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Background: Headache is one of the most common neurological symptoms. Headache disorders are associated with a high global burden of disease. Prior studies indicate that short-to-medium term sodium reduction reduces headache symptom. This study evaluated the effects of long-term reduced-sodium, added-potassium salt on headache frequency and severity in rural China. Methods: The Salt substitute and stroke study (SSaSS) was an open-label cluster-randomised trial in rural China designed to evaluate the effect of salt substitution on mortality and cardiovascular events. Participants included adults with a history of prior stroke and those aged ≥60 years with uncontrolled high blood pressure (BP). Villages were randomly assigned in a 1:1 ratio either to intervention with salt substitute (75% sodium chloride and 25% potassium chloride by mass) or to control with continued use of regular salt (100% sodium chloride). In this pre-specified analysis, between-group differences in headache frequency and severity were evaluated. The study was registered with ClinicalTrials.gov (identifier number: NCT02092090). Results: A total of 20,995 participants were included in the trial (mean age 64.3 years, 51% female, mean follow-up 4.7 years). At final follow-up at the end of the study, headache outcome data including frequency and severity of headaches was available for 16,486 (98%) of 16,823 living participants. Overall, 4454/16,486 (27%) individuals reported having headache: 27.4% in the intervention group (2301/8386) vs 26.6% in the control group (2153/8100) (RR 1.04, 95% CI: 0.93, 1.16, p = 0.48). There was no difference in headache severity between intervention and control groups (p = 0.90). Conclusion: Long term salt substitution did not reduce the frequency or severity of headaches in this population. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed to explore the protective effect of electroacupuncture (EA) pretreatment at Zusanli point (ST36) on ventilation-induced lung injury (VILI) and its potential anti-inflammatory mechanism. Methods: High tidal volume ventilation was used to induce the VILI in mice, and EA pretreatment at ST36 was given for 7 consecutive days. The wet/dry ratio and pathological injury score of lung tissue, and total protein content of pulmonary alveolar lavage fluid (BALF) were detected after 4 h of mechanical ventilation (MV). Meanwhile, the expressions of TLR4 and NF- κB in lung tissue were evaluated by Western Blot, and the inflammatory factors in lung tissue were detected by ELISA. Results: After four hours of mechanical ventilation, mice with ventilator-induced lung injury showed significant increases in lung wet/dry ratio, tissue damage scores, and protein content in bronchoalveolar lavage fluid. Pro-inflammatory cytokines (IL-6, IL-1β, TNF-α) and TLR4/NF-κB expression levels in the lung were also markedly elevated (P < 0.05). Conversely, ST36 acupuncture point pre-treatment significantly reduced these parameters (P < 0.05). Conclusion: EA pretreatment at ST36 could alleviate the inflammatory response for VILI via inhibiting TLR4/NF- κB pathway. [ABSTRACT FROM AUTHOR]

The representation of aerosol–cloud interaction (ACI) and its impacts in the current climate or weather model remains a challenge, especially for severely polluted regions with high aerosol concentration, which is even more important and worthy of study. Here, ACI is first implemented in the atmospheric chemistry model GRAPES_Meso5.1/CUACE by allowing for real-time aerosol activation in the Thompson cloud microphysics scheme. Two experiments are conducted focusing on a haze pollution case with coexisting high aerosol and stratus cloud over the Jing–Jin–Ji region in China to investigate the impact of ACI on the mesoscale numerical weather prediction (NWP). Study results show that ACI increases cloud droplet number concentration, water mixing ratio, liquid water path (CLWP), and optical thickness (COT), as a result improving the underestimated CLWP and COT (reducing the mean bias by 21 % and 37 %, respectively) over a certain subarea by the model without ACI. A cooling in temperature in the daytime below 950 hPa occurs due to ACI, which can reduce the mean bias of 2 m temperature in the daytime by up to 14 % (∼ 0.6 ∘ C) in the subarea with the greatest change in CLWP and COT. The 24 h cumulative precipitation in this subarea corresponding to moderate-rainfall events increases, which can reduce the mean bias by 18 %, depending on the enhanced melting of the snow by more cloud droplets. In other areas or periods with a slight change in CLWP and COT, the impact of ACI on NWP is not significant, suggesting the inhomogeneity of ACI. This study demonstrates the critical role of ACI in the current NWP model over the severely polluted region and the complexity of the ACI effect. [ABSTRACT FROM AUTHOR]

Background: Research on the association between breastfeeding and postpartum post-traumatic stress disorder (PTSD) is sparse. This study aimed to examine the association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD. Methods: An epidemiologic study was conducted in a tertiary hospital in China between October 2019 and October 2020. Eligible mothers were recruited at 3 days after childbirth and assessed using the Post-Traumatic Stress Disorder Checklist – Civilian version (PCL-C) for PTSD at 42 days postpartum. The independent association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD was estimated using log-binomial regression models, after adjusting for potential confounders. Results: Ninety-two of 759 (12.1%) mothers developed postpartum PTSD within 42 days after childbirth. Compared with partially breastfeeding mothers, exclusively breastfeeding mothers had lower risks of postpartum PTSD (relative risk [RR] 0.28; 95% confidence interval [CI] 0.13, 0.59), re-experience (RR 0.48; 95% CI 0.30, 0.76), avoidance (RR 0.55; 95% CI 0.32, 0.97), and hyperarousal (RR 0.52; 95% CI 0.34, 0.78). After adjustment for family support, parity, mode of delivery, perceived birth trauma, early contact / suckling, and rooming-in, associations between exclusive breastfeeding and postpartum PTSD remained significant: the overall PTSD adjusted relative risk [aRR] was 0.31; (95% CI 0.15, 0.66), with a re-experience aRR of 0.48; (95% CI 0.30, 0.77) and hyperarousal aRR of 0.56; (95% CI 0.37, 0.85). Conclusion: Exclusive breastfeeding up to 42 days after childbirth was associated with reduced risk of postpartum PTSD. While the potential for reverse causation cannot be ruled out, strategies to improve rates of exclusive breastfeeding through teaching, counselling, and support may benefit mothers and their infants by reducing the risk of postpartum PTSD. [ABSTRACT FROM AUTHOR]

Atmospheric heavy metals are seriously harmful, and porous materials have unique advantages in the control of air pollutants. However, the direct use of plant porous materials to purify atmospheric heavy metals are rare. So agricultural waste corn silk with porous structures was selected to analyze the retention capability and mechanism to the atmospheric lead. The results show that the corn silk can effectively retain atmospheric lead in natural growing state or fixed experimental conditions. The analysis of a total of 765 corn silk samples from 17 different regions in Shandong province, China, shows that atmospheric lead is the main source of lead in the corn silk, and corn silk can be used for biological monitoring of atmospheric lead to some extent. Based on the analysis with different techniques including scanning electron microscope (SEM), energy spectrum dispersive X-ray spectrometer (EDS), Fourier infrared spectrometer (FTIR) and Zeta potential, the effective retention of lead by corn silk is due to a variety of mechanisms, including physical adsorption, electrostatic adsorption, complexation, chelation and ion exchange. So agricultural waste corn silk has great potential in the application of biosorption or preparation of porous materials in purification of atmospheric heavy metals. (1) Atmospheric lead is the main source of lead in the corn silk based on the analysis of a total of 765 corn silk samples from 17 different regions in Shandong province, China. (2) The pore diameter in the corn silk is 1.62–3.51 μm, suitable for lead retention, and the functional groups –OH, –COOH and –O– of the corn silk play a vital role in the lead retention process. (3) The potential value of agricultural waste corn silk was firstly revealed in the purification of atmospheric heavy metals. [ABSTRACT FROM AUTHOR]

Background: SSaSS (Salt Substitute and Stroke Study), a 5-year cluster randomized controlled trial, demonstrated that replacing regular salt with a reduced-sodium, added-potassium salt substitute reduced the risks of stroke, major adverse cardiovascular events, and premature death among individuals with previous stroke or uncontrolled high blood pressure living in rural China. This study assessed the cost-effectiveness profile of the intervention.Methods: A within-trial economic evaluation of SSaSS was conducted from the perspective of the health care system and consumers. The primary health outcome assessed was stroke. We also quantified the effect on quality-adjusted life-years (QALYs). Health care costs were identified from participant health insurance records and the literature. All costs (in Chinese yuan [¥]) and QALYs were discounted at 5% per annum. Incremental costs, stroke events averted, and QALYs gained were estimated using bivariate multilevel models.Results: Mean follow-up of the 20 995 participants was 4.7 years. Over this period, replacing regular salt with salt substitute reduced the risk of stroke by 14% (rate ratio, 0.86 [95% CI, 0.77-0.96]; P=0.006), and the salt substitute group had on average 0.054 more QALYs per person. The average costs (¥1538 for the intervention group and ¥1649 for the control group) were lower in the salt substitute group (¥110 less). The intervention was dominant (better outcomes at lower cost) for prevention of stroke as well as for QALYs gained. Sensitivity analyses showed that these conclusions were robust, except when the price of salt substitute was increased to the median and highest market prices identified in China. The salt substitute intervention had a 95.0% probability of being cost-saving and a >99.9% probability of being cost-effective.Conclusions: Replacing regular salt with salt substitute was a cost-saving intervention for the prevention of stroke and improvement of quality of life among SSaSS participants. [ABSTRACT FROM AUTHOR]

Trichloroethylene (TCE) hypersensitivity syndrome (THS), called occupational medicamentosa-like dermatitis due to TCE (OMDT) in China, is a fatal occupational disorder caused by TCE exposure. Visceral damage, including kidney injury, is one of the major complications. Necroptosis is a regulated cell death form linked to local inflammatory response. This study aimed to investigate whether renal cell necroptosis was involved in TCE-induced kidney injury. A Balb/c mouse model of TCE sensitization was utilized to study mechanisms of modulation of TCE-induced renal necroptosis. Renal histology (using light and transmission electron microscopy) and renal tubular impairment indexes, including α1-microglobulin (α1-MG), and β2-microglobulin (β2-MG), were evaluated. In addition, tissue expression of necroptosis-related proteins, including tumor necrosis factor (TNF)-α, TNF receptor 1 (TNFR1), receptor-interacting protein kinase 3 (RIPK3), p-RIK3, mixed lineage kinase domain-like protein (MLKL), and p-MLKL, were also evaluated. The study here confirmed TCE sensitization caused damage to renal tubules and renal tubular epithelial cell (RTEC) necroptosis. In mice treated with R7050 (a specific TNFα antagonist), it was also seen that inhibition of TNFα expression could effectively inhibit RTEC necroptosis and improve renal function in the TCE-sensitized mice. Taken together, these results help to define a novel mechanism by which RTEC necroptosis plays a key role in TCE-induced kidney damage. [ABSTRACT FROM AUTHOR]

BACKGROUND Tomato chlorosis virus (ToCV) is mainly vectored by Bemisia tabaci in China, which has a worldwide distribution, and greatly reduces the yields of tomato and other vegetables. At present, control of ToCV has been focused mainly by the use of insecticides to control whitefly populations. Transcriptome sequencing showed high expression of the B. tabaci Bta11975 gene, an α‐glucosidase (AGLU) during ToCV acquisition by whitefly Mediterranean (MED) species. To investigate the role of Bta11975 gene in ToCV acquisition and transmission by B. tabaci MED, we used RNA interference (RNAi) to reduce the expression of the Bta11975 gene. RESULTS: The relative expression of the Bta11975 gene was correlated with the ToCV content in B. tabaci. The AGLU is highly expressed in primary salivary gland and gut. After the Bta11975 gene was silenced, the gene expression of B. tabaci was reduced and B. tabaci mortality was increased. Besides, ToCV acquisition by B. tabaci at 48 and 72 h AAP was reduced, and ToCV transmission was significantly reduced by 25 or 50 of B. tabaci. CONCLUSIONS: These results indicate that suppression of expression of the Bta11975 gene in B. tabaci MED by RNAi can reduce acquisition and transmission of ToCV by B. tabaci MED. [ABSTRACT FROM AUTHOR]

Ice‐phase cloud microphysical processes are very complicated, and there are still many uncertainties in current microphysics parameterization schemes. In this study, two alternative ice crystal deposition/sublimation (ICDS) parameterizations, following the Harrington et al., Journal of the Atmospheric Sciences, 1995, 52, 4344–4366 and Koenig, Monthly Weather Review, 1972, 100, 417–423 methods, were implemented into the Weather Research and Forecast (WRF) Single‐Moment 6‐class Microphysics (WSM6) scheme in the Global/Regional Assimilation and Prediction System (GRAPES) regional operational model to investigate their impact on overestimation of snowfall over North China. The results show that the snowfall amount and cloud particle composition are very sensitive to the ICDS parameterization. Sensitivity tests with WSM6 using the Harrington and Koenig ICDSs, referred to as WSM6_H and WSM6_K, respectively, notably reduced overestimation of the snowfall amount and simulated more realistic supercooled cloud water content compared with ERA5 reanalysis data. The vertical distributions, intensities, and duration of radar echoes simulated by WSM6_H are the most consistent with millimeter‐wavelength cloud radar observations. There is competition for water vapor in WSM6 due to the sequential order in which processes are updated. This tends to weaken the deposition of snow and graupel and the condensation of cloud water when the deposition of ice crystals is too strong in a cold region. In both WSM6_H and WSM6_K, the deposition processes of ice crystals are reduced and the other microphysical transformation processes become more active compared with WSM6. Overall, the WSM6_H configuration improves the forecast performance as evaluated by Taylor diagrams for eight snowfall days over North China. The ICDS parameterizations must therefore be handled carefully due to their large uncertainties in the development of the cloud microphysics schemes. [ABSTRACT FROM AUTHOR]

Mechanical properties of intact completely decomposed granite (CDG) soil, widely distributed in South China, decrease drastically as encountering external load-related disturbance or soaked by water. In this study, staged triaxial consolidated drained (CD) test and microscopic scanning were conducted using intact CDG specimens extracted from a construction site to investigate the mechanical behavior and microscopic pore distribution. The results show that the stress-strain relationship reveals a shrinking behavior in the first-stage loading and a brittle behavior in the second-stage loading. The development of cracks is affected by the principal stress, which causes the pores and cracks to shrink or partially close. In addition, Esec-1 increases linearly with the increase of confining pressure, but Esec-2 decreases exponentially. [ABSTRACT FROM AUTHOR]

What is known and objectives: Caffeine citrate is a commonly used methylxanthine for pharmacologic treatment of apnea of prematurity. The aim of this study was to develop and verify a population pharmacokinetic (PPK) model, which can provide a reference for individualized caffeine citrate treatment of apnea in Chinese premature infants. Methods: A total of 88 serum concentration measurements from 46 preterm patients (median gestational age 29 weeks) were retrospectively collected and the relevant clinical data of patients were recorded. The PPK analysis was performed by non‐linear mixed‐effect modelling method using NONMEM. Allometric scaling was applied in the PPK analysis, and the final model was evaluated by graphic and statistical methods, including goodness‐of‐fit plots, normalized prediction distribution errors plots and bootstrap procedures. Results: A one‐compartment model with first‐order elimination was successfully fitted to the data. The typical scaled values for the parameters clearance and volume of distribution (V) were 0.268 L/h and 109 L per 70 kg, respectively. The weight at the time of blood collection (CW) and post‐natal age were identified as important predictors for pharmacokinetic parameters of caffeine. The evaluation process showed good stability and predictability of the final PPK model. What is new and conclusion: This is a complete PPK study of caffeine citrate in Chinese premature infants with apnea, which complements caffeine pharmacokinetic data of the premature from China. A final PPK model was developed which may serve as a beneficial tool for the use of caffeine citrate in the treatment of apnea in Chinese preterm infants. [ABSTRACT FROM AUTHOR]

Syphilis and human immunodeficiency virus (HIV) co-infection is expected to play a role in HIV-1-related immunodeficiency progression; however, studies involving syphilis/HIV co-infection have not been conclusive. We investigated the factors associated with co-infection of syphilis and HIV and to assess the effect of syphilis on HIV progression in the context of HIV-1 diversity in an observational cohort of 246 newly-diagnosed HIV-infected but antiretroviral therapy-naive men who have sex with men enrolled in Guangzhou, China between 2008 and 2012. CD4+ cell counts of all the participants were measured from the time of diagnosis until 2015 with an average of 32 ± 18 months. Logistic analysis indicated that patients with syphilis/HIV co-infection were more likely to be older with an adjusted odds ratio (AOR) of 2.48 (95% CI: 1.28–4.80) for those aged between 31 and 40 years and 3.20 (1.11–9.22) for those aged ≥40 years as compared to 16–30 year-olds. The AOR of patients infected with HIV-1 CRF07_BC as compared to CRF01_AE was 2.14 (95% CI: 1.01–4.53). Co-infection of syphilis and HIV was associated with lower baseline CD4+ cell count (0.45, 95% CI: 0.22–0.94), but was not associated with HIV disease progression (HR: 1.03; 95% CI, 0.86–1.23) based on Kaplan–Meier analysis. Our results provide new evidence about the interaction between syphilis and HIV and indicate differential rates of immunodeficiency progression as a function of HIV-1 genetic diversity. [ABSTRACT FROM AUTHOR]

A total of 472 samples from domestic pigs collected in China from 2015 to 2018 were tested for the presence of porcine circovirus types 2 and 3 (PCV2 and PCV3, respectively) by conventional polymerase chain reaction analysis. The prevalence of PCV2, PCV3, and PCV2/3 co-infection was 50.0%, 13.3%, and 6.78%, respectively. The complete genomic sequences of 66 PCV2 isolates and four PCV3 isolates were determined. Based phylogenetic analysis, the PCV2 isolates were assigned to three genotypes, PCV2a, PCV2b, and PCV2d, representing 13.6% (9/66), 25.8% (17/66), and 60.6% (40/66) of the total, respectively. All four PCV3 isolates shared a high degree of similarity in their complete nucleotide sequences (98.8–99.8% identity) and ORF2 amino acid sequences (98.6–99.5% identity). These results indicate that all three PCV2 genotypes (PCV2a, PCV2b, and PCV2d) are present on pig farms and that PCV2d has become the predominant genotype. The predicted amino acid sequences of the four PCV3 isolates indicated that PCV3-CN-JL53/PCV3-CN-LN56, PCV3-CN-HLJ3, and PCV3-CN-0710, belonged to the genotypes PCV3a, PCV3b, and PCV3a-IM, respectively. In view of the great harm that PCV2 causes to the pig industry, the epidemic trend of PCV3 should continue to be closely monitored. This study provides information about the prevalence, genetic diversity, and molecular epidemiology of PCV2 and PCV3 in China from 2015 to 2018. [ABSTRACT FROM AUTHOR]

Background: The capacity of spot urine samples for detecting changes in population sodium and potassium excretion is unclear.Methods: Changes in urinary sodium and potassium excretion, over a 6-month to 2-year interval, were measured from 24-h urine samples and estimated from spot urine samples using several published methods in 3270 Chinese. Additional estimates were made by multiplying individual spot sodium and potassium concentrations by a single estimated 24-h urine volume derived from external data.Results: The measured difference in 24-h urinary excretion between intervention and control groups was -0.35 g (95% CI: -0.68 to -0.02; P = 0.039) for sodium and 0.66 g (95% CI: 0.52 to 0.80; P < 0.001) for potassium, based upon 24-h urine samples. The corresponding estimates of sodium differences for the Tanaka (-0.06 g), Kawasaki (-0.09 g), Intersalt without potassium (-0.09 g) and Intersalt with potassium (-0.14 g) equations were all smaller and identified no reduction in sodium excretion (all P > 0.10). The estimates were -0.65 g for sodium and 1.11 g for potassium using individual spot urine concentrations and an externally derived standard urine volume (both P < 0.01).Conclusions: The published equations were unable to detect the differences in sodium excretion measured by 24-h urine samples. A method based upon spot urine electrolyte concentrations and a standard urine volume may offer an alternative approach to measuring differences in sodium and potassium excretion between population groups without requiring 24-h urine, but will need further investigation. [ABSTRACT FROM AUTHOR]

Forty-one living larch (Larix principis-rupprechtii) trees collected from two sampling sites in 1310-1530 m a.s.l. in the southern Greater Higgnan Mountains in the northeastern China are used to develop a regional tree-ring width chronology. The credible chronology spans 185 years from 1830 to 2014. The results of correlation analyses indicate that moisture is the main climatic factor controlling radial growth of larch trees in this mountainous area. Spatial correlation proves that the regional tree-ring width chronology contains climatic signals representative for a large area including the eastern Mongolian Plateau and Nuluerhu Mountains. A comparison between the newly developed chronology and a May-July Palmer Drought Severity Index (PDSI) reconstruction for the Ortindag Sand Land reveals similar variations, particularly in the low-frequency domain. The tree-ring records also capture a severe and sustained drying trend recorded in the 1920s across a wide area of northern China. [ABSTRACT FROM AUTHOR]

Practical application of photo-assisted bioelectrochemical systems (BESs) for actual etching terminal wastewater (ETW) treatment, requires its energy-saving and high treatment efficiency with simultaneous recovery of multiple heavy metals. Herein photo-assisted self-driven BESs composed of two serially connected microbial fuel cells (MFC) in-situ utilized for powering one microbial electrolysis cell (MEC), are continuously fed with actual ETW. Such BESs achieve enhanced recalcitrant organics mineralization (37.9–38.2%) with simultaneous Cu(II) recovery (68.2 ± 0.4%-69.1 ± 0.4%) in the cathodes of MFCs, along with those (recalcitrant organics mineralization: 29.9 ± 0.4%; Ni(II) recovery: 64.9 ± 0.0% on the cathode electrodes; Zn(II) recovery: 75.7 ± 1.4% at the cathodic bottoms) in the MECs without any external energy consumption, allowing the final effluent meeting the China national wastewater discharge standards. Active species of ·OH, O 2 ·-, holes and H 2 O 2 varying degrees contribute to recalcitrant organics mineralization in the MFC and MEC units. This study provides an alternative zero energy consumption approach for efficient mineralization of recalcitrant organics with simultaneous selective recovery and separation of multiple heavy metals in actual ETW, moving photo-assisted self-driven BESs closer to applicable complex wastewater treatment with simultaneous recovery of multiple value-added heavy metals. [Display omitted] • Photo-assisted self-driven bioelectrochemical systems (BESs) are constructed. • BESs consist of microbial fuel cells (MFCs) and microbial electrolysis cells (MECs). • Photo-assisted self-driven BESs efficiently treat etching terminal wastewater. • Recalcitrant organics are varying degrees mineralized in MFCs and MECs of BESs. • Cu is mainly recovered in MFCs, compared to Ni (electrodes) and Zn (bottoms) in MECs. [ABSTRACT FROM AUTHOR]

Background Fetal interrupted aortic arch (IAA) is a rare cardiac anomaly and its prenatal diagnosis is challenging. The purpose of our report is to evaluate the use of two-dimensional echocardiography (2 DE) and 4D echocardiography with B-flow imaging and spatiotemporal image correlation (4D BF- STIC) in detecting IAA type A ( IAA-A). Materials & Methods Twenty-three cases of confirmed IAA-A identified by fetal echocardiography were involved in the study. The fetal echocardiography image data were reviewed to analyze the ratio of right ventricle to left ventricle ( RV/ LV) diameter, the ratio of main pulmonary artery to ascending aorta ( MPA/ AAO) diameter, and the correlation of RV/ LV diameter ratio and size of ventricular septal defect ( VSD). 4D BF- STIC was performed in 21 fetuses using the sagittal view (4D BF- STIC-sagittal) and the four-chamber view (4D BF- STIC-4 CV) as initial planes of view. An additional 183 normal fetuses were also included in our study. RV/ LV and MPA/ AAO ratios were calculated and compared with that of IAA-A fetuses. Fetal 2 DE, 4D BF- STIC-sagittal, and 4D BF- STIC-4 CV were used to visualize the aortic arch and its associated neck vessels. Six subgroups were evaluated according to gestational age. Results Fetal 2 DE, 4D BF- STIC-sagittal, and 4D BF- STIC-4 CV made the correct prenatal diagnosis of IAA-A in 19/23 (82.6%), 14/21 (66.7%), and 19/21 (90.5%) of patients, respectively. A significantly enlarged MPA combined with symmetric ventricles was found in the IAA-A fetuses, while the size of the VSD was negatively correlated with RV/ LV ratio. 4D BF- STIC-sagittal and 4D BF- STIC-4 CV were better than traditional 2D ultrasound in detecting the aortic arch and neck vessels between 17 and 28 gestational weeks and 29 to 40 gestational weeks in normal fetuses. Conclusion It is demonstrated that IAA-A could be diagnosed by traditional fetal echocardiography, while 4D technique could better display the anatomic structure and the spatial relationships of the great arteries. Use of volume reconstruction may promote its clinical usage and help prenatal diagnosis. [ABSTRACT FROM AUTHOR]

A total of 450 samples from domestic pigs in China were tested for porcine parvoviruses (PPVs) and co-infections with porcine circovirus type 2 (PCV2), and their complete capsid genes were sequenced. The prevalence of PPV1, PPV2, PPV3, PPV4, and PCV2 was 5.56 %, 39.56 %, 45.11 %, 21.56 %, and 47.33 %, respectively, and co-infection with PCV2 occurred in 4 % (PPV1), 22.44 % (PPV2), 24 % (PPV3), and 12 % (PPV4) of the samples. Phylogenetic analysis revealed two main lineages for each virus, and residues that differentiated these viruses were identified. The co-infections of emerging PPVs and PCV2 were prevalent, indicating their cooperative roles in porcine circovirus-associated diseases. [ABSTRACT FROM AUTHOR]

[Display omitted] • Etching terminal wastewater is efficiently treated in MECs of different scales. • MECs performance scales almost with the reactor volume. • Electrode potentials in scaled-up MECs (40 L) are resilient to wastewater strength. • Switch from low to high strengths wastewater alters microbial community composition. The treatment of actual low and high strengths etching terminal wastewater (ETW) from plating and electronic industry meeting national discharge standards is demonstrated in laboratory scale (1 L) and in scaled-up (40 L) microbial electrolysis cells (MECs). Both cylindrical single-chamber MECs achieved complete removal of heavy metals and efficient treatment of organics using either low strength ETW at an hydraulic retention time (HRT) of 5 d, or high strength wastewater at HRTs of 7 d (1 L) or 9 d (40 L). The removal rate of organics and heavy metals increased by 36-fold and scaled almost with the reactor volume ratio of 40. Electrode potentials in the scaled-up MECs (40 L) were resilient to the wastewater strength. Bacterial communities on both anodes and cathodes of the 1 L and the 40 L reactors experienced a selective shock and a significant community change after switching from low to high strengths wastewater, although reactor performance was effectively maintained. This study demonstrates complete removal of multiple heavy metals with simultaneous efficient wastewater treatment in MECs of different scales meeting China national discharge standards and provides a plausible approach for simultaneous removal of value-added products (e.g., heavy metals) and efficient treatment of practical etching terminal wastewater. [ABSTRACT FROM AUTHOR]

marine actinomycete strain BS01 with algicidal activity to the toxic dinoflagellate, Alexandrium tamarense, was isolated from Xiamen Bay, China. Sequence analysis of 16S rDNA demonstrates that BS01 is closely related to the genus Brevibacterium of Actinomycetales. BS01 exhibited algicidal activity in an indirect manner. Additional organic nutrients, but not algal-derived dissolved organic matter, were necessary for the synthesis of yet unidentified algicidal compounds (molecular weight less than 100), which were heat tolerant, a stable in acidic or alkali conditions, and exhibited a wide range of algicidal activity. This is the first report of an actinomycete algicide to the toxic dinoflagellate A. tamarense. Our results indicate that BS01 could be a potential bio-agent for controlling harmful algal blooms. [ABSTRACT FROM AUTHOR]

The land-based oil extraction activity has led to serious pollution of the soil. While microbes may play an important role in the remediation of contaminated soils, ecological effects of oil pollution on soil microbial relationships remain poorly understood. Here, typical contaminated soils and undisturbed soils from seven oilfields of China were investigated in terms of their physicochemical characteristics, indigenous microbial assemblages, bacterial co-occurrence patterns, and metabolic enzymes. Network visualization based on k -core decomposition illustrated that oil pollution reduced correlations between co-existing bacteria. The core genera were altered to those related with oil metabolism (Pseudarthrobacter , Alcanivorax , Sphingomonas , Chromohalobacter and Nocardioides). Under oil pollution pressure, the indigenous bacteria Gammaproteobacteria was domesticated as biomarker and the enzyme expression associated with the metabolism of toxic benzene, toluene, ethylbenzene, xylene and polycyclic aromatic hydrocarbons was enhanced. Functional pathways of xenobiotics biodegradation were also stimulated under oil contamination. Finally, twelve culturable hydrocarbon-degrading microbes were isolated from these polluted soils and classified into Stenotrophomonas , Delftia , Pseudomonas and Bacillus. These results show that the soil microbial communities are transformed under oil pollution stress, and also provide useful information for future bioremediation processes. [Display omitted] • Ecological effects of soil oil contamination were revealed. • Oil-affected microbial communities were enriched with Gammaproteobacteria. • Petroleum contamination altered the soil bacterial co-occurrence pattern. • Oil stress stimulated the expression of BTEX and PAH-related metabolic enzymes. • Twelve hydrocarbon-degrading strains were isolated from oil-polluted soils. [ABSTRACT FROM AUTHOR]

According to the modularization and standardization of program structure in Global/Regional Assimilation and Prediction System (GRAPES), the plug-compatible and transplantable regional meso-scale and global middle-range physics software package is established. The package's component integrality is comparative with the other advanced models physics. A three-level structure of connecting GRAPES physics and dynamic frame has been constructed. The friendly interface is designed for users to plug in their own physics packages. Phenomenon of grid-point storm rainfall in numerical prediction is analyzed with the numerical tests. The scheme of air vertical velocity calculation is improved. Optimizing tests of physics schemes are performed with the correlative parameters adjusting. The results show that the false grid-point storm rainfall is removed by precipitation scheme improving. Then the score of precipitation forecast is enhanced. [ABSTRACT FROM AUTHOR]

This article applies field survey data from Red Yao villages of Longsheng multinationalities autonomous county in the mountainous region of northern Guangxi to examine the current condition of rural village environmental sanitation, with water use in daily life, garbage disposal, and housing as indexes. It shows that the modern transformation of environmental sanitation in Red Yao villages has been driven by factors including the adoption of external sanitation techniques, external interventions, and institutional improvements. Based on their successful experience, it offers some advice for environmental sanitation construction strategies in rural villages in all nationality (minority) regions. [ABSTRACT FROM AUTHOR]

• A quantitative and more rigorous measure for behavioral cost and attitude effect on behavior have been proposed. • Low cost hypothesis is confirmed on our data using new proposed behavioral cost measure and attitude effect on behavior measure. • We included the cost components directly in the survey for a series of pro-environmental behaviors. Key cost components are identified for each behavior of China urban residents through logit regression analysis. • Personal norm and perceived efficacy are also important for some pro-environmental behaviors. There have been many studies on behavioral cost's role in influencing pro-environmental behavior, however, a quantitative and universal measure for behavioral cost is still lacking. In this study, we first made an attempt to construct an indirect yet more rigorous measure for behavioral cost. Only with such a behavioral cost measure can more quantitative studies of behavioral cost's role on behavior become feasible across a series of pro-environmental behaviors. Based on this measure, low cost hypothesis is tested and confirmed with our surveyed data. To extend behavioral cost study beyond recycling, we have carried out an in-depth and extensive study on a series of daily environmental behaviors from China's urban residents, with cost components associated with each behavior directly surveyed. Key behavioral cost components in each studied environmental behavior have been identified through logit regression analysis. Habits are still hindering China urban residents from conducting pro-environmental behaviors across all environmental behaviors significantly. For recycling, improper facility is the major barrier, while for other resource saving behaviors, loss of comfort and financial burden are acting as major behavioral barriers. We also explicitly studied the separate roles of personal norm and perceived efficacy together with attitude and behavioral cost in an integrated framework, and we found that personal norm and perceived efficacy play considerable roles for certain behaviors. [ABSTRACT FROM AUTHOR]

Background: It is well known that unexpected pandemic has led to an increase in mental health problems among a variety of populations.Methods: In this study, an online non-probability sample survey was used to anonymously investigate the anxiety and depression symptoms among medical staff under the COVID-19 outbreak. The questionnaire included Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-Item Scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Factors associated with anxiety and depression symptoms were estimated by logistic regression analysis.Results: A total of 1090 medical staff were investigated in this study. The estimated self-reported rates of anxiety symptoms, depression symptoms and both of the two were 13.3%, 18.4% and 23.9% respectively. Factors associated with self-reported anxiety symptoms include married status (OR=2.3, 95%CI: 1.2, 4.4), not living alone (OR=0.4, 95%CI: 0.2, 0.7), never confiding their troubles to others (OR=2.2, 95%CI: 1.4, 3.5) and higher stress (OR=14.4, 95%CI: 7.8, 26.4). Factors associated with self-reported depression symptoms include not living alone (OR=0.4, 95%CI: 0.3, 0.7), sometimes/often getting care from neighbours (OR=0.6, 95%CI: 0.4, 0.9), never confiding their troubles to others (OR=2.0, 95%CI: 1.3, 3.0) and higher stress (OR=9.7, 95%CI: 6.2, 15.2).Limitations: The study was a non-probability sample survey. Besides, scales used in this study can only identify mental health states.Conclusions: Under outbreak of COVID-19, self-reported rates of anxiety symptoms and depression symptoms were high in investigated medical staff. Psychological interventions for those at high risk with common mental problems should be integrated into the work plan to fight against the epidemic. [ABSTRACT FROM AUTHOR]

Abstract: Chloroacetanilide herbicides are frequently detected in groundwater and surface waters, and pose high risks to aquatic biota. In this study, sodium bisulfite (NaHSO3), a plant growth regulator used in China, was used to remove three chloroacetanilide herbicides including alachlor, acetochlor and S-metolachlor. These herbicides were rapidly dechlorinated by NaHSO3 in neutral conditions. The dechlorination was accelerated with increasing pH, temperature and NaHSO3 concentrations. Kinetic analysis and mass spectrum identification revealed that the reaction followed SN2 nucleophilic substitution, in which the chlorine was replaced by the reactive specie sulfite. Alachlor and its isomer acetochlor had similar reaction rates, whereas they were more readily transformed than S-metolachlor that had larger steric hindrance and weaker electrophilicity. The transformation products were chloroacetanilide ethane sulfonic acids (ESAs), which were also encountered as major metabolites of these herbicides in natural environment via common metabolic pathways and were less toxic to green algae compared to the parent herbicides. These results indicate that NaHSO3 can accelerate transformation of chloroacetanilide herbicides to the less toxic transformation products by nucleophilic substitution and dechlorination in aquatic environment. NaHSO3 can be potentially used for the removal of chloroacetanilide herbicides from wastewater effluent, spill sites and accidental discharge. [Copyright &y& Elsevier]

To estimate the distribution and sources of soil polycyclic aromatic hydrocarbons (PAHs) in metropolitan and adjacent areas, soil samples were collected from urban, suburban and rural locations of Dalian, China, and concentrations of 14 PAHs were determined. The spatial PAH profiles were site-specific and determined by the sources close to the sampling sites. PAH concentrations decreased significantly along the urban–suburban–rural transect. The gradient implied that the fractionation effect influenced PAH distribution. Bivariate plots of selected diagnostic ratios showed general trends of co-variation and allowed to distinguish samples taken from different areas. An improved method, factor analysis (FA) with nonnegative constrains, was used to determine the primary sources and contributions of PAHs in soils. The FA model showed traffic average (74%) and coal related residential emission (26%) were two primary sources to Dalian soils. In addition, the FA model provided reasonable explanations for PAH contributions in soils from different sites. The results suggest that FA with nonnegative constraints is a promising tool for source apportionment of PAHs in soils. [Copyright &y& Elsevier]

Post-migration infection and domestic transmission of HIV-1 between immigrants and local population are critical for the HIV epidemic, but have not been addressed thus far in China. Transmission clusters were analyzed with two cluster reconstruction methods, HIV-TRACE and Cluster Picker, using 1695 HIV-1 pol sequences obtained from 139 HIV-infected foreigners and 1556 Chinese natives in Guangzhou, China from 2008 to 2012. The geographic origin of the HIV-1 sequences was further determined by PastML while the factors associated with recent HIV-1 transmission were documented by logistic regression analysis. HIV-1 genotypes that are prevalent in African and East Asian countries were identified in HIV-infected Chinese subjects and vice versa. In addition, more NRTI drug resistance mutations were found in HIV-infected foreigners than in native Chinese (p < 0.001). HIV-1 transmission between HIV-infected foreigners and native Chinese individuals was documented in 12.95% (18/139) of the HIV-infected foreigners. Furthermore, Asian (odds ratio [OR] = 3.45), male (OR = 16.88) and those with known HIV-1 infection routes (OR = 3.23) were more likely associated with recent HIV-1 transmission in China. The Chinese natives linked to recent HIV-1 transmission were more likely to be infected through men who have sex with men (OR = 3.05) or people who inject drugs (OR = 3.05), rather than by heterosexual transmission. Our study demonstrates the impact of recent HIV-1 transmission between HIV-infected foreigners and Chinese natives on the HIV-1 epidemic in Guangzhou, China. Moreover, the results highlight the importance of phylogenetic analysis of HIV-1 surveillance data and the need for specific prevention strategies that target the immigrant population. • The introduction of HIV-1 clades from foreign immigrants increased genetic diversity of HIV-1 in China. • 12.95% of HIV-infected foreigners involved in the recent HIV-1 transmission with local Chinese natives. • Phylogenetic analysis and transmission network construction of HIV-1 surveillance data are important for precise prevention of HIV-1 epidemic. [ABSTRACT FROM AUTHOR]

Objectives: Invasive lumbar puncture is the conventional method for diagnosing neurosyphilis (NS). We investigated a non-invasive alternative method to detect serum Treponema pallidum-specific antibodies against highly immunogenic antigens TP0171 (TP15), TP0435 (TP17), and TP0574 (TP47) by using luciferase immunosorbent assay., Methods: A total of 816 HIV-negative patients suspected of NS from the Beijing and Guangzhou cohorts were retrospectively selected and tested for serum anti-TP15, TP17, and TP47 IgG antibodies. Two diagnostic prediction models were developed using stepwise logistic regression in the Beijing cohort, and evaluated in the Guangzhou cohort for external validation., Results: Serum antibodies against TP15, TP17, and TP47 showed moderate capability for NS diagnosis in the Beijing cohort and the corresponding area under the receiver operating characteristic curves (AUCs) were 0.722 [95% confidence interval (CI): 0.680-0.762)], 0.780 (95% CI: 0.741-0.817), and 0.774 (95% CI: 0.734-0.811), respectively. An expanded NS prediction model integrated with anti-TP17 and anti-TP47 antibodies showed better performance than the base NS diagnostic model without anti-TP17 and anti-TP47 antibodies with the AUC of 0.874 (95% CI: 0.841-0.906) vs. 0.845 (95% CI: 0.809-0.881) (p = 0.007) in the development cohort, and 0.934 (95% CI: 0.909-0.960) vs. 0.877 (95% CI: 0.840-0.914) (p < 0.001) in validation cohort, respectively. Decision curve analysis revealed that the net benefit of the expanded model exceeded that of the base model when the threshold probability was between 0.10 and 0.95 in both the development and external validation cohorts., Discussion: Serum antibodies against TP17 and TP47 exhibited promising diagnostic capability for NS and significantly enhanced the predictive accuracy of model for NS diagnosis. Our study highlights the potential of serum treponemal antibody detection as a non-invasive method for NS diagnosis to substitute invasive lumbar puncture in NS diagnosis., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Associations of dietary sodium and potassium intake with fracture risk are inconsistent and the effects of salt substitute on fracture incidence are unknown. We assessed the effect of salt substitute compared to regular salt intake on fracture incidence using data from the Salt Substitute and Stroke Study (SSaSS)., Methods: SSaSS was a cluster-randomized controlled trial conducted in 600 villages in northern China. Villages were randomly allocated into intervention and control groups in a 1:1 ratio. Salt substitute was provided to intervention villages and control villages continued regular salt use for 5 years. The primary outcome for this secondary analysis was the incidence of all fractures. Secondary outcomes included incidence of vertebral fracture, non-vertebral fracture, and fracture of unknown or non-specific location., Results: 20,995 participants were included in this study, and 821 fractures occurred during follow-up. Intention-to-treat analyses showed no differences between the salt substitute and regular salt groups in the incidence of all fractures (rate ratio (RR) 0.96; 95% CI 0.81 to 1.14), vertebral fracture (RR 0.82; 95% CI 0.53 to 1.26), non-vertebral fracture (RR 1.05; 95% CI 0.86 to 1.29), or fracture of unknown or non-specific location (RR 0.80; 95% CI 0.54 to 1.18)., Conclusions: Use of salt substitute compared to regular salt had no detectable effect on the incidence of fracture in a population at high risk of cardiovascular disease and fracture., Trial Registration: ClinicalTrials.gov, NCT02092090. Registered on March 12, 2014., (© 2024. The Author(s).)

Background: Household air pollution from solid fuel combustion is a leading cause of age-related diseases worldwide. However, little is known about the association between indoor solid fuel use and sarcopenia, especially in developing countries., Methods: A total of 10,261 and 5129 participants from the China Health and Retirement Longitudinal Study were enrolled in the cross-sectional and follow-up analysis, respectively. The effects of household solid fuel use (for cooking and heating) on sarcopenia were evaluated using generalized linear models in the cross-sectional analysis and Cox proportional hazards regression models in the longitudinal analysis., Results: The prevalence of sarcopenia in the total population, clean cooking fuel users, and solid cooking fuel users were 13.6 % (1396/10,261), 9.1 % (374/4114), and 16.6 % (1022/6147), respectively. A similar pattern was observed for heating fuel users, with a higher prevalence of sarcopenia among solid fuel users (15.5 %) than among clean fuel users (10.7 %). In the cross-sectional analysis, solid fuel use for cooking/heating, separately or simultaneously, was positively associated with an elevated risk of sarcopenia after adjusting for potential confounders. During the four-years follow-up period, 330 participants (6.4 %) with sarcopenia were identified. The multivariate-adjusted hazard ratio (HR) (95 % confidence interval [95 % CI]) for solid cooking fuel users and solid heating fuel users was 1.86(95 % CI:1.43-2.41) and 1.32(95 % CI:1.05-1.66), respectively. Moreover, compared with persistent clean fuel users, participants who switched from clean to solid fuel for heating appeared to have an increased risk of sarcopenia (HR:1.58; 95 % CI:1.08-2.31)., Conclusions: Our findings show that household solid fuel use is a risk factor for sarcopenia development among middle-aged and older Chinese adults. The transition from solid to clean fuel use may help reduce the burden of sarcopenia in developing countries., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: Recent data show that maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) are associated with offspring neurobehavior in childhood. However, little is known about the effect on infants that less than 20 months of age, and whether this association has sex differences., Methods: In this birth cohort study, a total of 661 mother-infant pairs were enrolled in Shanghai, China, between February 2017 and April 2019. Maternal prepregnancy BMI was categorized according to the Chinese classification and GWG according to the 2009 Institute of Medicine (IOM). Neurobehavioral development for infants of 12 months of age was assessed by Gesell Developmental Scale (GDS), which contained five subscales of gross motor, fine motor, adaptive behavior, language, and social behavior., Results: Abnormal maternal prepregnancy BMI and excessive GWG were associated with infant birth weight and/or birth length ( p  < .05), while no influence was found on yearling weight or length. Women who were overweight/obese prior to pregnancy or excessive GWG during pregnancy had infants who were more deficient in neurobehavioral developmental including language ( p  < .01) and/or social behavior ( p  < .05). Specifically, excessive GWG was associated with lower language ability in girls but not boys ( p  < .05)., Conclusions: Aberrant prepregnancy BMI and excessive GWG not only affect the body size of newborn infants, but also impair their neurobehavioral development, suggesting that general guidance to the women should be advised to attain optimal prepregnancy BMI and GWG.

Purpose: To describe the prevalence and analyse the associated factors of possible sarcopenia and sarcopenia among community-dwelling old adults in China, in order to provide effective strategies for early prevention and treatment of sarcopenia., Methods: This cross-sectional study evaluated community-dwelling old adults aged over 60 years. The basic information, morphological indices, body composition, physical activities were collected and assessed. Possible sarcopenia and sarcopenia were diagnosed by the criteria of Asian Working Group for Sarcopenia (AWGS) in 2019. A multivariate logistic regression model with stepwise method was employed to identify factors associated with possible sarcopenia and sarcopenia., Results: In total 729 old adults from Tianjin were included in this study. Eighty-one participants were diagnosed with possible sarcopenia (prevalence of 11.11%). Seventy-five participants were diagnosed with sarcopenia (prevalence of 10.29%). Age (odds ratio (OR):1.047, 95% confidence interval (CI): 1.055-1.090) and lower physical activities (low level OR:4.171, 95% CI:1.790-9.720; medium level OR:2.634, 95% CI:1.352-5.132) were significantly associated with possible sarcopenia. Age (OR:1.187, 95% CI:1.124-1.253), higher body fat percentage (OR:1.225, 95% CI:1.140-1.317), lower BMI (OR:0.424, 95% CI:0.346-0.519), lower mini-mental state examination (MMSE) scores (OR:0.865,95% CI:0.781-0.958) and low physical activities (OR:4.638, 95% CI:1.683-12.782) were significantly associated with sarcopenia., Conclusion: Possible sarcopenia and sarcopenia are prevalent among community-dwelling old adults in China. Ageing and lower physical activities were both associated with possible sarcopenia and sarcopenia. Old adults with sarcopenia more likely have higher body fat percentage, lower BMI and lower cognitive function compared with those without this condition., (© 2022. The Author(s).)

Importance: Lowering sodium intake reduces blood pressure and may reduce the risk of cardiovascular diseases. The use of reduced-sodium salt (a salt substitute) may achieve sodium reduction, but its effectiveness may be associated with the context of its use., Objective: To identify factors associated with the use of salt substitutes in rural populations in China within the Salt Substitute and Stroke Study, a large-scale cluster randomized trial., Design, Setting, and Participants: This sequential mixed-methods qualitative evaluation, conducted from July 2 to August 28, 2018, in rural communities across 3 provinces in China, included a quantitative survey, collection of 24-hour urine samples, and face-to-face interviews. A random subsample of trial participants, selected from the 3 provinces, completed the quantitative survey (n = 1170) and provided urine samples (n = 1025). Interview respondents were purposively selected from the intervention group based on their different ranges of urinary sodium excretion levels. Statistical analysis was performed from September 18, 2018, to February 22, 2019., Exposures: The intervention group of the Salt Substitute and Stroke Study was provided with the free salt substitute while the control group continued to use regular salt., Main Outcomes and Measures: Knowledge, attitudes, and behaviors regarding the use of the salt substitute were measured using quantitative surveys, and urinary sodium levels were measured using 24-hour urine samples. Contextual factors were explored through semistructured interviews and integrated findings from surveys and interviews., Results: A total of 1170 individuals participated in the quantitative survey. Among the 1025 participants with successful urine samples, the mean (SD) age was 67.4 (7.5) years, and 502 (49.0%) were female. The estimated salt intake of participants who believed that high salt intake was good for health was higher; however, it was not significantly different (0.84 g/d [95% CI, -0.04 to 1.72 g/d]) from those who believed that high salt intake was bad for health. Thirty individuals participated in the qualitative interviews (18 women [60.0%]; mean [SD] age, 70.3 [6.0] years). Quantitative and qualitative data indicated high acceptability of and adherence to the salt substitute. Contextual factors negatively associated with the use of the salt substitute included a lack of knowledge about the benefits associated with salt reduction and consumption of high-sodium pickled foods. In addition, reduced antihypertensive medication was reported by a few participants using the salt substitute., Conclusions and Relevance: This study suggests that lack of comprehensive understanding of sodium reduction and salt substitutes and habitual consumption of high-sodium foods (such as pickled foods) were the main barriers to the use of salt substitutes to reduce sodium intake. These factors should be considered in future population-based, sodium-reduction interventions.

Background: Salt substitutes with reduced sodium levels and increased potassium levels have been shown to lower blood pressure, but their effects on cardiovascular and safety outcomes are uncertain., Methods: We conducted an open-label, cluster-randomized trial involving persons from 600 villages in rural China. The participants had a history of stroke or were 60 years of age or older and had high blood pressure. The villages were randomly assigned in a 1:1 ratio to the intervention group, in which the participants used a salt substitute (75% sodium chloride and 25% potassium chloride by mass), or to the control group, in which the participants continued to use regular salt (100% sodium chloride). The primary outcome was stroke, the secondary outcomes were major adverse cardiovascular events and death from any cause, and the safety outcome was clinical hyperkalemia., Results: A total of 20,995 persons were enrolled in the trial. The mean age of the participants was 65.4 years, and 49.5% were female, 72.6% had a history of stroke, and 88.4% a history of hypertension. The mean duration of follow-up was 4.74 years. The rate of stroke was lower with the salt substitute than with regular salt (29.14 events vs. 33.65 events per 1000 person-years; rate ratio, 0.86; 95% confidence interval [CI], 0.77 to 0.96; P = 0.006), as were the rates of major cardiovascular events (49.09 events vs. 56.29 events per 1000 person-years; rate ratio, 0.87; 95% CI, 0.80 to 0.94; P<0.001) and death (39.28 events vs. 44.61 events per 1000 person-years; rate ratio, 0.88; 95% CI, 0.82 to 0.95; P<0.001). The rate of serious adverse events attributed to hyperkalemia was not significantly higher with the salt substitute than with regular salt (3.35 events vs. 3.30 events per 1000 person-years; rate ratio, 1.04; 95% CI, 0.80 to 1.37; P = 0.76)., Conclusions: Among persons who had a history of stroke or were 60 years of age or older and had high blood pressure, the rates of stroke, major cardiovascular events, and death from any cause were lower with the salt substitute than with regular salt. (Funded by the National Health and Medical Research Council of Australia; SSaSS ClinicalTrials.gov number, NCT02092090.)., (Copyright © 2021 Massachusetts Medical Society.)

Introduction: Cardiovascular diseases (CVDs) are the leading causes of death and disability worldwide. Reducing dietary salt consumption is a potentially cost-effective way to reduce blood pressure and the burden of CVD. To date, economic evidence has focused on sodium reduction in food industry or processed food with blood pressure as the primary outcome. This study protocol describes the planned within-trial economic evaluation of a low-sodium salt substitute intervention designed to reduce the risk of stroke in China., Methods and Analyses: The economic evaluation will be conducted alongside the Salt Substitute and Stroke Study: a 5-year large scale, cluster randomised controlled trial. The outcomes of interest are quality of life measured using the EuroQol-5-Dimensions and major adverse cardiovascular events. Costs will be estimated from a healthcare system perspective and will be sought from the routinely collected data available within the New Rural Cooperative Medical Scheme. Cost-effectiveness and cost-utility analyses will be conducted, resulting in the incremental cost-effectiveness ratio expressed as cost per cardiovascular event averted and cost per quality-adjusted life year gained, respectively., Ethics and Dissemination: The trial received ethics approval from the University of Sydney Ethics Committee (2013/888) and Peking University Institutional Review Board (IRB00001052-13069). Informed consent was obtained from each study participant. Findings of the economic evaluation will be published in a peer-reviewed journal and presented at international conferences., Trial Registration Number: ClinicalTrials.gov Registry (NCT02092090)., Competing Interests: Competing interests: Between 24 months and 48 months, salt substitute in SSaSS has been provided by Jiangsu Sinokone Technology Co for free., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Two new aporphine alkaloids, (R)-1,2-methylenedioxy-3,9-dimethoxy-11-hydroxy-N- carbamoyl-noraporphine (1) and 3,10,11-trimethoxy-1,2-methylenedioxy-7-oxoaporphine(2), and one new dihydrochalcone, 4',5'-dimethoxy-2'-hydroxy-3',6'-quinodihydrochalcone (3), along with five known alkaloids were isolated from the ethanol extracts of the stems of Fissistigma oldhamii var. longistipitatum. The compounds were obtained by various classical column chromatographic methods, and the structure elucidation was completed primarily on the basis of spectroscopic analysis, such as UV, NMR and HR-ESI-MS. The isolated compounds were subjected to evaluate cytotoxic activities in vitro, compound 1 had activity against HL-60 and HELA (IC 50 value of 8.4 μM and 5.2 μM, respectively), compound 2 against MCF-7 (IC 50 value of 3.7 μM), compound 3 against HEPG2 (IC 50 value of 10.8 μM), respectively., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Postpartum depression (PPD) is prevalent and may present major adverse impacts on mother and child health. According to previous studies, mostly from the western society, PPD may have complicated etiologies, such as genetic, social and psychological factors. The aim of this study was to explore the associations of some social and clinical factors, particularly those unique in Chinese, with significant PPD symptoms., Methods: A sample of 556 pregnant women in their 36th to 40th gestational week were randomly recruited in a cross-sectional study using a self-reported questionnaire, which collected maternal sociodemographic and clinical information. During their 2nd to 4th postpartum months, 522 participants responded to our screening of significant PPD symptoms, based on a score of Edinburgh Postnatal Depression Scale ≥9., Results: A total of 90 (17.3%) participants were identified with significant PPD symptoms, and the following factors were observed more frequently in women with significant PPD symptoms (PPD + ) than with fewer symptoms (PPD - ): intensive involvement of parents-in-law in a participant's life (living together with her, taking care of her, or discriminating against a female baby), lack of support from husband, cesarean delivery, and breast milk insufficiency (supplemented with formula). After multiple logistic regression analysis, parents-in-law's preference to baby boy while devaluing baby girl, dissatisfaction with husband's support, cesarean delivery, and mixed feeding were strongly associated with significant PPD symptoms., Conclusion: The potential risk factors for significant PPD symptoms, i.e., "son preference" custom, cesarean delivery and mixed feeding, deserve confirmation in continued, especially clinical diagnosis-based longitudinal studies.

The Salt Substitute and Stroke Study is an ongoing 5-year large-scale cluster randomized trial investigating the effects of potassium-enriched salt substitute compared to usual salt on the risk of stroke. The study involves 600 villages and 20,996 individuals in rural China. Intermediate risk markers were measured in a random subsample of villages every 12 months over 3 years to track progress against key assumptions underlying study design. Measures of 24-hour urinary sodium, 24-hour urinary potassium, blood pressure and participants' use of salt substitute were recorded, with differences between intervention and control groups estimated using generalized linear mixed models. The primary outcome of annual event rate in the two groups combined was determined by dividing confirmed fatal and non-fatal strokes by total follow-up time in the first 2 years. The mean differences (95% CI) were -0.32 g (-0.68 to 0.05) for 24-hour urinary sodium, +0.77 g (+0.60 to +0.93) for 24-hour urinary potassium, -2.65 mmHg (-4.32 to -0.97) for systolic blood pressure and +0.30 mmHg (-0.72 to +1.32) for diastolic blood pressure. Use of salt substitute was reported by 97.5% in the intervention group versus 4.2% in the control group (P<.0001). The overall estimated annual event rate for fatal and non-fatal stroke was 3.2%. The systolic blood pressure difference and the annual stroke rate were both in line with the statistical assumptions underlying study design. The trial should be well placed to address the primary hypothesis at completion of follow-up., Competing Interests: Disclosures After 24 months, salt substitute has been provided by Jiangsu Sinokone Technology Co. Ltd for free. The company does not participate in any aspect of the study design or implementation., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To elucidate the association between lifestyle and dietary factors and esophageal squamous cell carcinoma( ESCC) in three different sections of the esophagus., Methods: From January 2010 to December 2016, a hospital-based case-control study was conducted, and a total of 550 patients with ESCC and gender and age( ±3 age) frequency-matched 550 cancer-free control subjects were recruited in this study. Odds ratios( ORs) and their corresponding 95% confidence intervals( CIs) were calculated by using unconditional binary or multinomial logistic regression. Multiple correspondence analysis( MCA) was applied to illustrate the influence of the risk factors on different sections of the esophagus., Results: Tea drinking was associated with lower risk of upper( Ut) and lower thoracic( Lt) ESCC( OR = 0. 40, 95% CI 0. 22-0. 73; OR= 0. 50, 95% CI 0. 31-0. 81; for Ut and Lt, respectively), and lower intake of vegetables increased the risk of Ut and Lt ESCC( OR = 3. 93, 95% CI 1. 61-9. 61; OR =2. 68, 95% CI 1. 30-5. 53; for Ut and Lt, respectively). Intake of hot food, hard food and lower intake of fruits were associated with an elevated risk of the ESCC in all subsites( P<0. 05). The strength of association between drinking and ESCC was lower in middle thoracic( Mt) compared with the Lt ESCC( OR = 0. 58, 95% CI 0. 35-0. 98). Moreover, this reduction of association strength were also found in eating hot food( OR = 0. 45, 95%CI 0. 27-0. 76) and lower intake of vegetables( Ut OR = 0. 44, 95% CI 0. 20-0. 99). However, the association between lower intake of fruits and the Mt ESCC risk was stronger compared with Lt ESCC( OR = 1. 66, 95% CI 1. 08-2. 55). In additional, the association between lower intake of fruits and the Ut ESCC risk was stronger compared with Mt ESCC. Joint category plot of MCA also identified the heterogeneous associations between risk factors and different sections of the esophagus., Conclusion: Differences in risk factors of ESCC in different subsites, intake of hot food, hard food, and lower intake of vegetables were common risk factors for three subsites of ESCC.

To characterize HIV-1 gp41 as an antigen for developing HIV-1 incidence assay and to investigate the impact of HIV-1 genetic diversity on the assay performance, a number of truncated peptides were synthesized to identify the immunodominant epitopes (IDEs) of HIV-1 gp41 protein. Subsequently, the mixed peptides (MP3) or the recombinant protein (MP4) containing HIV-1 gp41 IDEs of the major HIV-1 genotype CRF01&#95;AE, CRF07&#95;BC/ CRF08&#95;BC and subtype B in China were used to verify the sensitivity and specificity of HIV-1 recency testing. We identified the QKFLG and GKIIC motifs located in the loop region of HIV-1 gp41 as the two major IDEs. The surrounding amino acids EAQQHLLQLT and WNSSWSN could block the binding of gp41 peptide and anti-HIV antibody with low avidity, making the gp41 peptide p57 suitable for distinguishing recent and long-term HIV-1 infections. Furthermore, MP3 or MP4-based immunoassay could significantly improve the assay sensitivity and showed 93.33% (140/150) vs. 94.59% (35/37) and 94.08% (143/152) vs. 94.59% (35/37) concordance with commercially available LAg-Avidity EIA test among the cross-sectional and longitudinal samples, respectively. The estimated mean duration of recent infection (MDRI) was 130 days (95% CI: 83-167) and 166 days (95% CI: 123-202) for MP3 and MP4 assays, respectively. Our preliminary results indicate that the HIV-1 gp41 peptide-based immunoassay specifically targeting the major HIV-1 genotype CRF01&#95;AE, CRF07&#95;BC/CRF08&#95;BC and subtype B could serve as a simple incidence assay for differentiating recent and long-term HIV-1 infections in China., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: We aimed to evaluate the performance of the newly developed deep learning Radiomics of elastography (DLRE) for assessing liver fibrosis stages. DLRE adopts the radiomic strategy for quantitative analysis of the heterogeneity in two-dimensional shear wave elastography (2D-SWE) images., Design: A prospective multicentre study was conducted to assess its accuracy in patients with chronic hepatitis B, in comparison with 2D-SWE, aspartate transaminase-to-platelet ratio index and fibrosis index based on four factors, by using liver biopsy as the reference standard. Its accuracy and robustness were also investigated by applying different number of acquisitions and different training cohorts, respectively. Data of 654 potentially eligible patients were prospectively enrolled from 12 hospitals, and finally 398 patients with 1990 images were included. Analysis of receiver operating characteristic (ROC) curves was performed to calculate the optimal area under the ROC curve (AUC) for cirrhosis (F4), advanced fibrosis (≥F3) and significance fibrosis (≥F2)., Results: AUCs of DLRE were 0.97 for F4 (95% CI 0.94 to 0.99), 0.98 for ≥F3 (95% CI 0.96 to 1.00) and 0.85 (95% CI 0.81 to 0.89) for ≥F2, which were significantly better than other methods except 2D-SWE in ≥F2. Its diagnostic accuracy improved as more images (especially ≥3 images) were acquired from each individual. No significant variation of the performance was found if different training cohorts were applied., Conclusion: DLRE shows the best overall performance in predicting liver fibrosis stages compared with 2D-SWE and biomarkers. It is valuable and practical for the non-invasive accurate diagnosis of liver fibrosis stages in HBV-infected patients., Trial Registration Number: NCT02313649; Post-results., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Torque teno sus viruses (TTSuVs) are non-enveloped viruses and have single-stranded, negative sense circular DNA genomes and are widely distributed in pigs. But till now, the prevalence of TTSuVs with porcine circovirus type 2 (PCV2) in pig herds of China is not very clear; and the genetic variation among different TTSuVs isolate is very large and need to divide the subgroups. In this study, the co-infection with TTSuVs and porcine circovrius (PCV) in the pig population of China was investigated and the subgroups of all TTSuVs genomes in Genbank were divided., Results: Results showed that the rate of co-infection with TTSuV1 and TTSuV2 reached 75% in PCV2-positive samples. Also Two TTSuV1 and four TTSuV2 isolates genome sequences were obtained, and the similarity of all TTSuV1 and TTSuV2 genomic sequences in GenBank were compared. Phylogenetic trees indicated that both the TTSuV1 and TTSuV2 sequences could be divided into four genotypes. Interestingly, the sub-genotypes TTSuV1d, TTSuV2c and TTSuV2d exist only in the pig population of China., Conclusions: This study demonstrates that co-infection with TTSuVs and PCVs is very common in the pig population of China, in which the viruses maybe contribute to clinical diseases cooperatively. In addition, three new subgroups of TTSuVs emerged in China for the first time and a high level of variation among different isolates of TTSuV1 and TTSuV2 was indicated by their genetic diversity.

Background: Large studies on semen quality of the general healthy population from China are rare., Methods: A cross-sectional study was performed to evaluate the semen quality of 1346 healthy men residing in Chongqing area of southwest China in 2007. The semen parameters were measured and compared with the World Health Organization (WHO) criteria. A linear regression model was used to examine the determinants of semen quality., Results: The medians were 2.3 ml for semen volume, 77.8 x 10(6) per ml for semen concentration, 167.7 x 10(6) for total sperm count, 33% for sperm rapid progressive motility, 52.6% for sperm progressive motility and 70.9% for total motility. According to WHO criteria, 61.1% of healthy males had at least one semen parameter below normal threshold values. Season and abstinence duration were found to be significantly associated with semen quality (P < 0.001). Age, smoking, alcohol use and BMI had little or no effect on semen parameters., Conclusions: A high proportion of healthy males in Chongqing area of southwest China had abnormal semen parameters values according to WHO criteria. The semen parameters in the study population were markedly different from those reported for the other Chinese, USA and European populations. The differences remain unexplained and may be due to demographic characteristics, lifestyle, environmental factors or genetic variation.