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Purpose: This study traces the development of China's online education policy over the past 20 years. Design/Approach/Methods: Employing a textual research method, this study examines online education policymakers, policy content and influence, and related policies and regulations. Findings: This study identifies the starting point of China's online education policy and divides its development into four stages: namely, the pilot exploration stage (1999-2002), the standard development stage (2002-2012), the transformation stage (2012-2017), and the governance improvement stage (2017-present). Policy development reflects three characteristics: the need to meet the requirements of the times, shifting from a single management to multiple governance approach, and developing from one object for some people to one object for everyone. Current policy focuses on regulating institutions, content, and products, as well as guiding social capital to participate in online education. Originality/Value: This study systematically analyzes the development of China's online education policies, discerns policy characteristics, and identifies current policy priorities. In doing so, this study enhances our understanding of the current status and potential needs of online education in China so as to promote its development from the perspective of education policy and governance.

Background: Plasma beta-amyloid (Aβ) are important biomarkers for Alzheimer's disease and cognitive impairment (CI), but results are controversial. It remains unclear whether hypertension modulates their relationship. This cross-sectional study investigates whether hypertension moderates the relationship between plasma Aβ and cognitive impairment (CI). Methods: This cross-sectional study included 1488 subjects ≥ 40 years from rural areas of northwestern China. CI was defined as a Mini-Mental State Examination score lower than the cutoff. Firstly, plasma Aβ40, Aβ42, Aβ42/Aβ40 were analyzed as restricted cubic spline. Then, categories of combined plasma Aβ were created by making bisection of plasma Aβ according to average and combining them as L-Aβ40 and L-Aβ42, H-Aβ40 and L-Aβ42, L-Aβ40 and H-Aβ42, H-Aβ40 and H-Aβ42. Decreased plasma Aβ40 was defined as < 25th percentile. Multivariate logistic regression examined the relationship between plasma Aβ and CI in total population, the hypertension subgroup and the non-hypertension subgroup. Results: 737 participants (49.5%) had hypertension and 189 participants (12.7%) had CI. Simultaneously elevated plasma Aβ40 and Aβ42 was associated with CI in hypertension (H-Aβ40 and H-Aβ42 vs. L-Aβ40 and L-Aβ42, 21.1% vs.10.7%, P = 0.033; OR = 1.984 [95% CI, 1.067–3.691], P = 0.030) but not in the non-hypertension. Decreased plasma Aβ40 was associated with CI in the non-hypertension (14.9% vs. 9.2%, P = 0.026; OR = 1.728 [95% CI, 1.018–2.931], P = 0.043) but not in the hypertension. Conclusion: Hypertension is an important modulator in the relationship between plasma Aβ and CI. Simultaneously elevated plasma Aβ40 and Aβ42 in the hypertension, and decreased plasma Aβ40 in the non-hypertension, may be risk factors for CI. These findings emphasize the need to consider hypertension in CI detection. [ABSTRACT FROM AUTHOR]

This article is an overview of the National Assessment of Education Quality (NAEQ) of China in reading, mathematics, sciences, arts, physical education, and moral education at Grades 4 and 8. After a review of the background and history of NAEQ, we present the assessment framework with students' holistic development at the core and the design for each subject used in the 2015-2017 assessment cycle. Technical details including item response modeling and the standard setting procedure are presented. We conclude with a discussion of the social impact, current issues, and future directions of national educational assessment.

Background The impact of cardiometabolic multimorbidity (CMM) on functional dependency (FD) is well established, but the temporal effect of FD on CMM and its mechanisms remain underexplored. Design A multicohort study pooled data from three international cohorts. Setting Data were sourced from the Health and Retirement Study (USA), the China Health and Retirement Longitudinal Study (China) and the Survey of Health, Ageing and Retirement in 18 European countries. Methods FD was defined as the inability to perform basic activities of daily living (ADLs) and instrumental ADLs (IADLs) independently. CMM was defined as the co-occurrence of two or three cardiometabolic diseases, including diabetes, heart disease and stroke. Generalised estimating equation models assessed associations between FD and CMM, with mediation analysis using the Karlson, Holm and Breen method to explore the effects of hypertension and depressive symptoms. Sensitivity analyses ensured robustness. Results The final cohort included 157 512 and 190 249 individuals for ADL and IADL analyses, respectively. CMM prevalence was 18.97% and 16.65% in these groups. FD was consistently associated with higher CMM risk, with odds ratios ranging from 1.47 (95% confidence interval: 1.33–1.63) to 1.56 (1.42–1.73). Hypertension and depressive symptoms increased CMM risk, particularly at higher FD levels. Mediation analysis showed hypertension and depressive symptoms accounted for 8.01%–16.43% and 12.04%–18.36% of the adverse effect of FD on CMM, respectively, with more pronounced effects among smokers and heavy drinkers. Conclusions Targeted interventions focusing on hypertension, mental wellness, lifestyle factors, and integrated treatments for FD are crucial to prevent CMM in older adults. [ABSTRACT FROM AUTHOR]

Cabotegravir (CAB-LA), the first long-acting injectable pre-exposure prophylaxis (PrEP), has been approved for use in the USA and is not currently on the market in China. However, willingness to use CAB-LA and associated factors among men who have sex with men (MSM) have not yet been evaluated in China. A cross-sectional study was conducted in Guangxi, China, in 2022 recruiting 1,006 MSM. Their mean age was 30.2 years, 74.2% had college or above education, and 48.6% had a monthly income between 3,000 and 5,999 Chinese yuan (CNY). Most (73.4%) had previously heard of PrEP while few (8.3%) had ever used this type of preventative medication. Willingness to use CAB-LA was 79.8% and was positively associated with eight variables: younger age, being married to a woman, having a low monthly income, having six or more male partners in the past six months, having only regular male partners in the past month, having a high perceived risk of HIV infection, and history of using PrEP. Ten other variables were not significantly associated with willingness to use CAB-LA. Among 894 participants who were willing to use or did not definitely reject using CAB-LA, the main concerns about CAB-LA were its side effects (90.2%), efficacy (63.6%), and high cost (58.2%). Only 14.7% were willing to pay more than 1,200 CNY (~US$180) every two months to use CAB-LA. The preferred injection places were centers for disease control facilities, hospitals, and social organizations. Many (89.0%) said that they would recommend CAB-LA to their male sexual partners. We conclude that willingness to use CAB-LA was high among MSM in Guangxi. However, implementation of CAB-LA faces tough challenges due to its high cost and the low use of PrEP. Peer education may play a large role in the implementation of CAB-LA in China. [ABSTRACT FROM AUTHOR]

Background: Patients diagnosed with advanced stage cancer face an elevated risk of suicide. We aimed to develop a suicidal ideation (SI) risk prediction model in patients with advanced cancer for early warning of their SI and facilitate suicide prevention in this population. Patients and Methods: We consecutively enrolled patients with multiple types of advanced cancers from 10 cancer institutes in China from August 2019 to December 2020. Demographic characteristics, clinicopathological data, and clinical treatment history were extracted from medical records. Symptom burden, psychological status, and SI were assessed using the MD Anderson Symptom Inventory (MDASI), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire‐9 (PHQ‐9), respectively. A multivariable logistic regression model was employed to establish the model structure. Results: In total, 2814 participants were included in the final analysis. Nine predictors including age, sex, number of household members, history of previous chemotherapy, history of previous surgery, MDASI score, HADS‐A score, HADS‐D score, and life satisfaction were retained in the final SI prediction model. The model achieved an area under the curve (AUC) of 0.85 (95% confidential interval: 0.82–0.87), with AUCs ranging from 0.75 to 0.95 across 10 hospitals and higher than 0.83 for all cancer types. Conclusion: This study built an easy‐to‐use, good‐performance predictive model for SI. Implementation of this model could facilitate the incorporation of psychosocial support for suicide prevention into the standard care of patients with advanced cancer. [ABSTRACT FROM AUTHOR]

The effect of climate warming on rice production in China is profound, yet there has been limited research on how it affects the grain yield, nitrogen (N) uptake, and N utilization efficiency (NUtE) of the double-cropping indica rice in South China. To address this gap, we conducted a free air temperature increase (FATI) experiment in Guangdong province during 2020 and 2021. Our findings revealed that warming led to a significant reduction in grain yield, with early rice (ER) and late rice (LR) experiencing average decreases of 5.2% and 6.3%, respectively, compared to control treatments. This decline was primarily attributed to the reduced grain weight of ER and the fewer spikelet numbers per panicle of LR under warming conditions. Although the dry matter translocation, harvest index, and N translocation efficiency of ER remained unchanged under warming conditions, these of LR decreased by an average of 58.1%, 8.8%, and 22.3%, respectively. Additionally, while warming did not affect the N uptake in ER at maturity, it significantly increased the N uptake in LR by an average of 11.0%. Therefore, under warming conditions, the NUtE of both ER and LR was markedly decreased by 6.9% and 15.5% over the two years. These results indicate that climate warming may have significant negative impacts on the grain yield and the NUtE of indica rice within double-rice cropping systems in South China. Understanding these dynamics is vital for maintaining the stability of rice yields in anticipation of future climate warming. [ABSTRACT FROM AUTHOR]

Objectives: Patients with advanced colorectal cancer (CRC) have multiple concurrent physical and psychological symptoms. This study aimed to explore the relationship between anxiety, depression, and symptom burden in advanced CRC. Methods: A multicenter cross‐sectional study was conducted in 10 cancer centers from geographically and economically diverse sites in China. A total of 454 patients with advanced CRC completed the Hospital Anxiety and Depression Scale and the MD Anderson Symptom Inventory. Multiple regression analysis was applied to explore the relationship between anxiety, depression and symptom burden. Results: About one‐third of the patients showed symptoms of anxiety or depression. Patients with anxiety or depression reported significantly higher symptom burden than those without (p < 0.001). Patients with anxiety or depression reported a higher proportion of moderate‐to‐severe (MS) symptom number than those without (p < 0.001). About 52% of the patients with anxiety or depression reported at least three MS symptoms. The prevalence of MS symptoms was ranging from 7.3% (shortness of breath) to 22% (disturbed sleep), and in patients with anxiety or depression was 2–10 times higher than in those without (p < 0.001). Disease stage (β = −2.55, p = 0.003), anxiety (β = 15.33, p < 0.001), and depression (β = 13.63, p < 0.001) were associated with higher symptom burden. Conclusions: Anxiety and depression in patients with advanced cancer correlated with higher symptom burden. Findings may lead oncology professionals to pay more attention to unrecognized and untreated psychological symptoms in symptom management for advanced cancer patients. [ABSTRACT FROM AUTHOR]

Climate warming is a critical environmental issue affecting rice production. However, its effects on cooked rice texture and rice thermal properties remain unstudied in China. To address this gap, we conducted a two-year multi-site field warming experiment using free-air temperature increase facilities across three major Chinese rice cropping systems. Interestingly, warming had a minimal impact on the hardness of cooked rice, while it significantly increased stickiness by an average of 16.3% under warming conditions. Moreover, compared to control treatments, rice flour exhibited a significant increase in gelatinization enthalpy, onset, peak, and conclusion temperatures under warming conditions, with average increments of 8.7%, 1.00 °C, 1.05 °C, and 1.17 °C, respectively. In addition, warming significantly declined the amylose content, remarkedly elevated the protein content and relative crystallinity, and altered the weight distribution of the debranched starch. Correlation analysis revealed significant relationships between cooked rice stickiness, rice flour thermal properties, amylose content, protein content, and partial starch structures. Therefore, warming-induced alterations in rice composition and starch structure collectively enhanced cooked rice stickiness and rice thermal stability. [ABSTRACT FROM AUTHOR]

Background: Myofascial pelvic pain (MFPP), which is identified by tender points in the pelvic floor musculature, is a prevalent source of chronic pelvic pain in women. It may lead to physical and mental exhaustion, reproductive concerns, and coping difficulties in daily life and work than the disease itself. Pain-related cognitive processes can affect pain relief and quality of life. Kinesiophobia, self-efficacy and pain catastrophizing are frequently treated as mediators between pain and its related consequences. Greater kinesiophobia and pain catastrophizing have been shown to be associated with adverse functional outcomes, while higher self-efficacy has been related with improved quality of life. Regarding MFPP in females of childbearing age, it remains unclear whether the effects of kinesiophobia, self-efficacy and pain catastrophizing on daily interference are direct or indirect; the influence on each variable is, therefore, not entirely evident. Aim: The present study aimed to evaluate the relationship between pain and daily interference in reproductive-age women with MFPP through kinesiophobia, self-efficacy and pain catastrophizing, as well as to identify areas for future investigation and intervention based on the data collected from this population. Methods: This is a multi-center cross-sectional study. The study was conducted from November 15, 2022 to November 10, 2023, 202 reproductive-age women with MFPP were recruited from 14 hospitals in ten provinces of China. The demographic variables, Brief Pain Inventory, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, and Pain Catastrophizing Scale were used to measure the participants' related information. The data was described and analyzed using Descriptive analyses, Pearson correlation analysis, and Serial mediation modeling. Results: Pain not only had a direct positive impact (B = 0.575; SE = 0.081; 95%CI: LL = 0.415, UL = 0.735) on daily interference, but also had an indirect impact on daily interference through the independent mediating role of pain catastrophizing (B = 0.088; SE = 0.028; 95%CI: LL = 0.038, UL = 0.148), the chain mediating of kinesiophobia and catastrophizing (B = 0.057; SE = 0.019; 95%CI: LL = 0.024, UL = 0.098), and the four-stage serial mediating of kinesiophobia, self-efficacy and catastrophizing (B = 0.013; SE = 0.006; 95%CI: LL = 0.003, UL = 0.027). The proposed serial mediation model showed a good fit with the collected data. Conclusion: The findings illustrate the significance of addressing pain catastrophizing and kinesiophobia (especially catastrophizing), and increasing self-efficacy in pain therapy, and suggest that functional recovery be integrated into pain therapy for reproductive-age women suffering from MFPP. [ABSTRACT FROM AUTHOR]

Since 2017, human encephalitis caused by pseudorabies virus (PRV) has been reported in 28 cases in China. The clinical symptoms include fever, headache, seizures, focal neurological loss, disturbance of consciousness, etc.. This disease has the high disability rate and fatality rate. PRV is mainly transmitted through close contact with infected pigs or their excrement, or spread via blood-borne. Patients are mostly practitioners in the live pig industry chain. Early diagnosis and treatment are critical to the prognosis of patients. Therefore, this article reviews the progress on diagnosis and treatment of human encephalitis caused by PRV, in order to improve the clinical diagnosis and treatment of this disease. [ABSTRACT FROM AUTHOR]

Purpose: The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and SI in Chinese patients with advanced breast cancer. Methods: Patients with advanced breast cancer (n = 509) were recruited as study participants from 10 regional cancer centers across China from August 2019 to December 2020. Participants were required to complete five questionnaires using an electronic patient-reported outcomes (ePRO) system: 9 item- Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L), and MD Anderson Symptom Inventory (MDASI). Risk factors for SI were identified using multivariable logistic regression, and inputted into serial multiple mediation models to elucidate the pathways linking the risk factors to SI. Results: SI prevalence was 22.8% (116/509). After adjusting for covariates, depression (odds ratio [OR] = 1.384), emotional distress (OR = 1.107), upset (OR = 0.842), and forgetfulness (OR = 1.236) were identified as significant independent risk factors (all p < 0.05). The ORs indicate that depression and distress have the strongest associations with SI. Health status has a significant indirect effect (OR=-0.044, p = 0.005) and a strong total effect (OR=-0.485, p < 0.001) on SI, mediated by insomnia severity and emotional distress. Conclusions: There is a high SI prevalence among Chinese patients with advanced breast cancer. Our analysis revealed predictive pathways from poor health to heightened SI, mediated by emotional distress and insomnia. Regular management of distress and insomnia can decrease suicide risk in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Little is understood about the association between psychosomatic symptoms and advanced cancer among older Chinese patients. Methods: This secondary analysis was part of a multicenter cross-sectional study based on an electronic patient-reported outcome platform. Patients with advanced cancer were included between August 2019 and December 2020 in China. Participants (over 60 years) completed the MD Anderson Symptom Inventory (MDASI) and Hospital Anxiety and Depression Scale (HADS) to measure symptom burden. Network analysis was also conducted to investigate the network structure, centrality indices (strength, closeness, and betweenness) and network stability. Results: A total of 1022 patients with a mean age of 66 (60–88) years were included; 727 (71.1%) were males, and 295 (28.9%) were females. A total of 64.9% of older patients with advanced cancer had one or more symptoms, and up to 80% had anxiety and depression. The generated network indicated that the physical symptoms, anxiety and depression symptom communities were well connected with each other. Based on an evaluation of the centrality indices, 'distress/feeling upset' (MDASI 5) appears to be a structurally important node in all three networks, and 'I lost interest in my own appearance' (HADS-D4) had the lowest centrality indices. The network stability was relatively high (> 0.7). Conclusion: The symptom burden remains high in older patients with advanced cancer in China. Psychosomatic symptoms are highly interactive and often present as comorbidities. This network can be used to provide targeted interventions to optimize symptom management in older patients with advanced cancer in China. Trial registration: Chinese Clinical Trial Registry (ChiCTR1900024957), registered on 06/12/2020. [ABSTRACT FROM AUTHOR]

Background: Lack of social support is a known predictor of the prognosis after acute myocardial infarction (AMI). Although as a common factor associated with social support, there are limited data on long-term prognostic impact of living status in young and middle-aged patients with AMI. Methods: We analyzed data from the China Acute Myocardial Infarction (CAMI) Registry, consecutive AMI young and middle-aged patients admitted at 108 hospitals in China between January 2013 and September 2014 were included. Eligible patients were assigned to living alone and not living alone groups based on their living status. The primary endpoint was 2-year all-cause mortality. The secondary endpoints included in-hospital mortality and 2-year major adverse cardiac and cerebrovascular events (MACCEs; a composite of all-cause mortality, MI, or stroke). Multilevel logistic and multilevel Cox regression models were used to evaluate the effect of living status on short-term and long-term outcomes. Results: A total of 8307 consecutive AMI young and middle-aged patients were included, 192 (2.3%) patients were living alone. Of the analyzed patients, living alone was associated with 2-year all-cause mortality and MACCEs among all analyzed patients after multivariate adjustment (adjusted hazard ratio [HR] = 2.171 [1.210–3.895], P = 0.009; adjusted HR = 2.169 [1.395–3.370], P = 0.001), but not with poorer in-hospital mortality. Conclusions: The analysis suggested that living alone was associated with both 2-year all-cause mortality and MACCEs in AMI young and middle-aged patients but did not show an extra effect on the in-hospital mortality after covariate adjustment. Trial registration: Trial registration number: NCT01874691; Registered 31 October 2012. [ABSTRACT FROM AUTHOR]

Background: The impact of heat waves and atmospheric oxidising pollutants on residential mortality within the framework of global climate change has become increasingly important. Objective: In this research, the interactive effects of heat waves and oxidising pollutants on the risk of residential mortality in Fuzhou were examined. Methods We collected environmental, meteorological, and residential mortality data in Fuzhou from 1 January 2016, to 31 December 2021. We then applied a generalised additive model, distributed lagged nonlinear model, and bivariate three-dimensional model to investigate the effects and interactions of various atmospheric oxidising pollutants and heat waves on the risk of residential mortality. Results: Atmospheric oxidising pollutants increased the risk of residential mortality at lower concentrations, and O3 and Ox were positively associated with a maximum risk of 2.19% (95% CI: 0.74–3.66) and 1.29% (95% CI: 0.51–2.08). The risk of residential mortality increased with increasing temperature, with a strong and long-lasting effect and a maximum cumulative lagged effect of 1.11% (95% CI: 1.01, 1.23). Furthermore, an interaction between atmospheric oxidising pollutants and heat waves may have occurred: the larger effects in the longest cumulative lag time on residential mortality per 10 µg/m3 increase in O3, NO2 and Ox during heat waves compared to non-heat waves were [−3.81% (95% CI: −14.82, 8.63)]; [−0.45% (95% CI: −2.67, 1.81)]; [67.90% (95% CI: 11.55, 152.71)]; 16.37% (95% CI: 2.43, 32.20)]; [−3.00% (95% CI: −20.80, 18.79)]; [−0.30% (95% CI: −3.53, 3.04)]. The risk on heat wave days was significantly higher than that on non-heat wave days and higher than the separate effects of oxidising pollutants and heat waves. Conclusions: Overall, we found some evidence suggesting that heat waves increase the impact of oxidising atmospheric pollutants on residential mortality to some extent. [ABSTRACT FROM AUTHOR]

Background: Antepartum depression is a prevalent unhealthy mental health problem worldwide, particularly in low‐income countries. It is a major contributor to adverse birth outcomes. Previous studies linking antepartum depression to birthweight have yielded conflicting results, which may be the reason that the depressive symptoms were only measured once during pregnancy. This study aimed to explore the associations between trajectories of antepartum depressive symptoms and birthweight. Methods: Depressive symptoms were assessed prospectively at each trimester in 3699 pregnant women from 24 hospitals across 15 provinces in China, using the Edinburgh Postpartum Depression Scale (EPDS). Higher scores of EPDS indicated higher levels of depressive symptoms. Associations between trajectories of depressive symptoms and birthweight were examined using group‐based trajectory modeling (GBTM), propensity score‐based inverse probability of treatment weighting (IPTW), and logistic regression. Results: GBTM identified five trajectories. Compared with the low‐stable trajectory of depressive symptoms, only high‐stable (OR = 1.35, 95% CI: 1.15–2.52) and moderate‐rising (OR = 1.18, 95% CI: 1.12–1.85) had an increased risk of low birthweight (LBW) in the adjusted longitudinal analysis of IPTW. There was no significant increase in the risk of LBW in moderate‐stable and high‐falling trajectories. However, trajectories of depressive symptoms were not associated with the risk of macrosomia. Conclusion: Antepartum depressive symptoms were not constant. Trajectories of depressive symptoms were associated with the risk of LBW. It is important to optimize and implement screening, tracking, and intervention protocols for antepartum depression, especially for high‐risk pregnant women, to prevent LBW. [ABSTRACT FROM AUTHOR]

Background: Studies exploring whether metastatic organotropism and risk in gastric cancer (GC) differ by primary anatomical site are scarce. Methods: This study included 15,260 and 1623 patients diagnosed with GC from the Surveillance, Epidemiology, and End Results (SEER) registry database and the Nanfang Hospital in China, respectively. Patients were stratified according to primary site of GC, and the incidence of metastasis to different organs was used to determine the metastatic organotropism for each GC subsite. Finally, the metastatic organotropism and risk were compared among the different subsite groups. Results: Liver metastasis was the most common metastasis site in cardia GC, whereas other‐site metastases were more common in the body, antrum, overlapping lesions, and unspecified GCs. Liver and other‐site metastases were also frequently observed in the fundus, pylorus, lesser curvature, and greater curvature GCs. Patients with GC with definite primary tumor sites in the SEER and validation Nanfang hospital cohorts were compared by grouping as proximal and distal GCs for further analysis. In the SEER cohort, the top three metastatic sites of proximal GC were liver (21.4%), distant lymph node (LN) (14.6%), and other‐site (mainly peritoneum, 11.9%), whereas those of distal GC were other‐site (mainly peritoneum, 19.5%), liver (11.8%), and distant LN (9.5%). The incidence of metastasis to the liver, distant LN, lung, and brain was significantly higher in patients with proximal GC than in those with distal GC in both the SEER and Nanfang cohorts (p < 0.05). However, metastasis to other‐site/peritoneum was significantly lower in patients with proximal GC compared to those with distal GC in the Nanfang Hospital and SEER cohorts, respectively (p < 0.05). Conclusion: Liver and distant LN are the preferred metastatic sites for proximal GC, whereas peritoneal metastasis is more common in distal GC. Proximal GC has a higher risk of lymphatic and hematogenous metastases, and a lower risk of transcoelomic metastasis than distal GC. Our findings highlight the need to stratify GC by its primary subsite to aid in planning and decision‐making related to metastatic management in clinical practice. [ABSTRACT FROM AUTHOR]

Flexible ureteroscopy (f-URS) is a minimally invasive surgical technique used for treating urinary tract stones. While general anesthesia (GA) is the standard method used, it comes with risks. Local anesthesia (LA) is a safer and more cost-effective alternative to GA, and its use in f-URS could potentially reduce patients' risks and increase accessibility to treatment. This study aims to investigate the feasibility, safety, and efficacy of using LA for f-URS in treating stones, as an initial experience in the diagnosis related group (DRG) era of China. Patients who met the inclusion and exclusion criteria and were continuously included in the study Between 2021 and 2023. We analyzed the stone free status, postoperative complication rate, hospitalization costs, and presented key points of the procedure performed under LA that we had summarized over the past two years. A study of 614 patients undergoing f-URS under LA for urinary stones in our hospital showed 83.4% stone-free rate with a mean operative time of 44.12 ± 16.63 minutes; 18 patients experienced fever postoperatively, and 12 had ureteral injuries. No severe complication was reported. The cost of LA was found to be only 1.7% of the DRG payment, which is around $40. The highest VAS scores were observed during the sheath insertion, with STAI scores decreasing during and after surgery. The study revealed that f-URS administered under LA was a well-tolerated, efficient, safe, and economical procedure. In the DRG era, this new anesthetic option for f-URS provides urologists with a more cost-effective alternative. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) is a necessary cause of cervical cancer, and a tool more sensitive than cytology for the early screening of cervical precancers. The two most carcinogenic genotypes HPV 16/18 have been reported in the majority of studies. High‐risk HPVs other than HPV 16/18 (non‐16/18‐hrHPVs) cause approximately a quarter of cervical cancers, and we aimed to analyze the genotype‐specific prevalence, risk and diagnostic efficiency of non‐16/18‐hrHPVs in cervical carcinogenesis among Chinese cytology‐negative women. Methods: A total of 7043 females who had abnormal cervical testing results from January 2018 to October 2021 were enrolled, among them 3091 were cytology‐negative. Descriptive statistics was used to estimate the HPV genotype‐specific prevalence, and multivariable logistic regression was used to estimate the genotype‐specific non‐16/18 hrHPVs risk of cervical carcinogenesis. The evaluation of diagnostic value among HPV genotypes included the possibility of predicting cervical intraepithelial neoplasia grade 2/3 or worse (CIN2+/CIN3+) and the diagnostic efficiency measured by increased referral rate and referral numbers of colposcopies per additional CIN2+/CIN3+ detected. Results: Among HPV‐positive cytology‐negative women, the five dominant genotypes for CIN2+/CIN3+ were HPV 31/33/35/52/58. HPV 52/58/33 had comparatively high sensitivity and specificity in predicting CIN2+/CIN3+, while the referral strategy of multiple HPV58 required 26 colposcopies to detect 1 CIN3+, compared with 14, 12, and 8 required by multiple HPV52, 31, and 33, respectively. Conclusions: HPV31/33/35/52/58 infections are significant risk factors for cervical lesions, and multiple HPV 31/33/52 infections should be included in the previously recommended HPV16/18 genotyping triage for colposcopy in China, as the benefits of disease prevention may outweigh the disadvantages of increasing requirements for colposcopy services. [ABSTRACT FROM AUTHOR]

Cumin (Cuminum cyminum L). belongs to the family Apiaceae and the order Apiales, which is a widely grown spice and medicinal plant in Xinjiang province, China. In the current study, whole genome sequencing of C. cyminum was performed using the Illumina HiSeq 4000 platform, and the complete mitogenome sequence was assembled and annotated. We found that the single circular mitogenome of C. cyminum was 246,721 bp in length, and has about 45.5% GC content. It comprised 73 genes in the coding region (35 protein-coding genes, 18 tRNA genes, 3 rRNA genes, and 15 open-reading frames) and a non-coding region. Phylogenetic analysis indicated that C. cyminum is closely related to Daucus carota and the subtribes Daucinae. The mitogenome of C. cyminum revealed its phylogenetic relationships with other species in the Apiaceae family, which would further help in understanding its evolution. [ABSTRACT FROM AUTHOR]

The Panxi area in Sichuan Province is the main area for the production of truffles in China, and several species of truffle are known to exist in this region. Nevertheless, it is unclear what the differences in chemical composition between the truffles are. Using an ultra‐high‐performance liquid chromatography quadrupole/orbitrap high‐resolution mass spectrometry coupled with Compound Discoverer 3.0, we identified chemical components in three mainly known truffles from the Panxi region. Further analysis of chemical composition differences was conducted using principal component analysis, and orthogonal partial least squares discriminant analysis. Note that, 78.9% of the variance was uncovered by the principal component analysis model. As a result of the orthogonal partial least squares discriminant analysis model, the three species of truffles (Tuber pesudohimalayense, Tuber indicum, and Tuber sinense) from Panxi were better discriminated, with R2X, R2Y, and Q2 being 0.821, 0.993, and 0.947, respectively. In this study, 87 components were identified. T. pesudohimalayense contained significantly higher levels of nine different compounds than the other two species. Hence, it was possible to identify similarities and differences between three species of truffles from Panxi in terms of chemical composition. This can be used as a basis for quality control. [ABSTRACT FROM AUTHOR]

Background: As a neuroprogressive illness, depression is accompanied by brain structural abnormality that extends to many brain regions. However, the progressive structural alteration pattern remains unknown. Methods: To elaborate the progressive structural alteration of depression according to illness duration, we recruited 195 never-treated first-episode patients with depression and 130 healthy controls (HCs) undergoing T1-weighted MRI scans. Voxel-based morphometry method was adopted to measure gray matter volume (GMV) for each participant. Patients were first divided into three stages according to the length of illness duration, then we explored stage-specific GMV alterations and the causal effect relationship between them using causal structural covariance network (CaSCN) analysis. Results: Overall, patients with depression presented stage-specific GMV alterations compared with HCs. Regions including the hippocampus, the thalamus and the ventral medial prefrontal cortex (vmPFC) presented GMV alteration at onset of illness. Then as the illness advanced, others regions began to present GMV alterations. These results suggested that GMV alteration originated from the hippocampus, the thalamus and vmPFC then expanded to other brain regions. The results of CaSCN analysis revealed that the hippocampus and the vmPFC corporately exerted causal effect on regions such as nucleus accumbens, the precuneus and the cerebellum. In addition, GMV alteration in the hippocampus was also potentially causally related to that in the dorsolateral frontal gyrus. Conclusions: Consistent with the neuroprogressive hypothesis, our results reveal progressive morphological alteration originating from the vmPFC and the hippocampus and further elucidate possible details about disease progression of depression. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: We aim to assess the performance of the Gail model and the fifth edition of ultrasound BI‐RADS (Breast Imaging Reporting and Data System) in breast cancer for predicting axillary lymph node metastasis (ALNM). Materials and Methods: We prospectively studied 958 female patients with breast cancer between 2018 and 2019 from 35 hospitals in China. Based on B‐mode, color Doppler, and elastography, radiologists classified the degree of suspicion based on the fifth edition of BI‐RADS. Individual breast cancer risk was assessed with the Gail model. The association between the US BI‐RADS category and the Gail model in terms of ALNM was analyzed. Results: We found that US BI‐RADS category was significantly and independently associated with ALNM (P < 0.001). The sensitivity, specificity, and accuracy of BI‐RADS category 5 for predicting ALNM were 63.6%, 71.6%, and 68.6%, respectively. Combining the Gail model with the BI‐RADS category showed a significantly higher sensitivity than using the BI‐RADS category alone (67.8% vs. 63.6%, P < 0.001). The diagnostic accuracy of the BI‐RADS category combined with the Gail model was better than that of the Gail model alone (area under the curve: 0.71 vs. 0.50, P < 0.001). Conclusion: Based on the conventional ultrasound and elastography, the fifth edition of ultrasound BI‐RADS category could be used to predict the ALNM of breast cancer. ALNM was likely to occur in patients with BI‐RADS category 5. The Gail model could improve the diagnostic sensitivity of the US BI‐RADS category for predicting ALNM in breast cancer. [ABSTRACT FROM AUTHOR]

Background: Cross breeding is an important way to improve livestock performance. As an important livestock and poultry resource in Henan Province of China, Bohuai goat was formed by crossing Boer goat and Huai goat. After more than 20 years of breeding, BoHuai goats showed many advantages, such as fast growth, good reproductive performance, and high meat yield. In order to better develop and protect Bohuai goats, we sequenced the whole genomes of 30 BoHuai goats and 5 Huai goats to analyze the genetic diversity, population structure and genomic regions under selection of BoHuai goat. Furthermore, we used 126 published genomes of world-wide goat to characterize the genomic variation of BoHuai goat. Results: The results showed that the nucleotide diversity of BoHuai goats was lower and the degree of linkage imbalance was higher than that of other breeds. The analysis of population structure showed that BoHuai goats have obvious differences from other goat breeds. In addition, the BoHuai goat is more closely related to the Boer goat than the Huai goat and is highly similar to the Boer goat. Group by selection signal in the BoHuai goat study, we found that one region on chromosome 7 shows a very strong selection signal, which suggests that it could well be the segment region under the intense artificial selection results. Through selective sweeps, we detected some genes related to important traits such as lipid metabolism (LDLR, STAR, ANGPTL8), fertility (STAR), and disease resistance (CD274, DHPS, PDCD1LG2). Conclusion: In this paper, we elucidated the genomic variation, ancestry composition, and selective signals related to important economic traits in BoHuai goats. Our studies on the genome of BoHuai goats will not only help to understand the characteristics of the crossbred but also provide a basis for the improvement of cross-breeding programs. [ABSTRACT FROM AUTHOR]

Background: Colposcopic examination with biopsy is the standard procedure for referrals with abnormal cervical cancer screening results; however, the decision to biopsy is controvertible. Having a predictive model may help to improve high-grade squamous intraepithelial lesion or worse (HSIL+) predictions which could reduce unnecessary testing and protecting women from unnecessary harm. Methods: This retrospective multicenter study involved 5,854 patients identified through colposcopy databases. Cases were randomly assigned to a training set for development or to an internal validation set for performance assessment and comparability testing. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to reduce the number of candidate predictors and select statistically significant factors. Multivariable logistic regression was then used to establish a predictive model which generates risk scores for developing HSIL+. The predictive model is presented as a nomogram and was assessed for discriminability, and with calibration and decision curves. The model was externally validated with 472 consecutive patients and compared to 422 other patients from two additional hospitals. Results: The final predictive model included age, cytology results, human papillomavirus status, transformation zone types, colposcopic impressions, and size of lesion area. The model had good overall discrimination when predicting HSIL + risk, which was internally validated (Area Under the Curve [AUC] of 0.92 (95%CI 0.90–0.94)). External validation found an AUC of 0.91 (95%CI 0.88–0.94) across the consecutive sample, and 0.88 (95%CI 0.84–0.93) across the comparative sample. Calibration suggested good coherence between predicted and observed probabilities. Decision curve analysis also suggested this model would be clinically useful. Conclusion: We developed and validated a nomogram which incorporates multiple clinically relevant variables to better identify HSIL + cases during colposcopic examination. This model may help clinicians determining next steps and in particular, around the need to refer patients for colposcopy-guided biopsies. [ABSTRACT FROM AUTHOR]

In an emerging economy like China where the domestic income inequality has dramatically increased between middle‐class urban consumers and poor rural farmers, food grown by poor farmers with poverty alleviation labels may receive price premiums from consumers with multiple incentives. To reveal consumers' willingness‐to‐pay (WTP) for anti‐poverty labelled food, we implement a non‐hypothetical Becker–DeGroot–Marschak auction online experiment for apples with real shoppers. Results show that consumers are willing to pay 3.66 RMB extra for each kilogram of apples with anti‐poverty labels, indicating the opportunities for using voluntary public food consumption to supplement the government's anti‐poverty responsibilities. Consumers who are more empathic, who believe that anti‐poverty products have higher quality, who have donated money within the past year, and who are not involve with anti‐poverty related production or selling processes are willing to pay more. Additionally, three different information treatments (a beneficiary description, an appreciation certificate and a government promotion document) were found to increase consumers' WTP for anti‐poverty products. Treatment effects are different among consumers with different demographic characters and perspectives about the anti‐poverty label. Lastly, anti‐poverty labels can attract consumers for trial purchase but are not sufficient to lead consumers to make repeat purchases. [ABSTRACT FROM AUTHOR]

To assess the outcomes and risk factors for adult patients with acute fulminant myocarditis (AFM) supported with venoarterial extracorporeal membrane oxygenation (VA ECMO) in China mainland. Data were extracted from Chinese Society of ExtraCorporeal Life Support (CSECLS) Registry database. Data from adult patients who were diagnosed with AFM and needed VA ECMO in the database were retrospectively analyzed. The primary outcome was 90-day mortality after ECMO initiation in patients with AFM supported with VA ECMO. Cox proportional hazard regression model was used to examine the risk factors associated with 90-day mortality. Among 221 patients enrolled and followed up to 90 days, 186 (84.2%) patients weaned from ECMO and 159 (71.9%) patients survived and discharged home. The median age was 38 years (IQR 29–49) and males (n = 115) represented 52.0% of the total accounted patients. The median ECMO duration was 134 h (IQR 96–177 h). The main adverse event during ECMO course was bleeding (16.3%), followed by infection (15.4%). In the multivariate Cox model analysis, cardiac arrest prior to ECMO initiation (adjusted HR 2.529; 95%CI: 1.341–4.767, p = 0.004), lower pH value (adjusted HR 0.016; 95%CI: 0.010–0.059, p < 0.001) and higher lactate concentration at 24 h after ECMO initiation (adjusted HR 1.146; 95%CI: 1.075–1.221, p < 0.001) were associated with 90-day mortality. 71.9% patients with AFM (clinical diagnosed) supported with VA ECMO survived. Cardiac arrest prior to ECMO, lower pH and higher lactate concentration at 24 h after ECMO initiation were correlated with 90-day mortality of AFM patients supported with VA ECMO. • >70% of adult patients with acute fulminant myocarditis supported with VA ECMO survived in China mainland. • The median ECMO duration was 134 h. • Cardiac arrest prior to ECMO, pH and lactate after ECMO were independent risk factors correlated with 90-day mortality. [ABSTRACT FROM AUTHOR]

Long-term intensive use of mineral fertilizers in double rice-cropping systems has led to soil acidification and soil degradation. Manure fertilization was suggested as an alternative strategy to mitigate soil degradation. However, the effects of long-term mineral and manure fertilization on rice grain yield, yield stability, soil organic carbon (SOC) content, soil total nitrogen (TN) content, and the underlying mechanisms are unclear. Based on a long-term experiment established in 1981 in southern China, we compared four treatments: no fertilizer application (Control); application of nitrogen–phosphorus–potassium (NPK); NPK plus green manure in early rice (M1); and M1 plus farmyard manure in late rice and rice straw return in winter (M2). Our results showed that 37 years of NPK, M1, and M2 significantly increased rice grain yield by 54%, 46%, and 72%, and yield stability by 22%, 17%, and 9%, respectively. M1 and M2 significantly increased SOC content by 39% and 23% compared to Control, respectively, whereas there was no difference between Control and NPK. Regarding soil TN content, it was significantly increased by 8%, 46%, and 20% by NPK, M1, and M2, respectively. In addition, M2 significantly increased bacterial OTU richness by 68%, Chao1 index by 79%, and altered the bacterial community composition. Changes in soil nutrient availability and bacterial Simpson index were positively correlated with the changes in grain yield, while shifts in bacterial community were closely related to yield stability. This study provides pioneer comprehensive assessments of the simultaneous responses of grain yield, yield stability, SOC and TN content, nutrient availability, and bacterial community composition to long-term mineral and manure fertilization in a double rice-cropping system. Altogether, this study spanning nearly four decades provides new perspectives for developing sustainable yet intensive rice cultivation to meet growing global demands. [ABSTRACT FROM AUTHOR]

In emerging economies where small farms are the main source of food supply, it is costly for the government to monitor and control food safety and production impact on the environment. However, the online food market can potentially give farmers stronger incentives to supply safer and more eco‐friendly products, as they can access a national market where consumers are interested in healthy food, and they can differentiate their products by providing production information using videos and pictures. This research uses the choice experiment method to elicit farmers' preference for production practices and marketing channels in China where e‐commerce and delivery businesses are fast‐growing. Our main finding is that farmers perceive higher utility in selling safer and more eco‐friendly products than conventional products when using e‐commerce platforms, evidence of the online market's positive role in food safety enhancement. Our results also identify two types of farmers: traditional farmers and farmers open to the idea of online markets. Farmers who have higher education and live in villages with e‐commerce service centers are more likely to be the latter. [ABSTRACT FROM AUTHOR]

Background: Colposcopy plays an essential role in cervical cancer control, but its performance remains unsatisfactory. This study evaluates the feasibility of machine learning (ML) models for predicting high-grade squamous intraepithelial lesions or worse (HSIL+) in patients referred for colposcopy by combining colposcopic findings with demographic and screening results. Methods: In total, 7485 patients who underwent colposcopy examination in seven hospitals in mainland China were used to train, internally validate, and externally validate six commonly used ML models, including logistic regression, decision tree, naïve bayes, support vector machine, random forest, and extreme gradient boosting. Nine variables, including age, gravidity, parity, menopause status, cytological results, high-risk human papillomavirus (HR-HPV) infection type, HR-HPV multi-infection, transformation zone (TZ) type, and colposcopic impression, were used for model construction. Results: Colposcopic impression, HR-HPV results, and cytology results were the top three variables that determined model performance among all included variables. In the internal validation set, six ML models that integrated demographics, screening results, and colposcopic impression showed significant improvements in the area under the curve (AUC) (0.067 to 0.099) and sensitivity (11.55% to 14.88%) compared with colposcopists. Greater increases in AUC (0.087 to 0.119) and sensitivity (17.17% to 22.08%) were observed in the six models with the external validation set. Conclusions: By incorporating demographics, screening results, and colposcopic impressions, ML improved the AUC and sensitivity for detecting HSIL+ in patients referred for colposcopy. Such models could transform the subjective experience into objective judgments to help clinicians make decisions at the time of colposcopy examinations. [ABSTRACT FROM AUTHOR]

Aedes albopictus is an indigenous primary vector of dengue and Zika viruses in China. Understanding the population spatial genetic structure, migration, and gene flow of vector species is critical to effectively preventing and controlling vector-borne diseases. The genetic variation and population structure of Ae. albopictus populations collected from 22 cities along the Yangtze River Basin were investigated with nine microsatellite loci and the mitochondrial CoxI gene. The polymorphic information content (PIC) values ranged from 0.534 to 0.871. The observed number of alleles (Na) values ranged from 5.455 to 11.455, and the effective number of alleles (Ne) values ranged from 3.106 to 4.041. The Shannon Index (I) ranged from 1.209 to 1.639. The observed heterozygosity (Ho) values ranged from 0.487 to 0.545. The FIS value ranged from 0.047 to 0.212. All Ae. albopictus populations were adequately allocated to three clades with significant genetic differences. Haplotype 2 is the most primitive molecular type and forms 26 other haplotypes after one or more site mutations. The rapid expansion of high-speed rail, aircraft routes and highways along the Yangtze River Basin have accelerated the dispersal and communication of mosquitoes, which appears to have contributed to inhibited population differentiation and promoted genetic diversity among Ae. albopictus populations. [ABSTRACT FROM AUTHOR]

Recently published guidelines depend upon screening for cervical precancer risk stratification; however, colposcopy provides key information. There is no data from developing countries that could be used comparatively. Therefore, we assessed the potential benefits of intercalating colposcopic impressions with screening results to detect cervical precancers through a multicenter, cross-sectional study of a Chinese population. Anonymized data from 6012 women with cytologic assessment, human papillomavirus (HPV) testing, colposcopic impressions, and histological results were analyzed. Univariate and multivariate analysis showed that high-grade squamous intraepithelial lesion (HSIL) cytology, HPV16/18+, and/or high-grade colposcopic impressions markedly increased cervical precancer risk, while high-grade colposcopic impressions were associated with the highest risk. The risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) ranged from 0% for normal/benign colposcopic impressions, 19% increased risk of CIN3+, even in participants without HSIL+ cytology and/or HPV16/18+. Regardless of screening outcomes, normal/benign colposcopic impressions were associated with the lowest risk of CIN3+ (<0.5%). Integrating colposcopic impressions into risk assessment may therefore provide key information for identifying cervical precancer cases. Adopting this approach may improve detection rates while also providing reassurance for women with a lower risk of developing cervical cancer. [ABSTRACT FROM AUTHOR]

Introduction: Major depressive disorder (MDD) is associated with an increased risk of suicide and suicide attempt among cancer patients. However, we do not know how many cancer patients without MDD have suicidal ideation (SI). Objectives: This study aimed to investigate the prevalence, characteristics and correlated factors of SI among advanced cancer patients without MDD. Methods: This is a multi‐center, cross‐sectional study based on an electronic patient‐reported outcome systems in patients who were diagnosed with advanced lung, liver, gastric, esophageal, colorectal or breast cancer, the top six prevalent cancers in China. A total of 2930 advanced cancer patients were recruited from 10 regional representative cancer centers across China from August 2019 to December 2020. Patients completed the Patient Health Questionnaire‐9 regarding if they had thoughts of being better off dead or of hurting themselves in some way in the previous 2 weeks. Patients also completed the symptom inventory and quality of life assessment. Generalized estimating equation model was performed to explore the correlated factors associated with SI among the patients without MDD. Results: The overall prevalence of SI among advanced cancer patients without MDD was 13.1%. The prevalence was higher in older patients. After adjusted for existing conditions, patients with vomiting symptom (p < 0.001), poorer life quality (p < 0.001), and middle education level (p = 0.031) were correlated factors of SI. Conclusions: The suicidal ideation is common in advanced cancer patients without MDD. Patients with vomiting, poor quality of life, and middle education level should be screened and monitored for suicidal ideation even without MDD. Clinical Trial Information: ChiCTR1900024957. [ABSTRACT FROM AUTHOR]

Toxoplasma gondii is a worldwide food-borne protozoa that has harmful influences on animal and human health. Raw milk containing T. gondii has been considered as one of the possible infectious sources for humans. Although China is one of the world's leading milk consumers, there is still no study to investigate the seroprevalence of T. gondii in raw cow milk in China; especially for cows in rural areas. Thus, we conducted this study to examine the specific anti-T. gondii IgG-antibody in the raw milk and sera of domestic cows in China. In total, 894 cows were randomly selected from rural areas in northeastern China. The positive rate of T. gondii in the milk and serum samples were 6.38% (57/894) and 7.16% (64/894), respectively. Moreover, a history of abortion (OR = 2.03, 95% CI: 1.11–3.72, p = 0.022) was identified as the only risk factor for T. gondii infection in the studied cows. This study investigated the seroprevalence of T. gondii in the raw milk and sera of cows in China; it provided timely and useful data for public health and food safety, especially in rural areas. [ABSTRACT FROM AUTHOR]

Determining the effects of fertilization regimes on soil aggregates, carbon (C) and nitrogen (N) distribution, and pH is essential for improving soil structure and soil organic carbon (SOC) accumulation to help in proper soil fertility management. Based on a 41-year field fertilization experiment conducted on dark brown soil in northeast China, we examined the soil aggregate size distribution and associated C, N, and pH to provide a scientific basis for elucidation of the mechanisms underlying the effects of fertilization treatments on soil structure and fertility. Six different fertilization treatments included no fertilizer (CK), low-dose chemical fertilizer (NP), moderate-dose chemical fertilizer (2NP), high-dose chemical fertilizer (4NP), normal-dose organic fertilizer (M), and normal-dose organic fertilizer plus moderate-dose chemical fertilizer (M+2NP). Our findings showed that compared to CK, M and M+2NP significantly increased the proportion of macroaggregates by 40% and 28%, respectively, whereas 4NP significantly decreased it by 19%. The mean weight diameter (MWD) and geometric mean diameter (GMD) under M and M+2NP were significantly higher than that under CK, at 12–21% and 24–36%, respectively. The fractal dimension (D) value of M+2NP was significantly lower than those of 2NP and 4NP by 4% and 5%, respectively. Soil pH under the M treatment was highest, followed by M+2NP. Soil pH under 2NP and 4NP more significantly decreased, by 0.1 and 0.2 units, than under M treatment. Soil pH values were correlated with the proportion of soil macroaggregates, MWD, and GWD, respectively (p < 0.05). Relative to CK, M and M+2NP increased the contents and stocks of SOC (by 40–49% and 89–93%, respectively) and total N (59–68% and 119–123%, respectively). Furthermore, the contents and stocks of aggregate-associated SOC and total N decreased following the order: NP > 2NP > 4NP. Overall, the long-term application of organic fertilization regimes (M and M+2NP) effectively improved soil aggregation as well as SOC accumulation and decreased soil acidification in dark brown soil in northeast China. [ABSTRACT FROM AUTHOR]

Fetal cystic hygroma (CH) is associated with poor prognosis and chromosomal anomalies. Recent studies have suggested that the genetic background of affected fetuses is essential for predicting pregnancy outcomes. However, the detection performance of different genetic approaches for the etiological diagnosis of fetal CH remains unclear. In this study, we aimed to compare the diagnostic efficiency of karyotyping and chromosomal microarray analysis (CMA) in a local fetal CH cohort, and tried to propose an optimized testing strategy that may help improve the cost-effectiveness of disease management. We reviewed all pregnancies that underwent invasive prenatal diagnosis between January 2017 and September 2021 at one of the largest prenatal diagnostic centers in Southeast China. We collected cases identified by the presence of fetal CH. Prenatal phenotypes and laboratory records of these patients were audited, collated, and analyzed. The detection rates of karyotyping and CMA were compared, and the concordance rate of these two methods was calculated. A total of 157 fetal CH cases were screened from 6,059 patients who underwent prenatal diagnosis. Diagnostic genetic variants were identified in 44.6% (70/157) of the cases. Karyotyping, CMA, and whole-exome sequencing (WES) identified pathogenic genetic variants in 63, 68, and 1 case, respectively. The Cohen's κ coefficient between karyotyping and CMA was 0.96, with a concordance of 98.0%. Of the 18 cases in which cryptic copy number variants <5 Mb were detected by CMA, 17 were interpreted as variants of uncertain significance, and the remaining cases were interpreted as pathogenic. Trio exome sequencing revealed a pathogenic homozygous splice site mutation in the PIGN gene in a case undiagnosed by CMA and karyotyping. Our study demonstrated that chromosomal aneuploidy abnormalities are the main genetic cause of fetal CH. Based on this, we recommend karyotyping combined with rapid aneuploidy detection as a first-tier approach for the genetic diagnosis of fetal CH. WES and CMA could improve the diagnostic yield when routine genetic tests fail to determine the cause of fetal CH. [ABSTRACT FROM AUTHOR]

Background: The online market is getting popular today, and consumers' preferences about products are revealed differently in online and offline markets. Especially, fresh food purchasing online is very different from non-food products due to its unique features such as perishability, low cost and frequent purchases, low value-volume ratio, and highly relevance to safety and health. However, studies on online fresh food are rather few, and this study will fill the gap by investigating consumers' preferences for fresh food online purchasing. Methods: Using unique data observed from online stores, we conduct a hedonic analysis of fresh produce online market using apple market in China, avoiding hypothetical bias. Propensity Score Matching is used to check the online promotion effects. The data are apples transactions from Jingdong JD e-commerce platform with sample size 8,200, observed across six weeks from 11/26/2018 to 12/31/2018. Variables used include prices, promotions, varieties, places of origin, fruit size, labeled as organic or green food, watercore label, and customer reviews for the products as well as for the venders. Results: We found place of origin, food safety and eco-certificates, and sensory features all influence apple prices which reflect consumer preferences. In addition to product features, store features such as former customers' review for the store, a video post of the product, and other latent product features through former customers' review for the product quality also influence consumers' preference reflected by price. Conclusions: In additional to product intrinsic features, consumer show preferences and valuation for online market special features. [ABSTRACT FROM AUTHOR]

Aims: Limited epidemiological data on the combined impact of several lifestyle factors on type 2 diabetes (T2D) incidence was reported in Chinese population. This study aimed to examine how combinations of BMI, physical activity and diet relate to T2D incidence and estimate corresponding population attributable risk in the general population. Methods: A total of 56,691 male and 70,849 female participants aged 40–74 years old in two population‐based cohorts from the Shanghai Men's and Women's Health Studies were used for analysis. The Cox regression model was used to estimate the association between lifestyle factors collected at baseline and T2D incidence. Multivariable‐adjusted population attributable risks were calculated for specific combinations of lifestyle factors. Results: There were 3315 male and 5925 female incident T2D, with corresponding density incidence rates of 6.39 and 6.04 per 1000 person‐years. If the healthiest group of healthy lifestyle index (HLI) was used as a reference, the hazard ratios (95% confidence intervals) of T2D increased monotonically in men [2.04 (1.75, 2.38); 2.94 (2.53, 3.42); 4.31 (3.66, 5.07)] and women [1.85 (1.64, 2.08); 2.79 (2.49, 3.13); 4.14 (3.66, 4.67)]. One point increase of HLI was related to 35% and 35% lower risk in men and women. About 52.7% and 58.4% cases in men and women could have been avoided if participants had been adherent to a healthy lifestyle of maintaining healthy body weight, eating a healthy diet and keeping physically active. Conclusions: An increased number of healthy lifestyle factors were associated with a decreased risk of T2D in the Chinese population. Future interventions targeted at combined healthy lifestyle factors are needed to reduce the burden of T2D. [ABSTRACT FROM AUTHOR]

As a traditional Chinese medicine, Crocus sativus Linn has been used for a long time in China. However, the studies on secondary metabolites of its endophytic fungi were not fully sufficient. Thus, the endophytic fungus, Aspergillus fumigatus, collected from the lateral buds of C. sativus, was here investigated. An approach combining UHPLC-HRMS/MS (ultra-high performance liquid chromatography-high resolution mass spectrometry) with molecular network was carried out to construct a molecular network of crude EtOAc extract (CEE) of A. fumigatus, in which 32 chemical compounds were annotated. On the basis of analysis results, a total of 15 known natural compounds were isolated from CEE. Among them, compounds 11 and 12 were isolated for the first time from the genus Aspergillus. Moreover, CEE and compound 7 exhibited moderate inhibitory activity against Erwinia sp. with a MIC value of 100 μg/mL. This study provided a more convenient and rapid approach to investigating the crude extract with complex components of A. fumigatus, which is of great benefit to the further study and utilization of secondary metabolites of the genus Aspergillus. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence and molecular characteristics of fosA3 and fosA7 among Salmonella isolates.Methods: Five hundred and fifty-one Salmonella isolates collected from food animals in China during 2016-19 were screened for fos genes. The drug resistance, serovars, clonal relationships and genetic environments of fosA were compared between fosA7- and fosA3-positive Salmonella.Results: A relatively high prevalence of fosA7 (9.26%) and fosA3 (6.53%) was identified. fosA3 was associated with high-level fosfomycin resistance (≥512 mg/L), while fosA7 conferred relatively low-level resistance that was independent of the presence of glucose-6-phosphate. Additionally, fosA7 could facilitate Salmonella survival under oxidative stress. Both fosA3 and fosA7 were found in diverse serovars and STs, but segregated into distinct groups. The fosA3-positive Salmonella Typhimurium/Salmonella Indiana strains showed close genetic relationships, while fosA7-positive Salmonella Meleagridis/Salmonella Agona/Salmonella Derby showed a relatively high degree of whole-genome sequence heterogeneity. fosA3 was located on conjugative IncHI2 plasmids or chromosomes, while fosA7 was strictly chromosomal. Furthermore, two strains carried large chromosomal fosA7 regions within genomic islands. The fosA3 and fosA7 contigs from our isolates and the NCBI could be segregated into four primary and distinct genomic backbones. IS26 and the antibiotic resistance genes (ARGs) blaCTX-M, blaTEM-1B and rmtB were frequently adjacent to fosA3, while fosA7-carrying contigs generally lacked mobile elements and ARGs.Conclusions: fosA3 and fosA7 were the primary factors contributing to reduced fosfomycin susceptibility, to different degrees, in these Salmonella isolates. The distinct distributions and molecular characteristics of fosA7 and fosA3 indicated that their origin and evolution in Salmonella were most likely distinct. [ABSTRACT FROM AUTHOR]

Background: Colposcopy alone can result in misidentification of high-grade squamous intraepithelial or worse lesions (HSIL +), especially for women with Type 3 transformation zone (TZ) lesions, where colposcopic assessment is particularly imprecise. This study aimed to improve HSIL + case identification by supplementing referral screening results to colposcopic findings.Methods: This is an observational multicenter study of 2,417 women, referred to colposcopy after receiving cervical cancer screening results. Logistic regression analysis was conducted under uni- and multivariate models to identify factors which could be used to improve HSIL + case identification. Histological diagnosis was established as the gold standard and is used to assess accuracy, sensitivity, and specificity, as well as to incrementally improve colposcopy.Results: Multivariate analysis highlighted age, TZ types, referral screening, and colposcopists' skills as independent factors. Across this sample population, diagnostic accuracies for detecting HSIL + increased from 72.9% (95%CI 71.1-74.7%) for colposcopy alone to 82.1% (95%CI 80.6-83.6%) after supplementing colposcopy with screening results. A significant increase in colposcopic accuracy was observed across all subgroups. Although, the highest increase was observed in women with a TZ3 lesion, and for those diagnosed by junior colposcopists.Conclusion: It appears possible to supplement colposcopic examinations with screening results to improve HSIL + detection, especially for women with TZ3 lesions. It may also be possible to improve junior colposcopists' diagnoses although, further psychological research is necessary. We need to understand how levels of uncertainty influence diagnostic decisions and what the concept of "experience" actually is and what it means for colposcopic practice. [ABSTRACT FROM AUTHOR]

Background and Aim: Evidence about recently proposed data-driven clusters of type 2 diabetes (T2D) is mainly about its prognostic effects and Western populations. We tested the applicability of this clustering approach among the Chinese population. We further investigated the cardiorenal risk profiles among different T2D sub-phenotypes cross-sectionally and before diabetes diagnosis. Methods: With the use of data from the China Health and Nutrition Survey (1989–2009), 6,728 participants with available fasting blood samples and completed questionnaires in the 2009 survey were included. Glycemic statuses (normoglycemia, prediabetes, and new-onset T2D) were defined according to the 2020 American Diabetes Association criteria. Data-driven cluster analysis was conducted among new-onset T2D based on five variables: age at onset, body mass index (BMI), hemoglobin A1c, homeostasis model estimates of β-cell function, and insulin resistance. Linear regression models were used to cross-sectionally examine the differences of cardiorenal risk factors (body fat distribution, blood pressure, lipid profiles, and kidney function) between glycemic statuses. Mixed-effects models were used to explore a maximum of 20-year trajectories of cardiovascular risk factors (body fat distribution and blood pressure) before diabetes diagnosis. Results: Among 557 (8.3%) new-onset T2D, four sub-phenotypes were found, with 57 (10.2%) assigned to the severe insulin-resistant diabetes (SIRD), 72 (12.9%) to the severe insulin-deficient diabetes (SIDD), 167 (30.0%) to the mild obesity-related diabetes (MOD), and 261 (46.9%) to the mild age-related diabetes (MARD). People clustered within different T2D sub-phenotypes had different cardiorenal risk profiles. Three T2D sub-phenotypes (SIRD, SIDD, and MOD) had worse cardiorenal abnormalities, while the risk burden in the MARD sub-phenotype was similar to that in prediabetes. Compared with people with other T2D sub-phenotypes, people in the MOD sub-phenotype had a faster increment in BMI, waist, upper arm circumference, and triceps skinfold up to 10 years before diagnosis. Blood pressure was less distinct in different T2D sub-phenotypes; however, SIDD and MOD clusters had higher blood pressure levels before diabetes diagnosis. Conclusions: Data-driven T2D sub-phenotyping is applicable in the Chinese population. Certain sub-phenotypes such as MARD only have a minor cardiorenal risk burden, and distinct cardiovascular risk development occurs long before diabetes diagnosis. Our findings can help improve early prevention and targeted treatment for diabetes. [ABSTRACT FROM AUTHOR]

As a special socio-ecosystem, urban sustainability has been challenged by frequent human activities and natural disasters. Including climate into the socio-ecosystem evaluation framework, this paper constructed the climate, eco-environmental, and socio-economic evaluation index, respectively, to evaluate the core cities' socio-ecology in China's three economic circles. An improved entropy-TOPSIS method was subsequently employed to identify the contribution made by each indicator of the compound system, and a modified ternary Coupling Coordination Degree (CCD) model was developed to probe into the CCD levels among the three systems during the study. The results showed that: (1) The climate system's composite scores were characterized by inter-annual fluctuation without a time trend. However, the system's risk increased, manifesting in an increased probability of extreme weather events, especially in Shanghai. (2) The eco-environmental system witnessed an enormous stride, rising above the level of socio-economic development after 2007. Besides, the gap between the eco-environment and the socio-economy was gradually enlarged since 2014. (3) The eco-environment made the most contribution to the CCD's improvement, meaning enhancing the eco-environmental performance was of paramount significance. The findings can help the government formulate more effective measures to balance climate, eco-environment, and socio-economy to achieve sustainable urban development. [ABSTRACT FROM AUTHOR]

The rapid expansion of China's shadow banking system in recent years has led to continuous accumulation of risks and posed threats to the security of China's real economy. According to the specific mechanism of China's economic operation, this paper constructs a dynamic stochastic general equilibrium model to analyse the responses of China's shadow banking system to the exogenous shocks of benchmark interest rate adjustment, high-risk enterprise return rate fluctuation and shadow bank return rate fluctuation. Results indicate that (1) the shadow bank loan interest rate reacts intensively to the benchmark interest rate adjustment; (2) the shadow bank loan interest rate has immediate and short-term response to the fluctuation of high-risk enterprise return rate; (3) the fluctuation of shadow bank return rate indirectly affects the shadow bank loan interest rate. An empirical study using the time-varying VAR model provides further empirical evidence. The shadow banking risks caused by the impacts on the shadow bank loan interest would increase the fragility of China's financial system and endanger the security of China's real economy. [ABSTRACT FROM AUTHOR]

Background: The prenatal BACs-on-Beads™ (PNBoBs™) assay has been applied worldwide for prenatal diagnosis. However, there are neither guidelines nor consensus on choosing patients, sample types, or clinical pathways for using this technique. Moreover, different perspectives have emerged regarding its clinical value. This study aimed to evaluate its clinical utility in the context of clinical practice located in a prenatal diagnostic center in Xiamen, a city in southeast China. Methods: We tested 2,368 prenatal samples with multiple referral indications using both conventional karyotyping and PNBoBs™. Positive results from PNBoBs™ were verified using current gold-standard approaches. Results: The overall rates for the detection of pathogenic copy number variation (pCNV) by karyotyping and PNBoBs™ were 1.9% (46/2,368) and 2.0% (48/2,368), respectively. The overall detection rate of karyotyping combined with PNBoBs™ for pCNV was 2.3% (54/2,368). A total of 13 cases of copy number variation (CNV)with a normal karyotype were detected by PNBoBs™. Another case with a normal karyotype that was detected as a CNV of sex chromosomes by PNBoBs™ was validated to be maternal cell contamination by short tandem repeat analysis. Conclusion: Karyotyping combined with PNBoBs™ can improve both the yield and efficiency of prenatal diagnosis and is appropriate in the second trimester in all patients without fetal ultrasound anomalies who undergo invasive prenatal diagnosis. [ABSTRACT FROM AUTHOR]

How to model the 2019 CoronaVirus (2019-nCov) spread in China is one of the most urgent and interesting problems in applied mathematics. In this paper, we propose a novel time delay dynamic system with external source to describe the trend of local outbreak for the 2019-nCoV. The external source is introduced in the newly proposed dynamic system, which can be considered as the suspected people travel to different areas. The numerical simulations exhibit the dynamic system with the external source is more reliable than the one without it, and the rate of isolation is extremely important for controlling the increase of cumulative confirmed people of 2019-nCoV. Based on our numerical simulation results with the public data, we suggest that the local government should have some more strict measures to maintain the rate of isolation. Otherwise the local cumulative confirmed people of 2019-nCoV might be out of control. [ABSTRACT FROM AUTHOR]

Objectives: This study took Fuzhou city as a case, described how the public health insurance coverage policy in 2016 of novel anti-lung cancer medicines benefited patients, and who benefited the most from the policy in China. Methods: This was a retrospective study based on health insurance claim data with a longitudinal analysis of the level and trend changes of the monthly number of patients to initiate treatment with the novel targeted anti-lung cancer medicines gefitinib and icotinib before and after health insurance coverage. The study also conducted a multivariate linear regression analysis to predict the potential determinants of the share of patient out-of-pocket (OOP) expenditure for lung cancer treatment with the study medicines. Results: The monthly number of the insured patients in Fuzhou who initiated the treatment with the studied novel targeted anti-lung cancer medication abruptly increased by 26 in the month of the health insurance coverage (95% CI: 14–37, p < 0.01) and kept at an increasing level afterward (p < 0.01). By controlling the other factors, the shares of OOP expenditure for lung cancer treatment of the patients who were formal employee program enrollees not entitled to government-funded supplementary health insurance coverage and resident program enrollees were 18.3% (95% CI: 14.1–22.6) and 26.7% (95% CI: 21.0–32.4) higher than that of the patients who were formal employee program enrollees with government-funded supplementary health insurance coverage. Conclusion: The public health insurance coverage of novel anti-lung cancer medicines benefited patients generally. To enable that patients benefit from this policy more equally and thoroughly, in order to achieve the policy goal of not to leave anyone behind, it is necessary to strengthen the benefits package of the resident program and to optimize the current financing mechanism of the public health insurance system. [ABSTRACT FROM AUTHOR]

Background and aim: Autoantibody production are the main risk factors for inflammation of rheumatoid arthritis (RA). This study aimed to investigate differences in B lymphocyte subsets (native B, memory B, and plasmablasts) and several cytokines in RA patients and their correlation with the clinical parameters. Methods: In total, 81 RA patients (active RA and inactive RA) and 40 healthy subjects were recruited between September 2018 and October 2020. The distribution of B lymphocyte subsets in peripheral blood samples was measured via flow cytometry and the plasma cytokines were detected by enzyme linked immunosorbent assay. The receiver operating characteristic curve (ROC) was used to evaluate the value of each index for RA diagnosis and activity prediction. Results: The percentages of native B and memory B cells in RA patients did not differ significantly from the percentages of those in healthy controls. However, the percentage of plasmablasts in active RA patients was significantly higher compared with healthy subjects and inactive RA patients. The percentage of plasmablasts was significantly related to C reaction protein. ROC curve analysis showed that when the best cutoff value of plasmablasts/B cell was 1.08%, the area under the curve (AUC) for diagnosing RA was 0.831 (95% CI 0.748 ~ 0.915), the specificity was 91.4%, and the sensitivity was 67.5%. The AUC predicted by the combination of plasmablast and anti-CCP for active RA patients was 0.760, which was higher than that of plasmablast and anti-CCP. Conclusion: In conclusion, the percentage of plasmablast varies among RA patients in different stages. The percentage of plasmablasts can be used as an early diagnosis marker for RA. [ABSTRACT FROM AUTHOR]

Background: Sufficient physical activity (PA) during pregnancy is beneficial for a woman's health; however, the PA levels of Chinese women at different pregnancy stages are not clear. The aim of our study was to investigate PA changes during pregnancy and the association of population characteristics with PA change among Chinese women. Methods: Data were obtained from 2485 participants who were enrolled in the multicentre prospective Chinese Pregnant Women Cohort Study. PA level was assessed in early pregnancy (mean = 10, 5–13 weeks of gestation) and again in mid-to-late pregnancy (mean = 32, 24–30 weeks of gestation) using the International Physical Activity Questionnaire short form (IPAQ-SF). Sufficient PA (≥ 600 MET min/week) in early pregnancy and insufficient PA in mid-to-late pregnancy indicated decreasing PA. Insufficient PA in early pregnancy and sufficient PA in mid-to-late pregnancy indicated increasing PA. The associations between demographic, pregnancy and health characteristics and PA changes were examined by multivariable logistic regression. Results: Total energy expenditure for PA increased significantly from early (median = 396 MET min/week) to mid-to-late pregnancy (median = 813 MET min/week) (P < 0.001), and 55.25% of the participants eventually had sufficient PA. Walking was the dominant form of PA. Women with sufficient PA levels in early pregnancy were more likely to have sufficient PA in mid-to-late pregnancy (OR 1.897, 95% CI 1.583–2.274). Women in West China and those in Central China were most and least likely, respectively, to have increasing PA (OR 1.387, 95% CI 1.078–1.783 vs. OR 0.721, 95% CI 0.562–0.925). Smoking was inversely associated with increasing PA (OR 0.480, 95% CI 0.242–0.955). Women with higher educational levels were less likely to have decreasing PA (OR 0.662, 95% CI 0.442–0.991). Conclusions: PA increased as pregnancy progressed, and walking was the dominant form of PA among Chinese women. Further research is needed to better understand correlates of PA change. [ABSTRACT FROM AUTHOR]