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Background: Pneumonia has a high incidence in traumatic brain injury (TBI) patients and lacks effective treatments. Early mobilization (EM) may be a potentially effective treatment. Aim: To explore the impact of EM on TBI‐related pneumonia in the neurosurgical intensive care unit (NICU). Study Design: This study was a historical control study. 100 TBI patients who received EM intervention were prospectively included as the experimental group (EM cohort), and 250 TBI patients were retrospectively included as the control group. The propensity score matching (PSM) method was employed to balance baseline and minimize potential bias. The relationship between EM and TBI‐related pneumonia was investigated by univariate and multivariate logistic regression, then further determined by subgroup analysis. The influence of other variables was excluded by interaction analyses. Finally, the effect of EM on the prognosis of TBI patients was analysed by comparing the Glasgow Coma Scale (GCS) and the hospital stay. Results: After screening, 86 patients were included in the EM cohort and 199 patients were included in the control cohort. There were obvious differences between the two cohorts at baseline, and these differences were eliminated after PSM, when the incidence of pneumonia was significantly lower in the EM cohort than in the control cohort (35.0% vs. 61.9%, p <.001). Multivariate logistic regression showed that EM was an independent risk factor for TBI‐related pneumonia and was significantly associated with a decreased incidence of pneumonia. This correlation was present in most subgroups and was not affected by other variables (p for interaction >.05). Patients in the EM cohort had shorter length of ICU stay (6 vs. 7 days, p =.017) and higher GCS at discharge (12 vs. 11, p =.010). Conclusion: EM is a safe and effective treatment for TBI patients in NICU, which can reduce the incidence of pneumonia, help to improve prognosis and shorten the length of ICU stay. Relevance to Clinical Practice: Although the utilization rate of EM is low in TBI patients for various reasons, EM is still an effective method to prevent complications. Our study confirms that a scientific and detailed EM strategy can effectively reduce the incidence of pneumonia while ensuring the safety of TBI patients, which is worthy of further research and clinical application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors associated with brain frailty and the effect of brain frailty in patients with anterior circulation large artery occlusion (AC-LAO). Methods: 1100 patients with AC-LVO consecutively admitted to the Second Hospital of Hebei Medical University, North China between June 2016 and April 2018 were retrospectively analyzed. The variables associated with brain frailty and stroke outcome were analyzed by ANOVA analysis, the Mann-Whitney U test and multiple linear regression. Based on previous research. Brain frailty score comprises 1 point each for white matter hyperintensity (WMH), old infarction lesions, and cerebral atrophy among 983 participants with baseline brain magnetic resonance imaging or computed tomography. Results: Among AC-LAO participants, baseline brain frailty score ≥ 1 was common (750/983, 76.3%). Duration of hypertension > 5 years (mean difference [MD] 0.236, 95% CI 0.077, 0.395, p = 0.004), multiple vessel occlusion (MD 0.339, 95% CI 0.068, 0.611, p = 0.014) and basal ganglia infarction (MD -0.308, 95% CI -0.456, -0.160, p < 0.001) were independently associated with brain frailty score. Brain frailty score was independently associated with stroke events, and higher brain frailty scores were associated with higher rates of stroke events (p < 0.001). However, brain frailty has no independent effect on short-term outcome of ACI in AC-LAO patients. Conclusions: In AC-LAO patients, older age, duration of hypertension > 5 years, and multiple vessel occlusion influenced the brain frailty score. Brain frailty score was independently associated with the occurrence of stroke events in AC-LAO patients. [ABSTRACT FROM AUTHOR]

The large-scale implementation of the Gully Stabilization and Land Reclamation (GSLR) project induces various failures of loess slopes due to excavation in Yan' an, China. However, the deformation and failure behavior of these excavated loess slopes have not been fully understood. In this study, field investigation was undertaken for analyzing the distributions and failure features of excavation-induced loess slope failures. It is found that plastic failure mainly occurs in Q3 loess layers and brittle failure in Q2. To understand the underlying failure mechanism, a series of triaxial shear tests were conducted on intact Q3 and Q2 loess samples that with different water contents, namely natural water content (natural), dry side of the natural value (drying 5%), and wet side (wetting 5%). The characteristics of stress-strain curves and failure modes of the samples were analyzed. Results show that the stress-strain curves of Q2 samples are dominated by strain-softening characteristics, while Q3 samples mainly exhibit strain-harden features except in the drying state. Correspondingly, shear failures of Q3 specimens are mainly caused by shear crack planes (single, X or V-shaped). For Q2 loess, the dominance of tensile cracks is observed on the surface of damaged specimens. These disclose the different failure modes of excavated slopes located in different strata, that is, the arc sliding failure of Q3 loess slopes and the stepped tensile failure of Q2 loess slopes, and are helpful in the design and management of the ongoing GSLR projects in the Loess Plateau. [ABSTRACT FROM AUTHOR]

Background: Tan and Hu sheep are well-known local breeds in China, producing lamb fur with unique ornamental and practical values highly appreciated by consumers worldwide. Fur quality is optimal at one month of age and gradually declines with time. Despite active research on its genetic mechanism using transcriptomic and whole genome bisulfite sequencing analysis, the main effective gene locus has not been found, and its regulatory mechanism is still unclear, which limits the breeding and improvement of fur traits. Results: Scapular skin samples from newborn (1-month old) and adult (24-month old) Tan sheep were utilized for small ribonucleic acid (RNA) sequencing Principal Component Analysis (PCA) showed that the newborn and adult groups were completely separated. Differential expression analysis of micro-RNAs (miRNAs) identified 32 up-regulated miRNAs and 48 down-regulated miRNAs in the newborn groups. All up-regulated miRNAs were located in the imprinted. Dlk1-Gtl2 locus on chromosome 18, whereas all down-regulated miRNAs were distributed across the sheep chromosomes, without a clear pattern of positional consistency. Further, by systematically analyzing the target genes and signaling pathways of all 32 up-regulated miRNAs, we found that the PI3K-AKT signaling pathway has the potential to be targeted and regulated by most of the miRNAs in the Dlk1-Gtl2 region. In addition, we also re-analyzed miRNA sequencing data from public databases on Hu lambs (full sibling Hu lambs with high- and low-quality fur characteristics). Again, it was found that most of the up-regulated miRNAs in lambs with high-quality fur were also located in the Dlk1-Gtl2 region, whereas this patter was not present for down-regulated miRNAs. Conclusion: Sequencing of miRNAs in conjunction with public databases was employed to identify miRNAs within the imprinted Dlk1-Gtl2 region on chromosome 18, suggesting their potential roles as epigenetic regulators of fur traits. Small RNAs located at the Dlk1-Gtl2 locus were identified as having the potential to systematically regulate the PI3K-AKT signaling pathway, thereby indicating the relevance of the Dlk1-Gtl2/PI3K-AKT axis in the context of fur traits. Selection of parental specific expressed imprinted genes in the process of conserving and exploiting lamb fur traits should be emphasized. [ABSTRACT FROM AUTHOR]

This study aims to analyse the risk factors of Peristomal Moisture‐Associated Skin Damage (PMASD) in colorectal cancer patients, construct a prediction model, and verify its effect. A total of 375 patients who underwent rectal cancer stoma surgery at the Liaoning Cancer Hospital between January and December 2020 were selected according to the inclusion and exclusion criteria. The clinical data were retrospectively analysed for modelling and internal validation (modelling group). According to the same criteria, the clinical data of 242 patients from January and June 2021 were retrospectively analysed for external validation (validation group). Baseline patient data were recorded. Patients in the modelling group were divided into those with and without PMASD based on the occurrence of PMASD during hospitalisation. Logistic regression analysis was used to examine the factors of PMASD and the PMASD nomogram model of colorectal cancer. Internal model validation was performed with the Bootstrap method, using the ROC and H‐L goodness of fit test to evaluate the differentiation and calibration of the model. Last, external validation of the model was performed. In the modelling group, 212 patients with colorectal cancer developed PMASD. According to the results of the logistic regression analysis, high fasting plasma glucose and fasting blood glucose (FPG), a history of radiotherapy, the height of the stoma opening (i.e., flat or lower than the skin surface), and skin folds around the stoma are risk factors for PMASD (OR > 1, P < 0.05). The stool shaping and colostomy are protective factors for PMASD in patients with colorectal cancer (OR < 1, P < 0.05). To establish the prediction of colorectal cancer, patient development of PMASD line, graph model, and internal verification was carried out using the Bootstrap method: H‐L test P = 0.846, area under curve, area under the ROC curve (0 > 0.75, 95% CI: 0.778–0, AUC = 0.820). The external validation included the H‐L test (P = 0.137, AUC [0.862] > 0.75, 95% CI: 0.815–0.909), with the maximum value of the Youden index as the best cut‐off value for the model. The ROC curve had a Youden index of 0.559, a sensitivity of 0.877, and a specificity of 0.657. The prompt model area showed good calibration and discrimination. The PMASD in patients with colorectal cancer is affected by defecation traits, the stoma opening height, stoma type, FPG, skin folds around the stoma, and previous radiotherapy history. The nomogram model can provide an effective means to reasonably predict the risk of PMASD in patients with colorectal cancer. [ABSTRACT FROM AUTHOR]

Saline‐alkali soils cover an area of more than 900 million ha and pose an acute threat to global food security. Rice cultivation is an effective method of saline‐sodic soil amelioration in the Songnen Plain in northeastern China. However, the changes in soil microbial communities that follow rice cultivation are largely unknown. In this study, soil bacterial and fungal communities were investigated using high‐throughput sequencing along a chronosequence of rice paddies cultivated in saline‐sodic soils. The results showed that soil fungi and bacteria become more diverse and abundant after rice cultivation compared with uncultivated saline‐sodic soil, in combination with the decreased pH and increased soil organic matter, indicating the amelioration of saline‐sodic soil. The processes of microbial succession following rice cultivation can be divided into two stages: shorter than and longer than 10 years. Moreover, soil fungi and bacteria exhibited distinct variation patterns as they were dominated by different influential factors. The results indicated that bacteria were more strongly dominated by soil properties than fungi, while the latter were more dependent on vegetation. As rice cultivation continued, fungi exhibited better adaptation and faster succession than bacteria in response to environmental shifts after rice cultivation. Therefore, measures that can enhance plant–microbe interactions may be a viable approach for promoting saline‐sodic soil amelioration. This study provided novel insights into the microbial assembly processes following rice cultivation on saline‐sodic lands. [ABSTRACT FROM AUTHOR]

Background: Flurbiprofen has been one of the most commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) in China and other Asian countries for perioperative multimodal analgesia in recent years, yet its association with anastomotic leakage in gastrointestinal anastomoses is unknown. The current study was designed to investigate whether short-term administration of flurbiprofen would increase the risk of anastomotic leakage in patients undergoing gastrointestinal surgery for cancer resection. Methods: A total of 3653 patients (2487 (66.1%) men) undergoing elective operation for gastrointestinal cancer between 18 July 2017 and 30 Oct 2020 were included. The median age was 61 years (interquartile range 53–67 years). The exposure was the short-term postoperative use of flurbiprofen (defined as flurbiprofen treatment within the first week after surgery). The primary outcome was the frequency of clinical anastomotic leakage. Results: Of 3653 patients with available data who were included in the final analysis, 2282 received flurbiprofen administration, and 1371 did not. Anastomotic leakage was not significantly increased among the patients receiving flurbiprofen compared with those who did not (1.62% v 1.46%; P=0.70). In-hospital mortality was comparable between the two groups (0.04% v 0.07%; P=0.72). After adjusted analysis, male sex (OR 3.51, 95% CI 1.80–6.85), ASA score of 3–4 (OR 2.69, 95% CI 1.62–4.48), and intraoperative infusion (OR 2.24, 95% CI 1.19–4.21) were identified as risk factors for anastomotic leakage. Conclusions: Postoperative short-term use of flurbiprofen did not increase the risk of anastomotic leakage in gastrointestinal anastomoses. [ABSTRACT FROM AUTHOR]

Occupational stigma is pervasive, but there is a lack of understanding about how it impacts the behaviors of employees in relatively high-prestige occupations. We draw on the job characteristics model and social information processing theory to establish hypotheses about the effects of occupational stigma on the withdrawal behavior of employees in a relatively high-prestige occupation (preschool teacher). We suggest that perceptions of skill variety and task significance among high-prestige employees may be negatively influenced due to occupational stigma perception. In addition, occupational stigma conveys information to employees that the work they do is not appreciated by beneficiaries. For those reasons, making it difficult for them to perceive the meaningfulness of their work. This lack of meaningful experience is in turn positively associated with employees' withdrawal behavior. Furthermore, we propose that these indirect effects are moderated by perceived job embeddedness of employees. Based on data collected at two time points from 466 preschool teachers in China, we find that occupational stigma is positively related to employees' withdrawal behavior through meaningfulness. In addition, the negative relationship between perceived occupational stigma and experienced meaningfulness is stronger for employees with high job embeddedness than for employees with low job embeddedness. [ABSTRACT FROM AUTHOR]

aimed to develop and validate a simplified FI for use in Chinese older population. Design: Longitudinal study. Setting and Participants: Data were drawn from the Beijing Longitudinal Study of Aging. The study was conducted in 2004 with 1808 participants evaluated using the CGA and was followed-up for 13 years. Mortality was recorded at 3, 5, 8, 10, and 13 years intervals. Measures: 27-Item, 50-item, and 68-item frailty indices were investigated. A Cox proportional hazards model and area under the curve of the receiver operating characteristic (AUC-ROC) were calculated to compare mortality predictions. Results: The FI was positively correlated with age in males (r = 0.174, P < 0.001) and females (r = 0.270, P < 0.001). The mean baseline FI was 0.225 ± 0.085 (range: 0.04– 0.56) as evaluated by the 27-item FI, 0.181 ± 0.117 (range: 0.02– 0.62) by the 50-item FI, and 0.167 ± 0.101 (range: 0.02– 0.59) by the 68-item FI. Cox regression models showed that mortality was significantly higher in frail people than in non-frail people for all 3 indices (p< 0.001). The AUCs of the 68-item FI, 50-item FI, and 27-item FI for predicting mortality were 0.720, 0.717, and 0.677, respectively (p< 0.001). Conclusion: The 27-item FI is reasonable to expect that the AUC of the indices with the higher items number is inferior to the performance of the indices with higher number of items (FI50 and FI68). But 27-item maybe used as a tool to identify frail older adults and predict mortality in clinical and primary care practices in China. [ABSTRACT FROM AUTHOR]

We conducted a survey with 554 kindergarten teachers in China to explore the relationship between psychological empowerment and retention intention, along with the mediating role of psychological capital and the moderating role of professional emotion. The results show that psychological empowerment had a positive effect on retention intention through the mediating effect of psychological capital. Additionally, professional emotion significantly moderated the effects of psychological capital on retention intention. Thus, we confirmed that psychological capital mediated the effects of psychological empowerment on retention intention and that professional emotion moderated the second half of this mediation process. The results of our study have theoretical and practical significance for proposing intervention measures to improve the retention intention of kindergarten teachers. [ABSTRACT FROM AUTHOR]

Capital enrichment (CE) results from capital flows, which reflect the capital distribution among different regions and industries. This paper constructs the evaluation model of resource allocation efficiency from the perspective of capital and innovation resources. It expounds on CE's theoretical mechanism by using the panel data from 2011 to 2018 for system GMM estimation. It finds that the manufacturing capital allocation efficiency (CAE) and innovation resource allocation efficiency (IRAE) show a volatile development trend. Both static and dynamic panel models show that there is a significant U-shaped curvilinear relationship between CE and CAE, CE and IRAE. CE's inhibitory effect on CAE and IRAE decreases with the improvement of CE until it exceeds the critical value of 8.27 and 8.93. After that, its impact on CAE and IRAE changes from negative to positive. [ABSTRACT FROM AUTHOR]

Summary: In the study, lamb, feed and soil samples were collected from three regions of China in the year 2017 and 2018. The δ13C and δ15N values in lamb (defatted dry mass and lipids) and grass and the contents of nine elements in lamb, grass and soil were determined. The results indicated that except for Fe, Zn and Rb, most variables of lamb showed significant differences among two or three regions, and the contents of Fe, Sr and Cs showed significant differences between two years, and the contents of Cu and Zn showed significant differences among different muscle sections. Besides, significant correlations were found for δ13C between defatted lamb and lipid (r2 = 0.973, P < 0.05) and for the element contents between lamb and soil. Finally, four key variables δ13C, δ15N, Sr and Mo were selected through stepwise canonical discriminant analysis with the cross‐validation correct classification rate of 99.1%. [ABSTRACT FROM AUTHOR]

The demand for healthy old-age care is growing rapidly in China. The traditional old-age care model can no longer meet elderly patients' demands for medical care and old-age care. To promote the development of medical care-integrated old-age care, a solution covering multiple aspects is necessary. In the context of the global development of healthy aging, China recently issued many policies to integrate old-age care with medical care, establishing protection for a large number of disabled elderly people. The Integrated Care of Older People (ICOPE) project is an international program developed by the World Health Organization. This paper reviews China's medical and old-age care integration model and the opportunities and challenges in implementing the ICOPE in the context of healthy aging in China. [ABSTRACT FROM AUTHOR]

Background: Poor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic. This study used the effort–reward imbalance model to investigate the association between work-stress characteristics (effort, over-commitment, reward) and mental health problems (anxiety and depression) among front-line public health workers during the COVID-19 pandemic in China. Methods: A total of 4850 valid online questionnaires were collected through a self- constructed sociodemographic questionnaire, the adapted ERI questionnaire, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression analysis was conducted to investigate the association between ERI factors and mental health problems (i.e., depression and anxiety), with reward treated as a potential moderator in such associations. Results: The data showed that effort and over-commitment were positively associated with depression and anxiety, while reward was negatively associated with depression and anxiety. Development and job acceptance were the two dimensions of reward buffered the harmful effect of effort/over-commitment on depression and anxiety, whereas esteem was non-significant. Conclusions: This study confirmed the harmful effects of effort and over-commitment on mental health among public health workers during the COVID-19 pandemic in China. Such effects could be alleviated through an appropriate reward system, especially the development and job acceptance dimensions of such a system. These findings highlight the importance of establishing an emergency reward system, comprising reasonable work-allocation mechanism, bonuses and honorary titles, a continuous education system and better career-development opportunities. [ABSTRACT FROM AUTHOR]

Although geriatric research in general has increased in recent years, there is no effective treatment for frailty. Among older adults, those with frailty have an increased risk of falls, disability, and death. The population of older adults has increased rapidly in China, and resulting in an increased demand for medical care services for older adults, including those with frailty. However, much of the research on frailty has been conducted in Europe and the United States, and European and American standards for frailty are not always applicable to Chinese individuals. Clinicians and researchers in China have shown increasing interest in frailty in recent years. Here, we reviewed the current state of frailty research in China. [ABSTRACT FROM AUTHOR]

Form trimming is an important practice in horticulture. Currently, handheld trimming tools are the most commonly used in China, which presents certain disadvantages including high human labor input, low productivity and inconsistent performance. In this work, a wheeled form trimming machine was designed for shrub plants with the aim of reducing labor input, increasing efficiency and improving trimming performance. The machine was mainly composed of three parts: a supporting frame, a rotary base and a knife system. The design and construction of the key components of the machine were introduced. The knife system was a combination of multiple cutter units with reciprocating motions. The number of units and their connecting angles could be adjusted to realize different trimming shapes. The knife system was carried by the rotary base and could realize 360° rotations to cut the plants into a desired form. Experiments were performed to determine the optimal working parameters (cutting frequency of the cutter unit and rotating speed of the rotary base). The similarity between the plant profile after trimming and the profile of the knife system and the consumed time in each operation were chosen as two evaluation indexes. Results showed that when the cutting frequency was 16.7 Hz and the rotating speed of the rotary base was 13.5 r/min, the trimming operation could be completed by two circles, and the time consumption was 8.89 s. Furthermore, to test the adaptability of the machine, five different shrub plants were chosen and trimmed by the machine, and results showed that the overall similarity was above 93%. Therefore, the form trimming machine developed could meet the requirements of shrub trimming in horticulture with desirable precision and adaptability. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between psychological empowerment, psychological capital, job involvement, and the retention intention of kindergarten teachers in mainland China and the internal mechanism of action. Methods: A total of 554 kindergarten teachers were investigated by scales for psychological empowerment, psychological capital, job involvement, and retention intention. Results: (1) Psychological empowerment was positively correlated with psychological capital and job involvement. Psychological capital was positively correlated with job involvement. Psychological empowerment, psychological capital, and job involvement were significantly and positively correlated with retention intention. (2) Psychological empowerment influences kindergarten teachers' retention intention mainly through three indirect effects: the single intermediary effects of psychological capital and job involvement and the chain intermediary effect of psychological capital → job involvement. Conclusion: Psychological empowerment can not only indirectly predict the retention intention of kindergarten teachers through the single intermediary effects of psychological capital and job involvement, but also indirectly predict the retention intention of kindergarten teachers through the chain intermediary effect of psychological capital and job involvement. [ABSTRACT FROM AUTHOR]

Background: Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic.Methods: Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders.Results: The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001).Conclusions: Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19. [ABSTRACT FROM AUTHOR]

Objectives: The burden of multimorbidity is increasing worldwide; however, little is known about trends in multimorbidity prevalence among Chinese older adults. We aimed to estimate the prevalence and trends of multimorbidity in community-dwelling older adults in Beijing. Design: Longitudinal. Setting and participants: Residents of Beijing aged ≥60 years. Measurements: Data were derived from the Beijing Longitudinal Study of Aging, using cluster, stratification, and random sampling. A total of 1842, 2914, and 1837 participants were included in the 2004, 2011, and 2017 sample, respectively. Multimorbidity was defined as the presence of two or more chronic conditions. Trends in multimorbidity were examined by age, sex, and geographical area. Results: The prevalence of multimorbidity was 32.5%, 52.9%, and 53.2% in 2004, 2011, and 2017, respectively, following an upward trend over time (P =0.003). A similar multimorbidity increase trend was present in age-, sex-, and region-stratified analysis for the 2004–2017 period (all P<0.05). The most common chronic diseases in 2004 were hypertension (34.3%), cataract (18.2%), coronary heart disease (CHD) (15.6%), stroke (14.3%), and chronic obstructive pulmonary disease (7.9%); in 2011, these were hypertension (49.6%), arthritis (30.9%), CHD (22.3%), stroke (21.9%), and diabetes (15.1%); in 2017, these were hypertension (54.4%), arthritis (26.3%), stroke (22.6%), cataract (20.5%), and CHD (20.1%). The proportion of older adults diagnosed with ≥3 chronic diseases significantly increased from 13.4% in 2004 to 73.1% in 2011 and 69.5% in 2017. Conclusions: Multimorbidity is common and the overall and age-, sex-, and region-specific multimorbidity prevalence has been increasing over the past 13 years. Public health policies should account for the more complex care needs and growing costs associated with increasing prevalence of chronic disease and multimorbidity in Chinese older adults. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effects of fermented Caragana korshinskii feed on meat quality in three muscle tissues (longissimus dorsi m., triceps brachii and biceps femoris) in Tan sheep. Sheep were randomly divided into two groups: the control group was fed a basic diet, and the experimental group was fed the basic diet supplemented with 10% fermented Caragana korshinskii. The results for the meat quality characteristics showed that the fermented Caragana korshinskii group had significantly greater more crude protein in all three muscles and more ash in the longissimus dorsi m. and triceps brachii than the control group. The fermented Caragana korshinskii group had a significantly higher ultimate pH in the biceps femoris and triceps brachii than the control group. The fermented Caragana korshinskii group had greater inosinic acid content in the longissimus dorsi m. and triceps brachii than the control group. The fermented Caragana korshinskii group had significantly higher levels of Asp, Thr, Glu and Ser in the triceps brachii than the control group. The fermented Caragana korshinskii group had significantly higher levels of C12:0 in the triceps brachii, of C15:0 and C16:0 in the biceps femoris, of C16:1 in the longissimus dorsi m. and triceps brachii, of C18:0 in the triceps brachii than the control group. Therefore, adding 10% fermented Caragana korshinskii to the diet of the sheep significantly improved the crude protein, ash, inosinic acid, partial amino acid and fatty acid contents as well as the ultimate pH and L* values in Tan sheep muscles. Fermentative caragana korshinskii was partially substituted for corn stalk to feed Tan sheep could significantly improve crude protein, ash, ultimate pH, L* value, inosinic acid, partial amino acid and fat acid species and content of Tan sheep. It was provided scientific basis for the rational utilization of caragana korshinskii resources by studying its effect on meat quality of Tan sheep. Fermented Caragana korshinskii solves the problem of lack of forage resources in China and the imbalance of forage supply in winter and spring in China. [ABSTRACT FROM AUTHOR]

Standard scheduled flight block time (SBT) setting is of great concern for Civil Aviation Administration of China (CAAC) and airlines in China. However, the standard scheduled flight block times are set in the form of on-site meetings in practice and current literature has not provided any efficient mathematical models to calculate the flight block times fairly among the airlines. The objective of this paper is to develop and solve a mathematical model for standard SBT setting with consideration of both fairness and reliability. We use whale optimization algorithm (WOA) and an improved version of the whale optimization algorithm (IWOA) to solve the SBT setting problem. A novel nonlinear update equation of convergence factor for random iterations is used in place of the original linear one in the proposed IWOA algorithm. Experimental results show that the suggested approach is effective, and IWOA performs better than WOA in the concerned problem, whose solutions are better compared to the flight block times released by CAAC. In particular, it is interesting to find that MSE, RMSE, MAE, MAPE and Theil of the reliability in 60%–70% range are always the smallest and the average fairness of airlines is better than that of 60%–75% range. The model and solving approach presented in this article have great potential to be applied by CAAC to determine the standard SBTs strategically. [ABSTRACT FROM AUTHOR]

Shenmayizhi formula (SMYZF) has been shown to have an effect on vascular dementia (VaD) in previous studies. The aim of this study was to evaluate whether a combination of SMYZF with Ginkgo extract tablets improves mild-to-moderate VaD. In this 12-week, randomized, double-blind, controlled study, we randomly assigned 196 patients with VaD (aged 50–85 years) to either the SMYZF group (n = 98) or the Ginkgo group (n = 98). All patients received Ginkgo extract tablets as a basic treatment, while the SMYZF group also received SMYZF treatment. We evaluated the participants at baseline and after 12 weeks of the intervention for the following: the Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), activities of daily living (ADL), Chinese Medicine Symptom Scale (CM-SS) scores, serum endothelin-1 (ET-1), nitric oxide (NO), vascular endothelial growth factor (VEGF), von Willebrand factor (vWF), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), and homocysteine (Hcy) serum levels. Both interventions significantly increased MMSE scores and decreased NIHSS, ADL, and CM-SS scores. The SMYZF group showed greater improvement in MMSE, NIHSS, and CM-SS scores. Both groups showed a significant decrease in serum ET-1 and an increase in serum VEGF. Furthermore, serum NO increased, and vWF decreased significantly in the SMYZF group. Changes in serum ET-1 and NO were greater in the SMYZF group. Both groups showed a significant increase in serum BDNF and a decrease in serum NSE and Hcy. Improvement in serum NSE and BDNF was greater in the SMYZF group. SMYZF combined with Ginkgo extract tablets improved vascular endothelial and cognitive functions, as well as the syndromes diagnosed based on the traditional Chinese medicine in patients with VaD. [ABSTRACT FROM AUTHOR]

In the context of the new normal in China's economy, the development of coal enterprises continues to be sluggish, and their social responsibility issues have received increased attention from all walks of life. The stakeholder model of social responsibility was constructed based on the stakeholder theory to reveal the influence of social responsibility on the corporate value in the Chinese coal sector and their transmission mechanism. The panel data of coal enterprises in Shenzhen and Shanghai Stock Exchanges from 2011 to 2019 was used to employ the system GMM (Generalized Moment Estimation) and the mediating effect model for empirical research. The results show that social responsibility has a positive influence over corporate value, and the impact of social responsibility on corporate value is heterogeneous for stakeholders in different dimensions. Social responsibility towards employees, shareholders, creditors, resources, and the environment has the greatest contribution to corporate value. Additionally, capital enrichment plays a mediating role in this effect, which enhances the positive impact of social responsibility on corporate value. Such findings reveal the transmission mechanism of social responsibility on corporate value and provide policy suggestions for coal enterprises to promote their sustainable development, which is beneficial for the national energy security and strategy. [ABSTRACT FROM AUTHOR]

Background: Frailty, at the core of geriatric medicine, is an important concept underpinning health problems but the rapid and valid measurement of frailty for older adults in the Emergency Department (ED) is lacking in China. The Frailty Screening Questionnaire (FSQ), has been shown to be a simple, rapid and practical tool to identify frailty in both community and inpatients settings, yet its utility in acute care settings is not well understood. Objective: To determine whether FSQ is useful to identify frailty and predict adverse outcomes in an emergency care setting. Design and Participants: This prospective study included 350 adults aged 60 and over and admitted to the ED. Measurements: The FSQ questionnaire which assessed self-reported slowness, weakness, inactivity, exhaustion, and weight loss was used to rapidly recognize frailty. FRAIL, Clinical frailty score (CFS), activities of daily living (ADL) and nutrition risk screening 2002 were also assessed. Outcome measures included all-cause 28-day mortality, ADL dependency, mechanical ventilation, length of hospital stay, and ICU readmissions 30 and 90 days after discharge. Cox proportional hazard model was used for survival comparison. Results: The prevalence of FSQ frailty and prefrailty in older adults were 44.6% and 30.9% respectively in the emergency setting. FSQ frailty was associated with increasing age, chronic diseases, malnutrition risk, poor physical function and worse outcomes indicated by higher 28-d mortality, ADL dependency, mechanical ventilation, length of hospital stay, and ICU readmissions after discharge. The Kappa coefficient between the FSQ and FRAIL was 0.552. FSQ score was negatively correlated with grip strength and positively correlated with Barthel index, length of hospital stay and CFS score. Cox regression adjusted by epidemiological variables and chronic diseases showed FSQ and all components predicted mortality except weight loss. Conclusion: The FSQ is a rapid and useful tool to screen frailty and an effective tool to predict mortality in busy emergency settings. [ABSTRACT FROM AUTHOR]

This paper examines the impact of institutional ownership on merger and acquisition (M&A) performance of Chinese listed firms from 2006 to 2017. The results indicate that institutional ownership positively affects M&A performance, and so does institutional ownership concentration. Moreover, the results suggest that pressure-sensitive, large, and domestic institutional ownership have a greater positive effect on M&A performance than pressure-insensitive, small, and foreign institutional ownership. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence and related factors of cognitive impairment in community-dwelling older residents in Beijing, China.Methods: This is a cross-sectional study. A total of 2017 older individuals aged ≥ 60 years from Beijing Longitudinal Study of Aging were included in this study. Information on demographic characteristics, life style, chronic disease and geriatric syndromes was collected. Cognitive function was assessed by Mini-Mental State Examination.Results: The prevalence of cognitive impairment was 13.6% in community-dwelling older residents in Beijing. The prevalence of cognitive impairment was higher in women than it was in men and in rural areas than it was in urban areas, and increased with age. Logistic regression showed that older age [odds ratio (OR) = 1.496-3.033, P < 0.001], illiteracy (OR = 1.200-2.434, P = 0.003), low income (OR = 1.268-3.906, P = 0.005), less social participation (OR = 1.011-2.147, P = 0.044), stroke (OR = 1.410-3.305, P < 0.001), hearing loss (OR = 1.231-2.295, P = 0.001), depression (OR = 1.115-2.385, P = 0.012) and disability (OR = 2.315-4.681, P < 0.001) were independent risk factors for cognitive impairment.Conclusions: The prevalence of cognitive impairment among the older adults in Beijing was high. More attention should be paid to the identification of and intervention for factors influencing cognitive impairment, and health education should be carried out to improve the quality of life of the older adults. [ABSTRACT FROM AUTHOR]

Hypertension and frailty are associated and often coexist in older adults. Few studies have examined the association between hypertension and frailty in Chinese population. We explored the prevalence of and the factors associated with frailty as well as whether frailty could identify patients at risk of adverse outcomes among older adults with hypertension. Data were from the Beijing Longitudinal Study of Aging. A total of 1111 hypertensive participants aged ≥60 years old who completed the comprehensive geriatrics assessment were included. All participants were followed up for 8 years. The total number of deaths was 604. Frailty was assessed by the 68-item frailty index. Stepwise forward logistic regression was used to explore the association between the associated factors and frailty in hypertensive participants. The prediction for mortality was assessed using the adjusted Cox proportional hazards model. Two hundred and eighteen older adults were determined as frail (prevalence rate: 19.6%). Frail older adults with hypertension had worse physical performance, worse psychological, and social function, as well as worse lifestyle habits, compared to nonfrail older adults with hypertension. Chair stand test failure, balance test failure, fracture, disability, depression, and physical frailty measured with modified frailty phenotype were independently associated with frailty. Frailty was associated with a higher 8-year mortality, hazard ratio (HR) = 3.40, adjusted for age and sex, HR = 2.61. Frailty is associated with poorer physical function and higher mortality in community-dwelling hypertensive older adults in China. These findings emphasize the importance and need for frailty intervention and prevention in older adults with hypertension. [ABSTRACT FROM AUTHOR]

Objective: Frailty, which involves low physical activity (PA), is as a well-established factor of increased risk of hospitalization, disability, and mortality. To date, there are no specific tools to assess PA among Chinese elderly. As part of the Beijing Longitudinal Study of Aging (BLSA), we aimed to develop the BLSA Leisure-Time Physical Activity Questionnaire (BLSA-PAQ) and assess its prediction of mortality.Design: Longitudinal study.Setting: Community.Participants: 1810 Chinese older adults completed the BLSA-PAQ questionnaire.Measurements: BLSA-PAQ questionnaire containing four items: walking, outdoor chores, low-intensity exercise, and moderate-intensity exercise. Physical function was assessed through the balance test, chair-stand test, and the activities of daily living (ADL), and instrumental activities of daily living (IADL). Frailty was evaluated using a modified frailty phenotype and frailty index.Results: The following equation was obtained based on the 8-year mortality for the four BLSA-PAQ components: BLSA-PAQ index (BLSA-PAQ total score) = Walking score + Outdoor chores score + 2 × (low-intensity exercise score) + 3 × (moderate-intensity exercise score). The BLSA-PAQ index decreased with age, and was negatively related to modified frailty phenotype score and frailty index. Low PA and pre-low PA statuses were associated with poorer results in the balance and chair-stand tests, ADL dependency, IADL dependency, and frailty. After adjusting for age and gender, the 8-year mortality HRs were 1.453 (95% CI, 1.166-1.811) and 2.358 (95% CI, 1.856-2.995) for low PA and pre-low PA, respectively. Low PA defined by the BLSA-PAQ index was associated with frailty, disability, worse physical function, and higher mortality.Conclusion: The BLSA-PAQ seems to be a reliable tool to measure PA in Chinese older adults. Further studies are needed to confirm these findings and validate the use of the BLSA-PAQ for frailty assessments of older adults. [ABSTRACT FROM AUTHOR]

Background/Objectives: Frailty in older adults predicts dependence and mortality and is a major challenge for healthcare systems in countries with rapidly aging populations. Little is known about frailty in China. We investigated the prevalence and associated risk factors of frailty in older adults in China. Design: Cross‐sectional. Setting: Data were obtained from the China Comprehensive Geriatric Assessment Study, conducted in 2011–12, which was the first uniform comprehensive assessment system adopted in China. Participants: Older adults from 7 cities were selected based on well‐established cluster, stratification, and random selection statistical sampling techniques (N = 5,844). Measurements: The Comprehensive Geriatric Assessment‐Frailty Index was measured based on demographic characteristics, physical health, physical function, living behavior and social function, mental health, and cognitive function. Results: The overall weighted prevalence of frailty was 9.9%: 12.7% in southwestern China, 11.0% in northern China, 5.9% in northwestern China, 5.0% in south‐central China, 2.5% in eastern China, and 2.3% in northeastern China. The prevalence of frailty increased with age and was significantly higher in women and those living in rural areas. After adjusting for sex, age, area, region, and education, activity of daily living impairment was the strongest risk factor for frailty. Chronic diseases, depression, poor lifestyle, and geriatric syndromes were also independent risk factors. Conclusion: Our study provides epidemiological characteristics and the risk factors of frailty in China; the findings indicate greater regional disparities. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially in women and those living in rural areas. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore the epidemiological characteristics of antihypertensive drug use by community residents in Beijing, China. Methods Based on well-established statistical sampling techniques such as cluster, stratification, and random selection, 2832, 1828, and 2277 elderly residents aged ≥60 years in Beijing in 2000, 2004, and 2007, respectively, were included. The trend in antihypertensive drug use by elderly patients with hypertension was analyzed. Results The proportion of patients using angiotensin converting enzyme inhibitors (ACEIs) or β-blockers increased, while the proportions of both male and female patients using Chinese single-pill combination decreased. The proportion of relatively young patients using ACEIs or β-blockers increased, as did the proportion of relatively old patients using calcium channel blockers (CCB), ACEIs, or β-blockers. The proportions of both relatively young and relatively old patients using Chinese single-pill combination decreased. The proportion of urban patients using ACEIs, or β-blockers and the proportion of rural patients using CCBs or diuretics increased, while the proportion of both urban and rural patients using Chinese single-pill combination decreased. Conclusion During the 7-year study period in Beijing, the proportion of patients using CCBs, ACEIs, diuretics, or β-blockers increased, while the proportion of patients using Chinese single-pill combination decreased. Our results provide important data for the limited evidence on the trend of prevalence of antihypertensive drug used in China. [ABSTRACT FROM AUTHOR]

Objective Disability affects older adults’ quality of life. This study aimed to examine the socio-demographic characteristics of disability in older adults in China. Method Data was obtained from the China Comprehensive Geriatric Assessment Study (CCGAS). The sample comprised 6864 people aged 60 years and above from seven provinces in China. A door-to-door survey was conducted by formally trained interviewers using a unified questionnaire. Disability was assessed with physical health assessment comprising activities of daily living (ADL), and independent activities of daily living (IADL). For the purpose of this study, we analyzed only disability and some socio-demographic dimensions. The rates were standardized based on China’s Sixth National Census population distribution. Results The disability rate in older adults was 7.0%. The disability rate was significantly higher in women than men, significantly higher in rural areas than urban areas, and higher in northern China than southern China. Urban disability rates ranged from 5.7% to 1.2%. The differences were statistically significant, with Beijing having the highest and Shanghai the lowest disability rates. Disability increased with age. Conclusion In China, the disability rate in older adults is 7.0%, and increases with age. The disability rate is significantly higher in women, rural area, and northern China. This is the first study to report the epidemiology of disability in older adults in China in recent years and indicates the need for further epidemiological data on disability in China to facilitate long-term care and care policy formulation. [ABSTRACT FROM AUTHOR]

Campylobacterjejuni is an important foodborne pathogen worldwide; however, there is a lack of information on the prevalence and antibiotic-resistant profile of C. jejuni in the People's Republic of China. We determined the prevalence and characteristics of C. jejuni on the retail level in Tianjin, one of the five national central cities in China. A total of 227 samples of chicken wings, legs, and breasts were collected from supermarkets and wet markets; 42 of these samples were confirmed to be positive for Campylobacter contamination. The contamination rates of C. jejuni and other Campylobacter species were 13.7% (31 of 227 samples) and 5.7% (13 of 227 samples), respectively. A group of 31 C. jejuni isolates was subjected to antimicrobial susceptibility testing. All (100%) the selected isolates were resistant to ciprofloxacin and nalidixic acid; 77.4% were resistant to tetracycline, 67.7% to doxycycline, 35.5% to gentamicin, 25.8% to clindamycin and florfenicol, 19.4% to chloramphenicol, and 12.9% to erythromycin and azithromycin. A remarkably high proportion (41.9%) of multidrug-resistant isolates was identified. Multilocus sequence typing was conducted to study the population structure of the C. jejuni strains and their relationship to human isolates. The correlation between antimicrobial resistance traits and certain sequence types (STs) or clonal complexes was determined as well. A great genetic diversity of poultry isolates was identified, with 11 STs belonging to 6 clonal complexes and 11 singleton STs. The novel STs accounted for 40.9% (n = 9) of the 22 STs. ST-21, ST-353, ST-354, ST-443, ST-607, and ST-828 complexes had been previously identified from human isolates. This study revealed an extensive level of antimicrobial resistance and genetic diversity in C. jejuni isolated from chicken products in Tianjin, highlighting the necessity of performing enforced interventions to reduce Campylobacter prevalence in China. [ABSTRACT FROM AUTHOR]

Objective Frailty is a significant healthcare challenge in China. However, the relationship between frailty and the prognosis of older people in China remains unclear. The present study aimed to evaluate the prevalence of frailty and determine if the frailty index, a comprehensive geriatric assessment, was associated with the prognosis of older people in a Chinese population. Methods Data were drawn from the Beijing Longitudinal Study of Aging, a representative cohort study with an 8-year follow-up. Evaluations based on the use of the frailty index were performed in a cohort of 1808 people aged 60 years and over residing in Beijing urban and rural areas. The initial survey was conducted in 2004, with follow-up surveys at 3, 5, and 8 years. Mortality data for all individuals were collected and analyzed. Results The frailty index and the age of individuals showed the same trend, with a higher frailty index expected as age increased. Respondents with the same frailty index level differed across factors such as sex and location. Male individuals, rural dwellers, and older individuals showed higher frailty rates than female individuals, urban dwellers, and younger individuals. Conclusions Frailty is a condition associated with problems across multiple physiological systems. The frailty index increases with age, and may be a significant tool for evaluation of the prognosis of older people in China. [ABSTRACT FROM AUTHOR]

The authors reflect on geriatric medicine in China as of January 2021. Other topics include the strategic health policies of the Chinese government to address health and social challenges of population ageing like the "Healthy China 2030" policy, the promotion of specialised geriatric care and ageing research, and the researches' focus on the epidemiology and management of common chronic diseases and geriatric syndromes.

Background and Aim: Hepatitis B surface antigen (HBsAg) clearance is the closest cure outcome in hepatitis B. The goal of this study was to investigate clinical features in chronic hepatitis B patients achieving seroconversion of HBsAg after treatment with α-interferon (IFN-α) and a nucleos(t)ide analog. Methods: This retrospective study enrolled 38 chronic hepatitis B patients treated with IFN-α plus a nucleos(t)ide analog who achieved HBsAg seroconversion during the period from June 2001 to May 2009. Clinical and laboratory data of the patients were collected before and after treatment every 3 months. All patients with HBsAg seroconversion in this study were followed up for at least 12 months post-treatment. Results: A total of 38 out of 142 patients achieved HBsAg seroconversion after treatment with IFN-α and a nucleos(t)tide analog for a prolonged period of time (medium 31 months). The median time to hepatitis B e antigen seroconversion and to HBsAg seroconversion was 19.5 months (range 3-60 months) and 25.5 months (range 9-63 months), respectively. Thirty-six patients (95%) sustained HBsAg seroconversion during the post-treatment follow up. Three different HBsAg response patterns were observed with classical model accounting for 57.9% (22/38 cases), simultaneous transition mode accounting for 23.7% (9/38 cases), and HBsAg prior transition model accounting for 18.4% (7/38 cases). Conclusions: Extended treatment with IFN-α in combination with a nucleos(t)ide analog in patients with hepatitis-B-e-antigen-positive appears to be a promising approach for achieving a high rate of HBsAg clearance-the closest outcome to cure. [ABSTRACT FROM AUTHOR]

Background: Physical frailty, characterized by reduced physiologic complexity and ability to cope with stressors, is closely associated with cognitive impairment, which increases the risk of poor clinical outcomes. To better capture the association between frailty and cognitive impairment, a new construct, cognitive frailty, has been proposed. Cognitive frailty is a clinical condition characterized by the simultaneous presence of physical frailty and cognitive impairment. There is little evidence on the relationship between physical frailty and cognition, as well as cognitive frailty, in Chinese older adults. We aimed to elucidate whether physical frailty is associated with cognitive impairment in an older Chinese population.Methods: Data were obtained from the China Comprehensive Geriatric Assessment Study. The sample comprised 3202 community-dwelling adults, aged 60 years and older, from seven Chinese cities. Physical frailty was assessed using a modified, four-item version of the Fried criteria, according to frailty phenotype. Cognitive function was assessed using the Mini-Mental State Examination (MMSE).Results: The prevalence of physical frailty, prefrailty, cognitive impairment, and cognitive frailty was 9.9, 33.9, 7.5, and 2.3%, respectively (weighted: 8.8, 33.8, 6.5, and 2.0%). The prevalence of the combination of prefrail/frail and cognitive impairment was 5.1% (weighted 4.5%). Frail participants performed worse on global cognition and all cognitive domains than robust and prefrail participants. The MMSE total score was positively correlated with walking speed and negatively correlated with age and frailty. A multivariate logistic regression revealed that after adjusting for age, gender, education level, living area, and chronic diseases, frailty, exhaustion, slowness, and inactivity were significantly associated with poor global cognition.Conclusions: The standard prevalence of physical frailty, prefrailty, cognitive impairment, and cognitive frailty in community-dwelling older adults in China was 8.8, 33.8, 6.5, and 2.0%, respectively. Frailty, exhaustion, slowness, and inactivity were significantly associated with poor global cognition. [ABSTRACT FROM AUTHOR]

• The expansibility of mudstone in the foundation for cutting heaved area was investigated. • An in-situ experiment was carried out of the micro-expansion red-bed mudstone in foundation. • The heave mechanisms of cutting for the ballastless track in summer were studied. • The heave mitigation techniques using the water-blocking ditch was proposed. The cutting of the ballastless track for the Lanzhou-Xinjiang high-speed railway (LXHR) shows a transfinite heave deformation in the summer. This paper investigates the mechanisms of cutting heave by analyzing the water content, mineral composition, microstructure, and expansibility of mudstone in the foundation using drilling core sampling in the cutting heaved area for the (LXHR). Besides, an in-situ test is performed on a typical cutting heaving position to investigate the overall expansibility of the micro-expansion red-bed mudstone after absorbing water under different overlying loads. The results showed that the clay mineral content of the mudstone in the foundation was very low, and it does not belong to the category of expansive rock but only has micro-expansion. The in-situ experiment revealed that the swelling value of micro-expansion red-bed mudstone with a thickness of 80 cm was 12.61, 8.78, 7.31, and 5.77 mm under an overlying load of 0, 15, 30, and 45 kPa, respectively, which exceeded the tolerance limit (4 mm). In addition, the study proposed the possible mechanisms that lead to the heave deformation for the LXHR cutting in summer, including the micro-expansion red-bed mudstone in the foundation, the lateral water supply mechanism, and the excavation and unloading. As a result, it preliminarily suggests the heave mitigation techniques for the LXHR by using the water-blocking ditch. [ABSTRACT FROM AUTHOR]

• IC of a large number of Chinese community older adults has deteriorated over 4 years. • The decline in cognitive function over time was the most significant among all dimensions after 4 years. • Age, low education level, widowhood were independently associated with IC deterioration. Intrinsic capacity (IC), the sum of individual mental and physical capabilities, as well as living environment and behavior, jointly determine the functional ability of older adults, shifting the focus from disease to function. At the population level, IC in older adults is associated with adverse health outcomes, such as disability, falls, and death. At the individual level, IC changes dynamically. However, studies on the longitudinal IC trajectory and the factors influencing IC deterioration are limited. We aimed to analyze the IC trajectory and explore the risk factors for IC deterioration in Chinese older adults. Data were obtained from the baseline (2011–2012) and 4-year follow-up (2015) CHARLS surveys, including 1906 people aged 60 years and older. IC comprises six dimensions: locomotion, vitality, hearing, vision, cognition, and psychology. IC trajectory was categorized into three groups: improved, maintained, and deteriorated. Logistic regression analysis was used to analyze factors influencing the trajectory of IC deterioration. After 4 years, 32.1 % had deteriorated, 38.5 % remained stable, and 29.4 % had improved. Age, low level of education, widowed were independently associated with IC deterioration. Dynamic IC monitoring supports the development of individualized intervention policies to delay or prevent IC deterioration. [ABSTRACT FROM AUTHOR]

To study the effects of nitrogen (N), phosphorus (P), and potassium (K) fertilizers on the yield of 'Jianbao' pumpkin (Cucurbita maxima Duch), we conducted experiments using the "3414" optimal design scheme in Dehua County, Quanzhou, Fujian, China. Overall, three fertilizer factors (N, P, K) were tested with four fertilization levels (level 0, no fertilizer; level 1, 0.5-times the typical fertilizing amount; level 2, typical fertilizer application; level 3, 1.5-times the typical application), with a total of 14 different fertilization treatments. Based on the results of this study, a corresponding fertilization performance model was established to provide a practical basis for ensuring highly efficient cultivation of pumpkin in the field. Our results showed that the experimental data could not be fitted with a ternary quadratic polynomial fertilizer model, but that it could be fitted with a single-variable quadratic fertilizer model. According to the fitted model, pumpkin yield first increased and then decreased with the increasing amount of N, P, and K used. We identified significant regression relationships between 'Jianbao' pumpkin yield and the amount of N, P, andKin the fertilizer. Finally, based on the singlevariable quadratic fertilizer model, we suggest that the quantities of N, P, andK fertilizer used for growing 1 ha of 'Jianbao' pumpkin should be 390.5, 213.8, and 371.3 kg, respectively. [ABSTRACT FROM AUTHOR]

Background: Mobility limitation, a manifestation of impaired intrinsic capacity, is the first obvious sign of functional decline. However, few studies have been conducted on the prevalence and incidence of mobility limitation. This study aimed to estimate the prevalence and incidence of mobility limitation in Chinese older adults (over 60 years old) and evaluate its impact on mortality., Methods: The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2013. The prevalence and incidence of mobility limitation were assessed using the methods recommended by the World Health Organization in the integrated care for older people guidelines, using the five-time sit-to-stand test as a screening and then the Short Physical Performance Battery assessment for diagnosis. Multivariable logistic regression was used to analyze the association between mobility limitation and death., Results: Of the 5507 participants with complete baseline data, 1486 had limited mobility, and 4021 had intact mobility at baseline; 4093 participants completed follow-up assessment 2 years later, and 189 died between the baseline and follow-up assessments. Of the 2828 participants with intact mobility at baseline who completed the follow-up mobility assessment, 408 developed mobility limitation. The standardized prevalence was 30.4% (95% CI = 28.8-32.1 %). The standardized incidence of mobility limitation in 2 years was 18.1% (95% CI = 15.8-20.4 %). A total of 189 patients died during the follow-up period. After adjusting for sociodemographic factors and chronic diseases, mobility limitation was associated with an increased risk of death (odds ratio = 1.84, 95% CI = 1.33-2.55, P < .001)., Conclusions: The standardized prevalence of mobility limitation in Chinese older adults living in the community was 30.4%, and the standardized incidence was 18.1%. Mobility limitation significantly predicts 2-year death in older adults. This suggests that early screening, assessment of intrinsic capacity (particularly locomotion domain) as well as tailored interventions to tackle mobility limitation in older adults might reduce mortality., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Background: Intrinsic capacity is the combination of individual physical and mental abilities, reflecting the aging degree of the older adults. However, the mechanisms and metabolic characteristics of the decline in intrinsic capacity are still unclear., Aims: To identify metabolic signatures and associated pathways of decline in intrinsic capacity based on the metabolite features., Methods: We recruited 70 participants aged 77.19 ± 8.31 years. The five domains of intrinsic capacity were assessed by Short Physical Performance Battery (for mobility), Montreal cognition assessment (for cognition), 30-Item Geriatric Depression Scale (for psychology), self-reported hearing/visual impairment (for sensory) and Nutritional risk screening (for vitality), respectively. The serum samples of participants were analyzed by liquid chromatography-mass spectrometry-based metabolomics, followed by metabolite set enrichment analysis and metabolic pathway analysis., Results: There were 50 participants with a decline in intrinsic capacity in at least one of the domains. A total of 349 metabolites were identified from their serum samples. Overall, 24 differential metabolites, 5 metabolite sets and 13 pathways were associated with the decline in intrinsic capacity., Discussion: Our results indicated that decline in intrinsic capacity had unique metabolomic profiles., Conclusion: The specific change of acyl carnitines was observed to be a feature of decline in intrinsic capacity. Dysregulation of the pentose phosphate pathway and of arginine and ornithine metabolism was strongly associated with the decline in intrinsic capacity., (© 2024. The Author(s).)

How people encode numbers in the context of multiple overlapping encoded cues remains unclear. In this study, we explored Chinese finger numbers, which contain both a numerical magnitude cue and a left-right hand cue offered by the expressing hand, to investigate the number encoding mechanism in the context of multiple overlapping cues. Chinese finger numbers expressed by the left or right hand were randomly and centrally presented on a computer screen to participants who were asked to perform a hand classification task (Experiment 1), a magnitude classification task (Experiment 2), a parity classification task (Experiment 3) and a magnitude classification or ring classification task (Experiment 4). We discovered (a) only an association effect between the pressed key and the expressing hand in hand classification and parity classification tasks, (b) the SNARC effect only on the magnitude classification task, (c) the association effect between the pressed key and the expressing hand on the larger, Chinese finger number, magnitude classification task in Experiment 2, and (d) the SNARC effect and the association between the pressed key and the expressing hand were reversed on the ring classification task. From these results, we concluded that people can flexibly choose appropriate number encoding cues and how numbers are encoded in the context of multiple overlapping cues depending on (a) which cognition task individuals perform and (b) the character of the numbers involved.

Background: Frailty is known to be highly prevalent in older hemodialysis (HD) patients. We studied the prevalence of frailty and its associated factors in Chinese HD patients. We further studied if frailty could predict survival in HD patients. Methods: This is a prospective study involving patients receiving maintenance HD in the dialysis center of Xuanwu Hospital, Beijing. Study subjects were enrolled from October to December, 2017 and followed up for two years. Demographic data, comorbidities and biological parameters were collected. Frailty was assessed using the Fried frailty phenotype at baseline. Cox regression analysis was performed to identify the relationship between frailty and mortality in HD patients. Kaplan-Meier was plotted using the cutoff value obtained by ROC curve to evaluate survival rates in different frailty status. Results: Total of 208 HD patients were enrolled with a mean age of 60.5±12.7 years. According to the frailty criteria, at baseline the prevalence of robust, pre-frail and frail in HD patients was 28.7%, 45.9%, and 25.4%, respectively. The two-year all-cause mortality was 18.8% (39/207) and underlying causes of death included coronary artery disease (CAD), cerebrovascular disease (CVD), hyperkalemia, severe infection, malignant tumor and others. Survival curve showed the patients with frailty score ≥4 to have significantly shorter survival time as compared to patients with frailty score ≤ 3. Frailty predicted two-year mortality when frailty score ≥4 with a sensitivity of 70% and a specificity of 83.67% with an AUC of 0.819. Frailty score was positively associated with age and ratio of ultrafiltration volume to dry weight, while negatively associated with levels of serum albumin, uric acid and diastolic blood pressure after HD. Conclusions: Our results confirm frailty to be very common among HD patients and severity of frailty was a significant predictor of mortality for HD patients. Factors such as age, malnutrition and low blood pressure are the factors to be associated with frailty. Interdialytic weight gain inducing excessive ultrafiltration volume is an important risk factor., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Objectives: The aim of this study is to address the difficulties encountered by public health workers in the early and middle stages of their efforts to combat COVID-19, compare the gaps among different types of institutions, and identify shortcomings in epidemic control., Methods: Using multi-stage sampling, a survey of public health workers involved in the prevention and control of COVID-19 was conducted from 18 February to 1 March 2020 through a self-administered questionnaire. These public health workers were from the primary health care center (defined as "primary-urban" and "primary-rural" for those in urban and rural areas, respectively) and the center for disease control and prevention (defined as "non-primary") in five provinces including Hubei, Guangdong, Sichuan, Jiangsu and Gansu, China., Results: A total of 9,475 public health workers were surveyed, of which 40.0 %, 27.0 % and 33.0 % were from the primary-rural, primary-urban and non-primary, respectively. The resources shortage were reported by 27.9 % participants, with the primary-rural being the worst affected (OR = 1.201, 95 %CI: 1.073-1.345). The difficulties in data processing were reported by 31.5 % participants, with no significant differences among institutions. The difficulties in communication and coordination were reported by 29.8 % participants, with the non-primary being the most serious (primary-rural: OR = 0.520, 95 %CI: 0.446-0.606; primary-urban: OR = 0.533, 95 %CI: 0.454-0.625). The difficulties with target audiences were reported by 20.2 % participants, with the primary-urban being the worst (OR = 1.368, 95 %CI: 1.199-1.560). The psychological distress were reported by 48.8 % participants, with no significant differences among institutions., Conclusions: Psychological distress is the most serious problem in the prevention and control of COVID-19. Resources shortage in primary-rural, difficulties in communication and coordination in non-primary, and difficulties with target audiences in the primary-urban deserve attention. This study will provide scientific evidences for improving the national public health emergency management system, especially for reducing the urban-rural differences in emergency response capacity.

Background: The COVID-19 outbreak in China has created multiple stressors that threaten individuals' mental health, especially among public health workers (PHW) who are devoted to COVID-19 control and prevention work. This study aimed to investigate the prevalence of mental help-seeking and associated factors among PHW using Andersen's Behavioral Model of Health Services Use (BMHSU). Methods: A cross-sectional survey was conducted among 9,475 PHW in five provinces across China between February 18 and March 1, 2020. The subsample data of those who reported probable mental health problems were analyzed for this report ( n = 3,417). Logistic and hierarchical regression analyses were conducted to examine the associations of predisposing, enabling, need, and COVID-19 contextual factors with mental health help-seeking. Results: Only 12.7% of PHW reported professional mental help-seeking during the COVID-19 outbreak. PHW who were older, had more days of overnight work, received psychological training, perceived a higher level of support from the society, had depression and anxiety were more likely to report mental help-seeking (OR m range: 1.02-1.73, all p < 0.05) while those worked in Centers for Disease Control and Prevention were less likely to seek help (OR m = 0.57, p < 0.01). The belief that mental health issues were not the priority (64.4%), lack of time (56.4%), and shortage of psychologists (32.7%) were the most frequently endorsed reasons for not seeking help. Conclusions: The application of BMHSU confirmed associations between some factors and PHW's mental health help-seeking. Effective interventions are warranted to promote mental health help-seeking of PHW to ameliorate the negative impact of mental illness and facilitate personal recovery and routine work., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 She, Wang, Zhang, Li, Xu, You, Li, Liang, Li, Ma, Wang, Chen, Zhou, Lau, Hao, Zhou and Gu.)

Objectives: Intrinsic capacity (IC) was proposed by the WHO as a new concept for capturing an individual's functional capacities across their lifetime. We aimed to investigate the prevalence and factors associated with IC decline and examine associations between IC and adverse outcomes among community-dwelling older adults in China., Design: A cross-sectional study., Setting: Community, China., Participants: Data were derived from the China Comprehensive Geriatric Assessment Study, a population-based nationally representative sample. IC comprises of five domains: locomotion, cognition, vitality, sensory and psychology. Participants were deemed to have IC decline if they showed a decline in any of the five domains. Sociodemographic characteristics, chronic diseases, geriatric syndromes and adverse outcomes were also examined., Results: Of the 5823 community-dwelling participants aged 60-98 years, 2506 had IC decline (weighted 39.9%): 57.7% in western, 38.3% in northern, 33.7% in northwest, 36.1% in middle, 16.9% in eastern and 19.8% in northeast China. The number of participants with decline in the locomotion, cognition, vitality, sensory and psychological domains were 1039 (17.8%), 646 (11.1%), 735 (12.6%), 824 (14.2%) and 713 (12.2%), respectively. Age, northern residence, low education, being unmarried, low income, less exercise, less meat intake, insomnia, memory loss, urinary incontinence, constipation, slowness, chronic obstructive pulmonary disease and osteoarthritis were related to IC decline. After adjusting for age, sex, area, district, marriage, education, waist-hip ratio, smoking, alcohol consumption, exercise, income and chronic diseases, IC decline was independently associated with risk of frailty, disability, falls, fractures and immobility., Conclusion: The prevalence of IC decline in China is high. IC decline was significantly associated with adverse outcomes, after adjustment for related variables. Efforts promoting IC to delay functional dependence should focus on modifiable factors, including negative social factors, poor lifestyle, chronic diseases and geriatric syndromes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The association between serum uric acid and the risk of incident diabetes in Chinese adults remains unknown. This study aimed to investigate this association in a community-dwelling population aged ≥ 40 years in Shanghai, China. Oral glucose tole3rance test was conducted during baseline and follow-up visits. Relative risk regression was utilized to examine the associations between baseline gender-specific serum uric acid levels and incident diabetes risk. A total of 613 (10.3%) incident diabetes cases were identified during the follow-up visit after 4.5 years. Fasting plasma glucose, postload glucose, and glycated hemoglobin A1c during the follow-up visit progressively increased across the sex-specific quartiles of serum uric acid (all Ps < 0.05). The incidence rate of diabetes increased across the quartiles of serum uric acid (7.43%, 8.77%, 11.47%, and 13.43%). Multivariate adjusted regression analysis revealed that individuals in the highest quartile had 1.36-fold increased risk of diabetes compared with those in the lowest quartile of serum uric acid (odds ratio (95% confidence interval) = 1.36 (1.06-1.73)). Stratified analysis indicated that the association was only observed in women. Accordingly, serum uric acid was associated with the increased risk of incident diabetes among middle-aged and elderly Chinese women.

Objectives: Hypertension is highly prevalent in the elderly and represents a major risk factor for cardiovascular complications such as coronary heart disease, stroke, and cognitive dysfunction. Frailty is a common geriatric syndrome characterized by increased risk of disability, hospitalization, and mortality. However, little is known about the frailty status in older adults with hypertension. Thus, we aimed to explore the epidemiological characteristics and related factors of frailty in older Chinese adults with hypertension., Methods: The current study included data collected from participants in the China Comprehensive Geriatric Assessment Study. Frailty was defined using the frailty index. Hypertension was defined as SBP at least 140 mmHg, DBP at least 90 mmHg, current treatment with antihypertensive medication, or a self-reported diagnosis of hypertension., Results: Frailty index was positively correlated with age. The prevalence of frailty was significantly higher in hypertensive patients than in normal controls. The prevalence of frailty in older adults with hypertension was 13.8% in China. The awareness and treatment of hypertension was higher in frail individuals than in nonfrail individuals. The control rate of hypertension did not differ significantly between the two groups. Logistic analysis showed that older age, poor marital status, coronary heart disease, chronic obstructive pulmonary disease, cerebrovascular disease, diabetic mellitus, osteoporosis, hearing loss, lack of exercise, depression, cognitive impairment, and higher white blood cell count were factors independently related with frailty in older participants with hypertension., Conclusion: The current study provides the first evidence regarding the status of frailty in older Chinese adults with hypertension.

China has the largest number of individuals with dementia worldwide. Alzheimer's disease (AD) is a growing global health issue that seriously threatens human health and quality of life and imposes a significant burden on families and society. To date, no treatment exists that can delay AD progression. This review describes the current understanding of AD in China, including its prevalence, cost burden, diagnosis, and treatment, and summarizes the major advances in AD in China, including government strategies and research. Such findings highlight the need for a brain health action plan to prevent and control AD and to reduce its increasing prevalence and dementia-related costs in China., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)