Search

In recent years, several researchers have introduced spherical video-based virtual reality (SVVR) into classroom teaching to help students learn different subjects. In SVVR learning, learners are typically presented with great autonomy over their learning process. Therefore, learners should engage in self-regulated strategy (SRS) learning in order to successfully study in SVVR. However, learners often struggle to self-regulate their learning. Therefore, we implemented a SRS intervention in SVVR. In this study, a SVVR environment was developed to situate students in art history contexts; moreover, the SRS was employed to guide students to improve their performance and to make reflections on their own performance. In order to evaluate the proposed approach's effectiveness, we carried out an experiment in a university art history class. The experiment results reveal more positive effects of the SRS-based SVVR approach compared with the non-SRS-based SVVR approach in terms of the learners' learning achievements, self-regulation, meta-cognitive awareness, as well as self-efficacy. In addition, this study specified that this approach would not have an effect on students' cognitive load. As a result, the SRS-based SVVR approach proposed in the current study was effective in art history education.

Takeaway food has become a prominent component of the diet in urban areas of China, especially for young people. Although dietary intake is a major pathway to contaminants for human exposure, studies on emerging organophosphite antioxidants (OPAs) and organophosphate esters (OPEs) in food are scarce. Here, we investigated four OPAs and 19 OPEs in takeaway foods (n = 99) and paired takeaway food packaging (n = 50) in China. AO168=O (mean: 14.9 ng/g ww), TPPO (mean: 1.05 ng/g ww), and TCIPP (mean: 0.579 ng/g ww) were dominant in the takeaway food. Some OPEs had significant correlations in takeaway food. Emerging OPAs and OPEs in takeaway food varied significantly depending on the packaging materials and food types. AO168 and AO168=O were widespread in the paired takeaway food packaging. The migration efficiencies of emerging OPAs and OPEs were low in takeaway food packaged in aluminum foil. Although the actual contamination of emerging OPAs and OPEs in takeaway food significantly differed from those of in food simulants migrated from paired takeaway food packaging, the results imply that food itself and takeaway food packaging are potential contamination sources of emerging OPAs and OPEs in takeaway food. The average estimated dietary intakes of emerging OPAs and OPEs were 465 ng/kg body weight (bw)/day and 91.9 ng/kg bw/day, respectively. The exposure risk of emerging OPAs and OPEs through takeaway food intake is low in China. [ABSTRACT FROM AUTHOR]

This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A (RVA) in the Pearl River Delta region of Guangdong Province, China. This study included individuals aged 28 days–85 years. A total of 706 stool samples from patients with acute gastroenteritis collected between January 2019 and January 2020 were analyzed for 17 causative pathogens, including RVA, using a Gastrointestinal Pathogen Panel, followed by genotyping, virus isolation, and complete sequencing to assess the genetic diversity of RVA. The overall RVA infection rate was 14.59% (103/706), with an irregular epidemiological pattern. The proportion of co-infection with RVA and other pathogens was 39.81% (41/103). Acute gastroenteritis is highly prevalent in young children aged 0–1 year, and RVA is the key pathogen circulating in patients 6–10 months of age with diarrhea. G9P[8] (58.25%, 60/103) was found to be the predominant genotype in the RVA strains, and the 41 RVA-positive strains that were successfully sequenced belonged to three different RVA genotypes in the phylogenetic analysis. Recombination analysis showed that gene reassortment events, selection pressure, codon usage bias, gene polymorphism, and post-translational modifications (PTMs) occurred in the G9P[8] and G3P[8] strains. This study provides molecular evidence of RVA prevalence in the Pearl River Delta region of China, further enriching the existing information on its genetics and evolutionary characteristics and suggesting the emergence of genetic diversity. Strengthening the surveillance of genotypic changes and gene reassortment in RVA strains is essential for further research and a better understanding of strain variations for further vaccine development. [ABSTRACT FROM AUTHOR]

Escherichia coli is a common Gram-negative human pathogen. The emergence of E. coli with multiple-antibiotic-resistant phenotypes has become a serious health concern. This study reports the whole-genome sequences of third-generation cephalosporin-resistant (3GC-R) and multidrug-resistant (MDR) E. coli EC6868 and explores the acquired antibiotic-resistance genes (ARGs) as well as their genetic contexts. Methods: E. coli EC6868 was isolated from a vaginal secretion sample of a pregnant patient in China. The antimicrobial susceptibility was assessed, and whole-genome sequencing was conducted. The acquired ARGs, insertion sequence (IS) elements, and integrons within the genome of E. coli EC6868 were identified, and the genetic contexts associated with the ARGs were analyzed systematically. Results: E. coli EC6868 was determined to belong to ST69 and harbored a 144.9-kb IncF plasmid (pEC6868-1) with three replicons (Col156, IncFIBAP001918, and IncFII). The ESBL gene blaCTX-M-27 was located on the structure "∆ISEcp1-blaCTX-M-27-IS 903B", which was widely present in the species of Enterobacteriales. Other ARGs carried by plasmid pEC6868-1 were mainly located on the 18.9-kb IS 26-composite transposon (five copies of intact IS 26 and one copy of truncated IS 26) composing of IS 26-mphA-mrx(A)-mphR(A)-IS 6100, ∆TnAs3-eamA-tet(A)-tetR(A)-aph(6)-Id-aph(3")-Ib-sul2-IS 26, and a class 1 integron, which was widely present on IncF plasmids of E. coli, mainly distributed in ST131, ST38, and ST405. Notably, pEC6868 in our study was the first report on a plasmid harboring the 18.9-kb structure in E. coli ST69 in China. Conclusion: The 3GC-R E. coli ST69 strain with an MDR IncF plasmid carrying blaCTX-M-27 and other ARGs, conferring resistance to aminoglycosides, macrolides, sulfonamides, tetracycline, and trimethoprim, was identified in a hospital in China. Mobile genetic elements including ISEcp1, IS 903B, IS 26, Tn 3, IS 6100 and class 1 integron were found within the MDR region, which could play important roles in the global dissemination of these resistance genes. [ABSTRACT FROM AUTHOR]

Air pollution is potentially leading to cancer mortality; however, there is little evidence for a link between nasopharyngeal carcinoma and air pollution. In particular, limited studies have examined the role of traffic and multiple chemical components on the prognosis of this carcinoma. Here, we hypothesized that fine particulate matter (PM2.5) and traffic-related compositions, i.e., black carbon and organic matter, and ozone (O3), might be associated with increased mortality. We collected individual-level data from a 10-year nasopharyngeal cohort in southern China. Time-varying Cox models were developed. Traffic proximity and road density were studied. Results show that The hazard ratios for each interquartile range elevation in O3, black carbon and organic matter were 1.14, 1.21, and 1.22, respectively, whereas hazards for PM2.5 were significant only at above 31.2 μ g / m 3 . Women and patients below 49 years were susceptible to PM2.5, while men and patients above 50 years were vulnerable to high levels of black carbon, organic matter, and O3. The mortality risks were 28–33% or 16–73% greater for those living near traffic or in high-road density areas. There were positive associations between multiple air pollutants and nasopharyngeal carcinoma mortality among various subgroups. [ABSTRACT FROM AUTHOR]

An imbalance in urban development in China has become a contradiction. Points of Interest (POIs) serve as representations of the spatial distribution of urban functions. Analyzing POI spatial co-occurrence patterns can reveal the agglomeration patterns of urban functions across cities at different levels, providing insights into imbalances in urban development. Using POI data from 297 cities in China, the Word2vec model was employed to model the POI spatial co-occurrence patterns, allowing for the quantification of fine-granular urban functionality. Subsequently, the cities were clustered into five tiers representing different levels of development. An urban hierarchical disparity index and graph were introduced to examine variations in urban functions across different tiers. A significant correlation between POI spatial co-occurrence patterns and the GDP of cities at different levels was demonstrated. This study revealed a notable polarization trend characterized by the development of top-tier cities and lagging tail-end cities. Top-tier cities exhibit advantages in terms of their commercial environments, such as international banks, companies, and transportation facilities. Conversely, tail-end cities face deficiencies in urban infrastructure. It is crucial to coordinate resource allocation and establish sustainable development strategies that foster mutual support between the top-tier and tail-end cities. [ABSTRACT FROM AUTHOR]

Background: Despite evidence that severe and poorly controlled asthma are associated with more clinical unmet needs and intensive utilization of healthcare resources, limited data is available on severe asthma expenditure in China. The study aimed to assess Medical Resource Utilization (MRU) costs of asthma and explore the cost drivers in order to better understand the economic burden of the Chinese population suffered from asthma. Methods: A retrospective analysis was conducted using Chinese sampled national claim database. Patients aged 6 years and above with primary diagnosis of asthma and asthma-related medical visit/hospitalization during 2015 were included. Medication was used as a proxy per the GINA and China guideline to identify asthma severity (i.e. mild, moderate, and severe). multiple linear regression model was conducted to identify MRU costs drivers. Results: 7,254 patients diagnosed with asthma were included: 4,529 (62.4%), 2,200 (30.3%), and 525 (7.2%) had mild, moderate, and severe asthma, respectively. On average, each severe patient spent 6,782 Chinese Yuan (CNY) on asthma treatment and had 57.0% hospitalization rate during the year, 3.9- and 4.4-fold of the average of overall population (P < 0.001 for both). The proportion of patients experiencing exacerbation significantly higher in the severe asthma population (66.5%; P < 0.001) compared to mild (30.0%) and moderate (16.8%) groups. In subgroup with 1,660 samples had annual consecutive data, severe patients had annual cost of CNY 8,314 and 52.2% hospitalization rate. 13% of severe patients who had frequent severe exacerbation (≥ 2 events) experienced the highest annual average cost CNY 23,037, P < 0.001) whereas children aged from 6 to 14 with a lower annual cost of CNY 1,094.2, 1,660.2 and 3,020.2 for mild, moderate, and severe patients respectively. The multiple model identified degree of severity, control status, complications, age, and live region as independent drivers of MRU costs. Conclusions: Chinese asthma patients bear heavy economic burden. Severe asthma associated with higher MRU (mainly from hospitalization) and costs compared with mild to moderate asthma in China. More efforts should be devoted to the control of the disease severity and complication as the main drivers of asthma cost. [ABSTRACT FROM AUTHOR]

After entering the new century, the role of science and technology and innovation in promoting economic development has become increasingly obvious, and the Chinese government has also attached great importance to patent management. With the joint efforts of the people of the whole country, the number of patent applications in China has been among the highest in the world for many consecutive years. However, from the perspective of patent quality, there is still a certain gap with developed countries, resulting in generally low efficiency for Chinese export enterprises. Therefore, it is of great significance to explore the relationship between the quality of patents and the competitiveness of exporting enterprises. Through variance calculation, we constructed a countermeasure system for using intellectual property rights to enhance competitiveness. The experimental results show that the patent quality is proportional to the competitiveness of export enterprises, and the higher the patent quality, the stronger the competitiveness of export enterprises. The development of this study further clarifies the important value of patent quality, which helps export enterprises adjust their development strategies and effectively enhance their competitiveness. [ABSTRACT FROM AUTHOR]

Background: Schistosoma infection is a significant public health issue, affecting over 200 million individuals and threatening 700 million people worldwide. The species prevalent in China is Schistosoma japonicum. Recent studies showed that both gut microbiota and metabolome are closely related to schistosomiasis caused by S. japonicum, but clinical study is limited and the underlying mechanism is largely unclear. This study aimed to explore alterations as well as function of gut microbiota and metabolite profile in the patients with S. japonicum infection. Methods: This study included 20 patients diagnosed with chronic schistosomiasis caused by S. japonicum, eight patients with advanced schistosomiasis caused by S. japonicum and 13 healthy volunteers. The fresh feces of these participators, clinical examination results and basic information were collected. 16S ribosomal RNA gene sequencing was used to investigate gut microbiota, while ultraperformance liquid chromatography-mass spectrometry (UHPLC-MS) was applied to explore the metabolome of patients in different stages of schistosomiasis. Results: The study found that gut microbiota and metabolites were altered in patients with different stages of S. japonicum infection. Compared with healthy control group, the gut microbial diversity in patients with chronic S. japonicum infection was decreased significantly. However, the diversity of gut microbiota in patients with chronic schistosomiasis was similar to that in patients with advanced schistosomiasis. Compared with uninfected people, patients with schistosomiasis showed decreased Firmicutes and increased Proteobacteria. As disease progressed, Firmicutes was further reduced in patients with advanced S. japonicum infection, while Proteobacteria was further increased. In addition, the most altered metabolites in patients with S. japonicum infection were lipids and lipid-like molecules as well as organo-heterocyclic compounds, correlated with the clinical manifestations and disease progress of schistosomiasis caused by S. japonicum. Conclusions: This study suggested that the gut microbiota and metabolome altered in patients in different stages of schistosomiasis, which was correlated with progression of schistosomiasis caused by S. japonicum. This inter-omics analysis may shed light on a better understanding of the mechanisms of the progression of S. japonicum infection and contribute to identifying new potential targets for the diagnosis and prognosis of S. japonicum infection. However, a large sample size of validation in clinic is needed, and further study is required to investigate the underlying mechanism. [ABSTRACT FROM AUTHOR]

The 1931 Yangtze River flood in eastern China, which had an associated death toll of over 2 million, is regarded as one of the world's deadliest natural disasters on record. However, due to the lack of meteorological data before the 1950s, the causes of this event are rarely investigated. Here, we combine multiple lines of evidence from recently available historical observations, reanalysis datasets, and atmospheric general circulation model simulations driven by historical sea surface temperatures (SSTs) that cover the early twentieth century to reveal the physical mechanisms underlying this flood. We find that the flooding in 1931 along the Yangtze River valley was dominated by July rainfall. Although the rainfall totals in July 1931 were not the largest in history (ranking second over the past century), the totals exceeded those for many other pluvial years between 1951 and 2010 in terms of its persistence, which was associated with a steady western Pacific subtropical high (WPSH). The flooding resulted from the combined effects of tropical El Niño–related SST forcing and extratropical wave activities over the Eurasian continent. On the one hand, warm SST anomalies in the tropical Indian Ocean following an El Niño event led to the southwestward extension of the WPSH. On the other hand, the southward shift of the westerly jet due to extratropical wave activities prevented the normal northward movement of the WPSH typical in July. Additionally, the impact that the preceding springtime precipitation and soil moisture had on the summer flood of 1931 is also discussed. [ABSTRACT FROM AUTHOR]

Simple Summary: Low-dose computed tomography (LDCT) has become the standard approach for lung cancer screening, but the definition of populations at high risk of lung cancer still remains inconsistent. Several studies on the cost-effectiveness analysis of LDCT screening for lung cancer in China were identified. The majority of them have focused on the cost-effectiveness analysis of LDCT screening with different starting ages. This economic evaluation assessed up to 36 LDCT screening strategies for current smokers with different starting ages, stopping ages and smoking eligibility criteria. The findings proved that annual screening for those aged 55 to 79 who smoked more than 20 pack-years could be the most recommended strategy for current smokers in the whole of China. Compared with previous studies in China, we provided a more extensive economic evaluation of LDCT screening and provided references and suggestions for the update of the screening guidelines. Although the effectiveness of lung cancer screening by low-dose computed tomography (LDCT) could be shown in China, there could be variation in the evidence concerning the economic impact. Our study explores the cost-effectiveness of lung cancer screening and optimizes the best definition of a high-risk population. A Markov model consisting of the natural history and post-diagnosis states was constructed to estimate the costs and quality-adjusted life years (QALYs) of LDCT screening compared with no screening. A total of 36 distinct risk factor-based screening strategies were assessed by incorporating starting ages of 40, 45, 50, 55, 60 and 65 years, stopping ages of 69, 74 and 79 years as well as smoking eligibility criteria. Screening data came from community-based mass screening with LDCT for lung cancer in Guangzhou. Compared with no screening, all screening scenarios led to incremental costs and QALYs. When the willingness-to-pay (WTP) threshold was USD37,653, three times the gross domestic product (GDP) per capita in China, six of nine strategies on the efficiency frontier may be cost-effective. Annual screening between 55 and 79 years of age for those who smoked more than 20 pack-years, which yielded an incremental cost-effectiveness ratio (ICER) of USD35,000.00 per QALY gained, was considered optimal. In sensitivity analyses, the result was stable in most cases. The trends of the results are roughly the same in scenario analyses. According to the WTP threshold of different regions, the optimal screening strategies were annual screening for those who smoked more than 20 pack-years, between 50 and 79 years of age in Zhejiang province, 55–79 years in Guangdong province and 65–74 years in Yunnan province. However, annual screening was unlikely to be cost-effective in Heilongjiang province under our modelling assumptions, indicating that tailored screening policies should be made regionally according to the local epidemiological and economic situation. [ABSTRACT FROM AUTHOR]

Forest phenology is sensitive to climate change, and its responses affect many land surface processes, resulting in a feedback effect on climate change. Human activities have been the main driver of climate change's long-term shifts in temperature and weather patterns. Forest phenology, understood as the timing of the annual cycles of plants, is extremely sensitive to changes in climate. Quantifying the responses of temperate forest phenology under an elevational range of topographic conditions that mimic climate change is essential for making effective adaptive forest ecosystem management decisions. Our study utilized the Google Earth Engine (GEE), gap filling, and the Savitzky–Golay (GF-SG) algorithm to develop a long-time series spatio-temporal remote sensing data fusion. The forest phenology characteristics on the north slope of Changbai Mountain were extracted and analyzed annually from 2013 to 2022. Our study found that the average start of the growing season (SOS) on the north slope of Changbai Mountain occurred between the 120th–150th day during the study period. The end of the growing season (EOS) occurred between the 270th–300th day, and the length of the growing season (LOS) ranged from the 110th–190th day. A transect from the northeast to southwest of the study area for a 10-year study period found that SOS was delayed by 39 d, the EOS advanced by 32 d, and the LOS was gradually shortened by 63 d. The forest phenology on the north slope of Changbai Mountain showed significant topographic differentiations. With an increase of 100 m in altitude, the mean SOS was delayed by 1.71 d (R2 = 0.93, p < 0.01). There were no obvious trends in EOS variation within the study area altitude gradient. LOS decreased by 1.23 d for each 100 m increase in elevation (R2 = 0.90, p < 0.01). Forests on steep slopes had an earlier SOS, a later EOS, and a longer LOS than forests on gentle slopes. For each degree increase in slope, SOS advanced by 0.12 d (R2 = 0.53, p = 0.04), EOS was delayed by 0.18 d (R2 = 0.82, p = 0.002), and the LOS increased by 0.28 d (R2 = 0.78, p = 0.004). The slope aspect had effects on the EOS and the LOS but had no effect on the SOS. The forest EOS of the south aspect was 3.15 d later than that of the north aspect, and the LOS was 6.47 d longer. Over the 10-year study period, the phenology differences between the north and south aspects showed that the LOS difference decreased by 0.85 d, the SOS difference decreased by 0.34 d, and the EOS difference decreased by 0.53 d per year. Our study illustrates the significance of the coupling mechanism between mountain topography and forest phenology, which will assist our future understanding of the response of mountain forest phenology to climate change, and provide a scientific basis for further research on temperate forest phenology. [ABSTRACT FROM AUTHOR]

Background: EQ-5D-3L has been used in the National Health Services Survey of China since 2008 to monitor population health. The five-level version of EQ-5D was developed, but there lacks evidence to support the use of five-level version of EQ-5D in China. This study was conducted to compare the measurement properties of both the EQ-5D-3L and EQ-5D-5L in quantifying health-related quality of life (HRQoL) burden for 4 different health conditions in China. Methods: Participants from China were recruited to complete the 3L and 5L questionnaire via Internet. Quota was set to recruit five groups of individuals, with one group of individuals without any health condition and one group of generalized anxiety disorder (GAD), HIV/AIDS, chronic Hepatitis B (CHB), or depression, respectively. The 3L and 5L were compared in terms of response distributions, percentages of reporting 'no problems', index value distributions, known-group validity and their relative efficiency. Results: In total, 500 individuals completed the online survey, including 140 healthy individuals, 122 individuals with hepatitis B, 107 with depression, 90 individuals with GAD and 101 with HIV/AIDS. 5L also had smoother and less clustered index value distributions. Healthy group showed different response distributions to the four condition groups. The percentage of reporting 'no problems' decreased significantly in the 5L in all domains (P < 0.01), especially in the pain/discomfort dimension (relative difference: 43.10%). Relative efficiency suggested that 5L had a higher absolute discriminatory power than the 3L version between healthy participant and the other 4 condition groups, especially for the HIV/AIDS group when the 3L results was not significant. Conclusions: The 5L version may be preferable to the 3L, as it demonstrated superior performance with respect to higher sensitivity to mild health problems, better relative efficiency and responses and index value distributions. [ABSTRACT FROM AUTHOR]

The Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol optical depth (AOD) has been widely used in atmospheric environment and climate change research. Based on data of the Aerosol Robotic Network and Sun–Sky Radiometer Observation Network in the Yangtze River Delta, the retrieval accuracies of MODIS C6.1 Dark Target (DT), Deep Blue (DB), and C6.0 Multi-angle Implementation of Atmospheric Correction (MAIAC) products under different land cover types, aerosol types, and observation geometries were analyzed. About 65.64% of MAIAC AOD is within the expected error (Within EE), which is significantly higher than 41.43% for DT and 56.98% for DB. The DT product accuracy varies most obviously with the seasons, and the Within EE in winter is more than three times that in spring. The DB and MAIAC products have low accuracy in summer but high in other seasons. The accuracy of the DT product gradually decreases with the increase in urban and water land-cover proportion. After being corrected by bias and mean relative error, the DT accuracy is significantly improved, and the Within EE increases by 24.12% and 32.33%, respectively. The observation geometries and aerosol types were also examined to investigate their effects on AOD retrieval. [ABSTRACT FROM AUTHOR]

Background and Objectives: Vaccine is the most essential avenue to prevent hepatitis B virus (HBV) infection in infants and preschool children in China, with the largest populations carrying HBV in the world. This study aimed to evaluate the factors associating the response level of anti-HBs in children, providing instructions for HBV prevention clinically.Methods: The children taking physical examinations in the Third Xiangya Hospital from January 2013 to April 2020 were recruited. Telephone follow-up were adopted to collect further information. Univariate logistic regression was used to analyse the relationship between age and anti-HBs expression. Grouping by age and anti-HBs expression, we used chi-square test and T test to compare qualitative and quantitative data between positive group and negative group in each age subgroup. The meaningful variables (P < 0.10) in chi-square test or T test were further assessed with collinearity and chosen for univariate and multivariate logistic regression analysis by the stepwise backward maximum likelihood method (αin = 0.05, αout = 0.10).Results: A total of 5838 samples (3362 males, 57.6%) were enrolled. In total, the incidence of negative anti-HBs increased with age[OR = 1.037(1.022-1.051)]. Multivariate logistic regression analysis illustrated that anemia[OR = 0.392(0.185-0.835)], age[OR = 2.542(1.961-3.295)] and Vit D[OR = 0.977(0.969-0.984)] in 0.5-2.99 years subgroup, Zinc deficiency[OR = 0.713(0.551-0.923] and age[OR = 1.151(1.028-1.289)] in 3-5.99 years subgroup, Vit D[OR = 0.983(0.971-0.995)] in 12-18 years subgroup had significant association with anti-HBs.Conclusions: This retrospective study illustrated that age, anemia status, zinc deficiency and vitamin D were associated with anti-HBs expression in specific age groups of children, which could serve as a reference for the prevention of HBV. [ABSTRACT FROM AUTHOR]

Introduction: The standard EQ-5D-Y-3L valuation protocol applies DCE data as the primary preference source to model the relative importance of dimensions while cTTO data served to anchor the DCE coefficients onto the QALY scale. This study aims to estimate an EQ-5D-Y-3L value set for China following this protocol, but with a larger cTTO design to better understand the role of cTTO data in estimating EQ-5D-Y-3L value sets. Methods: In total, 150 choice sets and 28 EQ-5D-Y-3L health states were valued using DCE and cTTO methods with two independent samples, respectively. General public from 14 different regions were recruited using quota sampling method to achieve representativeness. We compared two modelling strategies: (1) fit the DCE data with mixed logit model with correlated coefficients and a subsequent mapping procedure for anchoring; (2) fit the DCE and TTO data jointly in a hybrid model. Two evaluation criteria (1) coefficient significance and monotonicity; (2) prediction accuracy of the observed cTTO values were used to select the value set. Results: In total, 1476 individuals participated in the study, with 1058 participated the DCE interview and 418 participated the cTTO interview. The highest mean TTO value was 0.924 for state 11112 and the lowest mean TTO value was − 0.088 for state 33333. The hybrid model with an A3 term performed the best and was selected as the value set. Discussion: Following the international protocol and using a larger cTTO design, this study established the EQ-5D-Y-3L value set using a hybrid model for China. Future EQ-5D-Y-3L valuation study could consider using a larger cTTO design for estimating the value set. [ABSTRACT FROM AUTHOR]

Background: Lung cancers arising in never smokers have been suggested to be substantially different from lung cancers in smokers at an epidemiological, genetic and molecular level. Focusing on non-small cell lung cancer (NSCLC), we characterized lung cancer patients in China looking for demographic and clinical differences between the smoking and never-smoking subgroups.Methods: In total, 891 patients with NSCLC, including 841 with adenocarcinoma and 50 with squamous cell carcinoma, were recruited in this study. Association of smoking status with demographic and clinical features of NSCLC was determined, and risk factors for lymph node metastasis and TNM stage were evaluated using Multivariate logistic regression analysis.Results: In patients with adenocarcinoma, never smokers showed a younger age at diagnosis (54.2 ± 12.7vs. 59.3 ± 9.4, padjusted<0.001), a lower risk for lymph node metastasis than smokers (7,6% vs. 19.5%, padjusted<0.001) and less severe disease as indicated by lower percentages of patients with TNM stage of III or IV (5.5% vs. 14.7%, padjusted<0.001 ). By contrast, these associations were not observed in 50 patients with squamous cell carcinoma. Multivariate logistic regression analysis showed that smoking status was a risk factor for lymph node metastasis (OR = 2.70, 95% CI: 1.39-5.31, p = 0.004) but not for TNM stage (OR = 1.18, 95% CI: 0.09-14.43, p = 0.896) in adenocarcinoma.Conclusion: This study demonstrates that lung adenocarcinoma in never smokers significantly differ from those in smokers regarding both age at diagnosis and risk of lymph node metastasis, supporting the notion that they are distinct entries with different etiology and pathogenesis. [ABSTRACT FROM AUTHOR]

In recent years, increasing evidence supports the notion that obesity risk is affected by residential greenness. However, limited studies have been established in low- and middle-income countries, especially in China. The study aimed to evaluate the associations of residential greenness with obesity and body mass index (BMI) level in Chinese rural-dwelling adults. A total of 39,259 adults from the Henan Rural Cohort Study (HRCS) were included in the analyses. According to the guideline for prevention and control of overweight and obesity in Chinese adults, obesity was defined as BMI ≥ 28 kg/m2. Residential greenness was measured by satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). Generalized linear mixed models were used to study the associations between exposure to residential greenness with obesity and BMI level. Higher residential greenness was significantly correlated with lower odds of obesity and BMI level. For example, in the full-adjusted analyses, an interquartile range (IQR) increase in EVI500-m was linked with reduced odds of obesity (OR = 0.77, 95%CI 0.72–0.82) and BMI level (β = − 0.41 kg/m2, 95%CI − 0.48 to − 0.33 kg/m2). Mediation analyses showed air pollution and physical activity could be potential mediators in these associations. Besides, we found that the association of NDVI500-m with BMI was stronger in females and low-income populations. Higher residential greenness was associated with a lower prevalence of obesity and BMI level, particularly among females and the low-income population. These relationships were partially mediated by reducing air pollution and increasing physical activity. [ABSTRACT FROM AUTHOR]

Copyright of Advances in Atmospheric Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An analytical conversion method was developed for the self-balanced test results of monopile bearing capacity in layered soils to realize the better applicability of the self-balanced test theory for the bearing capacity test of foundation piles. To the additional settlement of the lower pile bottom brought on by the negative friction of the upper pile soil during the loading process in layered soils, the interaction effect between the upper piles and lower piles is first taken into account. To accurately convert the results of the self-balanced test pile into the traditional static load test curve form and solve the ultimate bearing capacity, the displacements and internal forces at micro-segment piles in each layer of soil were obtained using the finite difference method. Then, for verification, conventional static test piles and indoor model tests were conducted in a multi-layered ground foundation. The outcome demonstrates that the simplified conversion method's bearing capacity of the test pile is greater than that of the traditional static pressure test, the analytical conversion method's Q-s curve is relatively similar to the results of the conventional static load test, and the accuracy of the analytical conversion results is increased by about 9.3 percent. At the same time, the analytical conversion method was applied to the self-balanced test project of bored cast-in-place piles in Wutong Garden, Laibin, Guangxi, China, and the accurate bearing capacity and internal force deformation characteristics were obtained. The accuracy of the calculation result is improved by 12% compared with that of the simple conversion calculation result. Therefore, it can be widely promoted and applied in self-balanced pile bearing capacity test projects. [ABSTRACT FROM AUTHOR]

Introduction: Wearable devices, including smart wristbands and watches, are often used with e-health applications (apps). The users' characteristics of wrist wearable devices currently lack description, and the cardiovascular disease (CVD) high-risk rate of users remains unknown. Purpose: This study aimed to (1) describe the basic characteristics and habits of users of the "Amazfit Health" app and Huami wrist wearable devices and (2) analyze the proportion and define the population characteristics of users with a high risk of developing CVD. Subjects and Methods: This study included users >18 years of age, residing in mainland China, using the "Amazfit Health" app and Huami wearable devices. Devices data and users' self-reported information were collected in the app. The risk stratification was based on WHO/ISH cardiovascular risk prediction charts for the Western Pacific Region. Subjects with CVD history, total cholesterol ≥8 mmol/L, or ≥10% predicted CVD risk and those with <10% predicted CVD risk were considered to be at high and low risk of developing CVD, respectively. Results: Data were obtained from 80,098 (total users) and 10,866 users (subjects) for risk stratification. The age of the total users and subjects were 45.6 ± 15.4 and 50.7 ± 14.0 years, respectively. The number of male and female users was 50,024, and 30,074 in total users, and 7,284, and 3,582 in subjects, respectively. The body mass index of total users and subjects was 24.0 ± 4.6 kg/m2 and 24.6 ± 3.8 kg/m2, respectively. By classifying users' residences into first-tier cities, municipalities and provincial capitals, and other areas, the numbers of total users were 20,179, 28,213, and 31,137, and subjects were 2,587, 3,966, and 4,269, respectively. The number of subjects with high CVD risk was 1,161, accounting for 10.7% of all subjects. Conclusions: Users with high CVD risk only accounted for a small proportion of the population of wearable devices users. [ABSTRACT FROM AUTHOR]

Rice‐fish co‐culture system has a history of more than 2,000 years in Asia and has been recognized as one of FAO's Globally Important Agricultural Heritage Systems (GIAHS). To date, few studies have explored rice‐fish co‐culture effects on the relationship between predator–prey aggregations and associated tri‐trophic cascades of predatory spiders, insect herbivores and rice. Indeed, predators have been shown to increase prey spatial aggregation but it is still not clear how fish (tertiary consumers) affect aggregations and interactions of their prey on multiple trophic levels (i.e. predatory spiders and rice insect herbivores).Here, we conducted a 2‐year experiment to measure the abundance and distribution of herbivores (leafrollers, stemborers and planthoppers) and their predators (spiders) along with rice yield in rice‐fish co‐culture versus monoculture‐rice (fish free) systems in eastern China. We analysed spatial aggregations of herbivores and predators using geostatistics and used correlations to examine tri‐trophic interactions.Results showed that co‐culture enhanced predatory spider and herbivore spatial aggregations, which in turn increased biocontrol of herbivores by predators, decreased herbivore damage and increased rice productivity.Synthesis and applications. Fish presence increased spatial aggregation of two different trophic levels, which enhanced a tri‐trophic cascade of predatory spiders, insect herbivores and rice in co‐culture systems. Our approach linking spatial aggregations of herbivores and predators with trophic cascades can be applied to study trophic interactions in other ecosystems. Incorporating fish into monoculture paddy fields can increase both natural pest control by predatory spiders and crop productivity via aggregation, and thus increase multiple ecosystem services. [ABSTRACT FROM AUTHOR]

Snail intermediate host monitoring and control are essential for interrupting the parasitic disease schistosomiasis. Identifying large-scale high-risk areas of snail spread after floods has been greatly facilitated by remote sensing imagery. However, previous studies have usually assumed that all inundation areas carry snails and may have overestimated snail spread areas. Furthermore, these studies only used a single environmental factor to estimate the snail survival risk probability, failing to analyze multiple variables, to accurately distinguish the snail survival risk in the snail spread areas. This paper proposes a systematic framework for early monitoring of snail diffusion to accurately map snail spread areas from remote sensing imagery and enhance snail survival risk probability estimation based on the snail spread map. In particular, the flooded areas are extracted using the Sentinel-1 Dual-Polarized Water Index based on synthetic aperture radar images to map all-weather flooding areas. These flood maps are used to extract snail spread areas, based on the assumption that only inundation areas that spatially interacted with (i.e., are close to) the previous snail distribution regions before flooding are identified as snail spread areas, in order to reduce the misclassification in snail spread area identification. A multiple logistic regression model is built to analyze how various types of snail-related environmental factors, including the normalized difference vegetation index (NDVI), wetness, river and channel density, and landscape fractal dimension impact snail survival, and estimate its risk probabilities in snail spread area. An experiment was conducted in Jianghan Plain, China, where snails are predominantly linearly distributed along the tributaries and water channels of the middle and lower reaches of the Yangtze River. The proposed method could accurately map floods under clouds, and a total area of 231.5 km2 was identified as the snail spread area. The snail survival risk probabilities were thus estimated. The proposed method showed a more refined snail spread area and a more reliable degree of snail survival risk compared with those of previous studies. Thus, it is an efficient way to accurately map all-weather snail spread and survival risk probabilities, which is helpful for schistosomiasis interruption. [ABSTRACT FROM AUTHOR]

Accurate extraction of urban landscape features in the historic district of China is an essential task for the protection of the cultural and historical heritage. In recent years, deep learning (DL)-based methods have made substantial progress in landscape feature extraction. However, the lack of annotated data and the complex scenarios inside alleyways result in the limited performance of the available DL-based methods when extracting landscape features. To deal with this problem, we built a small yet comprehensive history-core street view (HCSV) dataset and propose a polarized attention-based landscape feature segmentation network (PALESNet) in this article. The polarized self-attention block is employed in PALESNet to discriminate each landscape feature in various situations, whereas the atrous spatial pyramid pooling (ASPP) block is utilized to capture the multi-scale features. As an auxiliary, a transfer learning module was introduced to supplement the knowledge of the network, to overcome the shortage of labeled data and improve its learning capability in the historic districts. Compared to other state-of-the-art methods, our network achieved the highest accuracy in the case study of Beijing Core Area, with an mIoU of 63.7% on the HCSV dataset; and thus could provide sufficient and accurate data for further protection and renewal in Chinese historic districts. [ABSTRACT FROM AUTHOR]

The use of ground cover vegetation is becoming a prominent way of promoting biodiversity and associated ecosystem services in Chinese orchards. Despite the large number of studies that have addressed the effects of ground cover vegetation on promoting natural enemy populations and related pest control, it is still unclear whether enhanced natural pest control can increase yield and reduce the use of pesticide. We performed an experiment comparing three cover vegetation practices (ryegrass, clover and hairy vetch) versus a bare ground control in commercial pear orchards in the Yangtze River Delta of East China (YRDEC), China. Natural enemy density (predator and parasitoid abundance), invertebrate herbivore performance (piercing‐sucking herbivore abundance and branch‐boring and fruit‐boring percentage), pesticide input, and pear fruit yield were recorded. The results indicated that cover vegetation decreased herbivore abundance and boring percentage by 50% and 64%, respectively, thus decreasing pesticide use by 26%. We also found that cover vegetation increased the abundance of natural enemies by 621%, and increased pear fruit yield by 7%. Piecewise structural equation modelling confirmed that increased natural enemy densities, decreased herbivore performance by 102%, pesticide use by 51% and increased fruit yield by 10%. This study suggests that the use of ground cover vegetations, especially with clover and hairy vetch, is an effective way of promoting biocontrol services and associated ecosystem services in pear orchards. [ABSTRACT FROM AUTHOR]

Lithium plays an increasingly important role in scientific and industrial processes, and it is extremely important to extract lithium from a high Mg2+/Li+ mass ratio brine or to recover lithium from the leachate of spent lithium-ion batteries. Conventional wisdom shows that Li+ with low valence states has a much weaker adsorption (and absorption energy) with graphene than multivalent ions such as Mg2+. Here, we show the selective adsorption of Li+ in thermally reduced graphene oxide (rGO) membranes over other metal ions such as Mg2+, Co2+, Mn2+, Ni2+, or Fe2+. Interestingly, the adsorption strength of Li+ reaches up to 5 times the adsorption strength of Mg2+, and the mass ratio of a mixed Mg2+/Li+ solution at a very high value of 500 : 1 can be effectively reduced to 0.7 : 1 within only six experimental treatment cycles, demonstrating the excellent applicability of the rGO membranes in the Mg2+/Li+ separation. A theoretical analysis indicates that this unexpected selectivity is attributed to the competition between cationâ€" Ď€ interaction and steric exclusion when hydrated cations enter the confined space of the rGO membranes. [ABSTRACT FROM AUTHOR]

Study Objective: This study aimed to determine the safety and efficacy of a novel GP Ib receptor inhibitor in patients with non‐ST segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). Design and Setting: Multicenter, randomized, double‐blind, placebo‐controlled, dose‐escalating, phase Ib‐IIa clinical trial. Eligible patients were randomly assigned to the low‐dose (n=20, 2 IU/60 kg), moderate‐dose (n=20, 3 IU/60 kg), or high‐dose anfibatide group (n=20, 5 IU/60 kg), or the placebo group (n=30). Anfibatide was administered for up to 48 hours along with standard aspirin and clopidogrel therapy. Patients: Ninety patients with NSTEMI who underwent PCI at six academic hospitals in China. Measurements and Main Results: All three doses of anfibatide showed dose‐dependent antiplatelet activity as measured by ex vivo platelet aggregation at 5 minutes, 24 hours, and 48 hours during infusion, and 4 hours post‐infusion compared with placebo. Higher inhibition of platelet aggregation occurred in all anfibatide groups compared with the placebo group. The post‐procedural TIMI grade flow, myocardial blush grade, and corrected TIMI frame count were not significantly different among the four groups. Thirty‐day mortality, non‐fatal myocardial infarction, and major bleeding were rare and comparable between patients who received anfibatide and placebo. There was no significant difference in the platelet count among the groups during follow‐up. Conclusions: This study shows that intravenous administration of the platelet receptor GP Ib antagonist anfibatide is feasible and safe to inhibit platelet aggregation without increasing the risk of bleeding and thrombocytopenia in patients with NSTEMI undergoing PCI. [ABSTRACT FROM AUTHOR]

Limited epidemiological literature identified the associations between residential greenness and hypertension in low-/middle-income countries. A random sampling strategy was adopted to recruit 39,259 residents, ≥ 18 years, and from 5 counties in central China. Blood pressure was measured based on the protocol of the American Heart Association. Hypertension was defined according to the 2010 Chinese guidelines for the management of hypertension. The satellite-derived normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were applied to estimate the residential greenness. Mixed logit model and mixed linear model were utilized to explore the relationships of residential greenness with hypertension and blood pressure. Higher residential greenness was associated with lower odds of hypertension and blood pressure levels. For instance, an interquartile range (IQR) increase in NDVI500m was linked with lower odds of hypertension (OR = 0.92, 95%CI 0.88 to 0.95), a decrease of −0.88 mm Hg (95% CI −1.17 to −0.58) and −0.64 mm Hg (95% CI −0.82 to −0.46) in SBP and DBP, respectively. The effect of residential greenness was more pronounced in males, smokers, and drinkers. Long-term exposure to residential greenness was linked with lower odds of hypertension. More prospective studies are needed to verify the hypothesis. [ABSTRACT FROM AUTHOR]

The COVID‐19 outbreak has been one of the world's most severe challenges since World War II, which not only reflected in the observable economic depression, but also in emotional damage that is scarcely underscored. This paper estimates the effect of the epidemic on happiness of Chinese residents by capturing the emotions conveyed through massive social media, combined with city‐level epidemic data. We confirm the significant negative impact of the outbreak on life satisfaction, with an extra 1% of cumulative death cases associated with a 0.54% decrease in expressed happiness. Meanwhile, we find that well‐being drops the most in regions with high‐level risk of COVID‐19, and happiness in regions with higher or lower income levels are more vulnerable to the effects of the epidemic, in comparison to the intermediate‐level income regions. Female sentiment exhibits more sensitivity to the epidemic situation than does male sentiment. Furthermore, the timing of major public events also plays a sizable role in determining self‐reported happiness, and our results suggest that pandemic alerts announced by the World Health Organization significantly increased the loss of well‐being, while announcements of city‐unlocking had the opposite impact. The interaction between the outbreak and real‐time expressed happiness provides an important opportunity for reflection on the future governance policies of epidemic containment. Key Points: First, the results indicate significant negative impact of the outbreak on life satisfactionSecond, we find that well‐being drops the most in regions with high‐level risk of COVID‐19Female sentiment exhibits more sensitivity to the epidemic situation than does male sentiment [ABSTRACT FROM AUTHOR]

Background: More than 50% cognitive impairment was reported by cancer patients before and after medical treatment. However, there are no effective interventions to manage the cognitive problem in women with breast cancer. This pilot study was designed to evaluate the protective effect of Baduanjin exercise on cognitive function and cancer-related symptoms in women with early-stage breast cancer undergoing chemotherapy. Method: A single-blinded, randomized control trial was designed. The trial will recruit 70 patients with early-stage breast cancer scheduled to receive chemotherapy from Shanghai in China. All participants will be randomly assigned to (1:1) the supervised Baduanjin group (5 times/week, 30 min each time) or the wait-list control group for 3 months. The effect of Baduanjin exercise intervention will be evaluated by outcome measures including subjective and objective cognitive function, symptoms (fatigue, depression, and anxiety), and health-related quality of life at pre-intervention (T0), 8 weeks (T1), and 12 weeks (T2). The PCI score in the FACT-Cog as the primary cognitive outcome will be reported descriptively, while effect sizes and 95% confidence intervals (CIs) will be calculated. The collected data will be analyzed by using an intention-to-treat principle and linear mixed-effects modeling. Discussion: This is the first randomized clinical trial to investigate whether Baduanjin exercise will have a positive role in improving cognitive function in women with breast cancer receiving chemotherapy. If possible, Baduanjin exercise will be a potential non-pharmacological intervention to manage cognitive dysfunction and promote survivorship care among breast cancer survivors. Trial registration: Chinese Clinical Trial Registry (ChiCTR) ChiCTR2000033152. Registered on 22 May 2020 [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the measurement properties of two versions of EQ-5D (i.e.EQ-5D-3L and EQ-5D-5L) in hypertensive patients in rural China. Methods: A cross-sectional survey was carried out in hypertensive patients in rural China. We compared the ceiling effects, redistribution properties, informativity, known-groups validity, and relative efficiency of the 3L and 5L and examined their agreement. Results: A total of 11,412 patients were enrolled in our study. The mean EQ-5D index score was 0.84 (SD 0.21) according to the 5L and 0.86 (SD 0.17) according to the 3L. A good agreement was observed between the 3L and 5L. The overall ceiling effect decreased from 46.4% (3L) to 29.4% (5L). The Shannon index, H′ improved in all dimensions when used 5L. When used 3L, the median responses of all groups were consistent with 5L across the three dimensions of 'mobility', 'self-care', 'usual activities', while the median responses were inconsistent for the 'pain/discomfort' and 'anxiety/depression' dimensions. The 3L performed better in eight comorbidities in terms of F-statistics and six comorbidities in terms of the area under the receiver operating characteristic curves (AUROCs). The 5L performed better both in terms of the F-statistics and AUROCs in age, education level, anti-hypertensive medication use. Conclusion: Taking all comparisons into account, we recommend the EQ-5D-5L for use in patients with hypertension in rural China. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to generate a value set for the SF-6Dv2 using time trade-off (TTO) and a discrete-choice experiment with a duration dimension (DCETTO) in China. Methods: A large representative sample of the Chinese general population was recruited from eight provinces/municipalities in China, stratified by age, sex, education level, and proportion of urban/rural residence. Respondents completed eight TTO tasks and ten DCETTO tasks during face-to-face interviews. Ordinary least squares (OLS), random-effects, fixed-effects, and Tobit models were used for TTO data, and conditional logit and mixed logit models were used for DCETTO. The monotonicity of model coefficients and the consistency of the predicted values according to intraclass correlation coefficient (ICC), mean absolute difference (MAD), and mean squared difference (MSD) were compared between the two approaches. Results: In total, 3320 respondents (50.3% male; range 18–90 years) were recruited. The random-effects model and the conditional logit model were preferred for the TTO and DCETTO, respectively. The TTO values ranged from − 0.277 to 1, with 927 (4.94%) states considered as worse than dead (WTD). The corresponding range for DCETTO was − 0.535 to 1, with a higher WTD of 8.50%. DCETTO presented minor non-monotonicity with the coefficients in two dimensions. Values from the two approaches were highly consistent (ICC 0.9804, MAD 0.0588, MSD 0.0055), albeit those with DCETTO were slightly lower than those with TTO. The value set generated by TTO was preferred given the better monotonicity and the statistical significance of coefficients. Conclusions: The Chinese value set for the SF-6Dv2 was established based on the TTO approach, but the DCETTO also performed well. Minor issues of non-monotonicity did present for DCETTO. [ABSTRACT FROM AUTHOR]

Research shows that many investors are loss averse (reluctant to sell investments that have lost value). However, there is open debate about whether mutual fund investors suffer from loss aversion. We use over 300,000 Chinese mutual fund investor accounts from five open‐end funds to test for loss aversion using survival analysis controlling for time‐varying covariates (Cox analysis). We find strong evidence of loss aversion as these investors are between 60% and 91% less likely to sell a fund that is down in value across the five funds. We also find that more sophisticated investors are less loss averse. [ABSTRACT FROM AUTHOR]

Since the beginning of the twenty-first century, several countries have made great efforts to develop space remote sensing for building a high-resolution earth observation system. Under the great attention of the government and the guidance of the major scientific and technological project of the high-resolution earth observation system, China has made continuous breakthroughs and progress in high-resolution remote sensing imaging technology. The development of domestic high-resolution remote sensing satellites shows a vigorous trend, and consequently, a relatively stable and perfect high-resolution earth observation system has been formed. The development of high-resolution remote sensing satellites has greatly promoted and enriched modern mapping technologies and methods. In this paper, the de velopment status, along with mapping modes and applications of China's high-resolution remote sensing satellites are reviewed, and the development trend in high-resolution earth observation system for global and ground control-free mapping is discussed, providing a reference for the subsequent development of high-resolution remote sensing satellites in China. [ABSTRACT FROM AUTHOR]

Eggerthella lenta is part of the normal bacterial flora of the intestinal tract, but may cause life-threatening infections. E. lenta has been isolated from blood, abscesses, wounds, skin ulcers, and intra-abdominal infections. However, due to historical difficulties with laboratory identification by conventional biochemical methods, some cases of E. lenta infection have previously gone undiagnosed, especially in China where E. lenta infections are very rare. Recently, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), a new type of technology, has made it possible to identify E. lenta. We report a case of postoperative infection caused by E. lenta which was treated successfully using meropenem. [ABSTRACT FROM AUTHOR]

What is known and objective: Since the December 2019 discovery of several cases of coronavirus disease 2019 (COVID‐19) in Wuhan, China, the infection has spread worldwide. Our aim is to report on the clinical characteristics, treatments and prognoses of COVID‐19. Methods: This was a retrospective, single‐centre, case series of 136 patients who were diagnosed with COVID‐19 at Wuhan Third Hospital in Wuhan, China, between 28 January 2020 and 12 February 2020. The clinical characteristics, laboratory tests, treatment features and prognoses were summarized. Results and discussion: The 136 patients were divided into a moderate (M) group (n = 103, 75.7%) and a severe and critical (SC) group (n = 33, 24.3%). There were significant differences in the incidences of concomitant chronic medical illnesses (eg, hypertension, diabetes and cardiovascular disease), fever, dry cough and dyspnoea among the two groups (P <.05). Compared with those in the M group, lymphocyte count (LYM) decreased significantly in the SC group, while the serum levels of C‐reactive protein (CRP), procalcitonin (PCT), creatinine (Cre), D‐dimer, lactic dehydrogenase (LDH), myoglobin (MB) and troponin I (cTnl) increased significantly in the SC group (P <.05). The main therapeutic drugs were antivirals, antibiotics, glucocorticoids, immunomodulators, traditional Chinese medicine preparations and symptomatic support drugs. There were significant differences in the incidences of shock, myocardial injury, acute respiratory distress syndrome (ARDS) and renal injury among the two groups (P <.05). Among the 136 patients, 99 (72.7%) were cured, 14 (10.3%) were transferred to other hospital and 23 (16.9%) died. What is new and conclusion: Elderly patients with chronic diseases are more likely to develop severe or critical COVID‐19 with multiple organ damage or systemic injuries. The improvement of LYM and CRP may be associated with the prognoses of COVID‐19. The combined use of three or more antiviral drugs is to be avoided. The combination of broad‐spectrum antibacterial drugs is not recommended and the risk of drug‐induced liver injury should be monitored. Throughout a patient's hospitalization, their treatment plan should be evaluated and adjusted according to their vital signs, clinical symptoms, laboratory tests and imaging changes. Patients should receive effective psychological counselling. [ABSTRACT FROM AUTHOR]

Background: Pembrolizumab (Pembro) in combination with chemotherapy has been approved for the treatment of pretreated advanced NSCLC in the United States and China for its significant efficacy. However, the cost‐effectiveness is unknown considering Pembro's high price. The impact of programmed death ligand 1 (PD‐L1) test on the cost‐effectiveness is also unknown. The current study assessed the cost‐effectiveness of combination therapy for nonsquamous NSCLC from the United States and China public payers' perspective. Materials and Methods: A literature‐based Markov model was conducted using KEYNOTE‐189 trial data to compare cost and quality‐adjusted life years (QALYs) of three treatment strategies for nonsquamous NSCLC: Pembro‐chemotherapy combination and chemotherapy strategy without PD‐L1 test, and treatment strategy according to their PD‐L1 status. Results: In base case analysis, the combination strategy generated an additional 0.78 QALYs and 0.59 QALYs over chemotherapy in the United States and China respectively, resulting in an ICER of $132 392/QALY in the United States and $92 533/QALY in China. In the PD‐L1 ≥1% base case, the ICERs were $77 754/QALY and $56 768/QALY respectively in the United States and China for PD‐L1 test strategy. In the PD‐L1 ≥50% base case, the ICERs were $44 731/QALY and $34 388/QALY respectively in the United States and China for PD‐L1 test strategy. Lowering Pembro price can also partly decrease the ICERs. Conclusion: Compared with chemotherapy, the combination strategy is not cost‐effective for the treatment of NSCLC in the American and Chinese health care system at WTP threshold of $100 000/QALY for the United States and $27 351/QALY for China. Using PD‐L1 test for patient selection and price reduction could improve the cost‐effective probabilities of immunotherapy for nonsquamous NSCLC. [ABSTRACT FROM AUTHOR]

In order to effectively reduce and retard corrosion of the power transmission and transformation equipment in Chengdu power grid and to improve power supply reliability, Q235 carbon steel material which is the most widely used metal material in power grid was selected as the targeted research object in this article. Exposure experiments were performed in urban atmospheric environment of Chengdu city in the southwest region of China. The corrosion behavior of Q235 carbon steel material was investigated at different seasons. The macro- and micromorphologies after corrosion were observed using a digital camera and scanning electron microscopy (SEM), respectively. Element distribution of the rust layer and the corrosion products was characterized by energy-dispersive spectroscopy (EDS), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR); the corrosion mechanism was also briefly analyzed. [ABSTRACT FROM AUTHOR]

Purpose: Hypertension is a major global public health problem, including rural China. However, studies examining health-related quality of life (HRQoL) for patients with hypertension have been mostly conducted in urban populations. This study aimed to use the EuroQol five-dimensional-five-level (EQ-5D-5L) and its recently developed Chinese value set to analyze HRQoL and its influencing factors among hypertensive population in rural China.Methods: This is a cross-sectional population-based survey. Standard interview of participants was conducted from July to September 2016 in Donghai County's 334 villages of Jiangsu Province, China. Data collection included the EQ-5D-5L, along with sociodemographic characteristics and disease-related factors such as duration of hypertension, antihypertensive treatment and comorbid conditions. The Tobit regression model was employed to analyze potential influencing factors on HRQoL.Results: A total of 16,596 adults (18 years and older) with hypertension participated in this study. 62.4% were women. The mean utility score was 0.85 (standard deviation [SD] = 0.23). The proportion of participants reporting pain/discomfort problems was highest, while least patients reported problems in self-care dimension. Females, elderly, illiterate patients, ex-smokers and patients with longer duration of hypertension or comorbidities scored lower on HRQoL than others. Stroke, heart failure and coronary heart disease were associated with a larger negative impact on HRQoL among all comorbidities.Conclusions: The HRQoL was lower in this rural hypertensive population than previously reported urban counterparts. To improve the HRQoL of hypertensive patients in rural areas, it is important to control hypertension and prevent its associated co-morbidities. More attention needs to be directed to elderly female patients with less education who scored much lower HRQoL than their male counterparts. [ABSTRACT FROM AUTHOR]

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

Humans are at risk of exogenous exposure to exogenous chemicals. Challenges exist for the comprehensive monitoring of residues with different physical and chemical properties in serum. Here, an on-line two-dimensional liquid chromatography (2D-LC) - high resolution mass spectrometry system (HRMS) was developed, expanding the range of the partition coefficient in octanol/water of the residue analysis from −8 to 12. A high-coverage serum residue screening strategy was further designed by integrating 2D-LC system with HRMS full MS/data independent acquisition and automatic spectral library searching. This strategy enables to simultaneously screen 1210 pesticides, veterinary/human drugs, other chemical pollutants and their metabolites in serum with a single analysis. Method validation showed 92% and 81% of 1022 residues spiked in serum could be detected at 50 ng/mL and 5 ng/mL, respectively. The developed method was applied to the analysis of 24 separately pooled serum samples, 58 suspect residues were found, some of them were detected at high frequencies over than 50%. Among them, 4,6-Dinitro-O-cresol and probable carcinogenic folpet are highly toxic, and cimaterol is banned in China. Collectively, this study developed a 2D-LC-HRMS -based screening strategy for screening pesticides, veterinary/human drugs, and other chemical pollutants in serum, it is helpful for studying the effect of exogenous exposures on human health. [Display omitted] • Relatively polar residue analysis was enabled using the novel 2D-LC-HRMS system. • An in-house database of 1210 exogenous chemicals and metabolites was constructed. • An efficient screening method integrated 2D-LC-HRMS analysis and database retrieval. • High-coverage screening was performed, 58 exogenous residues were detected from human sera. [ABSTRACT FROM AUTHOR]

Organophosphite antioxidants (OPAs) and organophosphate esters (OPEs) are used as additives in food packaging. Because these chemicals have been found in various foods, they have caused increasing concern about potential health risks through food intake. Little information is available about the migration behaviors of OPAs and OPEs from single-use food packaging into food. In the present study, four OPAs and 23 OPEs were analyzed in paper and plastic single-use food packaging (n = 312), which are widely used for take-out food in China. The total concentrations of OPAs and OPEs in the packaging samples were 1966 and 189 ng/g, respectively. Tris (2,4-di- tert -butylphenyl) phosphite (AO168) was the dominant compound. OPAs and OPEs were present at higher concentrations in the plastic packaging than in the paper packaging. In a migration test, four OPAs and 15 OPEs were found in food simulants (4% acetic acid, 10% ethanol, and hexane). Higher levels of individual and total OPAs were found in hexane than the other food simulants, especially for AO168 migration from plastic packaging. The amounts of OPEs in the food simulants increased from the aqueous simulants (4% acetic acid and 10% ethanol) to the fatty food simulant (hexane). The migration efficiencies of the OPAs were higher than those of the OPEs. Preliminary calculations suggest that dietary exposure to OPAs and OPEs because of migration will be low for the population in China. [Display omitted] • OPAs and OPEs were existed in single-use food packaging and food simulants. • OPAs/OPEs had higher concentrations in plastic materials than paper materials. • OPAs had higher migration efficiencies than OPEs. • Dietary risk by migration of OPAs/OPEs from single-use food packaging was low. • Migration of OPAs/OPEs from single-use food packaging was firstly studied. [ABSTRACT FROM AUTHOR]

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

Objective: Cardiac hypertrophy is the heart's response to a variety of extrinsic and intrinsic stimuli, some of which might finally lead up to a maladaptive state. Clinical evidence, in vitro and in vivo studies have implicated urotensin II (U-II/UTS2) in the development of cardiac hypertrophy, contributing to the (patho)-physiological regulation of cardiovascular homeostasis in humans. Several genes are associated with left ventricular hypertrophy; considering these, our objective was to evaluate the possible role of UTS2 gene polymorphisms (Thr21Met and Ser89Asn) in the genetic susceptibility to cardiac hypertrophy in a Chinese population.Methods: A case-control study was designed to compare the distribution of alleles and genotypes between three groups: case group 1 (subjects with hypertension and cardiac hypertrophy, n=265), case group 2 (subjects with hypertension, without cardiac hypertrophy, n=768), and the control group (subjects neither with hypertension nor with cardiac hypertrophy, n=416). The detection of UTS2 gene polymorphisms was achieved with the PCR restriction fragment length polymorphism technique.Results: We did not identify statistically significant differences between the three groups, neither with regard to the frequency of genotype/variant at the Ser89Asn locus nor at the Thr21Met locus. When stratified by sex, differences in genotype distribution of polymorphism Ser89Asn were only seen in female subjects in both the additive tested inheritance model (OR=0.507, 95% CI 0.249 to 1.032, p=0.032) and the recessive tested inheritance model (OR=0.475, 95% CI 0.239 to 0.945, p=0.034) between case group 2 (subjects with hypertension, without cardiac hypertrophy) and the control group (subjects neither with hypertension nor with cardiac hypertrophy). When stratified by sex, for female subjects with cardiac hypertrophy, we identified statistically significant differences in left ventricular posterior wall thickness for variant genotypes at the Ser89Asn locus (AA vs GG: 1.2500 (1.2000, 1.3750) vs 1.2500 (1.2000, 1.3750), p=0.03) and (AG+AA vs GG: 1.2000 (1.2000, 1.3000) vs 1.2000 (1.1000, 1.2000), p=0.01).Conclusions: Ser89Asn (S89N) polymorphisms of the UTS2 gene were associated with hypertension in a Chinese female population. Additionally, we demonstrated that genotype Asn89Asn was associated with left ventricular posterior wall thickness for subjects with hypertension and cardiac hypertrophy in a Chinese female population. [ABSTRACT FROM AUTHOR]

Kawasaki disease (KD) is an acute systemic vasculitis complicated by development of coronary artery lesions. PECAM-1 is a kind of cell adhesion molecule, which plays an important role in coronary artery disease. The relationship between PECAM-1 gene polymorphisms and their susceptibility to Kawasaki diseases (KD) is still unclear. In our study, we examined the PECAM-1 gene polymorphisms in 44 KD patients and 59 healthy children and revealed the correlation of PECAM-1 gene polymorphisms in KD children with and without coronary artery lesions (CAL). [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) mortality is associated with long-term particulate matter (PM) exposure. However, evidence from large, highly-exposed population cohort and observational-data-based causal inference approaches remains limited. We examined the potential causal links between PM exposure and the CVD mortality in South China. 580,757 participants were recruited during 2009–2015 and followed up through 2020. Satellite-based annual concentrations of PM 2.5 , PM 10 , and PM coarse (i.e., PM 10 - PM 2.5) at 1 km2 spatial resolution were estimated and assigned to each participant. Marginal structural Cox models with time-varying covariates, adjusted using inverse probability weighting, were developed to evaluate the association between prolonged PM exposure and CVD mortality. For overall CVD mortality, the hazard ratios and 95% confidence interval for each 1 μg/m3 increase in the annual average concentration of PM 2.5 , PM 10 , and PM coarse were 1.033 (1.028–1.037), 1.028 (1.024–1.032), and 1.022 (1.012–1.033), respectively. All three PMs were linked to a higher mortality risk for myocardial infarction and ischemic heart disease (IHD). The mortality risk of chronic IHD and hypertension was linked to PM 2.5 and PM 10. Significant association between PM coarse and other heart disease mortality was also observed. The older, women, less-educated participants, or inactive participants exhibited particularly higher susceptibility. Participants who were generally exposed to PM 10 concentrations below 70 μg/m3 were more vulnerable to PM 2.5 -, PM 10 - and PM coarse -CVD mortality risks. This large cohort study provides evidence for the potential causal links between increased CVD mortality and ambient PM exposure, as well as socio-demographics linked to the highest vulnerability. [Display omitted] • CVD mortality elevated by 1.4–6.1% following each 1 μg/m3 increase in PM exposure. • The older, female, less educated and inactive ones tended to be more vulnerable. • CVD mortality risk from PM 2.5 was generally 0.2–1.3% higher than that from PM 10. [ABSTRACT FROM AUTHOR]

Lead, a ubiquitous heavy metal, can be found in the environment and food. The present study is the first to estimate the lead dietary exposure of Shenzhen adults (≥ 20 years old) in various age-gender subgroups, and to assess the associated health risk. Food samples that represented the Shenzhen people's dietary pattern were collected and prepared for analysis. Lead was determined in 13 food groups using 276 individual cooked samples by inductively coupled plasmamass spectrometry (ICP-MS). Dietary exposures were estimated by combining the analytical results with the local food consumption data of Shenzhen adults. The mean and 95th percentile lead exposure of Shenzhen adults were 0.59-0.73 and 0.75-0.94 µg kg-1 bw day-1, respectively. In all food groups, the highest lead exposure was from 'Eggs and their products' (42.4-51.6% of the total exposure); preserved eggs being the main contributor. The other major contributors to lead exposure of Shenzhen adults were 'Fish and seafood, and their products' (14.3-16.7% of the total exposure) and 'Vegetables and their products' (15.5.16.2% of the total exposure). The margin of exposure (MOE) approach was used for the risk assessment of lead, and the results showed that the risk was considered to be low in all age.gender groups for Shenzhen adults. However, having considered a number of toxic effects of lead, it is suggested that more efforts should be made to reduce the lead levels in foodstuff for Shenzhen adults. [ABSTRACT FROM AUTHOR]

A mortality rate higher than 90 % was observed in a larva-rearing facility for Pacific cod, Gadus macrocephalus, in China. Larvae showing clinical signs of infection were collected. Initial suspicion of nervous necrosis virus (NNV) infection was confirmed by sequencing, absolute quantification real-time PCR (A-qPCR), and electron microscopy. The nucleotide sequence of RNA2 was 1,375 bases long (GenBank no. KM576685), coding for a single ORF corresponding to the capsid protein from residues 21 to 1034. Phylogenetic analysis of the capsid protein sequence showed that PCNNV belongs to the barfin flounder NNV (BFNVV) genotype. An amino acid sequence alignment revealed 39 differences between the cold- and warm-resistant viral groups, suggesting that PCNNV evolved under temperature selection. The 3-D structure of the predicted capsid protein was modeled to identify potential epitopes, and the gene was expressed in Escherichia coli, yielding a protein with a molecular mass of 55 kDa. During PCNNV outbreaks, the viral copy number was found to reach 10 per ng of total RNA, which could be considered the lethal copy number of NNV in cod. The gonads, eggs, fertilized eggs and asymptomatic cod fry were all positive for PCNNV, indicating viral vertical transmission as the main source of the viral load. The amount of virus in the apparent healthy fry or survivors seemed to decrease gradually with development. These results might lead to efficient diagnostic methods to help farmers select NNV-free broodfish for cod breeding. [ABSTRACT FROM AUTHOR]

We assessed the efficiency of point-of-care (POC) tests in the emergency department (ED) by comparing them with the international standard. We recorded the turnaround times (TATs) for processing laboratory biomarkers to assess laboratory efficiency from 17 EDs in national/regional hospitals. We also compared patient components between national and regional hospitals. Although the 17 enrolled hospitals expanded their EDs, they contained only five POC machines among them. The P50 (P25, P75) of the TATs for POC tests was 47 min (39, 55.5 min) for cardiac troponin T, which was much longer than the international standard (30 min). The TATs of other cardiac biomarkers were also longer than 30 min. The low efficiency of TATs for POC tests was a common feature in both regional and national hospitals (p > 0.05). Myocardial infarction was diagnosed in 61% of investigated ED patients who visited national hospitals, which is more frequently than those diagnosed at regional hospitals (46%, p < 0.05). Chronic heart failure was less frequent at national hospitals (28%) than at regional hospitals (41%, p < 0.05). The patient distribution in this study indicates that patients have the tendency to choose hospitals when they are affected with chest pain. However, the POC panel is rarely used in the ED, which delayed the TAT level and affected laboratory efficiency. This finding indicates a severe problem in the administrative management of EDs. This issue should be addressed in the next version of the medical reform policy. [ABSTRACT FROM PUBLISHER]

Increasing nitrogen (N) diagnosis efficiency and accuracy is crucial for optimizing wheat N management. We aimed to establish a spatially and temporally explicit model for the diagnosis of winter wheat N status on small scale farms using multivariate information. To determine the most accurate approach, seven field experiments involving different cultivars and N treatments were conducted in east China over five years. A fixed-wing unmanned aerial vehicle (UAV) mounted multispectral camera was used to acquire canopy spectral data of winter wheat at the jointing and booting stages, while agronomic indicators of plant dry matter (PDM), plant N accumulation (PNA) and N nutrition index (NNI), as well as agrometeorological (AM) and field management (FM) data, were measured synchronously. Direct and indirect strategies of NNI estimation were applied for N diagnosis at the jointing and booting stages. Four machine learning (ML) algorithms were used to characterize the relationships between agronomic variables and UAV remote sensing, AM and FM data. The results demonstrated the random forest (RF) model that integrated UAV remote sensing, AM and FM data achieved the higher accuracy for predicting NNI (R 2 = 0.82–0.87, RMSE = 0.11–0.12 and RE = 12.94%−15.57%) amongst the four ML models based on the direct strategy at the jointing and booting stages. Similarly, the RF model performed most accurate estimation for PDM (R 2 = 0.69–0.78, RMSE = 0.43–0.61 t ha−1 and RE = 12.74%−24.49%) and PNA (R 2 = 0.83–0.84, RMSE = 13.00–17.53 kg ha−1 and RE = 17.03%−25.44%), then NNI (R 2 = 0.54–0.55, RMSE = 0.09–0.13 and RE = 8.34–12.65%) was further calculated using the indirect diagnosis strategy. Based on the optimal NNI diagnosis interval derived from the relationships between relative yield (RY) and plant NNI at the jointing (0.92–1.04) and booting (0.97–1.15) stages, the two diagnosis strategies obtained similar diagnostic accuracies in the three study farms and performed more accurately at the booting (areal agreement = 0.70–0.90, Kappa = 0.49–0.82) than jointing (areal agreement = 0.54–0.71, Kappa = 0.36–0.53) stages. The combination of fixed-wing UAV remote sensing with AM and FM information using the RF algorithm can significantly increase the accuracy and efficiency of in-season wheat N diagnosis at the farm scale. • Four machine learning algorithms were used to characterize the relationships between agronomic variables and multivariate data. • Direct and indirect strategies of NNI estimation were evaluated based on the optimal NNI diagnosis interval. • Mapping the wheat N status based on fixed-wing UAV imagery at the farm scale. [ABSTRACT FROM AUTHOR]