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Background: A workplace-based primary prevention intervention be an effective approach to reducing the incidence of hypertension (HTN). However, few studies to date have addressed the effect among the Chinese working population. We assessed the effect of a workplace-based multicomponent prevention interventions program for cardiovascular disease on reducing the occurrence of HTN through encouraging employees to adopt a healthy lifestyle. Methods: In this post hoc analysis of cluster randomized controlled study, 60 workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20). All employees in each workplace were asked to complete a baseline survey after randomization for obtaining sociodemographic information, health status, lifestyle, etc. Employees in the intervention group were given a 2-year workplace-based primary prevention intervention program for improving their cardiovascular health, including (1) cardiovascular health education, (2) a reasonable diet, (3) tobacco cessation, (4) physical environment promotion, (5) physical activity, (6) stress management, and (7) health screening. The primary outcome was the incidence of HTN, and the secondary outcomes were improvements of blood pressure (BP) levels and lifestyle factors from baseline to 24 months. A mix effect model was used to assess the intervention effect at the end of the intervention in the two groups. Results: Overall, 24,396 participants (18,170 in the intervention group and 6,226 in the control group) were included (mean [standard deviation] age, 39.3 [9.1] years; 14,727 men [60.4%]). After 24 months of the intervention, the incidence of HTN was 8.0% in the intervention groups and 9.6% in the control groups [relative risk (RR) = 0.66, 95% CI, 0.58 ~ 0.76, P < 0.001]. The intervention effect was significant on systolic BP (SBP) level (β = − 0.7 mm Hg, 95% CI, − 1.06 ~ − 0.35; P < 0.001) and on diastolic BP (DBP) level (β = − 1.0 mm Hg, 95% CI, − 1.31 ~ − 0.76; P < 0.001). Moreover, greater improvements were reported in the rates of regular exercise [odd ratio (OR) = 1.39, 95% CI, 1.28 ~ 1.50; P < 0.001], excessive intake of fatty food (OR = 0.54, 95% CI, 0.50 ~ 0.59; P < 0.001), and restrictive use of salt (OR = 1.22, 95% CI, 1.09 ~ 1.36; P = 0.001) in intervention groups. People with a deteriorating lifestyle had higher rates of developing HTN than those with the same or improved lifestyle. Subgroup analysis showed that the intervention effect of BP on employees with educational attainment of high school above (SBP: β = − 1.38/ − 0.76 mm Hg, P < 0.05; DBP: β = − 2.26/ − 0.75 mm Hg, P < 0.001), manual labor workers and administrative worker (SBP: β = − 1.04/ − 1.66 mm Hg, P < 0.05; DBP: β = − 1.85/ − 0.40 mm Hg, P < 0.05), and employees from a workplace with an affiliated hospital (SBP: β = − 2.63 mm Hg, P < 0.001; DBP: β = − 1.93 mm Hg, P < 0.001) were significantly in the intervention group. Conclusions: This post hoc analysis found that workplace-based primary prevention interventions program for cardiovascular disease were effective in promoting healthy lifestyle and reducing the incidence of HTN among employees. Trial registration: Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the current status and related risk factors of 48-hour unplanned return to the intensive care unit (ICU) to reduce the return rate and improve the quality of critical care management. Methods: Data were collected from 2365 patients discharged from the comprehensive ICU. Multivariate and 1:1 propensity score matching analyses were performed. Results: Forty patients (1.69%) had unplanned readmission to the ICU within 48 hours after transfer. The primary reason for return was respiratory failure (16 patients, 40%). Furthermore, respiratory failure (odds ratio [OR] = 5.994, p = 0.02) and the number of organ failures (OR = 5.679, p = 0.006) were independent risk factors for unplanned ICU readmission. Receiver operating characteristic curves were drawn for the predictive value of the number of organ injuries during a patient's unplanned transfer to the ICU (area under the curve [AUC] = 0.744, sensitivity = 60%, specificity = 77.5%). Conclusion: The reason for patient transfer and the number of organ injuries during the process were independent risk factors for patients who were critically ill. The number of organs damaged had a predictive value on whether the patient would return to the ICU within 48 hours. [ABSTRACT FROM AUTHOR]

Previous studies have documented the associations between short-term diurnal temperature range (DTR) exposure and cardiovascular disease (CVD) via time-series analyses. However, the long-term impacts of DTR through a population-based prospective cohort have not been elucidated thoroughly. This study aimed to quantify the longitudinal association of DTR exposure with all-cause mortality and CVD in a nationwide prospective cohort and, by extension, project future DTR changes across China under climate change. We included 22,702 adults (median age 56.1 years, 53.7% women) free of CVD at baseline from a nationwide cross-sectional study in China during 2012–2015, and examined three health outcomes during a follow-up survey in 2018–2019. We estimated the chronic DTR exposure as baseline annual mean daily maximum minus minimum temperature. The Cox proportional hazards regression was adopted to assess the multivariable-adjusted hazard ratio and its corresponding 95% confidence interval (95% CI). We employed 31 downscaled global climate models under two shared socioeconomic pathways for future projection. During the median follow-up period of ~5 years, 1096 subjects died due to all causes while 993 and 597 individuals developed fatal or nonfatal CVD and fatal or nonfatal stroke, respectively. The cumulative incidence rates of all-cause mortality, CVD, and stroke were 10.49, 9.45, and 5.64 per 1000 person-years, respectively. In the fully adjusted models, the risks for all-cause mortality, CVD, and stroke would increase by 13% (95% CI: 8–18%), 12% (95% CI: 7–18%), and 9% (95% CI: 2–16%) per 1 °C increment in DTR, respectively. Moreover, linear positive associations for the concentration–response curves between DTR and mortality and CVD were observed. We also found significantly greater DTR-related mortality risks among rural residents than their urban counterparts. The DTR changes featured a dipole pattern across China under a warming climate. The southern (northern) China would experience increased (decreased) DTR exposure by the end of 21st century. The present study indicates that chronic DTR exposure can exert long-term impacts on mortality and CVD risks, which may inform future public health policies on DTR-related susceptible population and regions. [ABSTRACT FROM AUTHOR]

Han painting is an important art display form in Chinese history; it has a history of hundreds of years. It is the embodiment of a higher level of Chinese painting. Han paintings can also show the development of China's political economy and culture. However, with the continuous progress of time, the patterns of Han paintings and the color characteristics of Han paintings will be greatly damaged. This limits people's research on the civilization displayed by Han paintings. At the same time, changes in the environment also have a great relationship with the integrity of Chinese painting. Therefore, the study of the impact of environmental protection on the integrity of Han paintings is crucial to the study of Chinese civilization. It is difficult for traditional research methods to discover the quantitative relationship between environmental protection and the integrity of Han paintings. In this study, the atrous convolutional neural network (ACNN) in the artificial intelligence method and the GRU method were used to explore the relationship between environmental protection and the patterns, colors, and shapes of Chinese paintings. The research results show that the ACNN method and the GRU method can better predict the patterns, shapes, and color characteristics of Chinese paintings. Through research, it can also be found that the color and pattern features of Chinese paintings contain obvious time characteristics, which requires the GRU method for feature extraction. The prediction errors of ACNN and GRU in predicting the integrity of Chinese paintings are all within 2.5%, and the largest prediction error is only 2.45%. [ABSTRACT FROM AUTHOR]

Purpose: Public private partnership (PPP) has gained increasing popularity around the globe. Whether the government needs to participate in the PPP special purpose vehicle (SPV) as an equity coinvestor is a critical issue in PPP development. This research aims to examine the influence of government equity investment on PPP performance by taking public-private communication as an intermediate variable. Design/methodology/approach: A questionnaire survey was adopted as the main research method. PPP practitioners with extensive experiences from both the public and private sectors were targeted respondents. The survey results were subsequently analyzed using statistical data analysis method. Findings: Based on the results from the questionnaire survey, this research indicates an inverted U-shaped relationship between the ratio of government equity and performance in PPP projects. In addition, communication plays a mediating role between government equity investment and PPP project performance. Originality/value: This research explicates the relationship between the equity structure in a PPP SPV and the project performance. It provides important guidance and reference for PPP practitioners to structure the SPV and associated financial and commercial arrangements. It also offers valuable insights into the development of PPP policy, especially regarding the structuring of PPP models in China and elsewhere. [ABSTRACT FROM AUTHOR]

Background: Dental caries have a serious impact on general health and well-being; however, there is a lack of relevant data on the development trends of dental caries in permanent teeth among 12-year-old children in China. We aim to assess long-term trends of dental caries in permanent teeth among 12-year-old children in China and identify the susceptible subgroups based on five consecutive national surveys from 1995 to 2014. Methods: A total of 88 972 subjects were extracted from five consecutive national surveys (1995, 2000, 2005, 2010, 2014). Standardized dental examinations were conducted and the oral health status of each subject was recorded. The prevalence of Decayed, Missing and Filled teeth (DMF%), mean Decayed, Missing, Filled teeth score (DMFT) and Caries Filling Ratio (CFR) were used as measurement indicators. Cochran–Armitage trend test was used to evaluate the trends in DMF% and CFR, and multivariate linear regression was used to evaluate the trends in DMFT. Results: A V-shaped fluctuating upward trend in DMF% during 1995–2014 was observed (Z = − 13.124, P < 0.001), and the DMF% in 1995–2014 was 21.1%, 15.9%, 16.2%, 21.9% and 24.3%. The trend in DMFT was approximately consistent with DMF% (β = 0.057, P < 0.001), but the downward volatility appeared in 2014. The DMFT in 1995–2014 was 0.38, 0.28, 0.31, 0.66 and 0.54. A continuously fluctuant trend in CFR was observed during past two decades (Z = 1.927, P > 0.05), and the CFR in 1995–2014 was 17.4%, 22.8%, 19.3%, 23.4% and 15.6%. The DMF% and DMFT of rural children had a larger absolute increase than that of urban children during 1995–2014 (DMF%-urban: Z = − 0.242, P > 0.05; DMF%-rural: Z = − 19.036, P < 0.001; DMFT-urban: β = 0.035, P < 0.001, DMFT-rural: β = 0.077, P < 0.001). The DMF% and DMFT in girls were higher than that in boys at each survey year (P < 0.001). CFR of urban children was higher than that of rural children at each survey year (P < 0.001). Conclusions: Over the past 20 years, DMFT and DMF% of 12-year-old children in China presented V-shaped fluctuant upward trends, with a decline trend from 1995 to 2000 and an upward trend from 2000 to 2014. CFR had no significant improvement. The rural children and girls are the more vulnerable groups in the development of dental caries and need to pay priority. Our study supports the continuation of policies to improve children' oral health. [ABSTRACT FROM AUTHOR]

Objective: To assess the association of baseline anti‐Müllerian hormone (AMH) levels with ovulation, time to ovulation and fertility outcomes in women with polycystic ovary syndrome (PCOS) receiving clomiphene citrate (CC) and compare this with placebo. Design: Secondary analysis of the PCOSAct trial (NCT01573858). Setting: 27 trial centres in mainland China. Population or sample: 1000 infertile women with PCOS receiving either CC or placebo. Methods: Baseline serum AMH was measured and analysed as a continuous and as a categorical variable. Interaction between AMH and CC was tested. Predictive values of AMH for ovulation, time to ovulation and fertility outcomes were assessed. Main outcome measures: Ovulation and time to ovulation. Results: 900 baseline AMH data were available for analysis. There were no significant interactions with ovulation or conception for AMH and CC treatment (P = 0.782 and 0.419, respectively). Women in the upper quartile of AMH >15.88 ng/ml had significant lower ovulation (odds ratio [OR] 0.34, 95% CI 0.20–0.58) and conception rates (OR 0.65, 95% CI 0.42–1.00) compared with women in the lower quartile. Associations of AMH with clinical pregnancy (OR 0.98, 95% CI 0.95–1.01) and live birth (OR 0.98, 95% CI 0.96–1.01) were not significant. Ovulation rate increased until baseline AMH levels ≥7.0 ng/ml in women treated with CC but decreased when AMH increased in women with placebo. When AMH <7.0 ng/ml, an AMH threshold at 4.11 ng/ml predicted ovulation in women receiving CC (area under the curve [AUC] 0.64, 95% CI 0.42–0.86), with a sensitivity of 64% and a specificity of 62%, whereas prediction was poor for AMH ≥7.0 ng/ml (AUC 0.38, 95% CI 0.28–0.47). Median time to ovulation was 35 days in the lower quartile for women with placebo but this was significantly prolonged up to 98 days in the upper quartile. CC significantly shortened the time to ovulation up to 56 days. Conclusions: Among women with PCOS, high baseline AMH levels were associated with a 20.1% lower chance of ovulation with a 63‐day longer time to ovulation. AMH can predict ovulation only when the baseline AMH level was <7.0 ng/ml in women with PCOS undergoing ovulation induction with CC. Ovulation rate increased until baseline AMH levels ≥7.0 ng/ml in women treated with CC; a successful ovulation and time to ovulation was highly associated with baseline AMH level in these women. Ovulation rate increased until baseline AMH levels ≥7.0 ng/ml in women treated with CC; a successful ovulation and time to ovulation was highly associated with baseline AMH level in these women. [ABSTRACT FROM AUTHOR]

Background: This study applied the susceptible-exposed-infectious-removed (SEIR) model to analyze and simulate the transmission mechanisms of the coronavirus disease 2019 (COVID-19) in China.Methods: The population migration was embedded in the SEIR model to simulate and analyze the effects of the amount of population inflow on the number of confirmed cases. Based on numerical simulations, this study used statistical data for the empirical validation of its theoretical deductions and discussed how to improve the effectiveness of epidemic prevention and control considering population migration variables. Statistics regarding the numbers of infected people in various provinces were obtained from the epidemic-related data reported by China's National Health Commission.Results: This study explored how the epidemic should be prevented and controlled from the perspective of population migration variables. It found that the combination of a susceptible population, an infected population, and transmission media were important routes affecting the number of infections and that the migration of a Hubei-related infected population played a key role in promoting epidemic spread. Epidemic prevention and control should focus on regions with better economic conditions than the epidemic region. Prevention and control efforts should focus on the more populated neighboring provinces having convenient transportation links with the epidemic region. To prevent and control epidemic spread, priority should be given to elucidating the destinations and directions of population migration from the domestic origin of infections, and then controlling population migration or human-to-human contact after such migration.Conclusions: This study enriched and expanded on simulations of the effects of population migration on the COVID-19 epidemic and China-based empirical studies while offering an epidemic evaluation and warning mechanism to prevent and control similar public health emergencies in the future. [ABSTRACT FROM AUTHOR]

We examined the impacts of venture capital investment (VCI) on the performance of online Peer-to-Peer (P2P) lending platforms. The research results show that: (1) Gaining the first round of VCI can increase the transaction scale and improve the compliance with regulatory requirement of the online P2P lending platforms; and (2) the platforms acquiring more rounds of VCI have greater turnover. The above research shows that under the background of information asymmetry, the certification function and monitoring mechanism of VCs can work in online P2P lending markets. [ABSTRACT FROM AUTHOR]

In the present study, biochar was prepared from scrap wetland macrophyte Arundo donax at different temperatures and then was evaluated for its feasibility as substrate to enhance nitrogen removal performance of surface flow constructed wetlands (SFCWs). Three groups of SFCW systems with different addition of biochar (0, 10, 20%, v/v) were constructed to investigate the effect of dissolved organic matter (DOM) released from biochar on nitrogen transformation. Results showed that the concentration of DOM released from biochar widely ranged from 6.01 to 125.67 mg L−1, and the DOM amount decreased with increasing pyrolysis temperature. Five humic acid-like components of DOM were identified by the parallel factor analysis (PARAFAC) model. The release capacity of DOM from biochar is observed to be closely related to microbial nitrogen removal efficiency. Enhanced removal efficiencies of NO3−-N (81.16%) and total nitrogen (85.62%) were achieved in SFCWs with 20% biochar, which was higher than SFCWs with 10% biochar (62.74 and 73.83%) and the control groups with no biochar (36.16 and 57.90%), respectively. Increased plant height in SFCWs with more biochar addition confirmed the positive effect of biochar on plant growth. Results from the present study suggested that the application of wetland plant-derived biochar was a promising strategy to enhance treatment performance and utilization of waste biomass resource in SFCWs. [ABSTRACT FROM AUTHOR]

This paper aims to broaden the scope of analysis of the contemporary global land rush by examining crop booms not only outside, but inside China; and investment flows not only from China, but also within and into China. It does so by examining the eucalyptus and sugarcane sectors in southern China, which have witnessed investment booms during the past decade, with capital being infused by both domestic capital and foreign capital, including Finnish, Indonesian, and Thai companies. Our argument addresses three key issues: (a) explaining why foreign and domestic companies enter into a multitude of lease and grower contracts involving holders of micro-plots, (b) revisiting the notion of extra-economic coercion, and (c) a critique of thinking about flows of large-scale investments centred primarily on nationality. These issues are central in current debates in the land grabs literature, and our study offers a different perspective from dominant narratives. [ABSTRACT FROM PUBLISHER]

Aquaponics is considered to be a promising production system in the future, due to its high nitrogen utilization efficiency (NUE). In this study, lab-scale aquaponic systems with native species, common carp ( Cyprinus carpio ) and pakchoi ( Brassica chinensis ), were achieved successfully in northern China. And nitrogen transformations in aquaponics during summer and autumn were thoroughly investigated. High fish and plant yields were observed in summer because of suitable environment. However, seasonal variation has minimal effect on NUE, which was 43.8 ± 5.9% and 44.6 ± 3.7% in summer and autumn, respectively. Similar phenomenon occurred for N 2 O. N 2 O emission flux of aquaponics was 508.2 ± 80.6 ug m −2 h −1 in summer, and decreased to 218.5 ± 30.6 ug m −2 h −1 in autumn, whereas the N 2 O conversion ratio changed from 1.6 ± 0.2% to 1.3 ± 0.1%, correspondingly. This was mainly because of the decrease of nitrogen input at lower temperature. TAN concentration was lower in summer (0.5 mg/l) than autumn (1.0 mg/l), indicating faster nitrification occurred at higher temperature. And NO 3 − -N concentrations showed an obvious increase and decrease period in summer but only a slow increase in autumn, which was ascribed to the effect of seasonal variation on the balance between nitrification, denitrification and plant growth. Results of this study could provide theoretical supports of aquaponics’ seasonal performance for aquaponics’ application in northern China. [ABSTRACT FROM AUTHOR]

Although much research has been done to investigate the influence of regulatory and customer pressure on green innovations, the existing literature paid little attention to the question of how such pressure motivates organizations to improve their green innovation performance. A conceptual model based on the concept of green organizational responses is developed in this paper. The model is tested using structural equation modeling on a sample of 427 manufacturing organizations in six provinces in central China. The results of modeling show that regulatory and customer pressure promotes green organizational responses and enhances green innovation performance. However, these two forms of pressure are shown to have different impacts on specific organizational responses and different extent of impact on green innovation performance. For example, while regulatory pressure has significant positive impact on training and plays a direct role in green innovation performance, customer pressure has significant positive impact on research and development investments and collaboration networks. These results offer important implications for promoting green innovations in the manufacturing industry. [ABSTRACT FROM AUTHOR]

Objectives The distribution of methicillin-resistant Staphylococcus aureus (MRSA) clones is dynamic and geographically unique. To understand the changing epidemiology of MRSA infections in China, we performed a prospective, multicity surveillance study with molecular typing and phenotypic analysis to determine the association of major prevalent clones with their antimicrobial resistance profiles. Methods A total of 517 S. aureus isolates collected between January 2009 and March 2012 from six cities in China were subjected to antibiogram analysis and molecular typing, including staphylococcal cassette chromosome mec typing, multilocus sequence typing, staphylococcal protein A gene typing and PFGE typing. Results Among the isolates collected, 309 were characterized as MRSA, with a prevalence of 59.8%. Three major clones were found to be prevalent in China: ST239-MRSA-III-t030, ST239-MRSA-III-t037 and ST5-MRSA-II-t002. These three clones were associated with two characteristic resistance profiles, namely, gentamicin/ciprofloxacin/rifampicin/levofloxacin for the first clone and gentamicin/ciprofloxacin/clindamycin/erythromycin/tetracycline/levofloxacin/trimethoprim/sulfamethoxazole for the latter two. Several geographically unique minor clones were also identified. Conclusions The predominant MRSA clones in China were associated with characteristic antimicrobial resistance profiles. Antibiotics for treating patients with MRSA infections can be selected based on the strain typing data. [ABSTRACT FROM PUBLISHER]

Describes the new species of Batrachospermum from a mountain stream in Hubei Province, China. Varieties of the Chinese freshwater Rhodophyta; Details of the eleven taxa of the genus Batrachospermum; Characteristics of the species.

Buildings account for a majority of the primary energy consumption of the human society, therefore, analyses of building energy consumption monitoring data are of significance to the discovery of anomalous energy usage patterns, saving of building utility expenditures, and contribution to the greater environmental protection effort. This paper presents a unified framework for the automatic extraction and integration of building energy consumption data from heterogeneous building management systems, along with building static data from building information models to serve analysis applications. This paper also proposes a diagnosis framework based on density-based clustering and artificial neural network regression using the integrated data to identify anomalous energy usages. The framework and the methods have been implemented and validated from data collected from a multitude of large-scale public buildings across China. [ABSTRACT FROM AUTHOR]

As an important part of urban carbon emissions, the carbon emissions from household energy consumption are increasing with the continuous improvement of Chinese urbanization. This study divides family population into 4 groups: adolescents (aged 0–17), young people (aged 18–44), middle-aged people (aged 45–59), and elderly people (aged 60 and older) and develops a calculation model for carbon emissions of household energy consumption in accordance with the latest standards of the World Health Organization based on Chinese Family Panel Studies in 2016. Results showed that the marginal and intergenerational effects coexist in various types of household energy consumption: Families with 3–5 people have the most economical consumption scale and the largest marginal sharing effect; multigenerational families or families with a large proportion of middle-aged and older people are beneficial in reducing household energy consumption. This paper suggests it is important to fully consider the impact of the intergenerational effect, marginal effect, and cultural shock caused by the electronic information age on household energy consumption when formulating standards of household energy consumption. [ABSTRACT FROM AUTHOR]

The aim of this work was to compare the composition and physicochemical properties (SEM, XRD, solubility, swelling power, paste clarity, retrogradation, freeze–thaw stability, thermal property, and pasting property) of three Chinese yam (Dioscorea opposita Thunb.) starches (CYYS-1, CYYS-2, and CYYS-3) in Yunlong town, Haikou, Hainan Province, China. Our results show that all the CYYS gave a typical C-type X-ray diffraction pattern. The swelling power of CYYS varied from 10.79% to 30.34%, whereas solubility index was in the range of 7.84–4.55%. The freeze–thaw stability of each CYYS showed a contrary tendency with its amylose content. In addition, CYYS-3 showed the highest To (81.1 °C), Tp (84.8 °C), Tc (91.2 °C), and ΔH (14.1 J/g). The pasting temperature of CYYS-1 increased significantly with sucrose addition. NaCl could inhibit the swelling power of CYYS. There were significant decreases in pasting temperature and pasting time of CYYS when pH decreased. [ABSTRACT FROM AUTHOR]

Background: Foodborne diseases are a worldwide public health problem. However, data regarding epidemiological characteristics are still lacking in China. We aimed to analyze the characteristics of foodborne diseases outbreak from 2010 to 2016 in Guangxi, South China.Methods: A foodborne disease outbreak is the occurrence of two or more cases of a similar foodborne disease resulting from the ingestion of a common food. All data are obtained from reports in the Public Health Emergency Report and Management Information System of the China Information System for Disease Control and Prevention, and also from special investigation reports from Guangxi province.Results: A total of 138 foodborne diseases outbreak occurred in Guangxi in the past 7 years, leading to 3348 cases and 46 deaths. Foodborne disease outbreaks mainly occurred in the second and fourth quarters, and schools and private homes were the most common sites. Ingesting toxic food by mistake, improper cooking and cross contamination were the main routes of poisoning which caused 2169 (64.78%) cases and 37 (80.43%) deaths. Bacteria (62 outbreaks, 44.93%) and poisonous plants (46 outbreaks, 33.33%) were the main etiologies of foodborne diseases in our study. In particular, poisonous plants were the main cause of deaths involved in the foodborne disease outbreaks (26 outbreaks, 56.52%).Conclusions: Bacteria and poisonous plants were the primary causative hazard of foodborne diseases. Some specific measures are needed for ongoing prevention and control against the occurrence of foodborne diseases. [ABSTRACT FROM AUTHOR]

Simulation of pollutant dispersion and wind environment is of significant importance to the safety and health of pedestrians and residents. However, the high threshold of data collection and model configuration has hindered its application in the building industry. To address the problem, this paper proposes a Micro-in-Meso-scale (MiM) simulation framework for automatic and foolproof pollutant dispersion and wind environment simulation. The meso-scale Weather Research and Forecast (WRF) model is first carried out to obtain city-level meteorology data with sufficient resolution. The micro-scale Computational Fluid Dynamics (CFD) model is then initialized to simulate pollutant dispersion and wind environment in building groups. The two models are coupled where the numerical results of WRF are provided to CFD for the configuration of boundary conditions. Fluid dynamics knowledge and spatial characteristics of building groups are also embedded in the model to lower the threshold of performing atmospheric simulations. A Geographic Information System (GIS)-based data management module is established simultaneously to achieve automatic collection, processing and management of raw data for simulation. The conversion algorithm of GIS data is further implemented to achieve the automatic generation of the CFD domain. Finally, the framework is developed to embed the data module and simulation module, and provide an easy-to-operate environment for building industry personnel. The framework is validated by data of actual building groups in four major cities in China. The test results illustrate the efficiency and feasibility of the platform. The study is expected to enhance the application of wind environment simulation in building industries. • A framework for modeling wind environment and pollutant dispersion in building groups. • A Micro-in-Meso-scale model is developed to carry out meso-scale meteorology simulation and micro-scale CFD simulation. • A GIS-based database is established to provide reliable building and meteorology data. • An automated workflow is designed to reduce the involvement of expert knowledge. • A prototype platform is developed to provide an easy-to-operate environment for building industry personnel. [ABSTRACT FROM AUTHOR]

Abstract: This research studies the low carbon transition of the electric power sector in China using a multi-level perspective (MLP) of niches, socio-technical regime, and landscape, as well as literature on innovation systems. Three lines of thought on transition process are integrated in the paper to probe the possible transition pathways in China. A MLP analysis is presented to understand the current niches, regime, and landscape of China’s power sector. A brief analysis on the future macroscopic socio-economic transition in the process of industrialization, urbanization, and modernization of Chinese society and its implication on power landscape are depicted to prove the urgency and magnitude of transition in China and why systematic transition management is needed. Five transition pathways, namely reproduction, transformation, substitution, reconfiguration, de-alignment/re-alignment, and reconfiguration, with their possible technology options are presented. The paper goes further to propose an interactive framework for managing the transition to a low carbon energy system in China. Representative technology options are appraised by employing innovation theory to indicate the logic of policymaking within the framework. Institutional gaps in realizing the transition are also addressed. The work presented in the paper will be useful in informing policy-makers and other stakeholders and may provide references for power sector transition management in other countries. [Copyright &y& Elsevier]

Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes a wide range of both hospital- and community-acquired infections. The high prevalence of MRSA and the extensive use of vancomycin in Mainland China may lead to the emergence of vancomycin-intermediate S. aureus (VISA) isolates. In this case, we report a VISA isolate from a 34-year-old male patient with steam burn. The isolate was determined to be sequence type 239 staphylococcal cassette chromosome mec type III, the most prevalent MRSA clone in Mainland China. [Copyright &y& Elsevier]

Abstract: Methane (CH4) emissions from a full-scale anaerobic/anoxic/oxic (A/A/O) wastewater treatment plant (WWTP) (Jinan, China) were investigated during spring and summer of 2010. Results showed that the major emission sources of CH4 performed the following descending order: anaerobic tanks, oxic tanks, aerated grit chambers and sludge concentration tanks. The total annual fluxes of CH4 emissions from the Jinan WWTP were 1.69×104 kgyr−1, with the emission factors of per capita emissions of 11.3g CH4 person−1 yr−1 and flow-based emissions of 1.55×10−4 g CH4 (L of wastewater)−1. The estimated source strength of methane for all WWTPs in China was 6.2Ggyr−1 (1Gg=109 g). The most significant factors influencing methane emissions were dissolved oxygen concentration in aerated grit chamber and oxic tank and water temperature in high density settler tanks. [Copyright &y& Elsevier]

Gubenquduyishen (GBQDYS) decoction, the modified remedy of a classical Chinese prescription named Liuweidihuang decoction, has been clinically employed to treat nephrotic syndrome and chronic nephritis in chronic kidney disease (CKD). The present study was designed to examine whether GBQDYS decoction has a protective effect on renal function associated with the raised level of cystatin-C (Cys-C), serum creatinine (Scr), blood urea nitrogen (BUN) and decreased Glomerular filtration rate (GFR) in stage-II CKD. Materials and methods: A total of 68 stage-II CKD patients were randomly divided into two groups, the control group and the treatment group who received GBQDYS decoction as an additional therapy supplement. Results: Following up on a period of 48 months, levels of serum Cys-C, Scr, and BUN were significantly reduced by the treatment of GBQDYS decoction and GFR was elevated in the treated group. Whereas not achieved in the control group, suggesting the nephro-protective activity of GBQDYS decoction. Conclusions: Taken together, these results demonstrated that GBQDYS decoction is able to protect renal function by delaying the progression of renal failure, and this may be used as an effective alternative treatment for CKD patients. [Copyright &y& Elsevier]

Diagnosis of benign–malignant nodules in the lung on Computed Tomography (CT) images is critical for determining tumor level and reducing patient mortality. Deep learning-based diagnosis of nodules in lung CT images, however, is time-consuming and less accurate due to redundant structure and the lack of adequate training data. In this paper, a novel diagnosis method based on Deep Transfer Convolutional Neural Network (DTCNN) and Extreme Learning Machine (ELM) is explored, which merges the synergy of two algorithms to deal with benign–malignant nodules classification. An optimal DTCNN is first adopted to extract high-level features of lung nodules, which has been trained with the ImageNet dataset beforehand. After that, an ELM classifier is further developed to classify benign and malignant lung nodules. Two datasets, including the Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) public dataset and a private dataset from the First Affiliated Hospital of Guangzhou Medical University in China (FAH-GMU), have been conducted to verify the efficiency and effectiveness of the proposed approach. For LIDC-IDRI dataset, the experimental results show that our novel DTCNN-ELM model achieved the performance with an accuracy of 94.57%, a sensitivity of 93.69%, a specificity of 95.15%, an area under the receiver operator curve (AUC) of 94.94%, and testing time per nodule of 0.5 ms, which has the most reliable results compared with current state-of-the-art methods. Codes are available 1 1 https://github.com/hxf1228/dtcnn_elm_lnd.. • Deep Transfer Convolutional Neural Networks (DTCNN) is used for nodule diagnosis. • An optimal pre-trained DTCNN is adopted to capture richer features of lung nodules. • An Extreme Learning Machine (ELM) model is used to ease the computational burden. • Two cases study shows the effectiveness and efficiency of the proposed approach. [ABSTRACT FROM AUTHOR]

• PTEN germline mutation frequency was 0.23% among 3955 unselected primary breast cancer patients. • 7 PTEN germline variants were not identified as pathogenic mutations among the 9 detected mutations. • The germline mutations of PTEN gene may not be closely associated with breast cancer in the China population. PTEN is a tumour suppressor gene that has been proven to be related to breast cancer incidence and tumour progression. The aim of this study was to investigate the frequency of PTEN mutations in breast carcinomas in China and the relationships of PTEN mutations with clinicopathological parameters and clinical outcomes. Trimmomatic, Burrows-Wheeler Aligner (BWA), ANNOVAR, SAMtools, and Sanger sequencing were used to analyse PTEN mutations and identify variants in Chinese breast cancer. The frequency of PTEN mutations and the relationships of PTEN mutations with clinicopathological parameters and clinical outcomes were evaluated in breast carcinomas in China. The rate of PTEN germline mutation was 0.23% (n = 9) among 3955 unselected primary breast cancer patients. Of these 9 patients, 2 carried pathogenic mutations, and both were identified as having infiltrative carcinoma. One patient had a family history. The other 7 patients carried only PTEN germline variants that were not identified as pathogenic mutations. We studied the frequency of PTEN germline mutations in a sequential cohort of Chinese breast carcinoma patients. Based on these data, we hypothesize that the germline mutation of the PTEN gene is not closely related to the occurrence of breast cancer in the Chinese population. In the clinic, the PTEN germline mutation cannot be used as the basis for the detection of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Hypertension-related knowledge, attitude and practice (KAP) of hypertensive patients can affect the awareness, treatment and control of hypertension. However, little attention has been paid to the association between the change of hypertension preventive KAP and blood pressure (BP) control in occupational population using longitudinal data. We assess the effectiveness of a workplace-based multicomponent hypertension intervention program on improving the level of KAP of hypertension prevention, and the association between improvement in KAP and BP control during intervention., Methods: From January 2013 to December 2014, workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20) using a cluster randomized control method. All employees in each workplace were asked to complete a cross-sectional survey to screen for hypertension patients. Hypertension patients in the intervention group were given a 2-year workplace-based multicomponent hypertension intervention for BP control. The level of hypertension prevention KAP and BP were assessed before and after intervention in the two groups., Results: Overall, 3331 participants (2658 in the intervention group and 673 in the control group) were included (mean [standard deviation] age, 46.2 [7.7] years; 2723 men [81.7%]). After 2-year intervention, the KAP qualified rate was 63.2% in the intervention groups and 50.1% in the control groups (odds ratio = 1.65, 95% CI, 1.36∼2.00, P < .001). Compared with the control group decreased in the qualified rate of each item of hypertension preventive KAP questionnaire, all the items in the intervention group increased to different degrees. The increase of KAP score was associated with the decrease of BP level after intervention. For 1 point increase in KAP score, systolic blood pressure (SBP) decreased by .28 mmHg and diastolic blood pressure (DBP) decreased by .14 mmHg [SBP: β = -.28, 95%CI: -.48∼-.09, P = .004; DBP: β = -.14, 95%CI: -.26∼-.02, P = .024]. SBP and DBP was significantly in manual labor workers (SBP: β = -.34, 95%CI: -.59∼-.09, P = .008; DBP: β = -.23, 95%CI: -.38∼-.08, P = .003), workers from private enterprise, state-owned enterprise (SOE) (SBP: β = -.40, 95%CI: -.64∼-.16, P = .001; DBP: β = -.21, 95%CI: -.36∼-.06, P = .005) and a workplace with an affiliated hospital (SBP: β = -.31, 95%CI: -.52∼-.11, P = .003; DBP: β = -.16, 95%CI: -.28∼-.03, P = .016). The improvement of knowledge (SBP: β = -.29, 95%CI: -.56∼-.02, P = .038; DBP: β = -.12, 95%CI: -.29∼.05, P = .160), as well as attitude (SBP: β = -.71, 95%CI: -1.25∼-.18, P = .009; DBP: β = .18, 95%CI: -.23∼.59, P = .385) and behavior (SBP: β = -.73, 95%CI: -1.22∼-.23, P = .004; DBP: β = -.65, 95%CI: -.97∼-.33, P < .001) was gradually strengthened in relation to BP control., Conclusion: This study found that workplace-based multicomponent hypertension intervention can effectively improve the level of hypertension preventive KAP among employees, and the improvement of KAP levels were significantly associated with BP control., Trial Registration: Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Shrews being insectivores, serve as natural reservoirs for a wide array of zoonotic viruses, including the recently discovered Langya henipavirus (LayV) in China in 2018. It is crucial to understand the shrew-associated virome, viral diversity, and new viruses. In the current study, we conducted high-throughput sequencing on lung samples obtained from 398 shrews captured along the eastern coast of China, and characterized the high-depth virome of 6 common shrew species (Anourosorex squamipes, Crocidura lasiura, Crocidura shantungensis, Crocidura tanakae, Sorex caecutiens, and Suncus murinus). Our analysis revealed numerous shrew-associated viruses comprising 54 known viruses and 72 new viruses that significantly enhance our understanding of mammalian viruses. Notably, 34 identified viruses possess spillover-risk potential and six were human pathogenic viruses: LayV, influenza A virus (H5N6), rotavirus A, rabies virus, avian paramyxovirus 1, and rat hepatitis E virus. Moreover, ten previously unreported viruses in China were discovered, six among them have spillover-risk potential. Additionally, all 54 known viruses and 12 new viruses had the ability to cross species boundaries. Our data underscore the diversity of shrew-associated viruses and provide a foundation for further studies into tracing and predicting emerging infectious diseases originated from shrews., (© 2024. The Author(s).)

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever with high fatality rates. The blockade of pro-inflammatory cytokines presents a promising therapeutic strategy., Methods: We conducted a randomized clinical trial at the 154th hospital, Xinyang, Henan Province. Eligible patients with severe SFTS disease were randomly assigned in a 1:2 ratio to receive either a single intravenous infusion of tocilizumab plus usual care; or usual care only. The primary outcome was the clinical status of death/survival at day 14, while secondary outcomes included improvement from baseline in liver and kidney damage and time required for hospital discharge. The efficacy of tocilizumab plus corticosteroid was compared to those receiving corticosteroid alone. The trial is registered with the Chinese Clinical Trial Registry website (ChiCTR2300076317)., Results: 63 eligible patients were assigned to the tocilizumab group and 126 to the control group. The addition of tocilizumab to usual care was associated with a reduced death rate (9.5%) compared to those received only usual care (23.0%), with an adjusted hazard ratio (aHR) of 0.37 (95% confidence interval [CI], 0.15 to 0.91, P = 0.029). Combination therapy of tocilizumab and corticosteroids was associated with a significantly reduced fatality (aHR, 0.21; 95% CI, 0.08 to 0.56; P = 0.002) compared to those receiving corticosteroids alone., Conclusions: A significant benefit of reducing fatality in severe SFTS patients was observed by using tocilizumab. A combined therapy of tocilizumab plus corticosteroids was recommended for the therapy of severe SFTS., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: The health impact of retirement is controversial. Most previous studies have been based on self-reported health indicators or the endpoints of some chronic diseases (e.g., morbidity or mortality), but objective physiological indicators (e.g., blood pressure) have rarely been used. The objective of this study is to elucidate the health effects of retirement on blood pressure, thereby offering empirical evidence to facilitate the health of retirees and to optimize retirement policies., Methods: From 2012 to 2015, 84,696 participants of the Chinese Hypertension Survey (CHS) were included in this study. We applied the fuzzy regression discontinuity design (FRDD) to identify retirement's causal effect on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure. We also explored the heterogeneity in the effects of retirement across different sex and education level groups., Results: Based on the fully adjusted model, we estimated that retirement increased SBP by 5.047 mm Hg (95% CI: -2.628-12.723, P value: 0.197), DBP by 0.614 mm Hg (95% CI: -3.879-5.108, P value: 0.789) and pulse pressure by 4.433 mm Hg (95% CI: -0.985-9.851, P value: 0.109). We found that retirement led to a significant increase in male participants' SBP and pulse pressure as well as a possible decrease in female participants' blood pressure. Additionally, the blood pressure levels of low-educated participants were more vulnerable to the shock of retirement., Conclusion: Retirement is associated with an increase in blood pressure level. There is a causal relationship between the increase in blood pressure levels of men and retirement. Policy-makers should pay extra attention to the health status of men and less educated people when adjusting retirement policies in the future., (© 2024. The Author(s).)

Background: We aimed to evaluate the impacts of short-term daily temperature variability (DTV) on blood pressure (BP) among participants with normotension, prehypertension, and hypertension, respectively, and explore the effects in different climate zones and seasons., Methods: A representative population sample (n = 397,173) covering the subtropical, temperate continental, and temperate monsoon zones was obtained from the China Hypertension Survey. DTV was calculated as the standard deviation of daily minimum and maximum temperatures during the exposure days. The linear mixed effect regression model was used to estimate the associations between DTV exposure and BP among normotension, prehypertension, and hypertension, respectively, and further stratified analysis was performed by climate zones and seasons., Results: After adjustment for confounders, per interquartile range (IQR) increase in DTV (2.28 °C) at 0-6 days of exposure was associated with an increase of 0.41 mmHg (95 % confidence interval [CI]: 0.07, 0.75) in systolic BP (SBP) and 0.41 mmHg (95 % CI: 0.09, 0.72) in pulse pressure (PP) among hypertensive participants in the subtropical zone. Similarly, DTV exposure was associated with an increase of 0.31 mmHg (95 % CI: 0.06, 0.55) in SBP and 0.59 mmHg (95 % CI: 0.24, 0.94) in PP among prehypertensive participants in the temperate continental zone. Additionally, during the warm season, DTV was positively associated with SBP among populations with prehypertension and hypertension, and with PP among all three populations., Conclusion: Short-term DTV exposure was associated with an increase in SBP and PP among hypertensive and prehypertensive participants in the subtropical zone and the temperate continental zone. In addition, positive associations of DTV with SBP and PP were observed among participants with prehypertension and hypertension in the warm season. Comprehensive health education and effective intervention strategies should be implemented to mitigate the effects of temperature variations on BP, particularly among prehypertensive and hypertensive populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Bay ecosystem has garnered significant attention due to the severe threat posed by organic pollutants, particularly polycyclic aromatic hydrocarbons (PAHs). However, there is a dearth of information regarding the extent of PAHs pollutant risk and its impact on microbial communities and metabolism within this environment. In this study, the distribution, sources, ecological risk, and microbial community and metabolic response of PAHs in Jiaozhou Bay, Aoshan Bay, and Lingshan Bay in Qingdao, China were investigated. The results showed that the average concentration of ∑PAHs ranged from 120 to 614 ng/L across three bays, with Jiaozhou and Aoshan Bay exhibiting a higher risk than Lingshan Bay due to an increased concentration of high-molecular-weight PAHs. Further analysis revealed a negative correlation between dissolved organic carbon concentration and ∑PAHs concentration in water. Metagenomic analysis demonstrated that higher levels of PAHs can lead to decreased microbial diversity, while the abundance of PAHs-degrading bacteria is enhanced. Additionally, the Erythrobacter, Jannaschia and Ruegeria genera were found to have a significant correlation with low-molecular-weight PAH concentrations. In terms of microbial metabolism, higher PAH concentrations were beneficial for carbohydrate metabolic pathway but unfavorable for amino acid metabolic pathways and membrane transport pathways in natural bay environments. These findings provide a foundation for controlling PAHs pollution and offer insights into the impact of PAHs on bacterial communities and metabolism in natural bay environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Air pollution is a growing public health concern of global significance. Till date, few studies have explored the associations between air pollutants and cardiac imaging phenotypes. In this study, we aim to explore the association of ambient air pollution and abnormal left ventricular diastolic function (ALVDF) among a large-scale free-living population., Methods: The participants were from a national representative large-scale cross-sectional study, i.e., the China Hypertension Survey (CHS), 2012-15. After exclusion, 25,983 participants from 14 provinces and 30 districts in China were included for the final analysis. The annual average ambient PM 2.5 , PM 10 and NO 2 concentrations were obtained from the chemical data assimilation system (ChemDAS). The clinical evaluation of left ventricular function was conducted in the survey field which was based on echocardiography. Grading diastolic dysfunction was based on Recommendations for the evaluation of left ventricular diastolic function by echocardiography (2009)., Results: The mean age of 25,983 participants was 56.8 years, 46.5% were male, and the crude prevalence of GradeI-III ALVDF were 48.1%, 1.6% and 1.1%, respectively. The ORs (95% CI) for ALVDF in the fully adjusted model were 1.31 (1.11-1.56), 1.11 (1.01-1.21) and 1.18 (0.90-1.54) for an increase of 10 μg/m 3 of PM 2.5 , PM 10 and NO 2 , respectively. And for different grades of ALVDF, elevated concentration of PM 2.5 and PM 10 exposures significantly increased the risk of gradeIinstead of gradeII ~ III ALVDF. There was a positive linear and "J" shape concentration-response association between annual average ambient PM 2.5 and NO 2 and the ALVDF risk assessed by the restricted cubic spline. The exposure level of most participants to PM 10 was less than 130 μg/m 3 , and the risk of ALVDF increased significantly with the concentration rise., Conclusions: This large-scale nationwide population study demonstrated a significantly positive association between ambient PM 2.5 , PM 10 and NO 2 with ALVDF, especially for mild ALVDF. The functional abnormality may partially explain the enhanced cardiovascular morbidity and mortality associated with air pollution, which highlights the importance of appropriate interventions to reduce ambient air pollution in China., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Importance: The prevalence of hypertension is high and still increasing across the world, while the control rate remains low in many countries. Emerging technology, such as telemedicine, may offer additional support to change the unsatisfactory situation., Objective: To establish a multicomponent intervention delivered on a web-based telemedicine platform and oriented with the Chinese hypertension management guidelines and to evaluate the effect of the intervention on blood pressure (BP) control for patients with hypertension., Design, Setting, and Participants: This cluster randomized clinical trial of a hypertension management program was conducted at 66 community health centers in China from October 1, 2018, to May 31, 2020, with a 12-month follow-up. Patients with hypertension were blinded to randomization and were randomized to either the intervention group or control group. Hypertension was diagnosed at mean systolic BP (SBP) and diastolic BP (DBP) readings higher than 140 and 90 mm Hg or with use of antihypertensive medication. Evaluation of the intervention effect was based on the principle of modified intention to treat., Interventions: Multicomponent intervention was delivered on a web-based platform and consisted of a primary prevention program for cardiovascular disease and standardized management for hypertension., Main Outcomes and Measures: The primary outcome was the change in BP control rate (SBP and DBP levels <140 and 90 mm Hg, or <130 and 80 mm Hg for patients with diabetes) from baseline to the 12-month follow-up among patients with hypertension in the intervention and control groups., Results: A total of 4118 patients (mean [SD] age, 61.6 [9.4] years; 2265 women [55.0%]) were included in the analysis, with 2985 in the intervention group and 1133 in the control group. The BP control rate at baseline was 22.8% in the intervention group and 22.5% in the control group. After 12 months of the intervention, the BP control rate for the intervention group compared with the control group was significantly higher (47.4% vs 30.2%; odds ratio, 1.18; 95% CI, 1.13-1.24; P < .001). The intervention effect on SBP level was -10.1 mm Hg (95% CI, -11.7 to -8.5 mm Hg; P < .001) and on DBP level was -1.8 mm Hg (95% CI, -2.8 to -0.8 mm Hg; P < .001)., Conclusions and Relevance: Results of this trial showed that a multicomponent intervention delivered on a web-based platform improved BP control rate and lowered BP level more than usual care alone. Such a telemedicine program may provide a new, effective way to treat patients with hypertension in the community and may generate public health benefits across diverse populations., Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR1800017791.

Previous studies on the number of births and the health of the elderly have been highly focused on physical health and used samples from developed countries. Therefore, this study aimed to explore the effect of the lifetime number of births on depression in Chinese older adults. We used panel data for men and women aged 50 and over from the 2013-2018 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed through a short form of the Center for Epidemiologic Studies Depression Scale. We found that depression levels in women were significantly higher than in men, with a mean difference of 2.44 ( p < 0.001). The model estimation results indicated that the number of births affected depression in older adults, and its increase could exacerbate depression in older adults. The number of births significantly impacted depression among the elderly aged 50-69. Furthermore, there was a negative relationship between the proportion of sons and older adults' depression, which was significant in older males; the number of abortions may exacerbate depression in older adults, especially in females.

Background: To better understand the difference between traditional breast-conserving surgery (BCS) and oncoplastic surgery (OPS), we conducted a retrospective cohort study involving breast cancer patients who received neoadjuvant chemotherapy (NAC) and then underwent breast conservation at the Fudan University Shanghai Cancer Center., Methods: A retrospective chart review was conducted. All breast cancer patients who received NAC and then underwent traditional BCS or OPS at the Fudan University Shanghai Cancer Center from January 1, 2008, to December 31, 2019, were included., Results: Three hundred ninety-nine breast cancer patients received NAC and underwent traditional BCS, and 99 patients underwent OPS. The average age of the patients in the OPS group was younger than that in the BCS group (43 vs 48 years, P = 0.017). The size of the tumor assessed by ultrasonography at baseline in the OPS group was larger than that in the BCS group (31.3 vs 28.1 mm, P = 0.013). The same trend was observed in the clinical T stage and overall staging assessments before the administration of NAC in these 2 groups. Oncoplastic techniques were more frequently applied when tumors were located in areas with relatively few glands, such as the upper inner quadrant. There were no significant differences in the margins and distributions of pathological types and molecular subtypes between these 2 groups. The rates of pathological complete response were similar in the traditional BCS and OPS groups., Conclusions: Unlike traditional BCS, in breast cancer patients after NAC, the adoption of oncoplastic techniques makes breast conservation feasible, even in patients with large tumors, late stages, and unfavorable tumor locations., Competing Interests: Conflicts of interest and sources of funding: None of the authors has any funding received for this work from any of the following organizations: National Institutes of Health; Wellcome Trust; Howard Hughes Medical Institute; and others., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Increased population aging is associated with increased incidence of depression among the elderly. Existing studies have shown that ill-advised fertility behaviors during their youth also affect the health of the elderly. However, insufficient attention has been paid to depression among elderly in China. This paper focuses on how fertility behaviors affect senile depression among parents by examining the heterogeneity of such effects and tests the applicability of existing theoretical findings in a Chinese sample. Methods: The effects of fertility behaviors on depression among the elderly were investigated using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset. The effects of early-age fertility behaviors on the degree of depression among the elderly were investigated using ordinary least squares and ordered probit models that adjusted for demographic and socioeconomic factors. Results: (1) The age of first childbirth, childbearing period, and number of births were significantly and positively correlated with the degree of depression among the elderly (particularly rural persons aged 50-70 and older womens). (2) Elderly persons with sons had no better mental health status than those without sons, thus indicating the inapplicability of the traditional concept of "more sons are equal to more happiness" to the actual mental health situation of the elderly in China today. Conclusion: Overall, multiple, late, and boy-oriented childbearing and overly long childbearing periods had negative effects on mental health among Chinese elderly persons. This study tested the applicability of existing theoretical inferences and empirical conclusions in China, thereby further expanding the current literature regarding the effects of fertility behaviors on depression among 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 © 2021 Hu, Wu, Yang, Xie, Zhang, Lin, Nie and Zhang.)

Background/objectives: During the 2019 coronavirus disease (COVID-19) outbreak, obesity may contribute to COVID-19 transmission and deterioration. In addition, many patients with COVID-19 infection have suffered liver damage which might contribute to a worse prognosis. We conducted a clinical epidemiological analysis to investigate the association of overweight/obesity and abnormal liver function (ALF) with hospitalized duration in patients infected with COVID-19., Subjects/methods: Fifty-eight patients with diagnosed COVID-19 (22 women & 36 men; average age: 49.2 ± 13.1 yr) were included, and their clinical data were collected at The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang. Overweight/obesity was determined as body mass index (BMI) ≥24 kg/m 2 , ALF was determined as alanine aminotransferase >40 U/L, and prolonged hospitalization was lasting more than the median value of the hospitalized days (19 days) in this population., Results: The proportions of prolonged hospitalization were elevated in patients with overweight/obesity and ALF compared with those without overweight/obesity (62.1% versus 26.1%, P = 0.010) and those without ALF (70.6% versus 41.5%, P = 0.043). Kaplan-Meier analysis showed that the hospitalized duration was increased from the patients with neither overweight/obesity nor ALF to those with either overweight/obesity or ALF, and to those with both of overweight/obesity and ALF (mean with 95% confidence interval: 16.4 [14.5-18.3] versus 25.3 [21.6-29.1] versus 28.3 [24.6-32.0], P for trend = 0.001). Being discharged from hospital in time was inversely and independently associated with BMI (hazard ratio [HR] = 0.75, 95% CI: 0.63-0.90, P for trend = 0.002) and ALT (HR = 0.95, 95% CI: 0.92-0.99, P for trend = 0.007)., Conclusions: Present findings suggested that overweight/obesity and/or ALF contributed to predicting a probability of prolonged hospitalization in patients with COVID-19 infection, to whom extra attentions and precautions should be paid during clinical treatments.

Background: Breast cancer is a one of the malignant carcinomas partially caused by genetic risk factors. Germline BRCA1 gene mutations are reportedly associated with breast cancers. Identification of BRCA1 mutations greatly improves the preventive strategies and management of breast cancer. The aim of our study was to investigate the frequency of the deleterious BRCA1 : p.Ile1845fs variant in breast carcinomas, as well as the correlation between p.Ile1845fs variant with clinicopathological parameters and clinical outcomes., Results: A total of 23,481 clinically high-risk patients with breast cancer and 6489 healthy controls were recruited for p.Ile1845fs variant sequencing (either sanger or next generation sequencing). We identified 94 breast cancer patients (0.40%, 94/23481) as well as 11 healthy controls (0.17%, 11/6489) carried p.Ile1845fs variant. BRCA1 : p.Ile1845fs variant showed a higher frequency in patients with TNBC molecular typing (20.21%, 19/94) and family history (37.23%, 35/94) compared with non-carriers ( P  = 3.62E-6 and 0.034, respectively). According to our data, we advanced the frequency of p.Ile1845fs variant and we confirmed that BRCA1 : p.Ile1845fs variant was associated with increased risk of breast cancer (OR = 2.36, 95%CI = 1.26-4.89, P  = 0.004)., Conclusions: BRCA1 : p.Ile1845fs variant was a frequently pathogenic mutation in breast cancer in Han Chinese women and our data may be helpful for diagnosis and therapy of breast cancer., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)

In the present study, the performance of surface flow constructed wetlands (SFCWs) added with different dosage of biochar (group A 0%, group B 10%, group C 20%; v/v) was investigated, to evaluate the effect of biochar on nitrogen removal of a constructed wetland. No significant difference was observed in NH 4 + -N removal among three groups even during different seasons. Labile organic carbon released from biochar distinctly enhanced denitrification process, which improved NO 3 - -N removal efficiency by 4.58% in group B and 10.33% in group C. More importantly, compared with group A, biochar addition increased plant N removal by 82.24% and 192.11% in groups B and C, respectively. This result indicated that biochar could increase the accumulation of plant net biomass. In addition, TN removal of group A was much lower at low temperature (4.9 °C). However, no obvious influence of temperature on TN removal was observed in groups B and C with biochar addition. Microbial community analysis showed that, compared with that in group A, the total relative abundance of the main denitrification bacteria (Proteobacteria, Firmicutes, and Bacteroidetes) increased by 0.81% in group B and 13.63% in group C. These results provide a reasonable strategy for improving the performance of SFCWs under cold climate.

Background: Sinapis Semen is derived from the dried mature seeds of Sinapis alba L. or Brassica juncea (L.) Czern. et Coss. Traditionally, the seeds from S. alba are called "White Sinapis Semen" while those from B. juncea are called "Yellow Sinapis Semen"., Purpose: The present study aimed to compare the chemical composition and the anti-inflammatory effects of 50% aqueous ethanol extracts of the White Sinapis Semen (EWSS) and Yellow Sinapis Semen (EYSS) using both acute (12-O-tetradecanoylphorbol-acetate (TPA)- and arachidonic acid (AA)-induced mouse ear edema) and chronic (multiple applications of croton oil (CO)) inflammatory models., Methods: The anti-inflammatory effects of EWSS and EYSS were determined by measuring the ear thickness and myeloperoxidase (MPO) activity. The anti-inflammatory mechanism was explored by measuring the protein and mRNA levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6 in the ear of the TPA-treated mice., Results: The results showed that both EWSS and EYSS significantly decreased the ear thickness in both the TPA- and AA-induced acute models, as well as in the CO-induced chronic model. In addition, EWSS and EYSS could markedly inhibit the MPO activity in the ears of TPA-, AA- or CO-treated mice. Moreover, EWSS and EYSS also remarkably inhibited the protein and mRNA levels of TNF-α and IL-6 in the ears of TPA-treated mice. Comparatively, EWSS exerted more potent anti-inflammatory effect than that of EYSS., Conclusion: Our results revealed that both EWSS and EYSS are effective anti-inflammatory agents against acute and chronic inflammatory processes, and EWSS possess more potent anti-inflammatory effect than EYSS. The anti-inflammatory effect of the two herbs may be mediated, at least in part, by suppressing the mRNA expression of a panel of inflammatory mediators including TNF-α, IL-6 and IL-1β., (Copyright © 2018. Published by Elsevier GmbH.)

Background: The creation of a superior palpebral crease has been the most popular plastic surgery procedure in Asians for several decades. The most important criterion for judging the success of this procedure is the achievement of the desired size and shape of this crease or the perfect crease width. However, the determinants of crease width remain unclear, which may account for the high rate of unsatisfactory results., Methods: Standard images were used to study the anatomic parameters, including crease width, crease height, and upper eyelid movement distance (ULMD) at the midpupillary axis, of the inherent double eyelid crease in 32 Chinese women aged 19-26 years. The thickness of the eyelid tissue at 5, 7.5, 10, and 15 mm from the lid margin was measured in the oblique sagittal direction by magnetic resonance imaging (MRI) at the central axis of the optic nerve. Multiple linear regression was used to analyze the relationship between crease width and crease height, ULMD, and eyelid thickness., Results: Multiple linear regression revealed that crease height, crease thickness, and ULMD were significantly associated with crease width (partial regression coefficients: 0.67, -0.33, and -0.29 respectively). The determination coefficient R 2 was 0.667 in the regression model, and the result of analysis of variance (ANOVA) showed that the regression model was significant (F = 16.04, p = 0.000)., Conclusions: In performing upper blepharoplasty, it is important to consider eyelid thickness and movement distance of the upper eyelid margin rather than relying on crease height alone. Attention to these factors will help to achieve the desired size and shape of the crease., (Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: This study aims to understand the quality of life (QOL) and psychological state (PS) of Chinese breast cancer patients who received BRCA1/2 genetic testing; to examine the psychological changes between BRCA1/2 mutation carriers and non-carriers; and to further explore the psychological experience of BRCA1/2 mutation carriers., Methods: This study was combined with quantitative and qualitative designs. First, we performed a quantitative investigation using FACT-B (Chinese version) and Irritability, Depression and Anxiety scale (IDA) to assess the QOL and PS in breast cancer patients who received BRCA1/2 genetic testing. Then semi-structured in-depth qualitative interviews among 13 mutation carriers were conducted in hospital., Results: Results from the quantitative study showed QOL scores were relatively high and the IDA scores were relatively low among the patients, and there was no significant difference in the QOL or IDA scores between non-carriers and carriers. Based on the qualitative analysis, four main themes emerged: (1) Finding the reason for having breast cancer; (2) Negative emotions; (3) Behavioral changes; (4) Lack of information., Conclusions: The present study showed that QOL and PS are good among the breast cancer patients who received genetic testing. Genetic testing itself does not cause long psychosocial effects. BRCA1/2 mutation carriers may have certain negative emotions at the first stage they knew the testing results and may initiate behavioral and lifestyle changes. The patients with a BRCA1/2 mutation desire knowledge with regard to genetic aspects in mainland China. Professional information and advice can be provided to relieve the patients' negative emotions when they were informed of gene defect.

Objective: To evaluate the role of germline mutations of TP53 gene among a Chinese population with high risk for breast cancer., Methods: A total of 81 BRCA-negative breast cancer probands from cancer families were analyzed using targeted capture and next-generation sequencing. Candidate mutations were verified with Sanger sequencing. Co-segregation analyses were carried out to explore the likely pathogenicity of the mutation., Results: Of the 81 BRCA-negative patients, 3 exonic mutations in the TP53 gene were identified in 3 breast cancer patients. Of these, 2 mutations were previously reported and 1 was novel. One family with TP53 mutation has met the criteria for Li-Fraumeni syndrome (LFS) and accounted for 9.1% of all families who fulfilled the diagnostic criteria for LFS. Two of the carriers were diagnosed with breast cancer under the age of 30, and have accounted for 11.8% (2/17) of all very young (≤30 years) breast cancer patients in our study., Conclusion: The TP53 germline mutation is more common in Chinese population with a high risk for breast cancer than previously thought. TP53 gene mutation screening should be considered particularly for patients with a family history of LFS and very young age of onset.

Background: The goal of this study was to evaluate patient satisfaction with four common types of breast reconstruction performed at our institution: latissimus dorsi myocutaneous (LDM) flap reconstruction with or without implants, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, and free deep inferior epigastric perforator (DIEP) flap reconstruction., Methods: A custom survey consisting of questions that assessed general and aesthetic satisfaction was sent to patients who had undergone breast reconstruction in the last 5 years. The clinical data and details of the surgery were also collected from the patients who returned the surveys. We compared satisfaction rates across the four breast reconstruction types and analyzed the effects of various factors on overall general and aesthetic satisfaction rates using a binary logistic regression model., Result: A total of 207 (72%) patients completed the questionnaires. Overall, significant differences in general and aesthetic satisfaction among the four procedures were not observed. A multivariate analysis revealed that the factor "complications" (p = 0.001) played a significant role in general satisfaction and that the factors "> 2 years since reconstruction" (p = 0.043) and "age > 35 years" (p = 0.05) played significant roles in overall aesthetic satisfaction., Conclusion: The present study demonstrated that the type of breast reconstruction might not influence satisfaction in Chinese patients.

The genetic etiology of hereditary breast cancer has not been fully elucidated. Although germline mutations of high-penetrance genes such as BRCA1/2 are implicated in development of hereditary breast cancers, at least half of all breast cancer families are not linked to these genes. To identify a comprehensive spectrum of genetic factors for hereditary breast cancer in a Chinese population, we performed an analysis of germline mutations in 2,165 coding exons of 152 genes associated with hereditary cancer using next-generation sequencing (NGS) in 99 breast cancer patients from families of cancer patients regardless of cancer types. Forty-two deleterious germline mutations were identified in 21 genes of 34 patients, including 18 (18.2%) BRCA1 or BRCA2 mutations, 3 (3%) TP53 mutations, 5 (5.1%) DNA mismatch repair gene mutations, 1 (1%) CDH1 mutation, 6 (6.1%) Fanconi anemia pathway gene mutations, and 9 (9.1%) mutations in other genes. Of seven patients who carried mutations in more than one gene, 4 were BRCA1/2 mutation carriers, and their average onset age was much younger than patients with only BRCA1/2 mutations. Almost all identified high-penetrance gene mutations in those families fulfill the typical phenotypes of hereditary cancer syndromes listed in the National Comprehensive Cancer Network (NCCN) guidelines, except two TP53 and three mismatch repair gene mutations. Furthermore, functional studies of MSH3 germline mutations confirmed the association between MSH3 mutation and tumorigenesis, and segregation analysis suggested antagonism between BRCA1 and MSH3. We also identified a lot of low-penetrance gene mutations. Although the clinical significance of those newly identified low-penetrance gene mutations has not been fully appreciated yet, these new findings do provide valuable epidemiological information for the future studies. Together, these findings highlight the importance of genetic testing based on NCCN guidelines and a multi-gene analysis using NGS may be a supplement to traditional genetic counseling.

The emergence of Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) is a public health concern worldwide. PVL is associated with community-associated MRSA and is linked to skin and soft tissue infections (SSTIs). However, PVL genes have also been detected in health care-associated (HA) MRSA isolates. The diseases associated with PVL-positive HA-MRSA isolates and the distributions of PVL-encoding bacteriophages in HA-MRSA have not been determined. In this study, a total of 259 HA-MRSA strains isolated between 2009 and 2012 in China from inpatients with SSTIs, pneumonia, and bacteremia were selected for molecular typing, including staphylococcal cassette chromosome mec typing, multilocus sequence typing, and staphylococcal protein A gene typing. The PVL genes and PVL bacteriophages in the MRSA isolates were characterized by PCR. Among the tested MRSA isolates, 28.6% (74/259) were PVL positive. The high prevalence of PVL-carrying HA-MRSA was observed to be associated with SSTIs but not with pneumonia or bacteremia. The PVL-positive HA-MRSA isolates were colonized mainly by infective PVL phages, namely, Φ7247PVL, ΦSLT, and ΦSa2958. The distribution of PVL-carrying bacteriophages differed geographically. Our study highlights the potential risk of the emergence of multidrug-resistant HA-MRSA strains with increased virulence., (Copyright © 2015, American Society for Microbiology. All Rights Reserved.)

In this study, the removal performances of organic pollutants and nitrogen in vertical flow constructed wetlands (VFCWs) with and without intermittent aeration fed with different strengths of influent were evaluated as a possible treatment for decentralized domestic wastewater in northern China. The intermittent aeration strategy not only significantly increased removal efficiencies of organic pollutants and ammonium nitrogen (NH4(+)-N), but also successfully created alternate aerobic and anaerobic conditions resulting in high total nitrogen (TN) removal. Moreover, increasing influent strength did not affect the removal efficiencies of organic matters and nitrogen in aerated VFCWs. Compared with non-aerated VFCWs, much higher removal of organic pollutants (96%), NH4(+)-N (98%), and TN (85%) was obtained simultaneously in intermittent aeration VFCWs, especially at high influent strengths. The results suggest that the intermittent aeration could be an appropriate strategy for achieving the high removal performance in VFCWs, especially for in-situ treatment of high strength decentralized domestic wastewaters., (Copyright © 2014 Elsevier Ltd. All rights reserved.)