Search

Men who have sex with men (MSM) have high incidence rates of HIV infection worldwide. Voluntary medical male circumcision (VMMC) reduces HIV risk for men who have sex with women, but whether it is an effective strategy for MSM remains uncertain. This randomized controlled trial assessed the efficacy of VMMC in preventing incident HIV infection among MSM in China at a time when preexposure prophylaxis was not routinely offered or used. Visual Abstract. Efficacy of Voluntary Medical Male Circumcision to Prevent HIV Infection Among Men Who Have Sex With Men: Men who have sex with men (MSM) have high incidence rates of HIV infection worldwide. Voluntary medical male circumcision (VMMC) reduces HIV risk for men who have sex with women, but whether it is an effective strategy for MSM remains uncertain. This randomized controlled trial assessed the efficacy of VMMC in preventing incident HIV infection among MSM in China at a time when preexposure prophylaxis was not routinely offered or used. Background: Observational studies suggest that voluntary medical male circumcision (VMMC) may lower HIV risk among men who have sex with men (MSM). A randomized controlled trial (RCT) is needed to confirm this. Objective: To assess the efficacy of VMMC in preventing incident HIV infection among MSM. Design: An RCT with up to 12 months of follow-up. (Chinese Clinical Trial Registry: ChiCTR2000039436) Setting: 8 cities in China. Participants: Uncircumcised, HIV-seronegative men aged 18 to 49 years who self-reported predominantly practicing insertive anal intercourse and had 2 or more male sex partners in the past 6 months. Intervention: VMMC. Measurements: Rapid testing for HIV was done at baseline and at 3, 6, 9, and 12 months. Behavioral questionnaires and other tests for sexually transmitted infections were done at baseline, 6 months, and 12 months. The primary outcome was HIV seroconversion using an intention-to-treat analysis. Results: The study enrolled 124 men in the intervention group and 123 in the control group, who contributed 120.7 and 123.1 person-years of observation, respectively. There were 0 seroconversions in the intervention group (0 infections [95% CI, 0.0 to 3.1 infections] per 100 person-years) and 5 seroconversions in the control group (4.1 infections [CI, 1.3 to 9.5 infections] per 100 person-years). The HIV hazard ratio was 0.09 (CI, 0.00 to 0.81; P  = 0.029), and the HIV incidence was lower in the intervention group (log-rank P  = 0.025). The incidence rates of syphilis, herpes simplex virus type 2, and penile human papillomavirus were not statistically significantly different between the 2 groups. There was no evidence of HIV risk compensation. Limitation: Few HIV seroconversions and limited follow-up period. Conclusion: Among MSM who predominantly practice insertive anal intercourse, VMMC is efficacious in preventing incident HIV infection; MSM should be included in VMMC guidelines. Primary Funding Source: The National Science and Technology Major Project of China. [ABSTRACT FROM AUTHOR]

The ability of a system to tolerate disruptions and mitigate against malicious attacks is crucial in many applications, especially when a failure of the system can have huge economic and social consequences. The concept of system resilience has drawn increasing research and practical interest, and in this article, we propose a framework to define system resilience based on modelling of fortification strategies in the context of network interdiction problems. Specifically, we consider fortification strategies that address disruptions in two ways: immunization, where a certain disruption is not permitted to take place, and mitigation, where the disruption occurs, but is unable to impair significantly the system performance. We then propose the resilience optimization problem (RES-OPT) to maximize the capability of a system in fortifying against disruptions through immunization and mitigation strategies. The flexibility of this approach lies in that instead of assuming a fixed set of disruption scenarios, we fortify the system against as powerful an attacker as possible. In addition, we propose a cutting plane methodology to effectively solve the resulting optimization problem, and apply it to a network flow with transmission-links fortification and an electricity transmission network problem in Southern China. The results show that RES-OPT yields good quality solutions in terms of both resilience and average costs, compared to other benchmark approaches. [ABSTRACT FROM AUTHOR]

People living with HIV (PLWH) are particularly vulnerable to SARS‐CoV‐2. This multicentre prospective cohort study evaluated the long‐term immunogenicity and safety of a third homologous dose of Sinovac CoronaVac in PLWH in China. A total of 228 PLWH and 127 HIV‐negative controls were finally included and followed up for 6 months. Fewer participants reported mild or moderate adverse reactions, and no serious adverse events were observed. The median levels of neutralizing antibodies (nAbs) and immunoglobulin G against the receptor‐binding domain of the spike protein (S‐IgG) in PLWH (655.92 IU/mL, IQR: 175.76–1663.55; 206.83 IU/mL, IQR: 85.20–397.82) were comparable to those in control group (1067.16 IU/mL, IQR: 239.85–1670.83; 261.70 IU/mL, IQR: 77.13–400.75), and reached their peak at 4 weeks, exhibiting a delayed peak pattern compared to the 2‐week peak in control group. After then, the immune titres gradually decreased over time, but most participants still maintained positive seroconversion at the 6‐month mark. Multivariable generalized estimating equation analysis indicated that CD4+T cell count, HIV viral load, and antiretroviral therapy (ART) were independent factors strongly associated with immune response (each p < 0.05). We suggested that PLWH should maintain well‐controlled HIV status through ART and receive timely administration of the second booster dose for optimal protection. [ABSTRACT FROM AUTHOR]

The FY-3E satellite plasma analyzer marks China's first detection of the characteristics, occurrence, and development of the typical plasma environment in the dawn–dusk orbit space. It provides data source support for operational space weather alerts and forecasts, helps ensure the in-orbit safety of the satellite, and accumulates space environment detection data for space environment modeling and space physics research. This paper gives a detailed introduction to the detection technology adopted by the FY-3E satellite plasma analyzer. We calibrated its performance through a calibration experiment and then analyzed and compared it with similar instruments in China. It is indicated that the instrument is capable of measuring an ion energy spectrum of 24 eV~32 keV and an electron energy spectrum of 23.7 eV~31.6 keV, its field of view reaches 180° × 90°, and the inversed measurement range of spacecraft absolute potential is better than −30 kV~+30 kV. All these contribute to a notably improved technology for plasma and satellite potential detection of China's LEO satellites. [ABSTRACT FROM AUTHOR]

The FY-4B satellite is one of the second generation of China's geosynchronous meteorological satellites aiming at numerical weather forecasts. The space environment monitoring package (SEMP) onboard the FY-4B is a comprehensive instrument package for plasma, high-energy particle, and energetic neutral particle measurements. The low-energy particle analyzer (LEPA) is one of the instruments of the SEMP and consists of two top hat electrostatic analyzers designed for plasma detection. The electron and ion sensors are back-to-back assembled and are integrated to a shared electronic box. It measures the three-dimensional velocity distribution of low-energy electrons and ions on the geosynchronous orbit. In this paper, we present the ground calibration and in-flight performance of the instrument. With the electrostatic deflectors and the cylindrically symmetric structure, the instrument provides high-cadence measurements of electron and ion velocity distributions with a wide field of view (FOV) of 180° by 100°, an angular resolution of 16.7° × 20°, and a broad energy range for both the electrons and ions from tens of eV to above 30 keV, with a 1 s time resolution. The geometric factors of the electron and ion analyzers are 1.1 × 10−3 cm2·sr·eV/eV and 1.4 × 10−3 cm2·sr·eV/eV, respectively, which fulfills the requirements of the low-energy plasma measurement. The LEPA monitored typical space environment disturbance such as geomagnetic storms and successfully recorded the responses of plasma energy fluxes. Satellite surface charging events were measured, with the highest potentials of −2000 V in the shadow period and −500 V in the nonshadow period. [ABSTRACT FROM AUTHOR]

Despite the proven virological advantages, there remains some controversy regarding whether first-line integrase strand transfer inhibitors (INSTIs)-based antiretroviral therapy (ART) contributes to reducing mortality of people living with HIV (PLHIV) in clinical practice. Here we report a retrospective study comparing all-cause mortality among PLHIV in China who were on different initial ART regimens (nevirapine, efavirenz, dolutegravir, lopinavir, and others [including darunavir, raltegravie, elvitegravir and rilpivirine]) between 2017 and 2019. A total of 41,018 individuals were included across China, representing 21.3% of newly reported HIV/AIDS cases collectively in the country during this period. Only the differences in all-cause mortality of PLHIV between the efavirenz group and the nevirapine group, the dolutegravir group and the nevirapine group, and the lopinavir group and the nevirapine group, were observed in China. After stratifying the cause of mortality, we found that the differences in mortality between initial ART regimens were mainly observed in AIDS-related mortality. First-line integrase strand transfer inhibitors are commonly used for people with HIV. Here, Wu et al. report results from a multicenter cohort study in China observing significant differences in all-cause mortality among patients between various treatment groups. [ABSTRACT FROM AUTHOR]

Carbon abatement efforts in China are penetrating to sub-national level. Zhejiang province, as the 4th wealthy region in China and important player in global market (e.g., textiles, cloth, petroleum, and chemical products), lacks in-depth study of its climate change mitigation efforts, especially after China's accession to the WTO in 2001. This paper analyzed carbon emissions and intensity in Zhejiang province using most comprehensive and time-series dataset available to date since 2002. Its carbon emissions were growing at a declining speed, and carbon intensity was almost halved. The leading emitters largely agglomerate around Hangzhou Bay, close to Zhoushan Port and Shanghai Port. The growth in absolute emissions primarily arose from higher investment (323.1 Mt) and exports (280.6 Mt), while the slower growth was mainly due to efficiency improvements (− 245.7 Mt) stemming from energy and carbon abatement policies and inflows of emission-intensive products from the rest of China. Similarly, declined carbon intensity was mainly attributed to efficiency improvement. Major contributors were sector S13-Non-metallic minerals, S12-Chemicals, S26-Transport, storage and post, S07-Textiles, and S10-Paper. Economic restructuring played different roles on emissions and intensity during various development stages. Policy implications of the findings are discussed for future developments. [ABSTRACT FROM AUTHOR]

Background: In the context of climate change, it has been well observed that short-term temperature variability (TV) could increase the overall and cause-specific mortality and morbidity. However, the association between long-term TV and a broader spectrum of diseases is not yet well understood, especially in the elderly. Methods: Our study used data from the fourth Urban and Rural Elderly Population (UREP) study. Long-term TV was calculated from the standard deviation (SD) of daily minimum and maximum temperatures within the study periods (2010–2014, 2011–2014, 2012–2014, 2013–2014, and 2014). Ten self-reported diseases and conditions were collected by questionnaire, including cataract, hypertension, diabetes, cardio-cerebrovascular diseases, stomach diseases, arthritis, chronic lung disease, asthma, cancer, and reproductive diseases. The province-stratified logistic regression model was used to quantify the association between long-term TV and the prevalence of each disease. Results: A total of 184,047 participants were included in our study. In general, there were significant associations between TV and the prevalence of most diseases at the national level. Cardio-cerebrovascular disease (OR: 1.16, 95% CI: 1.13, 1.20) generated the highest estimates, followed by stomach diseases (OR: 1.15, 95% CI: 1.10, 1.19), asthma (OR: 1.14, 95% CI: 1.06, 1.22), chronic lung diseases (OR: 1.08, 95% CI: 1.03, 1.13), arthritis (OR: 1.08, 95% CI: 1.05, 1.11), and cataract (OR: 1.06, 95% CI: 1.02, 1.10). Moreover, the associations varied by geographical regions and across subgroups stratified by sex, household income, physical activity, and education. Conclusions: Our study showed that long-term exposure to TV was associated with the prevalence of main diseases in the elderly. More attention should be paid to the elderly and targeted strategies should be implemented, such as an early warning system. [ABSTRACT FROM AUTHOR]

Reassortment can introduce one or more gene segments of influenza A viruses (IAVs) into another, resulting in novel subtypes. Since 2013, a new outbreak of human highly pathogenic avian influenza has emerged in the Yangtze River Delta (YRD) and South‐Central regions of China. In this study, using Anhui province as an example, we discuss the possible impact of H7N9 IAVs on future influenza epidemics through a series of gene reassortment events. Sixty‐one human H7N9 isolates were obtained from five outbreaks in Anhui province from 2013 to 2019. Bioinformatics analyses revealed that all of them were characterized by low pathogenicity and high human or mammalian tropism and had introduced novel avian influenza A virus (AIV) subtypes such as H7N2, H7N6, H9N9, H5N6, H6N6, and H10N6 through gene reassortment. In reassortment events, Anhui isolates may donate one or more segments of HA, NA, and the six internal protein‐coding genes for the novel subtype AIVs. Our study revealed that H7N9, H9N2, and H5N1 can serve as stable and persistent gene pools for AIVs in the YRD and South‐Central regions of China. Novel AIV subtypes might be generated continuously by reassortment. These AIVs may have obtained human‐type receptor‐binding abilities from their donors and prefer binding to them, which can cause human epidemics through accidental spillover infections. Facing the continual threat of emerging avian influenza, constant monitoring of AIVs should be conducted closely for agricultural and public health. [ABSTRACT FROM AUTHOR]

Improving the measurement of environmental policy intensity would affect not only the selection of variables in environmental policy research but also the research conclusions when evaluating policy effects. Because direct evaluation is lacking, the existing research usually applies data such as pollutant emission data, or the number of policies to construct proxy variables. However, these proxy variables are affected by many assumptions and different selection criteria, and they are inevitably accompanied by endogeneity problems. In this study, China's environmental policy is comprehensively collected for the first time, and a machine learning algorithm is applied to evaluate the policy intensity. We provide all the policies issued by the Chinese government from 1978 to 2019 and the quantified intensity for each policy. We also distinguish all policies into three types according to their attributes. This dataset can help researchers to further understand China's environmental policy system. In addition, it provides a valuable dataset for related research on evaluating environmental policy and recommending actions for further improvement. Measurement(s) China's environmental policy intensity Technology Type(s) machine learning algorithm [ABSTRACT FROM AUTHOR]

Objectives: Although antiretroviral therapy (ART) has prolonged the lives of HIV‐infected individuals, HIV reservoir remains the main stumbling block to HIV cure. Presently, early ART initiation is one of the effective measures to reduce the HIV reservoir. The effects of ART in Chinese individuals with acute and early HIV infection (AEHI) and chronic HIV infection (CHI) were analyzed in this study. Methods: We performed virological and immunological parameter analysis in 29 AEHI and 19 CHI individuals who were initiated into ART in Beijing, China. The HIV DNA, CD4+ T‐cell and CD8+ T‐cell counts, and CD4/CD8 ratios between the two groups were compared using statistical analyses. Results: At weeks 48 and 96, the total HIV DNA was significantly lower in the AEHI group than that the CHI group (2.48 [2.26–2.66] vs. 3.06 [2.79–3.33] log10 copies/106 peripheral blood mononuclear cells (PBMCs), p < 0.01 at week 48 and 2.17 [1.85–2.45] vs. 2.92 [2.73–3.24] log10 copies/106 PBMCs, p < 0.01 at week 96, respectively). The CD4/CD8 T‐cell ratio in the AHI group at week 24 was significantly higher than that in the CHI group (0.71 [0.50–0.99] vs. 0.45 [0.34–0.65], p = 0.08). After 48 weeks of ART, there was still a negative correlation between the CD4/CD8 ratio and the HIV DNA level in the CHI group rather than the AEHI group. Conclusions: Early ART initiation could enhance an earlier immunological recovery in AEHI. Immunological normalization after ART initiation could provide important protection against the viral reservoir seeded in AEHI individuals. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated the impact of low‐level viremia (LLV) on virological failure and immune reconstitution among people living with human immunodeficiency virus type 1 (HIV‐1) treated with different antiretroviral regimens in Beijing, China. Methods: Human immunodeficiency virus type 1‐positive adults who were registered at an infectious disease hospital in Beijing between January 1, 2005 and January 1, 2020 were administered antiretroviral therapy (ART) and whose viral load and CD4 counts were monitored were included in this retrospective cohort study. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with LLV in patients on different ART regimens. Cox proportional hazard model was employed to analyze the virological suppression and immune reconstitution cumulative probability in patients with LLV during follow‐up. Results: A total of 10 124 HIV‐1‐infected participants was included. LLV occurred in 723 (8.2%), 204 (10.9%), 133 (8.6%), and 53 (14.4%) patients on first‐line ART, second‐line ART, third‐line ART, and simplified regimens, respectively. Virological failure occurred in 514 (5.8%), 289 (15.5%), 86 (5.5%), and 34 (9.2%) patients on first‐line ART, second‐line ART, third‐line ART, and simplified regimens, respectively. Earlier enrollment, lower baseline CD4 count, and higher baseline viral load were risk factors associated with LLV. LLV was related to increased hazards of virological failure compared to viral suppression of ≤50 copies/ml for those on first‐line ART. Conclusions: The risk of virological failure and poor immune reconstitution increases when LLV occurs. Targeted viral load and CD4 count monitoring are recommended for people living with HIV‐1 with LLV to improve health‐related outcomes. [ABSTRACT FROM AUTHOR]

Untangling the reasons underlying changes in air pollution trajectories and regional emission differences is critical to guide efforts to attain air pollution reduction goals in China. Using Index decomposition analysis and the air pollution emission inventory, we identify the contributions of different regions and sectors to the socioeconomic factors driving China's sulfur dioxide and nitrogen oxides emissions change and difference from 2007 to 2012. We find that the reinforced end‐of‐pipe treatment, improved energy intensity and adjusted industrial structure dominated the emissions mitigation, while the provincial disparities in economy scale, energy pollution intensity and energy intensity led the emissions differences between regions. The emissions change was mainly driven by the utilities, capital‐intensive manufacturing and service sectors of several key provinces in Central, North, Northwest and Southwest. Less developed provinces generally had a larger potential in decreasing emissions by improving energy intensity and adjusting industrial structure, especially for the utilities and capital‐intensive manufacturing sectors. Our findings indicate that the successful emission reduction experiences for the power sector should be expanded to other major industrial sectors, further attention should be given to structure‐focused policy actions, and different pathways of emissions reduction should be chosen for different types of provinces based on change and difference characteristics of each driver. Plain Language Summary: Identifying key factors, regions and sectors that driving China's sulfur dioxide (SO2) and nitrogen oxides (NOx) emissions change and regional differences is crucial for decision‐makers to curb air pollution in a targeted way. By exploring this issue during 2007–2012, we found that end‐of‐pipe treatment, energy intensity and industrial structure represent the main factors offsetting SO2 and NOx emissions. The emissions reduction was dominated by the utilities, capital‐intensive manufacturing and service sectors of several key provinces in Central, North, Northwest and Southwest. We also found that disparities in economy scale, energy pollution intensity and energy intensity have largely contributed to provincial emission differences; less developed provinces generally showed poorer performances in energy intensity and industrial structure compared to developed provinces. Provinces are classified into four types based on each driver's temporal change and regional difference characteristics. We proposed that for different types of provinces, their emissions reduction potential can be further exploited by learning from other provinces instead of adjusting the mitigation measures depending only on their own historical air pollution emissions trajectories. Key Points: Regional and sectoral contributions to the drivers of air pollution are quantifiedBoth the temporal change and regional difference of drivers are exploredFurther attention should be given to structure‐focused policy actions [ABSTRACT FROM AUTHOR]

Background: Efavirenz (EFV) is widely used in antiretroviral therapy (ART), but the incidence and risk factors of neuropsychiatric adverse events (NPAEs) after EFV treatment have rarely been studied in Chinese ART naïve patients. Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4, 22.7, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower income, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months. Conclusions: These findings suggested EFV discontinuation due to NAPEs was low, and the HADS-A, HADS-D, and PSQI scores after 12 months of EFV treatment were associated with several risk factors. The clinicians should keep in mind and routinely screen for the risk factors associated with neuropsychiatric disorders in HIV-infected patients. [ABSTRACT FROM AUTHOR]

It is vital to calculate Chinese provinces' exports in domestic and global value chains from the perspective of value-added to address the problem of double counting. In this study, we calculated the direct and indirect domestic value-added in exports of 30 Chinese provinces using cross-border and cross-regional input–output tables in 2007 and 2012. We analysed the drivers of export value-added based on structural decomposition analysis. The results show that there is a value-added spatial imbalance in trade development. The export value-added of eastern provinces is significantly higher than that of central and western provinces, but this imbalance is gradually improving. The domestic value chain is the main channel for each province to realize export value-added, and the province production channels account for the highest proportion in this chain. The export value-added through international production channels is relatively small but growing in importance. The structural analysis shows that the increase of Chinese provinces' export value-added is mainly caused by an increase of export scale and the provincial multiplier effect, while the value-added ratio of Chinese provinces has the main restraining effect. The spillover effect from industrial cooperation between provinces and other economies also increases the domestic value-added of exports. [ABSTRACT FROM AUTHOR]

New approaches to increase HIV‐1 testing and HIV‐1 viral load (VL) monitoring are needed for people living with HIV (PLHIV) in China. The Xpert HIV‐1 VL assay was prequalified by the World Health Organization in 2017 but has not been evaluated in China. A multicenter evaluation was conducted to assess the accuracy of the Cepheid Xpert HIV‐1 VL assay compared to the Abbott RealTime HIV‐1 assay in China. Overall agreement was seen in 558 of 562 specimens (99.29%) with a κ value of 0.962. Pearson's coefficient between the two assays was 0.943. Analyzed by the Bland‐Altman method, the mean bias was −0.54 log10 copies/mL, and 94.05% results fell within the 95% confidence limit of agreement (−1.248 to 0.168 log10 copies/mL). The coefficient of variation of the Cepheid Xpert HIV‐1 VL assay ranged from 0.61% to 1.55%, as determined by testing eight positive plasma specimens with three different lots on different days. Due to its simplicity, random‐access, rapid turnaround time, and accuracy, the Xpert HIV‐1 VL assay can be used in local hospitals and clinics that bear the burden of identifying and treating HIV patients in China. Highlights: A random‐access HIV‐1 quantitative assay (Xpert HIV‐1 VL assay, Cepheid, Sunnyvale, CA) was introduced to China.The positive and negative percent agreements of the Xpert assay were 99.60% and 96.61%, respectively, assessed at a multicenter clinical trial.The coefficient of variation of the Xpert assay ranged from 0.61 to 1.55%.The Xpert HIV‐1 VL assay was rapid and accurate in viral load monitoring at the point of care in China. [ABSTRACT FROM AUTHOR]

Background: This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients' adherence, and ameliorate antiretroviral treatment (ART)-related outcomes.Methods: All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model.Results: 4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18-133) days, much shorter than the control group (56 (26-253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years' follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17-0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group.Conclusions: People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country. [ABSTRACT FROM AUTHOR]

Background: Although the global human immunodeficiency virus (HIV) epidemic has improved significantly due to antiretroviral treatment (ART), ART-related adverse events (AEs) remain an issue. Therefore, investigating the factors associated with ART-related AEs may provide vital information for monitoring risks.Methods: A prospective cohort study was conducted among adult patients (aged 18 years or older) with HIV who received Tenofovir (TDF) + Lamivudine (3TC) + Efavirenz (EFV) as first-line ART regimens. All AEs during the first 12 months of therapy were recorded. Logistic regression analysis was used to identify variables associated with AEs.Results: Four hundred seventy-four patients receiving TDF+ 3TC+ EFV ART regimens between March 2017 and October 2017 were included in the study analysis. Among them, 472 (99.6%) experienced at least one AE, 436 (92.0%) patients experienced at least one AE within 1 month of treatment, 33 (7.0%) between one and 3 months of treatment, and three (0.6%) patients after 3 months of treatment. The most commonly reported AE was nervous system (95.6%) related, followed by dyslipidemia (79.3%), and impaired liver function (48.1%). Patients with baseline body mass index (BMI) greater than 24 kg/m2 (adjusted OR 1.77, 95%CI 1.03-3.02), pre-existing multiple AEs (adjusted OR 2.72, 95%CI 1.59-4.64), and pre-existing severe AEs (adjusted OR 5.58, 95%CI 2.65-11.73) were at increased odds of developing a severe AE. Patients with baseline BMI greater than 24 kg/m2 (adjusted OR 2.72, 95%CI 1.25-5.89) were more likely to develop multiple AEs.Conclusion: The incidence of ART-related adverse events over a 12-month period in China was high. Baseline BMI greater than 24 kg/m2, pre-existing multiple AEs, and pre-existing severe AEs were shown to be independent risk factors for developing a severe AE. [ABSTRACT FROM AUTHOR]

Background: Lopinavir/ritonavir (LPV/r) is a major antiretroviral treatment in China, but little is known about the performance of first-line LPV/r-based regimen in treatment-naïve patients with human immunodeficiency virus type 1 (HIV-1) infection. This study aims to assess the efficacy and adverse effect events of LPV/r plus lamivudine and tenofovir or zidovudine as an initial antiretroviral treatment in HIV-1-infected individuals for whom cannot take efavirenz (EFV) or is allergic to EFV. Methods: We performed a retrospective study of patients registering with the China's National Free Antiretroviral Treatment Program from July 2012 to January 2017, followed at a tertiary care hospital in Beijing, China. The primary outcome was the proportion of subjects with HIV-1 RNA ≤40 copies/ml at 6 and 24 months of treatment. We assessed the immunological response and adverse events. Results: In total, 4,862 patients were enrolled in the study and 237 were eligible for analysis in each study arm. During the first six months, virological suppression was better with the LPV/r-based regimen than with the EFV-based regimen (93.80 vs 87.80% for P < 0.05). Viral suppression rates continued to increase until 12 months, remain steady thereafter until 24 months, for both groups. The multilevel analysis revealed that patients in the LPV/r group were more likely to display improvements in CD4 T-cell count over time than those in the EFV group (P < 0.001). Grade 3 or 4 laboratory adverse events were observed in 14 patients (5.91%) from the LPV/r group and three patients (1.20%) in EFV group. Conclusion: Our findings demonstrate that LPV/r-containing regimens are effective and well-tolerated in Chinese treatment-naïve patients with HIV-1 infection. [ABSTRACT FROM AUTHOR]

Understanding the socioeconomic burden of severe fever with thrombocytopenia syndrome (SFTS) is important for making decisions on health resources allocation. This study aimed to assess the economic burden of patients with this syndrome in endemic areas of the Anhui Province in 2018. A total of 114 patients were recruited, and the median age was 63.5 years, 62 (54.4%) were female, 97 (85.1%) were farmers, 108 (94.7%) were survival patients, and 71 (62.3%) had a family monthly income less than $453.3. The median times of hospital visits and hospitalizations of patients were three times, and the median lost work days of these patients, caregivers and visitors were 14.5 days, 14.5 days and 7.5 days, respectively. The median direct costs of the patient were $3,761.6, and the median indirect costs were $508.3. Taking direct and indirect costs into consideration, the median total economic costs of patients were $4,323.9, and the total annual cost of 2018 was $1,396,913.6. Although 113 (99.1%) patients had medical insurance, only 25.8% of costs were covered by reimbursement, and the total cost paid for by the patients and their families was $1,041,073.6 in 2018. Our findings revealed that the patients and their families had a significant economic burden, and preventive measures should be strengthened in endemic areas. The findings also provided baseline data for assessing the cost‐effectiveness of the vaccines or anti‐viral drugs in the near future in China. [ABSTRACT FROM AUTHOR]

In today's China, the reverse distribution of electricity resources and electricity demand makes large-scale and long-distance transmission of electricity inevitable, resulting in the problem of electricity allocation optimization. To address this problem in the region covered by the China Southern Grid (CSG), the paper establishes an optimized model for electricity generation and interprovincial trading strategies in southern China. Based on data from 2015, this paper simultaneously optimizes electricity generation and interprovincial trading strategies in each of the five provinces. The result shows that interprovincial trading in the CSG-served area can yield significant energy, economic, environmental and interconnection benefits. It can reduce the power supply cost and environmental pressure in Guangdong province, help make Yunnan province a hydropower base in China and a thermal power base in southern China, facilitate the completion of the "West-to-East Power Transmission" project, and partly resolve the issues raised in each province's 13th Five-Year Plan as well as the problem of optimizing electricity allocation in the region covered by the CSG. • We propose an annual total optimized model for electricity generation and interprovincial trading in Southern China. • The model optimizes the electricity trading and transmission routes across regions. • The model considers the generation cost and penalty cost of emitting CO 2 , SO 2 and NO x. • Corresponding policies and proposals are put forward for power grid and five regions in South China. [ABSTRACT FROM AUTHOR]

Energy efficiency (EE) is an important strategy for China to save energy and reduce energy-related emissions. With significant regional diversities in China, it is important to conduct the EE assessment at the regional level. Usually, the regional EE assessment is applied to 30 regions in Mainland China using the data envelopment analysis (DEA) technique. With the "Belt and Road" strategy initiated by the Chinese government, it is reasonable and necessary to take Hong Kong, Macao, and Taiwan into consideration. However, such data expansion for China's regional EE assessment using DEA can reverse the relative rankings of some decision-making units, which is called the "rank reversal" phenomenon. In this paper, we illustrate in theory that rank reversal occurs in general DEA models, and apply the most popular five DEA models to assess China's regional energy efficiency from 2000 to 2014. The empirical study shows that the 30 regions in Mainland China have the least rank reversal when Tone's slack-based model (SBMT) is adopted. The main cause of ranking reversal is the addition of decision-making units lying on production frontier. Better understanding of the rank reversal phenomenon is critical for the energy efficiency assessment using DEA to inform the policy makings. [ABSTRACT FROM AUTHOR]

The energy supply–demand security and climate change has continued to be problematic, making it significant and necessary to investigate embodied energy flow, particularly in a large and fast-growing developing country like China. One of the effective approaches is the energy/emissions embodied in bilateral trade (EEBT) aiming to locate the destination of energy bi-directionally to evaluate how energy flow between producer and consumer sectors. However, in addition to the flow of energy and resources, the topological structure and impact of underlying components from a system science perspective are equally important for policy-making. This study therefore constructs an energy embodied in trade network (EETN) model to track multi-layer primary energy flow by integrating the EEBT approach and complex network analysis. The embodied coal, oil, natural gas, and non-fossil fuels associated with China’s 30 provinces/municipalities are quantified at the provincial level. By the joint analysis of the network-oriented metrics, the EETN model elicits the possibility of understanding the heterogeneity distribution of different types of energy flow and the potential impact of province-specific policy interventions. We explain how resource endowment, economic growth, income inequality, cross-provincial industrial transfer, and infrastructures affect China’s provincial energy embodiments as well as the clustering features. Other findings and policy recommendations are also presented. [ABSTRACT FROM AUTHOR]

Lateral berms are often constructed to protect highway bridges against debris flows in mountainous regions. Currently, different solutions for lateral berm design are debated. The lack of standardization results in the improper design of lateral berms, limiting the mitigating effect. In this paper, a monitoring case of the mitigating effect of a lateral berm is introduced. The lateral berm was constructed through a bridge culvert at the alluvial fan of a debris-flow gully. In September 2008, a debris flow in this gully completely buried the lateral berm. The proposed numerical integral method was used to back analyse the flowing velocity and mud depth in berm. Results supported the speculation that abrupt decreases in mud depth and flow velocity in the lateral berm caused deposits that compressed the effective berm depth and resulted in overtopping flow. Therefore, we suggested reducing the berm width in order to increase the flow velocity in the berm. In June 2011, another debris flow with a smaller magnitude occurred in the gully, and the reconstructed lateral berm reportedly performed well to protect the bridge of Yalu highway. The case studies highlighted that berm width should be one of the main considerations in the berm design. [ABSTRACT FROM AUTHOR]

Orogenic mantle-derived peridotites commonly originate from the subcontinental lithospheric mantle (SCLM) and thus provide a key target to investigate the modification of the SCLM by a subducting slab. The Maowu ultramafic rocks from the Dabie ultrahigh-pressure (UHP) metamorphic belt have formerly been debated as representing cumulates or mantle-derived peridotites. Detailed petrological and geochemical data presented in this study provide new constraints on the origin and formation of the peridotites involving melt depletion in the ancient SCLM and deep crustal metasomatism. The Maowu garnet dunites have refractory bulk compositions characterized by high Mg# (91.9–92.0) and Ni (2537–2892 ppm) values and low Al 2 O 3 (0.26–0.76 wt.%), CaO (0.05–0.32 wt.%), TiO 2 (< 0.03 wt.%), Pd/Ir (0.40–0.46) and 187 Os/ 188 Os (minimum 0.11461) values. The Paleoproterozoic model ages (T RD = 2.1 Ga, T MA = 2.3 Ga) of the most refractory dunites represent minimum estimates for the age of the initial melt extraction. The extremely depleted nature, high olivine Fo (92.7–93.9), high Cr# (82–87) of spinel, and Re–Os isotopic data suggest that the Maowu garnet dunites are the residues of ~ 40% partial melting and represent a Paleoproterozoic fragment of the SCLM beneath the southeastern margin of the North China craton. Many garnet orthopyroxenite veins crosscutting the Maowu dunites preserve abundant metasomatic textures and show variable enrichment in incompatible elements. Mineral and whole-rock chemistry indicate that these veins represent metasomatic products between the wall dunites and silica-rich hydrous melts under UHP conditions. The veins show large variations in platinum-group element (PGE) signatures and Re–Os isotopes. The garnet-poor orthopyroxenite veins are characterized by low Al 2 O 3 (< 2 wt.%) and S (< 31 ppm) contents and have PGE patterns and 187 Os/ 188 Os ratios similar to the wall dunites, whereas the garnet-rich orthopyroxenite veins have high Al 2 O 3 (> 6 wt.%) and S (99–306 ppm) contents and show melt-like PGE patterns and high 187 Os/ 188 Os ratios (up to 0.36910). These features, combined with the occurrence of interstitial sulfides in the garnet-rich orthopyroxenite veins, suggest that crust-derived sulfur-saturated silicate melts may have significantly modified the PGE signature and destroyed the Re–Os systematics of the SCLM. However, when the crust-derived silicate melts became sulfur-depleted, such melts would not significantly modify the PGE patterns, radiogenic Os-isotope compositions or the Re-depletion model ages of the SCLM. Consequently, deep crust-mantle interactions in continental subduction zones could induce high degrees of Os isotopic heterogeneity in the SCLM wedge. [ABSTRACT FROM AUTHOR]

Background: HIV drug resistance is associated with faster clinical progression of AIDS. However, the effect of significant polymorphisms and mutational covariation on mortality among HIV/AIDS patients receiving long-term antiretroviral therapy (ART), have rarely been studied. Methods: In this prospective cohort study from December 2003 to December 2014, we present a new computational modelling approach based on bioinformatics-based models and several statistical methods to elucidate the molecular mechanisms involved in the acquisition of polymorphisms and mutations on death in HIV/AIDS patients receiving long-term ART in China. Results: This study involved 654 ART-treated patients, who had been followed for 5473.4 person-years, a median of 9.8 years, and 178 died (25.2%, 3.3/100 person-years). The first regimens included AZT/d4T + NVP+ ddI (78.9%) or AZT/d4T + NVP+ 3TC (20.0%). We calculated an individual Ka/Ks value for each specific amino acid mutation. Result showed that 20 polymorphisms (E6D, Q18H, E35D, S37N, T39A, K43E, S68N, L74I, I93L, K103N, V106A, E169D, Y181C, G190A, Q197K, T200V, T200E, T215I, E224D and P225H) were strongly associated with AIDS related deaths. Among them, 7 polymorphisms (L74I, K103N, V106A, Y181C, G190A, T215I and P225H) were known to be drug resistance mutations, 7 polymorphisms (E6D, E35D, S37N, I93L, E169D, T200V and T200E were considered to be potential drug resistance mutations, and 6 polymorphisms (T39A, K43E, S68N, Q197K, T200V and E224D) were newly found to have an association with drug resistance mutations, which formed a complex network of relationships. Conclusions: Some polymorphisms and mutational covariation may be the important influencing factors in the failure of treatment. Understanding these mechanisms is essential for the development of new therapies, designing optimal drug combinations, and determining effective clinical management of individual patients. [ABSTRACT FROM AUTHOR]

The use of data envelopment analysis (DEA) in China’s regional energy efficiency and carbon emission efficiency (EE&CE) assessment has received increasing attention in recent years. This paper conducted a comprehensive survey of empirical studies published in 2006–2015 on China’s regional EE&CE assessment using DEA-type models. The main features used in previous studies were identified, and then the methodological framework for deriving the EE&CE indicators as well as six widely used DEA models were introduced. These DEA models were compared and applied to measure China’s regional EE&CE in 30 provinces/regions between 1995 and 2012. The empirical study indicates that China’s regional EE&CE remained stable in the 9th Five Year Plan (1996–2000), then decreased in the 10th Five Year Plan (2000–2005), and increased a bit in the 11th Five Year Plan (2006–2010). The east region of China had the highest EE&CE while the central area had the lowest. By way of conclusion, some useful points relating to model selection are summarized from both methodological and empirical aspects. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to assess the status and progress of rural household energy sustainable development in China. A new composite indicator, rural energy sustainable development index (RESDI), is developed based on the improved grouped principal component analysis method (GPCA) which is the combination utilization of principal component analysis (PCA), factor analysis (FA), and entropy weight method. The improved grouped principal component analysis method keeps the advantages of principal component analysis and factor analysis. To capture the characters of rural energy sustainable development, ten indicators selected based on the criteria presented by OECD are designed to construct the RESDI. The main results are as follows. The RESDI increased from 0.185 in 1991 to 3.189 in 2012. However, the curve of RESDI can be divided into three phases: a slow increase stage between 1991 and 1996, a rapid decrease stage from 1997 to 1998, and a rapid increase stage between 1999 and 2012. [ABSTRACT FROM AUTHOR]

Background: The assessment of adherence to antiretroviral therapy (ART) is important in order to predict treatment outcomes. Lamivudine (3TC) is one of the most widely used NRTIs in China, but its concentrations in hair and association with virologic failure and drug resistance have not been studied. Methods: We conducted a cross-sectional survey to investigate 3TC concentrations in hair as a predictor of virologic failure and drug resistance among HIV patients receiving free ART. We also compared the capacity of hair 3TC concentrations with self-reported adherence in predicting virologic responses. Hair 3TC concentrations were detected through the LC-MS/MS system. Results: In patients without HIV drug resistance (HIVDR), with a threshold hair 3TC concentration of 260 ng/g, the sensitivity and specificity in predicting virologic suppression were 76.9% and 89.9%, respectively. Some factors, including CD4+ cell counts, initial treatment regimens with 3TC, and current regimens with second-line drugs, influenced the association between hair 3TC concentrations and virologic suppression. In patients who experienced virologic failure with HIVDR, with a threshold of 180 ng/g, the sensitivity and specificity were 70.0% and 74.4%, respectively. Hair 3TC concentrations had higher sensitivity and specificity in predicting virologic failure and drug resistance than self-reported adherence. Conclusions: The hair 3TC concentration was a stronger indicator than self-reported adherence in predicting virologic failure and drug resistance in HIV patients receiving free ART. [ABSTRACT FROM AUTHOR]

Different oil price shock incentives under different domestic and international environment will cause different oil price shocks and bring different impacts to China’s macroeconomy. However, there are few empirical studies on early warning prediction of the co-movements between oil price shocks and macroeconomy. This paper presents an incentive-oriented artificial intelligent (AI) early warning system (EWS) with ontology supported case based reasoning (CBR) method, called “relationship between oil price shocks and economy-an early warning system (ROSE 2 )”, to forecast the co-movements between macroeconomy and oil price shocks in China. Simultaneously, multi-galois lattice (MGL), which is more suitable for matching multiple attributes, is used to improve the recall and precision capability of ROSE 2 . Finally, several practical queries called Q1–Q4 are presented for verifying the validation and efficiency of the ROSE 2 system. [ABSTRACT FROM AUTHOR]

The decoupling theory is an appropriate tool to study the relationship between economic growth and energy consumption (or environment pollution). But the underlying causes of the states of decoupling are difficult to find. Based on the Log-Mean Divisia Index (LMDI) theory, this paper provides a new way to find the nature of the factors governing the changes in the state of decoupling between the economic growth and energy consumption in China. Our results show that only four states of decoupling occurred during the period 1991-2012: weak decoupling, expansive coupling, expansive negative decoupling, and strong decoupling. The economic activity effect made a negative impact on the decoupling in the study period. The energy intensity effect played a positive role in the development of decoupling except in 2003, 2004, and 2008. The economic structure effect only played a positive role in the development of decoupling in several years. However, the energy structure effect plays a relative small role in the development of decoupling. [ABSTRACT FROM AUTHOR]

Taking into account the heterogeneity of production technologies across Chinese cities, we adopted a meta-frontier function and a non-radial directional distance function to construct an index that comprehensively evaluates the performance achieved by coupling energy-saving and emissions reduction. We also analyzed the theoretical factors leading to performance loss in energy-saving and emissions reduction. An empirical analysis of 209 Chinese cities suggests the following. First, the energy-saving and emissions reduction performances of Chinese cities are generally low, and the relationship between these variables and the economic development level is U-shaped. The results also suggest that cities place more importance on energy-saving than on emissions reduction. Second, the technology gap and insufficient management are the two primary sources of latent capacity that could contribute to energy-saving and emissions reduction in Chinese cities; insufficient management is the dominant factor in both high-income and lower-middle income cities. Four combinable strategies for energy-saving and emissions reduction are proposed. Third, the heterogeneities of production technologies related to energy-saving and emissions reduction are universal; the technological gap between the current and the best production technologies is seen in the largest of the middle income cities, and the gap is smallest in high-income cities. [ABSTRACT FROM AUTHOR]

In light of the fact that most wastewater in China contained both industrial and domestic wastewater, a 52-d systematical investigation was conducted on the long-term effect of low concentration Cr(VI) (0.3–0.8 mg L −1 ) on P removal performance of granule-based EBPR system in this study. The mechanisms were likewise discussed. Results showed that high Cr(VI) concentration (⩾0.5 mg L −1 ) could significantly inhibit P removal, while this phenomenon was not found when Cr(VI) concentration was less than (or equal to) 0.4 mg L −1 . Most of the granules was disintegrated and filamentous bacteria overgrew inducing sludge bulking occurred at 0.7 mg L −1 Cr(VI). During the exposure test, the abundance of poly-phosphate-accumulating organisms (PAOs) significantly decreased while the populations of glycogen accumulating organisms (GAOs) and other bacteria increased. Both production and degradation of poly-β-hydroxyakanoates (PHAs) were apparently inhibited. An improved polysaccharide/protein (PS/PN) ratio was observed with the increasing Cr(VI) concentration, implying excessive polysaccharide was secreted by microorganisms to support its resistance to the toxicity of Cr(VI). Besides, good linear regression between PS/PN ratio and the granule size ( R 2 = −0.86, p < 0.01) was obtained, indicating that high PS/PN was adverse to granule stability. Correlation analysis indicated that the accumulation of granules intracellular Cr was directly responsible for the observed inhibitory effect on P removal process. The long-term Cr(VI) treatment had irreversible effects on granule-based EBPR system as it could not revive after a 16-d recovery process. [ABSTRACT FROM AUTHOR]

Highlights: [•] We combine the HEET approach and SWD-EET analysis for regional emission modeling. [•] A comprehensive study of China’s regional emission embodiments is presented. [•] How interregional and international trade affect China’s regional CO2 are explained. [•] Developed regions are generally net importers of embodied emissions from trade. [•] Developing regions are generally net exporters of embodied emissions from trade. [Copyright &y& Elsevier]

China's Chang'E-5 mission returned new samples from the Moon and has extended the eruption ages of lunar volcanism ca. 800 million years younger than previous determinations. This finding challenges our past perceptions of the lunar thermal and magmatic evolution and has attracted great attention. Since the lunar basalts show a wide compositional range, it is essential to classify them carefully in order to define their origin and evolution. However, whether the Chang'E-5 basalts are classified as high-Ti or low-Ti type remains debatable because the basalt clasts picked from the Chang'E-5 soil samples are so tiny that their bulk composition estimations involve large uncertainties. Instead of using bulk composition, this study employs Ti in olivine to track the crystallization sequence of the Chang'E-5 basalts and then to classify them. In the Chang'E-5 olivines, Ti contents first increase and then decrease with a continuous decrease of forsterite values. Such a compositional variation reveals a magma differentiation series from early ilmenite unsaturation to ilmenite saturation during the late stage. Furthermore, the TiO 2 content of the hypothesized parental magma that corresponds to the most primitive olivine is estimated to be ~4.4 wt%. These results confirm that the Chang'E-5 basalts originated from a low-Ti primary magma. This study shows that olivine can be used as a robust mineral indicator to distinguish between high-Ti and low-Ti mare basalts. • This study performed olivine minor element analyses on Chang'E-5 lunar basalts. • Ti in olivine reveals ilmenite crystallization later than olivine and clinopyroxene. • The Chang'E-5 basalts can be classified as low-Ti type of mare basalt. • Olivine has a great potential to illuminate lunar magmatic origin and evolution. [ABSTRACT FROM AUTHOR]

• A hybrid approach was used to calculate embodied SO 2 flows in each province. • This study calculated the aggregate embodied SO2 emission intensity at the provincial level. • This study presented an up-to-date and comprehensive analysis of embodied SO 2 flows in 2015. • With Tibet data, this study provided a comprehensive examination of the the equilibrium of the inflow and outflow balance of embodied SO 2 and value added flows in China's 31 provinces. Reducing SO 2 emissions remains crucial for China in terms of controlling air pollution. There is great heterogeneity in SO 2 emissions across provinces in China due to trade. This paper applies a hybrid approach to study SO 2 emission transfer among 31 provinces (including Tibet) in China in 2015. The differences of SO 2 emissions are compared from the perspectives of pollution transfer in the domestic supply chain and international supply chain. Moreover, this paper calculates the aggregate embodied SO 2 emission intensity (ratio between embodied SO 2 emissions and embodied value added) from demand perspective. The results show an inequitable distribution of SO 2 emissions and embodied intensities in China's 31 provinces. The provinces in the eastern region account for a large proportion of interprovincial import trade and international exports. For the provinces in the western region, the proportions of embodied SO 2 are higher than those in the central region. Under the consumption-based principle, the eastern region is the main contributors to SO 2 emissions. In addition, the emission intensity in the eastern region is much lower than that in the western region. The SO 2 emission intensity generated by international export trade is lower than that generated by interprovincial trade. Therefore, China should strengthen both the joint management in various provinces and international cooperation, so as to promote the coordinated management of the industrial chain. [ABSTRACT FROM AUTHOR]

Abstract: In recent years, energy-related CO2 emissions embodied in international trade and the driving forces have been widely studied by researchers using the environmental input–output framework. Most previous studies however, do not differentiate different input structures in manufacturing processing exports and normal exports. Using China as an example, this paper exemplifies how implications of results obtained using different export assumptions differ. The study posits that the utilization of traditional I–O model results in an overestimation of emissions embodied in processing exports and an underestimation in normal exports. The estimate of CO2 emissions embodied in China''s exports drops by 32% when the extended I–O model is used. The choice of export assumption has more impact on the decomposition results for processing exports. The study further highlights that for a country with an export structure similar to China, it is meaningful to look into the impact of export assumption in embodied emission studies. [Copyright &y& Elsevier]

With the introduction of the environmentally extended input–output (I–O) framework, traditional economic I–O modeling and analysis can be conveniently adopted in energy and emission studies. Based on such an extended framework, many empirical studies investigating the driving forces of energy consumption and emission changes using structural decomposition analysis have been reported. Three aggregation issues are inherent in such decomposition studies, namely sector aggregation, spatial aggregation and temporal aggregation. This study, as an extension of our previous work on the first two issues, focuses on the third or temporal aggregation. An empirical study using the emission data of China from 1997 to 2007 is presented to illustrate the problems involved. How to deal with temporal aggregation and its possible interactions with the other two aggregations is also discussed. [ABSTRACT FROM AUTHOR]

This study compared the immunogenicity of inactivated SARS-CoV-2 vaccines between people living with HIV (PLWH) and HIV-negative individuals. We recruited 120 PLWH and 53 HIV-negative individuals aged 18–59 years who had received an inactivated SARS-CoV-2 vaccine in two Chinese cities between April and June 2021. Blood samples were tested for immunogenicity of the inactivated SARS-CoV-2 vaccines. The prevalence and severity of adverse events associated with SARS-CoV-2 vaccines were similar between PLWH and HIV-negative individuals. The seropositivity of neutralizing activity against authentic SARS-CoV-2, of the total amount of antibody (total antibody) and of S-IgG were 71.3%, 81.9%, and 92.6%, respectively, among fully vaccinated PLWH. Among all participants, PLWH had lower neutralizing activity, total antibody, S-IgG, and T-cell-specific immune response levels, compared to HIV-negative individuals, after controlling for types of vaccine, time interval between first and second dose, time after receiving the second dose, and sociodemographic factors. PLWH with a longer interval since HIV diagnosis, who received their second dose 15–28 days prior to study commencement, and who had an interval of ≥21 days between first and second dose had higher neutralizing activity levels. The immunogenicity of the inactivated SARS-CoV-2 vaccines was lower among PLWH as compared to HIV-negative individuals. Vaccination guideline specific for PLWH should be developed. [ABSTRACT FROM AUTHOR]

White mica is an important reservoir of boron (B) in subducted metasedimentary rocks. To quantify the effect of phengite breakdown on B release and transfer, we investigated the replacement processes of phengitic mica and associated element redistribution in exhumed ultra-high pressure (UHP) impure marbles from the Dabie terrane, China. Three types of microstructures, which are related to the liberation, transport, and precipitation of B, are recognized: (1) Type-I is the pseudomorphic replacement of phengite by the assemblage of biotite + plagioclase ± quartz ± epidote. The assemblage maintains a flaky shape of pre-existing phengite, which only rarely occurs as a relict phase in the product assemblages. Phase equilibria modelling indicates that the conditions of replacement reactions are 1.2–1.3 GPa at ~600 °C, with a relatively low X CO2 of 0.04–0.16. (2) Type-II is characterized by the local occurrence of fine-grained tourmaline (Tur-F) along the outer margin of Type-I texture domains, which represents the in situ precipitation of B released by the replacement reactions. (3) Type-III texture involves the irregularly shaped intergrowth of tourmaline (Tur-In) + quartz in the calcite matrix, isolated from the Type-I and Type-II texture domains. The Type-III minerals are in equilibrium with diopside and plagioclase and most likely represent the precipitation from a "transported", B-bearing fluid. Mineral trace element analyses indicate that relict phengite in Type-I texture has significantly higher B contents (284–464 μg/g) than all of the product minerals (2–26 μg/g). A mass balance estimate indicates that the majority (>90%) of B in the reactants is lost during the process of phengite replacement. The calculations in terms of mineral-fluid partition indicate that the fluid involved in the replacement reactions has B contents of 1893–6858 μg/g. In situ B isotopic analyses indicate that Tur-F and Tur-In have a similar variation range of δ11B (+4 ~ +7‰). Both types of low-pressure tourmaline have lower δ11B values than the previously reported eclogite-facies tourmaline (reaching +15‰) from phengite-bearing marbles in the same study area. This result indicates two episodes of tourmaline growth and B transfer. Thus, a two-stage model of B loss from phengite during slab exhumation is proposed. Our results reveal that the breakdown of white mica in exhumed metasedimentary rocks can cause a strong release of B, which would largely influence the B budget at convergent plate margins. • Microtextures of B loss, transfer, and precipitation induced by phengite breakdown are recognized in UHP marbles • Behaviour of B and its isotopes is quantitatively assessed during phengite breakdown • A two-stage model of B loss from phengite during the slab exhumation is proposed [ABSTRACT FROM AUTHOR]

The multi-region input-output (MRIO) model has been widely adopted to capture feedback effects in energy/emission studies. For regional emission studies, linking regional and global datasets is essential to capture both interregional and international feedback effects. However, this will lead to spatial aggregation. This paper deals with spatial aggregation issues in the MRIO analysis of regional embodied emissions/intensities when linking regional and global datasets. When such data are available for two different years, there are also spatial aggregation issues in the structural decomposition analysis (SDA) that may be conducted to investigate the driving forces of changes of regional embodied emissions/intensities between the two years. In this paper, we discuss four such spatial aggregation schemes with different data requirements. An empirical study linking the data of China's 30 regions and 43 world countries for 2007 and 2012 and analyzing the impacts of spatial aggregation on China's regional embodied emissions and intensities and their driving forces between these two years is presented. The study shows the impacts of spatial aggregation on the regional results. It is found that the spatial aggregation has a greater impact on the sectoral results than the regional results. Implications of the findings on regional emission studies are discussed. • We analyze spatial aggregation in the MRIO analysis of embodied emissions/intensities. • The MRIO and SDA analyses are conducted by linking regional and global datasets. • National AEI framework is extended to global AEI framework. • An empirical study of linking China's 30 regions and 43 world countries is presented. • Impacts of spatial aggregation on China's regional results are discussed. [ABSTRACT FROM AUTHOR]

Energy trade has been a hot topic in countries participating in the Belt and Road Initiative (BRI), while cooperation and competition are two elementary modes of international trade. This study examines the coopetition relations in terms of renewable energy trade among BRI countries by constructing a two-layer network model for 1996–2018. We examined 65 BRI countries and indicated that the interplay between intrinsic and network dynamics features either cooperation or competition. First, the evolutionary patterns between cooperation network and competition network are different but with a declining gap. Besides, the BRI policy promotes cooperation more effectively than competition. Second, competitiveness and cooperativeness are heterogeneously distributed across countries and influential cooperators are not necessarily top competitors. Notably, BRI has reinforced China's competitive position. Third, the intralayer and interlayer network dissimilarity are integrated to provide insights that numerous countries play dual roles of competitor and collaborator, while cooperation-oriented competition is more conducive. Finally, policy recommendations are proposed so that sustainable renewable energy supply can be attained. [ABSTRACT FROM AUTHOR]

An integrated approach is proposed in this paper to incorporate the group heterogeneity into the framework of natural disposability and managerial disposability, which allows evaluating the CO 2 emission performance under different mitigation strategies (scale-oriented strategy and innovation-oriented strategy). It is able to deal with the intertemporal incomparability when adopting a global technology. In the empirical study, we categorized China's 27 manufacturing sectors into five groups and evaluated their emission performance under different mitigation strategies during 2003–2016. According to the empirical results, we found that there is still much potential (about 70%–80%) for improving the CO 2 emission performance considering the entire manufacturing industry. From the perspective of different groups, the global technologies/innovators group shows the highest emission efficiency, while the energy-/resource-intensive commodities' group performed the worst. Besides, different sectors showed significant technology heterogeneity. Finally, the desirable CO 2 mitigation strategies varied with the different groups. For the labor-intensive tradables' group, we found that the desirable strategy is to decrease the input of energy and other production factors, i.e. scale-oriented strategy. For the regional processing group, the innovation-oriented strategy is more efficient. • Modified global meta-frontier non-radial DDF approach is proposed. • Group heterogeneity is incorporated in natural/managerial disposability framework. • CO 2 emissions performance for China's manufacturing sectors is measured. • Global technologies/innovators group performs best, while energy-/resource-intensive commodities group performs worst. • Desirable mitigation strategies varies with respect to technology heterogeneity of different groups. [ABSTRACT FROM AUTHOR]

City, which consumes the majority of the total energy consumptions, has great influences on the national energy issues. As the widespread spatial differences, a quantitative energy analysis among multi-city allows exploring the targeted and distinguishing energy policy implications at the city level in China. Considering the significant role of final demands, the input-output model and spatial structural decomposition analysis were adopted to evaluate the energy performances and quantify the spatial differences. In 2012, the spatial differences in the energy consumptions were distinct, with the greatest gap between Shanghai and Chongqing, which were mainly driven by the domestic Leontief structure effect and the total final demand effect. In particular, the spatial differences in the embodied energy by net domestic outflow were remarkable. For the relative energy efficiency, Beijing was discovered the best, followed by Tianjin, Shanghai and Chongqing. The spatial differences in their energy intensity were primarily influenced by the energy intensity effect and the domestic Leontief structure effect. In addition, the spatial differences in the aggregate embodied energy intensity by domestic investment were prominent. Inspired by the results, the structure adjustments with respect to the production and final demands and regional cooperation are strongly advised at the city level. • Distinct spatial differences in energy performances were discovered in China's cities. • Additive and multiplicative spatial structural decomposition analysis are adopted. • Investment and exports were significant to the spatial differences. • Adjustments on structure of production and final demand were suggested. [ABSTRACT FROM AUTHOR]

Background: The proportion of older HIV-1 infected people in China has increased rapidly in recent years. Elucidation of the transmission characteristics of this high-risk population subgroup is helpful for the development of tailored interventions.Methods: A phylogenetic analysis was performed that uses available HIV-1 pol sequences amplified with nested RT-PCR from plasma samples of all newly diagnosed participants spanning from October 2017 to September 2018 in Fuyang, Anhui Province. Transmission clusters were identified as two or more sequences that shared a corresponding node with an aLRT-SH value ≥90 in the maximum-likelihood phylogenetic tree and had an overall mean genetic distance of ≤1.5%. A local transmission cluster was defined as a cluster that had more than 80% of its sequences from Fuyang. The role of older people in local HIV-1 transmission was determined using an integration of molecular and demographic data.Results: Of 362 available sequences, 14 subtypes, and 28 local transmission clusters were identified. It was found that the proportion of older people in the local transmission cluster (69/77, 89.61%) was much higher than that of younger people (46/114, 40.35%) (χ2 test, P < 0.001). In the pretreatment drug resistance analysis, the proportion of sequences with PDRMs in the local transmission cluster was not significantly different between the older people group (57.14%, 4/7) and non-old-aged group (11.11%, 1/9) (Fisher's exact test, P > 0.05).Conclusion: By combining phylogenetic analyses with demographic data, more detailed information was provided about the local transmission structure in Fuyang. These findings suggested that older people play an important role in local transmission, and more tailored interventions for this population subgroup are urgently needed. [ABSTRACT FROM AUTHOR]

The transport sector proves a major energy consumer in China, but improving energy-saving performance in China's provincial transport sector from the lifecycle perspective remains unresolved. Thus, this study employs the environmentally extended multi-region input–output (MRIO) method, structural path analysis, and the newest MRIO table of China from 2017, to investigate how to improve the energy-saving performance from final demand structure, supply chain, and pathway perspectives. The relevant results are threefold. (1) Regarding the final demand structure level, the embodied energy consumption of China's transport sector is predominantly driven by investment from the production side, while that of the consumption side is primarily caused by exports. (2) At the supply chain level, production-side embodied energy consumption primarily occurs along a three-echelon supply chain, while that from the consumption side mostly occurs via a two-echelon supply chain. (3) At the pathway level, the production-side energy-saving performance of China's provincial transport sector is dominated by two pathways along the construction sector, including transport sector → construction sector → final demands, and transport sector → intermediate inputs → construction sector → final demands, while that of the consumption side is chiefly determined by three pathways along internal transportation chains. • The production-side energy-saving performance is dominated by investment. • The consumption-side energy-saving performance is led by exports. • 30% of production-side energy use occurs via a three-echelon supply chain. • 68% of consumption-side energy use occurs along a two-echelon supply chain. • It discloses the top four significant energy use pathways in each province. [ABSTRACT FROM AUTHOR]

Abstract Household carbon emissions account for a significant proportion of the national total emissions. Using a unique nation-wide survey data, this paper investigates the impact of different subjective measures of social awareness on household carbon emissions in China. Subjective variables are found to have significant impacts on household carbon emissions. Feeling secure, compliance with rules, and happiness have negative and significant effects on household carbon emissions, whereas the impact of interest in social issues is positive, which indicates the existence of a gap between awareness and behavior. The impacts of consumer lifestyles on the relationship between awareness and household emissions are also explored and are found to play a significant role in the relationship between awareness and emissions. People with a frugal lifestyle not only associate with lower emissions but also reinforce the role of social awareness. Furthermore, substantial differences are found across rural/urban areas and regional and income groups in China. The government should further promote a green lifestyle and give households more incentives to engage in green consumption behavior. Highlights • Household emissions are studied based on China Household Finance Survey. • Subjective factors are found to have significant impacts on household emissions. • Lifestyles matter in the relationship between awareness and household emissions. • Regional and income differences are considered in the analysis. [ABSTRACT FROM AUTHOR]

This paper systematically presents a survey of the empirical literature studying the embodied CO 2 emissions in China’s foreign trade (ECCT). Based on the bibliometric method and the online version of Science Citation Index-Expanded (SCI-E) and Social Sciences Citation Index (SSCI), this study summarizes the latest publications regarding ECCT in peer-reviewed journals in terms of quantities, most productive countries, institutions, authors, citations, and disciplines. By using synthetic analysis of keyword frequency, this study reveals the most popular methodologies applied in measuring ECCT, discusses the variation of numerical results in the literature, and reasons and countermeasures for the results uncertainties. Continuous investigation of the literature releases the methodology employed for measuring ECCT becoming more reasonable and the results more critical. However, the numerical results of ECCT are of great discrepancies within given year by different considerations on methodology specification, accounting principles, and data sources and processing. For instance, the estimates of CO 2 embodied in China’s exports changed from 478 Mt to over 3000 Mt and those of in China’s imports ranged from 140 Mt to over 1700 Mt in 2007. Therefore, overcoming data inherent limitations and reducing discrepancies among available databases should be urgently considered. The results imply that the prospective research tendencies on ECCT are to (1) improve China’s regional input-output data and energy intensity data to more precise estimates under global perspective; (2) estimate China’s carbon emission at firm level by different firm ownerships in production and consumption worldwide; (3) assess China’s carbon emission from processing or non-processing trade by compiling more detailed multi-regional input-output table; (4) evaluate city level carbon mitigation capacity in China under global MRIO model; (5) explore new carbon management experience in China’s carbon trading market and new trade expansion policy of ‘ one belt and one road’ in her new growth era. [ABSTRACT FROM AUTHOR]

The Chinese experience of economic development and environmental protection provides an important reference for developing countries. Although changes in aggregate NO x emissions have been widely studied, there is a relative lack of studies analysing NO x intensity changes and their related development strategies in China. This study attempts to identify the socioeconomic drivers and change patterns for both NO x emissions and intensity considering the cleaner production and end-of-pipe treatments. Both structural decomposition analysis and structural path analysis were used to analyse the NO x emissions/intensity changes at different levels and transmission layers in China in the last two decades (1997–2018). The results indicate that construction contributes the most to NO x emissions/intensity, followed by transportation. The emission intensity effect is the primary driver of NO x emissions/intensity reduction, which mainly benefits from end-of-pipe treatment and energy efficiency improvement. Especially, during 2012–2018, they decreased 11,916 Kt-NO x and 8,103 Kt-NO x emissions and aggregate embodied intensity by 43.2% and 29.8%, respectively. The final demand effect is the primary deterrent, which is attributed to investment and consumption effects. The critical sectors for future NO x reduction are the construction and building materials industry, transportation and other services industry. The policy implications and recommendations for the future developments are discussed based on the study findings. • The NO x emissions/intensity changes and related development strategies are studied in China. • Both SDA and SPA techniques are applied to investigate the drivers of NO x embodiments and intensities. • Key final demand categories and sectors for the decrease of aggregate embodied emissions/intensity are identified. • End-of-pipe treatment and energy efficiency improvement are effective measures for NO x emission/intensity abatement. • Critical sectors for future NO x reduction are construction materials industry and transportation. [ABSTRACT FROM AUTHOR]

The impact of air pollution or socio-economic status on public health is a lively topic for social economists and environmental researchers across the world. Despite a lot of research, there is still a lack of clear understanding of the spatial heterogeneous impacts related to public health. In this study, we use the spatial econometric model with panel data to investigate the direct and interactive effects of air pollution and socio-economic status on public health and further explore the regional heterogeneity among different regions. The research results show that there is strong spatial agglomeration in air pollution, socio-economic status, and public health. Aggravation of air pollution significantly damages local public health status, leading to increased infant mortality rate and lower average life expectancy. Aggravated air pollution in one province significantly increases infant mortality in neighboring provinces. The increase in per capita income significantly leads to a significant positive effect on public health. As air pollution continues to increase, the impact of per capita income on improving public health has diminished gradually. Improving the level of education per capita significantly improves public health. As per capita education level increases, the impact of increased air pollution on public health damage has diminished gradually. The effects of air pollution and socio-economic status on infant mortality in the eastern, central, and western regions are heterogeneous. • There is strong spatial agglomeration in air pollution, socio-economic status, and public health. • As air pollution increases, the impact of per capita income on improving public health has diminished gradually. • As per capita education level increases, the impact of increased air pollution on public health damage has diminished gradually. • The effects on infant mortality in the eastern, central, and western regions are heterogeneous. [ABSTRACT FROM AUTHOR]