncating variants, compared with the nonsyndromic RP patients., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Background: This study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. It further aimed to characterize the prodromal traits between bipolar disorder type I (BD-I) and type II (BD-II)., Methods: 120 individuals with BD-I (n = 92) and BD- II (n = 28) were recruited to the study. Semi-structured interviews were then administered to evaluate prodromal symptoms in patients, within 3 years of BD onset, by using the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R)., Results: In the prodromal phase of the first depressive episode, patients with BD-II experienced more prodromal symptoms (p = 0.0028) compared to BD-I. Additionally, more frequent predictors were reported in patients with BD-II than BD-I including educational and occupational dysfunction (p = 0.0023), social isolation (p < 0.001), difficulty making decisions (p = 0.0012), oppositionality (p = 0.012), and suspiciousness/persecutory ideas (p = 0.017). There were also differences in the duration of the precursors. The duration of "weight loss or decrease in appetite" (p = 0.016) lasted longer in patients with BD-I, while "obsessions and compulsions" (p = 0.023) started earlier in patients with BD-II and occurred during the pre-depressive period. The prevalence and duration of each reported prodrome, preceding a first (hypo) manic episode, showed no difference between patients with BD-I and BD-II., Conclusions: Specific affective, general, or psychotic symptoms occurred prior to both affective episodes. The characteristic of prodromal symptoms were key predictors for later episodes of BD including attenuated mania-like symptoms, subthreshold depressed mood, mood swings/lability, and anxiety. In the pre-depressive state, when compared to BD-II, BD-I presented with more prodromal symptoms in nonspecific dimensions, which indicated the substantial burden of BD-II. In conclusion, this study extends the understanding of the characteristics of prodromes of BD-I and BD-II.

Background: Accurate prediction of ischemic stroke is required for deciding anticoagulation use in patients with atrial fibrillation (AF). Even though only 6% to 8% of AF patients die from stroke, about 90% are indicated for anticoagulants according to the current AF management guidelines. Therefore, we aimed to develop an accurate and easy-to-use new risk model for 1-year thromboembolic events (TEs) in Chinese AF patients., Methods: From the prospective China Atrial Fibrillation Registry cohort study, we identified 6601 AF patients who were not treated with anticoagulation or ablation at baseline. We selected the most important variables by the extreme gradient boosting (XGBoost) algorithm and developed a simplified risk model for predicting 1-year TEs. The novel risk score was internally validated using bootstrapping with 1000 replicates and compared with the CHA2DS2-VA score (excluding female sex from the CHA2DS2-VASc score)., Results: Up to the follow-up of 1 year, 163 TEs (ischemic stroke or systemic embolism) occurred. Using the XGBoost algorithm, we selected the three most important variables (congestive heart failure or left ventricular dysfunction, age, and prior stroke, abbreviated as CAS model) to predict 1-year TE risk. We trained a multivariate Cox regression model and assigned point scores proportional to model coefficients. The CAS scheme classified 30.8% (2033/6601) of the patients as low risk for TE (CAS score = 0), with a corresponding 1-year TE risk of 0.81% (95% confidence interval [CI]: 0.41%-1.19%). In our cohort, the C-statistic of CAS model was 0.69 (95% CI: 0.65-0.73), higher than that of CHA2DS2-VA score (0.66, 95% CI: 0.62-0.70, Z = 2.01, P = 0.045). The overall net reclassification improvement from CHA2DS2-VA categories (low = 0/high ≥1) to CAS categories (low = 0/high ≥1) was 12.2% (95% CI: 8.7%-15.7%)., Conclusion: In Chinese AF patients, a novel and simple CAS risk model better predicted 1-year TEs than the widely-used CHA2DS2-VA risk score and identified a large proportion of patients with low risk of TEs, which could potentially improve anticoagulation decision-making., Trial Registration: www.chictr.org.cn (Unique identifier No. ChiCTR-OCH-13003729)., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Retinitis pigmentosa (RP) is a group of genetically heterogeneous retinal diseases with more than 80 identified causative genes to date. Mutations in the RHO (rhodopsin, OMIM, 180380) are the most common cause of autosomal dominant RP (adRP) worldwide. RHO is also one of the few RP genes that can cause autosomal recessive RP (arRP). To explore the frequency of RP mutations in Chinese populations, panel-based NGS (next-generation sequencing) screening and Sanger sequencing validation were performed for RP patients from 72 unrelated Chinese families. Here we reported the identified mutations only in the RHO gene. Our results showed that 4 mutations in RHO were detected in 5 (6.94%) of the 72 RP families, including two known missense mutations, c.158C > G (p.P53R) and c.551A > C (p.Q184P), and two novel mutations, c.34delC (p.P12NA) and c.82C > T (p.Q28X). The c.34delC (p.P12NA) mutation was detected in heterozygous state in one patient with intermediate RP phenotype. The c.82C > T (p.Q28X) mutation was found in a homozygous state in one proband with advanced RP phenotype at the age of 32. Clinical examination of the heterozygous carriers of c.82C > T (p.Q28X) in that family showed that the father at the age of 60s experienced no symptoms of RP and normal fundus examinations but displayed reduced electroretinography (ERG) and abnormal visual field. The sister and brother at the age of 30s showed no typical aspects of RP phenotypes. Our results not only expand the mutation spectrum of the RHO gene, but also suggest that the 2 null mutations might play minor dominant effects, leading to less severe and slower retinal degeneration in heterozygous state and more severe phenotype in homozygous state., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The online patient question and answering (Q&A) system, either as a website or a mobile application, attracts an increasing number of users in China. Patients will post their questions and the registered doctors then provide the corresponding answers. A large amount of questions with answers from doctors are accumulated. Instead of awaiting the response from a doctor, the newly posted question could be quickly answered by finding a semantically equivalent question from the Q&A achive. In this study, we investigated a novel deep learning based method to retrieve the similar patient question in Chinese. An unsupervised learning algorithm using deep neural network is performed on the corpus to generate the word embedding. The word embedding was then used as the input to a supervised learning algorithm using a designed deep neural network, i.e. the supervised neural attention model (SNA), to predict the similarity between two questions. The experimental results showed that our SNA method achieved P@1 = 77% and P@5 = 84%, which outperformed all other compared methods.

Renalase, a recently discovered enzyme released by the kidneys, breaks down blood-borne catecholamines and may thus regulate blood pressure (BP). Animal studies have suggested that high levels of dietary salt might reduce blood and kidney renalase levels. We conducted a randomized trial to assess the effects of altered salt and potassium intake on serum renalase levels and the relationship between serum renalase levels and BP in humans.Forty-two subjects (28-65 years of age) were selected from a rural community of northern China. All subjects were sequentially maintained on a low-salt diet for 7 days (3.0 g/day of NaCl), a high-salt diet for additional 7 days (18.0 g/day of NaCl), and a high-salt diet with potassium supplementation for final 7 days (18.0 g/day of NaCl + 4.5 g/day of KCl).Serum renalase levels were significantly higher than baseline levels during the low-salt diet intervention period. Renalase levels decreased with the change from the low-salt to high-salt diet, whereas dietary potassium prevented the decrease in serum renalase induced by the high-salt diet. There was a significant inverse correlation between the serum renalase level and 24-h urinary sodium excretion. No significant correlation was found between the renalase level and BP among the different dietary interventions.The present study indicates that variations in dietary salt intake and potassium supplementation affect the serum renalase concentration in Chinese subjects.

The structural health monitoring system (SHMS) provides an effective tool to conduct full-scale measurements on existing bridges for essential research on bridge wind engineering. In July 2008, Typhoon Fung-Wong lashed China and hit Sutong cable-stayed bridge (SCB) in China. During typhoon period, full-scale measurements were conducted to record the wind data and the structural vibration responses were collected by the SHMS installed on SCB. Based on the statistical method and the spectral analysis technique, the measured data are analyzed to obtain the typical parameters and characteristics. Furthermore, this paper analyzed the measured structural vibration responses and indicated the vibration characteristics of the stay cable and the deck, the relationship between structural vibrations and wind speed, the comparison of upstream and downstream cable vibrations, the effectiveness of cable dampers, and so forth. Considering the significance of damping ratio in vibration mitigation, the modal damping ratios of the SCB are identified based on the Hilbert-Huang transform (HHT) combined with the random decrement technique (RDT). The analysis results can be used to validate the current dynamic characteristic analysis methods, buffeting calculation methods, and wind tunnel test results of the long-span cable-stayed bridges.

Purpose: Little is known about gender differences associated with major depressive disorder (MDD) in China. This study examined gender differences associated with other demographic and clinical characteristics and psychotropic drug treatment in Chinese patients with MDD., Methods: A total of 1178 patients with MDD from 13 psychiatric hospitals or psychiatric units of general hospitals in China nationwide were enrolled. Cross-sectional data including patients' demographic and clinical characteristics and prescriptions of psychotropic medications were recorded using a standardized protocol and data collection procedure., Results: The sample consisted of 793 female and 385 male patients. Univariate analyses revealed that male patients were younger than female patients, had a younger age of onset of depression, had less lifetime depressive episodes and had more bipolar features (i.e. patients who screened positive for hypomanic symptoms on the 32-item Hypomania Checklist, but did not meet the diagnostic criteria for DSM-IV bipolar disorders as measured by the Mini International Neuropsychiatric Interview). Also, men were more likely to be employed than women and less likely to have depressive episodes following stressful life events. In multivariate analyses, being employed, having bipolar features and not having depressive episodes following stressful life events were independently associated with being a male patient with major depressive disorder. There was no difference in use of psychotropic medications by gender., Conclusions: Most gender differences in MDD patients in this study are not consistent with findings of Western studies suggesting that gender differences in MDD may be determined by both biological and sociocultural differences among ethnically different patient populations., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Little has been known about the demographic and clinical features of the melancholic subtype of major depressive disorder (MDD) in Chinese patients. This study examined the frequency of melancholia in Chinese MDD patients and explored its demographic and clinical correlates and prescribing patterns of psychotropic drugs., Methods: A consecutively collected sample of 1,178 patients with MDD were examined in 13 psychiatric hospitals or psychiatric units of general hospitals in China nationwide. The cross-sectional data of patients' demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The diagnosis of the melancholic subtype was established using the Mini International Neuropsychiatric Interview (MINI). Medications ascertained included antidepressants, mood stabilizers, antipsychotics and benzodiazepines., Results: Six hundred and twenty nine (53.4%) of the 1,178 patients fulfilled criteria for melancholia. In multiple logistic regression analyses, compared to non-melancholic counterparts, melancholic MDD patients were more likely to be male and receive benzodiazepines, had more frequent suicide ideations and attempts and seasonal depressive episodes, while they were less likely to be employed and receive antidepressants and had less family history of psychiatric disorders and lifetime depressive episodes., Conclusions: The demographic and clinical features of melancholic MDD in Chinese patients were not entirely consistent with those found in Western populations. Compared to non-melancholic MDD patients, melancholic patients presented with different demographic and clinical features, which have implications for treatment decisions.

We analyzed changes in immunologic values over time for 28 hospitalized patients with pandemic (H1N1) 2009. Levels of interleukin-6, interferon-y, and interleukin-10 increased 1 day after illness onset and then decreased to baseline levels. Levels of virus-specific antibody were undetectable 1 day after illness onset and peaked 36 days later.