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The COVID-19 pandemic posed significant disruptions in traditional educational policies and practices worldwide. The study adopted an equity, diversity, and inclusion lens to investigate the impact of the pandemic on international students in a Canadian university. The findings from data analysis identified challenges and supports for international students in five areas: academic, financial, health and well-being, socialization, and housing and accommodation. There were several gaps between international students' academic and social needs during the pandemic and the institutional support. While the university prioritized supports in the academic domain, international students identified social challenges as more significant during the pandemic. The gap was also evident in communicating institutional support to students, as some students were not aware of the spectrum of institutional services. Finally, there was a need for more targeted support for international students. The pandemic called for more fundamental and comprehensive actions to support the diverse student population.

This study provides an empirical investigation into the lives of kindergarten-aged left-behind children (LBC) who could not migrate with their parents in rural China. Two research questions are answered as follows: (1) What are the characteristics of the LBC in kindergarten and at home? and (2) How does family cultural capital influence the LBC's behaviors in kindergarten and at home? The study employs Bourdieu's concept of cultural capital, with a qualitative case study approach based on interpretivism being adopted. It was found that the LBC present different characteristics in kindergarten and at home and that their particular form of family cultural capital/environment is not supportive of their school-based development in China. The data on the LBC in the study provide insight into practices for policymakers and academics.

English has assumed a new role in international communication in recent decades, that is, as a Lingua Franca (ELF) among speakers with different first languages. This study attempts to investigate and analyze Chinese university students' perception and production of paired English fricatives from the perspective of ELF. By using a listening discrimination task and a reading task, respectively, the study examined how thirty two non-English major freshmen from a key university in Mainland China perceived and produced English fricative consonants. It was found that the participants had extreme difficulty distinguishing between the two sounds in three pairs of consonants in perception, namely, /ð-z/, /v-w/, and /?-s/. In terms of production, the participants tended to replace the English fricative sounds, especially /ð/, /?/, /v/, /?/, with various substitutes. These results indicate that Chinese students often have more difficulties with certain fricatives than with others. In addition, they seem to have particular problems with voiced fricatives. Therefore, it is suggested that priorities should be given to those that impede mutual intelligibility in international communication, namely, to those that fall into the Lingua Franca Core (LFC).

Background: The diagnosis of tuberculous pleurisy (TP) presents a significant challenge due to the low bacterial load in pleural effusion (PE) samples. Cell-free Mycobacterium tuberculosis DNA (cf-TB) in PE samples is considered an optimal biomarker for diagnosing TP. This study aimed to evaluate the applicability of cf-TB testing across diverse research sites with a relatively large sample size. Methods: Patients suspected of TP and presenting with clinical symptoms and radiological evidence of PE were consecutively enrolled by treating physicians from 11 research sites across 6 provinces in China between April 2020 and August 2022. Following centrifugation, sediments obtained from PE were used for Xpert MTB/RIF (Xpert) and mycobacterial culture, while the supernatants were subjected to cf-TB testing. This study employed a composite reference standard to definite TP, which was characterized by any positive result for Mycobacterium tuberculosis (MTB) through either PE culture, PE Xpert, or pleural biopsy. Results: A total of 1412 participants underwent screening, and 1344 (95.2%) were subsequently enrolled in this study. Data from 1241 (92.3%) participants were included, comprising 284 with definite TP, 677 with clinically diagnosed TP, and 280 without TP. The sensitivity of cf-TB testing in definite TP was 73.6% (95% CI 68.2–78.4), significantly higher than both Xpert (40.8%, 95% CI 35.3–46.7, P < 0.001) and mycobacterial culture (54.2%, 95% CI 48.4–59.9, P < 0.001). When clinically diagnosed TP was incorporated into the composite reference standard for sensitivity analysis, cf-TB testing showed a sensitivity of 46.8% (450/961, 95% CI 43.7–50.0), significantly higher than both Xpert (116/961, 12.1%, 95% CI 10.2–14.3, P < 0.001) and mycobacterial culture (154/961, 16.0%, 95% CI 13.8–18.5, P < 0.001). The specificities of cf-TB testing, Xpert, and mycobacterial culture were all 100.0%. Conclusions: The performance of cf-TB testing is significantly superior to that of Xpert and mycobacterial culture methods, indicating that it can be considered as the primary diagnostic approach for improving TP detection. Trial registration The trial was registered on Chictr.org.cn (ChiCTR2000031680, https://www.chictr.org.cn/showproj.html?proj=49316). [ABSTRACT FROM AUTHOR]

China's college entrance examination reforms necessitate a new view of adolescent career development along with suitable assessment instruments for career intervention with secondary school students. We conducted two studies to address this need. The first study examined the evidence for the validity and reliability of the Student Career Construction Inventory (SCCI). The results of the Confirmatory Factor Analysis (CFA) supported the four-factor structure of the SCCI. The findings suggest that the SCCI is an effective measure of career-construction behaviors among Chinese secondary school students. The second study evaluated the applicability of the career construction model of adaptation (CCMA). The model was empirically tested using the validated SCCI. The results of the serial mediation analysis confirmed that adaptive readiness indirectly influences adaptability resources, adapting responses, and adaptation results in the CCMA model. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine factors associated with career preparation of high school students in four countries: China, Japan, South Korea, and the United States. The human bioecological theory was used as a framework to examine personal, process, and context factors associated with career preparation of the adolescents. Data were from a cross-national sample of more than 5,000 students in Grades 10 to 12. Results indicate that career planning and planning to attend a university after high school are distinct aspects of career preparation. Whereas process variables including interactions with parents about career planning and thinking about the future are related to the two aspects of career preparation across the four countries, other person and context predictors show country differences.

Young adults are at high risk of experiencing economic abuse—a form of intimate partner violence (IPV)—and Chinese young adults in non-marital cohabitation are especially vulnerable. To reduce economic abuse, an important question to answer is: What factors are associated with economic abuse? After controlling for constructs (e.g., demographic information and other types of IPV) that were linked to economic abuse, we investigated how financial behaviors (i.e., individuals' money management capability) were associated with power (im)balance (i.e., whether individuals shared equal influence with the romantic partner) and, in turn, economic abuse among non-marital cohabitating Chinese young adults. We also investigated whether associations among financial behaviors, power (im)balance, and economic abuse varied across young adults' gender and SES. We used a Qualtrics survey to collect data from 445 non-marital cohabitating Chinese young adults (53.3% male vs. 46.7% female; 22.7% lower socioeconomic status [SES] vs. 77.3% higher-SES). A structural equation model was conducted to test the associations of research interests. We found that money management capability (e.g., spending within budget and tracking expenses) is associated with balanced power—the individual sharing equal influence with the partner in the decision-making process—and, in turn, less experience of being economically abused. These associations were statistically equivalent across gender and SES. Collectively, our findings suggested that promoting money management capability be a timely and new avenue for reducing economic abuse among Chinese young adults in non-marital cohabitation, possibly because this population faces common and severe economic abuse but generally lacks the opportunity to learn money management. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyze the existing problems of quality education of specialization of international trade in current colleges and universities of China, and then propose several pieces of corresponding suggestion on educational reform. According to the characteristics of college and university education, we shall emphasize on the importance of quality education. Finally, we bring forward a series of countermeasures and proposals on the aspects of lecture mode, bilingual teaching, and training practical operation ability on instruction of specialization of international trade.

To analyze the relevant research publications on infectious disease nursing in China to understand the current research status of infectious disease in nursing. Methods: Retrieve relevant literature on infectious disease in nursing from the establishment of the Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), VIP Database, and Wanfang Database until May 10, 2021. Conduct bibliometric analysis using CiteSpace software. Key words were analyzed using cluster analysis. Results: A total of 4693 relevant literature on infectious disease research in nursing care were included in this study. The overall number of publications on infectious disease research in nursing showed an increasing trend, with a peak in 2010. There were 324 papers funded by scientific research funds, mainly from provincial-level fund projects. The core journal with the most published articles was Nursing Research. The research on infectious disease in nursing mainly focused on various aspects of infectious disease in nursing and infection control. CiteSpace cluster analysis of keywords showed that a total of six clusters were formed: infectious diseases, infectious disease care, health education, mental health, infectious disease nurses, and etiology. After 2015, high-mutation keywords included "quality nursing" and "infection control". Conclusion: Chinese research on infectious disease research in nursing closely follows clinical reality and has developed rapidly. Currently, research focuses on infectious disease research in nursing and infection control. Future research trends will further broaden the depth and breadth of the research, enhance research on infection control and quality nursing, and improve the breadth and depth of the research. [ABSTRACT FROM AUTHOR]

Objectives: To determine the relationship between occupational noise, and obesity and body mass index (BMI) changes. Methods: Baseline data were collected from participants (n = 1264) who were followed for 6 years in a retrospective study. The noise exposure level (LAeq,8h) was determined by equivalent continuous weighted sound pressure levels using the fixed-point surveillance method for noise monitoring. The cumulative noise exposure (CNE) level was determined using the equal energy formula, which is based on exposure history and level. Results: The incidence of obesity at low (RR = 2.364, 95% CI 1.123–4.739]), medium (RR = 3.921, 95% CI 1.946–7.347]), high (RR = 5.242, 95% CI 2.642–9.208]), and severe noise levels (RR = 9.322, 95% CI 5.341–14.428]) was higher risk than the LAeq,8h control level. The risk of obesity among participants exposed to low (RR = 2.957, 95% CI 1.441–6.068]) and high cumulative noise levels (RR = 7.226, 95% CI 3.623–14.415]) was greater than the CNE control level. For every 1 dB(A) increase in LAeq,8h, the BMI increased by 0.063 kg/m2 (95% CI 0.055–0.071], SE = 0.004). For every 1 dB(A) increase in the CNE, the BMI increased by 0.102 kg/m2 (95% CI 0.090–0.113], SE = 0.006). Conclusions: Occupational noise is related to the incidence of obesity. The occupational noise level and occupational noise cumulative level were shown to be positively correlated with an increase in BMI. [ABSTRACT FROM AUTHOR]

This study explores determinants of attitudes toward gender inequality among Chinese people using five waves of the Chinese General Social Survey (CGSS) and East Asian Social Survey (EASS, 2016). The study uses five survey questions regarding the relative roles of men and women in the family and workplace to measure gender attitudes. Utilizing the pooled data, the study finds temporal changes of attitude: women are expected to be more responsible for paid jobs than before while their job security is not given enough support; meanwhile, women's share in housework is not anticipated to be reduced. The results suggest that the Chinese attitude toward women's roles is stuck between the modern and old eras. Education is found to be the most crucial determinant of attitude. Education is positively correlated with attitudes supporting women regarding gender inequality. In addition, if the wife has a higher education than the husband, the respondent tends to have an attitude toward gender equality. Furthermore, a large part of the urban-rural difference in attitude can be explained by the urban-rural difference in education. These findings have a straightforward policy implication: to reduce the negative attitude toward gender inequality, education for women and rural regions needs to be promoted. Additionally, by combining the Chinese General Social Survey 2017 and the East Asian Social Survey 2016, this study finds that an individual's patrilineal values conflict with the attitude toward gender equality, suggesting that traditional culture is a potential root of gender inequality. [ABSTRACT FROM AUTHOR]

Background: There are a variety of determinants that are key to functional disability of older adults. However, little is known regarding the relationship between cognitive frailty and disability among older people. The aims of this study were to examine the associations between cognitive frailty and its six components with instrumental activities of daily living (IADL) functioning in community-dwelling older adults. Methods: A total of 313 community-dwelling older adults (aged ≥ 65 years) were recruited from eight community centers in central China. Cognitive frailty was operationalized using the Mini-Mental State Examination for the evaluation of cognitive status and the Fried criteria for the evaluation of physical frailty. The outcome was functional disability assessed by the IADL scale. The association between cognitive frailty, as well as its components, and IADL limitations was identified by conducting binary logistic regression analysis. Results: The prevalence of cognitive frailty was 8.9% in this study. The results showed that cognitive frailty (OR = 22.86) and frailty without cognitive impairment (OR = 8.15) were associated with IADL limitations. Subdimensions of cognitive frailty, exhaustion, weakness, low physical activity and cognitive impairment components were independently associated with IADL limitations. Conclusion: Cognitive frailty was associated with a higher prevalence of disability. Interventions for improving cognitive frailty should be developed to prevent IADL disability among community-dwelling older adults in China. [ABSTRACT FROM AUTHOR]

The aim of this study was to test the gender invariance of the Chinese version of the Achievement Goal Questionnaire (AGQ-C) utilizing a sample of 1,115 Chinese university students. Multi-group confirmatory factor analysis supported the configural, metric, and scalar invariance of the AGQ-C across genders. Analyses also revealed that the latent factor means were different in male and female students.

Background. Vigilance and executive functions are integral to nursing practice. Prolonged working hours are associated with heightened fatigue and increased nursing errors. However, the impact of work duration on the vigilance and executive function of ICU nurses remains unexplored. Objective. This study aims to elucidate the association between ICU nurses' working hours, vigilance, and executive function. Design. A cross-sectional study. Setting. Intensive care medicine department of a tertiary hospital in Zhengzhou, China. Participants. A total of 51 registered nurses who participated in 12 h shifts in the ICU completed the survey. Methods. E-prime software was employed to develop four test tasks to measure the vigilance and executive functioning of ICU nurses. The test was performed before the start of the shift and after 4, 8, and 12 h. Results. The analysis revealed no statistically significant differences in the response time of vigilance for ICU nurses across shifts (p = 0.503) or working hours (p = 0.078). However, a significant difference existed in lapses across working hours (p = 0.005), significantly increasing after 8 and 12 h. The analysis indicated a significant difference in Flanker effect size across different working hours (p = 0.035). The analysis revealed no significant differences in the switch cost (p = 0.200) or response accuracy (p = 0.479) of the task switching across working hours. The response accuracy for the 2-back task differed significantly (p = 0.003) across working hours. Conclusion. Limited evidence demonstrated that vigilance and specific aspects of executive functioning (inhibitory control and working memory) of ICU nurses were negatively correlated with the duration of their work in a real clinical setting. Furthermore, no vigilance and executive function differences were identified between day and night shifts. Implications for Nursing Management. Nursing administrators should reconsider scheduling 12 h shifts, shortening shifts, or implementing short rest periods to reduce fatigue and cognitive load. In addition, flexible scheduling and rationalizing the order of work may help reduce the possible risks associated with prolonged work. [ABSTRACT FROM AUTHOR]

Background: Biliary atresia is a rare and serious neonatal disease that affects the quality of life of both infants and parents. There is currently limited literature on the experiences of parents with infants diagnosed with biliary atresia. Purpose: To explore the psychological journey and coping styles of parents of infants with biliary atresia in a single center in Shanghai, China. Methods: A qualitative study design was used. Face-to-face and semistructured interviews were conducted with 10 parents of infants with biliary atresia. Colaizzi’s method of data analysis was utilized, using NVivo 11.0 software. Results: The psychological journey and coping styles of parents could be divided into 4 stages. Different themes were extracted at different stages: before diagnosis, parents experienced complex emotions and actively sought treatment; at the diagnosis stage, negative emotions dominated and parents convinced themselves to accept reality; in the postop- erative stage, positive emotions, accepting reality, active response, and the need to learn to take care of their infant gradually appeared; and at the discharge stage, parents accepted the coexistence of positive and negative emotions and the variety of needs that emerged. Implications for Practice: The findings of the study may help healthcare professionals identify and focus on the psychological needs of parents of infants with biliary atresia, leading them to implement effective coping strategies to increase the caregiving ability of parents. Implications for Research: Future research should explore the effects of supportive interventions for parents of infants with serious chronic illnesses. [ABSTRACT FROM AUTHOR]

The invasive plant species, Solidago canadensis, often shares a common mycorrhizal network (CMN) with native plant species in southeast China. We ask whether the transfer of carbon (C) and nitrogen (N) among the invasive S. canadensis, the native Kummerowia striata and their CMN could contribute to the invasiveness of S. canadensis.We conducted a microcosm experiment in which a CMN was established on S. canadensis and K. striata. We used 13CO2 pulse‐labelling to quantify the relative contribution of recently fixed C from the two host species to the CMN. We also calculated the relative N distribution to each host species from the CMN.We found that 89% of the recently fixed C in the CMN originated from S. canadensis, while 11% originated from K. striata. We also found that the CMN distributed 77% of the N it absorbed to S. canadensis and 23% to K. striata.Our results suggest that the unequal distribution of N from a CMN to the invasive and native plant species is related to the unequal contribution of C from the plant species. This mechanism could contribute to invasion of native communities by alien species when there is a stoichiometric exchange of limiting nutrients for C, and when alien species contribute more C to the CMN than natives. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

As an important propaganda position of China's water conservancy, the core journals of water conservancy play an important role in promoting the development of China's water conservancy science and technology. In order to further enhance the influence of water conservancy journals in China, this study takes the journal " China Rural Water and Hydropower" as an example, combined with the bibliometric indicators of the journals in the past five years, this paper puts forward the following measures: ➀ closely track major national water conservancy research projects; ➁ Strengthen the solicitation of research papers on macro policies; ➂ Strengthen the solicitation of technical application papers and improve the quality of engineering technology papers; ➃ Fully utilize the Council platform to expand the influence of journals ; ➄ Give full play to the role of the editorial board in running the journal. [ABSTRACT FROM AUTHOR]

Under the current complex economic situation and the impact of COVID-19, China's capital market reform has entered a critical period, with opportunities and challenges coexisting. One of the important challenges is how to improve the well-being of investors in capital markets. Financial education, which has been offered by financial institutions in many countries in recent years, is likely to become an effective policy instrument to meet this challenge. Using survey data of individual investors from China, this study examines the potential impact of financial education programs offered by financial institutions on individuals' investment diversification. The results show financial education is positively associated with the investment diversification of individual investors. An analysis of the underlying mechanism shows that financial education contributes to the improvement of investment diversification by mitigating limited attention bias, strengthening social trust, and promoting the use of professional investment advisors. These findings suggest that the persistent promotion of financial education programs has a positive effect on optimizing financial asset allocation decisions and improving financial welfare of Chinese households. [ABSTRACT FROM AUTHOR]

Green innovation is an important way for manufacturing enterprises to achieve green and high-quality development. The existing literature has ignored the heterogeneous motivations for enterprise green innovation. The strategic green innovation behavior (SGIB) aiming at seeking strategic differences and building core competitiveness is the necessary measure for enterprises to realize green transformation. Furthermore, the existing research studies the influencing factors of green innovation from a single perspective, ignoring the interaction of institutional and resource factors. Based on this, this study uses QCA to identify the driving mechanism of enterprise SGIB. The research collected questionnaire data from 199 manufacturing enterprises in China. The main results show that a single factor will not constitute a necessary condition for positive SGIB, but the not-high green dynamic capability is a necessary condition for negative SGIB. Positive SGIB includes four configuration paths: institution-ethics synergy, normative pressure oriented, environmental ethics oriented, and institutional incentive oriented. Lack of institutional pressure is the only configuration path that leads to negative SGIB. Further analysis found that environmental ethics and institutional pressure are the main forces to promote SGIB. After a series of robustness tests, the above basic conclusions did not change significantly. Based on the above conclusions, we believe that government departments, industry associations, and enterprises should form a joint force to enhance the level of institutional pressure and enterprise environmental ethics, promoting the implementation of strategic green innovation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the association between sustainable consumption and life satisfaction. One aspect of sustainable consumption focused on in this study is the environment friendly purchase or green purchase. Using data collected from consumers in 14 cities in China, we found that consumers who reported green purchase intention and behavior had higher scores in life satisfaction compared to other consumers after controlling for gender, age, education, and family income. The findings add evidence to the literature that suggests happiness is associated with prosocial spending (Dunn et al., "Science" 319:1687-1688 in 2008).

Objective: This study aimed to analyze the epidemiological and clinical characteristics of measles in Jinan, Shandong, China, over a 32-year stage to facilitate measles prevention in the future. Methods: Data on measles cases from 1991 to 2022 were obtained from the public health department and medical records of patients at Shandong Public Health Clinical Center. Retrospective analysis was conducted on the distribution of measles cases in different years, months, and age groups, and observation of the differences in clinical manifestations and complications among different age groups. Results: From January 1991 to December 2022, 7531 measles cases were recorded at Shandong Public Health Clinical Center. During the 32-year period, there were two outbreaks of measles in 2008 and 2016, respectively. During the COVID-19 pandemic period from 2020 to 2022, the number of cases reached the lowest point in the past 30 years. The number and percentage of cases in the 0– 1y groups was significantly higher than in other age groups, and 97.75% patients in this group did not receive measles vaccine. Complications such as pneumonia and myocarditis appeared more frequent in patients under 12 years of age, but liver function damage is more common in adult patients. Conclusion: Although the measles epidemic has been greatly controlled since the use of measles vaccine, intermittent outbreaks still exist, so there is still a long way to go to eliminate measles. The proportion of infants under the age of 1 without measles vaccine and adults over 24 years old accounts for nearly 80% of the total. This group of people should be of concern, and feasible measures should be designated to protect these susceptible populations. [ABSTRACT FROM AUTHOR]

Introduction: Rimmed vacuolar myopathies (RVMs) are a group of genetically heterogeneous diseases that share histopathological characteristics on muscle biopsy, including the aberrant accumulation of autophagic vacuoles. However, the presence of non-coding sequences and structural mutations, some of which remain undetectable, confound the identification of pathogenic mutations responsible for RVMs. Therefore, we assessed the clinical profiles and muscle magnetic resonance imaging (MRI) changes in 36 Chinese patients with RVMs, emphasizing the role of muscle MRI in disease identification and differential diagnosis to propose a comprehensive literature-based imaging pattern to facilitate improved diagnostic workup. Methods: All patients presented with rimmed vacuoles with varying degrees of muscular dystrophic changes and underwent a comprehensive evaluation using clinical, morphological, muscle MRI and molecular genetic analysis. We assessed muscle changes in the Chinese RVMs and provided an overview of the RVMs, focusing on the patterns of muscle involvement on MRI. Results: A total of 36 patients, including 24 with confirmed distal myopathy and 12 with limb-girdle phenotype, had autophagic vacuoles with RVMs. Hierarchical clustering of patients according to the predominant effect of the distal or proximal lower limbs revealed that most patients with RVMs could be distinguished. GNE myopathy was the most prevalent form of RVMs observed in this study. Moreover, MRI helped identify the causative genes in some diseases (e.g., desminopathy and hereditary myopathy with early respiratory failure) and confirmed the pathogenicity of a novel mutation (e.g., adult-onset proximal rimmed vacuolar titinopathy) detected using next-generation sequencing. Discussion: Collectively, our findings expand our knowledge of the genetic spectrum of RVMs in China and suggest that muscle imaging should be an integral part of assisting genetic testing and avoidingmisdiagnosis in the diagnostic workup of RVM. [ABSTRACT FROM AUTHOR]

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Background: In most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China. Methods: This qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children's hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method. Results: Five themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother's willingness to actively breast feed and building the maternal confidence in baby care. Conclusion: Skin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother's role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants. [ABSTRACT FROM AUTHOR]

Background and aims: Metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to substitute NAFLD in 2020. This new term highlights the systematic metabolic disturbances that accompany fatty liver. We evaluated the correlations between MAFLD and subclinical carotid atherosclerosis (SCA) based on a nationwide health examination population in China. Methods: We performed a nationwide cross-sectional population and a Beijing retrospective cohort from 2009 to 2017. SCA was defined as elevated carotid intima-media thickness. The multivariable logistic and Cox models were used to analyze the association between MAFLD and SCA. Results: 153,482 participants were included in the cross-sectional study. MAFLD was significantly associated with SCA in fully adjusted models, with an odds ratio of 1.66; 95% confidence interval (CI): 1.62-1.70. This association was consistent in the cohort, with a hazard ratio (HR) of 1.31. The association between baseline MAFLD and incident SCA increased with hepatic steatosis severity. Subgroup analysis showed an interaction between age and MAFLD, with a higher risk in younger groups (HR:1.67, 95% CI: 1.17-2.40). Conclusion: In this large cross-section and cohort study, MAFLD was significantly associated with the presence and development of SCA. Further, the risk was higher among MAFLD individuals with high hepatic steatosis index and young adults. [ABSTRACT FROM AUTHOR]

This study aims to investigate the associations between financial education and consumer stock market satisfaction. Consumer financial education is measured through the objective aspect incorporating formal and informal financial knowledge education, and the subjective aspect is reflected through consumers' attitudes toward financial education. Using data from China's urban consumers, the results indicate a positive association between financial education and consumer stock market satisfaction. The findings suggest that consumers who were financially literate at high schools or colleges are more satisfied in participating in the stock market. Moreover, consumers who spend more money and time, as well as those who think financial education is more important, feel more satisfied in participating in stock market investment activities. The results imply that it is necessary to increase the supply of formal financial education in high schools and universities, encourage consumers to invest more in the informal education of financial knowledge, and promote policymakers to formulate informative policies to make consumers aware of the importance of financial education. [ABSTRACT FROM AUTHOR]

Therefore, the mechanisms that promote interactions between metastatic tumour cells and activated tumour-associated lymphatic endothelium in primary tumours and draining lymph nodes should be investigated in more detail to prevent and treat EMPD. Extramammary Paget's disease (EMPD) is a rare tumour presenting with an erythematous spread in elderly patients, mainly in the genital region.[[1]] It is most common in Caucasian women, but in Asian populations, there is a male predominance.[[3]] Given the rarity of this disease, limited studies have reported the 5-year outcomes on the Chinese population; hence a comprehensive survival analysis on the Chinese mainland is still lacking. Additional prospective data are needed to clarify the characteristics of high-risk EMPD patients and to further identify better and more effective superior management approaches to recurrent and potential tumour metastasis. [Extracted from the article]

Digital finance is an innovative business that applies information technology in the financial industry. Although empirical research on digital finance for development has grown enormously during the last decade, studies about the relationship between digital finance and human development remain limited. To fill this gap, this study uses data from the China Household Financial Survey and Peking University Digital Financial Inclusion Index to examine the association between digital finance and happiness. Results show that the association between digital finance and happiness is negative. Mechanism analyzes suggest that digital finance is negatively associated with happiness through the increasing debt burden and overspending behavior. Further heterogeneous analyzes find that age, debt level, and trust degree can be moderators in the relationship between digital finance and happiness. The results have both academic and practical implications for improving digital finance business and human development. [ABSTRACT FROM AUTHOR]

Legionella pneumophila is an intracellular pathogen causing pneumonia in humans. In February 2022, Legionnaires' disease caused by L. pneumophila strain Corby in a patient with lung adenocarcinoma was identified for the first time in China. This paper includes the case report and phenotypic and genomic analysis of the Corby (ICDC) strain. Its biological characteristics were evaluated by antibiotic sensitivity testing and cytology experiments, and genomic analysis was performed to understand its genetic evolution. The patient's clinical manifestations included cough, fever, pulmonary infiltration, and significantly decreased activity endurance. After empirical antimicrobial therapy, infection indicators decreased. The Corby (ICDC) strain was susceptible to nine antibiotics and exhibited strong intracellular proliferation ability. A phylogenetic tree showed that the Corby (ICDC) strain was closely related to the Corby strain, but under the pressure of a complex environment, its genome had undergone more rearrangement and inversion. The type IF CRISPR-Cas system was identified in its genome, and spacer analysis indicated that it had been invaded by several foreign plasmids, bacteria, and viruses during evolution. Legionnaires' disease caused by L. pneumophila strain Corby may be ignored in China, and it is urgent to improve long-term monitoring and investigation of aquatic environments and patients with respiratory infections to prevent a large-scale outbreak of Legionnaires' disease. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to determine the prevalence, antimicrobial resistance, virulence profiles, and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) obtained from ready-to-eat (RTE) foods in China. Methods: Two hundred seventy-six RTE food-associated S. aureus isolates were collected from 25 provinces across China in 2018, then characterized by antimicrobial susceptibility testing, virulence factors detecting, multilocus sequence typing (MLST), spa typing, SCCmec typing and pulsed-field gel electrophoresis (PFGE). Results: Two hundred fifty isolates (90.6%) were resistant to at least one antimicrobial agent; 73 (26.4%) isolates were multi-drug resistant (MDR). Thirty MRSA isolates were identified, among which nine toxin genes (sea, seb, sec, sed, seh, selk, sell, selq, and tsst-1) were detected. Sixty percent (18/30) of the MRSA isolates harbored multiple toxin genes. Four virulence gene patterns were identified, with seb-selk-selq (30/30) being the most common pattern. Thirteen sequence types, as well as 13 spa and 4 SCCmec types were found among 30 MRSA isolates. The most prevalent MRSA lineages were CC59-t437-SCCmecIV/V (23.3% [7/30]), CC398-t011-SCCmecV (23.3% [7/30]), and CC1-t114-SCCmecIV (16.7% [5/30]). Conclusions: Our findings highlight the importance for the identification of prevalent clones, assessment of drug-resistance and virulence, and formulation of food safety measures for public health. [ABSTRACT FROM AUTHOR]

Background: Intensive care is of great significance for very low birth weight infants (VLBWI). The Yangtze River Delta is the most ecomonically developed area in China. However, there are few data on the care practices and survival of VLBWI in this region.Objectives: To investigate the prevalence, care practices and motality of VLBWI in Yangtze River Delta in China.Methods: A multi-center retrospective investigation study was conducted at five tertiary hospitals within the Yangtze River Delta in China from January to December 2017. Clinical data included the general characteristics of the infants and the mothers, clinical prognosis, care practices in NICUs was collected by trained research members.Results: During the study period, 1059 VLBWIs were included. Infants with birth weight < 750 g, 750-1000 g, 1000-1250 g and 1250-1500 g accounted for 2.3, 14.9, 34.8 and 47.8%, respectively. Premature rupture of membranes (17.8%) was the main cause of premature delivery. The catheterization rates of umbilical vein catheterization (UVC) and peripherally inserted central catheter (PICC) were 25.0 and 64.4%, respectively. The duration of parenteral nutrition was 27.0 ± 19.5 d, the meantime of feeding tube indwelling was 36.2 ± 24.2 d. The corrected gestational age of the infants who reached full oral feeding was 35.8 ± 2.7 weeks. The breast feeding rate in the investigated infants was 61.9%. The mortality rate of preterm infants was 3.4%. The incidence of main complications BPD, PDA, ROP, NEC and sepsis were 24.9, 29.9, 21.7, 9.4 and 13.3% respectively.Conclusions: Maternal and infant care practices need to be improved in the very preterm births. This study provides a baseline for the improvement in the further study. [ABSTRACT FROM AUTHOR]

Background: Efavirenz (EFV)-induced neuropsychiatric toxicity bothers people living with HIV (PLHIV). Neuropsychiatric adverse effects of EFV may differ by length of time on EFV-based antiretroviral treatment (ART). Methods: A cross-sectional, single-center study was conducted at Beijing Ditan Hospital in China from June–August 2020 among ART-experienced PLHIV who were on long-term EFV-based ART. 424 eligible virological suppressed participants were enrolled and divided into four groups according to time on EFV-based ART: group A (0.5 ≤ ART < 2 year), B (2 ≤ ART < 4 year), C (4 ≤ ART < 6 year), and D (ART ≥ 6 year). The questionnaires about 12-item Short Form Health Survey (SF-12), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were administered to assess neuropsychiatric adverse events of EFV among different groups. Results: Overall mental component summary scores (MCS) of SF-12 in PLHIV was 50.2, which was lower than general population. Overall prevalence of anxiety, depression and sleep disturbances was 15.6%, 15.3% and 58%, respectively. Prevalence of anxiety, depression and sleep disturbances did not vary significantly between the time-on-ART groups. Anxiety, depression, sleep disturbances had no correlation with time on EFV-based ART or CD4+ T cells counts. Conclusions: In ART-experienced PLHIV in China, neuropsychiatric adverse events exist persistently and prevalence do not significantly change with prolonged time on EFV-based ART. The prevalence of sleep disturbances was high, suggesting that clinicians should pay more attention to long-standing psychiatric health to perform early and effective interventions. [ABSTRACT FROM AUTHOR]

SUMMARY: Wurfbainia villosa is a well‐known medicinal and edible plant that is widely cultivated in the Lingnan region of China. Its dried fruits (called Fructus Amomi) are broadly used in traditional Chinese medicine for curing gastrointestinal diseases and are rich in volatile terpenoids. Here, we report a high‐quality chromosome‐level genome assembly of W. villosa with a total size of approximately 2.80 Gb, 42 588 protein‐coding genes, and a very high percentage of repetitive sequences (87.23%). Genome analysis showed that W. villosa likely experienced a recent whole‐genome duplication event prior to the W. villosa–Zingiber officinale divergence (approximately 11 million years ago), and a recent burst of long terminal repeat insertions afterward. The W. villosa genome enabled the identification of 17 genes involved in the terpenoid skeleton biosynthesis pathway and 66 terpene synthase (TPS) genes. We found that tandem duplication events have an important contribution to the expansion of WvTPSs, which likely drove the production of volatile terpenoids. In addition, functional characterization of 18 WvTPSs, focusing on the TPS‐a and TPS‐b subfamilies, showed that most of these WvTPSs are multi‐product TPS and are predominantly expressed in seeds. The present study provides insights into the genome evolution and the molecular basis of the volatile terpenoids diversity in W. villosa. The genome sequence also represents valuable resources for the functional gene research and molecular breeding of W. villosa. Significance Statement: The present study reports a high‐quality chromosome‐level reference genome of Wurfbainia villosa with comprehensive genomic, transcriptomic, and metabolic analyses, as well as the identification and functional characterization of 66 terpene synthase (TPS)‐encoding genes, which can provide insights into the molecular genetic basis of the diversity and abundance of volatile terpenoids. [ABSTRACT FROM AUTHOR]

Membranous nephropathy (MN) is a common cause of nephrotic syndrome. The aim is to establish a non‐invasive diagnostic model of MN using differential gut microbiome analysis, and to explore the relationship between the gut microbiome and MN pathogenesis in vivo. 825 fecal samples from MN patients and healthy participants are collected from multiple medical centers across China. Key operational taxonomic units (OTUs) obtained through 16S rRNA sequencing are used to establish a diagnostic model. A rat model of MN is developed to explore the relationship between the gut microbiome and the pathogenesis of MN. The diversity and richness of the gut microbiome are significantly lower in patients with MN than in healthy individuals. The diagnostic model based on seven OTUs achieves an excellent efficiency of 98.36% in the training group and also achieves high efficiency in cross‐regional cohorts. In MN rat model, gut microbiome elimination prevents model establishment, but fecal microbiome transplantation restores the phenotype of protein urine. Gut microbiome analysis can be used as a non‐invasive tool for MN diagnosis. The onset of MN depends on the presence of naturally colonized microbiome. Early intervention in the gut microbiome may help reduce urinary protein level in MN. [ABSTRACT FROM AUTHOR]

Fractions are an important mathematical concept for elementary students. However, students with mathematics learning disabilities (MLD) struggle with learning fractions. Research has demonstrated that concrete-representational-abstract (CRA) instruction is an effective practice for students with learning and developmental disabilities. Here we investigated whether CRA instruction can support struggling learners' understanding of fractions in China. Using a multiple probe across-students single-case design, we applied CRA instructions to 4 fourth-grade students with MLD. Results showed that CRA instruction improved students' fraction proficiency. Limitations of the study, as well as implications on CRA instruction for elementary students with MLD in practice, are discussed. [ABSTRACT FROM AUTHOR]

Adults with type 2 diabetes (T2D) often experience two common diabetes-related psychological distress: diabetes distress and depressive symptoms. Both are associated with adverse diabetes outcomes including poor self-management and glycemic control. However, diabetes distress and depressive symptoms differ in their associations with diabetes outcomes in T2D patients. This study proposes a hypothetical model to examine whether self-efficacy mediates the adverse effects of depressive symptoms and/or diabetes distress on self-care behaviors and glycemic control. Additionally, we examined the bi-directional relationships between diabetes distress and depressive symptoms to identify potential underlying mechanisms. This study conducted in 15 rural health clinics in Jiangsu province China. 900 adults with T2D participated in the prospective cohort study. The data Diabetes distress (the 17-item Diabetes Distress Scale, DDS17), depressive symptoms(the 10-item Center for Epidemiologic Studies Depression Scale, CESD-10), self-efficacy, self-care behaviors (diet and physical activity), metabolic variables (fasting plasma glucose, FPG) and demographic characteristics were assessed at baseline. Subsequent 12-month Hemoglobin A1C (HbA1c) were measured after baseline. Hierarchical multiple regression and bootstrap mediation analysis were used to test the effects and pathways among these associations. Of 843 participants (93.67%) of total cohort with available subsequent 12-month HbA1c levels, mean age was 66.08 years and 66.55% were women, 25.15% of them had depressive symptoms (CES-D ≥ 10), 12.20% had moderate diabetes distress (mean DDS ≥2) and 4.98% had the both two psychological distress. Hierarchical multiple regression showed higher DDS score significantly predicted unhealthy diet(β = −1.10, P < 0.001) but not physical activities, while CESD score was negatively associated with physical activity (β = −0.06, P < 0.001) but not diet. No independent effects of the two psychological distress variables on subsequent 12-month HbA 1 c were observed. Mediation analysis supported that elevated self-efficacy solely mediated the negative effect of both diabetes distress and depressive symptoms on diet (DDS score: β = −0.238, 95 BCE% CI [−0.350, −0.141]; CESD score: β = −0.010, 95 BCE% CI [−0.016, −0.005]), physical activities (DDS score: β = −0.446, 95 BCE% CI [−0.630, −0.283]; CESD score: β = −0.019, 95 BCE% CI [−0.030, −0.010]) and subsequent 12-month HbA1c (DDS score: β = 0.105, 95 BCE% CI [0.030,0.189]; CESD score: β = 0.004, 95 BCE% CI [0.001,0.009]). Additionally, the interplay of diabetes distress and depressive symptoms exerts their effects on diabetes outcomes directly and indirectly via self-efficacy. Self-efficacy may contribute to better diabetes outcomes and ameliorate negative effects of diabetes distress and depressive symptoms. [ABSTRACT FROM AUTHOR]

Background Long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (LncRNA MALAT1) has been proven to promote osteogenesis in different health conditions. However, the role of plasma MALAT1 in postmenopausal osteoporosis (PMOP) has not been investigated. Objective To investigate whether plasma MALAT1 expressions are associated with severity of PMOP. Methods A total of 126 patients with PMOP and 126 healthy female control individuals were drafted into study participation. Plasma MALAT1 was detected using RT-PCR. Bone formation marker bone-specific alkaline phosphatase plasma concentration was determined using chemiluminescence immunoassay. Levels of bone absorption marker cross-linked N-telopeptidases of type I collagen were measured in duplicate using enzyme immunoassay. Bone mineral density (BMD) was examined in the total hips, femoral neck, and lumbar (L1–L4) spine using dual-energy x-ray absorptiometry. We used Genant semiquantitative (GSQ) criteria to assess the degree of vertebral deformity and fracture. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the potential diagnostic value of MALAT1 with regard to the GSQ grading. We used the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) to evaluate the symptomatic severity in and functional ability of the study participants. Results Plasma MALAT1 expressions were significantly lower in patients with PMOP, compared with healthy controls. Plasma MALAT1 expressions in patients with PMOP were positively associated with total hip, femoral neck, and lumbar (L1–L4) spine BMD. In total, 95 patients experienced vertebral deformity or fracture (VF), and 31 had no fractures. Plasma MALAT1 expressions were markedly decreased in patients with VF, compared with patients without fractures. Plasma MALAT1 expressions were negatively related to GSQ grading in patients with VF. ROC curve analysis demonstrated that decreased plasma MALAT1 expression exhibits decent diagnostic value with regard to GSQ grading. Finally, we discovered that plasma MALAT1 expression was also negatively associated with VAS and ODI. Conclusion Plasma MALAT1 expressions are negatively associated with severity of PMOP. [ABSTRACT FROM AUTHOR]

Background: The diverse manifestations of tuberculosis (TB) in chronic kidney disease (CKD) patients can cause difficulty in diagnosis, delayed treatment, even death. Therefore, this study investigated the clinical characteristics and the risk factors for mortality in CKD patients with TB. Methods: This retrospective study included 167 patients diagnosed with active TB at two tertiary medical centers in Chongqing within six years. Clinical characteristics and outcomes of anti-TB treatment in patients with and without CKD were collected, and the predictive mortality values of variables were analyzed. Results: Of the 167 patients, 66.7% (44/66) hemodialysis (HD), 41.1% (21/51) pre-HD, and 32.0% (16/50) non-CKD patients had extrapulmonary TB. The pleura and lymph node were the common sites in CKD patients. Clinical presentations of cough and hemoptysis in CKD patients were less common than those in non-CKD patients, 13.7% (16/117) of CKD patients even not having any clinical symptoms. The positive rates of tuberculin skin test, TB-polymerase chain reaction and acid-fast bacilli in sputum in HD patients were lower than those in pre-HD and non-CKD patients (p< 0.05). CKD patients were more prone to gastrointestinal and neurological side effects during anti-TB treatment. The mortality rates of non-CKD, pre-HD and HD patients was 6.1%, 31.9% and 37.3%, respectively. Multivariate Cox analysis revealed that age≥ 40 years (HR: 5.871; p=0.019), hypoalbuminemia (HR:2.879; p=0.004), CKD stage 4– 5 (HR:4.719; p=0.018) and HD (HR:6.13; p=0.005) were associated with mortality. Discussion: CKD patients with TB have atypical clinical manifestations and high mortality. Age, hypoalbuminemia, CKD stage 4– 5, and HD were independent predictors of mortality. [ABSTRACT FROM AUTHOR]

A growing number of biological studies suggest that exogenous sulfur dioxide (SO2) at a certain concentration may promote human resistance to Mycobacterium tuberculosis. However, the results of most relevant studies are inconsistent, and few studies have explored the relationship between SO2 exposure and tuberculosis risk at provincial level. In addition, occupational exposure has long been considered to have a certain impact on the human body, so for the first time, we discussed the differences between different occupations in the study on the relationship between air pollutant exposure and tuberculosis risk, and evaluated the impact of occupational exposure. This study aimed to explore the association between short-term SO2 exposure and the risk of outpatient visits to tuberculosis in Anhui province and 16 prefecture-level cities from 2015 to 2020. We used several models for multi-stage analysis, including distributed lag nonlinear model (DLNM), Poisson generalized linear regression model, and random-effects model. The association was assessed using the 28-day cumulative lag effect RR and 95%CI for each 10-unit increase in SO2 concentration. We divided all patients into the following six occupations: Worker, Farmer, Retired people, Children and Students, Cadre and Office clerk, and Service staff (catering, business, etc.). Sex, age, and season were analyzed by subgroup. Finally, the robustness of the multi-pollutant model was tested. At provincial level, the overall effect value of SO2 was RR=0.8191 (95%CI: 07702~0.8712); after grouping all patients by occupation, the association found only among Farmers (RR = 0.7150, 95%CI: 0.6699–0.7632, lag 0–28 days) and Workers (RR = 0.8566, 95%CI: 0.7930–0.9930, lag 0–4 days) was still statistically significant. Estimates for individual cities and using random-effects models to estimate average associations showed that SO2 exposure was associated with a reduced risk of outpatient TB visits in 14 municipalities, which remained significant when aggregated (RR = 0.9030, 95%CI: 0.8730–0.9340). Analysis of patients grouped by occupation in each municipality showed that statistical significance was again observed only in the Farmer (RR = 0.8880, 95%CI: 0.8610–0.9160) and Worker (RR = 0.8250, 95%CI: 0.7290–0.9340) groups. Stratified analysis of age, sex, and season showed that the effect of SO2 exposure was greater for middle-aged people (18–64 years old) and males, and less for seasonal changes. In summary, we found that exposure to SO2 reduces the risk of outpatient visits to tuberculosis, with farmers and workers more susceptible to SO2. Gender and age had a greater impact on the risk of TB outpatient visits than seasonal variations. [ABSTRACT FROM AUTHOR]

Aim: Older adults living alone is becoming the main family structure in rural China. This study aimed to explore the mediating effect of coping style on the relationship between perceived stress and mental health in rural older adults living alone in China. Methods: 356 rural older adults living alone were recruited in Huzhou, China. Subjects were investigated using the Chinese Perceived Stress Scale (CPSS), Chinese Coping Style Questionnaire (CCSQ), and Mental Health Questionnaire (MHQ). Data were analysed using a structural equation. Bootstrapping was used to validate the mediation effects. Results: Mental health showed significant correlations with a sense of nervousness, of uncontrollability, and with positive and negative coping styles (P < 0.05). The results of structural equation modeling showed a good fit for the total sample (χ2/df = 2.684, NFI = 0.927, GFI = 0.944, RMSEA = 0.069). Perceived stress (sense of nervousness and uncontrollability) impacted the mental health of rural older adults living alone mainly through two mediating variables, including positive and negative coping styles. The double mediating contribution rates were 42.11%, and 61.82%. Conclusion: Coping style partially mediated the relationship between perceived stress and mental health of rural older adults living alone in China. Consequently, to improve the mental health of rural older adults living alone, perceived stress and coping styles should be the focus. Geriatr Gerontol Int 2022; 22: 523–528. [ABSTRACT FROM AUTHOR]

Introduction: To date, little is known about the real-world protective role of Chinese inactivated and recombinant coronavirus disease 2019 (COVID-19) vaccines under the background of the long-term "Dynamic Zero COVID-19 Case" (i.e., no infection source) in China, especially when facing the widespread Omicron severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant infection. Methods: In this prospective, single-center cohort study, the clinical characteristics of post-vaccination Omicron SARS-CoV-2 variant infection were investigated in the initial largest outbreak of Omicron SARS-CoV-2 variant infection that occurred between the 8 January, 2022 and 29 January, 2022 in Anyang City, Henan Province, China. The primary endpoints were the rates of severe and critical diseases or death. The secondary endpoints were the SARS-CoV-2 shedding duration and length of hospitalization. Results: A total of 380 post-vaccination patients infected with the Omicron SARS-CoV-2 variant were enrolled. The median age was 18 (interquartile range [IQR] 17–35) years, 219 (57.6%) cases were female, and 247 (65.0%) cases were students. Before confirmation of Omicron SARS-CoV-2 variant infection, patients had 3 (IQR 2–4) days of dry cough (40.3%), nasal congestion (26.3%), and sore throat (26.3%). On admission, 294 (77.4%) cases had normal chest computerized tomography (CT) imaging. Additionally, only 5 (1.3%), 30 (7.9%), 4 (4/342, 1.2%), and 7 (7/379, 0.2%) patients had lymphocyte counts <800 per mm3, C-reactive protein levels >10 mg/L, lactate dehydrogenase levels ≥250 U/L, and D-dimer levels ≥0.5 mg/L on admission, respectively. During hospitalization, 308 (81.1%) and 72 (18.9%) were identified as mild and moderate cases, respectively, and no one progressed to severe and critical types, with a SARS-CoV-2 shedding period and length of hospital stay of 17 (IQR 12–22) and 19 (IQR 15–24) days, respectively. Conclusion: The current study found that approximately 80% of individuals infected with the Omicron SARS-CoV-2 variant were mild, approximately 20% of patients were moderate, and no severe, critical, or fatal cases were identified in a prospective cohort including 380 participants vaccinated with non-mRNA-based vaccines. Discussion: This study supports the consideration of policy adjustments and changes to prevent and control the Omicron-predominant COVID-19 in China and other regions with high SARS-CoV-2 vaccination rates. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to compare coronary risk factors, burden of coronary artery disease (CAD), and 1-year prognosis of people living with HIV (PLWH) and HIV-negative controls who underwent percutaneous coronary intervention (PCI) for acute coronary syndromes (ACSs).Background: Cardiovascular disease is drawing more and more attention in PLWH since effective antiretroviral therapy (ART) has been available. Clinical characteristics and outcomes of PLWH undergoing PCI for ACS in China remain unknown.Methods: We compared demographic characteristics, angiographic features, and 1-year outcomes of 48 PLWH versus 48 HIV-negative controls matched for age (±2 years), sex, diabetes mellitus, and year of PCI (±2 years) in Beijing Ditan Hospital, Capital Medical University from January 2008 to November 2020.Results: In PLWH (mean age: 53.6 ± 10.6 years, 95.8% male, and 79.2% on ART), high-density lipoprotein cholesterol was lower than in HIV-negative controls; however, the statin use was more common, the incidence of hypertension was lower, and low-density lipoprotein cholesterol, and the body mass index were significantly lower than in controls. Two groups had a similar extent of coronary atherosclerosis as measured by the presence of multivessel diseases and the median Gensini score; however, lesions of PLWH were longer and were more likely to locate at the proximal segment of the coronary artery. In addition, the risk of major adverse cardiac and cerebrovascular events at 1 year was similar in both groups.Conclusion: PLWH undergoing PCI displayed similar CAD burden and 1-year prognosis compared with HIV-negative patients. Early detection of cardiovascular risk factors and appropriate secondary prevention of CAD in PLWH might alleviate the risk of severe adverse cardiovascular events. [ABSTRACT FROM AUTHOR]

There is growing evidence that air pollution plays a role in TB, and most studies have been conducted in the core countries with inconsistent results. Few studies have comprehensively included the six common air pollutants, so they cannot consider whether various pollutants interact with each other. Our objectives were to investigate the association between short-term exposure to six common air pollutants and the risk of tuberculosis outpatient visits in Fuyang, China, 2015–2020. We combined the two models to explore the effects of exposure to six air pollutants on the risk of tuberculosis outpatient visits, including the Poisson generalized linear regression model and distributed lag non-linear model (DLNM). We performed stratified analyses for the season, type of cases, gender, and age. We used the lag-specific relative risks and cumulative relative risk obtained by increasing pollutant concentration by per 10 units to evaluate the connection between six air pollutants and TB; PM2.5 (RR = 1.0018, 95% CI: 1.0004–1.0032, delay of 12 days) and SO2 (RR = 1.0169, 95% CI: 1.0007–1.0333, lag 0–16 days) were 0.9549 (95% CI: 0.9389–0.9712, lag 0 day) and 0.8212 (95% CI: 0.7351–0.9173, 0–20-day lag). Stratified analyses showed that seasonal differences had a greater impact on TB, males were more likely to develop TB than females, older people were more likely to develop TB than younger people, and air pollution had a great impact on new cases. Exposure to O3, CO, PM10, PM2.5, and NO2 increases the risk of TB outpatient visits, except SO2 which reduces the risk. The incidence of TB has seasonal fluctuations. It is necessary for the government to establish a sound environmental monitoring and early warning system to strengthen the monitoring and emission management of pollutants in the atmosphere. Management, prevention, and treatment measures should be developed for high-risk groups (males and older people), reducing the risk of TB by reducing their specific behaviors and changing their lifestyle. We need to pay more attention to the impact of seasonal effects on TB to protect TB patients and avoid a shortage of medical resources, and it is necessary for the government to develop some seasonal preventive measures in the future. [ABSTRACT FROM AUTHOR]

• Efavirenz (EFV) 400 mg was noninferior to 600 mg among virologically suppressed patients • Adherence of two-tablet EFV 200 mg and one-tablet EFV 600 mg were similar • No improvement of neuropsychologic symptoms was observed in EFV 400 mg group • Mild improvement of liver enzymes and lipid profile was observed in EFV 400 mg group Efavirenz (EFV) 400 mg has been recommended to replace EFV 600 mg. There are only 200 mg and 600 mg dosage forms of EFV in China. Whether switching from one-tablet EFV 600 mg to two-tablet EFV 200 mg would weaken adherence or further affect efficacy or safety is unknown. Virologically suppressed people living with HIV with a regimen composed of one-tablet tenofovir (TDF), one-tablet lamivudine (3TC), and one-tablet EFV (600 mg) were randomized to continue original regimen or switch to two-tablet EFV (200 mg). Self-reported adherence questionnaires, 12-Item Short-Form Health Survey (SF-12), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were used. Primary end point was the difference in proportions of participants with plasma HIV-RNA ≥ 50 copies/mL at week 48 with noninferiority margin of 4%. A total of 209 participants were randomized to the EFV 400 mg group and 211 to the EFV 600 mg. Primary end point result was −3.3% (95% CI −8.1–1.6). Further decrease of GGT (−3.1 vs. −0.3 U/L) and TC (−0.26 vs. 0.12 U/L) was observed in EFV 400 mg participants through 48 weeks. No significant changes in adherence, quality of life, and neuropsychologic condition were reported. EFV 400 mg was noninferior to EFV 600 mg and showed mild improvement of safety profile. Adherence was not weakened in patients taking EFV 400 mg. For patients taking EFV 600 mg with neuropsychologic symptoms, it would be better to switch to other drugs instead of EFV 400 mg. [ABSTRACT FROM AUTHOR]

Background: Serum uric acid (SUA) is suspected to be associated with atherosclerosis and calcium deposition in atherosclerosis is known to related poor prognosis, yet there is no cohort study on the aged in China. We aimed to investigate the relationships between SUA levels and coronary calcium deposition in the middle-aged and elderly populations in China. Methods: A total of 326 participants between the ages of 50 and 85 who had undergone a coronary CT scan in 2015 at the Huadong Hospital Affiliated to Fudan University (Shanghai, China) were included in this study. Univariate and multivariate binary logistic regression was performed to analyze the correlation between SUA levels and coronary artery calcium score (CACS). The changes in CACS during a five-year follow-up were analyzed through Kaplan–Meier survival and binary cox regression analysis. An observational study was done on another 104 asymptomatic middle-aged and elderly patients to compare relative mRNA expressions of proinflammatory factors in peripheral blood mononuclear cells (PBMCs) from 104 subjects. Results: Based on the first year of follow-up data analysis, the elevation of SUA levels (P< 0.001) is an independent risk factor for the increase of CACS after coordinating the confounding factors. According to five-year follow-up data, cox regression analysis proved that SUA was a risk factor for CACS (HR =5.86, P< 0.001). The mRNA expression of IL-6 and CXCL8 in the HUA and HUA patients with CAC (HUA-CAC) groups was significantly higher than that in the normal control (NC) and coronary calcium deposition (CAC) groups. Conclusion: Taken together, the findings in this study indicate that high SUA levels (P< 0.001) are an independent risk factor for CACS and elevated SUA levels increase the risk of developing coronary calcium deposition among middle-aged and old people in the Chinese population, which may be related to an increase of pro-inflammatory cytokines in the PBMCs. [ABSTRACT FROM AUTHOR]

Background: The impact of radiotherapy interruption due to the Spring Festival holidays in China on the survival of patients with nasopharyngeal carcinoma (NPC) is unclear.Methods: Nontrial patients with locoregionally advanced NPC receiving radiotherapy plus induction chemotherapy (IC) and/or concurrent chemotherapy (CC) were included (N = 5035) and divided into two groups based on the Spring Festival-induced radiotherapy interruption. Kaplan-Meier curves for overall survival (OS) and failure-free survival (FFS) were compared between rival groups. Impact of the timing of radiotherapy interruption (during or outside the Spring Festival) on survival was investigated in a propensity score-matched dataset. We adopted ordination correspondence analysis to determine the cut-off of radiotherapy prolongation for prognostic prediction, and accordingly performed subgroup analysis based on delayed days and chemotherapy details. Individual patient data of three phase III NPC trials (NCT00677118, NCT01245959, NCT01872962) were used for validation (N = 1465).Results: Radiotherapy interruption was most frequently observed between December to January of the following year. Significantly lower OS and FFS were associated with the Spring Festival-induced interruption of radiotherapy (P = 0.009 and 0.033, respectively), but not that interruption of IC. In two matched comparison groups, the timing of radiotherapy interruption during the Spring Festival was more likely to lead to a decrease in FFS than outside the Spring Festival (P = 0.046), which was not observed in the validation using clinical trial data or in the subgroup analysis based on the 5-day delayed time. The absence of CC and the accumulated dose of cisplatin < 200 mg were related to the negative influences of the Spring Festival-induced radiotherapy interruption on FFS (P = 0.002) and OS (P = 0.010), respectively.Conclusions: The poor survival of patients with NPC is associated with the Spring Festival-induced interruption of radiotherapy. We recommend that these patients receive adequate doses of cisplatin concurrently with radiotherapy. [ABSTRACT FROM AUTHOR]

At present, lung cancer has become clinically the malignant tumor with the highest incidence and mortality rate in China. Smoking, environmental pollution, infection, etc., are closely related to lung cancer. To investigate the effect of the nursing method of psychological intervention combined with health education on lung cancer patients undergoing chemotherapy, 70 lung cancer patients who received chemotherapy in our hospital from June 2017 to June 2020 were selected and randomly divided into a routine intervention group (n = 35) and a combined intervention group (n = 35). Patients in the two groups had the same chemotherapy method and medication. The routine intervention group received the routine nursing intervention, while on this basis, the combined intervention group received psychological intervention combined with health education. After 6-week nursing, self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, cancer pain score before and after nursing, improvement of respiratory function before and after nursing, sleep quality score, quality of life score, and nursing satisfaction were analyzed. Through nursing intervention, the quality of life indexes such as physiological, physical, social, emotional, and other indexes in the combined intervention group were significantly better than those in the routine intervention group, with statistical differences P < 0.01 . The nursing satisfaction in the combined intervention group was significantly better than that in the routine intervention group, with statistical significance (χ2 = 8.9342, P < 0.05). The psychological intervention combined with health education for lung cancer patients undergoing chemotherapy can effectively alleviate anxiety and depression, increase confidence in treatment, reduce pain and significantly improve sleep quality, respiratory function, quality of life, and nursing satisfaction. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests an association between remnant cholesterol (RC) and vascular damage and hypertension. However, this association has not been explored in a large-scale population in China, and a temporal relationship between RC and hypertension also needs to be investigated. Methods: We conducted a retrospective cross-sectional study in 2,199,366 individuals and a longitudinal study in 24,252 individuals with repeated measurements of lipid profile and blood pressure in at least a 3-year follow-up. The logistic model was used to explore the association between lipid components and hypertension in the cross-sectional analysis. The Cox model was used to analyze the association between high RC (HRC) at baseline and the subsequent incidence of hypertension or the association between hypertension at baseline and incidence of HRC. The cross-lagged panel model was applied to analyze the temporal relationship between RC and hypertension. Results: RC level as a continuous variable had the highest correlation with hypertension among lipid profiles, including RC, low-density lipoprotein cholesterol, total cholesterol, non-high-density lipoprotein cholesterol, and triglycerides, with an odds ratio of 1.59 (95% confidence interval: 1.58–1.59). In the longitudinal cohort, HRC at baseline was associated with incident hypertension. We further explored the temporal relationship between RC and hypertension using the cross-lagged analysis, and the results showed that RC increase preceded the development of hypertension, rather than vice versa. Conclusions: RC had an unexpected high correlation with the prevalence and incidence of hypertension. Moreover, RC increase might precede the development of hypertension, suggesting the potential role of RC in the development of hypertension. [ABSTRACT FROM AUTHOR]

Risky financial asset holding is arguably a desirable financial behaviour that contributes to consumer financial well‐being. However, studies about associations between consumer financial education and risky financial asset holding in China remain limited. To fill this gap, using data from the 2015 China Household Finance Survey, this study examined the association between financial education and risky financial asset holdings and explored its mediators. Results from Probit regressions showed that financial education was positively associated with the household risky financial asset holding. Further analyses based on the mediating model found that financial literacy, economic and financial information search and risk tolerance were mediating factors in the association between financial education and risky financial asset holding. The results have policy implications for improving consumer financial education and financial market participation. [ABSTRACT FROM AUTHOR]