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The sediment acts as not only sink but also source of heavy metals in aquatic environment, which may cause the endogenous pollution in drinking water reservoirs. In this work, we collected the surface sediments from Qingcaosha Reservoir, the largest river-embedded reservoir in China, and investigated the spatial distribution, risk, and sources of heavy metals in four seasons. Significant spatial and seasonal heterogeneity could be found in the distribution of five heavy metals (Cr, Cu, Mn, Zn, and Ni) in the surface sediments. The highest concentrations of the five metals were detected in the sediments from the reservoir downstream, especially in summer and next spring. The geo-accumulation index (Igeo) and enrichment factor (EF) suggest that the sediment pollution caused by single metal was heavier in summer than in other seasons. Also, the Nemerow pollution index (PIN) manifests that the synergetic pollution induced by five metals was most serious in summer, followed by next spring. However, the potential ecological risk index (PERI) indicates that none of these metals caused potential ecological risk in four seasons. Comprehensive analysis demonstrates that the sediment pollution gradually increased from autumn to winter and then to next spring. Principal component analysis shows that the main pollution source of five heavy metals may come from industrial wastewater and domestic sewage, which was almost independent of seasons. This work can provide data support for the subsequent seasonal optimization of drinking water quality and reservoir management. [ABSTRACT FROM AUTHOR]

Background: Adult T-cell acute lymphoblastic leukemia (T-ALL) is a rare hematological malignancy and significantly linked to poor outcomes. Early T-cell precursor (ETP) leukemia is a unique subtype of T-ALL. The aim of this study is to compare the differences between ETP and non-ETP ALLs in China. Methods: We retrospectively analyzed the records of 122 adult T-ALL patients diagnosed and treated at our center between January 2014 and June 2019. All the patients enrolled were categorized into ETP and non-ETP ALL by immunophenotype, and further statistical analyses about clinical data and prognostic factors were performed. Results: Among the 122 cases, the male-to-female ratio was 2.8:1, and the median age is 29 (range, 16–82) years. Except for 10 patients with insufficient immunophenotyping results, 47.3% (53/112) are ETP and 52.7% (59/112) are non-ETP. Compared with non-ETP patients, ETP-ALL patients had lower white blood cell counts and lactate dehydrogenase levels, while they were older and had higher platelet counts and fibrinogen levels (all p < 0.05). Complete remission (CR) was achieved in 68.0% (83/122) of patients, 64.2 and 76.3% in ETP and non-ETP, respectively (p = 0.160). In total, 44.6% (37/83) of patients relapsed. Allogeneic stem cell transplantation (allo-SCT) was successfully performed in 36.1% (44/122) of patients, of which 79.5% (35/44) were in CR1. With a median follow-up of 9.1 (range, 0.5–70.3) months, the estimated 2-year overall survival (OS) and relapse-free survival (RFS) rates for the cohort were 38.0 ± 5.1 and 39.1 ± 6.3%, respectively. In the ETP group, the 2-year OS rate was 40.7 ± 8.2% and the RFS rate was 47.2 ± 10.7%, while in the non-ETP group, the 2-year OS rate was 37.9 ± 7.0% and the RFS rate was 39.2 ± 8.3% (both p > 0.05). In the landmark analysis of CR1 patients who had a survival of more than 6 months, the allo-SCT group had significantly better survival outcomes than the chemotherapy group, and the 2-year OS rates and RFS rates were 80.1 ± 7.3 vs. 28.4 ± 8.4% and 68.9 ± 8.8 vs. 12.8 ± 7.2%, respectively (both p < 0.0001). A multivariate analysis suggests that allo-SCT acts as an independent prognostic factor for both OS and RFS. Conclusions: Our results revealed that ETP accounted for a high proportion of T-ALL in Chinese. There are no CR rates and prognosis differences between ETP and non-ETP. Allo-SCT in CR1 can significantly improve patients' survival. [ABSTRACT FROM AUTHOR]

Background The advantages and disadvantages of three-dimensional (3 D) and two-dimensional (2 D) two-port video-assisted thoracoscopic surgery ( VATS) lobectomy and systematic dissection of mediastinal lymph nodes for lung cancer were investigated. Methods Between December 2013 and July 2015 at Beijing Hospital, 191 patients underwent lobectomy and systematic dissection of mediastinal lymph nodes for lung cancer. After applying the study criteria, a total of 165 patients were included and allocated to 3 D ( n = 76) and 2 D ( n = 89) groups. Variables of the study design, including duration of surgery, volume of intraoperative bleeding, numbers and groups of lymph nodes dissected, drainage volume after surgery, duration of drainage tube insertion, hospitalization time after surgery, hospitalization costs, and complications, were recorded and analyzed. Intergroup differences for all data were compared and statistically analyzed. Results No statistical difference was found between the two groups with respect to duration of surgery, volume of intraoperative bleeding, drainage volume after surgery, duration of drainage tube insertion, hospitalization time after surgery, hospitalization costs, and complications ( P > 0.05). Additionally, there was no significant difference in the numbers and groups of all lymph nodes or N2 lymph nodes resected ( P > 0.05). Conclusion Lobectomy with systematic lymph node dissection can be undertaken with two ports using a 3 D thoracoscope, and presents similar results to the use of a traditional 2 D thoracoscope, at no greater hospitalization cost but with better operational perception and sensitivity during surgery. Two-port lobectomy with systematic lymph node dissection using a 3 D thoracoscope is a safe and effective surgical process for lung cancer treatment. [ABSTRACT FROM AUTHOR]

Research has identified social exclusion as one of the social determinants of health. There are risks of social exclusion in later life in recent years. However, despite the fact that China has the largest aging population in the world and reports a rapid growth in the proportion of older people living alone, research on the role of social exclusion on depression is limited. This study examined the effects of social exclusion on depressive symptoms in older Chinese who are living alone in China, based on the data from one Shanghai neighbourhood. The data used were obtained between August and October 2008 through face-to-face interviews, using a structured survey questionnaire, from a simple random sample of 228 Chinese 60 and older living alone in a Shanghai community. Depressive symptoms were measured by a 15-item Chinese version Geriatric Depression Scale. Social exclusion was represented by income adequacy, social relations, civic participation, and housing condition. Over 30% of participants reported symptoms of a mild or above mild level of depression. When controlled for the demographics and health variables in hierarchical multiple regression, social exclusion variables, represented by a lower level income adequacy, a less favourable housing condition, and feeling more lonely correlated significantly with more depressive symptoms. Contrary to previous studies on depression in the older adults in China, this study has obtained findings indicating that social exclusion variables are more important than other socio-demographic factors in the context of contemporary China. While two significant social exclusion variables (i.e. income and housing) are related to structural changes in the economic context in China, the intra-personal role of feeling lonely that ties strongly living alone and role of older adults in an increasingly competitive market economy should not be underestimated. To address depression and mental health of older Chinese who live alone, social policies and programs to reduce various forms of social exclusion should be developed. In additional to providing assistance in financial support and housing improvement, services to strengthen the social networks and social relations of these older people are essential. [ABSTRACT FROM AUTHOR]

Summary: Background: Homoharringtonine-based induction regimens have been widely used in China for patients with acute myeloid leukaemia. However, their efficacy has not been tested in a multicentre randomised controlled trial in a large population. We assessed the efficacy and safety of homoharringtonine-based induction treatment for management of newly diagnosed acute myeloid leukaemia. Methods: This open-label, randomised, controlled, phase 3 study was done in 17 institutions in China between September, 2007, and July, 2011. Untreated patients aged 14–59 years with acute myeloid leukaemia were randomly assigned (by a computer-generated allocation schedule without stratification) to receive one of three induction regimens in a 1:1:1 ratio: homoharringtonine 2 mg/m2 per day on days 1–7, cytarabine 100 mg/m2 per day on days 1–7, and aclarubicin 20 mg/day on days 1–7 (HAA); homoharringtonine 2 mg/m2 per day on days 1–7, cytarabine 100 mg/m2 per day on days 1–7, and daunorubicin 40 mg/m2 per day on days 1–3 (HAD); or daunorubicin 40–45 mg/m2 per day on days 1–3 and cytarabine 100 mg/m2 per day on days 1–7 (DA). Patients in complete remission were offered two cycles of intermediate-dose cytarabine (2 g/m2 every 12 h on days 1–3). The primary endpoints were the proportion of patients who achieved complete remission after two cycles of induction treatment and event-free survival in the intention-to-treat population. The trial is registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-06000054. Findings: We enrolled 620 patients, of whom 609 were included in the intention-to-treat analysis. 150 of 206 patients (73%) in the HAA group achieved complete remission versus 125 of 205 (61%) in the DA group (p=0·0108); 3-year event-free survival was 35·4% (95% CI 28·6–42·2) versus 23·1% (95% CI 17·4–29·3; p=0·0023). 133 of 198 patients (67%) in the HAD group had complete remission (vs DA, p=0·20) and 3-year event-free survival was 32·7% (95% CI 26·1–39·5; vs DA, p=0·08). Adverse events were much the same in all groups, except that more patients in the HAA (12 of 206 [5·8%]) and HAD (13 of 198 [6·6%]) groups died within 30 days than in the DA group (two of 205 [1%]; p=0·0067 vs HAA; p=0·0030 vs HAD). Interpretation: A regimen of homoharringtonine, cytarabine, and aclarubicin is a treatment option for young, newly diagnosed patients with acute myeloid leukaemia. Funding: Chinese National High Tech Programme, Key Special Research Foundation of the Ministry of Science and Technology of China, National Nature Science Foundation of China, National Clinical Key Specialty Construction Project. [ABSTRACT FROM AUTHOR]

Natural resources are limited, and people often share these limited resources in groups, which creates an intergroup resource dilemma. To understand individuals' sustainable behaviours in intergroup resource dilemmas in the context of group interactions, the present research systematically investigates the effect of outgroup conspiracy theories on sustainable behaviours and preliminarily explores the internal mechanism underlying this effect. First, a survey study (Study 1) relying on real-world intergroup relations first confirmed the negative correlation between outgroup conspiracy beliefs and sustainable intentions in intergroup resource dilemmas. Then, an online experimental study that utilized the real situation of a region in China (Study 2) tested the causal relationship between exposure to an outgroup conspiracy theory and sustainable intentions, as well as showing the mediating role of intergroup threat perception underlying this relationship. Finally, a preregistered experimental laboratory study (Study 3) further verified the causal effect of exposure to an outgroup conspiracy theory on sustainable behaviours, again confirming the mediating role of intergroup threat perception. In general, our research demonstrates that exposure to an outgroup conspiracy theory stimulates individuals' environmental neglect and reduces their sustainable behaviours by increasing their perceptions of intergroup threat when faced with intergroup resource dilemmas., (© 2024 British Psychological Society.)

Background: Neglect is a common form of child maltreatment and profoundly affects children's mental health globally. Self-compassion may help children cope with neglect but the role of self-compassion in neglect context has been understudied. This study identifies distinct patterns of self-compassion and child neglect and explores how neglect and self-compassion profiles correlate with child mental health., Methods: The sample includes 3342 children aged 8-16 (49.6 % female) from a national survey of 29 provinces in China using a multistage sampling method. We used latent profile analysis to identify distinct profiles of self-compassion and neglect and examine their combined effects on child mental health, including both positive indicators (hope, resilience) and negative indicators (anxiety, depression, academic burnout, and peer problems)., Results: We identified four neglect/self-compassion profiles: Adaptable Self-Carers (average neglect/high self-compassion), Vulnerable Languishers (high neglect/low self-compassion), Stable Self-Soothers (low neglect/average self-compassion), and Opportune Thrivers (low neglect/high self-compassion). The Vulnerable Languishers group exhibited the poorest mental health outcomes, whereas the Opportune Thrivers showed the best outcomes. Adaptable Self-Carers, although experiencing more neglect than Stable Self-Soothers, had better mental health than the latter, possibly due to their greater self-compassion., Limitations: The cross-sectional design limits our ability to determine causality, and the use of self-reported measures increases response bias risk., Conclusions: More self-compassion and less neglect are associated with more positive mental health outcomes. Moreover, self-compassion is a potential protective factor against the adverse effects of neglect on child mental health. Fostering self-compassion may boost positive adjustment in children who have experienced neglect., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Research about the commercial sex industry rarely examines the women who are the clients purchasing sexual services. Examining how this challenges gender stereotypes through the undoing gender framework reveals how gender norms can be reshaped through contextual changes. Based on 3 years of ethnographic data from a high-end bar in Tianjin, interviews with 27 female clients and 47 MSWs paint a complex picture of how some women adopted ungendered strategies regarding sexuality. As women take control of their own sexual behavior, they free themselves of some traditional societal expectations about their identity. Primarily motivated by pleasure and control, purchasing sex becomes a means for women to experience empowerment and self-confidence by breaking with traditional gender norms and expectations. Undoing gender involves expanding gendered repertoires, with women finding empowerment in adopting a masculine model of sexuality. However, social stigma and personal efficacy indicate that gender deconstruction is a gradual process. The research contributes to understanding complex gender dynamics and sexual behaviors within commercial sex transactions, shedding light on societal norms and individual agency., (© 2024 The Authors. The British Journal of Sociology published by John Wiley & Sons Ltd on behalf of London School of Economics and Political Science.)

Simple and practical tools for screening high-risk new-onset diabetes after percutaneous coronary intervention (PCI) (NODAP) are urgently needed to improve post-PCI prognosis. We aimed to evaluate the risk factors for NODAP and develop an online prediction tool using conventional variables based on a multicenter database. China evidence-based Chinese medicine database consisted of 249, 987 patients from 4 hospitals in mainland China. Patients ≥ 18 years with implanted coronary stents for acute coronary syndromes and did not have diabetes before PCI were enrolled in this study. According to the occurrence of new-onset diabetes mellitus after PCI, the patients were divided into NODAP and Non-NODAP. After least absolute shrinkage and selection operator regression and logistic regression, the model features were selected and then the nomogram was developed and plotted. Model performance was evaluated by the receiver operating characteristic curve, calibration curve, Hosmer-Lemeshow test and decision curve analysis. The nomogram was also externally validated at a different hospital. Subsequently, we developed an online visualization tool and a corresponding risk stratification system to predict the risk of developing NODAP after PCI based on the model. A total of 2698 patients after PCI (1255 NODAP and 1443 non-NODAP) were included in the final analysis based on the multicenter database. Five predictors were identified after screening: fasting plasma glucose, low-density lipoprotein cholesterol, hypertension, family history of diabetes and use of diuretics. And then we developed a web-based nomogram ( https://mr.cscps.com.cn/wscoringtool/index.html ) incorporating the above conventional factors for predicting patients at high risk for NODAP. The nomogram showed good discrimination, calibration and clinical utility and could accurately stratify patients into different NODAP risks. We developed a simple and practical web-based nomogram based on multicenter database to screen for NODAP risk, which can assist clinicians in accurately identifying patients at high risk of NODAP and developing post-PCI management strategies to improved patient prognosis., (© 2024. The Author(s).)

According to the broaden-and-build theory, positive emotions can broaden our awareness and build psychological resources, which leads to better psychological outcomes. Previous studies demonstrated that hope partially mediates the association between positive emotions and life satisfaction in college students. Yet, there has no similar model been tested among older adults. The objective of the current study was to evaluate the mediating role of hope agency and pathways in the association between positive emotions and life satisfaction. Three hundred and forty-one Chinese community-dwelling older adults (mean = 70.83, SD  = 9.16) were asked to complete a survey questionnaire comprising measures assessing positive emotions, hope, life satisfaction, and other sociodemographic variables. Results showed that hope agency, but not hope pathways, partially mediated the relationship between positive emotions and life satisfaction. We discussed the importance of these initial findings concerning positive emotions and hope as predictors of life satisfaction in the older adult population., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Elite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach., Methods: Face-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis., Results: Seven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours., Conclusion: Support for Chinese elite athletes' mental health and help-seeking requires improvement., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Bu, Zhang, Liu, Han, Wang and Huang.)

Adverse childhood experiences (ACEs) are well-established risk factors for psychotic symptoms. This study replicated the relationship between ACEs and positive symptoms of psychosis in the Asian context and explored the moderating effect of dissociation. We analyzed data from 1439 high school students in China who completed validated measures of ACEs, positive symptoms of psychosis, and dissociative symptoms. The positive relationship between ACEs and psychotic symptoms was confirmed in our sample (r =0.244, p <0.001). Among different ACEs, childhood emotional neglect (β =0.139, p <0.001) and emotional abuse (β =0.125, p <0.001) had the strongest relationship with psychotic symptoms. Dissociative symptoms were also found to be a statistically significant moderator. We provide cross-cultural evidence for the relationship between ACEs and psychotic symptoms. Dissociative symptoms may exacerbate such effects. These results highlight the importance of child protection to prevent psychotic symptoms. Individuals with higher levels of dissociation may be at higher risk of developing psychotic symptoms when exposed to adversities. A trauma-informed approach to addressing psychotic symptoms in the community is recommended., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest in relation to the subject of this study., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The investigation of pharmaceuticals as emerging contaminants in marine biota has been insufficient. In this study, we examined the presence of 51 pharmaceuticals in edible oysters along the coasts of the East and South China Seas. Only nine pharmaceuticals were detected. The mean concentrations of all measured pharmaceuticals in oysters per site ranged from 0.804 to 15.1 ng g -1 of dry weight, with antihistamines being the most common. Brompheniramine and promethazine were identified in biota samples for the first time. Although no significant health risks to humans were identified through consumption of oysters, 100-1000 times higher health risks were observed for wildlife like water birds, seasnails, and starfishes. Specifically, sea snails that primarily feed on oysters were found to be at risk of exposure to ciprofloxacin, brompheniramine, and promethazine. These high risks could be attributed to the monotonous diet habits and relatively limited food sources of these organisms. Furthermore, taking chirality into consideration, chlorpheniramine in the oysters was enriched by the S -enantiomer, with a relative potency 1.1-1.3 times higher when chlorpheniramine was considered as a racemate. Overall, this study highlights the prevalence of antihistamines in seafood and underscores the importance of studying enantioselectivities of pharmaceuticals in health risk assessments.

Objective: Hypertriglyceridemic waist (HW), hypertriglyceridemic waist-to-height ratio (HWHtR), and waist-to-hip ratio (WHR) have been shown to be indicators of cardiometabolic risk factors. However, it is not clear which indicator is more suitable for children and adolescents. We aimed to investigate the relationship between HW, HWHtR, WHR, and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents., Methods: This was a national cross-sectional study. Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6-18 years from seven provinces in China. Demographics, physical activity, dietary intake, and family history of chronic diseases were obtained through questionnaires. ANOVA, χ 2 and logistic regression analysis was conducted., Results: A significant sex difference was observed for HWHtR and WHR, but not for HW phenotype. The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents (HW: OR = 12.22, 95% CI : 9.54-15.67; HWHtR: OR = 9.70, 95% CI : 6.93-13.58). Compared with the HW and HWHtR phenotypes, the association between risk of cardiometabolic health risk factors (CHRF) clustering and high WHR was much weaker and not significant (WHR: OR = 1.14, 95% CI : 0.97-1.34)., Conclusion: Compared with HWHtR and WHR, the HW phenotype is a more convenient indicator withhigher applicability to screen children and adolescents for cardiovascular risk factors., (Copyright © 2024 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.)

Background: Few studies have been conducted to explore medication non-adherence in persons with schizophrenia (PWS) and its influencing factors in rural China. This study aimed to investigate the medication non-adherence and its influencing factors among PWS in rural China., Methods: A total of 269 PWS and their family caregivers in Xinjin district, Chengdu, China were investigated on medication adherence and related factors. Logistic regression was employed to identify the influencing factors., Results: The results showed that 37.6% of PWS had medication non-adherence. PWS living with family caregivers had significantly lower rate of medication non-adherence (34.7%) than those not living with family caregivers (60.0%) ( p  < 0.01). Family caregivers' affiliate stigma of mental illness, knowledge of mental illness and self-esteem were significantly related to patients' medication non-adherence ( p  < 0.05). PWS' employment status, living with family caregiver, present mental status and social support were significantly related to medication adherence., Conclusion: This study shows medication non-adherence is severe among PWS in rural China. Both patient- and family-related factors affect patients' medication adherence seriously. Except improving patients' treatment and mental status, development of family caregiving, social support network and intervention on reducing stigma of mental illness should be crucial for enhancing PWS' medication adherence.

Tropane alkaloids (TAs), which are anticholinergic agents, are an essential class of natural compounds, and there is a growing demand for TAs with anesthetic, analgesic, and spasmolytic effects. Anisodus acutangulus (Solanaceae) is a TA-producing plant that was used as an anesthetic in ancient China. In this study, we assembled a high-quality, chromosome-scale genome of A. acutangulus with a contig N50 of 7.4 Mb. A recent whole-genome duplication occurred in A. acutangulus after its divergence from other Solanaceae species, which resulted in the duplication of ADC1 and UGT genes involved in TA biosynthesis. The catalytic activities of H6H enzymes were determined for three Solanaceae plants. On the basis of evolution and co-expressed genes, AaWRKY11 was selected for further analyses, which revealed that its encoded transcription factor promotes TA biosynthesis by activating AaH6H1 expression. These findings provide useful insights into genome evolution related to TA biosynthesis and have potential implications for genetic manipulation of TA-producing plants., (Copyright © 2023. Published by Elsevier Inc.)

Children are highly vulnerable to environmental pollutants, especially endocrine-disrupting chemicals (EDCs). Previous research has linked both organic UV filters and phthalates exposure to adiposity and pubertal development in children. Nevertheless, the individual and collective effects of these chemicals on this population remain poorly understood. In this study, twelve organic UV filters and metabolites, six phthalate metabolites and two oxidative stress biomarkers were analyzed in a prospective follow-up study in Shanghai, China after a baseline study conducted 1.5 years earlier. Results revealed a positive association between exposure to individual organic UV filters or their mixture and levels of 8-OHdG (β ranging from 0.242 to 0.588, P < 0.05), a marker of oxidative DNA damage. BP-3 and OD-PABA made a greater contribution to oxidative DNA damage than other UV filters. Levels of 8-OHdG were also positively correlated with single phthalate metabolites and their mixture, with MnBP and MMP contributing the most. Stratified analysis found that these associations were mainly observed in girls. Our mixture analysis revealed cumulative risks of oxidative DNA damage when there was co-exposure to these two kinds of EDCs. These results underscore the importance of considering the risks associated with organic UV filters and the necessity of evaluating the effects of all these pollutants, both individually and in mixtures., 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 © 2023. Published by Elsevier B.V.)

Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (M age  = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: About a fourth of Chinese adolescents developed clinically significant depressive symptoms following a disaster. However, little is known about whether and how post-trauma negative life events and a sense of security are associated with depressive symptoms in this population. This study examined the psychological experiences of Chinese young people who had experienced the 2013 Ya'an earthquake in Sichuan, China., Methods: This cross-sectional study was conducted in 2019. A total of 693 Chinese middle school students completed a questionnaire that measured their level of depressive symptoms, trauma exposure, stressful life events, and sense of security., Results: Results of hierarchical multiple-regression analyses showed that the level of life stress from stressful life events was positively associated with the level of depressive symptoms (β = 0.416, P < 0.001) and the level of the sense of security was negatively associated with the level of depressive symptoms (β = -0.352, P < 0.001) when analysis controlled for age, gender, and trauma exposure., Conclusions: These findings highlight the importance of considering the influence of life stressors and the sense of security in devising measures and strategies for the prevention of the manifestation of depression among young people, particularly those who were exposed to disasters.

The increasing consumption of ducks and chickens in China demands characterizing carcasses of domestic birds efficiently. Most existing methods, however, were developed for characterizing carcasses of pigs or cattle. Here, we developed a noncontact and automated weighing method for duck carcasses hanging on a production line. A 2D camera with its facilitating parts recorded the moving duck carcasses on the production line. To estimate the weight of carcasses, the images in the acquired dataset were modeled by a convolution neuron network (CNN). This model was trained and evaluated using 10-fold cross-validation. The model estimated the weight of duck carcasses precisely with a mean abstract deviation (MAD) of 58.8 grams and a mean relative error (MRE) of 2.15% in the testing dataset. Compared with 2 widely used methods, pixel area linear regression and the artificial neural network (ANN) model, our model decreases the estimation error MAD by 64.7 grams (52.4%) and 48.2 grams (45.0%). We release the dataset and code at https://github.com/RuoyuChen10/Image&#95;weighing., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Reporting quality is a critical issue in health sciences. Adopting the reporting guidelines has been approved to be an effective way of enhancing the reporting quality and transparency of clinical research. In 2012, we found that only 7 (7/1221, 0.6%) journals adopted the Consolidated Standards of Reporting Trials (CONSORT) statement in China. The aim of the study was to know the implementation status of CONSORT and other reporting guidelines about clinical studies in China., Methods: A cross-sectional bibliometric study was conducted. Eight medical databases were systematically searched, and 1039 medical journals published in mainland China, Hong Kong, Macau, and Taiwan were included. The basic characteristics, including subject, language, publication place, journal-indexed databases, and journal impact factors were extracted. The endorsement of reporting guidelines was assessed by a modified 5-level evaluation tool, namely i) positive active, ii) positive weak, iii) passive moderate, iv) passive weak and v) none., Results: Among included journals, 24.1% endorsed CONSORT, and 0.8% endorsed CONSORT extensions. For STROBE (STrengthening the Reporting of Observational Studies in Epidemiology), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), STARD (An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies), CARE (CAse REport guidelines), the endorsement proportion were 17.2, 16.6, 16.4, and 14.8% respectively. The endorsement proportion for SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials), TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis), AGREE (Appraisal of Guidelines, Research, and Evaluation), and RIGHT (Reporting Items for Practice Guidelines in Healthcare) were below 0.7%., Conclusions: Our results showed that the implementation of reporting guidelines was low. We suggest the following initiatives including i) enhancing the level of journal endorsement for reporting guidelines; ii) strengthening the collaboration among authors, reviewers, editors, and other stakeholders; iii) providing training courses for stakeholders; iv) establishing bases for reporting guidelines network in China; v) adopting the endorsement of reporting guidelines in the policies of the China Periodicals Association (CPA); vi) promoting Chinese medical journals into the international evaluation system and publish in English., (© 2022. The Author(s).)

Emission inventory plays an important role in designing effective emission control strategies. Currently, there is unbalanced development of CO 2 and air pollutant emission inventories in China and the spatial information of both cannot be obtained simultaneously, which prevents a collaborative control strategy. In this study, we developed a unified emission inventory including both CO 2 and air pollutants, then utilized spatial mapping methods to identify the co-hotspots of both CO 2 and air pollutants at a high spatial resolution (1 × 1 km 2 ). We applied Guangzhou city as a case study to illustrate the method. The results showed that CO 2 and air pollutants were mainly emitted from the stationary combustion sector and the transportation sector. These two sectors contributed 95 %, 67 %, and 93 % to total CO 2 , SO 2 , and NO x emissions, respectively. Up to 86 %, 86 %, 66 %, and 72 % of total CO 2 , SO 2 , NO x , and PM 2.5 emissions were attributed to the top 10 % emission grids with 1 × 1 km 2 resolution. However, our results showed high emission grids were not surrounded by other high emissions grids for all types of emissions analyzed in this study. The co-hotspot analysis enables accurate identification of high-emission grids, which helps environment managers to prioritize resource allocation when designing control strategies. Our study underscores the importance of managing CO 2 and air pollutants simultaneously at the city level., 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 © 2022 Elsevier B.V. All rights reserved.)

Ethnopharmacological Relevance: Licorice has been widely used as a medicinal herb since ancient times. Licorice is also spelled as "liquorice" and it is known as "Glycyrrhizae Radix et Rhizoma" (Chinese: gan cao) in the Chinese Pharmacopoeia. Licorice root has a wide range of pharmacological effects, including adrenocortical hormone-like effects, as well as multiple pharmacological effects on the digestive system, immune system, and cardiovascular system., Aim of the Review: This review aims to comprehensively investigate the history of licorice and its medicinal and industrial applications in China and other nations, including research and application prospects related to the aerial parts of licorice., Method: An extensive review of the literature was carried out, including ancient and modern texts, doctoral and masters' theses, monographs on medicinal plants, pharmacopoeias and electronic databases, including Web of Science, Springer, CNKI, and Google Scholar., Results: The ancient and modern applications of licorice were systematically investigated. In ancient times, practitioners in China discovered the medicinal potential of licorice and used it widely. In modern times, licorice is widely used in food, medicines and supplements, tobacco, chemical applications, environmental applications, animal husbandry and other industries. The potential of the aerial portion of the plant is also gradually being researched, developed, and utilized., Conclusion: Licorice is one of the oldest and most widely used herbal medicines in the world. This article reviews its medicinal potential and application in various fields, and briefly introduces current research into its aerial parts. This review aims to highlight the importance of licorice and provide direction for its future development., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This study examined the longitudinal changes of movement behaviors and their relationships with posttraumatic stress disorder (PTSD) among university students during the coronavirus disease 2019 in China. A total of 569 university students completed online surveys twice (Time 1: between December 2020 and January 2021; Time 2: between November and December 2021). Physical activity, sedentary behavior, sleep duration and quality, as well as PTSD were self-reported. According to Canadian 24-h movement guidelines, the longitudinal shifts in each movement behavior from Time 1 to Time 2 were divided into four categories (consistently meeting the guidelines, from meeting to not meeting the guidelines, from not meeting to meeting the guidelines, and consistently not meeting the guidelines). Generalized linear mixed models were conducted using 410 valid responses (20.2 ± 1.0 years old at Time 2, 41.2% males). From Time 1 to Time 2, 22.2%, 2.0%, and 45.6% of the students consistently met the physical activity, sedentary behavior, and sleep guidelines, respectively. Compared to those who consistently met the sedentary behavior guideline, students who consistently failed to meet or changed from meeting to not meeting the guidelines had higher levels of PTSD. Students who had poor sleep quality at both time points or changed from good to bad sleep quality had higher levels of PTSD than those who maintained good sleep quality over time. Compared to those who consistently failed to meet the guideline, students who consistently met the PA guideline had higher levels of PTSD. These findings highlight the needs to improve and maintain healthy behaviors for mental health.

The COVID-19 pandemic has had a great impact on the global economy and trade, and border regions have been hit severely because of their high dependency on foreign trade. To understand better the economic impact of COVID-19 on border regions, we developed a COVID-19 economic resilience analytical framework and empirically examined 10 Chinese-Russian border cities in Northeast China. We quantitatively analyzed five dimensions of economic resilience, distinguished four types of shock, and examined the determinants of economic resilience. The results show that: (1) the COVID-19 pandemic has wide-ranging impacts in the border areas, with import-export trade and retail sales of consumer goods being the most vulnerable and sensitive to the shock. The whole economy of the border areas is in the downward stage of the resistance period; (2) from a multi-dimensional perspective, foreign trade and consumption are the most vulnerable components of the borderland economic system, while industrial resilience and income resilience have improved against the trend, showing that they have good crisis resistance; (3) borderland economic resilience is a spatially heterogeneous phenomenon, with each border city showing different characteristics; (4) economic openness, fiscal expenditure, and asset investment are the key drivers of economic resilience, and the interaction between the influencing factors presents a nonlinear and bi-factor enhancement of them. The findings shed light on how border economies can respond to COVID-19, and how they are useful in formulating policies to respond to the crisis.

China is facing dual challenges of air pollution and climate change. By using city-level data, we comprehensively assessed air quality and CO 2 emission changes from 2015 to 2019 for 335 Chinese cities. We selected important regions for air pollution control and categorized all cities into different classes according to their development levels. Our novel approach revealed new insights on different patterns of changes of PM 2.5 , O 3 , and CO 2 by region and city class. We found that PM 2.5 concentrations decreased remarkably due to mandatory city-level reduction targets, especially in the Beijing-Tianjin-Hebei (-27%) region. Nonetheless, O 3 concentrations and CO 2 emissions increased in 91% and 69% of Chinese cities, respectively. Observed CO 2 emission reductions in more developed cities were mainly due to prominent energy intensity reduction and energy structure improvement. Our study indicates a lack of synergy in air pollution control and CO 2 mitigation under current policies in China. To address both challenges holistically, we suggest setting mandatory city-level CO 2 emission reduction targets and reinforcing clean energy and energy efficiency measures., 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 © 2022 Elsevier B.V. All rights reserved.)

Background: Despite emerging recognition of the benefits of green and blue spaces on human health, evidence for their effect modifications on heat-mortality associations is limited. We aimed to investigate the effect modifications of green and blue spaces on heat-mortality associations among different age and sex groups and at different heat levels., Methods: Daily mortality and meteorological data from 2008 to 2017 in Hong Kong, China were collected. The Normalized Difference Vegetation Index and distance to coast were used as proxies for green and blue space exposure, respectively. Time-series analyses was performed using fitting generalized linear mixed models with an interaction term between heat and levels of exposure to either green or blue space. Age-, sex-, and heat level-stratified analyses were also conducted., Results: With a 1 °C increase in temperature above the 90th percentile (29.61 °C), mortality increased by 5.7% (95% confidence interval [CI]: 1.6, 10.1%), 5.4% (1.4, 9.5%), and 4.6% (0.8, 8.9%) for low, medium and high levels of green space exposure, respectively, and by 7.5% (3.9, 11.2%) and 3.5% (0.3, 6.8%) for low and high levels of blue space exposure, respectively. Significant effect modifications of green and blue spaces were not observed for the whole population or any specific age and sex group, either at a moderate heat level or a heat level (Ps > 0.05)., Conclusions: No significant effect modifications of green and blue spaces on heat-related mortality risk were observed in Hong Kong. These findings challenge the existing evidence on the prominent protective role of green and blue spaces in mitigating heat-related mortality risks., 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 © 2022 Elsevier B.V. All rights reserved.)

Background: Physicians play a unique role in scientific and clinical research, which is the cornerstone of evidence-based medical practice. In China, tertiary public hospitals link promotions and bonuses with publications. However, the weight placed on research in the clinician's evaluation process and its potential impact on clinical practice have come under controversy. Despite the heated debate about physicians' role in research, there is little empirical evidence about the relationship between physicians' publications and their clinical outcomes., Method: This paper examines the association of the quantity and quality of tertiary hospitals' attending physicians' publications and inpatient readmission rates in China. We analyzed a 20% random sample of inpatient data from the Urban Employee Basic Medical Health Insurance scheme in one of the largest cities in China from January 2018 through October 2019. We assessed the relationship between the quantity and impact factor of physicians' publications and 30-day inpatient readmission rates using logistic regression. There were 111,965 hospitalizations treated by 5794 physicians in our sample., Results: Having any first-author publications was not associated with the rate of readmission. Among internists, having clinical studies published in journals with an average impact factor of 3 or above was associated with lower readmission rates (OR = 0.849; 95% CI (0.740, 0.975)), but having basic science studies published in journals with an average impact factor of 3 or above was not associated with the rate of readmission. Among surgeons, having clinical studies published in journals with an average impact factor of 3 or above was likewise associated with lower readmission rates (OR = 0.708 (0.531, 0.946)), but having basic science studies published in journals with an average impact factor of 3 or above was associated with higher readmission rates (OR = 1.230 (1.051, 1.439)).

Urban resilience efficiency is an important indicator to explore the relationship between resource consumption and urban resilience, shedding new light on the study of urban sustainable development. Based on the panel data of 2008, 2012, and 2017, this paper makes a spatiotemporal assessment on the urban resilience efficiency of 126 cities in the Yangtze River Economic Belt (YREB) in China by applying an entropy weight-TOPSIS method and a slack-based measure (SBM) model. Combined with the analysis of a geographically weighted regression model (GWR), the influencing factors on resilience efficiency are also investigated. The results show that both the resource consumption index (RC, inputs) and the urban resilience index (UR, outputs) presented a steady upward trend, and their spatial distribution characteristics were similar, showing a gradual decrease from the eastern coastal cities to the central and western inland cities. Derived from inputs and outputs, the mean values of resilience efficiency index (RE) in three periods were 0.3149, 0.2906, and 0.1625, respectively, revealing that there had been a noticeable decline. Spatially, its spatial distribution has evolved from a relatively balanced pattern to an unbalanced one, showing a gradual decrease from west to east. The results of the GWR model analysis indicate that the total electricity consumption and area of construction land had a considerable correlation with the overall urban resilience of the YREB. Furthermore, total quantity of water supply and science and technology (S&T) expenditure continued to be the main driving factors on urban resilience of the upstream cities. The midstream regions mainly depended on the scale of construction land, and the influencing factors are relatively single. The influencing factors in the downstream areas have changed from dominance of resources and capital factors to the single dominance of resource factors, and total electricity consumption had a strong explanatory power. Based on these findings, we had put forward the overall and local regional policy implications., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aims: The Cancer Health Literacy - 30 (CHLT-30) and Cancer Health Literacy - 6 (CHLT-6) are widely used instruments to measure cancer health literacy and to identify individuals with limited cancer health literacy, respectively. This study evaluated the psychometric performance of both instruments in Chinese cancer patient population., Methods: The back-translation method was used in cross-cultural adaptation. Chinese versions, labeled as CHLT-30-Chinese and CHLT-6-Chinese, were administered to a diverse cross-sectional sample of 602 cancer patients. Of these, 30 patients retook the instruments over a 2-week interval to estimate test-retest reliability. Classical and modern psychometric methods were used to estimate the item and test properties., Results: Model fit statistics confirmed the original measurement structures of CHLT-30-Chinese (one-factor model) and CHLT-6-Chinese (latent class model with limited and adequate cancer health literacy classes) providing construct validity evidence. The CHLT-30-Chinese showed high internal consistency (Cronbach's α = 0.83; McDonald's Ω = 0.93) and 2-week test-retest reliability (r = 0.78). The CHLT-6-Chinese separated limited and adequate cancer health literacy classes well (entropy = 0.77) with the estimated prevalence rates of 19% and 81%, respectively. The CHLT-6-Chinese was highly precise in assigning cancer patients into two categories: limited and adequate cancer health literacy classes with probability of 0.95 and 0.90, respectively. Invariant measurement properties of both instruments were supported between male and female patients as well as patients with and without high school diploma., Conclusions: The findings support the psychometric properties of the CHLT-30-Chinese for measuring cancer health literacy as a continuous trait and CHLT-6-Chinese for identifying patients with limited cancer health literacy with high precision. The two tools are recommended for use in both daily practice and clinical trials., (© 2021 John Wiley & Sons Australia, Ltd.)

Objective: Childhood is a critical period for brain development. However, it remains unknown whether the behaviors in a typical 24-h day are related to children's executive function (EF). This study aimed to investigate the relationship between the 24-h movement guidelines and children's EF., Method: Children aged 7-12 years (n = 376) were studied in 2017 in China. Physical activity (PA) was accelerometer-derived, while screen time (ST) and sleep duration were self-reported. Meeting the 24-h movement guidelines was defined as: 1) ≥ 60 min/day of moderate-to-vigorous PA; 2) ≤ 2 h/day of recreational ST; 3) 9-11 h/night of sleep. EF was assessed by the Wisconsin Card Sorting Test (WCST). Number of completed categories (CC), shifting efficiency (SE), non-perseverative errors (NPE), and failure to maintain set (FMS) were used to measure four processes of EF, respectively represented global performance, cognitive flexibility, efficiency in rule discovery, and sustained attention. Generalized linear mixed models (GLMM) were completed to explore the associations of meeting the PA, ST, and sleep duration recommendations with four processes of EF., Results: Statistically significant positive associations were observed between the number of guidelines met, regarded as a continuous variable, with CC [β = 0.343 (95% confidence interval [CI]: 0.125, 0.561)] and SE [β = 4.028 (95% CI: 0.328, 7.727)], while number of guidelines met negatively related to NPE [β =  - 4.377 (95% CI:-7.952,-0.802)]. Participants not meeting the two recommendations for PA and sleep duration had lower scores in CC [β = -0.636(95% CI:-1.125,-0.147)] and SE [β = -10.610 (95% CI:-18.794,-2.425)] compared with those meeting the two, suggesting inferior global performance and worse efficiency in rule discovery. However, ST recommendation had no significant association with any processes of EF., Conclusion: Meeting more recommendations of the 24-h movement guidelines was associated with superior EF in children. Specifically, more PA and healthy sleep duration should be encouraged to promote children's EF., (© 2022. The Author(s).)

Background: China implemented a universal two-child policy in 2015. It is important to understand infants' medical utilization in the context of this policy to inform health policies and resource allocation., Methods: This study utilized a 20% random sample of administrative data from China's Urban and Rural Basic Medical Insurance (URBMI) in one of the largest southern Chinese cities from January 2015 to June 2018. Ordinary least squares models were used to estimate changes in inpatient admission rates and costs for infants between 0 and 6 months old after the implementation of China's universal two-child policy., Results: The overall inpatient admission rate was 27.2% in 2015 and 31.3% in 2017. Compared with 2015, there was an increase in inpatient admission rates for infants 1 month old or younger (coef = 0.038, 95% CI = 0.029 to 0.047, p < .001) and infants 6 months old or younger (coef = 0.041, 95% CI = 0.030 to 0.052, p < .001) in 2017. The increase was larger for male infants than for female ones. The average inpatient admission cost was 8412.3 RMB ($1320.61) (SD = 15,088.2). There was no increase in inpatient admission costs overall. The average length of hospital stay was 7.3 days, the probability of going to a tertiary hospital was 76.2%, and the share of out-of-pocket costs was 53.0% for all diseases., Conclusion: After the implementation of the universal two-child policy in China, there was a significant increase in inpatient admission rates, especially for male infants. The overall associated costs did not change, but the increase in admission rates caused additional economic burdens for families and for social health insurance. Understanding the healthcare utilization of infants in the universal two-child period can provide insight for healthcare resource allocation in a time of dramatic changes in population policy., (© 2022. The Author(s).)

This study aimed to examine the associations between physical activity (PA), sedentary behavior (SB), sleep, and the mental health of caregivers of preschool children following the COVID-19 outbreak. From 5 October to 16 December 2020, responses from 2476 respondents in China were collated through an online survey or a written questionnaire. Movement behaviors (PA, SB, screen time, and sleep), mental health (depression, anxiety, and stress), and demographic information were self-reported by the respondents. Linear mixed models were used for data analysis. Valid responses were received from 2002 caregivers (35.5 ± 4.9 years old, 76.3% females) of children between 3 and 6 years old in China (Hong Kong 3.2%, Shanghai 20.6%, Guangzhou 34.1%, Guiyang 26.7%, Xuzhou 11.3%, Xi'an 4.1%). A higher level of PA was associated with a lower score of depression, while lower SB and longer sleep duration were associated with lower scores of depression, anxiety, and stress. Meeting the Canadian 24-h movement guidelines was associated with less symptoms of depression, anxiety, and stress. Higher PA was associated with lower levels of depression, while longer sleep and lower SB were associated with better scores of depression, anxiety, and stress. Meeting the Canadian 24-h movement guidelines has been associated with better mental health during the COVID-19 pandemic. Interventions to improve mental health among caregivers should involve enhancing their overall movement behaviors., (Copyright © 2021 Elsevier Inc. All rights reserved.)

A growing body of evidence highlights the important role of gut microbiota and host metabolism, particularly for lipid metabolism, in the development and progression of alcoholic liver disease (ALD). However, the effects of fermented alcoholic beverages on gut microbiota and host lipid metabolism remain under-investigated. Moreover, the crosstalk between gut microbiota and host lipid metabolism is still unclear in experimental ALD. Baijiu is a traditional Chinese alcoholic beverage. It contains large amounts of small molecule bioactive compounds in addition to a significant amount of ethanol (EtOH). In this study, we showed that baijiu caused lower degrees of liver injury than pure EtOH as revealed by phenotypic, biochemical and histologic analyses. Furthermore, baijiu and EtOH gavage resulted in different gut microbiota structures. Specifically, the baijiu group had a significantly higher abundance of Ruminococcus , Oscillospira , Mucispirillum , Bilophila , Parabacteroides and Odoribacter and a lower abundance of Helicobacter and Prevotella than that of the EtOH group. Using a targeted metabolomics approach, we also observed a greater than 19% increase of total hepatic free fatty acids (FFAs) after baijiu feeding and a 33% increase of hepatic FFAs after EtOH feeding. Baijiu feeding significantly increased total hepatic mono-unsaturated FAs (MUFAs). In contrast, polyunsaturated fatty acids (PUFAs), MUFAs and saturated FAs were significantly increased by EtOH feeding. Finally, Spearman's rank correlation showed that the increased levels of FFAs (mainly C20 and C22 unsaturated FAs) significantly correlated with key different gut microbiota, including a positive correlation with Desulfovibrio , Maihella , Helicobacter , Acholeplasma , Parasutterella , Prevotella , AF12 and Alistipes , and a negative correlation with Dorea , Olsenella , Adlercreutzia and Akkermansia . Our results suggest that compounds in baijiu attenuated the development of ALD and thus provided supporting evidence that the host-gut microbiota metabolic interactions play an important role in the development of ALD.

Background: UV filters are emerging contaminants with endocrine disrupting effects, but little is known about their health effects, especially for children., Objective: To assess the association between multiple organic UV filters exposure and adiposity measures and by gender in peripubertal children., Methods: This prospective follow-up study included 327 children aged 7-15 years old. Urinary organic UV filters including benzophenone derivatives (BP-2, BP-3), octyl dimethyl para-aminobenzoic acid (OD-PABA), ethylhexyl methoxycinnamate (EHMC) and its metabolite (4-MCA and 4'-MAP) were quantified. Six adiposity biometrics including height, weight, waist and hip circumferences, and triceps and subscapular skinfold thickness were measured with 1.5-year duration. The Bayesian kernel machine regression method was used to estimate the associations of UV filters mixture with adiposity measurements, and longitudinal analyses were then considered to further evaluate the associations between individual UV filters and trajectories of growth development using linear mixed models or generalized linear mixed models., Results: Exposure to mixture of UV filters was negatively associated with most adiposity measurements, with a reduction of 1.399 kg/m 2 (95% CI: -2.246 to -0.551 kg/m 2 ) in BMI, 0.674 (95% CI: -1.045 to -0.304) in BMI z-score, 0.033 BF% (95% CI: -0.053 to -0.013), and 2.301 mm (95% CI: -3.823 to -0.78) in subscapular skinfold thickness at baseline, comparing the 75th percentile to the 25th level of UV filters mixture exposure. Consistent associations were found at follow-up. Both baseline and follow-up results suggested that EHMC was identified as the most important contributor to lower adiposity measurements, which was also confirmed by linear mixed models in longitudinal analyses. No significant effects were found in girls., Conclusion: This study found that childhood organic UV filters exposure was negatively associated with adiposity measures in peripubertal boys, but not girls., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Older adult quality of life (QoL) is facing huge challenges during the COVID-19 pandemic. New normal lifestyle behaviors, including getting adequate physical activity (PA), consuming sufficient fruits and vegetables (FV) and enacting individual preventive behaviors (frequent hand washing, facemask wearing, and social distancing), as a significant determinant for QoL, have not been adequately addressed in older adults during the pandemic. This study aimed to investigate the characteristics of QoL in Chinese older adults after the first wave of the COVID-19 pandemic in Hubei China. The objective of the study was to examine any associations of lifestyle behaviors with QoL, and to identify the moderating role of socioeconomic indicators in the associations identified. Methods: A cross-sectional study was conducted in Hubei, China, from June 15, 2020, to July 10, 2020. Five hundred sixteen older adults completed an online survey (mean age = 67.6 ± 6.6; 57.9% women). The questionnaire consisted of demographic information, covariates (chronic diseases and infected cases of acquaintances), lifestyle behaviors [PA stage, FV intake (FVI) stage and three preventive behaviors], and QoL. T -tests, ANOVA tests, multiple linear regression models with simple slope analyses were used to test the hypotheses. Results: QoL significantly differed in relation to economic situation, chronic diseases, marital status, education, living situation, age group, and professional status. Participants' economic situation ( β average vs. below average = 0.17, p < 0.01; β above average vs. below average = 0.15, p < 0.01), chronic diseases ( β yes vs. no = 0.19, p < 0.001), FVI stage ( β = 0.21, p < 0.001), and preventive behaviors ( β = 0.10, p < 0.05) indicated a significant association with QoL. Education level and economic situation significantly interacted with preventive behaviors on QoL, respectively ( β preventive behaviors × educational level = -1.3, p < 0.01; β preventive behaviors × economic situation = -0.97, p < 0.05). Conclusions: Findings emphasize the importance of enhancing FVI and preventive behaviors on QoL improvement in older adults during the COVID-19 pandemic. Older adults who are in a lower economic situation with lower education levels should be given priority when implementing interventions to improve preventive behaviors and QoL in older adults., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Duan, Peiris, Yang, Liang, Baker, Hu and Shang.)

A great deal of attention has been directed to the toxicity, enrichment, and accumulation of urban river sediment pollution. To understand the spatial-temporal variation, ecological risk and source of nutrients, and heavy metals in sediments from the Weihe River, the concentrations of total nitrogen (TN), total phosphorus (TP), organic matter (OM), and 10 heavy metals (Cd, Sb, As, Co, Cu, Pb, Ni, Cr, Zn, and Mn) in sediments at 14 sampling sites along the river were investigated. The results showed that nutrients and heavy metals had an interannual decreasing trend, and that the high-value regions were concentrated in urban locations within the study area. Ecological risk assessment results showed that TN was between the security level (no toxic effect) and the lowest level (tolerable for organisms), TP was at the lowest level, and OM was within the security level, all mainly from external sources. The geoaccumulation index (I geo ) and enrichment factor (EF) of 10 heavy metals were all within the unpolluted level, while the pollution load index (PLI) of 12 sampling sites had reached the moderate pollution level. The results of Pearson correlation, principal component analysis, and cluster analysis showed that heavy metals originated mainly from industrial and domestic sources, geochemical environments, and agricultural activities, indicating that heavy metals in the Weihe River sediments were influenced significantly by anthropogenic activities. The results are expected to provide a scientific basis for the development and utilization of the Weihe River water resources., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

To prevent the spread of the COVID-19 epidemic, the Chinese megacity Wuhan has taken emergent lockdown measures starting on January 23, 2020. This provided a natural experiment to investigate the response of air quality to such emission reductions. Here, we decoupled the influence of meteorological and non-meteorological factors on main air pollutants using generalized additive models (GAMs), driven by data from the China National Environmental Monitoring Center (CNEMC) network. During the lockdown period (Jan. 23 - Apr. 8, 2020), PM 2.5 , PM 10 , NO 2 , SO 2 , and CO concentrations decreased significantly by 45 %, 49 %, 56 %, 39 %, and 18 % compared with the corresponding period in 2015-2019, with contributions by S(meteos) of 15 %, 17 %, 13 %, 10 %, and 6 %. This indicates an emission reduction of NO x at least 43 %. However, O 3 increased by 43 % with a contribution by S(meteos) of 6 %. In spite of the reduced volatile organic compound (VOC) emissions by 30 % during the strict lockdown period (Jan. 23 - Feb. 14, 2020), which likely reduced the production of O 3 , O 3 concentrations increased due to a weakening of the titration effect of NO. Our results suggest that conventional emission reduction (NO x reduction only) measures may not be sufficient to reduce (or even lead to an increase of) surface O 3 concentrations, even if reaching the limit, and VOC-specific measures should also be taken., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The catechol-O-methyltransferase (COMT) is a candidate gene to provide promising evidence of psychiatric disorders, but there is a knowledge gap between the genetic factor and multiple physical activity-related injuries (PARIs). The aim of this study was to explore the contribution of COMT to the risk of PARIs among university students in the Chinese Han population. We can further search for the intrinsic risk factors for the occurrence of multiple physical activity injuries and provide a scientific basis for early screening and precise intervention for the high-risk group of college students with multiple PARIs. A 1:1 matched case-control study of 61 PARIs cases and 61 healthy controls were carried out. DNA samples of the participants were isolated from saliva and genotyped on eight SNPs of the COMT gene (rs9265, rs4680, rs6269, rs4818, rs4633, rs165655, rs165656, and rs165722) using the MALDI-TOF MS method. We found that rs6269 and rs4818 were significantly associated with PARIs, and rs6269-GG and rs4818-GG contributed to the reduced risk of PARIs. Further haplotype analysis showed a four-marker C-G-C-G haplotype (rs165722-rs6269-rs4633-rs4818) acted with a protective role in the development of PARIs ( p = 0.037; OR: 0.474, 95% CI: 0.269 to 0.834). However, the interactions between club membership and rs6269 or rs4818 would significantly increase the risk of PARIs (both p < 0.001, OR: 5.121 and 4.977, respectively). This is the first study to find the contribution of COMT to PARIs occurrence, suggesting that the COMT polymorphisms and the gene-environment interactions may alter the risk of PARIs.

Ubiquitous human exposure to organophosphorus tri-esters (tri-OPEs) has been reported worldwide. Previous studies investigated the feasibility of using house dust and wristbands to assess human OPE exposure. We hypothesized that these two approaches could differ in relative effectiveness in the characterization of children and adult exposure. In the participants recruited from Guangzhou, South China, urinary levels of major OPE metabolites, including diphenyl phosphate (DPHP) and bis(butoxyethyl) phosphate (BBOEP), were significantly higher in children than their mothers (median 6.6 versus 3.7 ng/mL and 0.11 versus 0.06 ng/mL, respectively). The associations of dust or wristband-associated OPEs with urinary metabolites exhibited chemical-specific patterns, which also differed between children and mothers. Significant and marginally significant associations were determined between dust concentrations of triphenyl phosphate (TPHP), tris(2-butoxyethyl) phosphate (TBOEP), trimethylphenyl phosphate (TMPP), or tris(1-chloro-2-propyl) phosphate (TCIPP) and their metabolites in children urine and between dust tris(1,3-dichloroisopropyl) phosphate (TDCIPP), TPHP or TMPP and urinary metabolites in mothers. By contrast, wristbands exhibited better efficiency of predicting internal exposure to TDCIPP. While both house dust and wristbands exhibited the potential as a convenient approach for assessing long-term OPE exposure, their feasibility requires better investigations via larger-scale studies and standardized sampling protocols., (Copyright © 2021. Published by Elsevier Ltd.)

Water, sediment and biota (two fish and one shrimp species) samples were collected from rivers, ponds, mudflat and estuaries within the Mai Po Ramsar site in Hong Kong, China, to determine the concentrations of heavy metals/loid (HMs): cadmium (Cd), copper (Cu), mercury (Hg), lead (Pb), zinc (Zn), and arsenic (As). The mutagenicity and toxicity of water and sediment samples were evaluated using Ames test and Microtox® bioassay, respectively. Ecological risk assessments on water birds were also conducted based on HM concentrations in biota, sediment and water samples. In general, results showed that downstream of Shan Pui River and Ng Tung River had relatively higher HM concentrations (e.g. Cu: 0.992-9.49 μg/L; As: 0.342-5.83 μg/L) when compared with estuaries (Cu: 0.400-3.69 μg/L; As: 0.220-0.931 μg/L) and ponds (Cu: 0.0402-2.41 μg/L; As: 0.0501-2.10 μg/L), except Hg and Cd. On the other hand, sediment samples collected from Ng Tung River showed mutagenicity on Salmonella typhimurium tester strain TA100, while the mudflat samples had mutagenicity on tester strain TA98 used in the Ames tests. Microtox® bioassay indicated that only sediment of Ng Tung River showed acute toxicity with a 15 min half maximal effective concentration (EC 50 ) value of 30.5%. Results of ecological risk assessments showed that grey heron (Ardea cinerea), which feeds on fish and shrimps at Shan Pui River and ponds were not at risk. However, common sandpiper (Actitis hypoleucos), which feeds at ponds were subjected to a potential health risk due to its behavior of seeking food from the sediments, especially this bird species has a small body size. This indicates juvenile birds of other species may also be affected. Remediation should be implemented to relief the potential risk of Cu and Pb, to these water birds in the Mai Po Ramsar site., 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.)

Introduction: Saliva collection is a non-invasive test and is convenient. 1,5-anhydroglucitol (1,5-AG) is a new indicator reflecting short-term blood glucose levels. This study aimed to explore the relationship between saliva 1,5-AG and insulin secretion function and insulin sensitivity., Research Design and Methods: Adult patients with type 2 diabetes who were hospitalized were enrolled. Based on blood glucose and C-peptide, homeostasis model assessment 2 for β cell secretion function, C-peptidogenic index (CGI), △2-hour C-peptide (2hCP)/△2-hour postprandial glucose (2hPG), ratio of 0-30 min area under the curve for C-peptide and area under the curve for glucose (AUC CP30 /AUC PG30 ), and AUC 2hCP /AUC 2hPG were calculated to evaluate insulin secretion function, while indicators such as homeostasis model assessment 2 for insulin resistance were used to assess insulin sensitivity., Results: We included 284 subjects (178 men and 106 women) with type 2 diabetes aged 20-70 years. The saliva 1,5-AG level was 0.133 (0.089-0.204) µg/mL. Spearman's correlation analysis revealed a significantly negative correlation between saliva 1,5-AG and 0, 30, and 120 min blood glucose, glycated hemoglobin A 1c , and glycated albumin (all p<0.05), and a significantly positive association between saliva 1,5-AG and CGI ( r =0.171, p=0.004) and AUC CP30 /AUC PG30 ( r =0.174, p=0.003). The above correlations still existed after adjusting for age, sex, body mass index, and diabetes duration. In multiple linear regression, saliva 1,5-AG was an independent factor of CGI (standardized β =0.135, p=0.015) and AUC CP30 /AUC PG30 (standardized β =0.110, p=0.020)., Conclusions: Saliva 1,5-AG was related to CGI and AUC CP30 /AUC PG30 in patients with type 2 diabetes., Trial Registration Number: ChiCTR-SOC-17011356., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) assesses two emotion regulation (ER) strategies: cognitive reappraisal and expressive suppression. Researchers have used the ERQ in cross-national studies, such as with participants in Hong Kong. There is inconsistency in psychometric equivalence data for the ERQ in Chinese among adults, and prior research in Hong Kong contradicted the ERQ's original factor structure (Matsumoto et al., 2008). The present study examined the factor structure, reliability and validity of a translated Traditional Chinese-ERQ and the English-ERQ with Hong Kong college students. Results revealed that both versions replicated the original two-factor structure of the ERQ (Gross & John, 2003). Evidence of the measure's convergent, discriminant and predictive validity was obtained as well. Implications for cross-cultural scale validation particularly with Hong Kong Chinese students are discussed., (© 2020 International Union of Psychological Science.)

Background: The physical activity-environment relationship has been infrequently investigated in Chinese children. Reliable and valid environmental measures specific to the age group and the local context are crucial for better understanding this relationship. The purposes of this study were to adapt the Neighborhood Environment Walkability Scale for youth (NEWS-Y) for Chinese children (termed NEWS-CC), and to examine the reliability and factorial validity of the NEWS-CC., Methods: The development of the NEWS-CC involved the translation of the NEWS-Y to Chinese and the addition of nine new items capturing Hong Kong specific environmental attributes which were generated in our previous study. A total of 953 Hong Kong children aged 9-14 years volunteered to complete the NEWS-CC twice with 7-14 days apart. Confirmatory factor analysis (CFA) was performed to examine the factorial validity of the NEWS-CC. Test-retest reliability of subscales and individual items in the NEWS-CC was examined by intraclass correlation coefficients (ICCs)., Results: The CFA identified a 7-factor measurement model for the NEWS-CC which fitted the data well, with an additional "pollution" factor not included in the original NEWS-Y. The final NEWS-CC consisted of 67 items in 10 subscales. The test-retest reliability of subscales (range of ICC = 0.47-0.86) and individual items (range of ICC = 0.41-0.79) in the final NEWS-CC was moderate to good., Conclusion: The results of this study support the psychometric properties of the NEWS-CC. The NEWS-CC can be used to assess physical activity-related neighborhood environment among children in Hong Kong, as well as cities that share similar urban forms with Hong Kong.

The identification of genetic risk subgroups of T-cell acute lymphoblastic leukemia (T-ALL) may provide evidence for risk stratification and individualized treatment. We investigated the characteristics and prognostic value of tumor suppressor gene CDKN2A deletions in 101 patients with T-ALL. The CDKN2A deletion was present in 23% (23/101) of T-ALL by fluorescence in situ hybridization (FISH). The most common type of CDKN2A deletion was homozygous deletion (70%, 16/23). A lower frequency of CDKN2A deletion was found in patients with early T-cell precursor (ETP) ALL than in patients with non-ETP-ALL (10.4% vs 34.0%; P = .008). Deletion of CDKN2A was significantly associated with younger age (P = .001), higher white blood cell (WBC) count (P < .001) and higher lactate dehydrogenase (LDH) level (P = .002). Patients with CDKN2A deletion had lower 2-year overall survival (OS) and event-free survival (EFS) rates than patients without CDKN2A deletion (2-year OS: 18.6% ± 8.9% vs 47.4% ± 6.2%, P = .032; EFS: 16.4 ± 8.3 vs 38.6 ± 5.9%, P = .022). In multivariable analysis, CDKN2A deletion was an independent adverse prognostic factor for OS (P = .016). In conclusion, adult T-ALL patients with CDKN2A deletion had a poor prognosis, and these patients might benefit from intensive chemotherapy or allogeneic hematopoietic stem-cell transplantation., (© 2020 Wiley Periodicals LLC.)

Background: Little is known about the progression of obesity from childhood to adolescence. This study aimed to longitudinally examine the obesity status in a cohort of children across their childhood and adolescence, and to identify the factors associated with persistent obesity., Methods: The study used data from School Physical Fitness Award Scheme (SPFAS), a population-based programme in Hong Kong primary and secondary schools. Students were included if they participated in the SPFAS in both 2014 (Primary 1 and 2) and 2018 (Primary 5 and 6). Their anthropometric and physical fitness parameters were analyzed., Results: A total of 18,863 students were included. The baseline prevalence of obesity was 5.7 %. After 4 years, the prevalence increased to 6.7 %. Among those with obesity at baseline, 35.3 % remained obese after 4 years. The addition of baseline physical fitness level did not improve the prediction for persistent obesity., Conclusions: One-third of obese students in junior primary school remained to be obese into adolescence. Their baseline physical fitness level did not improve the predictive value for future obesity. Further studies should investigate the prognostic factors that may influence the natural course of childhood obesity.

It is unknown whether giving birth via caesarean section (c-section) is a modifier for the association between air pollution and asthma. From 2012 to 2013, 59,754 children between the ages of 2 and 17 were randomly selected from 94 middle schools, elementary schools and kindergartens in seven Chinese cities for a cross-sectional study. The children's parents or guardians completed questionnaires, from which data on asthma as well as asthma-related symptoms were obtained. Participants' exposure to particles with an aerodynamic diameter ≤1.0 μm (PM 1 ), ≤2.5 μm (PM 2.5 ), and ≤10 μm (PM 10 ) and exposure to nitrogen dioxide (NO 2 ) were estimated using random forest models. We used mixed effects logistic regression models and added an interaction term between mode of delivery and ambient air pollution into the model to estimate effect modification from c-sections after appropriate adjustments for potential confounding variables. Among children delivered by c-section, the adjusted ORs for asthma and its symptoms per interquartile range (IQR) increase of PM 1 , PM 2.5 , PM 10 and NO 2 (1.20 95% CI: 1.07-1.34 to 2.04 95% CI: 1.87-2.24) were significantly higher than those of children delivered vaginally (1.05 95% CI: 0.92-1.19 to 1.33 95%CI: 1.21-1.47). The interactions between c-sections and ambient air pollution were statistically significant for all studied respiratory disorders, except current wheeze. Delivery via c-section may increase the risks of air pollution on asthma and its symptoms in Chinese children., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The struggles of China's gay sex workers-men who sell sex to other men-illustrate how the multi-layered stigma that they experience acts as a form of necropolitical power and an instrument of the state's discrimination against gay sex workers who are living with HIV. One unintended side effect of this state power is the subsequent reluctance by medical professionals to care for gay sex workers who are living with HIV, and discrimination from Chinese government officers. Data obtained from 28 gay sex workers who are living with HIV provide evidence that the necropower of stigma is routinely exercised upon the bodies of gay sex workers. This article examines how the necropolitics of social death and state-sanctioned stigma are manifested throughout China's health system, discouraging gay sex workers from receiving health care. This process uses biopolitical surveillance measures as most of gay sex workers come from rural China and do not enjoy urban hukou , thus are excluded from the medical health care system in urban China. Public health priorities demand that the cultured scripts of gendered Chinese citizenship must reevaluate the marking of the body of gay sex workers as a non-entity, a non-human and socially "dead body."

Observations of coral reef losses to climate change far exceed our understanding of historical degradation before anthropogenic warming. This is a critical gap to fill as conservation efforts simultaneously work to reverse climate change while restoring coral reef diversity and function. Here, we focused on southern China's Greater Bay Area, where coral communities persist despite centuries of coral mining, fishing, dredging, development, and pollution. We compared subfossil assemblages with modern-day communities and revealed a 40% decrease in generic diversity, concomitant to a shift from competitive to stress-tolerant species dominance since the mid-Holocene. Regions with characteristically poor water quality-high chl- a , dissolved inorganic nitrogen, and turbidity-had lower contemporary diversity and the greatest community composition shift observed in the past, driven by the near extirpation of Acropora These observations highlight the urgent need to mitigate local stressors from development in concert with curbing greenhouse gas emissions., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

Background: UV filters, widely used in personal care and industrial products, are being found in the environment and, in humans where with limited understanding on their potential health effects, especially during puberty., Objectives: To examine the association between UV filter exposure and pubertal development in a prospective follow-up study., Methods: This study included 521 elementary and high school students from a suburban area of Shanghai. The initial study was done in October to November 2011; the follow-up study in April to May 2013. Twelve urinary organic UV filters were quantified, and the pubertal development was assessed at each study period by trained physicians using Tanner staging. We used (ordered) logistic regression model and multilevel mixed-effect (ordered) logistic regression model to assess cross-sectional and longitudinal effects between urinary concentration of five major UV filters and pubertal development of stages, onset and pace., Results: Ethylhexyl methoxycinnamate (EHMC) and its metabolite 4'-methoxyacetophenone (4'-MAP), two benzophenone derivatives (BP-2, BP-3) and Ethylhexyl dimethyl PABA (OD-PABA) were the most extensively detected UV filters in urine with geometric means (95% CI) in 2010 and 2012 as 1.77 (1.599, 1.956) and 2.28 (1.985, 2.622) ng/mL for EHMC; 4.55 (4.219, 4.907) and 5.26 (4.783, 5.775) ng/mL for 4'-MAP; 4.38 (4.011, 4.774) and 5.74 (5.023, 6.562) ng/mL for BP-2; 0.83 (0.760, 0.903) and 1.09 (0.967, 1.220) ng/mL for BP-3; 5.37 (4.949, 5.820) and 5.80 (5.193, 6.486) pg/mL for OD-PABA. Significant trend P-values (P < 0.05) include: EHMC and its metabolite were negatively correlated with stages of testicular volume and genital development; BP-3 was also negatively correlated with stages of testicular volume in boys, while OD-PABA positively correlated with stages of pubic hair and breast development in girls. Also, EHMC was associated with later pubertal onset of pubic hair and testicular volumes in boys, while OD-PABA correlated with earlier pubertal onset of breast development in girls. OD-PABA also significantly speeded up the progression of pubic hair and breast development in girls., Discussion: UV filters were extensively detected. Exposure to EHMC and BP-3 was significantly associated with later pubertal development in boys, and OD-PABA was associated with earlier pubertal development in girls. It demonstrates that the UV filters so widely used in personal care products and widely detected in environments are finding their way back into people where they are distorting endocrine function of adolescents., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)