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Objective To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder (FMD) based on movement disorders clinic in China. Methods and Results A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included, including 37 patients (6.24%) with FMD and 556 patients (93.76%) with organic movement disorder. Comparison of the epidemiological characteristics of the 2 groups, the proportions of corona virus disease (COVID-19) infection (χ² = 4.217, P = 0.040) and psychopsychological symptoms (χ² = 18.694, P = 0.000) in the FMD group were higher than those in the organic movement disorder group, while age (t = 3.757, P = 0.000), age of onset (t = 3.720, P = 0.000) and proportion of hypertension (χ² = 4.736, P = 0.030) were lower than those in the organic movement disorder group. Comparison of the clinical characteristics of the 2 groups, the FMD group had higher proportions of tremor (χ² = 3.955, P = 0.047) and myoclonus (Fisher's exact probability: P = 0.011) than the organic movement disorder group, and the proportions of parkinsonism (χ² = 8.491, P = 0.004) and gait disorder (χ² = 5.028, P = 0.025) were lower than those in the organic movement disorder group. Conclusions The age and age of onset, as well as the proportions of COVID-19 infection, hypertension, psychopsychological symptoms, tremor, myoclonus, parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China. [ABSTRACT FROM AUTHOR]

Improving the investment efficiency of renewable energy (RE) firms is one of the critical measures for energy low‐carbon transformation and mitigating climate change. To investigate the impact of climate change (greenhouse gas emissions, extreme temperatures, and extreme weather events) on the investment efficiency of RE firms, the present study applied a fixed effect regression model by using the panel data of China's 205 listed non‐hydro RE firms during 2008–2019. The influencing mechanism and the heterogeneity among RE firms are also explored. The results show that (1) CO2 emissions and extreme weather events significantly improve the investment efficiency of RE firms, whereas extreme temperatures' effect is significantly negative. (2) CO2 emissions can promote the investment efficiency of wind and solar firms with environmental responsibility through reducing agency problems and information asymmetry. (3) RE policies play an active role between climate change and investment efficiency of wind and solar energy firms, but the promotion effect is not significant for biomass energy firms. (4) The joint effect of climate change and RE policies on investment efficiency are more prominent for wind and solar energy firms in a low‐marketized environment and state‐owned firms. These results suggest that wind and solar firms should seize market investment opportunities when facing climate change. Besides, policymakers should strengthen market‐oriented construction and improve the completeness of RE policies in low‐marketization areas. [ABSTRACT FROM AUTHOR]

Identifying the determinants of wind curtailment is crucial to mitigating the overcapacity of wind power and achieving a low-carbon transition in China's economy. Existing literature sorted out various factual causes of wind curtailment, but recognizing key factors and revealing their economic mechanisms are missing. Based on power market equilibrium theory, we address the issue by comparing the marginal effects of factors in a 'supply-transmission-demand' framework. Using the panel Tobit model with bootstrap standard errors, we find that variable wind resources and wind power supply capacity are the main determinants of curtailment. The wind power equipment utilization is significantly and negatively related to wind curtailment rate, suggesting that the variable wind resources inhibit wind power consumption from electricity security concerns and increasing costs of grid companies. The wind power supply capacity positively affects wind curtailment by directly spurring market structural disequilibrium and resource waste. We also find that policy intensity has a negative but relatively slight role, whereas wind power price does not affect curtailment due to government pricing. [ABSTRACT FROM AUTHOR]

Differential evolution (DE) is a stochastic optimization technique that imitates the evolution process in nature. This paper uses an improved adaptive differential evolution to solve gravity inversion with multiplicative regularization. Compared with additive regularization, the advantage of multiplicative regularization is that it does not require the regularization parameter in the search process. The contributions in this paper mainly focus on two aspects: accelerating the convergence speed of adaptive DE and balancing the effect of model and data misfits in the objective function. The effectiveness of the proposed inversion method is verified by synthetic and field cases. For the synthetic cases, it is concluded that, based on the obtained results and analysis, the presented DE method is superior and competitive with its original version. Additionally, the designed parameter adaptation for multiplicative regularization is useful for trading off the effect of data and model misfits. For the field cases, two successful applications from China were conducted, and the obtained density source distributions were in accordance with those obtained from drilling wells. The synthetic and practical examples demonstrate that high-quality inversion results can be obtained using improved adaptive differential evolution and multiplicative regularization. [ABSTRACT FROM AUTHOR]

To analyze changes in the detection of parainfluenza virus (PIV) in children hospitalized with acute respiratory tract infection (ARTI) during 2014–2022 in Hubei Province, and explore the impact of the universal two‐child policy and the public health measures against COVID‐19 epidemic on the prevalence of PIV in China. The study was conducted at the Maternal and Child Health Hospital of Hubei Province. Children aged <18 years with ARTI admitted from January 2014 to June 2022 were enrolled. The infection of PIV was confirmed by the direct immunofluorescence method in nasopharyngeal specimens. Adjusted logistic regression models were used to analyze the influence of the universal two‐child policy implementation and public health measurements against COVID‐19 on PIV detection. Totally 75 128 inpatients meeting the criteria were enrolled in this study from January 2014 to June 2022 with an overall PIV positive rate of 5.5%. The epidemic seasons of PIV prevalence lagged substantially in 2020. A statistically significant higher positive rate of PIV was observed in 2017–2019 compared to that in 2014–2015 (6.12% vs 2.89%, risk ratio = 2.12, p < 0.001) after the implementation of the universal two‐child policy in 2016. A steep decline occurred in PIV positive rate during the COVID‐19 epidemic in 2020 (0.92% vs 6.92%, p < 0.001) and it rebounded during the regular epidemic prevention and control period in 2021–2022 (6.35%, p = 0.104). In Hubei Province, the implementation of the universal two‐child policy might have led to an increase of PIV prevalence, and public health measures during the COVID‐19 epidemic might have influenced the fluctuation in PIV detection since 2020. [ABSTRACT FROM AUTHOR]

Purpose: Influenza virus (IFV) causes acute respiratory tract infection (ARTI) and leads to high morbidity and mortality annually. This study explored the epidemiological change of IFV after the implementation of the universal two-child policy and evaluated the impact of coronavirus disease 2019 (COVID-19) pandemic on the detection of IFV. Methods: Hospitalized children under 18 years with ARTI were recruited from Hubei Maternal and Child Healthcare Hospital of Hubei Province from January 2014 to June 2022. The positive rates of IFV were compared among different periods by the implementation of the universal two-child policy and public health measures against COVID-19 pandemic. Results: Among 75,128 hospitalized children with ARTI, the positive rate of IFV was 1.98% (1486/75128, 95% CI 1.88–2.01). Children aged 6−17 years had the highest positive rate of IFV (166/5504, 3.02%, 95% CI 2.58−3.50). The positive rate of IFV dropped to the lowest in 2015, then increased constantly and peaked in 2019. After the universal two-child policy implementation, the positive rate of IFV among all the hospitalized children increased from 0.40% during 2014−2015 to 2.70% during 2017−2019 (RR 6.72, 95% CI 4.94−9.13, P < 0.001), particularly children under one year shown a violent increasing trend from 0.20 to 2.01% (RR 10.26, 95% CI 5.47−19.23, P < 0.001). During the initial outbreak of COVID-19, the positive rate of IFV decreased sharply compared to that before COVID-19 (0.35% vs. 3.37%, RR 0.10, 95% CI 0.04−0.28, P < 0.001), and then rebounded to 0.91%, lower than the level before COVID-19 (RR 0.26, 95% CI 0.20−0.36, P < 0.001). Conclusion: IFV epidemiological pattern has changed after the implementation of the universal two-child policy. More attention should be emphasized to comprehend the health benefits generated by COVID‐19 restrictions on IFV transmission in future. [ABSTRACT FROM AUTHOR]

Background: The prevalence of anxiety and other psychological disorders has increased during the COVID‐19 pandemic, especially among the elderly. Anxiety and metabolic syndrome (MetS) may aggravate each other. This study further clarified the correlation between the two. Methods: Adopting a convenience sampling method, this study investigated 162 elderly people over 65 years of age in Fangzhuang Community, Beijing. All participants provided baseline data on sex, age, lifestyle, and health status. The Hamilton Anxiety Scale (HAMA) was used to assess anxiety. Blood samples, abdominal circumference, and blood pressure were used to diagnose MetS. The elderly were divided into MetS and control groups according to the diagnosis of MetS. Differences in anxiety between the two groups were analysed and further stratified by age and gender. Multivariate logistic regression analysis was used to analyse the possible risk factors for MetS. Results: Compared with the control group, anxiety scores of the MetS group were statistically higher (Z = 4.78, P < 0.001). There was a significant correlation between anxiety levels and MetS (r = 0.353, P < 0.001). Multivariate logistic regression revealed that anxiety (possible anxiety vs no anxiety: odds ratio [OR] = 2.982, 95% confidence interval [CI] 1.295–6.969; definite anxiety vs no anxiety: OR = 14.573, 95%CI 3.675–57.788; P < 0.001) and BMI (OR = 1.504, 95% CI 1.275–1.774; P < 0.001) were possible risk factors for MetS. Conclusion: The elderly with MetS had higher anxiety scores. Anxiety may be a potential risk factor for MetS, which provides a new perspective on anxiety and MetS. [ABSTRACT FROM AUTHOR]

Simple Summary: Afatinib has been approved for patients with lung cancer carrying uncommon epidermal growth factor receptor gene (EGFR) mutations. Dacomitinib, another second-generation inhibitor, has also shown promising potential for these mutations. This is the first and largest comparative study on second-generation inhibitors in patients with uncommon EGFR mutations to date. We found that dacomitinib demonstrated a more favorable activity with manageable toxicity compared with afatinib, which provided more evidence for dacomitinib application in this setting. (1) Background: Afatinib has been approved for patients with non-small cell lung cancer (NSCLC) carrying major uncommon epidermal growth factor receptor gene (EGFR) mutations. Dacomitinib, another second-generation tyrosine kinase inhibitor, has also shown promising potential for uncommon EGFR mutations. However, no comparative study has been conducted. (2) Methods: Two cohorts were employed: the AFANDA cohort, an ambispective cohort including 121 patients with uncommon EGFR mutations admitted to two tertiary hospitals in China, and an external validation afatinib cohort (ex-AC), extracted from the Afatinib Uncommon EGFR Mutations Database (N = 1140). The AFANDA cohort was divided into an afatinib cohort (AC) and a dacomitinib cohort (DC) for internal exploration. Objective response rate (ORR), progression-free survival (PFS), and adverse events (AEs) were assessed for comparison. Progression patterns and resistance mechanisms were explored. (3) Results: In total, 286 patients with advanced NSCLC carrying uncommon EGFR mutations treated with afatinib or dacomitinib were enrolled, including 79 in the AFANDA cohort (44 in the DC, 35 in the AC) and 207 in the ex-AC. In internal exploration, the ORR of the DC was significantly higher than that of the AC (60.5 vs. 26.7%, p = 0.008), but there was no significant difference in median PFS between the DC and the AC (12.0 months vs. 10.0 months, p = 0.305). Multivariate analysis confirmed an independent favorable effect of dacomitinib on PFS (hazard ratio (HR), 1.909; p = 0.047). In external validation, multivariate analysis confirmed the independent prognostic role of dacomitinib in PFS (HR, 1.953; p = 0.029). Propensity score matching analysis confirmed the superiority of dacomitinib over afatinib in terms of PFS in both univariate and multivariate analyses. Toxicity profiling analysis suggested more G1 (p = 0.006), but fewer G3 (p = 0.036) AEs in the DC than in the AC. Progression patterns revealed that the incidence of intracranial progression in the AC was significantly higher than that in the DC (50 vs. 21.1%, p = 0.002). Drug resistance analysis indicated no significant difference in the occurrence of T790M between the AC and the DC (11.8 vs. 15.4%, p = 0.772). (4) Conclusions: Compared with afatinib, dacomitinib demonstrated a more favorable activity with manageable toxicity and different progression patterns in patients with NSCLC carrying uncommon EGFR mutations. [ABSTRACT FROM AUTHOR]

Developing renewable energy (RE) is necessary for economic growth and sustainable development. Policy support provides a source of motivation for developing RE. Thus, after analyzing the evolution of China's RE policy, we establish a Two-way fixed effects model using the data of 30 Chinese provinces during the period 2011–2018. We explored the differences in the impacts of five different types of RE policies on provincial RE development in China. Furthermore, we explored the influencing mechanism and heterogeneity of between different policies and RE development. Results show that: 1) technology development policies can promote RE development by creating an innovation effect while the effect worsens during 2015–2018. 2) the increase in market management policies can inhibit RE development, especially for the provinces with rich RE resources. and 3) the number of comprehensive planning policies and industrial management policies as well as polices' number of electricity price regulation, finance, and tax support have no significant effects on RE development in the total sample. To further achieve the high-quality development of RE, the Chinese government needs to control the number of policies in the market management but enhance the execution and supervision of planning management for provinces with poor RE resources. [ABSTRACT FROM AUTHOR]

Objective: Dacomitinib has been approved for non-small-cell lung cancer (NSCLC) patients harboring classical epidermal growth factor receptor (EGFR) mutations; however, clinical evidence of its activity on major uncommon EGFR mutations is currently limited. Materials and methods: This was a dual-center, single-arm, ambispective cohort study in China. Patients with histologically confirmed metastatic or recurrent NSCLC harboring major uncommon EGFR mutations were eligible for the study. The objective response rate and disease control rate were determined by RECIST 1.1 every 1–2 months. Adverse events were assessed by CTCAE 5.0. Results: In total, 32 NSCLC patients were enrolled between July 2020 and January 2022, and 18 (56.3%) patients received dacomitinib as first-line therapy. Median age was 64 years, and 20 (62.5%) were female. The mutations identified were G719X (n = 24; 75%), followed by L861X (n = 10; 31.3%), and S768I (n = 8; 25%). In the first-line setting, 72.2% of patients (13/18) had a confirmed partial response and 100% (18/18) had disease control, and the median progression-free survival (PFS) and overall survival (OS) were unreached. In the whole cohort, 56.3% of patients (18/32) had a confirmed partial response and 90.6% (29/32) had disease control, and the median PFS was 10.3 months (95% confidence interval, 6.1–14.5) and the median OS was 36.5 months. Except for one case not available for brain re-evaluation, control of the intracranial metastases was observed in 13 patients (13/14, 92.9%). No grade 4–5 adverse events (AEs) occurred, but all patients had grade 1–2 AEs, and 12.5% (4/32) patients required a dosage reduction due to intolerable AEs. Conclusions: Dacomitinib demonstrated favorable activity with manageable toxicity in patients with NSCLC harboring major uncommon EGFR mutations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to test the mediator role of patient safety behaviour between safety culture and safety performance among nurses. Methods: This cross‐sectional study was carried out between September and December 2017 in the nursing units of 10 primary hospitals, two secondary hospitals and two tertiary hospitals in Anhui Province, China. Results: The study participants comprised 79 RNs from primary hospitals, 147 RNs from secondary hospitals and 242 RNs from tertiary hospitals. Most were female (97.6%) and married (73.1%), and their ages ranged from less than 25 years to retirement age. The sample included nurses working in several departments, including medicine (27.1%), surgery (14.3%), emergency (11.5%) and ICU (9%). Structural equation model analysis results showed that espoused values directly affected safety performance, and practised values affected safety performance through safety behaviour. Conclusion: Our hypothetical model noted that safety behaviour is a positive mediating factor of practised safety values affecting safety performance, suggesting that Chinese nursing managers should construct a patient safety culture that is guided and driven by appropriate values, which will ultimately be externalized as nurses' daily behaviour. Summary statement: What is already known about this topic? Nurse‐based patient safety culture evaluation is the primary step towards building a patient safety culture.The investigation of patient safety culture in nursing has revealed that although considerable work has been accomplished towards building a patient safety culture by hospital administrators and nursing administrators, the expected results of patient safety management remain unrealized.Research on the correlation between patient safety culture and safety performance is currently lacking in China. What this paper adds? Nurses had positive self‐reported culture, behaviour and outcomes.Safety behaviour of nurses is a positive mediating factor of practised values and safety performance. The implications of this paper: The core of patient safety culture change is a fundamental shift in values. Chinese nursing managers should construct a patient safety culture that is guided and driven by appropriate values.Safety behaviour of nurses is a positive mediating factor of practised values. In management practice, we should first focus on refining espoused values and then promoting change among nurses by encouraging the adoption of specific management strategies. These strategies will then be internalized by nurses and become practised values, which will ultimately be externalized as nurses' daily habits. [ABSTRACT FROM AUTHOR]

As a popular population based heuristic evolutionary algorithm, differential evolution (DE) has been widely applied in various science and engineering problems. Similar to other global nonlinear algorithms, such as genetic algorithm, simulated annealing, particle swarm optimization, etc., the DE algorithm is mostly applied to resolve the parametric inverse problem, but has few applications in physical property inversion. According to our knowledge, this is the first time DE has been applied in obtaining the physical property distribution of gravity data due to causative sources embedded in the subsurface. In this work, the search direction of DE is guided by better vectors, enhancing the exploration efficiency of the mutation strategy. Besides, to reduce the over-stochastic of the DE algorithm, the perturbation directions in mutation operations are smoothed by using a weighted moving average smoothing technique, and the Lp-norm regularization term is implemented to sharpen the boundary of density distribution. Meanwhile, in the search process of DE, the effect of Lp-norm regularization term is controlled in an adaptive manner, which can always have an impact on the data misfit function. In the synthetic anomaly case, both noise-free and noisy data sets are considered. For the field case, gravity anomalies originating from the Shihe iron ore deposit in China were inverted and interpreted. The reconstructed density distribution is in good agreement with the one obtained by drill-hole information. Based on the tests in the present study, one can conclude that the Lp-norm inversion using DE is a useful tool for physical property distribution using gravity anomalies. [ABSTRACT FROM AUTHOR]

Background: Extensive‐stage small cell lung cancer (ES‐SCLC) is deemed as a fatal malignancy with a poor prognosis. Although immunotherapy has gradually played an important role in the treatment of ES‐SCLC since 2018, ES‐SCLC treatment data and patient outcome before 2018, when chemotherapy served as a fundamental therapeutic strategy, is still meaningful as a summary of the situation regarding previous medical treatment and is a baseline for comparative data. In addition, the prognostic factors of ES‐SCLC have failed to reach a consensus until now. Therefore, this study aimed to evaluate survival and identify the prognostic factors in an ES‐SCLC population. Methods: We retrospectively collected the detailed medical records of 358 patients with ES‐SCLC from January 1, 2011 to December 31, 2018 in a Chinese top‐level cancer hospital. The prognostic factors were evaluated by Cox univariate and multivariate analysis. Results: The median overall survival (OS) of ES‐SCLC patients (N = 358) was 14.0 months, the one‐ and two‐year OS rates were 56.2% and 21.7%, respectively. Moreover, we identified two demographic characters (age ≥ 70, smoking index ≥ 400), one tumor burden factor (bone multimetastasis), two tumor biomarkers (cyfra211, CA125) and two laboratory indexes (decreased Na, PLR < 76) as independent prognostic factors for OS in this patient population. Progression‐free survival (PFS) data of 238 patients was obtained for further analysis, and the median PFS was 6.2 months, and six‐month and one‐year PFS rates were 51.7% and 14.3%, respectively. Elevated cyfra211, decreased Hb and Na were identified as independent prognostic factors for PFS. Conclusions: This study provides real‐world evidence of the survival and prognosis of ES‐SCLC patients which will enable better evaluation and clinical decision‐making in the future. [ABSTRACT FROM AUTHOR]

Host specificity of phytophagous insects plays a critical role in the maintenance of plant diversity. However, a lack of approaches to identify the larvae of phytophagous insects, which usually have similar morphology, can lead to misinterpretation of their host ranges.Acorn weevils are seed‐exploiting parasites of Fagaceae species, a dominant plant group in subtropical evergreen broad‐leaved forests (EBLFs). Therefore, variation in their host specificity may profoundly influence plant diversity in this ecosystem.Here, we collected larvae of acorn weevils from 36 655 seeds of Fagaceae species in EBLFs in southeastern China and performed multiple operational taxonomic unit (OTU) delimitation analyses using one mitochondrial (COI) and two nuclear (ArgK and EF1‐α) genes to reveal species composition of acorn weevils and assess the variation in host specificity among OTUs.We analysed the DNA barcoding sequences from 478 larvae and 4 adults of acorn weevils sampled from 17 common Fagaceae species (five genera) and detected 11 OTUs. Moreover, host range varied drastically among different OTUs, with Curculio bimaculatus being the most generalised.Our results revealed high diversity of acorn weevils and that strong variation in host specificity can even exist among OTUs in the same genus, addressing the need to distinguish different Curculio species before conducting forest management in EBLFs. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis is a complication in acute-on-chronic liver failure (ACLF) patients associated with high rates of mortality and morbidity. Early diagnosis of sepsis in ACLF patients can improve prognosis. This study aimed to explore potential effective biomarkers for the early diagnosis of sepsis in ACLF patients. Methods: Ninety-four ACLF patients with sepsis were enrolled from 10 hospitals across China from January 2015 to June 2016 as well as 49 ACLF patients without infection from Xiangya Hospital. The first-day admission data and SOFA score and CLIF-SOFA score were collected. The differences of indicators between groups were compared with Kruskal-Wallis test. The receiver-operating characteristic (ROC) curve was analyzed to evaluate the diagnostic efficiency of the selected factors. Results: Soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and presepsin were significantly higher in ACLF-sepsis patients compared with ACLF patients with no infection (P < 0.001). sTREM-1 and presepsin presented higher diagnostic value in sepsis for ACLF patients compared with other biomarkers [white blood cells (WBC), procalcitonin (PCT) and C-reactive protein (CRP)]. Combining sTREM-1 or presepsin with the CLIF-SOFA score increased the diagnostic efficiency (AUC = 0.876 or AUC = 0.913, respectively). Conclusions: sTREM-1 and presepsin are potential biomarkers for the early diagnosis of sepsis in ACLF patients. The combination of presepsin and the CLIF-SOFA score is a promising method for diagnosing sepsis in ACLF patients. Trial Registration: ClinicalTrials.gov identifier, NCT02457637. [ABSTRACT FROM AUTHOR]

In the past two decades, both housing prices and carbon emissions have risen dramatically in China. However, it is unclear whether there is a nexus between them. This study employs a dynamic panel threshold regression model using residents' income levels as the threshold variable to investigate the relationship between housing prices and per capita carbon emissions. By considering 60 Chinese housing price-monitored cities, a threshold effect of income on carbon emissions was identified with a threshold value of 2.448, which divided the full sample into two regimes to further analyse the impacts of housing prices on per capita carbon emissions at each income level. The empirical results show that housing prices have a slight but positive effect on per capita carbon emissions both at two income levels. Specifically, a 10% change in housing prices can lead to a change in the same direction in per capita carbon emissions by 0.7% and 0.2% at lower and higher average income levels, respectively. However, in small cities, limited population may contribute to the negative impact of housing prices on carbon emissions. Furthermore, the results also confirm that the urbanization rate is an important factor of per capita carbon emissions. [ABSTRACT FROM AUTHOR]

From December 25, 2019 to January 31, 2020, 33 cases of the coronavirus disease 2019 (COVID-19) were identified in the Department of Respiratory and Critical Care Medicine of Zhongnan Hospital of Wuhan University, China, yet none of the affiliated HCWs was infected. Here we analyzed the infection control measures used in three different departments in the Zhongnan Hospital of Wuhan University and correlated the measures with the corresponding infection data of HCWs affiliated with these departments. We found that three infection control measures, namely the isolation of the presumed positive patients, the use of facemasks and intensified hand hygiene play important roles in preventing nosocomial transmission of COVID-19. [ABSTRACT FROM AUTHOR]

China has been analyzing, assessing, and enhancing renewable energy efficiency as crucial steps in mitigating global energy depletion and climate change. Most studies evaluating renewable energy efficiency (REE) use a single-stage data envelopment analysis (DEA) model, and thereby, ignore the interactions among economic, social, and environmental subsystems. In contrast, this study develops a matrix-type structure network DEA model that considers the influence of undesirable outputs and mutual interactions among these three subsystems to measure REE in China's 30 provinces. Examining the 2005 to 2019 timeframe, the study shows that: 1) the changes in China's REE reflect a significant "V" shape during this timeframe, with 2013 marking the boundary, owing to an improvement in the efficiency of the environmental subsystem; 2) REE improved in 15 provinces, decreased in 13, and barely changed in the other two; 3) REE tended to converge between 2005 and 2011 and diverge between 2011 and 2019; and 4) for further REE improvement, total fixed asset investments, fossil energy imports, and household waste collected and transported need to decrease by 26 %, at least; while GDP per capita, excellent air quality, and years of education need to increase by >4 %. The expansion of the advanced provinces contributes to REE improvement for international economies and industrial communities. It will accelerate the free movement of production inputs, facilitating international energy saving and sustainable development. • A matrix-type structure network DEA model is proposed. • REE of 30 provinces in China is measured by the proposed model. • The changes in China's REE reflect a significant "V" shape during 2005 to 2019. • REE converged between 2005 and 2011 but diverged between 2011 and 2019. • REE improved in 15 provinces, decreased in 13, and barely changed in the other two. [ABSTRACT FROM AUTHOR]

Parabens are alkyl esters widely used as preservatives in foodstuffs, cosmetics, and pharmaceuticals. Taihu Lake is the third largest freshwater lake in China. However, there is no information available on the occurrence of parabens in Taihu Lake. To investigate contamination of parabens in Taihu Lake and the influence of human activities on contamination levels, 199 fish samples, comprising five species, were collected from Taihu Lake from 2009 to 2017. Five parabens, including methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), butylparaben (BuP), and benzylparaben (BeP), were quantitated using an isotope dilution LC-MS/MS method. The total concentrations of the five parabens ranged from 261 to 1710 pg/g wet weight (ww) with an average of 642 pg/g ww. The predominant compounds were MeP, EtP, and PrP, whose amounts accounted for more than 95% of the total amounts. No significant differences in the concentrations of parabens among the five fish species were observed, suggesting no interspecies differences in bioaccumulation of these compounds. Σ 5 parabens in fish showed temporal variations with the means ranging between 532 and 772 pg/g ww during years. The levels of parabens were generally consistent with the economic development and urbanization rates of the regions surrounding Taihu Lake. The "typical" and "high" estimated daily intake (EDI) of parabens were 0.53 and 0.91 ng/kg-bw/day for children, and 0.46 and 0.79 ng/kg-bw/day for adults based on calculations using the means and the 95th concentrations, respectively. The EDIs were much lower than the reference dose values, suggesting that there are no obvious health risks posed by fish consumption. Image 1 • This is the first investigation of parabens in Taihu Lake. • Temporal trends of parabens in fish from Taihu Lake were investigated. • Levels of parabens in fish increased in line with social and economic development. • EDI values showed no obvious health risks of parabens to humans via fish consumption. The first report on parabens in Taihu Lake showed that they were widely distributed in fish and their concentrations increased with increasing human activities. [ABSTRACT FROM AUTHOR]

The convergence of carbon emissions in important regions is a key prerequisite for reaching China's carbon emissions peak target. The Yangtze River Economic Belt (YREB) is the latest strategic economic area in China. In this study, a method of investigating the convergence of per capita carbon emissions in the YREB is proposed, and it includes the following models: σ convergence, stochastic convergence and β convergence. Besides, the five control variables per capita Gross Domestic Product (GDP), energy consumption structure, industrial structure, population density and urbanization rate are considered in the test models. In addition to testing the whole sample of 74 cities belonging to the Economic Belt, the convergence of three subgroups (municipalities, capital and sub-provincial cities and prefecture-level cities) is also tested by considering spatial effects. The following results are obtained: (1) although σ convergence and β conditional convergence are observed, stochastic convergence is not observed for the 74 cities; (2) the per capita GDP and energy structure are the key factors influencing the cities' convergence, whereas the urbanization rate has a limited impact; and (3) improving the industrial structure and reducing the population density are effective methods of promoting the convergence of per capita carbon emissions among the capital and sub-provincial cities and municipalities, respectively. [ABSTRACT FROM AUTHOR]

Background To compare the overall survival ( OS) of patients with advanced lung adenocarcinoma in China before and after the approved use of gefitinib, and analyze clinical factors that may affect OS. Methods Clinical data of 558 patients with advanced lung adenocarcinoma who received chemotherapy from January 2002 to December 2010 were retrospectively analyzed. According to the matched-pair case-control study design, 255 patients who only received chemotherapy and 255 patients who received gefitinib treatment after its approval were stringently matched by age, gender, and smoking history and enrolled in the study. Clinical factors including age, gender, smoking history, Eastern Cooperative Oncology Group ( ECOG) performance status ( PS), tumor stage, organ metastasis, and the number of prior chemotherapies were analyzed to determine their correlations with OS. Results The median survival time ( MST) of the 510 enrolled patients with advanced lung adenocarcinoma was 22.8 months. The MST of the patients who received gefitinib treatment was significantly longer than that of patients who did not receive gefitinib treatment (33.5 vs. 14.1 months, P < 0.001). The OS in patients who received gefitinib treatment was significantly longer than in patients who did not receive gefitinib treatment in almost all clinical factor-based subgroups, including age, gender, smoking history, ECOG PS 0-1, tumor stage, the presence or absence of lung, pleural, bone, brain, adrenal gland and liver metastasis, and the number of prior chemotherapies (all P < 0.001), except in the ECOG PS ≥2 subgroup. Conclusions Gefitinib treatment significantly improved the survival of patients with advanced lung adenocarcinoma in China. [ABSTRACT FROM AUTHOR]

This article examines how international resources can be used to strengthen local support for civil society initiatives in China to improve the circumstances of poor and vulnerable populations. It identifies ways in which international resources have strengthened civil society in other countries, such as enhancing access to financial resources, building capacity of leaders and organizations, reducing sector fragmentation, building public legitimacy and improving cross-sector relations. It examines the characteristics and special circumstances facing civil society in China, arguing that institutional constraints are particularly problematic. Then it explores how international resources might be applied to each of the problem areas identified given the constraints of the Chinese context. Finally the article articulates five principles that might guide international donors for building more local support for civil society activity in China. [ABSTRACT FROM AUTHOR]

Abstract: The diesel contaminants in the sediments of Huangpu-Yangtze River estuary (HYRE) affect the ecological environment seriously. The diesel degradation of four species of indigenous plants, Scirpus triqueter (Scirpus tripueter L.; STL), reed (Phragmites australis; PA), Herba Caricis Phacotae (Carex phacota Spr.; CPS) and Sagittaria sagittifolia (Sagittaria sagittifolia L.; SSL), and hydrocarbon-degrading microorganisms (HDMs) isolated from the HYRE wetland were evaluated with the simulation experiment. The pot experiments were executed to investigate the decontaminating potential of the four plants species with HDMs, called PA-Ms, STL-Ms, SSL-Ms and CPS-Ms respectively. It showed that diesel amount were decreased about 76-80% (at 15 000mg/kg diesel level) respectively under the co-activation action of PA, STL, SSL and CPS with HDMs in the 60d experiment. The four plants with HDMs could degrade paraffins components which have high diesel indices in the diesel components, especially STL- Ms, CPS-Ms and SSL-Ms. The wetland plants with HDMs showed a marked capability to degrade diesel. [Copyright &y& Elsevier]

Suffering from structural deterioration and natural disasters, the resilience of civil structures in the face of extreme loadings inevitably drops, which may lead to catastrophic structural failure and presents great threats to public safety. Earthquake-induced extreme loading is one of the major reasons behind the structural failure of buildings. However, many buildings in earthquake-prone areas of China lack safety monitoring, and prevalent structural health monitoring systems are generally very expensive and complicated for extensive applications. To facilitate cost-effective building-safety monitoring, this study investigates a method using cost-effective MEMS accelerometers for buildings' rapid after-earthquake assessment. First, a parameter analysis of a cost-effective MEMS sensor is conducted to confirm its suitability for building-safety monitoring. Second, different from the existing investigations that tend to use a simplified building model or small-scaled frame structure excited by strong motions in laboratories, this study selects an in-service public building located in a typical earthquake-prone area after an analysis of earthquake risk in China. The building is instrumented with the selected cost-effective MEMS accelerometers, characterized by a low noise level and the capability to capture low-frequency small-amplitude dynamic responses. Furthermore, a rapid after-earthquake assessment scheme is proposed, which systematically includes fast missing data reconstruction, displacement response estimation based on an acceleration response integral, and safety assessment based on the maximum displacement and maximum inter-story drift ratio. Finally, the proposed method is successfully applied to a building-safety assessment by using earthquake-induced building responses suffering from missing data. This study is conducive to the extensive engineering application of MEMS-based cost-effective building monitoring and rapid after-earthquake assessment. [ABSTRACT FROM AUTHOR]

Clarifying the role of biomass resource endowment in green development efficiency (GDE) is necessary for economic growth and environmental protection. This study constructed a unified theoretical analysis framework that incorporates biomass resource endowment and GDE. Based on the proposed theoretical framework and provincial data in China from 2007 to 2018, we then integrated super-efficiency slacks-based measure (SBM) with undesirable outputs and spatial econometric panel regression models to explore the effect of biomass resource endowment on GDE. We constructed four kinds of spatial weight matrices to verify the existence of the "resource curse" phenomenon in the field of GDE, with consideration for the spatial correlation of not only geographical distance but also economic distance. Our results showed that biomass resource endowment had a positive direct effect on regional GDE. A 1% increase in provincial biomass resource endowment, on average, directly led to a 0.092% increase in GDE. The impact of biomass technological innovation on GDE could be underestimated by 15% if the spatial spillover effects were ignored. Provincial biomass energy policy may not play its due role in promoting GDE because of the high cost of biomass energy. [Display omitted] [ABSTRACT FROM AUTHOR]

Developing renewable energy is a crucial measure in addressing climate change and achieving carbon reduction. However, research evidence on its impact is mixed. To fill this gap, we construct a panel quantile regression model in this study to examine whether China's renewable energy development has effectively promoted a reduction in carbon emissions using panel data of 30 Chinese provinces from 2005 to 2016. The results show that: (1) Improving China's renewable energy development level is conducive to carbon emission reductions. Specifically, carbon intensity could drop by 0.084%–0.149% for every 1% increase in renewable energy generation. However, the inhibitory effect is limited due to trapped electricity as well as the fact that substituting renewable energy for fossil energy has not yet sufficiently transformed the energy consumption structure. (2) Renewable energy development has a greater impact on carbon intensity reduction in regions with high or low carbon intensity than in areas with intermediate carbon intensity. (3) The main factor in the decline in carbon intensity in China is a decrease in energy intensity. Nonetheless, the role of renewable energy in carbon reduction has increased over time. • Role of renewable energy development on carbon reduction is examined. • China's renewable energy development has limited effect on its carbon reduction. • Reduction effect is the minimal in areas with intermediate carbon intensity. • Reduction effect of renewable energy becomes more and more obvious with time. [ABSTRACT FROM AUTHOR]

The article offers a look on the status of medical care for women in Shanghai County, China in 1982. According to the authors, there have been significant improvements in health care for women in the county which are reflected by the increase of deliveries in hospitals and the decrease of infant and maternal mortality rates. It is noted that the county's Health Bureau has developed a maternal and child health (MCH) station and young women after marriage have received continuous health education and advice from the barefoot doctor of their brigade. Moreover, it cites that pregnant women have been given both antenatal care as well as special protection on their jobs.

The article reports on the developments in the delivery of child medical care in Shanghai County, China. It is stated that maternal and child health (MCH) organizations have been established all over the country so that medical services can be readily available and accessible to mother and children. Several preventive and surveillance services for children include home visits for care of the newborn, routine physical examinations, mass screening, and routine immunization. Accordingly, it cites that mass media and other means of health education are employed for the dissemination of information about children's health and the importance of child health care.

Abstract: The diesel contaminants in the sediments of Huangpu-Yangtze River estuary (HYRE) affect the ecosystem seriously. The effects of four species of indigenous plants, Scirpus triqueter (Scirpus tripueter L.; STL), reed (Phragmites australis; PA), Herba caricis phacotae (Carex phacota Spr.; CPS) and Sagittaria sagittifolia (S. sagittifolia L.; SSL), with oil-degrading bacteria (M) isolated from the oily HYRE wetland on the degradation ratio of diesel were evaluated by simulation experiments. The results showed that oil-degrading bacteria enhanced the degradation ratio of diesel. Besides, the indigenous plants combine with oil-degrading bacteria further improved the degradation ration. The diesel amount decreased about 76–80% (at 15,000 mg kg−1 diesel level) in the presence of PA & M, STL & M, SSL & M and CPS & M during the 60 d of experimental period. STL & M, SSL & M exhibited preferable degradation ratio at various diesel concentration throughout the whole experiment. The wetland plants with the oil-degrading bacteria showed a marked capability to degrade diesel contaminants. [Copyright &y& Elsevier]

Background: Chronic diseases, such as heart disease, cancer, and diabetes, are the leading causes of death and disability. Loneliness is linked to a greater risk of chronic disease. However, the lack of loneliness may change this relationship., Methods: The 4th Survey of the Aged Population in Urban and Rural China (SSAPUR) was performed. 222,179 people over 60 years old were recruited. Chronic disease was defined by self-reported tumble incidents using the fourth SSAPUR questionnaire. We found that the residuals were well normally distributed. Subsequently, we analyzed the association between each studied factor and chronic disease by univariate logistic regression analysis. Finally, we stratified the population by age, gender, and urban and rural., Results: 77,448 individuals experienced loneliness, while 137,593 did not. Loneliness correlated significantly with urban-rural classification, age, and gender (P < 0.001). There was a significant association between chronic diseases and loneliness (P < 0.05). Compared to lonely individuals, those with low level of loneliness had a lower incidence of gastric diseases (OR = 0.752, 95% CI, 0.736-0.769, P < 0.001), osteoarthritis (OR = 0.685, 95% CI, 0.673-0.697, P < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 0.678, 95% CI, 0.659-0.698, P < 0.001), asthma (OR = 0.608, 95% CI, 0.583-0.633, P < 0.001), malignant tumors (OR = 0.892, 95% CI, 0.822-0.968, P = 0.006), and reproductive system diseases (OR = 0.871, 95% CI, 0.826-0.918, P < 0.001)., Conclusion: In summary, loneliness is an important risk factor in the occurrence and development of chronic diseases in the elderly in China, and it has adverse effects on hypertension, stomach disease, cataract or glaucoma, osteoarthrosis, chronic lung disease, asthma, malignant tumor, and reproductive system diseases., (© 2024. The Author(s).)

Using Origin2022Pro, PAST4.09, GraphPad, and ArcGIS, this study analyzed the big data of the fourth national survey of traditional Chinese medicine resources in Jilin province from five dimensions: differences in resource quantity, taxonomic group, family, and genus, regional distribution, and spatiotemporal distribution, aiming to fully elucidate the biodiversity of medicinal plants in Jilin province. The results indicated that 2 241 species of medicinal plants existed in Jilin province, belonging to 881 genera of 243 families, with 20 dominant families and 3 dominant genera. There were 1 901 species of medicinal plants(belonging to 778 genera of 227 families) in the eastern mountainous region, 1 503 species(belonging to 690 genera of 225 families) in the mid-mountainous areas of the central mountainous region, and 811 species(belonging to 436 genera of 136 families) in the western plain region. The biodiversity of medicinal plants in Jilin province was high and presented a trend of high in the east and low in the west. The medicinal plant resources were mainly concentrated in the eastern mountainous region, and the number of medicinal plant groups had significant diffe-rences between regions, following the trend of western region &gt; central region &gt; eastern region. The species richness was in the order of eastern region &gt; western region &gt; central region. The species diversity structure in the central region was similar to that in the eastern and western regions, while it was significantly different between the western and eastern regions. Compared with the third national survey of traditional Chinese medicine resources, the fourth survey showed an increase of 1 417 species, a decrease of 580 species, and 824 common species, indicating significant changes in the biodiversity of medicinal plants in Jilin province. The reasons for these changes need to be further explored. This article elucidates the background and biodiversity changes of medicinal plant resources in Jilin province, laying a foundation for the protection, utilization, and industrial development of traditional Chinese medicine resources in Jilin province.

Aim: To examine the prevalence and potential risk factors of multimorbidity among older adult in China. In addition, we investigated the pattern of multimorbidity., Methods: This study is based on data from the fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) in 2015, a comprehensive survey of individuals aged 60 years or older in China. We calculated baseline data and prevalence rates for comorbidities, stratified by household registration, age, sex, education, exercise, and health insurance. Univariate and multivariate logistic regression analyses were conducted to identify potential risk factors for comorbidities. Furthermore, we determined the prevalence rates for the three most frequent disease combinations., Results: A total of 215,040 participants were included in our analysis. The prevalence of multimorbidity was 50.5% among the older adult in China. The prevalence rate was slightly higher in rural areas than in urban areas, with rates of 51.5 and 49.6%, respectively ( p  < 0.001). Moreover, the prevalence rate was higher in females than in males, with rates of 55.2 and 45.3%, respectively ( p  < 0.001). Multivariate logistic regression analysis revealed that individuals aged 70-79 years (OR:1.40, 95% CI: 1.38-1.43, p  < 0.001) and over 80 years (OR:1.41, 95% CI: 1.38-1.45, p  < 0.001) had a higher prevalence of multimorbidity than those aged 60-69 years. The most prevalent pair of comorbidities was hypertension and osteoarthropathy, with 19.6% of the participants having these two conditions, accounting for 5.4% of the total participants., Conclusion: Our findings indicate a high prevalence of multimorbidity among the older adult in China. Increased expenditure on preventive health care, popularization of general medicine and popular medical education may be adopted by the Government to cope with the high prevalence of multimorbidity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hu, Li, Wei, Wu, Meng, Li, Xu, Zhang, Ma, Li, Zeng, Zhang, Li and Liu.)

Background: There is growing evidence linking the age-adjusted Charlson comorbidity index (aCCI), an assessment tool for multimorbidity, to fragility fracture and fracture-related postoperative complications. However, the role of multimorbidity in osteoporosis has not yet been thoroughly evaluated. We aimed to investigate the association between aCCI and the risk of osteoporosis in older adults at moderate to high risk of falling., Methods: A total of 947 men were included from January 2015 to August 2022 in a hospital in Beijing, China. The aCCI was calculated by counting age and each comorbidity according to their weighted scores, and the participants were stratified into two groups by aCCI: low (aCCI < 5), and high (aCCI ≥5). The Kaplan Meier method was used to assess the cumulative incidence of osteoporosis by different levels of aCCI. The Cox proportional hazards regression model was used to estimate the association of aCCI with the risk of osteoporosis. Receiver operating characteristic (ROC) curve was adapted to assess the performance for aCCI in osteoporosis screening., Results: At baseline, the mean age of all patients was 75.7 years, the mean BMI was 24.8 kg/m 2 , and 531 (56.1%) patients had high aCCI while 416 (43.9%) were having low aCCI. During a median follow-up of 6.6 years, 296 participants developed osteoporosis. Kaplan-Meier survival curves showed that participants with high aCCI had significantly higher cumulative incidence of osteoporosis compared with those had low aCCI (log-rank test: P < 0.001). When aCCI was examined as a continuous variable, the multivariable-adjusted model showed that the osteoporosis risk increased by 12.1% (HR = 1.121, 95% CI 1.041-1.206, P = 0.002) as aCCI increased by one unit. When aCCI was changed to a categorical variable, the multivariable-adjusted hazard ratios associated with different levels of aCCI [low (reference group) and high] were 1.00 and 1.557 (95% CI 1.223-1.983) for osteoporosis (P <  0.001), respectively. The aCCI (cutoff ≥5) revealed an area under ROC curve (AUC) of 0.566 (95%CI 0.527-0.605, P = 0.001) in identifying osteoporosis in older fall-prone men, with sensitivity of 64.9% and specificity of 47.9%., Conclusions: The current study indicated an association of higher aCCI with an increased risk of osteoporosis among older fall-prone men, supporting the possibility of aCCI as a marker of long-term skeletal-related adverse clinical outcomes., (© 2024. The Author(s).)

Objective: Frailty increases poor clinical outcomes in older adults, the aim of this study was to investigate the prevalence and factors associated with frailty and pre-frailty in older adults in China., Research Design and Methods: Data were obtained from the Sample Survey of the Aged Population in Urban and Rural China in 2015, which was a cross-sectional study involving a nationally representative sample of older adults aged 60 years or older from 31 provinces/autonomous regions/municipalities in mainland China. The frailty index (FI) based on 33 potential deficits was used to classify individuals as robust (FI < 0.12), pre-frail (FI ≧0.12 and <0.25) and frail (FI ≥0.25)., Results: A total of 208,386 older people were included in the study, and the age-sex standardised prevalence of frailty and pre-frailty among older adults in China was 9.5% (95% CI 9.4-9.7) and 46.1% (45.9-46.3) respectively. The prevalence of frailty and pre-frailty was higher in female than in male older adults, higher in rural than in urban older adults, and higher in northern China than in southern China. The multinomial analysis revealed similar risk factors for frailty and pre-frailty, including increased age, being female, living in a rural area, low educational attainment, poor marital status, living alone, difficult financial status, poor access to medical reimbursement, and living in northern China., Conclusion: Frailty and pre-frailty are very common among older adults in China and differ significantly between southern and northern China, men and women, and rural and urban areas. Appropriate public health prevention strategies should be developed based on identified risk factors in frail and pre-frail populations. The management of frailty and pre-frailty should be optimised according to regional and gender differences in prevalence and associated factors, such as strengthening the integrated management of chronic diseases, increasing reimbursement rates for medical costs, and focusing on vulnerable groups such as the disabled, economically disadvantaged, living alone and those with low literacy levels, in order to reduce the burden of frailty among older adults in China., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zeng, Meng, Li, Jia, Shi, Zhang, Hu, Hu, Li, Wu, Li, Qi, Wang, Zhang, Li and Liu.)

Objective: Frailty increases adverse clinical outcomes in older patients with cardio-cerebral vascular disease (CCVD). The aim of this study was to investigate the prevalence of frailty and pre-frailty in older adults with CCVD in China and the factors associated with it., Research Design and Methods: In this cross-sectional study, we used data from the fourth Sample Survey of Aged Population in Urban and Rural China. We used the frailty index for frailty and pre-frailty assessment, and the diagnosis of CCVD in older adults was self-reported., Results: A total of 53,668 older patients with CCVD were enrolled in the study. The age-standardized prevalence of frailty and pre-frailty in older patients with CCVD was 22.6% (95% CI 22.3-23.0%) and 60.1% (95% CI 59.7-60.5%). Multinomial logistic regression analyses showed that being female, increasing age, rural residence, illiteracy, widowhood, ethnic minority, living alone, no health screening during the last year, hospitalization during the last year, difficult financial status, comorbid chronic conditions, and disability in activities of daily living were associated with frailty and pre-frailty in older patients with CCVD., Conclusion: CCVD is strongly associated with frailty and pre-frailty in older Chinese people, and assessment of frailty should become routine in the management of older CCVD patients. Appropriate public health prevention strategies should be developed based on identified risk factors for frailty in older CCVD patients, which can help prevent, ameliorate or reverse the development of frailty in CCVD in the older population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zeng, Meng, Jia, Shi, Zhang, Li, Hu, Hu, Li, Wu, Li, Qi, Wang, Zhang, Li and Liu.)

Purpose: Influenza virus (IFV) causes acute respiratory tract infection (ARTI) and leads to high morbidity and mortality annually. This study explored the epidemiological change of IFV after the implementation of the universal two-child policy and evaluated the impact of coronavirus disease 2019 (COVID-19) pandemic on the detection of IFV., Methods: Hospitalized children under 18 years with ARTI were recruited from Hubei Maternal and Child Healthcare Hospital of Hubei Province from January 2014 to June 2022. The positive rates of IFV were compared among different periods by the implementation of the universal two-child policy and public health measures against COVID-19 pandemic., Results: Among 75,128 hospitalized children with ARTI, the positive rate of IFV was 1.98% (1486/75128, 95% CI 1.88-2.01). Children aged 6-17 years had the highest positive rate of IFV (166/5504, 3.02%, 95% CI 2.58-3.50). The positive rate of IFV dropped to the lowest in 2015, then increased constantly and peaked in 2019. After the universal two-child policy implementation, the positive rate of IFV among all the hospitalized children increased from 0.40% during 2014-2015 to 2.70% during 2017-2019 (RR 6.72, 95% CI 4.94-9.13, P < 0.001), particularly children under one year shown a violent increasing trend from 0.20 to 2.01% (RR 10.26, 95% CI 5.47-19.23, P < 0.001). During the initial outbreak of COVID-19, the positive rate of IFV decreased sharply compared to that before COVID-19 (0.35% vs. 3.37%, RR 0.10, 95% CI 0.04-0.28, P < 0.001), and then rebounded to 0.91%, lower than the level before COVID-19 (RR 0.26, 95% CI 0.20-0.36, P < 0.001)., Conclusion: IFV epidemiological pattern has changed after the implementation of the universal two-child policy. More attention should be emphasized to comprehend the health benefits generated by COVID-19 restrictions on IFV transmission in future., (© 2023. The Author(s).)

Background: Longitudinal studies characterizing the epidemic trend of respiratory syncytial virus (RSV) in Hubei Province are scarce., Objective: We aimed to depict the dynamics of the RSV epidemic among hospitalized children with acute respiratory tract infections (ARTIs) during 2014 to 2022 in the Maternal and Child Health Hospital of Hubei Province and investigate the influence of the 2-child policy and the COVID-19 pandemic on RSV prevalence., Methods: The medical records and testing results of hospitalized children with ARTI from January 2014 to June 2022 were extracted. Nasopharyngeal samples were tested with direct immunofluorescence assay. Detection rates of RSV were categorized according to the diagnosis of patients: (1) overall, (2) upper respiratory tract infection (URTI), and (3) lower respiratory tract infection (LRTI). Poisson regression models were used to investigate the association between RSV detection rate and age, gender, or diagnosis. The detection rates of RSV before and after the implementation of the universal 2-child policy were compared using a Poisson regression model. Multiple comparisons of RSV detection rates were conducted among 3 stages of the COVID-19 pandemic using chi-square tests. Seasonal autoregressive integrated moving average was performed to predict RSV behaviors from February 2020 to June 2020 under the assumption of a non-COVID-19 scenario., Results: Among 75,128 hospitalized children with ARTI, 11.1% (8336/75,128) were RSV-positive. Children aged <1 year had higher detection rates than older children (4204/26,498, 15.9% vs 74/5504, 1.3%; P<.001), and children with LRTI had higher detection rates than children with URTI (7733/53,145, 14.6% vs 603/21,983, 2.7%; P<.001). Among all the children, a clear seasonal pattern of the RSV epidemic was observed before 2021. Most of the highest detection rates were concentrated between December and February. The yearly detection rate of RSV remained at a relatively low level (about 8%) from 2014 to 2017, then increased to 12% and above from 2018. The highest monthly detection rate was in December 2018 (539/1493, 36.1%), and the highest yearly rate was in 2021 (1372/9328, 14.7%). There was a moderate increase in the RSV detection rate after the 2-child policy was implemented (before: 860/10,446, 8.2% vs after: 4920/43,916, 11.2%; P<.001). The largest increase, by 5.83%, occurred in children aged <1 year. The RSV epidemic level decreased sharply in the short term after the COVID-19 outbreak (detection rate before: 1600/17,010, 9.4% vs after: 32/1135, 2.8%; P<.001). The largest decrease, by 12.0%, occurred in children aged <1 year, but a rebounding epidemic occurred after 2020 (680/5744, 11.8%; P<.001)., Conclusions: Children have been experiencing increased prevalence of RSV since 2018 based on surveillance from a hospital in Hubei Province with a large sample size. The 2-child policy might have increased the RSV prevalence, and the COVID-19 epidemic had a temporary inhibitory effect on RSV transmission. Vaccines against RSV are urgently needed., (©Xing-Wen Hu, Yiguo Zhou, Song Yi, Wan-Xue Zhang, Xin-Rui Wang, Juan Du, Qing-Bin Lu. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 27.04.2023.)

Objective: There are few studies on the prevalence and factors associated with frailty and pre-frailty in older adults with asthma worldwide. The aim of this study was to examine the epidemiological status and factors associated with frailty and pre-frailty in older adults with asthma in China., Research Design and Methods: Data were obtained from the Sample Survey of Aged Population in Urban and Rural China in 2015, a nationwide cross-sectional survey covering 224,142 older people aged 60 years or older in 31 provinces/autonomous regions/municipalities in mainland China. We performed frailty and pre-frailty assessments using the frailty index, and the diagnosis of asthma in the older adults was self-reported based on the history of the physician's diagnosis., Results: Nine thousand four hundred sixteen older adults with asthma were included in the study. The age-sex standardized prevalence of frailty and pre-frailty in Chinese older adults with asthma was 35.8% (95% CI 34.8%-36.7%) and 54.5% (95% CI 53.5%-55.5%). Multinomial logistic regression analysis showed that increased age, female, illiteracy, living alone, poor economic status, ADL disability, comorbid chronic diseases, previous hospitalization in the past year, and residence in northern China were associated with frailty and pre-frailty in older adults with asthma., Conclusion: The prevalence of frailty and pre-frailty in Chinese older adults with asthma is very high, and assessment of frailty should become routine in the management of older adults with asthma. Appropriate public health prevention strategies based on identified risk factors for frailty in older adults with asthma should be developed to reduce the burden of frailty in Chinese older adults with asthma., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zeng, Meng, Jia, Shi, Zhang, Li, Hu, Hu, Li, Wu, Li, Qi, Wang, Zhang, Li and Liu.)

Aim: To evaluated the prevalence and potential risk factors of self-reported diabetes among the elderly in China, by demographic data, socioeconomic factors, and psychological factors., Methods: Descriptive analysis and Chi-square analysis were used to assess the prevalence and variation between self-reported diabetes and non-diabetes by demographic data, living habits, socioeconomic factors and comorbidities. Univariate and multivariate logistic regression were used to describe the odds ratios (OR) of diabetes prevalence in different groups, while stratification analysis was performed to describe prevalence based on gender, age, and urban/rural areas., Results: 215,041 elderly adults (102,692 males and 112,349 females) were eventually included in the analysis. The prevalence of self-reported diabetes among the elderly in China is about 8.7%, with the highest prevalence in Beijing (20.8%) and the lowest prevalence in Xizang (0.9%). Logistic regression analysis showed that urban area ( P < 0.001), older age (65-84 years old, P < 0.001), female ( P < 0.001), higher income( P < 0.001), poor sleep quality ( P = 0.01) and some other factors were potential risk factors for diabetes., Conclusions: This study illustrates the prevalence and potential risk factors of diabetes among the elderly in China Meanwhile, these results provide information to assist the government in controlling non-communicable diseases in the elderly., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hu, Meng, Wei, Xu, Li, Li, Jia, Li, Qi, Zeng, Zhang, Li and Liu.)

Background: An unexplained pneumonia occurred in Wuhan, China in December 2019, later identified and named coronavirus disease 2019 (COVID-19). This study aimed to compare the ultrasonographic features of the lung between patients with COVID-19 in Wuhan (the primary region) and those in Beijing (the secondary region) and to find the value of applying ultrasound in COVID-19., Methods: A total of 248 COVID-19 cases were collected, including long-term residents in Wuhan (138), those who had a short-term stay in Wuhan (72), and those who had never visited Wuhan (38). Ultrasound examination was performed daily; the highest lung ultrasound score (LUS) was the first comparison point, while the LUS of the fifth day thereafter was the second comparison point. The differences between overall treatment and ultrasonography of left and right lungs among groups were compared., Results: The severity decreased significantly after treatment. The scores of the groups with long-term residence and short-term stay in Wuhan were higher than those of the group that had never been to Wuhan., Conclusion: Ultrasonography is effective for dynamic monitoring of COVID-19. The ultrasonographic features of patients in the Wuhan area indicated relatively severe disease. Thus, Wuhan was the main affected area of china., (© 2022 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

Objective: To investigate the prevalence of frailty and pre-frailty and its associated factors in Chinese older adults with diabetes through a nationwide cross-sectional study., Research Design and Methods: The data were obtained from the Sample Survey of the Aged Population in Urban and Rural China (SSAPUR), conducted in 2015, which was a cross-sectional study involving a nationally representative sample of older adults aged 60 years or more from 31 provinces, autonomous regions, and municipalities in mainland China. Subjects with diabetes were included in this study. Frailty index (FI), based on 33 potential deficits, was used to categorize individuals as robust, pre-frail, or frail., Results: A total of 18,010 older adults with diabetes were included in this study. The weighted prevalence of frailty and pre-frailty in older adults with diabetes in China was 22.7% (95% CI 22.1-23.3%) and 58.5% (95% CI 57.8-59.2%), respectively. The prevalence of frailty and pre-frailty among older adults with diabetes from different provinces/municipalities/autonomous regions was significantly different. Multinomial logistic regression analysis showed living alone, poor economic status, ADL disability, and comorbidities were strongly correlated with frailty and pre-frailty in older adults with diabetes., Conclusion: Frailty and pre-frailty are common in older adults with diabetes in China, and exhibit sociodemographic and geographic differences. In the clinical setting of older adults with diabetes, there is a need to increase awareness of frailty and to advance the early diagnosis and intervention of frailty., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zeng, Jia, Meng, Shi, Li, Hu, Hu, Xu, Li, Li, Qi, Wang, Zhang, Li and Liu.)

We examined the effects of Spartina alterniflora invasion on phosphorus forms of marsh soils, based on the method of space-for-time substitution by selecting S. alterniflora marshes with different invasion years (SA 1 , 5-6 years; SA 2 , 8-10 years; and SA 3 , 12-14 years) in Shanyutan of the Minjiang River estuary. The results showed that in marsh soils of different invasion years, the proportion of hardly decomposable phosphorus (HCl-Pi and Residual-P) was the highest (46.4%-46.7%), followed by moderately decomposable phosphorus (NaOH-Pi, NaOH-Po and Sonic-Pi) (40.0%-44.0%), and the easily decomposable phosphorus (Resin-Pi, NaHCO 3 -Pi and NaHCO 3 -Po) was the lowest (9.5%-13.3%). With increasing invasion years of S. alterniflora , soil phosphorus forms and their spatial distributions were greatly altered. The contents of moderately decomposable phosphorus, hardly decomposable phosphorus, and total phosphorus (TP) generally increased, while easily decomposable phosphorus content generally decreased. Compared with SA 1 , the contents of moderately decomposable phosphorus, hardly decomposable phosphorus and TP in SA 2 increased by 11.5%, 9.7% and 10.5%, while those in SA 3 increased by 24.8%, 13.2% and 13.5%, respectively. The distribution of phosphorus forms was greatly altered with increasing invasion years, which was dependent on the variations of key factors such as EC, pH value and grain composition. The implementation of regular mowing activities for S. alterniflora in the Minjiang River estuary in recent years, to some extent, reduced the return of phosphorus from residues to soils and decreased the availability of the easily decomposable phosphorus in soils.

Importance: Angiotensin II is significantly associated with the pathogenesis of acute aortic dissection. Angiotensin II type 1 receptor agonistic autoantibodies (AT1-AAs) can mimic the effect of angiotensin II., Objective: To investigate the association between AT1-AAs and all-cause and cause-specific mortality risk in patients with acute aortic dissection., Design, Setting, and Participants: A total of 662 patients with clinically suspected aortic dissection from 3 medical centers in Wuhan, China, were enrolled in this cohort study from August 1, 2014, to July 31, 2016. Of these, 315 patients were included in the 3-year follow-up study. Follow-up was mainly performed via telephone interviews and outpatient clinic visits. Data analysis was conducted from March 1 to May 31, 2020., Main Outcomes and Measures: The primary outcomes of interest were all-cause mortality, death due to aortic dissection, and late aortic-related adverse events., Results: The full study cohort included 315 patients with AAD (mean [SD] age, 56.2 [12.7] years; 230 men [73.0%]). Ninety-two patients (29.2%) were positive for AT1-AAs. The mortality of AT1-AA-positive patients was significantly higher than that of AT1-AA-negative patients (40 [43.5%] vs 37 [16.6%]; P < .001). The mortality risk in AT1-AA-positive patients was always significantly higher than that in AT1-AA-negative patients in patients with both type A and type B dissection. Multivariable analysis showed that the risk of AT1-AA-positive patients for type A dissection was significantly higher than that of AT1-AA-negative patients (odds ratio [OR], 1.88; 95% CI, 1.12-3.13; P = .02). The Cox proportional hazards regression model showed a significant increase of all-cause mortality risk (OR, 2.27; 95% CI, 1.44-3.57; P < .001) and late aortic-related adverse events (OR, 1.58; 95% CI, 1.06-2.36; P = .03) among AT1-AA-positive patients during the follow-up period compared with AT1-AA-negative patients., Conclusions and Relevance: This cohort study first detected AT1-AAs in patients with acute aortic dissection. The presence of AT1-AAs was associated with significantly higher all-cause and cause-specific mortality during a follow-up period of 3 years. The antibodies may be a risk factor for aortic dissection.

Objective: To explore the regulation effect of myeloid leukemia No.1 Chinese herb medicine prescription combined with chemotherapy on Th17 cells in bone marrow fluid of AML patients, so as to provide guidance for improving AML treatment effect and patients' long-term survival., Methods: Seventy patients with AML who were hospitalized in Department of Hematology, Wuwei People's Hospital from April 2017 to August 2019 were selected and enrolled in AML group, 25 healthy volunteers were selected and enrolled in control group; then according to therapeutic regimen, AML patients were divided into 2 groups: combined therapy group (myeloid leukemia NO.1 Chinese herb medicine prescription combined with chemotherapy) and non-combined therapy group (chemotherapy alone). Flow cytometry was used to detect the ratio of CD3 + CD161 + IL-17 + IFN-γ + T cells in bone marrow fluid, and ELISA was used to detect the vascular endothelial growth factor (VEGF) and interleukin-17 (IL-17) concentrations in bone marrow fluid. Statistical analysis was performed on the data with SPSS 22.0., Results: The ratio of CD3 + CD161 + IL-17 + IFN-γ + T cells, VEGF and IL-17 concentration in newly diagnosed and relapsed AML patients were significantly higher than those in the normal control group (P<0.001); while those in CR and DFS stage patients were significantly lower than those in newly diagnosed and relapsed patients (P<0.001), and the ratio of CD3 + CD161 + IL-17 + IFN-γ + T cells, VEGF and IL-17 concentration in DFS patients with AML were not significantly different from those in the control group (P>0.05). The ratio of CD3 + CD161 + IL-17 + IFN-γ + T cells, VEGF and IL-17 concentration in CR stage of AML patients treated with chemotherapy alone were significantly higher than those in the control group (P<0.05), but there was no difference between combined therapy group and the control group; the ratio of CD3 + CD161 + IL-17 + IFN-γ + T cells, the concentration of VEGF and IL-17 in CR stage of AML patients treated with chemotherapy alone were higher than those of patients treated with combined therapy regimen (P<0.05). AML patients treated with combined therapy regimen had a significantly higher complete remission rate compared with patients received chemotherapy alone (P<0.05), but the recurrence rate was significantly lower (P<0.05)., Conclusion: Th17 cells expression in bone marrow of newly diagnoses and relapsed AML patients significantly increase, and decrease significantly after treatment. Myeloid leukemia No.1 Chinese herb prescription combined with chemotherapy can significantly increase the CR rate and reduce the RL rate for AML.

To investigate the distributions and stocks of total phosphorus (TP) in plant-soil systems of marshes in Shanyutan of the Minjiang River estuary and explore its influencing factors, Phragmites australis (PA) marsh and Cyperus malaccensis (CM) marsh before spatial expansion and ecotonal marsh (EM, P. australis and C. malaccensis in EM were denoted by PA' and CM', respectively) during spatial expansion were studied. Results showed that, as affected by spatial expansion, the contents of TP in both plant and soil in different marshes showed great variations. Compared with PA and CM marshes, soil TP in EM increased by 20.0% and 7.1%, respectively. The variation of soil TP in EM might be attributed to the alteration of soil particle composition, plant bio-mass and root/shoot ratio during spatial expansion. Except for leaves, TP in organs of P. australis in P. australis-C. malaccensis community (PA') was lower than that in C. malaccensis in P. australis-C. malaccensis community (CM'), due to the differences in absorption, utilization and translocation way of P among organs between the two species. The competition effect caused by spatial expansion greatly changed plant P allocation ratio of the two species. Compared with PA and CM, the allocations of P in roots and leaves of PA' increased, while only that in roots of CM' rose. During spatial expansion, the two species might adopt different adaptation strategies for P absorption and utilization to maintain their competitiveness. The PA might compete primarily by strengthening the P accumulation capacities of its roots and promoting leaf photosynthesis, whereas the CM might resist the spatial expansion of PA by increasing its underground biomass to enhance P absorption.

Background: The PLASMIC score was recently published to aid in the early identification of thrombotic thrombocytopenic purpura (TTP) patients. This study aims to evaluate whether this score is suitable for Chinese suspected TTP patients and find the utility of patients' other characteristics in predicting severe ADAMTS13 deficiency., Methods: We retrospectively studied a Chinese cohort of 38 consecutive hospitalized patients with suspected TTP, ADAMTS13 test results, and other clinical data from September 2016 to May 2018. The predictive power of PLASMIC score in our cohort was evaluated, and patients' other characteristics, especially the high lactate dehydrogenase/the upper limit of normal (LDH/ULN), were studied to determine their distinguishing ability for TTP patients., Results: In this Chinese cohort, 17 patients were diagnosed with TTP according to ADAMTS13 activity results. When dichotomized at intermediate-high risk (scores 5-7) vs low risk (scores 0-4), the PLASMIC score predicted TTP with a sensitivity of 100%, a specificity of 9.52%, and a misdiagnosis rate of 90.48%. And the LDH/ULN alone, or plus platelet count, reticulocyte percentage and indirect bilirubin (IBIL) both had excellent predictive power (area under the curve [AUC] 0.937, 95% confidence interval [CI] 0.863-1.000, P = .000, and AUC 0.994, 95% CI 0.980-1.000, P = .000, respectively). The model including platelet count, reticulocyte percentage, IBIL, and LDH/ULN ratio had a sensitivity of 100%, a specificity of 95.2%, and a misdiagnosis rate of 4.8%., Conclusions: A modified PLASMIC score plus LDH/ULN ratio might be more suitable for identifying ADAMTS13 deficiency patients, especially for making an earlier diagnosis, guiding the immediate and reasonable plasma exchange, and also avoiding unnecessary allocation of plasma., (© 2019 Wiley Periodicals, Inc.)

Objective: To develop a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of voriconazole in human plasma, and to evaluate its application in clinical therapeutic drug monitoring., Method: Plasma samples were obtained from Chinese patients receiving voriconazole, precipitated with methanol (using fluconazole as an internal standard), and then subjected to LC-MS/MS using an SB C 18 column with a methanol and water mobile phase at a flow rate of 0.4 mL/minute. Quantification was performed by multiple-reaction monitoring using the precursor and product ion pair m/z 350-280.9 for voriconazole and m/z 307-219.9 for fluconazole., Results: The calibration curve was linear over a range of 0.1-10.0 µg/mL (R 2  = 0.9995). The inter-day and intra-day relative standard deviations were <7.68% and <8.97%, respectively. Extraction recovery, matrix effect, and stability were also validated. Sixty-eight plasma samples from 42 patients were analyzed, and the voriconazole concentrations in 25 samples (36.8%) were outside the optimal range of 1.5-4.5 µg/mL., Conclusions: We developed a simple and accurate method of drug monitoring, which could improve the efficacy and prevent adverse reactions of voriconazole.

This work aimed to determine the concentrations of parabens and triclosan (TCS) in shellfish from coastal waters of Shenzhen, South China. A method of isotope dilution with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to determine TCS and five paraben analogues, including methyl paraben (MeP), ethyl paraben (EtP), propyl paraben (PrP), butyl paraben (BuP), and benzyl paraben (BeP), in 186 shellfish samples covering eight species. Concentrations of parabens and TCS were 0.13-25.5 ng/g wet weight (ww) and 7  ng/kg bw/day) and TCS (200 ng/kg bw/day), indicating no significant human health risks from shellfish consumption in the studied region. To our knowledge, this is the first report on the occurrences of parabens and TCS in shellfish products from Shenzhen coastal waters., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To investigate the diversity and the distribution of host animal species of hantavirus and the effect on human health in Jiuhua Mountain area, China., Methods: The host animal species of hantavirus was surveyed by using the trap method and the species diversity was evaluated by using the Simpson, Shannon-Weaner, and Pielou indices. Hantavirus antigens or antibodies in lung and blood samples of all the captured host animals were detected by direct or indirect immunofluorescence., Results: Nine animal species of hantavirus were distributed in the forest ecosystem of Jiuhua Mountain. Of these, Niviventer confucianus and Apodemus agrarius were predominant, and N. confucianus, Rattus norvegicus, and Mus musculus had relatively large niche breadth index values. The host animals in the eastern and western mountain regions shared similar biodiversity index characteristics, predominant species, and species structures. Hantavirus was detected in 5 host animal species in Jiuhua Mountain area, the carriage rate of hantavirus was 6.03%. The average density of host animals in forest areas of the mountainous area was only 2.20%, and the virus infection rate in the healthy population was 2.33%., Conclusion: The circulation of hantavirus was low in the forest areas of Jiuhua Mountain and did not pose a threat to human health., (Copyright © 2014 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.)

Eight cases of rare genetic Creutzfeldt-Jakob disease (gCJD) with a mutation T188K in PRNP have been identified and diagnosed genetically in China since 2006. Among the eight cases, the median age of disease onset was 58years old (ranging from 39 to 76years old). Progressive dementia and pyramidal or extrapyramidal dysfunction appeared in all cases and lasted during the entire clinical course. Myoclonus and visual or cerebellar disturbances were also frequently observed. The median duration of disease was 3months. Cerebral MRI findings revealed high caudate and putamen signals in four out of eight cases. CSF in six out of eight patients tested positive for the 14-3-3 protein. Only one case showed periodic sharp-waves (PSW) in EEG. Most cases lacked a family history of associated diseases, though one patient's mother died of a neurologic disorder without a definite diagnosis. Our data reveal that Chinese T188K gCJD cases have clinical characteristics similar to that of sporadic CJD (sCJD). Compared with other inherited prion disease-associated mutations in China, the genetic frequencies of T188K in PRNP of Han-Chinese are relatively high., (Copyright © 2012 Elsevier B.V. All rights reserved.)