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The COVID-19 pandemic has popularized online learning as a mode of teaching and learning in universities, thereby exacerbating college students' stress levels in multiple ways. To enhance the quality of college student training, it is crucial to investigate the impact of perceived stress on their online self-directed learning. Using questionnaire data from 969 college students across China, this study performed an empirical analysis of the influence of perceived stress on their online self-directed learning, while also exploring the mediating role of phone dependence and the moderating role of self-management ability. The findings indicate that, firstly, perceived stress has a significant and positive effect on college students' online self-directed learning. Secondly, phone dependence masks the positive impact of perceived stress on students' self-directed learning, thereby weakening the effects of employment and learning stress on their online self-directed learning. Thirdly, self-management ability positively moderates the relationship between employment, social, interpersonal, and learning stress and college students' online self-directed learning. Fourthly, rural college students' online self-directed learning is more susceptible to employment, social, and interpersonal stress; vocational college students' self-directed learning is more influenced by employment, social, and learning stress; and students in the "Double First-Class" initiative universities are more likely to develop phone dependence. Therefore, this paper asserts that using stress reasonably, controlling stress appropriately, channeling stress properly, and enhancing self-management abilities can aid college students in learning autonomous online.

Background: SARS-CoV-2 (COVID-19) has disrupted lives worldwide, affecting individuals from all walks of life. Individuals who have a spinal cord injury (SCI) are also affected by this phenomenon. This survey compares the quality of life (QOL), depression, and anxiety of SCI patients before and during COVID-19 in Wuhan City, China. Methods: A cross-sectional survey utilized an online questionnaire to assess the QOL, levels of anxiety, and depression among 189 SCI patients admitted to Wuhan Tongji Hospital during pandemic from November 2020 to April 2021. Data before COVID-19 outbreak from November to December 2019 was retrieved from hospital records with the same assessment previously performed in-person or during a follow up visit. However, some participants were excluded for various reasons, such as declining to participate, not being admitted to a rehabilitation program due to the pandemic, or being under 18 years old. The World Health Organization's (WHO) QOL-Brief Version (BREF) and disability (DIS) modules, which focus on disability-related QOL, were used to assess the participants' QOL. Results: SCI patients had lower QOL scores during the pandemic compared to pre-pandemic times. Mean scores on the 12-item DIS module significantly differed before and during the COVID-19 period. Participants showed higher adherence to self-isolation and quarantine measures for high-risk encounters (64.94%), but lower compliance with home disinfection and proper rest practices (23.38%). Conclusions: The COVID-19 pandemic has had a detrimental effect on the QOL of SCI patients in China, highlighting the urgent requirement for telehealth-based rehabilitation to mitigate its impact. It is crucial to provide essential. [ABSTRACT FROM AUTHOR]

Background While statins have been widely used in patients with large-artery atherosclerotic stroke, their effectiveness in patients with cardioembolic large vessel occlusion (CE-LVO) undergoing endovascular treatment (EVT) remains unclear. This study aimed to evaluate whether combining statin therapy with EVT could improve clinical outcomes in patients with acute ischemic stroke caused by CE-LVO in the anterior circulation. Methods We performed a retrospective screening on patients with CE-LVO in the anterior circulation who underwent EVT in 27 hospitals across China between 2018 and 2021. The primary outcome measure was functional independence, defined as a 90-day modified Rankin Scale (mRS) score of 0 to 2. Safety outcomes included 90-day mortality and symptomatic intracranial hemorrhage (sICH). Results A total of 510 patients with CE-LVO in the anterior circulation undergoing EVT were included in this study. Of these, 404 (79.2%) patients received statin treatment (statin group), while 106 (20.8%) did not (non-statin group). Statin treatment was significantly associated with improved functional independence (adjusted OR (aOR) 2.072, 95% CI 1.197 to 3.586, P=0.009). Moreover, statin use was associated with a lower rate of 90-day mortality (aOR 0.343, 95% CI 0.197 to 0.596, P<0.001) and a lower rate of sICH (aOR 0.153, 95% CI 0.072 to 0.325, P<0.001). Conclusion Statin treatment was associated with improved clinical outcomes and reduced risks of mortality and sICH in patients with CE-LVO in the anterior circulation undergoing EVT. [ABSTRACT FROM AUTHOR]

In the present study, we address an important and increasingly relevant topic in mining safety and efficiency, namely the stability of open-pit bench slopes subjected to daily heavy truck cyclic loading. Specifically, we focus on the stability of Zhahanur open-pit slope (Inner Mongolia region, China) and investigate the potential role of daily heavy truck cyclic loading in bench slope instability. To this end, we incorporate a stress corrosion model into the particle flow code to develop a time-dependent deformation model of the rock. With the established model, we quantitatively analyse the effect of heavy truck cyclic loading on the bench slope stability. Our results support the hypothesis that daily heavy truck loading can cause gradual downward deformation of a rock mass, leading to slope instability. To validate our numerical modelling results, we compare and analyse them with in situ monitoring data. Our study demonstrates the significant impact of daily heavy vehicles on bench slope stability in open-pit mines and provides a practical tool for assessing the long-term stability of open-pit bench slopes and optimising mining operations. [ABSTRACT FROM AUTHOR]

The rock characteristic and size-frequency distribution (SFD) on Mars are important for understanding the geologic and geomorphic history of the surface, for evaluating the trafficability of roving, and for planning the potential infrastructure construction. Tianwen-1, China's first autonomous Mars exploration mission, formed an excavated depression during touchdown, which has been the deepest depression on the Martian surface so far compared with others. According to the images captured using the Navigation and Terrain Cameras (NaTeCams) onboard the rover, Zhurong, the SFD of rocks is calculated and compared inside the excavated depression, within and out of the blast zone. For the first time, the rock size distribution inside the excavated depression is obtained, exposing the geological features of the shallow subsurface on Mars at a depth of tens of centimeters, which will surely be important for future drilling missions. It is found that the rock abundance in the depression is smaller than the original abundance on the surface, and the distribution of rocks in the blast zone on the surface is greatly influenced by the touchdown. In addition, based on the fractal dimension of rock sizes, the rocks (>10 mm) at the shallow subsurface of the Zhurong landing site may experience two different geological processes. [ABSTRACT FROM AUTHOR]

Background: Internet gaming disorder (IGD) has become a social problem in children. Evidence from previous studies has proven that anxiety is associated with IGD. However, IGD was always assessed as a whole based on total scores, and the fine-grained relationship between anxiety and IGD was hidden. Objective: The present study aims to investigate the fine-grained relationship between anxiety and IGD in elementary school students during the COVID-19 lockdown, and to identify potential targets for psychological interventions. Methods: During the lockdown caused by the COVID-19 pandemic, 667 children from a primary school in China were investigated by the Spence Children's Anxiety Scale-Short Version and Internet Gaming Disorder Scale. R4.1.1 software was used to construct a network model, assess bridge centrality, and test the robustness of the network and conduct a network. Results: There were 23 cross-community edges (weight ranged from -0.03 to 0.12), and each node of anxiety was connected to different nodes of IGD. The nodes with the top 80th percentile bridge expected influence were A2 "social phobia" (0.20), A3 "panic disorder" (0.21) and IGD5 "escape" (0.22). The robustness of the network was acceptable. Conclusion: From the perspective of network analysis, the present study explored the correlation pathways between anxiety and IGD in children and identified social phobia and panic disorder as the best targets for intervention to reduce IGD. [ABSTRACT FROM AUTHOR]

Introduction: In the past two decades, mindfulness-based intervention programs have gradually become popular. Many studies have confirmed that these programs can effectively alleviate prenatal stress and negative emotion. The mindfulness-based stress-buffering hypothesis suggests that mindfulness training can induce changes in the levels of the cortisol secreted by the HPA axis, thereby reducing stress susceptibility. However, to date, only a few high-quality evidence-based medical studies have analyzed the effect of the mindfulness-based intervention in a maternal population. Thus, this study investigated the effects of a mindfulness-based psychosomatic intervention on pregnancy stress and the HYPERLINK "javascript:;" hypothalamicpituitary-adrenal (HPA) axis of pregnant Chinese women. Methods: Women experiencing first-time pregnancy (n = 117) were randomly allocated to the intervention group or parallel active control group, and data were collected at baseline and post-intervention periods. The participants completed questionnaires regarding mindfulness and pregnancy stress. Saliva samples was collected at the time of waking up, and 30, 45, and 60 min after waking up for analyzing the salivary cortisol levels. We analyzed differences between the two groups and changes within the same group before and after the intervention. Results and discussion: A total of 95 participants completed the trial. Compared with the parallel active control group, the intervention group exhibited lower levels of stress after the intervention (P = 0.047). For HPA-axis-related indicators after the intervention, Delta value (P = 0.01) and AUCM value (P = 0.031) of the intervention group were significantly higher than that of the control group. Mindfulness-based interventions effectively reduced the level of pregnancy stress and adjusted the HPA axis function in pregnant women in China. [ABSTRACT FROM AUTHOR]

Background: Allergic diseases are highly prevalent in the women of childbearing age. As we know, the immune system could change when pregnancy, which may affect the course of allergic diseases. Meanwhile, they also can affect the course and outcome of pregnancy. The data on incidence of allergies during pregnancy is lacking and conducting clinical trials in pregnant women was limited, therefore, we observed a prebirth cohort to supplement the relevant data and strengthen concerned research conductions. Objective: We aim to obtain the incidence of allergies in urban pregnancy and explore the relevant factors of allergic diseases in urban pregnancy. Methods: We design a multicenter and prospective cohort in 20 institutions above municipal level which were eligible according to the study design from 14 provinces covering all-side of China. This cohort was conducted from 13+6 weeks of gestation to 12 months postpartum and in our study, we chose the prenatal part to analyze. The outcome was developing allergies during pregnancy, which were diagnosed by clinicians according to the uniform criterion from National Health Commission. All the data was collected by electronic questionnaires through tablet computers. Results: The incidence of allergic diseases in urban pregnant women was 21.0% (95%CI 20.0% ~ 22.0%). From social demography data, the history of allergies of pregnant women and their parents had statistical significance(p < 0.01); For exposure to living or working environment, house decoration for less than half a year, exposure to plush toys, disinfectants, insecticides, antihistamines, glucocorticoids, antipyretic analgesics, tocolytic agent and probiotics had statistical significance (all p < 0.05); For psychological status, self-rated depression and anxiety had statistical significance (p = 0.026;p = 0.006). Conclusion: The incidence of allergic diseases in urban pregnant women was similar to the former study and kept a medium–high level. The history of allergies of pregnant women and their parents, house decoration time, exposure to plush toys, disinfectants, insecticides, antihistamines, glucocorticoids, antipyretic analgesics, tocolytic agents, probiotics, self-rated depression, and anxiety were relevant factors of allergic diseases during pregnancy. [ABSTRACT FROM AUTHOR]

Revealing the composition of free-living (FL) and particle-attached (PA) bacterial communities could provide insights into their distinct roles in biogeochemical processes and algal bloom dynamics. While there is still a lack of research about the difference and interactions between FL and PA communities, especially on the Yungui plateau with underestimated diversity. This study unveiled the structure of both FL and PA bacterial communities in a canyon reservoir (Wujiangdu) on the Yungui Plateau, southern China. Water samples were collected from surface water at nine sites in the reservoir. FL and PA bacterial community structures were identified by high-throughput 16S rRNA gene sequencing. We compared the structure and diversity of FL and PA bacteria and investigated their relationship with environmental factors. Results showed that there were different structures between FL and PA bacterial communities, and the dominant FL and PA phyla were affected by different environmental variables. Moreover, diversity of PA bacteria was greater than that of FL bacteria. Both groups exhibited distance decay patterns in this reservoir with varying correlations with geographic distances. FL fraction, however, exhibited a stronger correlation with environmental factors than the PA counterpart. Both FL and PA communities were phylogenetic clustering than expected according to the mean nearest taxon distance. This study provides fundamental information on FL and PA bacteria distribution and demonstrates how specific environmental factors affected these two bacterial fractions in canyon river reservoirs. [ABSTRACT FROM AUTHOR]

Purpose: We estimated the remission and transition rate between urinary incontinence (UI) subtypes in women with UI and evaluated the impact of body mass index (BMI) on this process. Materials and Methods: A Chinese population-based longitudinal study was conducted. Women aged -20 years were included using a multistage, stratified, cluster sampling method. Self-reported data on demographics, medical history, and physiological and anthropometric information were collected. UI was identified using 2 questions about any leaking symptom of stress UI (SUI) and urgency UI (UUI) in the past 6 months. Predicted probabilities of UI subtypes were calculated using multinomial logistic regression. Results: Analyses included 5,189 women (mean age 52.6 years, mean BMI 23.8 kg/m2), of whom 98.5% were parous. The median followup time was 4.0 years. Overall, the annual remission rate of UI was 12.7% among adult women. Regarding UI subtypes, the remission rates for UUI and SUI were similar, but higher than that for mixed urinary incontinence (MUI; p <0.05). In total, 7.6% of SUI patients and 16.4% of UUI patients developed MUI, and 35.3% of MUI patients continued to report MUI after 4 years. For women aged -60 years with a BMI -24 kg/m2 and MUI at onset, the predicted remission rate (95% CI) was only 0.32 (0.29e0.35), but the predicted probability of the MUI remaining reached 0.50 (0.46e0.54). Conclusions: The annual remission rate of UI was 12.7% among adult women. Women with a higher BMI had less remission and a higher predicted probability of MUI 4 years later. [ABSTRACT FROM AUTHOR]

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic acute infectious disease, especially with the features of possible asymptomatic carriers and high contagiousness. Currently, it is difficult to quickly identify asymptomatic cases or COVID-19 patients with pneumonia due to limited access to reverse transcription-polymerase chain reaction (RT-PCR) nucleic acid tests and CT scans. Goal: This study aimed to develop a scientific and rigorous clinical diagnostic tool for the rapid prediction of COVID-19 cases based on a COVID-19 clinical case database in China, and to assist doctors to efficiently and precisely diagnose asymptomatic COVID-19 patients and cases who had a false-negative RT-PCR test result. Methods: With online consent, and the approval of the ethics committee of Zhongshan Hospital Fudan University (NCT04275947, B2020-032R) to ensure that patient privacy is protected, clinical information has been uploaded in real-time through the New Coronavirus Intelligent Auto-diagnostic Assistant Application of cloud plus terminal (nCapp) by doctors from different cities (Wuhan, Shanghai, Harbin, Dalian, Wuxi, Qingdao, Rizhao, and Bengbu) during the COVID-19 outbreak in China. By quality control and data anonymization on the platform, a total of 3,249 cases from COVID-19 high-risk groups were collected. The effects of different diagnostic factors were ranked based on the results from a single factor analysis, with 0.05 as the significance level for factor inclusion and 0.1 as the significance level for factor exclusion. Independent variables were selected by the step-forward multivariate logistic regression analysis to obtain the probability model. Findings: We applied the statistical method of a multivariate regression model to the training dataset (1,624 cases) and developed a prediction model for COVID-19 with 9 clinical indicators that are accessible. The area under the receiver operating characteristic (ROC) curve (AUC) for the model was 0.88 (95% CI: 0.86, 0.89) in the training dataset and 0.84 (95% CI: 0.82, 0.86) in the validation dataset (1,625 cases). Discussion: With the assistance of nCapp, a mobile-based diagnostic tool developed from a large database that we collected from COVID-19 high-risk groups in China, frontline doctors can rapidly identify asymptomatic patients and avoid misdiagnoses of cases with false-negative RT-PCR results. [ABSTRACT FROM AUTHOR]

Shandong and Fujian are two important provinces regarding the development of the seaweed industry, which shared three-fourths of the national seaweed yield in the year 2020. The present study has analyzed the overall situation of the seaweed industry in Shandong and Fujian provinces by comparing annual output, farming area, and species structure. The current status of Laminaria japonica cultivation in two provinces is also compared to the production process, industrial organization, progress, and innovation. On this foundation, the following development strategies are proposed for the seaweed industry in Shandong Province: (1) change the mindset based on the present industrial basis, (2) retain and transform innovative achievements, (3) enhance the services of associations and organizations and (4) construct brands based on current market share. [ABSTRACT FROM AUTHOR]

In the 1980s, Shandong Province took the lead in establishing breakthrough industrialized seedling raising and breeding technologies for Apostichopus japonicus and successfully led the 'fifth wave of mariculture' in China. In 2008, the experiment of 'raising sea cucumber from north to south' proved successful, and sea cucumber culture gradually radiated and extended to Fujian, Jiangsu, Guangdong, and Zhejiang Provinces in southern China. The total output of sea cucumber culture in Shandong Province accounts for more than 70% of the market in China, and the sea cucumber industry is now a pillar of the fishery economy in Shandong Province. This paper systematically introduces the development status of the sea cucumber breeding industry in Shandong Province in recent ten years, summarizes the current problems and challenges, and puts forwards development suggestions; this guidance has significance for the healthy and sustainable development of the sea cucumber breeding industry in both Shandong Province and the whole country. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the status of oral health--related quality of life (OHRQoL) in Chinese adolescents aged 12 to 15 years based on the 4th National Oral Health Survey and to explore its associated factors. Methods: Students aged 12 to 15 years were recruited using to a multistage stratified random sampling method. All the subjects received oral examination and completed a questionnaire. Information relating to OHRQoL was collected through a Mandarin version of the child oral impacts on daily performances (Child-OIDP) questionnaire. The relationship between the Child-OIDP scores and independent variables was assessed using a Mann-Whitney U-test, Kruskal-Wallis test and a multivariate Poisson regression. Results: A total of 89,582 subjects were included in the analysis, of whom 76.6% reported oral impacts in the last 6 months. Eating was the most affected daily performance. The results of the regression analysis showed that factors associated with adolescents' OHRQoL included sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, self-perception of general/oral health, dental appointments in the past 12 months, oral health knowledge status, age, decayed, missing and filled teeth (DMFT) index and number of teeth with gingival bleeding. Conclusion: Oral impacts were common among Chinese adolescents, although most were not so severe. Eating was the most commonly affected performance. Sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, selfperception of general/oral health status, dental appointments in the previous 12 months, oral health knowledge status, age, DMFT index and number of teeth with gingival bleeding were found to be associated with OHRQoL. [ABSTRACT FROM AUTHOR]

Magnolia officinalis Rehd. et Wils. is an important traditional Chinese herbal medicine and widely distributed in the south of Yangtze River in China. In this study, the complete chloroplast genome sequence of wild M. officinalis was assembled and characterized from high-throughput sequencing data. The chloroplast genome was 160,009 bp in length, consisting of large single-copy (LSC) and small single-copy (SSC) regions of 88,134 bp and 18,739 bp, respectively, which were separated by a pair of 26,568 bp inverted repeat (IR) regions. The genome is predicted to contain 132 genes, including 87 protein-coding genes, 37 tRNA genes, and 8 rRNA genes. The overall GC content of the genome is 39.3%. A phylogenetic tree reconstructed by 86 chloroplast genomes reveals that M. officinalis is mostly related to cultivated M. officinalis, M. obovata and M. tripetala. [ABSTRACT FROM AUTHOR]

Breast milk is a potential source of infant and young children lead exposure, but national-level data on breast milk lead (BML) is unknown in China. To fill up this gap, we conducted a review by analyzing the articles enrolled through searching Wanfang MedOnline, CNKI, SinoMed, Pubmed, and Embase databases and relevant articles from 2000 through 2017. After screening and assessing process, 17 articles were included. The average concentrations of BML in these studies varied with regions (1.54-171.84 μg/L), and the BML level was dropping down in general. In conclusion, breast milk should still be encouraged to infant and young children in normal areas of China, and stopping breastfeeding should be considered prudently. Education for health workers and families on BML should be strengthened, and more surveys on BML should be conducted. [ABSTRACT FROM AUTHOR]

We analyzed the relationship between the conservation behavior of farmers and their environmental attitude and knowledge, whilst controlling for exogenous socio-economic factors. We employed the structural equation model with cross-sectional data from 442 farmers from the Guanzhong Plain of China. Results showed that local farmers generally possessed a positive environmental attitude and undertook considerable conservation action. Conservation behavior was directly affected by environmental attitude and indirectly by environmental knowledge (via attitude). Social networks, farm size, land rights, age and incentives were significant exogenous explanatory variables. Thus, understanding the importance of socio-behavioral characteristics, including the environmental attitude and knowledge of farmers, is important for the development of farmland conservation policies. Specifically, farmers in this area were found to significantly depend on each other for information on farmland conservation practices. Thus, role model farmer discussions, dissemination of environmentally friendly techniques via social networks and the rewarding of environmentally friendly behavior among farmers should be used to encourage ongoing restoration endeavors, and thereby help mitigate environmental degradation. [ABSTRACT FROM AUTHOR]

Background: Few nationally representative surveys regarding body composition and metabolic syndrome (MetS) have been done in a large-scale representative Chinese population to explore the prediction of body composition indicators for MetS. The objective of this study was to examine the relation of body composition and MetS and to determine the optimal cut-off values of body composition indicators that predict MetS in a large representative Chinese sample based on multiple provinces and ethnicities, covering a broad age range from 10 to 80 years old.Methods: The subjects came from a large-scale population survey on Chinese physiological constants and health conditions conducted in six provinces. 32,036 subjects completed all blood biochemical testing and body composition measure. Subjects meeting at least 3 of the following 5 criteria qualify as having MetS: elevated blood pressure, lower high density lipoprotein cholesterol level, higher triglyceride level, higher fasting glucose level and abdominal obesity.Results: The total prevalence rate of MetS for males (9.29%) was lower than for females (11.58%). The prevalence rates were 12.03% for male adults and 15.57% for female adults respectively. The risk of MetS increased 44.6% (OR = 1.446, 95%CI: 1.414-1.521) for males and 53.4% (OR = 1.534, 95%CI: 1.472-1.598) for females with each 5% increase of percentage of body fat. The risk of MetS increased two-fold (OR = 2.020, 95%CI: 1.920-2.125 for males; OR = 2.047, 95%CI: 1.954-2.144 for females respectively) with each 5% increase of waist-hip ratio. The risk of MetS increased three-fold (OR = 2.915, 95%CI: 2.742-3.099 for males; OR = 2.950, 95%CI: 2.784-3.127 for females respectively) with each 5% increase of Waist-to-Height Ratio (WHtR). Areas under the receiver operating curve (AUC) of most body composition indicators were larger than 0.70 and the sensitivities and the specificities of most cut-off values were larger than 0.65. AUCs of WHR and WHtR were the largest. The optimal cut-off values of WHtR were 0.51 for males and 0.53 for females.Conclusion: MetS has become a serious public health challenge in China. Body composition variables were closely related to MetS and they were reliable indicators in the screening of the presence of MetS. [ABSTRACT FROM AUTHOR]

Background: The prevalence of early childhood caries (ECC) among children in Beijing, China, has been increasing continuously though slowly. However, there is limited information about ECC in Beijing. The aim of this study was to identify risk factors of dental caries among preschool children in Beijing. Methods: For this case-control study, using a convenience sampling method, 787 children aged 3 and 4 years old were recruited; 386 children with caries constituted the early childhood caries (ECC) group and 401 children without caries formed the caries-free (CF) group. Dental caries was diagnosed at the tooth surface level by two calibrated examiners according to the WHO 1997 criteria. A structured questionnaire was filled in by the children's main guardians. Mutans streptococci in non stimulated saliva and plaque were measured with the Dentocult SM Strip. Negative binomial regression was used for multivariate analysis. Results: Analysis of the data showed that level of mutans streptococci in dental plaque and history of dental visit were significantly correlated with the prevalence of caries and the mean dmfs score. Conclusions: High level of plaque mutans streptococci is a risk factor for ECC in preschool children in Beijing. And longitudinal studies are needed to identify the causal relationships between the levels of mutans streptococci in dental plaque and caries development. [ABSTRACT FROM AUTHOR]

Background. This study was designed to evaluate the function of the foot undergoing the procedure of percutaneous Achilles tenotomy (PAT) in case of clubfoot management in terms of gait analysis. Methods. Nineteen patients with unilateral clubfeet were retrospectively reviewed from our database from July 2012 to June 2016. The result in all the cases was rated as excellent according to the scale of International Clubfoot Study Group (ICSG). The affected sides were taken as Group CF and the contralateral sides as Group CL. Three-dimensional gait analysis was applied for the functional evaluation of the involved foot. Results. Statistical difference was found in physical parameters of passive ankle dorsiflexion and plantar-flexion. No statistical difference was found in temporal-spatial parameters. There was statistical difference in kinematic parameters of total ankle rotation, ankle range of motion, and internal foot progression angle and in kinetic parameters of peak ankle power. No statistical difference was found in other kinematic and kinetic parameters. Conclusions. It is demonstrated that the procedure of PAT is safe and efficient for correcting the equinus deformity in case of clubfoot management and preserving the main function of Achilles tendon at the minimum of four-year follow-up. [ABSTRACT FROM AUTHOR]

Background: Up to date, most of previous studies about Chinese prehypertension were conducted based on a small sample or in only one province, which could not represent the general population in China. Furthermore, no information on the ethnic difference in prevalence of prehypertension has been reported in China. The aim of this study is to examine the sex-specific, age-specific and ethnic-specific prevalence of prehypertension and associated risk factors in a large-scale multi-ethnic Chinese adult population.Methods: The subjects came from a large-scale population survey about Chinese physiological constants and health conditions conducted in six provinces. 47, 495 adults completed blood pressure measurement. Prehypertension was defined as not being on antihypertensive medications and having SBP of 120-139 mmHg and/or DBP of 80-89 mmHg. Odds ratio (OR) and its 95 % confidence interval (CI) from logistic models were used to reflect the prevalence of prehypertension.Results: The mean age of all subjects was 43.9 ± 16.8 years. The prevalence of hypertension and prehypertension for all them was 29.5 and 36.4 %, respectively. The prevalence of hypertension and prehypertension for males (33.2 and 41.1 %, respectively) was higher than that for females (27.0 and 33.2 %, respectively), and P < 0.001. The mean age of the subjects was 54.8 ± 14.0 years for hypertensive, 44.0 ± 16.0 years for prehypertensive and 35.3 ± 14.5 years for normotensive. With aging, subjects had more odds of getting prehypertension. Multivariate logistic model indicated that males (OR = 2.076, 95 % CI: 1.952-2.208), laborers with mental work (OR = 1.084, 95 % CI: 1.020-1.152), Yi (OR = 1.347, 95 %CI: 1.210-1.500) and Hui subjects (OR = 1.133, 95 % CI: 1.024-1.253), alcohol drinkers (OR = 1.147, 95 % CI: 1.072-1.228), the generally obese (OR = 2.460, 95 % CI: 2.190-2.763), the overweight (OR = 1.667, 95 % CI: 1.563-1.788), the abdominally obese (OR = 1.371, 95 % CI: 1.280-1.467) and subjects with family history of cardiovascular diseases (OR = 1.132, 95 % CI: 1.045-1.226) had higher prevalence of prehypertension. Subjects with higher educational level (OR = 0.687, 95 % CI: 0.627-0.752 for university) and Miao (OR = 0.753, 95 % CI: 0.623-0.910), Tibetan (OR = 0.521, 95 % CI: 0.442-0.613), Tujia (OR = 0.779, 95 % CI: 0.677-0.898) subjects had lower prevalence.Conclusion: High prevalence rate of prehypertension was general in Chinese adults. Many sociodemographic characteristics were significantly associated with prehypertension. There were important clinical significance and public health significance about age-specific, gender-specific and ethnic-specific Chinese prehypertension conditions studies. [ABSTRACT FROM AUTHOR]

Stable nighttime light (NTL) data, derived from the Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS), are typically considered a proxy measure of the dynamics of human settlements and have been extensively used to quantitative estimates of demographic variables, economic activity, and land-use change in previous studies at both regional and global scales. The utility of DMSP data for characterizing spatio-temporal trends in urban development at a local scale, however, has received less attention. In this study, we utilize a time series of DMSP data to examine the spatio-temporal characteristics of urban development in 285 Chinese cities from 1992 to 2009, at both the local and national levels. We compare linear models and piecewise linear models to identify the turning points of nighttime lights and calculate the trends in nighttime light growth at the pixel level. An unsupervised classification is applied to identify the patterns in the nighttime light time series quantitatively. Our results indicate that nighttime light brightness in most areas of China exhibit a positive, multi-stage process over the last two decades; however, the average trends in nighttime light growth differ significantly. Through the piecewise linear model, we identify the saturation of nighttime light brightness in the urban center and significant increases in suburban areas. The maps of turning points indicate the greater the distance to the city center or sub-center, the later the turning point occurs. Six patterns derived from the classification illustrate the various characteristics of the nighttime light time series from the local to the national level. The results portray spatially explicit patterns and conspicuous temporal trends of urbanization dynamics for individual Chinese cities from 1992 to 2009. [ABSTRACT FROM AUTHOR]

China has been undergoing a remarkably rapid urbanization process in the last several decades. Urbanization is a complicated phenomenon involving imbalanced transformation processes, such as population migrations, economic advancements and human activity dynamics. It is important to evaluate the imbalances between transformation processes to support policy making in the realms of environmental management and urban planning. The Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS) nighttime lights time series imagery provides a consistent and timely measure to estimate socioeconomic dynamics and changes in human activity. In this study, we jointly compared the annual ranks of three variables: the population, the gross domestic product (GDP) and the sum of weighted DMSP/OLS nighttime lights to estimate spatial and temporal imbalances in the urbanization processes of 226 cities in China between 1994 and 2011. We used ternary plots and a Euclidean distance-based method to quantitatively estimate the spatial and temporal imbalances between cities and to classify diverse urban development patterns in China. Our results suggest that, from 1994 to 2011, the imbalances of urbanization processes observed in the eastern, western and middle cities decreased, respectively, by 35.26%, 29.04% and 25.84%; however, imbalances in the northeast increased by 33.29%. The average decrement in imbalances across all urbanization processes in the 226 cities was 17.58%. Cities in the eastern region displayed relatively strong attractions to population, more rapid economic development processes and lower imbalances between socioeconomic and anthropogenic dynamics than cities in other regions. Several types of urban development patterns can be identified by comparing the morphological characteristics of temporal ternary plots of the 226 cities in China. More than one third (35.40%) of the 226 cities presented balanced states during the period studied; however, the remainder showed alternative urban development patterns. [ABSTRACT FROM AUTHOR]

It has been seven years since China's Regulations on the Administration of Commercial Franchise1 (the "Franchise Regulation") went into effect. In these six years, the number of franchise systems in China has doubled to more than 5,000, and the number of franchised outlets has exploded from less than 200,000 to more than 1,000,000.2 Along with the maturing of the business of franchising in China, the legal framework of franchise regulation has also made great strides in the past few years. This article provides an overview the legal and case law developments concerning franchising in China in the last three years. [ABSTRACT FROM AUTHOR]

Background: Hyperuricemia (HUA) is a potential risk factor for developing insulin resistance, hypertension, dyslipidemia and cardiovascular disease. Therefore, we studied the prevalence of HUA and associated risk factors in the population of two provinces in northern China. Methods: Based on the research of Chinese Physiological Constant and Health Conditions conducted in 2008-2010, we enrolled 29,639 subjects in a randomized, stratified study in four sampling areas in Heilongjiang Province and the Inner Mongolia Autonomous Region. We collected 13,140 serum samples to determine biochemical indicators including uric acid(UA), glucose, blood lipids, liver function, and renal function, and finally a representative sample of 8439 aged 18 years and older was determined. We also defined and stratified HUA, hypertension, diabetes, obesity and lipid abnormalities according to international guidelines. Results: There were significant differences in the UA levels between different genders and regions. The total prevalence of HUA is 13.7%. Men had a higher prevalence of HUA than women (21% vs. 7.9%; P < 0.0001). As age increased, HUA prevalence decreased in men but rose in women. The suburbs of big cities had the highest HUA prevalence (18.7%), and in high-prevalence areas the proportion of women with HUA also increased. A stepwise logistic regression model was used to filter out twelve HUA risk factors, including age, gender, residence, hypercholesterolemia, hypertriglyceridemia, impaired fasting glucose, hypertension, obesity, abdominal obesity, CKD, drinking and sleeping. After adjusting for these factors, the odds ratio of HUA was 1.92 times higher in men than in women. Compared with agricultural and pastoral areas, the odds ratio of having HUA was 2.14 for participants in the suburbs of big cities and 1.57 in the center of big cities. Conclusions: The prevalence of HUA is high in northern China. The differences in HUA prevalence by geographic region suggested that unbalanced economic development and health education, therefore HUA prevention measures should be strengthened to improve quality of life and reduce health care costs. [ABSTRACT FROM AUTHOR]

Abstract: We studied the diversity of phytoplankton of Jia Lize wetlands in Kunming and made the environmental evaluation of the wetlands on it. After sampling four ponds and three rivers, microscopic observation and identification analysis, we found that in the pond 1and 3, cyanobacteria algal blooms, high eutrophication, evaluating as the mid-polluted water type A, and in the pond 2 and 4, evaluating as the mid-polluted water type B, Chlorococcum algal blooms. Yang Lin river water was as the type B, Guo Ma river was type A, Mi Liang River water was micro-polluted. Studies showed that eutrophication of ponds were due to the chemical fertilizer, while Yang Lin River was polluted by the agricultural irrigation and living sewage nearby, highly polluted Guo Ma river was due to accommodate lots of industrial pollutant. It is necessary for local people to make the pollutant treatment and ecological protection of this area. [Copyright &y& Elsevier]

In order to supply new information on the antioxidant function of selected beverages for nutritionists and the general public, total phenolic contents of 51 kinds of herbal and tea infusions made in China were measured by the Folin-Ciocalteu method, and their antioxidant capacities were evaluated using ferric reducing antioxidant power (FRAP) and Trolox equivalent antioxidant capacity (TEAC) assays. A significant correlation between FRAP and TEAC values suggested that antioxidant components in these beverages were capable of reducing oxidants and scavenging free radicals. The high correlation between antioxidant capacities and total phenolic contents indicated that phenolic compounds could be one of the main components responsible for antioxidant activities of these beverages. Generally, these beverages had high antioxidant capacities and total phenolic contents, and could be important dietary sources of antioxidant phenolics for prevention of diseases caused by oxidative stress. [ABSTRACT FROM AUTHOR]

In order to identify wild fruits possessing high nutraceutical potential, the antioxidant activities of 56 wild fruits from South China were systematically evaluated. The fat-soluble components were extracted with tetrahydrofuran, and the water-soluble ones were extracted with a 50:3.7:46.3 (v/v) methanol-acetic acid-water mixture. The antioxidant capacities of the extracts were evaluated using the ferric reducing antioxidant power (FRAP) and Trolox equivalent antioxidant capacity (TEAC) assays, and their total phenolic contents were measured by the Folin-Ciocalteu method. Most of these wild fruits were analyzed for the first time for their antioxidant activities. Generally, these fruits had high antioxidant capacities and total phenolic contents. A significant correlation between the FRAP value and the TEAC value suggested that antioxidant components in these wild fruits were capable of reducing oxidants and scavenging free radicals. A high correlation between antioxidant capacity and total phenolic content indicated that phenolic compounds could be the main contributors to the measured antioxidant activity. The results showed that fruits of Eucalyptus robusta, Eurya nitida, Melastoma sanguineum, Melaleuca leucadendron, Lagerstroemia indica, Caryota mitis, Lagerstroemia speciosa and Gordonia axillaris possessed the highest antioxidant capacities and total phenolic contents among those tested, and could be potential rich sources of natural antioxidants and functional foods. The results obtained are very helpful for the full utilization of these wild fruits. [ABSTRACT FROM AUTHOR]

To determine the relationship between birth size and later QOL for Chinese people. Birth data of 1074 subjects were obtained from obstetric birth records of Peking Union Medical College Hospital. All subjects are interviewed face to face with the 36-Item Short-Form Health Survey scale by trained investigators. Linear regression model was used to analyse the relationship between QOL and birth head circumference of the subjects after adjusting for the childhood and adulthood characteristics. The relationship was described with regression coefficients ( B) and its 95% confidence interval (CI). The mean weighted score of QOL was 88.1 ± 9.1, ranging from 76.8 to 100. Larger birth head circumference meant higher adulthood QOL total score ( P= 0.001). After controlling the adulthood confounders, as compared to larger head circumference (≥33 cm), small (<31 cm) and medium head circumferences (31-33 cm) meant lower adulthood QOL scores ( B=−2.356, P= 0.005 and B=−1.645, P= 0.014, respectively). The increase of head circumference by 1 cm was associated with 0.480 (95% CI: 0.141, 0.820) increase of QOL score after adjusting adulthood confounders ( P= 0.006). This study validated the relationship between birth head circumference and QOL in later life. Smaller head circumference at birth could predict worse adulthood QOL at above 50 years old. [ABSTRACT FROM AUTHOR]

Induced by high population density, rapid but uneven economic growth, and historic resource exploitation, China’s upper Yangtze basin has witnessed remarkable changes in land use and cover, which have resulted in severe environmental consequences, such as flooding, soil erosion, and habitat loss. This article examines the causes of land use and land cover change (LUCC) along the Jinsha River, one primary section of the upper Yangtze, aiming to better understand the human impact on the dynamic LUCC process and to support necessary policy actions for more sustainable land use and environmental protection. Using a repeated cross-sectional dataset covering 31 counties over four time periods from 1975 to 2000, we develop a fractional logit model to empirically determine the effects of socioeconomic and institutional factors on changes for cropland, forestland, and grassland. It is shown that population expansion, food self-sufficiency, and better market access drove cropland expansion, while industrial development contributed significantly to the increase of forestland and the decrease of other land uses. Similarly, stable tenure had a positive effect on forest protection. Moreover, past land use decisions were less significantly influenced by distorted market signals. We believe that these and other findings carry important policy implications. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the interpersonal relationships, physical health and schooling of children affected by AIDS/HIV in China's rural areas. A structured survey was used to collect quantitative data from 116 children and their caregivers. The result shows that parental death or illness adversely affect the children's school performance and school attendance. Moreover, 10% of orphans reported their relationship with peers become worse after parental death or illness.

The article presents a study which examines the initial validity of the Chinese Mandarin version of Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales in an examination of children in HIV/AIDS-affected families. It states that the PedsQL 4.0 was distributed to 116 children between 8 to 18 years-old from HIV/AIDS-affected households and 109 control group children. The outcome shows that children from HIV/AIDS-affected households scored considerably lower than the control group.

Ratoon rice (RR), the practice of obtaining a second crop from the stubble of harvested crop, is more resource efficient, economic-sound, and environmentally-sustainable than single-season rice (SR) and double-season rice (DR). Furthermore, RR can increase rice production where thermal energy is more than that required for SR but not enough for DR. However, the potential cultivation region and paddy area suitable for RR in China remains unknown. In this study, the Maxent model was used to estimate potential cultivation region and paddy area suitable for RR and DR, and their difference was the potential cultivation region and paddy area suitable only for RR. Results indicated that the suitability of RR was primarily influenced by the mean temperature of the warmest quarter, annual precipitation, >10 ℃ accumulated temperature, annual sunlight hours, and altitude. The northern boundary of RR potential cultivation region was northern Jiangsu, Anhui, and Hubei, southern Henan, and northeastern Sichuan. The total potential paddy area suitable for RR in China was 18.69 million hectares (Mha), which included 13.05 Mha suitable for DR and 5.64 Mha suitable only for RR. Out of the total potential paddy area for RR, 28.9% (5.41 Mha), 5.8% (1.08 Mha), and 65.3% (12.20 Mha) were currently planted with DR, RR, and SR, respectively. These results suggest that a total of 13.28 Mha can be planted with RR without the reduction of current planting area of DR. Thus, there is enormous potential to expand the planting area of RR for increasing rice production in China. • Paddy area for ratoon rice (RR) in China was estimated using Maxent model. • The total potential paddy area suitable for RR was 18.69 Mha. • Paddy area suitable for planting double-season rice (DR) was 13.05 Mha. • Paddy area suitable only for planting RR was 5.64 Mha. • Area for RR without the reduction of current planting area of DR was 13.28 Mha. [ABSTRACT FROM AUTHOR]

Actinobacillus pleuropneumoniae is the etiologic agent of porcine contagious pleuropneumonia, a cause of considerable world wide economic losses in the swine industry. We sequenced the complete genome of A. pleuropneumoniae, JL03, an isolate of serotype 3 prevalent in China. Its genome is a single chromosome of 2,242,062 base pairs containing 2,097 predicted protein-coding sequences, six ribosomal rRNA operons, and 63 tRNA genes. Preliminary analysis of the genomic sequence and the functions of the encoded proteins not only confirmed the present physiological and pathological knowledge but also offered new insights into themetabolic and virulence characteristics of this important pathogen.We identified a full spectrum of genes related to its characteristic chemoheterotrophic catabolismof fermentation and respiration with an incomplete TCA system for anabolism. In addition to confirming the lack of ApxI toxin, identification of a nonsensemutation inapxIVA and a 5′-proximal truncation of the flp operon deleting both its promoter and the flp1flp2tadV genes have provided convincing scenarios for the low virulence property of JL03. Comparative genomic analysis using the available sequences of other serotypes, probable strain (serotype)- specific genomic islands related to capsular polysaccharides and lipopolysaccharide O-antigen biosyntheses were identified in JL03, which provides a foundation for future research into the mechanisms of serotypic diversity of A. pleuropneumoniae. [ABSTRACT FROM AUTHOR]

To determine the variation of water quality in rice-crayfish (Procambarus clarkii) integrated systems (RCIS) in China, eleven water quality parameters were measured monthly in a typical RCIS located in Qianjiang City (Hubei Province) from July 2014 to June 2015, the parameters were analyzed with principal component analysis (PCA) and compared between the trenches and rice areas during the rice fallow period (Nov-May). The trench and rice area comprehensive results showed that pH (7.48-8.68), NH4 +-N (0.2-1.09 mg/L), NO2--N (<0.052 mg/L) and conductivity (435-951 µS/cm) were within the suitable ranges for P. clarkii and that turbidity (TU) was high during the crayfish harvesting and rice planting season. Annual averages of total nitrogen (TN), total phosphorus (TP), permanganate index (CODMn), and chlorophyll a (Chl.a) content were <2 (except in Nov-Dec), 0.25, 10 mg/L, and 50 mg/m3 (especially in Nov-May, <10 mg/m³), respectively. Dissolved oxygen (DO) was below 4 mg/L in Mar-Sep, with a minimum of ~ 1 mg/L, and much higher in Oct-Feb. The maximum and minimum monthly average water temperature (WT) were 31.4°C in July and 5.7°C in December, while the maximum and minimum instantaneous WT were 39.7°C and 2.5°C, respectively. PCA analysis showed that the first three axes, which were mainly correlated with DO, WT and nutrient level, described most information of the parameters, and parameters showed seasonal changes. Some differences were observed in water parameters between the trenches and rice areas, i.e., trenches generally had higher TU, WT and DO, and lower TN, TP and CODMn, although no significant differences were found in some months and some parameters. The study revealed relatively low water nutrient level, probable extreme WT and DO level in some seasons, and certain differences between the trenches and rice areas in typical CRIS in China. Accordingly, some measures should be taken to improve the negative parameters: 1) enhance the water fertility; 2) increase DO, especially in Mar-Sep; 3) increase the trench and water depth to avoid extreme WT. And water quality management should be addressed in both trenches and rice areas. [ABSTRACT FROM AUTHOR]

Hydromorphone is an alternative to morphine for intrathecal drug delivery system to treat refractory cancer pain; however, there is not enough clinical evidence to prove it. In our study, 233 patients from 12 different pain management centers across China were enrolled, 121 and 112 in the intrathecal hydromorphone (ITHM) and intrathecal morphine (ITMO) groups, respectively. The primary outcome was the clinical success rate, which was defined as ratio of patients achieving ≥50% pain relief. The noninferiority margin was defined as -0.15. Other outcomes included daily visual analogue scale score, breakthrough pain (BTP) incidence, intrathecal dose change, and patient-controlled analgesia bolus count change, GAD-7/PHQ-9. Clinical success was achieved in 85 and 79 of the 121 ITHM patients (70.2%) and 112 ITMO patients (70.5%), respectively. Compared to the corresponding baseline findings, significantly decreased visual analogue scale scores and BTP incidence were noted in both groups. The dose change rate decreased and increased with time in the ITHM and ITMO groups, respectively (ITHM -3.33% vs ITMO 35.4%, P < 0.01, t test) from the third week. The patient-controlled analgesia bolus change rate was lower in the ITHM group than in the ITMO group (ITHM -19.88% vs ITMO 7.79%, P < 0.01, t test) from first week. Our result shows that ITHM is noninferior to ITMO on pain relief to treat refractory cancer pain, however, at different doses and that the doses of morphine tended to increase, whereas those of hydromorphone decreased over time. Hydromorphone offers advantage over morphine in controlling BTP. [ABSTRACT FROM AUTHOR]

Resource scarcity, large environmental footprint and low economic profits are great challenges faced by global crop production. Development of feasible cropping systems that can coordinate productivity and sustainability is critical for addressing these challenges. Here, field experiments were conducted from 2017 to 2020 to compare the energy equivalent yield, energy use efficiency, labor and water productivity, carbon footprint, and net ecosystem economic benefits of the six rice-based crop rotation systems in central China, including rice-wheat (RW), rice-rapeseed (RRs), double-season rice (DR), ratoon rice (RR), maize-rice (MR), and rice-fallow systems (RF). The results demonstrated that MR had the highest energy equivalent yield of 20.3 Mg ha−1 among all the tested rotation systems, which was significantly increased by 28.0%, 32.8%, 18.9%, 26.9%, and 99.5% compared with that of RW, RRs, DR, RR, and RF, respectively. MR and RR achieved higher energy use efficiency than RW, RRs and DR due to their higher total energy output and lower total energy input, respectively. Meanwhile, MR and RR also exhibited the highest water and labor productivity among these rotation systems, respectively. Furthermore, their carbon footprint per area and per energy output were comparable to those of RW and RRs, but significantly lower than those of DR. Overall, MR and RR increased the net ecosystem economic benefits by 12.6–76.8% and 25.1–188.3% relative to other four traditional systems (RRs, RW, DR and RF), respectively. These results suggest that MR and RR are the recommended feasible rice-based crop rotation systems to coordinate high productivity, resource use efficiency, and economic benefit with lower carbon footprint in central China. • The performance of the six rice-based crop rotation systems was evaluated. • Maize-rice rotation and ratoon rice had higher energy use efficiency. • Maize-rice rotation achieved high productivity with lower carbon footprint. • Ratoon rice had high net ecosystem economic benefits due to its lower input. [ABSTRACT FROM AUTHOR]

The article discusses various aspects of distributed energy generation and microgrid technology in China as of December 2014, and it mentions technological innovations which are designed to alleviate an energy crisis. It states that Tianjin University in China led the national "973 Program" entitled "Basic Research on the Key Technologies of Distributed Generation." An increase in energy demand is mentioned, along with pollution and greenhouse gas emissions from fossil fuels.

This study enrolled 3266 pregnant women, to explore the relationship of prenatal phthalate exposure with the risk of preterm birth and gestational age. All participants filled questionnaires and provided with up to three urine samples during three trimesters. Seven phthalate metabolites in urines were measured. The incidences of very preterm, late preterm, early-term, late-term and postterm births were 0.58%, 3.52%, 24.22%, 10.53%, and 0.34%, respectively. Non-linear relationships were shown between phthalate metabolites and gestational age. Except for monomethyl phthalate (OR = 1.65, 95%CI = 1.17–2.34), the average concentrations of phthalate metabolites were associated with a slightly and insignificantly increased risk of overall preterm birth (<37+0 gestational weeks). Through a restricted cubic spline regression, phthalate metabolites were found to be related to the risk of overall preterm birth in a linear manner (p -value >0.05) or a non-linear manner (p -value <0.05). All curves indicated the overall preterm birth risk rose with the increase of phthalate metabolite concentrations. Finally, compared with full-term birth (39+0 to 40+6 gestational weeks), phthalate metabolites were associated with the elevated risks of very preterm, late preterm and postterm births, although some relationships were not statistically significant. In conclusion, these findings suggested non-linear associations between phthalate metabolites and gestational age. Exposure to some phthalate metabolites was associated with increased risks of overall preterm birth and postterm birth. • Rates of very preterm, late preterm, early-term and late-term births were 0.58%, 3.52%, 24.22% and 10.53%, respectively. • Non-linear relationship was observed between certain phthalate metabolites and the odds ratio of overall preterm birth. • Some phthalates were associated with increased risks of very preterm, late preterm and postterm births. • Non-linear curves for associations between phthalates and gestational age were revealed. Capsule: Based on a cohort study with large sample size, the levels of phthalate metabolites in urine at 3 time points during pregnancy were analyzed in relation to gestational age and preterm birth, which aimed to confirm the previous findings in this topic. [ABSTRACT FROM AUTHOR]

• Water use indicators of wheat production were modelled at high spatial resolution. • Irrigation in water-scarce northern regions caused the larger environmental impacts. • Hotspot regions accounted for 34% of the cropping area but 61% of irrigation. • Paradoxically, gains in total water efficiency have led to increased water scarcity. Water shortage is a critical constraint limiting China's capacity for food security. To provide evidence supporting environmentally sustainable water use in food production, this study compared irrigation water productivities (IWPs) and water-scarcity footprints (WSFs) for China's wheat production at high spatial resolution. Contrary to previous water productivity studies assessing crop yield over total water consumption, it was found that IWPs in China's water-scarce northern regions were much lower than those in water-rich southern regions. The WSFs further demonstrated the larger environmental impacts resulting from irrigation in water-scarce northern regions. Hotspot regions, having IWPs in the lowest tercile (<5.2 kg m−3) and WSFs in the highest tercile (>0.058 m3 H 2 O e kg − 1), were mainly located in the Huang-Huai-Hai and northwestern regions and accounted for 34% of the cropping area but 61% of irrigation water use. Historically, the south was also an important contributor of China's wheat production, but progressive shifts toward highly resource-efficient cropping in the Huang-Huai-Hai region has occurred. The paradox is that gains in total crop water efficiency have led to increased irrigation demand and water scarcity. Today, croplands suitable for wheat production lie fallow in some southern regions in the winter. A national reassessment of this situation is urgently needed. [ABSTRACT FROM AUTHOR]

Background and Objectives: Spinal cord injury (SCI) is a severe affliction that can have a profound impact on a person's ability to move and feel, affecting a significant number of individuals. However, rehabilitation after SCI treatment remains a critical method to improve motor-sensory functions, which improves the patient's quality of life. This study aims to describe the epidemiological profile of SCI during the COVID-19 pandemic ("COVID-19 period") and before and after the COVID-19 pandemic ("non-COVID-19 period") in Wuhan City, Hubei Province, China. Materials and Methods : Medical records of 93 patients diagnosed with SCI admitted to the rehabilitation department of Wuhan Tongji Hospital from January 2019 to May 2023 were retrospectively reviewed. Basic demographics and clinical characteristics such as level of injury, American Spinal Injury Association (ASIA) Impairment Scale, treatment method, and concomitant injuries were analyzed. Results : Forty patients with SCI from the non-COVID-19 period and fifty-three patients from the COVID-19 period were identified. The mean ages were 38.80 ± 17.71 and 44.53 ± 13.27 years, respectively, with a consistent male-to-female ratio of 2:1 across both periods. Notably, falls accounted for the most prevalent mechanism of injury, constituting 50% of cases during the non-COVID-19 period and 37.74% during the COVID-19 period. The most common initial ASIA grade was B in the non-COVID-19 period and grade C in the COVID-19 period. In addition, the final ASIA grade after treatment was grade C in the non-COVID-19 period and grade D in the COVID-19 period. Conclusions : A greater proportion of males suffer from SCI, and the primary causes are falls and traffic accidents. Workers are the most vulnerable group to SCI among all patients. Prevention strategies should be customized based on the unique characteristics of SCI patients. This study highlights the importance of SCI rehabilitation.

Objective: To evaluate the diagnostic efficacy of Qisexingtai hand diagnostic method in the diagnosis of coronary artery disease (CAD)., Methods: This was an investigator-initiated, prospective, multi-center, cross-sectional study. All the participants from three hospitals in China had been diagnosed by both Qisexingtai hand diagnostic method and coronary angiography. We compared the two diagnostic methods to calculate the sensitivity, the specificity, the omission diagnostic rate, the mistaken diagnostic rate and accuracy in order to evaluate the diagnostic efficacy of Qisexingtai hand diagnostic method for CAD., Results: A total of 326 subjects were enrolled, diagnosed by both Qisexingtai hand diagnostic method and coronary angiography. As a result, there were 166 positive cases according to Qisexingtai hand diagnostic method, and 131 positive cases according to coronary angiography. Compared with the results of coronary angiography, the sensitivity of Qisexingtai hand dia-gnostic method was 80.2%, the specificity was 68.7%, the omission diagnostic rate was 19.8%, the mistaken diagnostic rate was 31.3%, and the accuracy was 73.3%. Area under the receiver operating characteristic curve was estimated as 0.735 for all, and 0.718, 0.735, 0.783 for the three sub-centers., Conclusion: Qisexingtai hand diagnostic method with high accuracy and sensitivity has certain application value in the diagnosis of CAD.

Rice production in China is constrained by excessive water consumption, labor shortage, large environmental footprint, and low economic profit. Rice ratooning is a promising practice to increase famers' profit with higher resource use efficiency and less environmental impact compared with other rice cropping systems. However, there is limited information on the differences in energy use efficiency, water and labor productivity, environmental footprint, and economic return between main crop (MC) and ratoon crop (RC) in this cropping system. This study was conducted to compare the system performance between the two crops of ratoon rice using on-farm survey data. Average grain yield was 8.40 and 4.55 t ha -1 for MC and RC, respectively. Although RC produced 45.9% lower grain yield, it had 57.3% less total energy input and 71.0% lower total production cost than MC, which resulted in a significantly higher energy use efficiency, net energy ratio, net economic return and benefit-to-cost ratio. Lower total energy input and production cost of RC was mainly attributed to the reduction in fertilizer application and labor input, respectively compared with MC. In addition, both labor and water productivity of RC was significantly higher than those of MC. Furthermore, the global warming potential (GWP) and yield-scaled GWP of RC was 59.3% and 23.4% lower than those of MC, respectively, due to lower agronomic inputs and GHGs emissions. Overall, our results suggested that RC had higher resource use efficiency, better economic performance, and less environment impact compared with MC., 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 © 2021 Elsevier B.V. All rights reserved.)

Previous studies have investigated the association between cognitive frailty and falls among older adults in community; however, no study investigated this relationship among older patients living in hospital. This study aimed to examine the relationship of cognitive frailty with falls among older inpatients in Chinese hospital., Methods: This analysis consisted of 9192 older inpatients aged 65 years or over from six hospitals in China. We used FRAIL scale and Mini-Cog to assess frailty and cognitive impairment, respectively. A generalized estimating equation was used to examine the relationship between cognitive frailty and falls at 30-day follow-up., Results: Among 9192 older inpatients enrolled in this present study, the mean (SD) age was 72.40(5.72) years, with 3850(41.88%) women. The cross-sectional analysis found that after controlling for variables (age, gender, education, depression, and hospital ward cluster effect), hospitalized patients with cognitive frailty, frailty only, or cognitive impairment only at baseline were all associated with history of falls (P<0.05). At 30-day follow-up, generalized estimating equation with full-adjustment showed that inpatients with cognitive frailty were at greater risk of falls than those of non-frail and cognitive intact (OR=3.0,95%CI:1.32-6.83). This association was also observed in individuals with frailty only (OR=2.11,95%CI:1.04-4.27) but not for patients with cognitive impairment only((OR=1.11,95%CI:0.43-2.85)., Conclusion: Our study suggested that hospitalized Chinese older adults with cognitive frailty were independently associated with falls. Early screening frailty and cognitive impairment were significant for older patients by clinicians, and corresponding interventions, exercise training and nutritional programs, should be implemented to prevent falls., Competing Interests: All authors declare no conflicts of potential interest for this work.

Since December 2019, the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has occurred in Wuhan, Hubei Province, China. The infected cases were noted mostly in adults, but rarely reported in children, especially neonates. Most children with SARS-CoV-2 infection present mainly with respiratory symptoms, but less commonly with gastrointestinal symptoms, and tend to have mild clinical symptoms. A neonate with SARS-CoV-2 infection, who had vomiting and milk refusal as the first symptom, was recently admitted to Wuhan Children's Hospital. After two weeks of treatment, the patient recovered gradually and was discharged. Here, this case is reported to improve the understanding of SARS-CoV-2 infection in neonates.

Limited evidence revealed conflicting results on relationship between phthalate exposure and clinical pregnancy loss (gestational weeks >6). A prospective cohort study in Chinese pregnant women (n = 3220) was conducted to investigate the association between urinary phthalate metabolites and clinical pregnancy loss (gestational weeks 6 to 27; n = 109). Morning urine samples during gestational weeks 5 to 14 (mean 10.42) were collected to measure monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP). The concentrations of low- and high-molecular weight phthalate metabolites (ΣLMWP <250 Da and ΣHMWP >250 Da) were calculated. Adjusted logistic regression models showed increased risks of clinical pregnancy loss in women with higher creatinine- normalized concentrations of MEP, MBP, MEOHP, MEHHP, ΣLMWP and ΣHMWP. Stratified analysis by gestational weeks (10 weeks) of miscarriage indicated positive associations of MEP, MEOHP, MEHHP and ΣHMWP with embryonic loss (during gestational weeks 6 to 10). The only association of foetal loss (during gestational weeks 11 to 27) was observed with MEHHP. Our findings suggested that Chinese women who were exposed to phthalates during early pregnancy had an increased risk of clinical pregnancy loss, especially embryonic loss.

Introduction: Rare reports can be found about sex- and age-specific body composition survey among Chinese population. The aim of this study is to explore the change of sex-specific body compositions with aging among Chinese adolescents, adults and elders., Methods: In a large-scale population survey about physiological constants and health conditions, 75,714 subjects who aged from 8 to 80 completed body composition array. Body mass index (BMI), percentage body fat (PBF), water percentage of body weight (WPBW), water percentage of lean body mass (WPLBM), fat-free mass index (FFMI) and basic metabolic rate were examined with Biodynamics BI-310 body composition analyzer. General obesity is defined as BMI equal to or greater than 28 kg/m2., Results: The prevalence rates of general obesity were 9.4% for males and 7.7% for females respectively. With aging, PBF and FMI showed a U-shape curvilinear trend and WPBW showed a parabolic trend for males. At same age group: 18-19 age groups, PBF and FMI declined to the valley and WPBW rose to the peak. For females, PBF, WPBW and FMI changed in a linear trend. The values of WPLBM and FFMI showed same curvilinear trend for two genders. WPLBM changed in a U-shape trend and touched the valley in twenties for males and in 18-19 age groups for females. The value of FFMI was larger for older age groups in the younger generation but smaller in the older generation. A parabolic trend peaking was seen in the thirties for males and in the forties for females. Regression models with age as independent variable showed that the larger rate of increase of PBF and smaller rates of increase for WPBM and WPLBM with aging for males., Conclusion: This study presents detailed data about sex-specific body composition conditions. Different change trend with aging was found about body composition conditions.

Objective: A large proportion of preschoolers have been left behind due to parental migration in rural China. We conducted a preliminary cross-sectional survey to investigate the mental health of these left-behind preschool-aged children (LBPC) and associated risk factors., Methods: A total of 750 LBPC, comprising 217 and 433 children left behind as a result of migration of either or both parents, respectively, and 100 controls were enrolled from two counties in Anhui province, China. Their caregivers completed questionnaires on demographics, the Family Support Scale, the Parenting Self-efficacy Scale and the Preschool-aged Child Mental Health Scale., Results: There were no significant differences in mental outcomes among the three groups. However, male LBPC who were younger, fostered by caregivers with lower levels of life satisfaction and parenting efficacy, and came from poorer families with less social support, experienced more mental health problems than other children., Conclusions: LBPC did not have worse mental well-being than their control counterparts, but some subpopulations were at potential risk of mental health problems compared with other LBPC. More research on other underlying factors and strategies to prevent the development of psychopathology is urgently needed.