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The study aims to examine how higher education institutions (HEIs) in three countries responded to the challenges of COVID-19 over a six-month period at the outbreak of the global pandemic. Employing document analysis, we examined 732 publicly available communications from 27 HEIs in Canada, China, and the USA. Through theoretical frameworks of crisis management and Situational Crisis Communication Theory (SCCT), we explore how HEIs respond to the pandemic and protect campus stakeholders. The study revealed common patterns in communication strategies during different stages of the pandemic that include accepting responsibility, emotional reassurance, and compensating victims. It also revealed key differences across social contexts and environments and distinct leadership styles. Findings offer insight into how HEIs communicated at the outset of the COVID-19 pandemic and inform the application of SCCT and crisis management theory to institutional behavior in the context of prolonged and intersecting disasters.

Background: Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. Aims: This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language‐delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. Methods & Procedures: The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8‐h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3‐month online home intervention monitoring. Outcomes & Results: 146 families whose children aged 12–68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between‐group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. Conclusion & Implications: The online parent training focusing on improving daily interaction with children through speech–language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. WHAT THIS PAPER ADDS: What is already known on the subject: Parent‐implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech–language therapists and may be the primary mode of service delivery or may supplement in‐person services. What this paper adds to the existing knowledge: This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin‐speaking children and it is equally effective for children with ASD and non‐ASD diagnosis. What are the potential or actual clinical implications of this work?: Developmental behavioural paediatricians and speech–language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience. [ABSTRACT FROM AUTHOR]

Background: The overall benefits of the newly introduced family‐based Helicobacter pylori (H. pylori) infection control and management (FBCM) and screen‐and‐treat strategies in preventing multiple upper gastrointestinal diseases at national level in China have not been explored. We investigate the cost‐effectiveness of these strategies in the whole Chinese population. Materials and Methods: Decision trees and Markov models of H. pylori infection‐related non‐ulcer dyspepsia (NUD), peptic ulcer disease (PUD), and gastric cancer (GC) were developed to simulate the cost‐effectiveness of these strategies in the whole 494 million households in China. The main outcomes include cost‐effectiveness, life years (LY), quality‐adjusted life year (QALY), and incremental cost‐effectiveness ratio (ICER). Results: When compared with no‐screen strategy, both FBCM and screen‐and‐treat strategies reduced the number of new cases of NUD, PUD, PUD‐related deaths, and the prevalence of GC, and cancer‐related deaths. The costs saved by these two strategies were $1467 million and $879 million, quality‐adjusted life years gained were 227 million and 267 million, and life years gained were 59 million and 69 million, respectively. Cost‐effectiveness analysis showed that FBCM strategy costs −$6.46/QALY and −$24.75/LY, and screen‐and‐treat strategy costs −$3.3/QALY and −$12.71/LY when compared with no‐screen strategy. Compared to the FBCM strategy, the screen‐and‐treat strategy reduced the incidence of H. pylori‐related diseases, added 40 million QALYs, and saved 10 million LYs, but at the increased cost of $588 million. Cost‐effectiveness analysis showed that screen‐and‐treat strategy costs $14.88/QALY and $59.5/LY when compared with FBCM strategy. The robustness of the results was also verified. Conclusions: Both FBCM and screen‐and‐treat strategies are highly cost‐effective in preventing NUD, PUD, and GC than the no‐screen strategy in Chinese families at national level. As FBCM strategy is more practical and efficient, it is expected to play a more important role in preventing familial H. pylori infection and also serves as an excellent reference for other highly infected societies. [ABSTRACT FROM AUTHOR]

The carbon balance of the global ecosystems is significantly influenced by the soil organic carbon (SOC) pool in China's terrestrial ecosystems. Nevertheless, the current understanding of the main controlling factors of SOC in different ecosystems and their discrepancies is limited. The goal of this research was to better understand the human and environmental variables affecting SOC in China's terrestrial ecosystems. We designed a conceptual framework using 2674 samples collected from four ecosystems (grasslands, shrublands, wetlands, and croplands) in China during the 2000–2014 period, combining geodetector and multiple regression (MR) approaches to investigate the effects of environmental conditions, human activity, and their interplay on surface SOC (0–20 cm). Results showed that there were large discrepancies in the strength of influencing factors among different ecosystems. Total nitrogen (TN), mean annual temperature (MAT), and bulk density (BD) were the major factors influencing SOC in grasslands. BD, TN, and pH dominated in shrublands. For wetlands, SOC stocks were primarily attributed to maximum temperature (TMMX), MAT, and potential evapotranspiration (PET). Croplands are predominantly controlled by minimum temperature (TMMN), MAT, and TN. These results highlight that natural factors, particularly climatic and soil characteristics, were the dominant factors controlling SOC stocks in China's terrestrial ecosystems. This work also highlights that the interaction of two influencing factors, especially, pairs of soil characteristics factors, pairs of climate and soil characteristics factors, can well explain the drivers of SOC on the surface soil in China. Our study emphasizes the spatial heterogeneity of the factors that influence SOC in terrestrial ecosystems, enhancing knowledge of SOC at the national level, and providing the guideline for devising better policy to improve C sequestration and mitigate climate changes. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined factors associated with immediate antiretroviral therapy (ART) initiation among newly diagnosed people living with HIV (PLHIV) aged 18 years and above between May 2018 and June 2019 at six study sites in Guangdong Province, China. Topics include characteristics of the study participants, factors associated with immediate ART initiation among newly diagnosed PLHIV in Guangdong Province, and limitations of the study.

Globalization and urbanization have reshaped the way that service ecosystem subjects interact with each other in rural communities, providing conditions and possibilities for realizing value co-creation in rural communities. Therefore, this study selected rural communities in Guiyang City, China, as research subjects and explored the value co-creation mechanism in rural communities from the perspective of service ecosystems. The authors construct a theoretical framework encompassing "value co-creation conditions, value co-creation processes, and value co-creation results". The study found that the core mechanism in the process of value co-creation is "subject embedding, relationship interaction, and resource integration". At the macro level, resource sharing is achieved through complex and heterogeneous interactions among multiple subjects, under the influence of institutions, policies, and cultures. At the meso level, organizations complement each other's resources through the cooperation and empowerment of other actors horizontally, under the influence of structure, function, and rules. At the micro level, individuals optimize resources through cooperative and empowering interactions, under the influence of motivations and value preferences. Finally, the integration of individual, organizational, and overall values constitutes public values, under the joint cross-level action of institutional and cultural elements. This study provides a new theoretical perspective for exploring the value co-creation mechanism in rural communities and provides important practical insights for promoting the sustainable development of rural communities. [ABSTRACT FROM AUTHOR]

Net primary productivity (NPP) can indirectly reflect vegetation's capacity for CO 2 fixation, but its spatiotemporal dynamics are subject to alterations to some extent due to the influences of climate change and human activities. In this study, NPP is used as an indicator to investigate vegetarian carbon ability changes in the vital ecosystems of the Yangtze River Basin (YRB) in China. We also explored the NPP responses to climate change and human activities. We conducted a comprehensive analysis of the temporal dynamics and spatial variations in NPP within the YRB ecosystems from 2003 to 2020. Furthermore, we employed residual analysis to quantitatively assess the contributions of climate factors and human activities to NPP changes. The research findings are as follows: (1) Over the 18-year period, the average NPP within the basin amounted to 543.95 gC/m 2 , displaying a noticeable fluctuating upward trend with a growth rate of approximately 3.1 gC/m 2 ; (2) The areas exhibiting an increasing trend in NPP account for 82.55% of the total study area. Regions with relatively high stability in the basin covered 62.36% of the total area, while areas with low stability accounted for 2.22%, mainly situated in the Hengduan Mountains of the western Sichuan Plateau; (3) NPP improvement was jointly driven by human activities and climate change, with human activities contributing more significantly to NPP growth. Specifically, the contributions were 65.39% in total, with human activities contributing 59.28% and climate change contributing 40.01%. This study provides an objective assessment of the contributions of human activities and climate change to vegetation productivity, offering crucial insights for future ecosystem development and environmental planning. [ABSTRACT FROM AUTHOR]

The assessment of the value of villages is the basis of village conservation work. By evaluating the value of residential houses, it is possible to conduct graded conservation and targeted use of traditional villages with limited resources while also helping to guide the urban planning of architectural heritage sites scientifically. This work intends to evaluate the value of representative and ethnic Wengji villages in southern China. And to deal with the trend of traditional architectural culture being submerged by urbanization. First, according to the actual situation of the world-famous village, 12 evaluation index systems, including three subsystems of historical and cultural values, Aesthetic values, and architectural values, have been established. The entropy value method analyzes each index objectively and then solves it by MATLAB. The results are divided into four classes. Each building is numbered to obtain the corresponding weight. The main results show that: the most important factors are obtained for heritage value, architectural style (12%), building material (10.76%), and architectural space (9.68%). From the total value scores of 83 buildings in Wengji village and the distribution map of important value areas. it is known that the geographical location and the origin of village culture have a positive impact on the cultural value of buildings. These findings could provide a policy that offers a breakthrough point for stakeholders to protect ancient villages with architectural heritage in the future. [ABSTRACT FROM AUTHOR]

Slow-moving landslide-prone areas (SLAs) are unstable objects on the terrestrial surface that can collapse rapidly when provoked by earthquakes, leading to infrastructure damage. It is critical to identify SLAs prior to earthquake events and assess their hazard-causing probabilities when triggered. An assessment approach of earthquake-triggered geohazards is proposed in this paper by combining interferometric synthetic aperture radar (InSAR) derived SLAs and geological and geomorphological factors. Taking the Ms6.8 Luding earthquake, which occurred in the Sichuan Province of southwestern China on September 5, 2022, as an example, 1320 scenes of Sentinel-1 SAR data in western Sichuan were processed using the small baseline subset (SBAS) InSAR technique before the earthquake. After the earthquake, hazard probability assessment was performed in real-time by filtering the SLAs using a spatial analysis technique with geological and geomorphological factors, e.g., real-time peak ground acceleration (PGA), slope, distance to fault (DTF), and distance to the river (DTR) data. The results show that 11 SLAs were classified into high-risk zones. As verified by the Luding co-seismic landslide dataset from visual interpretation of optical remote sensing images, 142 coseismic landslides were triggered by the earthquake in these high-risk regions. In these areas, an ancient landslide, with high pre-earthquake displacement rates (−50 mm/year) on the scarp was reactivated under the Luding earthquake forces. This method can provide a scientific tool for disaster mitigation and rapid response emergency management. [ABSTRACT FROM AUTHOR]

Background: Originating in Africa, African swine fever (ASF) was introduced to China in 2018. This acute and highly virulent infectious disease affects domestic pigs. The World Organization for Animal Health has listed it as a statutory reportable disease, and China has listed it as a category A infectious disease. Methods: Primers and probes were designed for four ASFV genes (B646L, EP402R, MGF505-3R, and A137R). The primers/probes were highly conserved compared with the gene sequences of 21 ASFV strains. Results: After optimization, the calibration curve showed good linearity (R2 > 0.99), the minimum concentration of positive plasmids that could be detected was 50 copies/µL, and the minimum viral load detection limit was 102 HAD50/mL. Furthermore, quadruple quantitative polymerase chain reaction (qPCR) with nucleic acids from three porcine-derived DNA viruses and cDNAs from eight RNA viruses did not show amplification curves, indicating that the method was specific. In addition, 1 × 106, 1 × 105, and 1 × 104 copies/µL of mixed plasmids were used for the quadruple qPCR; the coefficient of variation for triplicate determination between groups was < 2%, indicating the method was reproducible. Conclusions: The results obtained by testing clinical samples containing detectable EP402R, MGF505-3R, and A137R strains with different combinations of gene deletions were as expected. Therefore, the established quadruple qPCR method was validated for the molecular diagnosis of ASF using gene-deleted ASFV strains. [ABSTRACT FROM AUTHOR]

Our work focuses on the impact of trade credit financing on firm efficiency exploiting a sample of Chinese manufacturing listed firms for the period 2004 to 2018. We find that trade credit significantly improves firm efficiency. This positive association is stronger in firms located in regions with higher levels of social trust, during periods with higher economic policy uncertainty and in times of economic downturn. We reveal three economic mechanisms underlying our baseline findings: alleviating financial constraints, mitigating agency conflicts, and reducing transaction costs. [ABSTRACT FROM AUTHOR]

Polybrominated diphenyl ethers (PBDEs) have been used as brominated flame retardants worldwide and are correlated with extensive environmental pollution and human health concerns. This study is aimed at analyzing the concentrations of PBDEs and at evaluating their temporal trends among a population of blood donors (n = 33) over a 4-year period. A total of 132 serum samples were used for PBDE detection. Nine PBDE congeners were quantified in serum samples by gas chromatography with mass spectrometry (GC–MS). The median concentrations of Σ9PBDEs in each year were 33.46, 29.75, 30.85, and 35.02 ng/g lipid, respectively. Most of the PBDE congeners showed a downward trend from 2013 to 2014 and then increased after 2014. No correlations between age and PBDE congener concentrations were observed, while concentrations of each congener and Σ9PBDE were nearly always lower in females than in males, especially in BDE-66, BDE-153, BDE-183, BDE-190, and Σ9PBDE. We also found that the intake of fish, fruit, and eggs in the daily diet was related to the exposure level of PBDEs. Our results suggest that, as deca-BDE is still produced and used in China, diet is an important exposure pathway for PBDEs, and follow-up studies will be required to improve our understanding of the behaviors of PBDE isomers in humans and the exposure levels. [ABSTRACT FROM AUTHOR]

We analyse how the COVID-19 pandemic crisis created the window of opportunity (WOP) in the digital industry and digital applications. These led to the leapfrogging of digital transformation in China. This was considered a major contribution to the pandemic recovery in early to mid-2020. By exploring this phenomenon, we examine alternatives for sustainable development during such turbulent circumstances mediating the destruction arisen from the crisis. We unveil the mechanisms that reveal the large-scale digitalisation that emerged as part of the response to managing the crisis. We find that during this crisis in China, the WOPs from policy, technology and demand perspectives facilitated the leapfrogging of the digital transformation in numerous social and economic areas. More importantly, we also discover that the WOPs are unevenly distributed among firms, time, and locations. Based on these results, we put forth that the COVID-19 pandemic brings a relative window of opportunity (RWOP) to society, impacting industries and firms. However, these impacts are disproportionately distributed. To the best of our knowledge, this is one of the first studies to illustrate how a social crisis leads to WOPs enhancing digital transformation. Furthermore, this also ultimately provided a coping mechanism to deal with the pandemic. [ABSTRACT FROM AUTHOR]

As one of the foods commonly eaten all over the world, eggs have attracted more and more attention for their quality and price. A method based on elemental profiles and chemometrics to discriminate between free-range and caged eggs was established. Free-range (n1 = 127) and caged (n2 = 122) eggs were collected from different producing areas in China. The content of 16 elements (Zn, Pb, Cd, Co, Ni, Fe, Mn, Cr, Mg, Cu, Se, Ca, Al, Sr, Na, and K) in the eggshell was determined using a inductively coupled plasma atomic emission spectrometer (ICP-AES). Outlier diagnosis is performed by robust Stahel–Donoho estimation (SDE) and the Kennard and Stone (K-S) algorithm for training and test set partitioning. Partial least squares discriminant analysis (PLS-DA) and least squares support vector machine (LS-SVM) were used for classification of the two types of eggs. As a result, Cd, Mn, Mg, Se, and K make an important contribution to the classification of free-range and caged eggs. By combining column-wise and row-wise rescaling of the elemental data, the sensitivity, specificity, and accuracy were 91.9%, 91.1%, and 92.7% for PLS-DA, while the results of LS-SVM were 95.3%, 95.6%, and 95.1%, respectively. The result indicates that chemometrics analysis of the elemental profiles of eggshells could provide a useful and effective method to discriminate between free-range and caged eggs. [ABSTRACT FROM AUTHOR]

Background: Migration can be linked to the transmission of COVID-19. COVID-19 vaccine uptake and hesitancy among rural-to-urban migrant workers in China, the largest group of internal migrants in the world, has not been characterized. Objective: To investigate COVID-19 vaccine uptake and identify vaccine hesitancy-associated factors among rural-to-urban migrant workers in the first round of COVID-19 vaccination in China. Methods: A cross-sectional questionnaire-based survey was conducted, including 14,917 participants. Socio-demographics, COVID-19 vaccine uptake, vaccine hesitancy and its associated factors based on Vaccine Hesitancy Determinants Matrix (VHDM) were applied for the survey. Data were principally analyzed by logistic regression analysis. Results: The COVID-19 vaccine uptake and vaccine hesitancy rates were 7.1% and 57.7%, respectively. Vaccine hesitancy was strongly associated with VHDM, including individual factors (female, higher annual income and fewer medical knowledge), group factors (less family support, friend support and public opinion support), COVID-19 epidemic factors (lower fatality, infection and emotional distress) and vaccine factors (less vaccine necessity, vaccine safety, vaccine efficacy, vaccine importance and vaccine reliability). Conclusion: The VHDM model has the potential utility in efforts to reduce COVID-19 vaccine hesitancy. Greater efforts should be put into addressing positive predictors associated with vaccine hesitancy. [ABSTRACT FROM AUTHOR]

The coastal saline-alkali soil in eastern China is an important reserve arable land resource. Adding exogenous organic material is an effective way to improve soil fertility and promote the conversion of saline-alkali soil to agricultural soil. In this study, a field plot experiment was used to investigate the influences of different organic materials (vinegar residue, VR; sewage sludge, SS; vermicompost, VC) on the reduction in salinity-alkalinity barrier factors, the accumulation of soil organic carbon (SOC), and the improvement in soil fertility in saline-alkali soil. The results indicated that applying different types of exogenous organic materials reduced soil electrical conductivity (EC) and pH, promoted SOC accumulation, and increased the barley yield. With the same application rate, VR application was more beneficial in reducing soil EC and pH, accumulating SOC, and increasing barley yield compared to SS and VC applications. In particular, the barley yield with VR application was higher than that with SS and VC applications by 18.4% and 26.6% on average, respectively, during the two-year experiment. Correlation and path analysis revealed that the barley yield was significantly negatively correlated with soil barrier factors (EC and pH), but EC in SS and VC-treated soils had an indirect negative effect on barley yield, while EC in VR-treated soil had a direct negative effect (−2.24). In addition, the direct (−4.46) and indirect (5.39) contributions of SOC to barley yield were higher with VR than those with SS and VC, while the direct contribution of soil aggregate to barley yield was lower with VR than that with SS and VC. Therefore, compared with SS and VC applications, VR application led to a fast reduction in soil barrier factors and the rapid accumulation of SOC, which were more beneficial for increasing barley yields in saline-alkali soil. [ABSTRACT FROM AUTHOR]

Objective: To determine if limb lengths, as markers of early life environment, are associated with the risk of diabetes in China. Design: We performed a cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS), and multivariable-adjusted Cox proportional hazard regression models were used to examine the associations between baseline limb lengths and subsequent risk of diabetes. Setting: The CHARLS, 2011–2018. Participants: The study confined the eligible subject to 10 711 adults aged over 45 years from the CHARLS. Results: During a mean follow-up period of 6·13 years, 1358 cases of incident diabetes were detected. When controlling for potential covariates, upper arm length was inversely related to diabetes (hazard ratio (HR) 0·95, 95 % CI (0·91, 0·99), P = 0·028), and for every 1-cm difference in knee height, the risk of diabetes decreased by about 4 % (HR 0·96, 95 % CI (0·93, 0·99), P = 0·023). The association between upper arm length and diabetes was only significant among females while the association between knee height and diabetes was only significant among males. In analyses stratified by BMI, significant associations between upper arm length/knee height and diabetes only existed among those who were underweight (HR 0·91, 95 % CI (0·83, 1·00), P = 0·049, HR 0·92, 95 % CI (0·86, 0·99), P = 0·031). Conclusions: Inverse associations were observed between upper arm length, knee height and the risk for diabetes development in a large Asian population, suggesting early life environment, especially infant nutritional status, may play an important role in the determination of future diabetes risk. [ABSTRACT FROM AUTHOR]

Background: Classical swine fever (CSF), African swine fever (ASF), and atypical porcine pestivirus (APPV) are acute, virulent, and contagious viral diseases currently hampering the pig industry in China, which result in mummification or stillbirths in piglets and mortality in pigs. Diagnostic assays for the differentiation of infection and vaccination of CSFV, in addition to the detection of ASFV and APPV, are urgently required for better prevention, control, and elimination of these viral diseases in China. Methods: A quadruple PCR-based gene microarray assay was developed in this study to simultaneously detect wild-type and vaccine CSFV strains, ASFV and APPV according to their conserved regions. Forty-two laboratory-confirmed samples, including positive samples of 10 other swine viral diseases, were tested using this assay to confirm its high specificity. Results: This assay's limit of detections (LODs) for the wild-type and vaccine CSFV were 6.98 and 6.92 copies/µL. LODs for ASFV and APPV were 2.56 × 10 and 1.80 × 10 copies/µL, respectively. When compared with standard RT-PCR or qPCR for CSFV (GB/T 26875–2018), ASFV (MARR issue No.172), or APPV (CN108611442A) using 219 clinical samples, the coincidence was 100%. The results showed that this assay with high sensitivity could specifically distinguish ASFV, APPV, and CSFV, including CSFV infection and immunization. Conclusion: This assay provides a practical, simple, economic, and reliable test for the rapid detection and accurate diagnosis of the three viruses and may have good prospects for application in an epidemiological investigation, prevention, and control and elimination of these three diseases. [ABSTRACT FROM AUTHOR]

Pseudomyxoma peritonei (PMP) is an extremely rare condition. Information regarding the disease burden of PMP in developing countries is limited. This study aimed to determine the epidemiology of PMP in China. PMP data were extracted from the national databases of Urban Basic Medical Insurance. All cases were identified using the International Classification of Diseases (ICD) codes and Chinese diagnostic terms. The national prevalence from 2012 to 2016 and incidence in 2016 were estimated. In total, 153 patients with PMP were identified. The crude prevalence of PMP in 2016 was 2.47 (95% confidence interval [CI] 1.71 to 3.23) per million person-year, with a higher prevalence in females than males. Prevalence increased with age, with the first peak in those aged 15–29 years and the highest in those aged >80 years. The crude incidence of PMP in 2016 was 1.19 (95% CI 0.59 to 1.78) per million person-years. Similar to the prevalence, the rates were higher in women than in men. The incidence also increased with age, with the highest prevalence in those aged >80 years. Besides, the most frequent comorbidities before and after the first diagnosis of PMP were unspecified secondary malignancies and malignancies of unspecified sites, followed by abdominal malignant tumours. The rate of PMP was lower in mainland China than in European countries and increased with advancing age. Women were more likely to have PMP than men. Furthermore, an insufficient understanding of this rare disease presents a major challenge in accurately evaluating the disease burden. [ABSTRACT FROM AUTHOR]

Built-up area (BA) extraction using synthetic aperture radar (SAR) data has emerged as a potential method in urban research. Currently, typical deep-learning-based BA extractors show high false-alarm rates in the layover areas and subsurface bedrock, which ignore the surrounding information and cannot be directly applied to large-scale BA mapping. To solve the above problems, a novel transformer-based BA extraction framework for SAR images is proposed. Inspired by SegFormer, we designed a BA extractor with multi-level dual-attention transformer encoders. First, the hybrid dilated convolution (HDC) patch-embedding module keeps the surrounding information of the input patches. Second, the channel self-attention module is designed for dual-attention transformer encoders and global modeling. The multi-level structure is employed to produce the coarse-to-fine semantic feature map of BAs. About 1100 scenes of Gaofen-3 (GF-3) data and 200 scenes of Sentinel-1 data were used in the experiment. Compared to UNet, PSPNet, and SegFormer, our model achieved an 85.35% mean intersection over union (mIoU) and 94.75% mean average precision (mAP) on the test set. The proposed framework achieved the best results in both mountainous and plain terrains. The experiments using Sentinel-1 shows that the proposed method has a good generalization ability with different SAR data sources. Finally, the BA map of China for 2020 was obtained with an overall accuracy of about 86%, which shows high consistency with the global urban footprint. The above experiments proved the effectiveness and robustness of the proposed framework in large-scale BA mapping. [ABSTRACT FROM AUTHOR]

Background: Acute histoplasmosis is a rare fungal disease in China. This study is aimed to summarize the clinical characteristics of the first large-scale outbreak of imported acute histoplasmosis in Chinese, so as to provide suggestions for clinical diagnosis and treatment. Methods: We collected the symptoms, signs, laboratory examination and imaging data of 10 patients in so far the biggest outbreak of imported acute histoplasmosis in immunocompetent Chinese. Their clinical characteristics and time-varying cytokine/chemokine levels were analyzed, and rank correlation analysis between these markers was utilized to show their condition. Results: The 10 patients of imported acute histoplasmosis were working without any respiratory protection in an abandoned mine tunnel in Guyana. The most common symptoms were fever and cough. Their chest CT imaging showed multiple nodular shadows in lungs. Laboratory examination showed that at admission the CRP, PCT, LDH, CysC, G-test, β2-MG were all increased in at least 9 patients, and the CD4/CD8 was decreased to < 1 in all patients. Most cytokines/chemokines (other than IL-4, IL-12, INF-α, TNF-α) varied widely with patients and time, but their overall trend is higher at admission and decreasing gradually during hospitalization, especially for the IL-6, IL-8, IL-10 and IFN-γ. The LDH, CysC, G-test, β2-MG, N/L, IL-6, IL-8, IL-10, IFN-γ, IL-27 are in positive associations to both CRP and PCT. Conclusions: The diagnosis of acute histoplasmosis needs a comprehensive analysis of epidemiological history, clinical symptoms and signs, and results of imaging, laboratory, microbiological and pathological examinations. Although none of the CRP, PCT, G-test, N/L, LDH, CysC, β2-MG, IL-6, IL-8, IL-10, IFN-γ shows specificity in the diagnosis of acute histoplasmosis, there is possibility that the above factors might help in the inflammation and prognosis estimation. However, more studies and further investigation are still required for the verification. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify risk factors for mortality and outcomes in hematological malignancy (HM) patients with bloodstream infection (BSI) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods: A retrospective study was conducted at a tertiary teaching hospital in Henan Province, China, between January 2018 and December 2021. All BSIs caused by CRKP in hospitalized HM patients were identified. Data on patient demographics, disease, laboratory tests, treatment regimens, outcomes of infection, and the antimicrobial susceptibility of each isolate were collected from medical records. Results: A total of 129 patients with CRKP BSI were included in the study, and the 28-day mortality rate was 80.6% (104/129). In Cox analysis an absolute neutrophil count < 500 at discharge (hazard ratio [HR] 6.386, 95% confidence interval [CI] 3.074– 13.266, p < 0.001), intensive care unit admission (HR 1.834, 95% CI 1.065– 3.157, p = 0.029), and higher Pitt bacteremia score (HR 1.185, 95% CI 1.118– 1.255, p < 0.001) were independent risk factors associated with 28-day mortality. Survival curve analysis indicated that compared with ceftazidime-avibactam-based therapy, both polymyxin b (HR 8.175, 95% CI 1.099– 60.804, p = 0.040) and tigecycline (HR 14.527, 95% CI 2.000– 105.541, p =0.008) were associated with a higher risk of mortality. Conclusion: In HM patients CRKP BSI resulted in high mortality. Intensive care unit admission, higher Pitt bacteremia score, and absolute neutrophil count < 500 at discharge were independently associated with higher mortality. Early initiation of new agents such as ceftazidime-avibactam may improve outcomes. [ABSTRACT FROM AUTHOR]

Timely and accurate information on rice cultivation makes important contributions to the profound reform of the global food and agricultural system, and promotes the development of global sustainable agriculture. With all-day and all-weather observing ability, synthetic aperture radar (SAR) can monitor the distribution of rice in tropical and subtropical areas. To solve the problem of misclassification of rice with no marked signal during the flooding period in subtropical hilly areas, this paper proposes a new feature combination and dual branch bi-directional long short-term memory (DB-BiLSTM) model to achieve high-precision rice mapping using Sentinel-1 time series data. Based on field investigation data, the backscatter time series curves of the rice area were analyzed, and a characteristic index (VV − VH)/(VV + VH) (VV: vertical emission and vertical receipt of polarization, VH: vertical emission and horizontal receipt of polarization) for small areas of hilly land was proposed to effectively distinguish rice and non-rice crops with no marked flooding period. The DB-BiLSTM model was designed, ensuring the independent learning of multiple features and effectively combining the time series information of both (VV − VH)/(VV + VH) and VH features. The city of Shanwei, Guangdong Province, China, was selected as the study area. Experimental results showed that the overall accuracy of the rice mapping results was 97.29%, and the kappa coefficient reached 0.9424. Compared to other methods, the rice mapping results obtained by the proposed method maintained good integrity and had less misclassification, which demonstrated the proposed method's practical value in accurate and effective rice mapping tasks. [ABSTRACT FROM AUTHOR]

Purpose: In the ongoing Industry 4.0 era, the internet of things (IoT) has become a global race in the current information technology climate. However, little is understood about the pattern of the global competitive arena or its players' set up strategy. This paper aims to attempt to compare the cross-country development of the IoT industry. In particular, from the lens of industrial policies, this paper highlights how China, as a latecomer, gains momentum to emerge victorious as a leader in this global race. Design/methodology/approach: Based on five dimensions, namely, foundation, trajectory, characteristic, application and social impacts, this paper presents the evolution of the IoT industry in the USA, European Union, Japan, South Korea and China. From the lens of windows of opportunities, this paper analyzes how China seized the opportunity with the emerging technology, thereby, enabling it to create a competitive advantage. Findings: This paper finds that China's IoT industry takes a distinct trajectory, where scientific institutions, enterprises and governmental policies collaborate in unison, during which the first phase was when scientific research institutions introduced the conceptual new technology from developed countries. This technological foresight allowed for the identification and realization of critical technologies, strategic fields and technological trends. The second phase was the continuous dissatisfaction of capabilities of critical technologies, which creates disruptions that significantly altered the environment of technological competition. Originality/value: This paper provides a comprehensive and comparative review of IoT industries in a global context, with the critical and influential role of the windows of opportunities on those enterprises lagging behind the technological wave. [ABSTRACT FROM AUTHOR]

The visual aesthetics of villages are remarkably affected by the exterior quality of traditional residences, influencing the impression and assessment of local culture. A proper scientific assessment of exterior quality can protect traditional cultures and improve the development of villages. This research was conducted in a village consisting of 115 residences (Mengjinglai village, which is on the border between China and Myanmar). The backpropagation (BP) neural network model with genetic algorithm (GA) was applied to evaluate the quality of the dwellings. All the evaluation values of the dwellings were defined by scores. Meanwhile, the score of each residence was affected by three main factors: architectural spatial elements, architectural construction elements, and historical and cultural elements. The results show that the village's dwellings are well preserved and clearly express the traditional Dai style. Moreover, the GA–BP approach is more suitable than the traditional BP method for the assessment of the exterior quality. The quantitative machine learning model would be useful for other aspects of the assessment of similar villages in the future. [ABSTRACT FROM AUTHOR]

China is facing a shortage of arable land resources, and the mudflat salt-affected soil along the east coast of China is an important reserve arable land resource. In this study, we conducted a randomized field trial to investigate the effects of vermicompost application rate (0, 25, 50, 125, and 250 t ha−1) on barley growth and heavy metal accumulation in mudflat salt-affected soil. We found that vermicompost application decreased bulk density, electrical conductivity (EC), and pH of mudflat salt-affected soil while increasing its organic carbon, nitrogen, and phosphorus contents. With the increase in vermicompost application rate, the yield of grain and total biomass of barley plants increased. The yield of grain in the vermicompost application treatments of 25, 50, 125, and 250 t ha−1 increased by 66.0%, 226.0%, 340.0%, and 512.0%, respectively, relative to the control. In addition, the concentrations of heavy metals (Cd, Cr, Cu, and Zn) in mudflat salt-affected soil and barley plant increased as the vermicompost application rate increased. [ABSTRACT FROM AUTHOR]

Background: Haemolytic uraemic syndrome (HUS) is a severe syndrome that causes a substantial burden for patients and their families and is the leading cause of acute kidney injury in children. However, data on the epidemiology and disease burden of HUS in Asia, including China, are limited. We aimed to estimate the incidence and cost of HUS in China.  METHODS: Data about HUS from 2012 to 2016 were extracted from the Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) databases. All cases were identified by ICD code and Chinese diagnostic terms. The 2016 national incidence rates were estimated and stratified by sex, age and season. The associated medical costs were also calculated.Results: The crude incidence of HUS was 0.66 per 100,000 person-years (95% CI: 0.35 to 1.06), and the standardized incidence was 0.57 (0.19 to 1.18). The incidence of HUS in males was slightly higher than that in females. The age group with the highest incidence of HUS was patients < 1 year old (5.08, 95% CI: 0.23 to 24.87), and the season with the highest incidence was autumn, followed by winter. The average cost of HUS was 2.15 thousand US dollars per patient, which was higher than the national average cost for all inpatients in the same period.Conclusions: This is the first population-based study on the incidence of HUS in urban China. The age and seasonal distributions of HUS in urban China are different from those in most developed countries, suggesting a difference in aetiology. [ABSTRACT FROM AUTHOR]

Environmental public interest litigation (EPIL) is an important development in the evolving framework of environmental governance in China. Through quantitative and qualitative analyses of decided cases brought by local government, public prosecutors and environmental non-governmental organisations (NGOs), this study critically examines the features, strengths, difficulties and obstacles in the EPIL practice of China. While there is remarkable success overall for all three groups in terms of outcome, they each display different approaches and focuses. The prosecutors have established themselves as the cornerstone of the system by being the most efficient in winning the greatest number of cases. NGOs moved away from collaboration with the prosecutors in low-value cases, effectively into a competition with the government in a smaller number of high-value cases, though they are willing to venture into areas where others hesitate over. The findings offer valuable insights into current EPIL practice and inform future policy adjustment and legislation. [ABSTRACT FROM AUTHOR]

Strain SYSU D01096T was isolated from a sandy soil sample collected from Gurbantunggut Desert in Xinjiang, PR China. Phylogenetic analysis of the nearly full-length 16S rRNA gene sequence revealed that strain SYSU D01096T belonged to the family Acetobacteraceae and was closest to Rubritepida flocculans DSM 14296T (96.0% similarity). Cells of strain SYSU D01096T were observed to be non-motile, short rod-shaped and Gram-staining negative. The colonies were observed to be translucent, reddish orange, circular, convex and smooth. Growth occurred at 15–37 °C (optimum, 28–30 °C), pH 4.0–8.0 (optimum, pH 7.0) and 0–0.5% NaCl (w/v; optimum, 0%) on Reasoner's 2A medium. The predominant ubiquinone was identified as ubiquinone 9 and the major fatty acids were Summed Feature 8 (C18:1ω7c and/or C18:1ω6c) and C16:0. The polar lipids consisted of diphosphatidylglycerol (DPG), phosphatidylethanolamine (PE), phosphatidylcholine (PC), phosphatidylglycerol (PG), one unidentified phospholipid (PL), three unidentified aminolipids (AL1-3) and one unidentified aminophospholipid (APL). The genomic DNA G + C content was 69.1%. Phylogenetic tree based on 16S rRNA gene sequences indicated strain SYSU D01096T represented an individual lineage in the family Acetobacteraceae, which was supported by 30 core gene-based phylogenomic tree. Based on the multi-analysis including physiological, chemotaxonomic and phylogenetic comparison, strain SYSU D01096T was proposed to represent a novel species of a novel genus, named Sabulicella rubraurantiaca gen. nov., sp. nov., within the family Acetobacteraceae. The type strain is SYSU D01096T (= CGMCC 1.8619T = KCTC 82268T = MCCC 1K04998T). [ABSTRACT FROM AUTHOR]

Purpose: Studies show that axillary surgery can be potentially omitted in certain breast cancer patients who achieve breast pathologic complete response (pCR) after neoadjuvant systemic therapy (NST). However, potential differences between the ypT0 and ypTis subgroups remain to be explored. Furthermore, whether axillary surgery can be omitted in patients with clinically assessed positive axillary lymph nodes (cN+) remains unknown. This study was to evaluate the status of axillary lymph nodes for patients who achieved breast pCR after NST in the real-world study. Methods: This retrospective cohort study included 258 patients with early or locally advanced breast cancer who underwent breast and axillary surgery after NST. Clinical and pathologic data were compared between patients with breast pCR (ypT0/is) and those without breast pCR. Results: The rate of breast pCR after NST was 27.1% (70/258). Among the patients with initial cN0, the rate of axillary pCR was similar between the breast pCR and breast non-pCR groups (100% vs. 85.7%, P = 0.1543). Among those with breast pCR, the rate of axillary pCR was 100% in both the ypT0 and ypTis subgroups. Furthermore, among those with initial cN+, the rate of axillary pCR was higher in the breast pCR group than in the breast non-pCR group (82.7% vs. 22.9%, P < 0.0001). Among the patients with breast pCR, the rate of axillary pCR was higher in the ypT0 subgroup than in the ypTis subgroup (94.3% vs. 58.8%, P = 0.0034). Conclusion: Axillary surgery may potentially be omitted in patients with initial cN0 who achieve breast pCR (ypT0/is), and may also be considered for omission in patients with initial cN+ who achieve ypT0 (not ypTis). [ABSTRACT FROM AUTHOR]

Nuclear power stations involve a range of complex and interacting multi-physical processes. With the rapid development of high-performance computing technology, accurate multi-physics simulation in virtual reactors has drawn more and more attention in industry and academia. Great efforts have been made toward the simulation of multi-physics coupling processes in reactors. The interpretations of many terms that describe multi-physics simulation vary in different literatures. We organize and discuss some important terms relevant to the multi-physics coupling simulation. We compare the three most frequently used multi-physics coupling strategies: the operator splitting, Picard iteration, and Jacobian-Free Newton–Krylov methods. We summarize three main viewpoints on the degree of coupling of the three strategies (loose, tight, or full coupling). Then we review the coupling software and corresponding coupling strategies in some representative virtual reactor projects. We present the research focuses of Spider coupling platform. The Spider is developed in the China Virtual Reactor (CVR) project. The multi-physics phenomena are considered in the CVR project from three scales: fuel scale, reactor core scale, and system scale. Both loose and tight coupling strategies are supported in the Spider platform. [ABSTRACT FROM AUTHOR]

Background and purpose: The aim was to determine the transitional patterns in the clinical characteristics, treatments and comorbidities in amyotrophic lateral sclerosis (ALS) patients over the past 14 years using data from a large clinical cohort in mainland China. Methods: Sporadic ALS patients who visited the Peking University Third Hospital from January 2005 to December 2018 were included in this study. The 14 years were divided into three periods, and changes in the baseline characteristics of the participants were analyzed at 5‐year intervals. Results: In total, 3410 patients with sporadic ALS were recruited: 2181 were men and 1229 were women. The proportion of patients with bulbar‐onset ALS increased from 13.0% in 2005–2009 to 19.5% in 2015–2018 (p < 0.001). The mean (standard deviation) age at onset increased from 49.5 (11.4) years in 2005–2009 to 53.0 (11.0) years in 2015–2018 (p < 0.001). ALS patients with diabetes or hypertension showed a delay in ALS onset, and the delay was even more apparent when the patients had both comorbidities. The proportion of riluzole users in 2015–2018 was approximately 2.5‐fold of that in 2005–2009 (p < 0.001). Conclusions: In the context of a lack of clinical data on ALS in mainland China, this study evaluated a large cohort of patients diagnosed over a 14‐year period. The age at onset and percentage of patients who used riluzole both increased over the study period. Additionally, it was found that patients with comorbidities such as diabetes and hypertension had a delayed age of ALS onset. [ABSTRACT FROM AUTHOR]

Purpose: Buoyed by the desire to reduce carbon dioxide emissions and develop sustainable urban transportation, the dockless bike-sharing industry boomed in China during 2017–2018. To the surprise of the stakeholders, this industry dramatically ebbed in 2019. The dockless bike-sharing system deviated from a problem-solver to a troublemaker in a very short period. The oversupplied and excessively discarded shared bikes caused a big waste of resources and serious pollution to the environment. In this paper, the decision-making of the key players of the industry, i.e. business operators, investors, customers and government, is analyzed through the lens of the cognitive bias. This paper aims to illuminate the process of how this innovative transport solution turned to a disastrous ending, which caused damage to urban environment and financial loss to investors. Design/methodology/approach: In this study, a qualitative analysis based on the rich secondary data sources is conducted. A rich amount of qualitative data including news reports, government policies, consulting reports and companies' annual reports etc. were collected. Findings: The study shows, in the product introduction period, the government, business operators, investors and consumers fell into the cognitive bias. They over focused on the positive side such as high-tech, eco-friendly, convenient image of the dockless bike-sharing solution. Thereby, the key stakeholders made irrational decisions in product adoption and management. This study moves toward increasing key stakeholders' awareness of the imperative to reduce these biases when promoting eco-innovations. This study also recommends a prudent attitude with a rational and comprehensive thinking style in dealing with eco-innovation and the emerging sharing economy. Originality/value: To solve the cognitive biases, this study recommends that people use rational decision-making style to examine and adopt the dockless bike-sharing solutions. Practical recommendations to tackle the existing recycling crisis of the dockless bike-sharing industry are also discussed. [ABSTRACT FROM AUTHOR]

Purpose: Psychotropic medications are commonly used for treating mental disorders; however, there is currently no study on how commonly they are used in China. This study reported the trends in psychotropic medications prescriptions in urban China. Methods: A national population-based study was conducted using the China Health Insurance Research Association database to estimate the period prescription prevalence of 11 major classes of psychotropic medications annually during 2013–2017. The World Health Organization Anatomical Therapeutic Chemical (ATC) classification codes were used to identify psychotropic medications. Results: The prescription prevalence of any psychotropic medication increased from 8.110% (8.106–8.114%) in 2013 to 11.362% (11.357–11.366%) in 2017. The prescription prevalence of six classes increased significantly during 2013–2017, including sedatives-hypnotics (from 3.177 to 5.388%), anxiolytics (from 1.436 to 2.200%), antiepileptic drugs (from 1.416 to 2.140%), antipsychotics (from 0.809 to 1.156%), antidepressants (from 0.891 to 1.045%), and psycholeptic polypills (from 0.682 to 0.866%). The prescription prevalence of antidementia drugs increased from 0.069 to 0.122%, and mood stabilizers increased from 0.029 to 0.037%, although not statistically significant. The prescription prevalence of nootropic drugs, attention deficit hyperactivity disorder (ADHD) medications and drugs used in the treatment of addictive disorders was largely stable. Psychotropic medication prescription increased with age for all classes except for ADHD medications and mood stabilizers. Conclusion: Increasing trends in prescription prevalence were observed for most classes of psychotropic medications in urban China, although the prevalence was still lower than that in most developed countries. Further research is warranted to explore the potential treatment gap between China and most developed countries. [ABSTRACT FROM AUTHOR]

Background: Depression is an important global public health problem. Whether sex differences exist in the association between serum lipids and depressive symptoms is controversial. This study aimed to investigate sex differences in the association between dyslipidemia and depressive symptoms in the middle-aged and elderly population in China.Methods: Data from the China Health and Retirement Longitudinal Study, which included 2 630 males and 2 929 females, were used. Serum lipids were measured using a standard enzymatic colorimetric technique. Depressive symptoms were evaluated by the 10-item Center for Epidemiologic Studies Depression Scale. Multivariable logistic regression was performed to evaluate the association between serum lipids and depressive symptoms in men and women separately. To preclude the effects of hypertension and diabetes, the above analysis was also performed among those free of hypertension and diabetes.Results: Total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not associated with depressive symptoms. High-level triglycerides showed a marginally significant association with depressive symptoms in men (adjusted OR 1.35, 95% CI 0.91 to 1.99). In the population without hypertension and diabetes, high-levels TGs were only associated with the development of depressive symptoms in men (adjusted OR 2.04, 95% CI 1.20 to 3.47).Limitations: Depression and chronic diseases were respectively identified by CESD-10 and self-report, which were subjective to some extent.Conclusions: High-level triglycerides increased the risk of depressive symptoms in men, especially in the nonhypertensive and nondiabetic population. This study provided a basis for formulating sex-specific prevention strategies and treatment measures for depressive symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Environmental non-governmental organizations (ENGOs), one of the major forces in environmental protection, have developed rapidly in the past few years, especially in developing countries such as China. This paper aims to reveal how the ENGOs select their focuses, specifically if they only concentrate on one focus or on contexts in which they obtain various focuses and the motivations behind their choosing strategies. Design/methodology/approach: The current research interviewed 103 leaders of ENGOs covering every province in mainland China and adopts existing theories of NGOs alongside diversification strategy from a management perspective. Findings: The results showed that most Chinese ENGOs now tend to be diversified but face different challenges. This research highlights the importance of ENGOs' resources and capacities in facing current challenges and suggests directions to improve their diversification strategy. Originality/value: This research adds value to the research of environmental NGOs and gives suggestions to environmental NGO practitioners, in particular to those in emerging markets. [ABSTRACT FROM AUTHOR]

Study Question: Does unplanned spontaneous follicular growth and ovulation affect clinical outcomes after planned artificial frozen-thawed embryo transfer (AC-FET) cycles?Summary Answer: AC-FET and spontaneous follicular growth and ovulation events resulted in notably better pregnancy outcomes with a significantly higher implantation rate (IR), clinical pregnancy rate (CPR), ongoing pregnancy rate (OPR) and live birth rate (LBR) and a significantly lower miscarriage rate.What Is Known Already: The AC-FET protocol without GnRH agonist administration is associated with a low incidence of follicular growth and ovulation. In the literature, authors often refer to these types of cycles with concern due to possibly impaired FET outcomes. However, the real impact of such cycles has yet to be elucidated due to the lack of existing data.Study Design, Size, Duration: This was a retrospective clinical study involving 2256 AC-FET cycles conducted between January 2017 and August 2019. Propensity score (PS) matching was used to control for confounding variables.Participants/materials, Setting, Methods: Subjects were divided into two groups: a study group: cycles with spontaneous follicular growth and ovulation (the maximum diameter of follicles in any ovary was ≥14 mm and ovulation was confirmed by consecutive ultrasound examinations) and a control group featuring cycles without growing follicles (the maximum diameter of follicles in both ovaries were <10 mm). The study group was matched by PS with the control group at a ratio of 1:2. The study group consisted of 195 patients before PS matching and 176 patients after matching. The numbers of participants in the control group before and after PS matching were 2061 and 329, respectively.Main Results and the Role Of Chance: This analysis showed that patient age (adjusted odds ratio [aOR] 1.05; 95% CI 1.01-1.09; P=0.010) and basal FSH level (aOR 1.06; 95% CI 1.01-1.11; P=0.012) were significantly and positively related with the spontaneous follicular growth and ovulation event. In addition, this event was negatively correlated with BMI (aOR 0.92; 95% CI 0.87-0.97; P=0.002), AMH level (aOR 0.66; 95% CI 0.59-0.74; P<0.001) and a high starting oestrogen dose (aOR 0.53; 95% CI 0.38-0.76 for 6 mg vs. 4 mg; P<0.001). Baseline characteristics were similar between groups after PS matching. Patients in the study group had a significantly higher IR (28.8% vs. 21.8%, P=0.016), CPR (44.9% vs. 33.4%, P=0.011), OPR (39.2% vs. 26.1%, P=0.002) and LBR (39.2% vs. 24.9%, P=0.001) and a lower miscarriage rate (12.7% vs. 25.5%, P=0.030), compared with those in the control group.Limitations, Reasons For Caution: This was a retrospective study carried out in a single centre and was therefore susceptible to bias. In addition, we only analysed patients with normal ovulation patterns and excluded those with follicular growth but without ovulation. Further studies remain necessary to confirm our results.Wider Implications Of the Findings: It is not necessary to cancel cycles that experience spontaneous follicular growth and ovulation. Our data support promising clinical outcomes after this event. Our findings are important as they can better inform clinicians and patients.Study Funding/competing Interest(s): This research was supported by National Natural Science Foundation of China (grant no. 81701507, 81801404, 81871210, 82071648), Natural Science Foundation of Jiangsu Province (grant no. BK20171126, BK20201123) and Jiangsu Province '333' project. The authors declare that they have no competing interests.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background and purpose: Multiple sclerosis (MS) is a rare neurological disease addressed by only few epidemiological studies in China. This population‐based study aimed to estimate the prevalence of MS in China by using national medical insurance databases. Methods: Data from the Urban Employee Basic Medical Insurance database and the Urban Residence Basic Medical Insurance database, which were collected during 2012 to 2016 and included approximately 0.20 billion residents in six provinces, were used in this population‐based study. The prevalent patients with MS were identified via diagnostic text or disease codes. Results: The crude prevalence in 2016 was 2.44 per 100,000 population (95% confidence interval (CI) 2.18–2.72), with the prevalence in females being higher than that in males. The standardized prevalence (based on 2010 Chinese census data) was 2.29 (95% CI 2.21–2.38). The prevalence in both sexes in 2016 increased up to the age range of 30–34 years. Subsequently, the female prevalence declined with increasing age, but male prevalence stabilized with increasing age. During the 5‐year time period, prevalence ranged from 2.32 (95% CI 2.06–2.60) in 2015 to 2.91 (95% CI 2.39–3.47) in 2012. Conclusions: The prevalence of MS in China was lower than that in Europe and North America. The temporal trend of prevalence in China was also observed to be stable. As the first prevalence study of MS in mainland China, this population‐based study can provide useful information for worldwide healthcare services and prevention of MS. [ABSTRACT FROM AUTHOR]

Soil conservation practices can greatly affect the soil erosion process, but limited information is available about its influence on the particle size distribution (PSD) of eroded sediment, especially under natural rainfall. In this study, the runoff, sediment yields, and effective/ultimate PSD were measured under two conventional tillage practices, downhill ridge tillage (DT) and plat tillage (PT) and three soil conservation practices, contour ridge tillage (CT), mulching with downhill ridge tillage (MDT), and mulching with contour ridge tillage (MCT) during 21 natural rainfall events in the lower Jinsha River. The results showed that (1) soil conservation practices had a significant effect on soil erosion. The conventional tillage of DT caused highest runoff depth (0.58 to 29.13 mm) and sediment yield (0.01 to 3.19 t hm−2). Compared with DT, the annual runoff depths and sediment yields of CT, MDT and MCT decreased by 12.24%–49.75% and 40.79%–88.30%, respectively. (2) Soil conservation practices can reduce the decomposition of aggregates in sediments. The ratios of effective and ultimate particle size (E/U) of silt-and sand-sized particles of DT and PT plots were close to 1, indicating that they were transported as primary particles, however, values lower/greater than 1 subject to CT, MDT and MCT plots indicated they were transported as aggregates. The ratios of E/U of clay-sized particles were all less than 1 independently of tillage practices. (3) The sediments of soil conservation practices were more selective than those of conventional tillage practices. For CT, MDT and MCT plots, the average enrichment ratios (ERs) of clay, silt and sand were 1.99, 1.93 and 0.42, respectively, with enrichment of clay and silt and depletion of sand in sediments. However, the compositions of the eroded sediments of DT and PT plots were similar to that of the original soil. These findings support the use of both effective and ultimate particle size distributions for studying the size selectivity of eroded sediment, and provide a scientific basis for revealing the erosion mechanism in the purple soil area of China. [ABSTRACT FROM AUTHOR]

In recent years, a series of earthquakes have occurred in Sichuan province, southwest China. On April 20, 2013, 1013 landslides were triggered in the Lushan earthquake within the research area of 1215.87 km2. On August 8, 2017, 821 landslides were induced in the Jiuzhaigou earthquake within the study area of 541.61 km2. The slope, aspect, elevation, distance to the river, distance to fault, stratum lithology, curvature, and PGA as evaluation factors were chosen to research the distribution characteristics of coseismic landslides. The relationship between influence factors and distribution of coseismic landslides were analyzed using landslide area density (LAD), defined as the ratio between the coseismic landslides area and the total area under the specific classification of eight factors, and landslide number density (LND), interpreted as the number of landslides per square kilometer affected by an earthquake. Both the LAD and LND curves show the common correlations between distribution characteristics of coseismic landslides and the classification of eight factors. The high density of coseismic landslides was found at locations where the valley evolves from U-shaped to V-shaped, along slopes with an inclination between 20 and 50°. Due to the effect of river cutting erosion and human engineering activities, massive coseismic landslides appeared within the scope of 200 m from the river system. Eight hundred sixty small shallow coseismic landslides were found less than 3 km from the seismogenic fault in both earthquakes. Both concave and convex terrain has the same effect of promoting coseismic landslides. The strata of the Carboniferous and Cretaceous are more prone to coseismic landslides occurrence. In the event of another earthquake of similar magnitude in southwest China in the future, the research results can quickly predict the distribution of coseismic landslides and provide a scientific basis for emergency rescue. [ABSTRACT FROM AUTHOR]

Precipitation regimes have been predicted to shift to more extreme patterns that are characterized by heavy rainfall events and longer dry intervals. Spatiotemporal variation of precipitation extremes may significantly influence the local ecosystem, especially in the arid and semi‐arid regions. This study investigated the variations in extreme precipitation indices across the arid and semi‐arid land of China from 1960 to 2018. Spatial autocorrelation analysis was also conducted to evaluate spatial autocorrelations within the study area. There was generally an increasing trend of precipitation intensity, however, most stations in the low‐altitude semi‐arid regions showed non‐significant trend. The frequency indices generally showed a decreasing trend in consecutive dry days, and an increasing trend in precipitation days in the arid land and high‐altitude semi‐arid regions, suggesting that the arid and high‐altitude semi‐arid regions are becoming wetter. Signals of decreasing precipitation intensity and frequency were still found, such as increasing trends in consecutive dry days in the stations from the low‐altitude semi‐arid regions, implying the possibility of increased drought risk at small spatial scale. The global Moran's I values indicated that the spatial autocorrelation of the trend in the low‐altitude semi‐arid region is high. The local Moran's I showed that the number of stations with wetting trend in the arid region were much higher than that in the semi‐arid regions. These observations imply that the precipitation extremes in the arid and semi‐arid regions of China are becoming more homogeneous. Hence, this study can serve as a useful reference to the policymakers and stakeholders for framing water resource and ecosystem management strategies in arid regions. [ABSTRACT FROM AUTHOR]

Background: Extramammary Paget's disease (EMPD) is an intraepithelial adenocarcinoma. The chronic relapsing clinical course and unbearable clinical symptoms of extramammary Paget's disease usually result in a markedly diminished quality of life. No national data are available on descriptive epidemiology of EMPD in China, the most populous country over the world. This population-based study aimed to estimate the prevalence and associated sex and age patterns of EMPD in China.Methods: This study was conducted using data from China's Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance, covering approximately 0.43 billion Chinese urban residents in 2016. Patients with EMPD were identified based on the diagnostic names and codes in claim data.Results: A total of 53 males and 31 females with EMPD were found. The crude prevalence in 2016 was 0.04 per 100,000 population [95% confidence interval (CI) 0.02-0.06], ranging from 0.01 (95% CI 0.00-0.02) in North or Northeast China to 0.08 (95% CI 0.03-0.16) in Southwest China. The rate was higher in males (0.05, 95% CI 0.03-0.08) compared with females (0.03, 95% CI 0.02-0.05). The mean age of patients was 65.87 (standard deviation: 14.21) years, with the peak prevalence appeared in patients aged 70-79 (0.28, 95% CI 0.16-0.42).Conclusions: The prevalence of EMPD was markedly lower than those in the United States and Europe, and varied across regions in China. Chinese patients were much younger, with significant male predominance. Further studies are warranted to examine potential pathophysiologic mechanism. [ABSTRACT FROM AUTHOR]

Traditional Chinese medicine (TCM), originated from China, is different from Western medicine in theory and practice. This study aimed to document the longitudinal trends and the patterns by demographical characteristics in the prevalence of TCM among the middle-aged and elderly Chinese population. This study used nationally representative longitudinal survey data from the China Health and Retirement Longitudinal Study (CHARLS), covering approximately 20,000 individuals in each panel survey from 2011 to 2018. The questions regarding medication use in the questionnaire was used to identify the TCM users. The prevalence of using TCM for treating chronic diseases among the patients with chronic diseases stabilized between 2011 and 2018, while the prevalence of TCM use for any purpose among the overall population climbed from 19.03% (95% CI 18.37% to 19.69%) in 2011 to 23.91% (95% CI 23.23% to 24.60%) in 2015. Moreover, the prevalence of TCM use for nonchronic conditions among the overall population increased during the same period as well. The TCM users were more likely to be females and city dwellers. The increasing prevalence of TCM use for any purpose among the overall population reflects the increasing influence and potentials of TCM by year. With the expected rising demand in TCM for the following decades in China, more clinical trials on safety and healthcare policy regarding TCM are merited in the future. [ABSTRACT FROM AUTHOR]

No national data have been available on descriptive epidemiology of mammary Paget's disease (MPD) in China. This population-based study aimed to estimate the prevalence of MPD and its pattens by sex, age and area in China. We conducted a population-based study using data in 2016 from China's Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance, covering approximately 0.43 billion residents. MPD cases were identified based on the diagnostic names and codes in claim data. A total of 825 patients of confirmed diagnosis of MPD were found during the study period. The prevalence of MPD in 2016 was 0.42 per 100,000 population (95% CI 0.19 to 0.73), with marked female predominance. The prevalence rates peaked at 40–59 years and ≥ 80 years in females and males, respectively. The prevalence rates varied among different regions, ranging from 0.06 (95% CI 0.00 to 0.23) in Northeast China to 1.21 (95% CI 0.07 to 3.72) in Northwest China. MPD showed marked female predominance in China. Chinese female patients were much younger, with lower prevalence than that in the United States. Obvious sex difference in the age pattern of MPD prevalence was also observed in China. [ABSTRACT FROM AUTHOR]

Background: Information on incidence of gastrointestinal stromal tumor (GIST), the most common type of mesenchymal tumor in gastrointestinal tract, was limited in China. This study aimed to estimate the incidence of GIST in urban population from mainland China in 2016. Methods: Urban Employee Basic Medical Insurance (UEBMI) and Urban Residence Basic Medical Insurance (URBMI) in China were used. The denominator of incidence was the total person‐years of insured individuals in 2016 in the database, covering approximately 0.43 billion individuals. The numerator was the number of incident GIST cases in 2016. Results: The crude incidence in 2016 was 0.40 per 100,000 person‐years (95% CI, 0.06–1.03). Male incidence was higher than female incidence (0.44 vs. 0.36, rate ratio: 1.22, p < 0.001). The mean age at diagnosis was 55.20 years (SD = 14.26) and the incidence among those aged 50 years or older was 2.63 times (0.84 vs. 0.32, p < 0.001) higher than those aged under 50. The highest incidence was observed in East China (2.29, 95% CI: 0.46–5.54). Conclusions: The incidence of GIST in mainland China was lower than Europe, North America and Korea. The mean age at diagnosis of GIST in China was younger than that of Europe and Canada. This study provides useful information to further research, policy formulating and management of GIST. [ABSTRACT FROM AUTHOR]

Blueberry fruits of different cultivars are featured with different quality indices. In this work, three types of quality factors, including 6 physical parameters, 12 chemical and nutritional components, and 3 antioxidant indices, were measured to compare and classify blueberry fruits from 12 different cultivars in China. Using the autoscaled data of quality factors, unsupervised principal component analysis was performed for exploratory analysis of intercultivar differences and the influences of quality factors. A supervised classification method, partial least squares discriminant analysis (PLSDA), was combined with the global particle swarm optimization algorithm (PSO) and two multiclass strategies, one-versus-rest (OVR) and one-versus-one (OVO), to select discriminative quality factors and develop classification models of the 12 cultivars. As a result, OVO-PLSDA with 8 quality factors could achieve the classification accuracy of 0.915. This study will provide new insights into the quality variations and key factors among different blueberry cultivars. [ABSTRACT FROM AUTHOR]

Background: Hip fracture is a public health concern because of its considerable morbidity, excess mortality, great risk of disability, and high societal healthcare costs. China has the largest population of older people in the world and is experiencing rapid population aging and facing great challenges from an increasing number of hip fractures. However, few studies reported the epidemiology, especially at a national level. We aimed to evaluate trends in hip fracture incidence and associated costs for hospitalization in China.Methods and Findings: We conducted a population-based study using data between 2012 and 2016 from the national databases of Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance in China, covering about 480 million residents. Data from around 102.56 million participants aged 55 years and older during the study period were analyzed. A total of 190,560 incident hip fracture patients (mean age 77.05 years, standard deviation 8.94; 63.99% female) were identified. Primary outcomes included the age- and sex-specific incidences of hip fracture. Associated annual costs for hospitalization were also calculated. Incidence was described as per 100,000 person-years at risk, and 95% confidence intervals were computed assuming a Poisson distribution. Hip fracture incidence overall in China did not increase during the study period despite rapid population aging. Incidence per 100,000 was 180.72 (95% CI 137.16, 224.28; P < 0.001) in 2012 and 177.13 (95% CI 139.93, 214.33; P < 0.001) in 2016 for females, and 121.86 (95% CI 97.30, 146.42; P < 0.001) in 2012 and 99.15 (95% CI 81.31, 116.99; P < 0.001) in 2016 for males. For both sexes, declines in hip fracture incidence were observed in patients aged 65 years and older, although incidence was relatively stable in younger patients. However, the total absolute number of hip fractures in those 55 years and older increased about 4-fold. The total costs for hospitalization showed a steep rise from US$60 million to US$380 million over the study period. Costs for hospitalization per patient increased about 1.59-fold, from US$4,300 in 2012 to US$6,840 in 2016. The main limitation of the study was the unavailability of data on imaging information to adjudicate cases of hip fracture.Conclusions: Our results show that hip fracture incidence among patients aged 55 and over in China reached a plateau between 2012 and 2016. However, the absolute number of hip fractures and associated medical costs for hospitalization increased rapidly because of population aging. [ABSTRACT FROM AUTHOR]

Objective: Amyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease and information on disease burden of ALS in mainland China was limited. We aimed to estimate the prevalence and incidence of ALS in China.Methods: We used 2012-2016 data from China's Urban Employee Basic Medical Insurance and Urban Residence Basic Medical Insurance, covering approximately 0.43 billion individuals. ALS cases were identified by the primary diagnosis (International Classification of Diseases code or text of diagnosis) in the insurance database.Results: The crude prevalence and incidence in 2016 were 2.91 per 100 000 person-years (95% CI 2.31 to 3.58) and 1.65 (95% CI 1.33 to 2.01), respectively. The standardised prevalence and incidence based on 2010 Chinese census data were 2.97 (95% CI 2.91 to 3.03) and 1.62 (95% CI 1.58 to 1.67), respectively. The annual prevalence between 2013 and 2016 remained relatively constant, ranging from 2.91 (95% CI 2.31 to 3.58) in 2016 to 3.29 (95% CI 2.51 to 4.17) in 2014 (linear regression: β=-0.129, p=0.104). Both rates peaked in the group aged 75-79 years.Conclusions: The prevalence and incidence of ALS in mainland China were lower than those in developed countries, and maintained a relatively stable trend. The age at onset and age at diagnosis for ALS patients were younger than those in developed countries. Further research is expected to clarify the potential pathophysiological mechanism of ALS. [ABSTRACT FROM AUTHOR]

Menthae Haplocalycis Herba has been utilized for food and medicinal purposes in China for thousands of years. It has various efficacies, including dispelling wind and heat and relieving sore throat. M. Haplocalycis Herba has been also widely used in food, cosmetics, spices, and other fields. Exploring the constituents and detecting the metabolites of M. Haplocalycis are of great significance to clarify the effective substances. However, the in vivo metabolites of M. Haplocalycis Herba water extract are still unclear. Herein, a sensitive and specific method, ultra‐high performance liquid chromatography with linear ion trap‐Orbitrap mass spectrometry, established in this assay was used to study the metabolism of M. Haplocalycis Herba water extract in rat plasma, urine, and feces. We characterized and identified 9, 50, and 34 metabolites in plasma, urine, and feces, respectively. Seven metabolic pathways, including phase Ⅰ (isomerization, demethylation, hydroxylation, and dehydration) and phase Ⅱ (sulfation and glucuronidation) were mainly involved in the metabolism. It is the first systematic study on the metabolism of M. Haplocalycis Herba water extract in vivo, which enrich current understanding of the metabolic behavior of M. Haplocalycis Herba water extract and provide a metabolic rationale for further in‐depth in vivo biotransformation and pharmacokinetic analysis. [ABSTRACT FROM AUTHOR]