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Chongming Island and its surrounding areas are highly significant coastal regions in China. However, the regions undergo continuous changes owing to various factors, such as the sedimentation from the Yangtze River, human activities, and tidal movements. Chongming Island is part of the Yangtze River Delta, which is one of the most economically developed regions in China. Studying the water body changes in this area is of great importance for decision making in water resource conservation, coastal resource management, and ecological environmental protection. In this study, we propose an improved ISUNet model by enhancing the skip-connection operations in the traditional UNet architecture. We extracted and analyzed the water bodies in Chongming Island and its surrounding areas from 2013 to 2022, providing a detailed spatiotemporal analysis of the water body area over the years. The results indicate that the water body area in the study area has decreased by 267.8 km2 over the past decade, showing a gradually fluctuating downward trend with an average annual reduction of nearly 27 km2. The analysis suggests that the reduction in the water body area is mainly attributed to sedimentation near river channels and ports, the formation of sandbars owing to channel erosion, and the artificial construction of ports and coastal areas. The influencing factors include human activities and sedimentation from the Yangtze River Estuary. Specifically, human activities such as land reclamation, port construction, and aquaculture play a major role in causing changes in the area. [ABSTRACT FROM AUTHOR]

Currently, very limited information is available regarding the economic burdens of patients with extremity post-traumatic osteomyelitis (OM). This study aimed to investigate direct health care costs and utilization for inpatients with extremity post-traumatic OM and analyze its constituent ratios and influencing factors in Southern China. We searched in the electronic medical record system for inpatients who had received surgical interventions at our department between 2013 and 2016 for extremity post-traumatic OM. Data of direct health care costs incurred during their hospitalizations were collected in six main categories (service, diagnosis, treatment, materials, pharmaceuticals, and miscellaneous expenses). In addition, data of total medical costs for contemporaneous inpatients with non–post-traumatic OM were also collected as controls. A total of 278 post-traumatic OM and 10,420 controls were included. The median cost for the post-traumatic OM inpatients was $10,504 US dollars, 4.8-fold higher than that for those with non–post-traumatic OM ($2189, P < 0.001). The direct cost in the category of materials accounted for the largest proportion (61%), followed by that in pharmaceuticals (12%) and treatment (11%). The median number of hospital admissions for post-traumatic OM patients was 1 time, with a median length-of-stay of 22 d. The most influencing factors for the health care costs of the post-traumatic OM inpatients were use of an external fixator ($16,016 for those who used versus $4956 for those who did not, P < 0.001), external fixator type ($19,563 for ring fixator versus $14,966 for rail fixator, P < 0.001), infection site ($13,755 for tibia, $14,216 for femur and $5673 for calcaneus, P < 0.001), and infection-associated injury type ($12,890 for infection after open fracture versus $8087 for infection after closed fracture, P = 0.001). An unexpectedly large proportion of the direct health care costs for inpatients with extremity post-traumatic OM went to cover an external fixator, with expenses for pharmaceuticals and treatment accounting for only a little more than the tenth of the total health care costs. Use of external fixator, external fixator type, infection site, and infection-associated injury type directly influenced the health care costs. [ABSTRACT FROM AUTHOR]

Global warming is a serious threat to human survival and health. Facing increasing global warming, the issue of CO 2 emissions has attracted more attention. China is a major contributor of anthropogenic CO 2 emissions and so it is essential to accurately estimate China's CO 2 emissions and analyze their changing characteristics. This study recalculates CO 2 emissions from Chinese cities from 2011 to 2020 using the SPNN-GNNWR model and multiple factors to reduce the uncertainty in emission estimates. The SPNN-GNNWR model has excellent predictions (R2: 0.925, 10-fold CV R2: 0.822) when cross-validation is used. The results indicate that the total CO2 emissions in China calculated by the model are close to those accounted for by other authorities in the world, with the total CO 2 emissions increasing from 9.122 billion tonnes in 2011 to 9.912 billion tonnes in 2020. The city with the largest increase in CO 2 emissions is Tianjin, and the city with the largest decrease is Beijing. The study also reveals the regional differences in CO 2 emissions in Chinese mainland, including emissions, emission intensity and per capita emissions. Capturing and understanding the emissions and the related socioeconomic characteristics of different cities can help to develop effective emission mitigation strategies. • We estimate the CO 2 emissions of cities in Chinese mainland from 2011 to 2020. • SPNN-GNNWR shows great prediction performance (R2:0.925, CV R2:0.822). • The emission intensity and per capita emissions are characterized by geographical distribution. [ABSTRACT FROM AUTHOR]

Aims: TCF21 is considered a tumor suppressor gene. This work was designed to explore the associations between TCF21 polymorphisms and colorectal cancer (CRC) susceptibility. Methods: A case-control study was designed with 421 patients with CRC and 469 non-CRC controls. Six tagging single-nucleotide polymorphisms (rs2327429 T>C, rs2327430 T>C, rs2327433 A>G, rs12190287 C>G, rs7766238 G>A and rs4896011 T>A) were genotyped by ligase detection reaction of PCR. Results: TCF21 rs2327429 and rs12190287 polymorphisms were associated with CRC susceptibility in a Chinese Han population. Conclusion: rs2327429 and rs12190287 polymorphisms may be predictive of CRC susceptibility in Chinese Han populations.

Background: Chongming Island in China serves as a breeding and shelter point on the East Asian-Australasian Flyway. The resting frequency of migratory birds, abundance of mosquito populations, and the popular domestic poultry industry pose a potential risk of mosquito-borne zoonotic diseases. The aim of this study is to explore the role of migratory birds in the spread of mosquito-borne pathogens and their prevalent status on the island., Methods: We conducted a mosquito-borne pathogen surveillance in 2021, in Chongming, Shanghai, China. Approximately 67,800 adult mosquitoes belonging to ten species were collected to investigate the presence of flaviviruses, alphaviruses, and orthobunyaviruses by RT-PCR. Genetic and phylogenetic analyses were conducted to explore the virus genotype and potential nature source. Serological survey was performed by ELISA to characterize Tembusu virus (TMUV) infection among domestic poultry., Results: Two strains of TMUV and Chaoyang virus (CHAOV) and 47 strains of Quang Binh virus (QBV) were detected in 412 mosquito pools, with the infection rate of 0.16, 0.16, and 3.92 per 1000 Culex tritaeniorhynchus, respectively. Furthermore, TMUVs viral RNA was found in serum samples of domestic chickens and faecal samples of migratory birds. Antibodies against TMUV were detected in domestic avian serum samples, generally ranging from 44.07% in pigeons to 55.71% in ducks. Phylogenetic analyses indicated that the TMUV detected in Chongming belonged to Cluster 3, Southeast Asia origin, and most closely related to the CTLN strain, which caused a TMUV outbreak in chickens in Guangdong Province in 2020, but distant from strains obtained previously in Shanghai, which were involved in the 2010 TMUV outbreak in China., Conclusions: We speculate that the TMUV was imported to Chongming Island through long-distance spreading by migratory birds from Southeast Asia, followed by spill over and transmission in mosquitoes and domestic avian species, threatening the local domestic poultry. In addition, the expansion and prevalence of insect-specific flaviviruses and its simultaneous circulation with mosquito-borne virus are worthy of close attention and further study., (© 2023. The Author(s).)

Particulate pollution caused by urban traffic emissions has become a significant public hazard. Many urban roads of under-viaduct spaces (UVSs) have become concentrated areas of particulate pollution. This study aims to explore the effects of landscape parameters on particulate matter in UVSs in Wuhan, China. We selected 14 types of UVS sections and nine potential environmental parameters to monitor four types of particulate matter (PM 1.0 , PM 2.5 , PM 10 , and TSP). Finally, linear regression analysis was employed to quantify the relative contributions of environmental parameters to the reduction in the concentration of the four types of particulate matter in the summer and winter. The results showed that particulate matter concentrations exhibit spatial and seasonal differences in UVSs. A single landscape parameter was correlated with particulate matter concentration, while compound environmental parameters had significant effects on the particulate matter concentration in UVSs. Meteorological factors and greening structures had a dominant impact on the particulate matter concentrations in summer and winter, respectively. Therefore, adjusting and optimizing the environmental parameters could reduce particulate pollution in UVSs and could have practical significance for the planning and design of UVSs.

Background: Tuberculosis (TB) is a great mimicker and diagnostic chameleon, and prone to be diagnosed as malignancy. Even though many reports have described the differences between pulmonary TB and lung cancer, the atypical systemic hematogenous disseminated TB (HDTB) is very rare and more confusing in clinical practice., Case Presentation: A 73-year-old man, HIV-negative, was hospitalized to the local county hospital because of chest pain, low-grade fever, asthenia, anorexia and weight loss for the pasting two months. The CT findings of the two lungs showed multiple round or round-like nodules of different sizes, with clear boundaries and partial fusion. The level of serum CA19-9 was significantly higher than normal, and progressively increased. There were multiple enlarged lymph nodes in the neck, mediastinum, abdominal cavity and pelvic cavity. The symptoms were diagnosed as hematogenous spread of gastrointestinal tumor in the local county hospital. However, when transferred to our provincial hospital, through comprehensive dynamic analysis, this patient was diagnosed as atypical systemic HDTB, no cancer at all. Through routine anti-TB therapy for one year, the patient was recovered very well at the follow-up of half year after withdrawal., Conclusions: In the past, most TB misdiagnosis cases involved in single organ and were finally confirmed through invasive examination. This case enriched clinical experiences in the diagnosis of atypical HDTB. We encouraged clinicians to establish a dynamic thinking for diagnosis and treatment and emphasized the value of biopsy and 18 F-FDG-PET in distinguishing TB and cancer.