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Subsurface wastewater infiltration system (SWIS) is an ecological wastewater treatment technology that has the advantages such as low operating costs, satisfactory pollutant removal effects and ecological service functions. However, emerging compounds in wastewater has increased uncertainties in its treatment performance. In this study, antibiotics were added to the raw water with stepwise increasing concentrations, and the content of pollutants and structure of microbial populations were analyzed, aiming to qualitatively and quantitatively reveal the effect of sulfamethoxazole (SMX), oxytetracycline (OTC) and levofloxacin hydrochloride (HCl-Lev) antibiotics on denitrification rate of SWIS and explore the responses of microbial community. The results showed that the SMX, OTC and HCl-Lev removal rates ranged 34.4–48.7%, negatively correlating with the influent loads in SWIS. Under the stress of compound antibiotic (30.90 ± 0.39–32.49 ± 0.37 mg L−1), N removal rate decreased from 89.8 ± 1.4 (control) to 43.6 ± 2.0% and 38.9 ± 5.0% with increasing the concentrations of antibiotics. As a result, the effluent NH4+-N, NO3−-N, NO2−–N and TN hardly meet the discharge standards in China. Proteobacteria, Acidobacteria, Bacillus, Firmicutes and Bacteroidetes dominated in SWIS, accounting for about 70–90% of all microorganisms, independent of the antibiotics additions. RDA analysis showed that the activities of urease and catalase were negatively correlated with the concentrations of COD, NH4+–N, NO3−–N, TN, SMX, OTC, and HCl-Lev, further indicating that in SWIS, nitrogen and organic compounds are mainly removed by microbial degradation. [ABSTRACT FROM AUTHOR]

The present paper has a research on the distribution and bioaccumulation of heavy metals (Pb, Zn, Cu, Cd and Cr) in the water, sediments, and three endemic fish species from the Huashan Reservoir, source of the Pearl River. The results showed that the water of Huashan Reservoir was under the grade II standard for most of the heavy metals according to the national environmental quality standard for surface water (GB3838-2002) launched by the State Environmental Protection Administration of China, and the metal concentrations of most surface sediments have exceeded the background values of the local soil in Yunnan Province. Furthermore, the Pb, Zn, Cu, Cd and Cr content in the sediment cores increased abruptly around early 1970s. Notably, most metals in all collected fish in this study didn't exceed the safety thresholds according to the national standards. Finally, the results found that the concentrations of heavy metals in the muscles of three fishes were all safe for human consumption, and the mean concentration in the fish organs followed the sequence of liver>gill>muscle. [ABSTRACT FROM AUTHOR]

Aims: This study assessed the relationships between different perpetrator-victim roles in intimate partner violence (IPV), emotion regulation (ER) and mental health problems among men who have sex with men (MSM) in China. Methods: From April to June 2019, 1233 participants were approached via gay-friendly non-governmental organisations in 15 cities across mainland China. Results: Of the total, 578 eligible participants completed an anonymous online survey. All participants provided informed consent and information about their violent perpetrator-victim role and mental health status. The results revealed a high prevalence of IPV in this study sample, with 32.7% of participants reporting IPV victimisation and 32.5% of participants reporting IPV perpetration during their lifetime. A total of 81 (14.0%) participants were suicidal, 309 (53.5%) participants reported poor general mental health and 208 (36.0%) had significant depressive symptoms. Adjusted logistic regression models revealed that both physical victimisation (adjusted odds ratio [ORa] = 3.22, 95% confidence interval [CI] = 1.11–9.32) and sexual victimisation (ORa = 2.90, 95% CI = 1.39–6.05) had positive associations with suicidality, and unidirectional and bidirectional psychological perpetration were associated with poor general mental health and significant depressive symptoms. Although high cognitive reappraisal showed a negative association with poor general mental health (ORa = 0.89，95% CI = 0.86–0.92), the correlation with victims of IPV was weaker than it was with non-victims. Conclusions: This study revealed that different perpetrator-victim roles in different IPV situations should be considered comprehensively in research, prevention and intervention. ER is not enough to buffer the effects of IPV on the mental health of MSM victims. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of neuroimaging in patients with primary headaches and the clinician‐based rationale for requesting neuroimaging in China. Data sources and study setting: This study included patients with primary headaches admitted to hospitals and clinicians in China. We identified whether neuroimaging was requested and the types of neuroimaging conducted. Study design: This was a cross‐sectional study, and convenience sampling was used to recruit patients with primary headaches. Clinicians were interviewed using a combination of personal in‐depth and topic‐selection group interviews to explore why doctors requested neuroimaging. Data collection: We searched for the diagnosis of primary headache in the outpatient and inpatient systems according to the International Classification of Diseases‐10 code of patients admitted to six hospitals in three provincial capitals by 2022.We selected three public and three private hospitals with neurology specialties that treated a corresponding number of patients. Principle findings: Among the 2263 patients recruited for this study, 1942 (89.75%) underwent neuroimaging. Of the patients, 1157 (51.13%) underwent magnetic resonance imaging (MRI), 246 (10.87%) underwent both head computed tomography (CT) and MRI, and 628 (27.75%) underwent CT. Fifteen of the 16 interviewed clinicians did not issue a neuroimaging request for patients with primary headaches. Furthermore, we found that doctors issued a neuroimaging request for patients with primary headaches mostly, to exclude the risk of misdiagnosis, reduce uncertainty, avoid medical disputes, meet patients' medical needs, and complete hospital assessment indicators. Conclusions: For primary headaches, the probability of clinicians requesting neuroimaging was higher in China than in other countries. There is considerable room for improvement in determining appropriate strategies to reduce the use of low‐value care for doctors and patients. [ABSTRACT FROM AUTHOR]

Duck tembusu virus (DTMUV) has caused significant economic losses to the poultry industry in China since the spring of 2010. In this study, a nano-PCR assay targeting E gene of DTMUV was developed and their sensitivities and specificities were investigated. Under the optimized conditions of nano-PCR assay for detection of DTMUV, the nano-PCR assay was 10-fold more sensitive than a conventional PCR assay. The lower detection limit of the nano-PCR assay was 1.8 × 102 copies μl -1 of DTMUV RNA, as no cross-reaction was observed with other viruses. This is the first report to demonstrate the application of a nano-PCR assay for the detection of DTMUV. The sensitive, and specific nano-PCR assay developed in this study can be applied widely in clinical diagnosis and field surveillance of DTMUV-infection. [ABSTRACT FROM AUTHOR]

Study design:Experimental study.Objective:To investigate the expression of C5a and its receptor after spinal cord ischemia reperfusion injury (SIRI) in rat.Setting:Department of Neurosurgery, the Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Province, Xi'an, ChinaMethods:Sprague Dawley rats were subjected to 1 h of infrarenal aorta occlusion to induce spinal cord ischemia. Spinal cord was reperfused for 12, 24, 48 h or 3 days separately after ischemia, respectively. Enzyme-linked immunosorbent assay was used to detect C5a in rat serum. Immunofluorescent staining was performed to detect the expression and cellular localization of C5aR in spinal cord following SIRI.Results:Following SIRI, the motor behavior of the rats was significantly compromised. The serum concentration of C5a in the rat was elevated after SIRI and peaked at 24 h. C5aR was significantly upregulated in the lumbar spinal cord following SIRI and expressed on motor neurons and the microglia, but not astrocyte. There was no significant difference in the expression level of C5aR localized on motor neurons after SIRI. Remarkable upregulation of the C5aR may be associated with increased number of C5aR-positive microglia and elevated cellular expression level.Conclusion:This study provides the first evidence of the expression of C5a and its receptors in SIRI and suggests their possible contribution to SIRI in a rat model. [ABSTRACT FROM AUTHOR]

The 2008 Wenchuan earthquake destroyed large areas of vegetation. Presently, these areas of damaged vegetation are at various stages of recovery. In this study, we present a probabilistic approach for slope stability analysis that quantitatively relates data on earthquake-damaged vegetation with slope stability in a given river basin. The Mianyuan River basin was selected for model development, and earthquake-damaged vegetation and post-earthquake recovery conditions were identified via the normalized difference vegetation index (NDVI), from multi-temporal (2001-2014) remote sensing images. DSAL (digital elevation model, slope, aspect, and lithology) spatial zonation was applied to characterize the survival environments of vegetation, which were used to discern the relationships between successful vegetation regrowth and environmental conditions. Finally, the slope stability susceptibility model was trained through multivariate analysis of earthquake-damaged vegetation and its controlling factors (i.e. topographic environments and material properties). Application to the Subao River basin validated the proposed model, showing that most of the damaged vegetation areas have high susceptibility levels (88.1%>susceptibility level 3, and 61.5%>level 4). Our modelling approach may also be valuable for use in other regions prone to landslide hazards. [ABSTRACT FROM AUTHOR]

We focus on the impact of migrants’ remittances on consumption patterns in China. Using a large homogenous sample of rural households surveyed in 2001 and 2004, we find that remittances are spent on nonhousing consumption expenditures at the margin, virtually dollar-for-dollar, when we instrument remittances and local employed earnings using proxies of social networks. Our findings are robust to intra-household division of labour and to fixed-effect for the county in which the respondents are registered. These results imply that rural households largely take remittances as permanent income and are consistent with the prevalence of circular and repeat migration in China. [ABSTRACT FROM PUBLISHER]

Background: Although metabolic syndrome (MetS) has been reported to be associated with cognitive decline and dementia, little was known about late-life MetS and cognitive decline among older old population. The main purpose of this study was to evaluate the role of MetS and cognitive decline among men aged 75 and over in Taiwan. Methods: This is a prospective cohort study which recruited men aged 75 years and older with intact cognitive function living in the Banciao Veterans Home, a retirement community for veterans in northern Taiwan. All participants received complete history taking, physical examinations, global cognitive tests and laboratory tests. Cognitive status was re-evaluated one year after enrollment to evaluate the role of MetS to cognitive decline in this study population. Results: Overall, 338 people participated in the study and 62 of them were excluded due to low baseline MMSE score, and the remaining 276 people (mean age: 82.4±4.2 years) were enrolled for study. The prevalence of MetS and annual cognitive decline were 22.5% and 15.6%, respectively. During the follow-up period, 9 (3.3%) participants died, 229(83.0%) complete the study. Subjects with cognitive decline were older and had lower serum levels of serum total cholesterol. Multivariate logistic regression showed that older age (OR:1.13, 95% C.I.: 1.01-1.25, P=0.026) and central obesity (OR: 4.19, 95% CI: 1.26-13.91, P=0.019) were independent risk factors for cognitive decline; and MetS defined by Adult Treatment Panel III was a protective factor (OR: 0.20, 95% CI: 0.04-0.94, P=0.041). The protective effect of MetS remained the same when MetS was defined by the criteria of International Diabetes Federation. Conclusions: Age and central obesity were significant risk factors of cognitive decline, but late-life MetS, however defined, had protective effect on cognitive function. Further investigation is needed to clarify the possible mechanism of MetS and cognitive function in older adults. [ABSTRACT FROM AUTHOR]

The authors systematically analyzed fluid inclusions in calcite veins from 33 samples collected from the fractures zones in 3 different units of southern Dabashan (SDBS) fold-thrust belt to study the characteristics of fluids in the different units and determine possible migration pathways of the fluids with particular reference to the petroleum exploration potential in the region. Homogenization temperatures and salinities of fluid inclusions and their stable isotope (δD, δ18O) showed a distinct zonation and variations of fluid characteristics in the different tectonic units of the SDBS fold-thrust belt. Homogenization temperature measurements and fluorescence observation results indicated that faults are the main conduits for fluids during their active periods. Oxygen and hydrogen isotopic compositions from the imbricate thrust belt to the fold-thrust belt and to the front detachment-fold belt shift from a mixing of surface meteoric water and sedimentary formation water box toward the magmatic water zone and metamorphic zone. The front detachment-fold belt has the best condition for petroleum preservation and is the potentially favorable area for future exploration. [ABSTRACT FROM AUTHOR]

Abstract: Background: Posttransplantation diabetes mellitus (PTDM) is a common metabolic complication in renal transplant recipients. Some studies have revealed predisposing or protective HLA genes for PTDM. Objective: To describe the characteristics of PTDM in patients in the south of China. Methods: The present study included 195 living-donor kidney transplant recipients. Informed consent was obtained from all participants, and the study was approved by our Institutional Ethics Committee. Each donor-recipient pair was related. Twenty-two patients had PTDM, whereas 173 did not. The frequency of each HLA phenotype was compared between these 2 groups. The 195 patients were divided into 2 groups according to immunosuppression regimen, a cyclosporine group and a tacrolimus group, and the incidence of PTDM was compared between the groups. Patients were then subdivided into 2 groups according to age, an elderly group (age 40 years or older) and a younger group (age younger than 40 years), and the incidence of PTDM was calculated and compared between these 2 groups. Results: HLA-A30 and HLA-DR7 seem to be predisposing genes for PTDM in patients in the south of China; Low dosages of calcineurin inhibitors were used in our center, There was no significant difference in the incidence of PTDM between the CsA and Tac groups; The incidence of PTDM in the elderly group was significantly higher than that in the younger group. Conclusion: Patients receiving HLA-A30 and HLA-DR7 antigens, and elderly patients are at higher risk of developing PTDM. Tacrolimus does not significantly increase the incidence of PTDM. [Copyright &y& Elsevier]

The prothrombin time (PT), International normalized ratio (INR) and activated partial thromboplastin time (APTT) are the most used coagulation tests in China, where more than one type of automated coagulation analyzer is often used in the clinical laboratory. The PT–INR results of 109 samples were compared with local mean normal PT (MNPT) and APTT ratio (APTTR) with mean normal APTT (MNAPTT) on two different coagulation analyzers in the same laboratory. The two different coagulation analyzers showed no significant difference ( P > 0.05) in PT and INR determination, but there was a significant difference ( P < 0.01) for APTT. The INR with local MNPT and APTTR with MNAPTT, obtained with the ACL Futura and CA 510, showed much better agreement; 98.8% (82/83) of bias for INR with local MNPT was less than 15% compared with 90.4% (75/83) of bias for INR; and 100% of bias for APTTR (62/62) was less than 15% compared with only 6.5% (4/62) of bias for APTT. Meanwhile, there was no significant difference ( P = 0.865) for APTTR with MNAPTT compared with APTT ( P = 0.002) between the ACL Futura and CA 510. In conclusion, these analyzers showed very poor agreement for both the PT and APTT, but the calculation of ratios significantly improved agreement. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis and fragility fracture have been a more serious health challenge to the elderly worldwide. Inadequate patient knowledge about them can result in various poor clinical outcomes. The purpose of the study was to (1) investigate osteoporosis knowledge among the patients with fragility fractures at an orthopedic ward in mainland China; (2) to evaluate the effectiveness of a nurse-initiated educational intervention on knowledge and awareness. Methods: In total, 51 eligible patients diagnosed with fragility fracture admitted in orthopedic wards in a tertiary hospital in central China were recruited and received a three-session inpatient osteoporosis education program. The intervention consisted of three face-to-face osteoporosis nurse education using easy-to-read educational materials, and the teach-back method, Participants completed questionnaires measuring demographics and osteoporosis knowledge at baseline and at discharge. Data were analyzed using descriptive analysis and compared t test. Results: In our study, 74.5 percent of participates were female and the average age was 63.4 ± 9.5 years. Osteoporosis knowledge increased from baseline to post-intervention in self-made questionnaire and item 1, 3-6, 9-11, 13, 15, 18 and 19 of the OKAT questionnaire (P < 0.05). Conclusion: The three-session inpatient osteoporosis education program was effective at improving osteoporosis knowledge among elderly Chinese inpatients with fragility fracture. [ABSTRACT FROM AUTHOR]

Both obesity and non-alcoholic fatty liver disease (NAFLD) increase the risk of metabolic abnormalities. However, the metabolic status of children suffering from NAFLD and exhibiting various subtypes of obesity is currently unclear. We aimed to explore the association between NAFLD and metabolic abnormalities in children with different weight statuses. We included 6086 participants aged 6–18 years from the China Child and Adolescent NAFLD Study (CCANS), all of whom had undergone ultrasonography or magnetic resonance imaging-proton density fat fraction (MRI-PDFF) to identify NAFLD and metabolic abnormalities, including hyperglycemia, high triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol, high total cholesterol, and hyperuricemia. Among the participants, there were 2408 children with obesity and NAFLD, 174 with NAFLD, 2396 with obesity, and 1108 without obesity and NAFLD. The odds ratios (ORs) of suffering from individual metabolic abnormalities were significantly greater in children with obesity and NAFLD than in children without obesity and NAFLD, with ORs ranging from 6.23 (95% CI: 4.56, 8.53) to 1.77 (95% CI: 1.06, 2.94). The ORs of metabolic abnormalities, except for low HDL-C, were greater in children with NAFLD alone than in children without obesity or NAFLD, with ORs ranging from 4.36 (95% CI: 2.77, 6.84) to 2.08 (95% CI: 1.14, 3.78). Notably, obesity and NAFLD had a multiplicative effect on overall metabolic abnormalities, high TG levels, and low HDL-C levels. Children with obesity and NAFLD could be at a significantly increased risk of metabolic abnormalities. Even for children without obesity, NAFLD appears to be associated with an increased risk of experiencing a worsened metabolic status. [ABSTRACT FROM AUTHOR]

Reports on the development of stem canker, a fungal plant disease caused by Leptosphaeria maculans in oilseed rape in China. Disease symptoms; Ascospore development; Plant growth conditions.

We investigated whether long-term ambient air pollutants (AAP) exposure was associated with estimated glomerular filtration rate (eGFR) among hospitalized patients living in urban areas of Shanghai, China. This was a cross-sectional observational study. A total of 3622 newly hospitalized inpatients were investigated from October 2014 to May 2015. The prior year's average exposure to particulate matter (PM) of each participant was estimated using the Kriging interpolation method of ArcGIS. The estimated eGFR was calculated according to the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Both generalized linear and logistic regression models were applied to assess the associations between AAP and renal function. One-year PM 10 exposure was associated with lower eGFR; each standard deviation (SD) increase in PM 10 was significantly associated with the increased prevalence of CKD [adjusted odds ratio (OR) 1.11; 95% confidence interval (CI): 1.02, 1.21], and lower eGFR by −0.40 (95%CI: −0.80, −0.01) ml/min/1.73 m2. Moreover, the effect of PM 10 was significantly greater in people over 65 years old. Our results supported that exposure to ambient PM 10 increased the risk of CKD and negatively affected renal function among Chinese adults. • We aim to evaluate the effect of long exposure to air pollutants on renal function among hospitalized patients in China. • One-year PM10 exposure was associated with lower eGFRs and increased prevalence of CKD (chronic kidney disease). • Patients over 65 years, males, patients with a BMI＜24 kg/m2 and without hypertension might be vulnerable to the effect. [ABSTRACT FROM AUTHOR]

Abstract: The China Low Activation Martensitic (CLAM) steel is being developed in ASIPP (Institute of Plasma Physics, Chinese Academy of Sciences) under wide collaboration with many institutes and universities. A heat of 1.2 tons was fabricated and tested. The tested main compositions are eligible and without segregation. The tensile, Charpy impact and fracture toughness tests showed that its mechanical properties were similar to those of small ingots of CLAM steel. Also, joining techniques such as Electron Beam Welding (EBW), Hot Isostatic Pressing–Diffusion Welding (HIP–DW) and fabrication techniques of rectangular tube with CLAM steel were studied in details. And a 1/3 scaled mockup of Test Blanket Module (TBM) by P91 are being fabricated to explore TBM fabrication technology. [Copyright &y& Elsevier]

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by vascular thrombosis and obstetric morbidity, with accurate laboratory examination of antiphospholipid antibodies (aPLs) being crucial for diagnosis. This study focused on anti-β2 glycoprotein I (aβ2GPI) antibodies and aimed to establish the first population-based cutoff values for aβ2GPI IgA/IgM/IgG antibodies in non-pregnant women of reproductive age in Southwest China. The study cohort comprised 181 healthy women of reproductive age for study. Blood samples were collected on an early morning fast. Anti-β2GPI antibodies including IgA, IgM and IgG were measured in serum using the HOB ® BioCLIA kit. According to the Clinical and Laboratory Standards Institute (CLSI) guidelines, the study used non-parametric percentile methods to calculate the 95th, 97.5th, and 99th percentiles cutoff values for aβ2GPI IgA/IgM/IgG antibodies, along with corresponding 90% confidence intervals (CI), while excluding outliers. A total of 168 independent samples were collected for verification, including 85 samples from healthy subjects and 83 samples from APS patients, in order to evaluate the analytical performance of the obtained cutoff values. The 99th percentile cutoff values were 3.36 RU/mL for aβ2GPI IgA, 27.54 RU/mL for aβ2GPI IgM and 1.81 RU/mL for aβ2GPI IgG, which indicated that the levels of aβ2GPI IgM antibodies were generally higher compared to those of IgA and IgG antibodies. Our established reference range was confirmed to be successful in validating the detected values of aβ2GPI antibodies in all healthy controls. With the 99th percentile cutoff value, the sensitivity was 14.46% for aβ2GPI IgA, 22.89% for aβ2GPI IgG, and 9.64% for aβ2GPI IgM in APS patients. This study established population-based cutoff values that are applicable to the local population for the accurate laboratory examination of aβ2GPI antibodies in non-pregnant women of reproductive age. The study also recommends paying more attention to IgM positivity in women of reproductive age., (© 2024. The Author(s).)

Background and Objectives: Hypoglycemia is a known risk of intensive postoperative glucose control in neurosurgical patients. However, the impact of postoperative hypoglycemia after craniotomy remains unexplored. This study aimed to determine the association between postoperative hypoglycemia and mortality in patients undergoing elective craniotomy., Methods: This study involved adult patients who underwent elective craniotomy at the West China Hospital, Sichuan University, between January 2011 and March 2021. We defined moderate hypoglycemia as blood glucose levels below 3.9 mmol/L (70 mg/dL) and severe hypoglycemia as blood glucose levels below 2.2 mmol/L (40 mg/dL). The primary outcome was postoperative 90-day mortality., Results: This study involved 15 040 patients undergoing an elective craniotomy. Overall, 504 (3.4%) patients experienced moderate hypoglycemia, whereas 125 (0.8%) patients experienced severe hypoglycemia. Multivariable analysis revealed that both moderate hypoglycemia (adjusted odds ratio [aOR] 1.86, 95% CI 1.24-2.78) and severe (aOR 2.94, 95% CI 1.46-5.92) hypoglycemia were associated with increased 90-day mortality compared with patients without hypoglycemia. Moreover, patients with moderate (aOR 2.78, 95% CI 2.28-3.39) or severe (aOR 16.70, 95% CI 10.63-26.23) hypoglycemia demonstrated a significantly higher OR for major morbidity after adjustment, compared with those without hypoglycemia. Patients experiencing moderate (aOR 3.20, 95% CI 2.65-3.88) or severe (aOR 14.03, 95% CI 8.78-22.43) hypoglycemia had significantly longer hospital stays than those without hypoglycemia. The risk of mortality and morbidity showed a tendency to increase with the number of hypoglycemia episodes in patients undergoing elective craniotomy (P for trend = .01, <.001)., Conclusion: Among patients undergoing an elective craniotomy, moderate hypoglycemia and severe hypoglycemia are associated with increased mortality, major morbidity, and prolonged hospital stays. In addition, the risk of mortality and major morbidity increases with the number of hypoglycemia episodes., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

The H9N2 subtype of the avian influenza virus (AIV) is widely prevalent in birds, threatening the poultry industry and providing genetic material for emerging human pathogens. The prevalence and genetic characteristics of H9N2 in Yunnan Province, China, are largely unknown. Samples were collected from live poultry markets (LPMs) and breeding farms in Yunnan Province. H9N2-positive samples were identified by polymerase chain reaction (PCR), with a high positivity rate of 42.86% in tissue samples. The positivity rate of swab samples in the LPMs in Kunming was 3.97% (17/564), but no AIV was detected in samples from poultry farms in Lijiang, Wenshan, and Yuxi. Evolutionary analysis and genotyping were performed for the 17 strains of isolated H9N2 virus. Phylogenetic analysis revealed that all H9N2 viral genes had 91.6%-100% nucleotide homology, belonged to the G57 genotype, and had high homology with H9N2 viruses isolated from Guangdong and Guangxi, suggesting that the H9N2 viruses in Yunnan Province may have been imported by chicks. Using a nucleotide divergence cutoff of 95%, we identified ten distinct H9N2 genotypes that continued to evolve. The surface genes of the H9N2 isolates displayed substantial genetic diversity, highlighting the genetic diversity and complexity of the H9N2-subtype AIVs in Yunnan. Molecular analysis demonstrated that all 17 strains of H9N2 isolates had mutations at H183N, Q226L, L31P, and I268V in hemagglutinin; S31N in matrix protein 2; and no replacements at positions 274 and 292 of the neuraminidase protein. Sixteen strains had the A558V mutation and one strain had the E627V mutation in polymerase basic protein 2. Analysis of these amino acid sites suggests that H9N2 influenza viruses in Yunnan continue to mutate and adapt to mammals and are sensitive to neuraminidase inhibitors but resistant to adamantanes. It is necessary to strengthen surveillance of AIV H9N2 subtypes in poultry and LPMs in Yunnan to further understand their genetic diversity., Competing Interests: DISCLOSURES The authors report no potential conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Oesophageal squamous cell carcinoma (OSCC) poses a considerable health burden, particularly in regions such as East Asia. This study aims to investigate the long-term outcomes of OSCC patients who are smokers and drinkers., Materials and Methods: In this retrospective analysis, data from Sichuan Cancer Hospital and Institute Esophageal Cancer Case Management Database between January 2010 and December 2017 were examined. Patients were categorised into different groups based on their smoking and alcohol consumption history: None, Smoker, Non-Smoker, Smoke-Only, Drinker, Non-Drinker, Drinker-Only, and Both. Survival outcomes were compared between the groups using Kaplan-Meier analysis and propensity score matching (PSM). The primary outcome was overall survival (OS), measured from surgery to death or last follow-up in April 2022., Results: The OS median was 45.4 months for all patients after oesophagectomy. Smokers had a significantly lower median OS of 36.6 months compared with Non-Smokers with 66.2 months (p<0.001). Similarly, Drinkers had a lower median OS of 34.4 months compared with Non-Drinkers with 52.0 months (p<0.001). PSM analysis confirmed the significant differences in OS between Smokers and Non-Smokers (p=0.002) and between Drinkers and Non-Drinkers (p=0.002). Subgroup analyses showed no significant differences in OS between Group Another and Group Both, Group Smoker-Only and Group Drinker-Only, and Group Drinker-Only and Group Both. (figure 4) CONCLUSION: Smoking and drinking were associated with significantly reduced OS in patients. However, no significant differences were found between the subgroups of patients who only smoked, only drank, or engaged in both habits., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

With climate change and anthropic influence on the coastal ecosystems, mangrove ecosystems are disappearing at an alarming rate. Accordingly, it becomes important to track, study, record and store the mangrove microbial community considering their ecological importance and potential for biotechnological applications. Here, we provide information on mangrove fungal community composition and diversity in mangrove ecosystems with different plant species and from various locations differing in relation to anthropic influences. We describe twelve newly assembled genomes, including four chromosomal-level genomes of fungal isolates from the mangrove ecosystems coupled with functional annotations. We envisage that these data will be of value for future studies including comparative genome analysis and large-scale temporal and/or spatial research to elucidate the potential mechanisms by which mangrove fungal communities assemble and evolve. We further anticipate that the genomes represent valuable resources for bioprospecting related to industrial or clinical uses., (© 2024. The Author(s).)

Objectives: To investigate predictors of hypogammaglobulinemia (HGG) and severe infection event (SIE) in patients with autoimmune disease (AID) receiving rituximab (RTX) therapy., Methods: This was a retrospective study conducted in a tertiary medical center in China. Predictors of HGG or SIE were assessed using Cox analysis. Restricted cubic spline (RCS) analysis was applied to examine the correlation between glucocorticoid (GC) maintenance dose and SIE., Results: A total of 219 patients were included in this study, with a cumulative follow-up time of 698.28 person-years. Within the study population, 117 patients were diagnosed with connective tissue disease, 75 patients presented with ANCA-associated vasculitis, and 27 patients exhibited IgG4-related disease. HGG was reported in 63.3% of the patients, where an obvious decline in IgG and IgM was shown three months after RTX initiation. The rate of SIE was 7.2 per 100 person-years. An increase in the GC maintenance dose was an independent risk factor for both hypo-IgG (HR 1.07, 95% CI 1.02-1.12, p = 0.003) and SIE (HR 1.06, 95% CI 1.02-1.1, p = 0.004). Further RCS analysis identified 7.48 mg/d prednisone as a safe threshold dose for patients who underwent RTX treatment to avoid a significantly increased risk for SIE., Conclusion: HGG was relatively common in RTX-treated AID patients. Patients with chronic lung disease or who were taking ≥ 7.5 mg/d prednisone during RTX treatment were at increased risk for SIE and warrant attention from physicians., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Environmental viruses in wastewater and sludge are widely recognized for their roles in waterborne diseases. However, previous studies mainly focused on RNA viruses, and little is known about the diversity of DNA viral communities and their driving factors in municipal wastewater treatment environments. Herein, we conducted a pilot study to explore DNA virus profiles in municipal wastewater and recycled sludge by metagenomics method, and track their temporal changes in northern China. Results showed that 467 viral species were co-shared among all the samples. We identified six families of human viruses with a prevalence of 0.1%, which were rare but relatively stable in wastewater and sludge for six months. Adenoviridae, Parvoviridae, and Herpersviridae were the most dominant human viral families in municipal wastewater and recycled sludge. A time series of samples revealed that the dynamic changes of human DNA viruses were stable based on qPCR results, particularly for high-risk fecal-oral transmission viruses of adenovirus, bocavirus, polyomavirus, human gamma herpesvirus, human papillomavirus, and hepatitis B virus. Concentrations of Adenovirus (5.39-7.48 log 10 copies/L) and bocavirus (4.36-7.48 log 10 copies/L) were observed to be the highest in these samples compared to other viruses. Our findings demonstrated the DNA viruses' high prevalence and persistence in municipal wastewater treatment environments, highlighting the value of enhancing public health responses based on wastewater-based epidemiology., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

The coal gangue dump may introduce heavy metal(oid)s (HMs) into surrounding agricultural soils, posing potential health risks to nearby communities. This study evaluated heavy metal(oid) pollution in agricultural soils adjacent to a gangue dump at an abandoned coal mine in Chongqing, Southwest China. The concentrations of HMs (As, Cd, Cr, Cu, Ni, Pb, and Zn) were quantified using ICP-MS, and the contamination status was assessed using the Geoaccumulation Index (I geo ), Contamination Factor (CF), Pollution Load Index (PLI), and Potential Ecological Risk Index (RI). Heavy metal(oid) contamination was detected in soils across a depth of 0-30 cm, particularly pronounced in the topsoil layer (0-10 cm and 10-20 cm depths). Cu emerged as the predominant contaminant across all examined depths, with average I geo values of 1.20, 1.21, and 1.16 for the 0-10 cm, 10-20 cm, and 20-30 cm depths, respectively, indicating moderate contamination. The CF for Cu was 3.55, 3.55, and 3.50 for these respective depths, classifying it as considerable contamination. The PLI values ranged from 1.61 to 2.50, with a mean value of 2.12, indicating overall contamination. The ecological risk assessment indicated that the soil's ecological risk was low at all depths. Cd was the major contributor to the RI, accounting for 48%, 47%, and 42% at 0-10 cm, 10-20 cm, and 20-30 cm depths, respectively. Health risk assessments revealed significant non-carcinogenic risks to children (mean HI = 1.30) and unacceptable carcinogenic risks to both adults and children (mean TCR = 3.26 × 10 -4 and 1.53 × 10 -3 , respectively). This study underscores the critical need for comprehensive risk assessments using multiple indicators to prioritize remediation efforts for HMs, providing a scientific basis for effective environmental management and public health protection in the Three Gorges Reservoir Area., (© 2024. The Author(s).)

In recent years, China has adopted numerous policies and regulations to control NO x emissions to further alleviate the adverse impacts of NO 3 - -N deposition. However, the variation in wet NO 3 - -N in precipitation were 0.67 mg L 3 and 0.54 mg L - -N deposition and its sources changes after such air pollution control through field observation and isotope tracing. Results showed that the annual mean concentrations of NO 3 - -N in precipitation were 0.67 mg L -1 and 0.54 mg L -1 in 2014-2015 and 2021-2022, respectively. The average wet NO 3 - -N depositions in 2014-2015 and 2021-2022 was 7.76 kg N ha -1 yr -1 and 5.03 kg N ha -1 yr -1 , respectively, indicating a 35% decrease. The δ 15 N-NO 3 - and δ 18 O-NO 3 - values were lower in warm seasons and higher in cold seasons, and both showed a lower trend in 2021-2022 compared with 2014-2015. The Bayesian model results showed that the NO x emitted from coal-powered plants contributed 53.6% to wet NO 3 - -N deposition, followed by vehicle exhaust (22.9%), other sources (17.1%), and soil emissions (6.4%) during 2014-2015. However, the contribution of vehicle exhaust (33.3%) overpassed the coal combustion (32.3%) and followed by other sources (25.4%) and soil emissions (9.0%) in 2021-2022. Apart from the control of air pollution, meteorological factors such as temperature, precipitation, and solar radiation are closely related to the changes in atmospheric N transformation and deposition. The results suggest phased achievements in air pollution control and that more attention should be paid to the control of motor vehicle exhaust pollution in the future, at the same time maintaining current actions and supervision of coal-powered plants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To investigate the current status and challenges of carrying out the four objective indicators which are necessary for the Sjögren's syndrome (SS) diagnosis in hospitals all over China. Methods: A questionnaire survey was conducted online by Questionstar from May to July 2023 among rheumatologists nationwide, to investigate whether unstimulated salivary flow (UWSF), Van Bijsterveld score (VBS), Schirmer test and labial gland focus score (FS) are carried out in their hospitals and the challenges that hinder their development. A cohort of patients with established SS was enrolled to verify the importance of the four objective indicators in diagnosing SS. Statistical analyses were performed using the chi-square test. Results: The questionnaire was completed by rheumatologists from 660 hospitals in 225 cities of 32 provinces, autonomous regions and municipalities all over China (one doctor from each hospital completed the questionnaire), of which 548 (83.0%) were tertiary care hospitals. The rate of carrying out the objective indicators in 660 hospitals was low: UWSF (290/660, 43.9%), FS (497/660, 75.3%) and VBS (393/660, 59.5%). The percentage of hospitals who consider it difficult to carry out UWSF, VBS, minor labial gland biopsy and Schirmer test was 92.6%(611/660), 69.4%(458/660), 59.8%(395/660) and 58.6%(387/660), respectively. All four objective indicators mentioned above could be carried out in only 139 (21.1%) hospitals. In 521 hospitals in which less than four objective indicators could be carried out, 23.2% (121/521) of rheumatologists selected clinical experience to diagnose SS. A total of 180 patients with SS diagnosed by perfecting all objective indices and meeting the 2016 the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria were included, 173 females (96%), aged (46.6±13.6) years, with the missed diagnosis rate was 17.8% (32/180) assuming their labial FS was unavailable. In 166 patients with established SS who met the classic 2002 AECG criteria, 160 females (96%), aged (47.0±13.6) years, the missed diagnosis rate was 52.4% (87/166) assuming their labial FS was unavailable; or 10.8% (18/166) assuming their UWSF was unavailable. SS diagnosis couldn't be estimated according to 2002 AECG criteria, assuming both labial FS and UWSF were unavailable in 156 (94.0%) patients with positive anti-SSA/Ro; or assuming either labial FS or UWSF was unavailable in 10 (6.0%) patients with negative anti-SSA/Ro. Conclusion: The application rates of four objective indicators necessary for SS diagnosis are low, the rate of carrying out labial gland biopsy should be increased, and the labial FS reports and UWSF test should be standardized.

Background: Pneumoconiosis mostly combines pulmonary and cardiovascular diseases, among which pulmonary heart disease (PHD) is of major concern due to its significant impact on the survival of pneumoconiosis patients. White cell count (WCC), red cell distribution width (RDW) and platelet parameters are thought to affect inflammatory responses and may be predictors of various cardiovascular diseases. However, very few studies have focused on PHD., Objectives: To examine the relationship between baseline complete blood count parameters (WCC, RDW, platelet parameters) and the risk of incident PHD in pneumoconiosis patients., Design: A retrospective cohort study., Setting: This was a single-centre, retrospective cohort study that used data from an Occupational Disease Hospital, Chengdu, Sichuan., Participants: A total of 946 pneumoconiosis patients from January 2012 to November 2021 were included in the study. Female patients and patients who had PHD, coronary heart disease, hypertensive heart disease, cardiomyopathy, heart failure, oncological disease, multiple organ dysfunction, AIDS at baseline and follow-up time of less than 6 months were also excluded., Outcome Measures: We identified PHD according to the patient's discharge diagnosis. We constructed Cox proportional hazard regression models to assess the HR of incident PHD in pneumoconiosis, as well as 95% CIs., Results: In the multiple Cox proportional hazard regression analysis, platelet count (PLT) and plateletcrit (PCT) above the median at baseline were associated with an increased risk of PHD in pneumoconiosis with adjusted HR of 1.52 (95% CI 1.09 to 2.12) and 1.42 (95% CI 1.02 to 1.99), respectively., Conclusion: Higher baseline PLT and PCT are associated with a higher risk of PHD in pneumoconiosis., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: According to the Seventh National Census, China's fertility rate is less than 1.5, marking a significant national issue with potential risks. To counter this low birth rate, the Chinese government has relaxed family planning policies and introduced supportive measures., Purpose: Changes in birth policy have attracted considerable attention from the people of China. This article aims to study the public's response to the three-child support policy using Weibo as a window. The goal is to provide a more balanced evaluation of current perspectives, enabling policymakers to formulate better fertility information, particularly when anticipating a poor public response to controversial policies., Methodology: This research uses a crawler to gather data from Sina Weibo. Through opinion mining of Weibo posts on the three-child policy, Weibo users' online opinions on the three-child policy are analyzed from two perspectives: their attention content and sentiment tendency. Using an interrupted time series, it examines changes in online views on the policy, matching policy documents to the time nodes of Weibo posts., Findings: The public has shown great interest in and provided short-term positive feedback on policies related to improving maternity insurance, birth rewards, and housing subsidies. In contrast, there has been a continuous negative response to policies such as extending maternity leave, which has particularly sparked concerns among women regarding future employment and marital rights protection. On social media, the public's attention to the three-child birth policy has focused mainly on the protection of women's rights, especially legal rights after childbirth, and issues related to physical and mental health. Child-rearing support and economic pressure are also hot topics, involving the daily expenses of multichild families, childcare services, and housing pressure. However, this study also revealed that infertile or single women express a strong desire to have children, but due to limitations in the personal medical insurance system, this desire has not been fully satisfied., Contributions: Our study demonstrates the feasibility of a rapid and flexible method for evaluating the public response to various three-child supportive policies in China using near real-time social media data. This information can help policy makers anticipate public responses to future pandemic three-child policies and ensure that adequate resources are dedicated to addressing increases in negative sentiment and levels of disagreement in the face of scientifically informed but controversial, restrictions., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Peng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Dry direct-seeded rice cultivation has gained popularity and expanded its cultivated area due to reduced labor requirements and water consumption. However, the impact of this cultivation method on cadmium (Cd) bioavailability in soil and the accumulation levels in grains remains uncertain. Field experiments were conducted in acidic soils at two locations in southern China to compare rice varieties and evaluate the dry direct-seeding method alongside the wet direct-seeding and traditional transplanting methods. Dry direct-seeded rice reached significantly higher Cd concentrations in its tissues starting from the heading stage than transplanted rice. Cd accumulation levels by the maturation stage in the brown rice of dry direct-seeded rice were 18.33 %-150.69 % higher than those of wet direct-seeded and transplanted rice, with a considerable ability to translocate Cd into brown rice. Furthermore, dry direct seeding decreased iron plaque formation, particularly in the amorphous Fe form; it resulted in high soil temperature and low moisture content during tillering, elevating Cd availability in the soil. Additionally, the proportion of ions and more labile forms of Cd in the soil solution was high. Moreover, the soil under dry direct seeding had high urease and acid phosphatase enzyme activities. However, low richness and diversity in the bacterial community were characterized by a significant increase in the relative abundance of Actinobacteria and Gammaproteobacteria at the class level, while exhibiting decreased relative abundances of Alphaproteobacteria, Bacilli, and KD4-96, along with fewer biomarkers. Nonetheless, these differences are gradually reduced during the maturation stage. Overall, although dry direct seeding offers several advantages, it is crucial to implement additional measures to mitigate the increased health risks linked to rice cultivation through this approach in Cd-contaminated areas., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Friedman's standards, developed almost 50 years ago, may no longer align with the needs of today's obstetric population and current pregnancy management practices. This study aims to analyze contemporary labor patterns and estimate labor duration in China, focusing on first-stage labor data from Chinese parturients with a spontaneous onset of labor., Methods: This retrospective observational study utilized data from electronic medical records of a tertiary hospital in Changsha, Hunan. Out of a total of 2,689 parturients, exclusions were made for multiple gestations, preterm, post-term, or stillbirth, cesarean delivery, non-vertex presentation, and neonatal intensive care unit admission. Average labor curves were constructed by parity using repeated-measure analysis, and labor duration was estimated through interval-censored regression, stratified by cervical dilation at admission. We performed an analysis to assess the impact of oxytocin augmentation and amniotomy on labor progression and conducted a sensitivity analysis using women with complicated outcomes., Results: Nulliparous women take over 180 minutes for cervical dilation from 3 to 4 cm, and the duration from 5 to 6 cm exceeds 145 minutes. Multiparous women experience shorter labor durations than nulliparous. Labor acceleration is observed after 5 cm in nulliparous, but no distinct inflection point is evident in the average labor curve. In the second stage of labor, the 95th percentile for nulliparous, with and without epidural analgesia, is 142 minutes and 127 minutes, respectively., Conclusions: These findings provide valuable insights for the reassessment of labor and delivery processes in contemporary obstetric populations, including current Chinese obstetric practice., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Peng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: To evaluate the association between handgrip strength (HGS) weakness and asymmetry with incident hip fracture among older Chinese adults., Methods: Data was obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). HGS weakness was defined as maximal HGS 〈 28 kg in men and < 18 kg in women. HGS asymmetry was defined as the HGS ratio < 0.9 or 〉 1.1. Participants were categorized into normal HGS, weakness only, asymmetry only, and both weakness and asymmetry. Given the sex differences in HGS, the association between HGS weakness and asymmetry was analyzed by sex using the multivariable logistic regression models., Results: A total of 4789 participants aged ≥ 60 years old without hip fracture at baseline were included in the final analysis. Over the four-year follow-up, there were 152 (3.17 %) participants having incident hip fractures, of which 69 (2.90 %) were men and 83 (3.45 %) were women. Compared to the normal group, men with both weakness and asymmetry had a significantly higher risk of incident hip fracture in the fully adjusted model (adjusted odds ratio (OR): 2.31, 95 % confidence interval (CI):1.17-4.52). There was no significant association between HGS asymmetry and weakness with hip fracture in women., Conclusions: Our findings indicated that among the Chinese population, men with both HGS weakness and asymmetry were associated with increased odds of hip fracture, while no significant association was observed in women., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The control of carbon emissions from agriculture is imperative in addressing the challenges posed by the greenhouse effect. China must develop a specific pathway for reducing its agricultural carbon emissions, accounting for its unique circumstances and considering the impacts of trade liberalization. (1) The study revealing that agricultural trade liberalization (ATL) has a marked effect on lowering China's agricultural carbon emission intensity (ACEI), with robustness and endogeneity tests supporting these findings. (2) In the pursuit of emissions reduction, the crucial role of technology spillovers (TS) and the optimization of industrial structure (OIS) are essential. (3) The reduction in ACEI is particularly notable in coastal regions, areas with low environmental regulations and during periods characterized by more stable agricultural tariffs. This study shows a synergistic association between ATL and ACEI, indicates the potential for a mutually beneficial situation with advantages in both economic and environmental aspects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Trace elements in atmospheric particulate matter play a significant role in air quality, human health, and biogeochemical cycles. In this study, the trace elements (Ca, Al, K, Fe, Na, Mg, Zn, Pb, Mn, Ti, Cu, Cr, Sr, Ni) in PM 2.5 samples collected at the summit of Mt. Lushan were analyzed to quantify their abundance, source, transport, and health risks. During the whole sampling period, the major trace elements was Ca, Al, and K. While the trace metals with the lowest concentrations were Sr, Ni, Rb, and Cd. The trace elements were influenced by air mass transport routes, exhibiting an increasing trend of crustal elements in the northwesterly airmass and anthropogenic elements (Zn, Mn, Cu, and Ni) in the easterly air masses. Construction dust, coal + biomass burning, vehicle emission, urban nitrate-rich + urban waste incineration emissions, and soil dust + industry emissions were common sources of PM 2.5 on Mt. Lushan. Different air mass transport routes had various source contribution patterns. These results indicate that trace elements at Mt. Lushan are influenced by regional anthropogenic emissions and monsoon-dominated trace element transport. The total resulting cancer risk value that these elements posed were below the acceptable risk value of 1 × 10 -6 , while the non-carcinogenic risk value (1.72) was higher than the safety level, suggesting that non-carcinogenic effects due to these trace elements inhalation were likely to occur. Vehicle emission and coal + biomass burning were the common dominant sources of non-cancer risks posed by trace elements at Mt. Lushan., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

The significance of ecological non-monotonicity (a function whose first derivative changes signs) in shaping the structure and functions of the ecosystem has recently been recognized, but such studies involving high-order interactions are rare. Here, we have proposed a three-trophic conceptual diagram on interactions among trees, rodents, and insects in mast and non-mast years and tested the hypothesis that oak (Quercus wutaishanica) masting could result in increased mutualism and less predation in an oak-weevil-rodent system in a warm temperate forest of China. Our 14-year dataset revealed that mast years coincided with a relatively low rodent abundance but a high weevil abundance. Masting not only benefited seedling recruitment of oaks through increased dispersal by rodents but also a decrease in predation by rodents and weevils, as well as an increase in the overwintering survival of rodents. Masting appeared to have increased weevil survival by reducing predation of infested acorns by rodents. These results suggest that masting benefits all participants in the plant-insect-rodent system by increasing mutualism and reducing predation behavior (i.e., a non-monotonic function). Our study highlights the significance of masting in maintaining the diversity and function of the forest ecosystem by facilitating the transformation from predation to mutualism among trophic species., (© 2024. Science China Press.)

Objectives: This study explores the clinical characteristics associated with the occurrence of acute anterior uveitis (AAU) in patients with axial spondyloarthritis (axSpA) within a large, multicentre database., Methods: This observational, cross-sectional study of patients with axSpA used data from the Chinese Spondyloarthritis Registry between August 1, 2018, and March 31, 2020. The demographic and clinical features of patients with and without AAU were compared. Univariate and multivariate analyses were performed to determine the association between variables and uveitis., Results: A total of 4304 patients were included in this study. The prevalence of AAU in patients with axSpA was 10.59%. Multivariate logistic regression analysis revealed a positive correlation between AAU and age at diagnosis (odds ratio [OR], 1.026; p<0.001), disease duration (OR, 2.117; p<0.001), current or past Achilles tendinitis (OR, 1.692; p<0.001), current or past dactylitis (OR, 1.687; p=0.002), current or past psoriasis (OR, 3.932; p<0.001), presence of human leukocyte antigen-B27 (HLA-B27) (OR, 2.787; p<0.001), and a good response to non-steroidal anti-inflammatory drugs (NSAIDs) (OR, 1.343; p=0.027)., Conclusions: AAU was the most common extra-articular manifestation in the Chinese Spondyloarthritis Registry. In Chinese patients with axSpA, older age at diagnosis, longer disease duration, presence of HLA-B27, current or past Achilles tendinitis, current or past dactylitis, current or past psoriasis, and a good response to NSAIDs were positively associated with AAU.

Background and Purpose: Genetic factors play an important role in the pathogenesis of stroke(S). This study aimed to screen the loci associated with S risk in northwestern Chinese population by genome-wide association analysis (GWAS)., Methods: A total of 1394 subjects, including 682 S patients and 692 controls, were enrolled in this study. SPSS 25.0 software was used for statistical analysis, and the independent sample t-test as well as Chi-square test were used to analyze the differences in age and gender between the case and control groups. The Precision Medicine Diversity Array (PMDA) genotyping chip was used in this study. The genotyping platform was the Gene Titan multi-channel instrument, and the Axiom Analysis Suite 6.0 software was used for the data analyzing. Besides, the LASSO analysis, SNP-SNP and GO/KEGG analysis were conducted to analyze the association between significant loci and S risk., Results: A total of 30 SNPs were found to be associated with the S risk based on additive model (p < 5 × 10 -8 ). After the LASSO screening, 22 SNPs showed the diagnostic value in S. The SNPs interaction analysis further screened the SNP-SNP interaction groups associated with the S risk(p < 0.05). Finally, the GO/KEGG analysis discovered the suggestive significance loci could be involved in the S development mainly by immune-related functions and pathways., Conclusion: This study discovered 30 S related SNPs and analyzed the potential pathways associated with genes located on the 30 SNPs, which were beneficial for enriching the genetic mechanism analysis of S in northwestern Chinese population., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objective: An elevated preoperative red cell distribution width (RDW) is associated with adverse prognostic outcomes in various diseases. However, the correlation between changes in RDW (ΔRDW) and the prognosis following brain tumor craniotomy remains unclear. Accordingly, this study aimed to investigate the prognostic significance of perioperative changes in RDW in patients undergoing brain tumor craniotomy., Methods: This retrospective cohort study included patients undergoing craniotomy for brain tumors at West China Hospital, Sichuan University, from January 2011 to March 2021. We defined perioperative changes in RDW: group A (non-significant RDW changes, ΔRDW ≤0.4%), group B (drop in RDW, ΔRDW < -0.4%), and group C (rise in RDW, ΔRDW >0.4%). The relationship between the changes in RDW and all-cause mortality was analyzed by categorizing the patients according to perioperative ΔRDW (RDW at postoperative one week - RDW at admission)., Results: The present study included a total of 9589 patients who underwent craniotomy for the treatment of brain tumors. A rise in RDW was significantly associated with increased mortality, with an adjusted OR of 3.56 (95% CI: 2.56-4.95) for 30-day mortality and 1.57 (95% CI: 1.33-1.85) for one-year mortality compared to those with non-significant RDW changes (ΔRDW ≤0.4%). Conversely, a decrease in RDW showed no significant association with 30-day mortality (adjusted OR: 1.04, 95% CI: 0.53-2.04) and one-year mortality (adjusted OR: 1.18, 95% CI: 0.92-1.53). These findings were also supported by restricted cubic spline, which shows that increases in RDW were significantly associated with lower survival rates compared to stable RDW levels during the follow-up period., Conclusions: Among patients undergoing craniotomy for a brain tumor, a rise in RDW was associated with 30-day mortality and higher long-term mortality risks, even if patients' admissions for RDW values were within the normal range. It was worth noting that maintaining stable RDW levels during this period was associated with better survival., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.ZCX., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Agricultural socialized service is gradually emerging as a new stimulus for enhancing the agricultural production environment. However, their precise impact on improving the agricultural ecological environment and promoting the green development of agriculture remains incompletely understood. Therefore, leveraging panel data spanning from 2003 to 2020 across 31 provinces in China, this study utilizes the bidirectional fixed effect model, moderating effect model, and spatial Durbin model to systematically assess the influence of agricultural socialized services on agricultural green development and its spatial ramifications. The findings show that (I) agricultural socialized services significantly contribute to promoting agricultural green development, particularly in regions with lower aging demographics. (II) The application of the spatial Durbin model reveals that this promotional effect does not exhibit significant spatial spillover effect. (III) The role of agricultural socialized services in fostering agricultural green development can be significantly enhanced by advancements in land transfer, agricultural technological innovations, and the improvement of rural human capital. In conclusion, the study provides a set of policy recommendations that include government financial support, facilitating land transfer, improving rural education and technical training, and promoting green production technologies to effectively promote agricultural green development., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To establish the population pharmacokinetics (PPK) of magnesium sulfate (MgSO 4 )in women with preeclampsia (PE), and to determine the key covariates having an effect in magnesium pharmacokinetics in Chinese PE., Methods: Pregnant women with PE prescribed MgSO4 were enrolled in this prospective study from April 2021 to April 2023. On the initial day of administration, the patients were administered a loading dose of 5 g in conjunction with 10 g of magnesium sulfate as a maintenance dose. On the second day, only the maintenance dose was administration, and maternal blood samples were taken at 0, 4, 5, and 12 h after the second day's 10 g maintenance dose. The software Phoenix was used to estimate PPK parameters of MgSO4, such as clearance (CL) and volume of distribution (V), and to model PPK models with patient demographic, clinical, and laboratory covariates., Results: A total of 199 blood samples were collected from 51 women with PE and PPK profiles were analyzed. The PPK of MgSO 4 is consistent with to a one-compartment model. The base model adequately described the maternal serum magnesium concentrations after magnesium administration. The population parameter estimates were as follows: CL was 2.98 L/h, V was 25.07 L. The model predictions changed significantly with covariates (BMI, creatinine clearance, and furosemide). Furosemide statistically influences V. The creatinine clearance, BMI and furosemide jointly affects CL. Monte Carlo simulation results showed that a loading dose combined with a maintenance dose would need to be administered daily to achieve the therapeutic blood magnesium concentrations. For the non-furosemide group, the optimal dosing regimen was a 5 g loading dose combined with a 10 g maintenance dose of MgSO4. For the furosemide group, the optimal dosing regimen was a 2.5 g loading dose combined with a 10 g maintenance dose of MgSO4., Conclusions: The magnesium PPK model was successfully developed and evaluated in Chinese preeclampsia population, and the dose optimization of MgSO 4 was completed through Monte Carlo simulation., (© 2024. The Author(s).)

Background: Toll-like receptor 4 (TLR4) is an important receptor for lipopolysaccharide and lipid A, components of gram-negative bacteria. At present, a variant in TLR4 has been shown to be associated with asthma, but it has not been reported whether variants in TLR4 are associated with bronchial asthma in children., Objective: The objective is to determine the relationship between the rs4986791 (+1196C/T) variants of TLR4 and bronchial asthma in Chinese children., Methods: DNA extracted from peripheral blood samples was amplified and the Bi-PASA technique was carried out to identify the genotypes in 600 patients., Results: The result showed no difference between the 1196 C/T variant of TLR4 and hemoglobin level, proportion of neutrophils and lymphocytes, leukocyte, basophil and eosinophil counts, log10IgE and hsCRP in the peripheral blood of bronchial asthmatic patients. However, the eosinophil ratio, FEV1% and FEV1/FVC level of asthma patients with the CT genotype was lower than those of patients with the CC genotype, which were 1.19 ± 0.10 and 1.67 ± 0.18 (P = 0.01), 81.25 ± 0.50 and 84.99 ± 0.65 (P < 0.0001), 81.72 ± 0.568 and 5.55 ± 0.78 (P < 0.0001), respectively. The incidence of bronchial asthma in patients with the CT genotype is higher than that in patients with the CC genotype. We analysed the influence of the two genotypes on the current medical history by multiple logistic regression, performing a comparative analysis between the two genotypes and bronchial asthma (P < 0.05). Patients with moderately persistent asthma with the CT genotype are more likely to develop severely persistent asthma compared to those with the CC genotype (P < 0.01)., Conclusions: This comparative analysis between rs4986791 and bronchial asthma in children indicates that this variant is associated with bronchial asthma risk in Chinese children.

Background: The population with chronic kidney disease (CKD) has significantly heightened risk of fall accidents. The aim of this study was to develop a validated risk prediction model for fall accidents among CKD in the community., Methods: Participants with CKD from the China Health and Retirement Longitudinal Study (CHARLS) were included. The study cohort underwent a random split into a training set and a validation set at a ratio of 70 to 30%. Logistic regression and LASSO regression analyses were applied to screen variables for optimal predictors in the model. A predictive model was then constructed and visually represented in a nomogram. Subsequently, the predictive performance was assessed through ROC curves, calibration curves, and decision curve analysis., Result: A total of 911 participants were included, and the prevalence of fall accidents was 30.0% (242/911). Fall down experience, BMI, mobility, dominant handgrip, and depression were chosen as predictor factors to formulate the predictive model, visually represented in a nomogram. The AUC value of the predictive model was 0.724 (95% CI 0.679-0.769). Calibration curves and DCA indicated that the model exhibited good predictive performance., Conclusion: In this study, we constructed a predictive model to assess the risk of falls among individuals with CKD in the community, demonstrating good predictive capability., 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 © 2024 Lin, Lin, Wan, Zhong, Wang, Tang, Wang, Ye, Peng, Liu and Deng.)

Paddy Crusts (PC) play a pivotal role in the migration and transformation of heavy metals within paddy ecosystems, situated at the critical intersection of air, water, and soil. This study focused on PC samples from heavy metal-contaminated rice paddies in six southern Chinese provinces. It's the first time we've screened and quantified the impact of nutrition, physicochemical properties, and heavy metals on bacterial diversity in PC. Our results highlight the significant influence of zinc, total nitrogen, and soil manganese on bacterial diversity. Using structural equation models, we identified the pathways through which these three types of environmental factors shape bacterial diversity. Heavy metal indicators and physical and chemical indicators exerted a direct negative effect on bacterial diversity in PC, while nutritional indicators had a direct and significant positive effect on bacterial diversity. Variance partitioning analysis revealed heavy metals had the most significant impact, accounting for 7.77% of the total effect. Moreover, the influence of heavy metals on bacterial diversity increased as diversity decreased, ranging from 3.81% to 42.09%. To remediate specific heavy metal pollution, our proposed method involves cultivating indigenous bacteria by controlling these environmental factors, based on an analysis of the interplay among bacterial diversity, environmental variables, and heavy metal bioconcentration factors. These findings enhance our understanding of PC and provide insights into rice field heavy metal pollution mitigation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To establish the reference values and growth curves of skeletal muscle mass among children in the Nanjing area. Methods: A cross-sectional study was conducted with children who underwent physical examination at the Department of Child Health Care, Children's Hospital of Nanjing Medical University from 2020 January to 2022 September. Their height, weight, body fat mass and skeletal muscle mass were measured. Body mass index, percentage of body fat mass, percentage of skeletal muscle mass, relative skeletal muscle mass index and the ratio of skeletal muscle to body fat were calculated. The associations between skeletal muscle mass indices and physical measurements index were analyzed through the Spearman correlation test. The Mann-Kendall test was used to assess the trend for skeletal muscle mass. Generalized additive models for location, scale and shape were used to construct percentile reference values and growth curves of male and female skeletal muscle mass indices at different ages. Results: A total of 32 690 children aged 4-14 years were enrolled in this study, including 19 912 boys (60.91%). Skeletal muscle mass, percentage of skeletal muscle mass, relative skeletal muscle mass index and the ratio of skeletal muscle to body fat of boys and girls was 11.10 (8.40, 14.90) and 10.30 (7.90, 13.20) kg, 40.36% (37.01%, 43.13%) and 39.38% (36.43%, 41.88%), 6.70 (6.07, 7.52) and 6.33 (5.79, 7.00), 2.39 (1.46, 3.47) and 2.14 (1.45, 3.00) kg/m 2 , respectively. Skeletal muscle mass of both boys and girls was all positively associated with weight ( r =0.97, 0.96), body mass index ( r =0.68, 0.63) and percentage of body fat mass ( r =0.40, 0.43) (all P <0.01). The reference values and growth curves showed that the percentage of skeletal muscle mass P 50 ranged from 37.75%-44.61% in boys and from 36.22%-40.55% in girls. The relative skeletal muscle mass index P 50 ranged from 5.80-9.68 kg/m 2 in boys and from 5.57-7.98 kg/m 2 in girls. The ratio of skeletal muscle to body fat P 50 ranged from 1.86-2.67 in boys and from 1.29-2.41 in girls. There was an increasing trend with age for both boys and girls in the growth of skeletal muscle mass ( Z =4.20, 3.75, both P trend <0.01), and increased slightly before 9 years of age and then increased rapidly until 14 years of age in both boys and girls. Conclusions: The skeletal muscle mass indices change with age and gender during childhood. Percentile reference values for pediatric skeletal muscle mass indices can be used to evaluate the muscular growth and development in children in the Nanjing area.

Objectives: This study aimed to assess the applicability of the National Academy of Medicine (NAM) interim guidelines for twin pregnancies to the specific population of gestational diabetes mellitus by exploring the relationship between gestational weight gain and adverse pregnancy outcomes in Chinese twin-pregnant women with gestational diabetes mellitus., Study Design: This was a retrospective cohort study of women diagnosed with diabetes in pregnancy between July 2017 and December 2020 at the Maternal and Child Health Hospital in Chongqing, China. The primary variable of interest was maternal total gestational weight gain. The primary outcomes were perinatal outcomes, which included: preeclampsia, small for gestational age, large for gestational age, low birth weight, neonatal pneumonia, neonatal respiratory distress syndrome, and neonatal intensive unit admission, etc. The association between inappropriate gestational weight gain and adverse pregnancy outcomes was estimated using multiple logistic regression analysis., Results: A total of 455 twin-pregnant women who had gestational diabetes mellitus were analyzed. Women with low gestational weight gain had reduced risk of preeclampsia (adjusted odds ratio [aOR], 0.32; 95% CI or confidence interval, 0.17-0.63; p  = 0.001) and their infants had higher risks of small for gestational age (aOR, 1.93; 95% CI, 1.04-3.58; p  = 0.037), low birth weight (aOR, 2.27; 95% CI, 1.32-3.90; p  = 0.003), neonatal intensive unit admission (aOR, 3.29; 95% CI, 1.10-5.78; p  = 0.038), pneumonia (aOR, 2.41; 95% CI, 1.08-5.33; p  = 0.031), and neonatal respiratory distress syndrome (aOR, 2.29; 95% CI, 1.10-4.78; p  = 0.027); the infants of women with excessive gestational weight gain had a higher risk of large for gestational age (aOR, 3.76; 95% CI, 1.42-9.96; p  = 0.008)., Conclusion: Gestational weight gain controlled within the range recommended by the NAM could reduce the risk of perinatal adverse outcomes. The 2009 NAM gestational weight gain recommendations can be used for Chinese twin-pregnant women with gestational diabetes mellitus., Key Points: · Inappropriate gestational weight gain can lead to adverse perinatal outcomes in twin pregnancies.. · Gestational weight gain controlled within recommended range could reduce the risk of poor perinatal outcomes.. · The National Academy of Medicine recommendations are suitable for Chinese twin-pregnant women with GDM.., Competing Interests: None declared., (Thieme. All rights reserved.)

Purpose: This study aims to systematically review and meta-analyze the evidence on the risk of esophageal adenocarcinoma (EAC) following metabolic and bariatric surgery (MBS)., Materials and Methods: A systematic literature search was conducted on the China National Knowledge Infrastructure (CNKI), Wanfang, EMBASE, MEDLINE, Web of Science, The Cochrane Library, and PubMed databases. Meta-analysis utilized odds ratios (ORs) and 95% confidence intervals (CIs) to analyze the correlation between MBS and the risk of EAC. Meta-analysis was performed using STATA software (version 12.0)., Results: Fourteen studies involving patients with obesity undergoing bariatric surgery and control groups receiving conventional treatment were included. The meta-analysis indicated a reduction in the overall incidence of esophageal cancer after bariatric surgery (OR = 0.69, 95% CI: 0.51-0.95, P = 0.022). Subgroup analysis results demonstrated a decreased risk of EAC in European patients with obesity undergoing MBS treatment (OR: 0.60, 95% CI: 0.38-0.95, P = 0.028). In studies with a sample size greater than or equal to 100,000 patients, the risk of EAC in patients with obesity undergoing MBS was significantly lower than the non-surgery group (OR: 0.59, 95% CI: 0.42-0.83, P = 0.003). Articles published before 2020 and those published in 2020 or earlier showed a significant difference in the incidence of EAC between the surgery and non-surgery groups (OR: 0.57, 95% CI: 0.43-0.75, P < 0.001). The risk of EAC in patients with obesity with a follow-up time of less than 5 years was statistically significant (OR: 0.46, 95% CI: 0.25-0.82, P = 0.009)., Conclusion: Our meta-analysis results suggest a reduced risk of esophageal cancer in patients with obesity after bariatric surgery., Prospero Registration: CRD 42024505177., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: In China, the world's largest developing country, low back pain (LBP) is a common public health issue affecting workability. This meta-analysis aimed to systematically assess the risk factors of LBP in the Chinese population., Methods: Four English language and four Chinese databases were searched, and cross-sectional studies on the risk factors for LBP in Chinese populations were identified and collected. The search timeframe covered the period from the establishment of the database to November 2023. Two researchers independently reviewed the literature, extracted the data, and evaluated the risk of bias. Begg's and Egger's tests were used to evaluate publication bias., Results: Fifteen cross-sectional studies involving 86,575 people were included. Seven risk factors for LBP were identified. Six risk factors were statistically significant: Cigarette smoking (odds ratio [OR] = 1.55; 95% confidence interval [CI]: 1.15, 2.08, P = 0.004, I 2  = 72%), body mass index (BMI) ≥ 28 kg/m² (OR = 4.51; 95% CI: 3.36, 6.07, P < 0.00001, I 2  = 8%), female sex (OR = 1.54; 95% CI: 1.25, 1.90, P < 0.0001, I 2  = 63%), vibration exposure at work (OR = 1.65; 95% CI: 1.16, 2.34, P = 0.006, I 2  = 84%), working overtime (OR = 2.57; 95% CI: 1.12, 5.91, P = 0.03, I 2  = 85%), and lack of exercise (OR = 2.48; 95% CI: 1.62, 3.78, P < 0.0001, I 2  = 0%). One risk factor that was not statistically significant was standing for long periods (OR = 1.02; 95% CI: 0.82, 1.26, P = 0.88, I 2  = 73%)., Conclusions: This study found that smoking, a BMI ≥ 28 kg/m², female sex, vibration exposure at work, working overtime, and lack of exercise may be risk factors for LBP in the Chinese population. Because the included studies were cross-sectional and the certainty of the evidence was very low, the results need to be interpreted cautiously. Multicentre, high-quality studies should be conducted in the future. To reduce the prevalence of LBP, the Chinese government and hospitals must develop early screening programs and implement effective preventive and interventional measures., Trial Registration: This study is registered in the PROSPERO database (No. CRD42023447857)., (© 2024. The Author(s).)

Background: Herbal nanoparticles are made from natural herbs/medicinal plants, their extracts, or a combination with other nanoparticle carriers. Compared to traditional herbs, herbal nanoparticles lead to improved bioavailability, enhanced stability, and reduced toxicity. Previous research indicates that herbal medicine nanomaterials are rapidly advancing and making significant progress; however, bibliometric analysis and knowledge mapping for herbal nanoparticles are currently lacking. We performed a bibliometric analysis by retrieving publications related to herbal nanoparticles from the Web of Science Core Collection (WoSCC) database spanning from 2004 to 2023. Data processing was performed using the R package Bibliometrix, VOSviewers, and CiteSpace., Results: In total, 1876 articles related to herbal nanoparticles were identified, originating from various countries, with China being the primary contributing country. The number of publications in this field increases annually. Beijing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, and Saveetha University in India are prominent research institutions in this domain. The Journal "International Journal of Nanomedicine" has the highest number of publications. The number of authors of these publications reached 8234, with Yan Zhao, Yue Zhang, and Huihua Qu being the most prolific authors and Yan Zhao being the most frequently cited author. "Traditional Chinese medicine," "drug delivery," and "green synthesis" are the main research focal points. Themes such as "green synthesis," "curcumin," "wound healing," "drug delivery," and "carbon dots" may represent emerging research areas., Conclusions: Our study findings assist in identifying the latest research frontiers and hot topics, providing valuable references for scholars investigating the role of nanotechnology in herbal medicine., (© 2024. The Author(s).)

From 2020 to December 2022, China implemented strict measures to contain the spread of severe acute respiratory syndrome coronavirus 2. However, despite these efforts, sustained outbreaks of the Omicron variants occurred in 2022. We extracted COVID-19 case numbers from May 2021 to October 2022 to identify outbreaks of the Delta and Omicron variants in all provinces of mainland China. We found that omicron outbreaks were more frequent (4.3 vs. 1.6 outbreaks per month) and longer-lasting (mean duration: 13 vs. 4 weeks per outbreak) than Delta outbreaks, resulting in a total of 865,100 cases, of which 85% were asymptomatic. Despite the average Government Response Index being 12% higher (95% confidence interval (CI): 9%, 15%) in Omicron outbreaks, the average daily effective reproduction number ( R t ) was 0.45 higher (95% CI: 0.38, 0.52, p  < 0.001) than in Delta outbreaks. Omicron outbreaks were suppressed in 32 days on average (95% CI: 26, 39), which was substantially longer than Delta outbreaks (14 days; 95% CI: 11, 19; p  = 0.004). We concluded that control measures effective against Delta could not contain Omicron outbreaks in China. This highlights the need for continuous evaluation of new variants' epidemiology to inform COVID-19 response decisions.

Urbanization is an inevitable outcome of the development of human society to a certain stage, and it is also an irreversible pattern of the concentration degree of human society. Based on multi-source data such as remote sensing images, ecological environment and socio-economic data, the evaluation index system of new urbanization is constructed from multi-dimensions of population, economy, society, space and ecology. To explore the spatio temporal evolution and driving factors of urbanization in 80 prefecture-level cities in central China from 2013 to 2021 by using entropy method, spatial autocorrelation model and geographic detector. The results show that: (1) The level of new urbanization continues to grow, with the average value rising from 0.1562 in 2013 to 0.2557 in 2021, and the regional differences are obvious, forming a circle structure with Wuhan, Zhengzhou and other provincial capitals as the center and weakening radiation to surrounding cities. (2) The agglomeration of ecological urbanization is significant, and the agglomeration trend is gradually enhanced. The high-high agglomeration areas tend to Xinzhou City, most prefecture-level cities in Hubei Province and some prefecture-level cities in Southern Hunan Province, while the low-low agglomeration areas tend to Changzhi City, most prefecture level cities in Henan Province and some prefecture-level cities in Northern Anhui Province. (3) The night light index, total retail sales of consumer goods, investment in fixed assets, proportion of built-up areas and urban economic density are the main driving factors affecting the level of new urbanization. (4) The interaction of driving factors shows double factor enhancement and nonlinear enhancement effects., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 An et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)