Search

The eastern part of the northern margin of the North China Craton is a key metal metallogenic province in China, hosting many important rare metal and rare earth element (REE) deposits and having great resource potential. This study investigated the Saima deposit, a niobium (Nb) and tantalum (Ta) deposit and the Baerzhe deposit hosting zirconium (Zr), Nb and REEs. Based on previous LA-ICP-MS zircon U–Pb dating results obtained by the authors' team, this study compared the whole-rock geochemistry and whole-rock Sr–Nd–Pb isotopes of an orebody with its surrounding rocks. The geochemical characteristics of both deposits are used to systematically review the evolution of the alkaline magma and the differences in the physical and chemical conditions for enrichment and mineralisation of late-stage rare elements and REEs such as Nb, Ta and Zr. Comparing the mineralisation of the Saima and Baerzhe deposits, the alkaline magmatic evolution plays a crucial role in the enrichment of rare-earth elements, which are generally formed in the late stage of alkaline magmatic evolution. The Saima deposit, which has a metallogenic age of 224.40 ± 6.10 Ma, formed in nepheline syenites with high alkali (Na2O + K2O) and low MgO and CaO contents, with high TFeO/MgO ratios. The A-type granites formed in an extensional tectonic setting after the closure of the Paleo-Asian Ocean. The Baerzhe deposit, which has a metallogenic age of 125.2–122.15 Ma, formed in A-type alkali granites (orebody and surrounding rocks) that have high alkali (Na2O + K2O) and low MgO and CaO contents with high TFeO/MgO ratios, strong uranium (U) depletion and typical V-shaped distribution of REE. The mineralisation is controlled by melt–fluid interactions in the later stage of highly evolved magmas. The enrichment and mineralisation of rare elements and REEs in the eastern part of the north margin of the North China Craton are mainly associated with the high degree of evolution of alkaline magmas. [ABSTRACT FROM AUTHOR]

The Cambrian Miaolingian Series strata are continuously exposed in the North China Platform and contain diverse sedimentary phenomena, including substantial with oncoid-rich units. Limestone samples from the Zhangxia Formation in the Sandaogou section were collected to characterise unique macroscale to microscale sedimentary characteristics of the marine carbonate oncoids. In the oncolitic beds (∼4.5 m thick), the individual size of oncoids gradually increases from bottom to top. The oncoid morphology and the presence of a nucleus and laminae in thin-sections are used to classify these oncoids into three types (concentric laminar, lateral growth and multicore oncoids). As evidenced by scanning electron microscopy and energy-dispersive X-ray observations, Girvanella are abundant inside these oncoids and are associated with nanospheres, framboidal pyrite, and spherical and filamentous microbial fossils, confirming the biogenicity of the studied oncoids. These results suggest that the oncolitic–oolitic limestone formed in an upward-shallowing marine environment caused by a forced regression process that resulted in a decrease in accommodation space in a fourth-order sequence. Thus, the conditions became increasingly suitable for the development of cyanobacteria-dominated microbial mats and large oncoids. The late stage of the depositional setting and elevated solar radiation resulted in the formation of the growth termination surface. Evidence of microbial origin from the oncoids of the Cambrian Miaolingian Series in the North China Platform. Vertical variation in oncoid size and distribution coincide with geochemical data. A shallowing depositional environment is interpreted as the reason for variation in oncoid size and formation of oncoid growth termination surfaces. [ABSTRACT FROM AUTHOR]

Elderly individuals in rural China have been known to be at increased risk of contracting tuberculosis (TB) and developing active disease. This study aims to estimate the burden of m ycobacterium tuberculosis (MTB) infection and to identify potential targeted subgroups for infection control. As part of the investigation of an interventional study, 50- to 70-year-old rural residents in Zhongmu County were targeted for MTB infection testing using QuantiFERON-TB Gold In-Tube (QFT). Questionnaires and physical examinations were conducted to acquire their demographic information and health status. A total of 20 486 individuals were included in the analysis. The prevalence of QFT positivity was 20.79% (4259/20 486) and 50 participants (0.24%) had indeterminate results. A positive dose–response relation was found for QFT positivity with smoking intensity. Compared with non-drinkers, the risk of MTB infection was lower among participants with moderate alcohol consumption (<10 g/day) with adjusted odds ratio (OR) of 0.82 (95% CI 0.71–0.94). In addition, gender of male, with a history of previous TB or silicosis, and hepatitis B/C virus infection were associated with increased risk of MTB infection. An indeterminate QFT result was related to being underweight (adjusted OR 3.18; 95% CI 1.09–9.26). Our results indicate a high burden of MTB infection among the elderly in this rural area. Smokers, individuals with a history of previous TB or silicosis, and those with hepatitis B/C virus infection should be prioritized for MTB infection control to reduce the risk of disease development from a new infection. [ABSTRACT FROM AUTHOR]

Abstract: Background: Posttransplantation diabetes mellitus (PTDM) is a well-recognized renal transplantation complication that is associated with increased graft loss, morbidity, and mortality. Adiponectin gene polymorphisms are associated with type 2 diabetes. However, it remains unknown whether these polymorphisms increase the risk for development of PTDM. Therefore, the aim of this study was to investigate the association between the adiponectin gene polymorphism and the risk of PTDM among Chinese renal allograft recipients. Methods: We genotyped 398 unrelated renal allograft recipients without a prior diagnosis of diabetes, including 97 PTDM and 301 without PTDM, for adiponectin gene variants: single nucleotide polymorphisms at position 45 and 276, that is, SNP-45: T/G, SNP-276: G/T, using the polymerase chain reaction-restriction fragment length polymorphism assay. No prisoners or organs from prisoners were used in the study. Results: The G allele of SNP-276 was significantly more frequent in PTDM than non-PTDM subjects (P = .041). For SNP-45 and SNP-276, the incidence of PTDM was significantly higher in patients with the GG genotype than those with the TG and TT genotypes (48.1% vs 21.5% and 23.6% and 30.7% vs 18.5% and 22.8%; (P = .011 and .024, respectively). Even after adjusting for age and sex, the effects of the SNP-45 genotypes for GG compared to TT (odds ratio [OR] = 3.108, P = .009) and GG compared to TG (OR = 3.620, P = .004) as well as for SNP-276 genotypes GG compared to TG (OR = 2.203, P = .002) and body mass index at transplantation (OR = 1.099, P = .024) remained significant. Conclusions: These data suggested that SNP-45 and SNP-276 of the adiponectin gene were significantly associated with an increased risk for PTDM among Chinese renal allograft recipients. [Copyright &y& Elsevier]

This study quantifies concentrations and emission rates (ER) of ammonia (NH3) and greenhouse gases (GHG) including carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) from a naturally ventilated cage layer (Hy-Line brown strain) house with daily manure removal, located in northeast China during four seasons of one year, with each monitoring episode lasting five consecutive days. Gaseous concentrations of background and exhaust air were measured using an infrared photoacoustic multi-gas monitor with a multi-channel sampler. Building ventilation rate (VR) was determined by CO2 mass balance using literature metabolic rate data for modern laying hens. Both gas concentrations and ER showed considerable diurnal and seasonal variations. Annual mean (±SD) ER of NH3, CO2, CH4, and N2O for the monitored layer house were, in mg d-1 bird-1, 129 ±40.3, 78,250 ±15,384, 112 ±56.5, and 9.4 ±2.5, respectively, or in g d-1 AU-1 (AU = 500 kg live body weight), 33.4 ±11.4, 19,975 ±3,071, 29.2 ±15.2, and 2.5 ±0.7, respectively. Ammonia ER from the current study was within the ranges of values reported for high-rise houses with annual manure removal and manure-belt houses with daily manure removal. Results of the study contribute to improving ammonia and GHG emissions inventory for animal feeding operations in China and worldwide. [ABSTRACT FROM AUTHOR]

This paper describes the research about the β -cyclodextrin influence on Vibrio fischeri toxicity of 10 phenylsulfonyl carboxylates. It is illustrated that the formation of 1:1 cyclodextrin-solute inclusion complexes dominates the toxicity influence of phenylsulfonyl carboxylates to Vibrio fischeri and greatly weakens the toxicity level. Using the octanol-water partition coefficients lg KOW, the grouped electrotopological state (E-state) index S(> SO2) and the stability constants of inclusion complexes lg KS, three models with high squared correlation coefficients r2adj at 0.908, 0.951 and 0.917, respectively were constructed to evaluate the β-cyclodextrin influence on Vibrio fischeri toxicity. For the type of phenylsulfonyl carboxylates, the inclusion stability constants lg KS can reliably model and predict the β-cyclodextrin influence on Vibrio fischeri toxicity (TI). [ABSTRACT FROM AUTHOR]

China raises 50% of global live pigs. However, few studies on the carbon footprint (CF) of large-scale pig production based on China's actual production conditions have been carried out. In this study, life cycle assessment (LCA) and actual production data of a typical large-scale pig farm in northern China were used to assess the greenhouse gas (GHG) emissions or CF associated with the whole process of pig production, including feed production (crop planting, feed processing, and transportation), enteric fermentation, manure management, and energy consumption. The results showed a CF of 3.39 kg CO2-eq per kg of live market pig and relative contributions of 55%, 28%, 13%, and 4% to the total CF by feed production, manure management, farm energy consumption, and enteric fermentation, respectively. Crop planting accounted for 66% of the feed production CF, while feed processing and transportation accounted for the remaining 34%. Long-distance transport of semi-raw feed materials caused by planting-feeding separation and over-fertilization in feed crop planting were two main reasons for the largest contribution of GHG emissions from feed production to the total CF. The CF from nitrogen fertilizer application accounted for 33% to 44% of crop planting and contributed to 16% of the total CF. The CF from the transport of feed ingredients accounted for 17% of the total CF. If the amount of nitrogen fertilizer used for producing the main feed ingredients is reduced from 209 kg hm-2 (for corn) and 216 kg hm-2 (for wheat) to 140 kg hm-2 (corn) and 180 kg hm-2 (wheat), the total CF would be reduced by 7%. If the transport distance for feed materials decreased from 325 to 493 km to 30 km, along with reducing the number of empty vehicles for transport, the total CF would be reduced by 18%. The combined CF mitigation potential for over-fertilization and transport distance is 26%. In addition, the use of pit storage, anaerobic digestion, and lagoon for manure management can reduce GHG emissions from manure management by 76% as compared to the traditional practice of pit storage and lagoon. This case study reveals the impact of planting-feeding separation and over-fertilization on the CF of the pig supply chain in China. The manure management practice of pit storage, anaerobic digestion, and lagoon is much more conductive to reducing the CF as compared to the traditional practice of pit storage and lagoon. [ABSTRACT FROM AUTHOR]

Bioaerosols from concentrated animal feeding operations (CAFOs) pose potential adverse effects on the health and well-being of animals, workers, and the general public. Consequently, the topic of characterizing and mitigating bioaerosols associated with CAFOs continues to draw attention as the scale of animal production increases, especially in developing countries. This study was conducted to quantify indoor and downwind concentrations of airborne bacteria, including total bacterial count (TBC), Escherichia coli, Streptococcus, and Staphylococcus aureus, of a mechanically ventilated growing swine barn (210-head capacity) in suburban Beijing, China. The results revealed that the indoor airborne bacterial levels averaged 1.96 Ö 104 ±3.08 Ö 103 colony forming units (CFU) m-3 for TBC, 2.29 Ö 103 ±5.04 Ö 102 CFU m-3 for E. coli, 1.44 Ö 104 ±1.59 Ö 103 CFU m-3 for Streptococcus, and 9.16 Ö 103 ±1.11 Ö 103 CFU m-3 for S. aureus. The airborne microbe concentrations decreased with distance downwind of the swine barn. Specifically, at 10 m downwind, E. coli concentration decreased by more than 60%, while the other microorganisms decreased by 30% to 40%. All the bioaerosol microbes decreased by 55% to 70% at 30 m downwind. The relationships between the airborne bacterial concentration and downwind distance were depicted graphically and through linear regression equations. [ABSTRACT FROM AUTHOR]

Hoop structures have been used quite widely for animal production in the U.S. due to their lower capital costs and multi-purpose versatility. Hoop barns for grower-finisher (G-F) swine production have attracted attention in China as an alternative, environmentally friendly, and water-saving production system. This study was conducted to assess concentrations and emissions of ammonia (NH3) and greenhouse gases (GHGs) for a hoop G-F pig barn at a commercial pig operation in suburban Beijing, China. The NH3 and GHG concentrations and emissions of the facility were measured for three consecutive days during spring and summer seasons. The results revealed the following hourly gaseous concentrations (mean ± SD, mg m-3): 5.9 ± 2.7 NH3, 2,183 ± 1,376 CO2, and 4.0 ± 2.5 CH4 in spring, and 6.8 ± 3.4 NH3, 1,530 ± 364 CO2, and 5.0 ± 2.3 CH4 in summer. The estimated gaseous emissions averaged, in g pig-1 d-1, 22.7 NH3, 2,003 CO2, and 6.7 CH4, or in g AU-1 d-1 (AU = 500 kg), 124 NH3, 11,264 CO2, and 36.2 CH4. The emission values from this study, while being generally comparable with those reported in the literature, add new information concerning emissions from alternative swine housing system. [ABSTRACT FROM AUTHOR]

Abstract: Gaseous emissions from animal feeding operations may be influenced by production stage, genetics, dietary type and nutritional plan, housing type, manure handling schemes, and climatic conditions. This study was conducted to quantify annual emission rates (ERs) of greenhouse gases (GHGs)—methane (CH4), carbon dioxide (CO2) and nitrous oxide (N2O) from naturally ventilated swine gestation (GE), farrowing (FA), nursery (NU) and growing-finishing (GF) barns under typical operational conditions in suburban Beijing, China. Variables relative to the GHG ERs were measured every two months for a one-year period, with each measurement episode lasting 72h. Air exchange rate of the naturally ventilated barns was estimated using CO2 balance method. The annual mean daily GHG ERs (mean SD), expressed in live body weight), for the GE, FA, NU, and GF barns were, respectively, and for CO2; and for CH4; and and for N2O. The GHG ER values from the current study paralleled those reported in the literature in some cases but differed considerably in other cases. This outcome of similarity and disparity confirms the need to exercise caution when applying literature data to estimation of GHG emissions under various production systems. Results of this study are expected to contribute to the global GHG inventory. [Copyright &y& Elsevier]

Although enhancing the knowledge of nitrogen (N) dynamics in aquatic systems is crucial for basin N management, there is still a lack of theories on the patterns of basin N sources and transport because of the intricate influence of human activities, climatic conditions, landscape patterns, and topography on the trajectory of basin N. To shed new light on the patterns of basin N sources and transport in the Chinese subtropical monsoon region, this study provides a comprehensive approach combining multiple isotopes and hydrological model based on monthly records of hydro-chemistry and isotopes ( 18 O-NO 3 - / 15 O-H 18 O-H 2 H-H 2 H-H 2 O) for river water, groundwater and rainfall in three basins over multiple years. Our observations of hydro-chemistry showed that fluvial N levels in highly urbanized basins (3.05 ± 1.42 mg·L -1 ) were the highest and were characterized by higher levels in the dry season. In the agricultural basin, fluvial N levels in February and March were approximately 1.9 times higher than those in the other months. The fluvial N load was higher in agricultural basins (0.624-0.728 T N km -2 y -1 ) than in urban basins (0.558 T N km -2 y -1 ), primarily because of variations in sewage treatment rates and fertilizer application. In highly urbanized basin, manure and sewage (46.9 %) were the dominant sources of fluvial N, which were discharged into rivers after treatment. In the plain agricultural basin, a substantial portion of diffused residential sewage leaches into aquifers and is stored. In the hilly agro-forest mixed basin, the high baseflow coefficient (75.8 %) and the key role of groundwater N, mainly from soil N (27.3 %), chemical fertilizers (20.2 %), manure and sewage (46.6 %), to fluvial N (26.5 %) indicated that a high proportion of the N sources leached into the aquifer and were then transported to rivers. For the first time, this study integrated multiple methods to substantiate the proposed typical patterns of N sources and transport within the basins. These findings have significant implications for tailored basin-specific N management strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The evidence on the association of fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) with pulmonary tuberculosis (PTB) retreatment is limited. There are no data on whether greenness exposure protects air pollution-related PTB retreatment in patients with prior PTB., Objective: In a population-based retrospective study, we aimed to investigate the influence of PM2.5 and residential greenness on the risk of PTB retreatment., Methods: A total of 26,482 patients with incident PTB, registered in a mandatory web-based reporting system between 2012 and 2019 in Zhengzhou, China, were included in the analysis. The exposure to PM2.5 was assessed based on the China High Air Pollutants dataset, and the level of greenness was estimated using the Normalized Difference Vegetation Index (NDVI) values. The associations of PTB retreatment with exposure to PM2.5 and greenness were evaluated, respectively, considering the local socioeconomic level indicated by the nighttime light index., Results: Among the 26,482 patients (mean age 46.86, SD 19.52 years) with a median follow-up time of 1523 days per patient, 1542 (5.82%) PTB retreatments were observed between 2012 and 2019. Exposure to PM2.5 was observed to be significantly associated with the increased risk of PTB retreatment in fully adjusted models with a hazard ratio of 1.97 (95% CI 1.34-2.83) per 10 μg/m3 increase in PM2.5. Patients living in the regions with relatively high quartiles of NDVI values had a 45% lower risk of PTB retreatment than those living in the regions with the lowest quartile for the 500 m buffers (hazard ratio 0.55, 95% CI 0.40-0.77). Such a protective effect of residential greenness was more pronounced among patients living in lower nighttime light areas. The strength of the association between PM2.5 exposure and the risk of PTB retreatment was attenuated by greenness. No significant association was observed between NDVI and the incidence of drug resistance., Conclusions: Long-term exposure to PM2.5 might be a risk factor for PTB retreatment, while an increased level of residential greenness was found to be associated with reduced risks of PTB retreatment. Our results suggest strengthening the control of ambient air pollution and improving residential greenness may contribute to the reduction of PTB retreatment., (© Tonglei Guo, Fei Shen, Henan Xin, Jiang Du, Xuefang Cao, Boxuan Feng, Yijun He, Lingyu Shen, Yuanzhi Di, Yanxiao Chen, Zihan Li, Qi Jin, Hongzhi Li, Chunming Zhang, Lei Gao. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org).)

Objectives: Advances in critical care technology have lowered mortality rates among critically ill individuals. Nonetheless, survivors and their families may develop new physical, mental, cognitive, and social challenges due to paediatric intensive care unit (PICU) treatments, impacting their quality of life. The aim of this study was to investigate the survival journey and post-traumatic growth process of children and their families following PICU admission within the Chinese cultural context., Methods: Twenty-six children who have been or are currently admitted to the PICU, alongside their parents and three PICU nurses, were chosen through purposive and theoretical sampling. Data collection involved face-to-face interviews and observations, with data analysis conducted through continuous comparison, open coding, and selective coding techniques., Findings: A model outlining the survival journey and post-traumatic growth process of critically ill children and their families post PICU admission has been established. This model encompasses two central trajectories: an upward trajectory consisting of confusion, charging, action, and sublimation phases and a downward trajectory comprising confusion, doubt and fear, inhibition (including confrontation and avoidance), and drowning phases., Conclusions: Critically ill children and their families encounter diverse survival experiences and psychological journeys following traumatic events in the PICU. The survival experience has alternative upwards or downwards trajectories that are flexible/adaptable. Hence, offering timely psychological support can alter their developmental trajectories and foster post-traumatic growth., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: Pulmonary rehabilitation (PR) is an effective intervention for people with chronic obstructive pulmonary disease (COPD). However, fewer than 5% of eligible individuals receive pulmonary rehabilitation, largely due to limited by the accessibility of rehabilitation and difficulties associated with travel and transport. Supervised home-based tele-rehabilitation (SHTR) is an alternative model to center-based pulmonary rehabilitation. We will determine whether supervised home-based tele-rehabilitation is non-inferior to center-based pulmonary rehabilitation., Methods: The participants will undergo an 8-week rehabilitation program. Pulmonary rehabilitation comprises four main modules: exercise training, education, nutritional support, and psychological and behavioral interventions. We mainly focus on the module of exercise training and education. The education module includes information on exercise training, nutrition, and psychology, which are presented in an educational booklet provided to each participant. Blinded assessors will evaluate the outcomes at baseline, post-intervention, and 6 months after the intervention. The primary outcome is the change in the 6-minute walking distance. Secondary outcomes will assess changes in the patients' 1-minute sit-to-stand test, maximal inspiratory pressure (MIP), scales (CAT, mMRC, HAD), diaphragm ultrasound (TD, DE, DIF), changes in extrathoracic muscle volume and mass, completion rate of patient exercise prescriptions, occurrence of adverse events, as well as disease exacerbation and rehospitalization rates after rehabilitation and during the 6-month follow-up., Discussion: In order to improve the accessibility of pulmonary rehabilitation and patient-related outcomes, it is necessary to propose an alternative model of pulmonary rehabilitation. This trial will establish whether a supervised home-based tele-rehabilitation is not inferior to traditional center-based pulmonary rehabilitation., Trial Registration: Chinese Clinical Trial Registry ChiCTR2300076969. Registered on October 25, 2023., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Xin et al.)

Background: Studies examining the potential association between cooking oil and frailty risk in older adults have produced conflicting outcomes. Therefore, our objective was to explore the relationship between cooking oil (vegetable and animal fat oils), changes in oil usage, and the risk of frailty in older adults., Methods: We included 4,838 participants aged ≥ 65 years without frailty (frailty index < 0.25) from the 2011 wave of the Chinese Longitudinal Healthy Longevity Survey. Follow-up occurred in the 2014 and 2018 waves. Cox proportional hazard models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) to examine the association between cooking oil and frailty. Additionally, we evaluated the effect of switching cooking oil on frailty during the follow-up period., Results: During a median follow-up of 3.0 (2.8-6.9) years, 1,348 individuals (27.9%) developed frailty. Compared to those using vegetable oil, users of animal fat oil had a lower risk of frailty (HR = 0.72, 95% CI: 0.61-0.85). Participants who switched from vegetable oil to animal fat oil, as well as those consistently using animal fat oil, had lower risks of frailty with HRs of 0.70 (0.52-0.95) and 0.63 (0.51-0.77) respectively, compared to those who consistently used vegetable oil. Conversely, individuals who switched from animal fat oil to vegetable oil experienced an increased risk of frailty (HR: 1.41, 95% CI: 1.01-1.97)., Conclusions: The utilization of animal fat oil in cooking exhibited a reduced frailty risk among older adults. Conversely, transitioning from animal fat oil to vegetable oil may elevate the risk. These findings propose that substituting vegetable oil with animal fat oil in the diet may safeguard against frailty., (© 2024. The Author(s).)

Groundwater plays a pivotal role in the water resources of Shicheng County; however, the issue of excessive fluoride content in groundwater and its associated health risks often goes unnoticed. Groundwater assumes a crucial role in the hydrological dynamics of Shicheng County; nevertheless, the matter concerning elevated levels of fluoride within groundwater and its accompanying health hazards frequently evades attention. The hydrogeochemical analysis, obscure comprehensive water quality assessment based on cloud model, and probabilistic human health risk assessment using Monte Carlo simulation were conducted on 34 collected water samples. The findings indicate that the predominant groundwater hydrochemical types are SO 4 ·Cl-Na and HCO 3 -Na. The processes of rock weathering and cation exchange play crucial roles in influencing water chemistry. Groundwater samples generally exhibit elevated concentrations of F - , surpassing the drinking water standard, primarily attributed to mineral dissolution. The concentrations of F - in more than 52.94% and 23.53% of the groundwater samples exceeded the acceptable non-carcinogenic risk limits for children and adults, respectively. Considering the inherent uncertainty in model parameters, it is anticipated that both children and adults will have a probability exceeding 49.36% and 30.50%, respectively, of being exposed to elevated levels of F ions in groundwater. The utilization of stochastic simulations, in contrast to deterministic methods, enables a more precise depiction of health risks. The outcomes derived from this investigation possess the potential to assist policymakers in formulating strategies aimed at ensuring the provision of secure domestic water supplies., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Bats are important mammal reservoirs of zoonotic pathogens. However, due to research limitations involving species, locations, pathogens, or sample types, the full diversity of viruses in bats remains to be discovered. We used next-generation sequencing technology to characterize the mammalian virome and analyze the phylogenetic evolution and diversity of mammalian viruses carried by bats from Haikou City and Tunchang County in Hainan Province, China. We collected 200 pharyngeal swab and anal swab samples from Rhinolophus affinis, combining them into nine pools based on the sample type and collection location. We subjected the samples to next-generation sequencing and conducted bioinformatics analysis. All samples were screened via specific PCR and phylogenetic analysis. The diverse viral reads, closely related to mammals, were assigned into 17 viral families. We discovered many novel bat viruses and identified some closely related to known human/animal pathogens. In the current study, 6 complete genomes and 2 partial genomic sequences of 6 viral families and 8 viral genera have been amplified, among which 5 strains are suggested to be new virus species. These included coronavirus, pestivirus, bastrovirus, bocavirus, papillomavirus, parvovirus, and paramyxovirus. The primary finding is that a SADS-related CoV and a HoBi-like pestivirus identified in R. affinis in Hainan Province could be pathogenic to livestock. This study expands our understanding of bats as a virus reservoir, providing a basis for further research on the transmission of viruses from bats to humans., Competing Interests: Declaration of competing interest None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript., (Copyright © 2024. Published by Elsevier Masson SAS.)

Purpose: Several model studies suggested the implementation of latent tuberculosis infection (LTBI) testing and treatment could greatly reduce the incidence of tuberculosis (TB) and achieve the 2035 target of the "End TB" Strategy in China. The present study aimed to evaluate the cost-effectiveness of LTBI testing and TB preventive treatment among key population (≥ 50 years old) susceptible to TB at community level in China., Methods: A Markov model was developed to investigate the cost-effectiveness of LTBI testing using interferon gamma release assay (IGRA) and subsequent treatment with 6-month daily isoniazid regimen (6H) (as a standard regimen for comparison) or 6-week twice-weekly rifapentine and isoniazid regimen (6-week H 2 P 2 ) in a cohort of 10,000 adults with an average initial age of 50 years., Results: In the base-case analysis, LTBI testing and treatment with 6H was dominated (i.e., more expensive with a lower quality-adjusted life year (QALY)) by LTBI testing and treatment with 6-week H 2 P 2 . LTBI testing and treatment with 6-week H 2 P 2 was more effective than no intervention at a cost of $20,943.81 per QALY gained, which was below the willingness-to-pay (WTP) threshold of $24,211.84 per QALY gained in China. The one-way sensitivity analysis showed the change of LTBI prevalence was the parameter that most influenced the results of the incremental cost-effectiveness ratios (ICERs)., Conclusion: As estimated by a Markov model, LTBI testing and treatment with 6-week H 2 P 2 was cost-saving compared with LTBI testing and treatment with 6H, and it was considered to be a cost-effective option for TB control in rural China., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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

This study was designed based on a cross-sectional investigation conducted Shanghai, China. Demographic characteristics, diaper utilization, Activities of Daily Living (ADL) and emotion were collected by Unified Needs Assessment Form for Elderly Care Questionnaire. Cognition function was assessed by Mini-mental State Examination (MMSE) scale. Multivariate logistic regression was used for statistical analysis. The diaper utilization rate was 31.2%. Female, higher level of education, poorer ADL and cognition, more severe incontinence and financial dependence on others were facilitating factors for diaper usage (P < 0.05). The possibility of using diaper differed according to the intimacy of caregivers. Among incontinent individuals with relatively good ADL and cognition level, diaper utilization can significantly decrease the risk of going out only once a month (OR: 2.63 vs 4.05), and going out less than once a month (OR: 5.32 vs 6.53). Incontinence people who going out at least once a week had a lower risk of some negative emotion. Significantly, diaper utilization further decreased this risk. In conclusion, for incontinence elderly people with relatively independent ability, proper use of diaper may improve the frequency of outdoor activity and emotion. Nevertheless, diaper utilization should be decided based on elderly people's own will., (© 2024. The Author(s).)

Background: The latent and incubation periods characterize the transmission of infectious viruses and are the basis for the development of outbreak prevention and control strategies. However, systematic studies on the latent period and associated factors with the incubation period for SAS-CoV-2 variants are still lacking. We inferred the two durations of Delta, BA.1, and BA.2 cases and analyzed the associated factors., Methods: The Delta, BA.1, and BA.2 (and its lineages BA.2.2 and BA.2.76) cases with clear transmission chains and infectors from 10 local SAS-CoV-2 epidemics in China were enrolled. The latent and incubation periods were fitted by the Gamma distribution, and associated factors were analyzed using the accelerated failure time model., Results: The mean latent period for 672 Delta, 208 BA.1, and 677 BA.2 cases was 4.40 (95%CI: 4.24 ~ 4.63), 2.50 (95%CI: 2.27 ~ 2.76), and 2.58 (95%CI: 2.48 ~ 2.69) days, respectively, with 85.65% (95%CI: 83.40 ~ 87.77%), 97.80% (95%CI: 96.35 ~ 98.89%), and 98.87% (95%CI: 98.40 ~ 99.27%) of them starting to shed viruses within 7 days after exposure. In 405 Delta, 75 BA.1, and 345 BA.2 symptomatic cases, the mean latent period was 0.76, 1.07, and 0.79 days shorter than the mean incubation period [5.04 (95%CI: 4.83 ~ 5.33), 3.42 (95%CI: 3.00 ~ 3.89), and 3.39 (95%CI: 3.24 ~ 3.55) days], respectively. No significant difference was observed in the two durations between BA.1 and BA.2 cases. After controlling for the sex, clinical severity, vaccination history, number of infectors, the length of exposure window and shedding window, the latent period [Delta: exp(β) = 0.81, 95%CI: 0.66 ~ 0.98, p = 0.034; Omicron: exp(β) = 0.82, 95%CI: 0.71 ~ 0.94, p = 0.004] and incubation period [Delta: exp(β) = 0.69, 95%CI: 0.55 ~ 0.86, p < 0.001; Omicron: exp(β) = 0.83, 95%CI: 0.72 ~ 0.96, p = 0.013] were significantly shorter in 18 ~ 49 years but did not change significantly in ≥ 50 years compared with 0 ~ 17 years., Conclusion: Pre-symptomatic transmission can occur in Delta, BA.1, and BA.2 cases. The latent and incubation periods between BA.1 and BA.2 were similar but shorter compared with Delta. Age may be associated with the latent and incubation periods of SARS-CoV-2., (© 2024. The Author(s).)

The risk of emerging infectious diseases (EID) is increasing globally. More than 60% of EIDs worldwide are caused by animal-borne pathogens. This study aimed to characterize the virome, analyze the phylogenetic evolution, and determine the diversity of rodent-borne viruses in Hainan Province, China. We collected 682 anal and throat samples from rodents, combined them into 28 pools according to their species and location, and processed them for next-generation sequencing and bioinformatics analysis. The diverse viral contigs closely related to mammals were assigned to 22 viral families. Molecular clues of the important rodent-borne viruses were further identified by polymerase chain reaction for phylogenetic analysis and annotation of genetic characteristics such as arenavirus, coronavirus, astrovirus, pestivirus, parvovirus, and papillomavirus. We identified pestivirus and bocavirus in Leopoldoms edwardsi from Huangjinjiaoling, and bocavirus in Rattus andamanensis from the national nature reserves of Bangxi with low amino acid identity to known pathogens are proposed as the novel species, and their rodent hosts have not been previously reported to carry these viruses. These results expand our knowledge of viral classification and host range and suggest that there are highly diverse, undiscovered viruses that have evolved independently in their unique wildlife hosts in inaccessible areas., Competing Interests: Conflict of interest No potential conflict of interest was reported by the authors., (Copyright © 2023 The Authors. Publishing services by Elsevier B.V. All rights reserved.)

Objective: To explore the rate and effect factors of hearing aids utilization in Chinese community elderly people, as well as the benefit role of hearing aids in the association of hearing loss and cognition decline., Methods: This study was designed based on a longitudinal 7-years follow-up conducted in Shanghai (China). Demographic characteristics, hearing level, hearing aids utilization and Activities of Daily Living (ADL) of participants were collected by Unified Needs Assessment Form for Elderly Care Questionnaire. Cognition function was assessed by Mini-mental State Examination (MMSE) scale. Multivariate logistic regression and linear regression were used for statistical analysis., Results: Hearing aids utilization rate in Chinese community elderly people is below 10 %. Participants with older age (≥80 years old), higher education (7-12 years and >12 years), who can manage money more independently were more likely to use hearing aids (P < 0.05). Whether hearing aids are used or not, hearing level is significantly associated with cognition in elderly people, but participants with hearing aids showed a slower cognitive decline speed., Conclusion: Hearing aids utilization may slow down the cognition descent via assisting hearing in daily life, so strategies need to be concerned in order to protect hearing function in all elderly and improve the use of hearing aids in HL elderly., Competing Interests: Declaration of competing interest The authors report no conflicts with any product mentioned or concept discussed in this article., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: For locally advanced rectal cancer (LARC), accurate response evaluation is necessary to select complete responders after neoadjuvant therapy (NAT) for a watch-and-wait (W&W) strategy. Algorithms based on deep learning have shown great value in medical image analyses. Here we used deep learning algorithms of endoscopic images for the assessment of NAT response in LARC., Method: 214 LARC patients were retrospectively included in the study. After NAT, these patients underwent total mesorectal excision (TME) surgery. Among them, 51 (23.8%) of the patients achieved a pathological complete response (pCR). 160 patients from Shanghai Changzheng Hospital were regarded as primary dataset, and the other 54 patients from Zhejiang Cancer Hospital were regarded as validation dataset. ResNet-18 and DenseNet-121 were applied to train the models based on endoscopic images after NAT. Deep learning models were valid in the validation dataset and compared to manual method., Results: The performances were comparable in AUC between deep learning models and manual method. For mean metrics, sensitivity (0.750 vs. 0.417) and AUC (0.716 vs. 0.601) in ResNet-18 deep learning model were higher than those in the manual method. The deep learning models were able to identify the endoscopic features associated with NAT response by the heatmaps. A diagnostic flow diagram which integrated the deep learning model to assist the clinicians in making decisions for W&W strategy was constructed., Conclusions: We created deep learning models using endoscopic features for assessment of NAT in LARC. The deep learning models achieved modest accuracies and performed comparably to manual method., Competing Interests: Declaration of competing interest All authors have no conflicts of interest or financial ties to disclose., (Copyright © 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier B.V. All rights reserved.)

The peak carbon dioxide emissions at the provincial level is the foundation for achieving the national target of carbon emission peak, thus it is important to analyze the characteristics of provincial CO 2 emissions. However, there is a lack of comprehensive analysis and research on quantifying the contributions of the driving factors to decoupling at the provincial level. Therefore, taking Henan Province as the research object, this study establishes the decoupling effort model by combining the traditional LMDI model and Tapio model based on compiling the CO 2 emission inventories from 2006 to 2019. The results showed that total CO 2 emissions increased from 2006 to 2011, and decreased after 2011 in Henan Province. Raw coal was the primary fuel source of Henan's CO 2 emissions, and the sector of "power and heat production" was the major industrial source, accounting for above 45% of the total emissions. Economic output and energy intensity were the major factors promoting and restraining the increase in Henan's CO 2 emissions, respectively. In terms of the decoupling state, Henan achieved the transformation from weak decoupling to strong decoupling from 2006 to 2019. Industry presented a strong decoupling condition, while weak decoupling was detected in the agriculture sector during the study period. The changing trend of energy intensity decoupling effort was consistent with that of total decoupling effort, indicating that energy intensity is a crucial factor in achieving decoupling. This study is helpful to grasp the CO 2 emission characteristics of Henan Province and provide the theoretical basis for formulating emission mitigation measures of peak carbon dioxide emissions in Henan and other provinces., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The water quality of the Heihe River Basin affects the life quality and health of tens of thousands of residents along it. However, there are relatively few studies that evaluate its water quality. In this study, we used principal component analysis (PCA), an improved comprehensive water quality index (WQI), and three-dimensional (3D) fluorescence technology to identify pollutants and evaluate water quality at nine monitoring sites in the Qilian Mountain National Park in Heihe River Basin. PCA was applied to concentrate the water quality indices into nine items. The analysis shows that the water quality in the study area is mainly polluted by organic matter, nitrogen, and phosphorus. According to the revised WQI model, the water quality of the study area is from moderate to good, while the water quality of Qinghai section is worse than that of Gansu section. According to the 3D fluorescence spectrum analysis of the monitoring sites, the organic pollution of water comes from vegetation decay, animal feces, and some human activities. This study can not only provide support and basis for water environment protection and management in the Heihe River Basin, but also promote the healthy development of the water environment in the Qilian Mountains., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

We conducted a study to analyze the unmet needs of and risk factors for use of assistive walking devices by the elderly based on sample survey data from Shanghai, China from July to October 2019. Among a total sample size of 11,193 people age 55 and older, 1,947 people (17.39%) needed assistive walking devices, 829 (42.58%) of whom needed but did not use those devices. Multivariate analysis indicated that residence, living alone or cohabitating, indoor handrails, the number of diseases, and IADL were factors influencing the unmet need for assistive walking devices (p < 0.05, respectively). People who lived in community health centers (p = 0.0104, OR = 1.956, 95% CI: 1.171-3.267) and those who lived only with their spouse (p = 0.0002, OR = 2.901, 95% CI: 1.641-5.126) were more likely to have an unmet need for assistive walking devices. People without indoor handrails (p = 0.0481, OR = 0.718, 95% CI: 0.517-0.997), those with 3 or more diseases (p = 0.0008, OR = 0.577, 95% CI: 0.418-0.796), and those with severely impaired IADL (p = 0.0002, OR = 0.139, 95% CI: 0.05-0.386) were less likely to have an unmet need for assistive walking devices. Self-perceived needs of the elderly, the diversity and performance of assistive devices, and the accessibility and affordability of assistive walking devices may lead to unmet needs.

Industrial symbiosis (IS) is an important tool to achieve green development for industrial parks. It is necessary to evaluate the IS performance for monitoring and managing the development of IS system. This study proposed an integrated framework to assess the IS performance based on the energy-intensive industrial park. Firstly, we established a Conceptual model of symbiotic coupling of three industries (iron and steel, thermal power, and cement). Then, the conceptual model was applied to extend the existing IS system in the energy-intensive industrial park. Finally, the IS performance of the extended IS system was evaluated. We verified this framework in Red flag cannel park (RFCP). The IS performance assessment in RFCP found that the existing IS activities produced significant multiple benefits and environmental impact reduction. For example, the existing IS activities produced 970.20 kt of low-carbon benefits, which accounted for 19% of the CO 2 emissions in RFCP. However, after extending the existing symbiotic system combined with the conceptual model proposed in this study, we found that there still was a large amount of symbiotic potential (the reuse of waste heat, BF slag, gypsum) waiting to be developed in RFCP. In addition, we also found that the resilience of existing IS network in RFCP was weak and need to be further perfected. In general, in the further development and perfection of IS system in RFCP, the manager should not only focus on the development of IS activities among energy-intensive enterprises but also strive to foster more influential enterprises to enhance the anti-risk ability of IS network. The result indicates the integrated framework can provide support for the development and perfection of IS system in energy-intensive industrial parks., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

As a key area in the Yellow River basin for sand control and management, the land change process in the Hobq Desert plays a crucial role in keeping the river and desert ecosystems and promoting the construction of ecological civilization in human systems. Based on multi-temporal remote sensing from 1991 to 2019 in the Hobq Desert along the Yellow River section, this study selected spatial statistical methods (land-use monitoring and landscape metrics) to examine land-use change dynamics. Then, we evaluated habitat quality using the InVEST model and quantitatively analyzed the factors causing spatial changes in habitat quality using geographic detectors. Finally, this paper predicted the pattern of land use and habitat quality in 2030 using the PLUS model. The results reveal that (1) from 1991 to 2019, the total area of forest grassland increased by 3572.5 km 2 , providing the most vegetation cover, and the sandy land and water area decreased continuously, while the cultivated land and construction land increased. There were 38.01% conversions of land types, with the land-use dynamic decreasing the greatest in sandy land (-12.66%) and increasing the greatest in construction land (9.26%); the comprehensive land-use dynamics were the highest in 2010-2019 (1.68%), which was the most active stage during our study period. (2) Both of the landscape indices NP and PD showed "N" type fluctuations during 1991-2019, and CONTAG and LSI rose from 69.19% to 70.29% and 36.01% to 38.89%, respectively, indicating that the land-use degree of landscape fragmentation increased, landscape connectivity turned better, and landscape dominance was enhanced, balanced, and developed evenly in overall landscape type. (3) From the overall region analysis, the average habitat quality in 1991, 2000, 2010, and 2019 was 0.3565, 0.5108, 0.5879, and 0.6482, respectively, with the overall habitat value showing a gradually increasing trend. Spatially, the habitat quality along the Yellow River section of the Hobq Desert has a certain regularity, and the overall pattern there is high in the south and low in the north, high in the east and west, and low in the middle. (4) The change in land use between 2019 and 2030 is similar to the previous period, but the change rate is generally lower. The habitat quality improved significantly, with the growth of high and medium habitat quality.

Rapid and reliable diagnosis is important for the management of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid antigen detection test (RADT) is a rapid, inexpensive, and easy method. Several studies have reported that RADTs performed well in many countries; however, very few studies have been reported in China. In this study, we assessed the performance of the RADT (Ediagnosis COVID-19 antigen test kit). This study was conducted in a centralized isolation site in Shanghai and enrolled 716 patients with COVID-19 and 203 noninfected participants. Nasopharyngeal swabs from all participants were collected on the same day and tested using the RADT and real-time reverse transcription-PCR (RT-PCR). The performance of the RADT was evaluated in different scenarios, such as threshold cycle ( C T ) values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that the sensitivity for patients with C T values lower than 20 was 96.55% (95% confidence interval [CI], 87.05 to 99.4). The sensitivities were 78.4% (95% CI, 69.96 to 85.05) for participants within 5 days after the first RT-PCR-positive result and 90.77% (95% CI, 80.34 to 96.19) within 5 days after symptom onset. Moreover, the sensitivity of the RADT was more than 80% for patients with symptoms on the day of testing, including fever (89.29%), cough (86.84%), stuffy nose (92.59%), runny nose (92%), sore throat (81.25%), and muscle pain (80.77%), especially for those with upper respiratory tract symptoms. The specificity of the RADT was good in all scenarios. During the SARS-CoV-2 epidemic, Ediagnosis performed excellently in individuals with a higher viral load (evidenced by lower C T values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms. IMPORTANCE RADTs have demonstrated excellent performance in many counties for screening SARS-CoV-2 infection, but very few studies have been conducted in China. The performance of RADTs is largely related to different real-life scenarios. In our study, the performance of the RADT was evaluated in different scenarios, such as C T values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that Ediagnosis (an RADT made in China) performed excellently for individuals with a higher viral load (evidenced by lower C T values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms.

Objectives: We aimed to explore the transmission dynamics of the Omicron BA.1.1 variant in an outbreak in China., Methods: We constructed 113 transmission pairs based on the time of exposure and symptom onset for identified infectors and infectees, using the epidemiological data collected during an outbreak in Hangzhou, Zhejiang province, China, between January and February 2022. The key epidemiological parameters were estimated., Results: The mean estimates of the incubation period and latent period distributions were 3.8 days (95% credible interval: 3.5, 4.1) and 3.1 days (2.8, 3.5), respectively. The overall transmission risk peaked at symptom onset, and we estimated that 33.6% (24.8, 42.5) of transmission occurred before symptom onset. The forward generation time decreased from 5.2 days (4.7, 5.7) at the start of the outbreak to 2.2 days (2.0, 2.5) by the end. Allowing this variation over time in the generation time distribution, we estimated that the reproduction number dropped rapidly from 9.5 (3.5, 18.4) to 0.8 (0.3, 1.5) over the outbreak., Conclusion: Shorter incubation period and latent period were estimated for the Omicron BA.1.1 variant. Stringent public health measures prevented a large epidemic by reducing transmission, as indicated by the shortened generation time., Competing Interests: Declaration of competing interest BJC consults for AstraZeneca, Fosun Pharma, GSK, Moderna, Pfizer, Roche, and Sanofi Pasteur. The others authors have no competing interests to declare., (Copyright © 2022. Published by Elsevier Ltd.)

In this intervention study, we examined the effects and psychological processes of different types of messaging intended to promote waste-separation behavior on the intent of residents to separate household waste and to engage in other pro-environmental behaviors (PEBs). Based on three studies (one survey with 76 residents and two experiments with 446 residents) in China, our results revealed that environmental appeals increased residents' intent to separate waste and engage in other PEBs, whereas monetary incentives had no effect. Although the main effects of the framing of messages on the intent to separate waste and other PEBs were not significant, we found an interactive effect of appeal type and message framing. When matched with loss framing, an environmental appeal indirectly generated a stronger positive impact by stimulating an individual's environmental risk perception. When monetary incentives matched with loss framing, individual pro-environmental identity weakened, thereby inhibiting the positive impact on intent to separate waste. With this study, we provide important theoretical support for the selection and optimization of waste-separation intervention strategies and guidance for persuading residents to engage in more PEBs.

Background: This study examined associations between body composition and physical fitness scores among medical students in Shenyang, China., Methods: A total of 2291 medical students aged 18-20 (815 male and 1476 female) in Shenyang of China were recruited to participate in the research in May 2019. With the use of the BCA-1B body composition analyzer and standard method of physical fitness assessment, the body composition and seven measures of physical fitness (body mass index, vital capacity, sit and reach, standing long jump, pull-ups/crunches, 50-m sprint, and 800/1000-m run) of college students were measured, respectively. The associations between body composition and physical fitness scores were assessed using multiple linear regression analysis., Results: The height, weight, total body water, protein mass, mineral content, body mass index, vital capacity, and body function scores of male students were significantly higher than those of female students. However, fat mass (FM), body shape score, physical quality score, and total physical fitness score of female students were significantly higher than those of male students. The results of the multiple linear regression analysis indicated that in male students, only FM was negatively associated with body shape score, body function score, physical quality score, and total physical fitness score. In female students, FM was associated with lower body shape scores, physical quality scores, and total physical fitness scores. Furthermore, the ratio of overweight to obesity in male students was significantly higher than that in female students., Conclusions: In Chinese medical colleges, the physical fitness level of female students is better than that of male students, and a higher FM was significantly associated with worse physical fitness of medical students. Moreover, male students with a higher rate of overweight and obesity are an important group that needs weight control., (© 2022. The Author(s).)

Objectives: This study aimed to examine the associations between body composition and vital capacity index (VCI) among medical students of Shenyang, China., Study Design: The design of this study is a cross-sectional study., Methods: Participants were 2063 individuals (17-25 years) from a medical college in Shenyang, who participated in this survey from April to May 2017. Height, weight, fat mass (FM), fat free mass (FFM), protein mass (PM), total body water (TBW), mineral mass (MM), vital capacity were measured, then BMI and VCI were calculated. Stepwise multiple linear regression analysis was used to evaluate the effect of body composition on VCI of participants in different genders. In addition, subgroup analysis was carried out according to BMI levels., Results: Male students showed significantly higher height, weight, BMI, FFM, PM, TBW, MM, VC, and VCI, but lower FM in comparison with female students. Stepwise multiple linear regression analysis showed that in both sexes FM was negatively correlated with VCI which represents pulmonary function (r < 0; P < 0.001). After dividing the whole participants by BMI, further correlation analysis showed FM was positively correlated with VCI only for male subgroups with BMI < 18.5 (r > 0; P = 0.050)., Conclusion: Overall, FM is highly negatively correlated with the VCI of Chinese medical students of both genders. However, there was a positive correlation between FM and VCI among low-weight male students., (© 2022. The Author(s).)

Background: Enlarging tuberculosis (TB) preventive treatment among at-risk populations is a critical component of the End TB Strategy. There is an urgent need to develop suitable latent tuberculosis infection (LTBI) testing and treatment tools according to the local TB epidemic and available resources worldwide., Methods: Based on an open-label randomised controlled trial conducted since 2015 in China among rural residents aged 50-70 years with LTBI, the protective efficacy of a 6-week twice-weekly regimen of rifapentine plus isoniazid was further evaluated in a 5-year follow-up survey., Results: 1298 treated participants and 1151 untreated controls were included in the 5-year protective efficacy analysis. In the per-protocol analysis, the incidence rate was 0.49 (95% CI 0.30-0.67) per 100 person-years in the untreated control group and 0.19 (95% CI 0.07-0.32) per 100 person-years in the treated group; the protection rate was 61.22%. Subgroup analysis showed that the protection rate was 76.82% in the per-protocol analysis among participants with baseline interferon (IFN)-γ levels in the highest quartile (≥3.25 IU·mL -1 ). Multiple logistic regression analysis indicated that participants with baseline body mass index <18.5 kg·m -2 and with pulmonary fibrotic lesions had increased hazard of developing active disease with an adjusted hazard ratio (aHR) of 3.64 (95% CI 1.20-11.00) and 5.99 (95% CI 2.20-16.27), respectively. In addition, individuals with higher baseline IFN-γ levels showed an increased risk of TB occurrence (aHR 2.27, 95% CI 1.13-4.58)., Conclusions: Our findings suggest the 6-week twice-weekly regimen of rifapentine plus isoniazid for LTBI treatment might be an optional tool for TB control in the Chinese population., Competing Interests: Conflict of interest: All co-authors disclose no conflicts of interest., (Copyright ©The authors 2022.)

Background: Safety data reported from the large-scale clinical trials of the coronavirus disease 2019 (COVID-19) vaccine are extremely limited in patients with decompensated cirrhosis. The vaccination campaign in this specific population could be difficult due to uncertainty about the adverse events following vaccination. We aimed to assessed the COVID-19 vaccination rate, factors associated with unvaccinated status, and the adverse events following vaccination in patients with decompensated cirrhosis., Methods: This is a retrospective study from Ruijin Hospial (Shanghai, China) on an ongoing prospective cohort designed for long-term survival analysis of decompensated cirrhotic patients who recovered from decompensating events or acute-on-chronic liver failure (ACLF) between 2016 and 2018. We assessed the COVID-19 vaccination rate, the number of doses, type of vaccine, safety data, patient-reported reasons for remaining unvaccinated, factors associated with unvaccinated status, and the adverse events of COVID-19 vaccine. Binary logistic regression was used for identifying factors associated with unvaccinated status., Results: A total of 229 patients with decompensated cirrhosis without previous SARS-CoV-2 infection participated (mean age, 56 ± 12.2 years, 75% male, 65% viral-related cirrhosis). Mode of decompensation were grade II‒III ascites (82.5%), gastroesophageal varices bleeding (7.9%), hepatic encephalopathy (7.9%). Eighty-five participants (37.1%) received at least one dose of vaccination (1 dose: n = 1, 2 doses: n = 65, 3 doses: n = 19) while 62.9% remained unvaccinated. Patient-reported reasons for remaining unvaccinated were mainly fear of adverse events (37.5%) and lack of positive advice from healthcare providers (52.1%). The experience of hepatic encephalopathy (OR = 5.61, 95% CI: 1.24-25.4) or ACLF (OR = 3.13, 95% CI: 1.12-8.69) and post-liver transplantation status (OR = 2.47, 95% CI: 1.06-5.76) were risk factors of remaining unvaccinated independent of residential areas. The safety analysis demonstrated that 75.3% had no adverse events, 23.6% had non-severe reactions (20% injection-site pain, 1.2% fatigue, 2.4% rash) and 1.2% had a severe event (development of acute decompensation requiring hospitalization)., Conclusions: Patients with decompensated cirrhosis in eastern China are largely remained at unvaccinated status, particularly those with previous episodes of ACLF or hepatic encephalopathy and liver transplantation recipients. Vaccination against COVID-19 in this population is safe., (© 2022. The Author(s).)

BackgroundThe Delta variant of SARS-CoV-2 had become predominant globally by November 2021.AimWe evaluated transmission dynamics and epidemiological characteristics of the Delta variant in an outbreak in southern China.MethodsData on confirmed COVID-19 cases and their close contacts were retrospectively collected from the outbreak that occurred in Guangdong, China in May and June 2021. Key epidemiological parameters, temporal trend of viral loads and secondary attack rates were estimated. We also evaluated the association of vaccination with viral load and transmission.ResultsWe identified 167 patients infected with the Delta variant in the Guangdong outbreak. Mean estimates of latent and incubation period were 3.9 days and 5.8 days, respectively. Relatively higher viral load was observed in infections with Delta than in infections with wild-type SARS-CoV-2. Secondary attack rate among close contacts of cases with Delta was 1.4%, and 73.1% (95% credible interval (CrI): 32.9-91.4) of the transmissions occurred before onset. Index cases without vaccination (adjusted odds ratio (aOR): 2.84; 95% CI: 1.19-8.45) or with an incomplete vaccination series (aOR: 6.02; 95% CI: 2.45-18.16) were more likely to transmit infection to their contacts than those who had received the complete primary vaccination series.DiscussionPatients infected with the Delta variant had more rapid symptom onset compared with the wild type. The time-varying serial interval should be accounted for in estimation of reproduction numbers. The higher viral load and higher risk of pre-symptomatic transmission indicated the challenges in control of infections with the Delta variant.

Background: To understand Clonorchis sinensis reinfection and the determinants of reinfection in endemic areas is important in establishment of control measures., Methods: A prospective cohort study was implemented in Hengxian County, Guangxi, China. Individuals with C. sinensis infection were completely treated, and those cured were enrolled as study subjects and followed up for 3, 6, and 12 months. The reinfection frequency and incidence were calculated, and a multivariable Cox proportional hazard model was constructed to capture reinfection determinants., Results: Among 635 enrolled subjects, 436 (68.7%) completed follow-up. Of these, 177 (40.6%) were reinfected; 133 (75.1%) were reinfected once, 41 (23.2%) twice, and 3 (1.7%) three times. The incidence of reinfection was 64.0 per 100 person-years. Men (adjusted hazard ratio [aHR], 1.67; 95% confidence interval [CI], 1.14-2.44), those with underlying diseases (aHR, 1.41; 95% CI, 1.02-1.95), and those with moderate- or heavy-intensity infections (aHR, 1.45; 95% CI, 1.14-1.85) had increasing reinfection probabilities., Conclusions: C. sinensis reinfection is high in endemic areas. Men and high-intensity infection are important determinants of reinfection. Repeated chemotherapy is necessary to control reinfection and its associated morbidities, especially in high-risk individuals. In addition, behavioral education is advised to decrease overall reinfection in endemic areas., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Incubation period is an important parameter to inform quarantine period and to study transmission dynamics of infectious diseases. We conducted a systematic review and meta-analysis on published estimates of the incubation period distribution of coronavirus disease 2019, and showed that the pooled median of the point estimates of the mean, median and 95th percentile for incubation period are 6.3 days (range, 1.8-11.9 days), 5.4 days (range, 2.0-17.9 days), and 13.1 days (range, 3.2-17.8 days), respectively. Estimates of the mean and 95th percentile of the incubation period distribution were considerably shorter before the epidemic peak in China compared to after the peak, and variation was also noticed for different choices of methodological approach in estimation. Our findings implied that corrections may be needed before directly applying estimates of incubation period into control of or further studies on emerging infectious diseases., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Chronic hepatitis B (CHB) virus infection remains the leading cause of hepatocellular carcinoma (HCC) in China. Oral antiviral drugs have been shown to significantly reduce the HCC risk in CHB patients, but it cannot completely eliminate the HCC occurrence. Therefore, accurate HCC risk assessment and standardized screening in CHB patients are essential for early diagnosis and improved prognosis. In recent years, medical researchers have established a variety of HCC risk prediction models for CHB patients, providing clinicians with a good assessment method. However, due to the differences in the baseline characteristics of each model when deriving and verifying the population, the applicable population and prediction effectiveness are still different, and it is difficult to achieve a "one-size-fits all" . To this end, this paper reviews the common HCC risk assessment model for CHB patients during antiviral therapy, and introduces the monitoring and screening strategies of domestic and foreign guidelines for high-risk HCC patients in order to help clinicians better manage such patients.

Tracing and isolation of close contacts is used to control outbreaks of coronavirus disease 2019 (COVID-19) in China. However, risk factors associated with the occurrence of COVID-19 among close contacts have not been well described. A total of 106 household contacts were included in this study, of whom 19 developed into COVID-19 cases, and the secondary attack rate was 17.9%. Multivariable analysis showed that increasing risk of occurrence of COVID-19 among household contacts was associated with female index patients (adjusted hazard ratio [aHR] = 3.84, 95% CI = 1.07-13.78), critical disease index patients (aHR = 7.58, 95% CI = 1.66-34.66), effective contact duration with index patients > 2 days (aHR = 4.21, 95% CI = 1.29-13.73), and effective contact duration > 11 days (aHR = 17.88, 95% CI = 3.26-98.01). The sex and disease severity of index patients with COVID-19 and longer effective contact duration with patients with confirmed COVID-19 could help epidemiologists to identify potential COVID-19 cases among household contacts at an early stage., (© 2020 Wiley-VCH GmbH.)

Background: The emergence and re-emergence of scrub typhus has been reported in the past decade in many global regions. In this study, we aim to identify potential scrub typhus infection risk zones with high spatial resolution in Qingdao city, in which scrub typhus is endemic, to guide local prevention and control strategies., Methodology/principal Findings: Scrub typhus cases in Qingdao city during 2006-2018 were retrieved from the Chinese National Infectious Diseases Reporting System. We divided Qingdao city into 1,101 gridded squares and classified them into two categories: areas with and without recorded scrub typhus cases. A boosted regression tree model was used to explore environmental and socioeconomic covariates associated with scrub typhus occurrence and predict the risk of scrub typhus infection across the whole area of Qingdao city. A total of 989 scrub typhus cases were reported in Qingdao from 2006-2018, with most cases located in rural and suburban areas. The predicted risk map generated by the boosted regression tree models indicated that the highest infection risk areas were mainly concentrated in the mid-east and northeast regions of Qingdao, with gross domestic product (20.9%±1.8% standard error) and annual cumulative precipitation (20.3%±1.1%) contributing the most to the variation in the models. By using a threshold environmental suitability value of 0.26, we identified 757 squares (68.7% of the total) with a favourable environment for scrub typhus infection; 66.2% (501/757) of the squares had not yet recorded cases. It is estimated that 6.32 million people (72.5% of the total population) reside in areas with a high risk of scrub typhus infection., Conclusions/significance: Many locations in Qingdao city with no recorded scrub typhus cases were identified as being at risk for scrub typhus occurrence. In these at-risk areas, awareness and capacity for case diagnosis and treatment should be enhanced in the local medical service institutes., Competing Interests: The authors have declared that no competing interests exist.

BACKGROUND: Occupational exposure-related risk of Mycobacterium tuberculosis infection has been reported for village doctors in China. This prospective study aims to estimate the infection acquisition in this key population. METHODS: At baseline, all village doctors registered in Zhongmu County were tested by QuantiFERON ® -TB Gold In-Tube (QFT) and QuantiFERON ® -TB Gold Plus (QFT-Plus) in parallel. Those negatives for either of the tests were retested to identify conversions at the 2-year follow-up investigation. RESULTS: A total of 367 eligible participants completed the 2-year follow-up survey with frequency of conversion of 5.0% (18/361) for QFT and 6.1% (21/343) for QFT-Plus. The agreement of follow-up results between the tests was 93.2% with a κ coefficient of 0.43 (95%CI 0.20-0.65). Among QFT-Plus convertors, the difference between TB1 and TB2 tubes (TB2-TB1) was significantly increased as compared with baseline results ( P = 0.039). Participants from the villages with occurrence of microbiologically confirmed pulmonary TB showed higher frequency of QFT conversions (11.0% vs. 3.2%, P = 0.011) and QFT-Plus conversions (12.3% vs. 4.4%, P = 0.027) than those from the villages without occurrence. CONCLUSION: Our results consistently suggest that capability on occupational protection and M. tuberculosis infection control should be improved in village doctors in China.

Objectives: Using QuantiFERON-TB Gold In-Tube (QFT-GIT) for monitoring tuberculosis (TB) and latent TB infection treatment effect is controversial. The present study aimed to evaluate the dynamic changes of interferon gamma (IFN-γ) levels along with latent TB infection treatment via a randomized controlled study., Methods: A total of 910 participants treated with 8 weeks of once-weekly rifapentine plus isoniazid (group A), 890 treated with 6 weeks of twice-weekly rifapentine plus isoniazid (group B) and 818 untreated controls (group C) were followed for 2 years to track active TB development. QFT-GIT tests were repeated three times for all groups: before treatment (T0), at completion of treatment (T1) and 3 months after completion of treatment (T2)., Results: Similar rates of persistent QFT-GIT reversion were observed in groups A (19.0%, 173/910), B (18.5%, 165/890) and C (20.7%, 169/818) (p 0.512). The dynamic changes of IFN-γ levels were not statistically significant among the three groups. In treated participants, individuals with higher baseline IFN-γ levels showed increased TB occurrence (1.0%, 9/896) compared to those with lower baseline levels (0.2%, 2/904) (p 0.037). A similar but statistically insignificant trend was also observed in untreated controls (1.8% (7/400) vs. 0.5% (2/418), p 0.100). When TB cases were matched with non-TB cases on baseline IFN-γ levels, no significant differences were found with respect to the dynamic changes in IFN-γ levels with time, regardless of whether they received treatment., Conclusions: QFT-GIT reversion or decreased IFN-γ levels should not be used for monitoring host response to latent TB infection treatment., (Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

High-intensity clonorchiasis infection is associated with serious outcomes, including cancer. Understanding the infection intensity of Clonorchis sinensis and its risk factors in local endemic regions could facilitate effective control measures. In a county located in a highly endemic area in Guangxi Province, P. R. China, local residents were randomly enrolled in the study; helminth egg examinations were performed with the Kato-Katz method, and the intensity of infection was identified as mild, moderate or heavy. Knowledge, attitudes, and high-risk behaviours were investigated among those infected with Clonorchis sinensis. A total of 2521 local residents participated in this study, and the Clonorchis sinensis-positive proportion was 28.9% (728 persons). Among the infected persons, the percentages of mild, moderate and heavy infections were 66.2%, 28.4% and 5.4%, respectively. Males experienced a higher proportion of moderate and heavy infections (37.5%) than females (18.1%) (p<0.05). The highest infection proportion among the different levels of infection intensity was identified among persons aged 30-59 years (15.7% for moderate and heavy infections). Among the 509 persons who reported eating raw fish, 302 persons (59.3%) had eaten raw fresh fish for more than 10 years, and 131 (25.7%) persons ate raw fish ≥12 times a year. Multivariate logistic regression revealed that eating raw fish 12-50 times in the last year (adjusted odds ratio [aOR] = 1.74, 95%CI: 1.09-2.80) and eating raw fish >50 times in the last year (aOR = 2.89, 95%CI: 1.20-7.50) were risk factors for high-intensity infections (moderate and heavy). The overall infection proportion was high in the study area, with a large group of residents experiencing high-intensity infections. High frequency of raw fish consumption was associated with high-intensity infections. Intervention strategies targeting people with a high frequency of raw fish consumption should be implemented to reduce the probability of severe consequences., Competing Interests: The authors have declared that no competing interests exist.

Scrub typhus is a life-threatening vector-borne disease. During the past decade, the number of areas affected by this disease has expanded in many countries. In this study, we aim to identify the spatiotemporal and demographic characteristics of scrub typhus in Southwest China, an emerging endemic region for scrub typhus. Population-based surveillance data capturing scrub typhus cases in two provinces of Southwest China during 2006-2017 were retrieved. Descriptive temporal and spatial analyses were conducted and stratified by age group. The space-time scan statistic was used to identify spatiotemporal clusters of scrub typhus occurrence at the county level. During the study period, 30,001 scrub typhus cases were recorded in Southwest China, with a total of 61.0% (191/313) of counties being affected; most cases (94.3%) occurred in rural areas. The annual incidence rate increased substantially from 0.25/100,000 in 2006 to 5.38/100,000 in 2017 (>21-fold change). The 0- to 4-year-old and 45- to 64-year-old subgroups had the highest cumulative incidence rates (57.46 and 32.98/100,000, respectively). Furthermore, since 2006, the 0- to 4-year-old (slope = 0.83, p < .01) and 45-64-year-old (slope = 0.69, p < .01) age groups have had the highest increases in incidence of all age groups. The most likely spatial cluster of overall cases (relative risk = 4.13, p < .01) occurred in the southern region of Southwest China and included 41 high-risk counties. In conclusion, scrub typhus appears to be widely distributed and rapidly increasing in Southwest China. Young children and middle-aged adults were the most severely affected groups, and the disease appeared to predominantly cluster in the southern part of Southwest China. Further in-depth surveys to determine the epidemiological characteristics and driving factors of this emerging disease and to facilitate effective control programmes among high-risk groups in the affected areas should be promoted., (© 2020 Blackwell Verlag GmbH.)

Scrub typhus, a miteborne rickettsiosis, has emerged in many areas globally. We analyzed the incidence and spatial-temporal distribution of scrub typhus in China during 1952-1989 and 2006-2016 using national disease surveillance data. A total of 133,623 cases and 174 deaths were recorded. The average annual incidence was 0.13 cases/100,000 population during 1952-1989; incidence increased sharply from 0.09/100,000 population in 2006 to 1.60/100,000 population in 2016. The disease, historically endemic to southern China, has expanded to all the provinces across both rural and urban areas. We identified 3 distinct seasonal patterns nationwide; infections peaked in summer in the southwest, summer-autumn in the southeast, and autumn in the middle-east. Persons >40 years of age and in nonfarming occupations had a higher risk for death. The changing epidemiology of scrub typhus in China warrants an enhanced disease control and prevention program.

Objective: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy., Methods: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed., Results: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy., Conclusion: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status., (© 2020 International Federation of Gynecology and Obstetrics.)

A 5-year follow-up study found declining disease development rates from latent tuberculosis infection. In the latter 3 years, the incidence, per 100 person-years, was 0.26 for interferon-γ release assay positives and 0.19 for tuberculin skin test positives (P = .28). In addition, all round have been checked., (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)