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When disadvantaged families seek to achieve upward social mobility, their most important breakthrough point is for their children to receive an education, and cultural capital is the most likely driving factor influencing educational attainment. In China, although the privileged classes have an advantage in terms of cultural capital, exhibiting a phenomenon of cultural reproduction, premium cultural capital does not display clear class divisions or exclusiveness, and students from disadvantaged families can compensate for their family's lack of cultural capital through important figures or other avenues. More importantly, the circumstances of disadvantage engender cultural capital characterized by disadvantage, greatly promoting the academic success of students from disadvantaged families. For "successful descendants" to emerge from humble families, impoverished families must not only actively compensate for their family's lack of cultural capital, but must also strive to produce the cultural capital particular to disadvantaged families; at the same time, the state and society must also provide multifaceted support.

Background: Chinese patent medicine is commonly used in China as an important treatment mechanism to thwart the progression of chronic kidney disease (CKD) stages 3-5, among which Niaoduqing granules are a representative Chinese patent medicine; however, its long-term efficacy on CKD prognosis remains unclear. Methods: Patients were grouped according to Niaoduqing granule prescription duration (non-Niaoduqing granule (non-NDQ) group vs Niaoduqing granule (NDQ) group). Serum creatinine (SCr) variation was compared using a generalized linear mixed model (GLMM). Multivariate Cox regression models were constructed, adjusting for confounding factors, to explore the risk of composite outcomes (receiving renal replacement therapy (RRT) or having an estimated glomerular filtration rate (eGFR)<5 mL/min/1.73m², ≥50% decline in the eGFR from the baseline, and doubling of SCr) in individuals consuming Niaoduqing granules. Results: A total of 1,271 patients were included, with a median follow-up duration of 29.71 (12.10, 56.07) months. The mean SCr Z-scores for the non-NDQ group and NDQ group were -0.175 and 0.153, respectively, at baseline (p = 0.015). The coefficients of the NDQ group from visit 1 to visit 5 were -0.207 (95% CI: -0.346, -0.068, p = 0.004), -0.214 (95% CI: 0.389, -0.039, p = 0.017), -0.324 (95% CI: 0.538, -0.109, p = 0.003), -0.502 (95% CI: 0.761, -0.243, p = 0.000), and -0.252 (95% CI: 0.569, 0.065, p = 0.119), respectively. The survival probability was significantly higher in theNDQgroup (p = 0.0039). Taking Niaoduqing granules was a significant protective factor for thwarting disease progression (model 1: HR 0.654 (95% CI 0.489-0.875, p = 0.004); model 2: HR 0.646 (95% CI 0.476, 0.877, p = 0.005); and model 3: HR 0.602 (95% CI 0.442, 0.820, p = 0.001)). Conclusion: The long-term use of Niaoduqing granules improved SCr variation and lowered the risk of CKD progression by 39.8%. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is one of the most common and severe complications of multiple myeloma (MM). The aim of this study was to learn about the current awareness regarding MM-associated VTE among Chinese hematologists. A nationwide, online, questionnaire-based survey was sent to the specialized hematologists in mainland China. The questionnaire investigated respondents' demographic and occupational characteristics, their ability to identify VTE risk factors, and their thromboprophylaxis decisions for different anti-MM regimens. Six clinical vignettes were used to evaluate hematologists' awareness of stratified thromboprophylaxis. The data were analyzed using SPSS software. A total of 518 valid questionnaires were received. Of the 518 hematologists investigated, only 23.7% of them could identify VTE-related risk factors correctly. Most hematologists could select appropriate thromboprophylaxis for common anti-MM regimens such as VCd (bortezomib, cyclophosphamide, and dexamethasone) and VRd (bortezomib, lenalidomide, and dexamethasone), but not for uncommon ones such as VTD-PACE (bortezomib, thalidomide, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, and etoposide) and KRd (carfilzomib, lenalidomide, and dexamethasone). The results from the vignettes suggested that only 19.5% of the hematologists could be defined as the 'stratified thromboprophylaxis' group, and the awareness of stratified thromboprophylaxis depended significantly on physicians' age and working seniority. The results of our study showed that a large proportion of Chinese hematologists failed to recognize the VTE risk factors, most of them cannot select appropriate thromboprophylaxis for different MM therapeutic regimens and lack awareness of stratified thromboprophylaxis for MM-associated VTE. A standard VTE prevention guideline is urgently needed for the Chinese myeloma group. Continuous education for new professionals should be encouraged. A VTE collaborative group is supposed to be established in each hospital to enhance the overall medical care for VTE patients. The substantial myeloma patient population and extensive use of immunomodulatory drugs indicate that MM-associated VTE deserves more attention in China. The results from our cross-sectional study showed that a significant proportion of Chinese hematologists failed to identify the VTE risk factors, most of them cannot select appropriate thromboprophylaxis for different MM therapeutic regimens and lack awareness of stratified thromboprophylaxis for MM-associated VTE. [ABSTRACT FROM AUTHOR]

Background: Studies suggest that thyroid peroxidase antibody (TPOAb) positivity exposure during pregnancy may contribute to changes in placental morphology and pathophysiology. However, little is known about the association of maternal TPOAb during pregnancy with placental morphology and cytokines. This study focuses on the effect of repeated measurements of maternal TPOAb during pregnancy on the placental morphology and cytokines. Methods: Based on Ma'anshan Birth Cohort (MABC) in China, maternal TPOAb levels were retrospectively detected in the first, second and third trimesters. Placental tissues were collected 30 minutes after childbirth, placental morphological indicators were obtained by immediate measurement and formula calculation, and cytokine mRNA expression was detected by real-time quantitative polymerase chain reaction (RT-qPCR) afterward. Generalized linear models and linear mixed models were analyzed for the relationships of maternal TPOAb in the first, second and third trimesters with placental indicators. Results: Totally 2274 maternal-fetal pairs were included in the analysis of maternal TPOAb levels and placental morphology, and 2122 pairs were included in that of maternal TPOAb levels and placental cytokines. Maternal TPOAb levels in early pregnancy were negatively associated with placental length, thickness, volume, weight and disc eccentricity, while positively correlated with placental IL-6, TNF-a, CRP, CD68, MCP-1, IL-10, HO-1, HIF-1α and GRP78. In mid-pregnancy, maternal TPOAb levels were negatively correlated with placental length, width and area. In late pregnancy, maternal TPOAb levels were negatively correlated with placental length, area, volume and weight. Repeated measures analysis showed that maternal TPOAb positivity tended to increase placental TNF-a, CD68 and MCP-1 while decreasing placental length, width and area than TPOAb negativity. Repeated measures analysis showed that maternal TPOAb levels were positively correlated with placental IL-6, TNF-α, CD68, MCP-1, IL-10, HO-1, HIF-1α and GRP78, while negatively correlated with placental length, area, volume, weight, and disc eccentricity. Conclusion: There may be trimester-specific associations between maternal TPOAb levels and placental morphology and inflammatory and oxidative stress responses. The effect of maternal TPOAb levels on placental morphology is present throughout pregnancy. Early pregnancy may be the critical period for the association between maternal TPOAb levels and placental inflammatory and oxidative stress responses. [ABSTRACT FROM AUTHOR]

How to improve the utilizations of water and nutrient is a research hotspot of sloping farmland in semi-arid and rain-fed areas. In this study, the spatial changes of soil moisture, nutrients, and roots under different tillage modes, as well as the efficient utilization mechanism of soil moisture and nutrients from rain-fed maize on three mulching treatments (no surface covering, ridge film and straw mulch and ridge film mulch) and two slope treatments (5° slope and 10° slope) of sloping farmlands were studied at the Nationally Agricultural Environment Fuxin Observation and Experiment Station in China through a micro-zone simulation and a long-term positioning experiment. The results indicated that ridge film mulch and furrow seeding significantly improve the water use efficiency and partial factor productivity of the plants in sloping farmlands, with the highest increases being 51.33% and 45.05%. By analyzing the coordinated relationship between water, nutrients, and roots, it was found that ridge film furrow seeding technology can significantly affect the spatial distribution of water, nutrients, and roots in different soil layers, and improves the effective coefficient of soil water and nutrients. The effective coefficient of ridge film and straw treatment was 2.53, while the average value of the effective coefficient of ridge film treatment was 1.39. Further analysis found that the degree of consistency between the root system, water, and nutrient barycenter was highly correlated with the effective coefficients of water and nutrients. Visual radar map analysis revealed that root development limits the improvement availability of the efficient use of water and nutrients in the soil. Promoting root development indicators and root spatial distribution through ridge film coverage was an effective way to improve the efficient use of maize water and nutrients. The ridge film mulching promoted the root development index and root spatial distribution, thus improving the efficient use of water and nutrients in maize. Overall, the ranking of the regulation effect was as follows: ridge film and straw mulch > ridge film mulch > no mulch, and 5° slope > 10° slope. This research provided a theoretical basis for the enhancement of use efficiency in water and nutrients in sloping farmlands. [ABSTRACT FROM AUTHOR]

The paper investigates whether eco-innovation, sustainability, and asset pricing effect of maximum daily return (maxing out effect), truly and steadily exists in A share market of China and the nexus among maxing out effect and idiosyncratic volatility in China's A Share Market. Regression analyses were conducted using the data of listed companies in China's A share market from July 1993 to May 2021. The empirical results show that the maxing out effect, eco-innovation and sustainability steadily exists in a sample country. In practice, this research help to improve asset pricing efficiency, provide high-quality materials for investor education, guide arbitrage trading activities, and improve resource allocation efficiency in the stock market. [ABSTRACT FROM AUTHOR]

The survey and change monitoring of natural resources can provide an important guarantee for the implementation of systematic policies, protection, and rational utilization of resources and are of great significance for the building of the national land space planning system, the reform of the resource management system, the modernization of space governance capacity, and the construction of national ecological civilization. Western China is characterized by a vast area, insufficient basic land data, and unreliable land change monitoring. Therefore, there is an urgent need to provide efficient and accurate survey results at a low cost for such a large area. Based on the domestic high -- resolution satellite (GF-6) images and the results of the third national land survey, this study carried out a demonstration of the application of the intelligent rural land survey to the areas subject to rapid development in western China in Xuyong County. To this end, remote sensing images with high spatial resolution and hyperspectral resolution were obtained through panchromatic and multispectral image fusion. Then, the fused data were used for the basic survey of land resources in Xuyong County. Subsequently, based on the object -oriented image classification and the results of the third national land survey, supervised classification of the remote sensing images was conducted, and areas with changes in land were automatically extracted, thus forming a new efficient land survey model for the areas subject to rapid development in western China. The survey results can provide strong support in terms of basic land information for the rapid development of specialty industries in western China and have a certain value in popularization and applications. [ABSTRACT FROM AUTHOR]

Plants allocate nutrients to new leaves via making a cost–benefit trade‐off between root nutrient absorption ('get') and leaf nutrient resorption ('save'). This active trade‐off in nutrient acquisition pathways may cause a passive trade‐off between resorption and decomposition ('return'). However, whether these nutrient‐associated processes are linked and form a 'get‐save‐return' (GSR) continuum, and its linkages with the above‐ground leaf economics spectrum (LES) and the below‐ground mycorrhizal association remain unclear.Here, we present the first empirical evidence of a direct link among multiple nutrient‐associated processes and tested this continuum hypothesis by synchronously integrating root nutrient absorption, leaf nutrient resorption and leaf litter decomposition of 15 co‐occurring tree species hosting either arbuscular mycorrhizal or ectomycorrhizal fungi in subtropical forests of China.Across species, there was an active trade‐off between phosphorus (P) absorption and resorption, which further caused a passive trade‐off between P resorption and leaf litter decomposition, indicating that the GSR continuum exists and runs on P economy. However, these processes associated with nitrogen economy were not well linked. Interestingly, the loading scores of species on the LES were positively correlated with root P absorption, negatively with leaf P resorption and positively with leaf litter decomposition. These linkages indicate that species running in the 'fast lane' had greater root P absorption, lower leaf P resorption and faster leaf litter decomposition than species running in the 'slow lane', and that the process‐based GSR continuum follows the trait‐based 'fast‐slow' LES. Furthermore, the continuum on P economy emerged evidently in the ectomycorrhizal tree species rather than in the arbuscular mycorrhizal tree species, indicating critical control of mycorrhizal association over the continuum.Synthesis. Overall, these results demonstrate the existence of the GSR continuum on tree P economy, which conforms to the economics spectrum theory but varies with mycorrhizal association type. Our findings provide a process‐based framework for mechanistic understanding of the whole plant nutrient economy and ecosystem nutrient cycling, and facilitate improved predictions of biogeochemical models. [ABSTRACT FROM AUTHOR]

Building sector consists of a major part of global energy consumption and carbon emission. Reducing energy consumption in buildings can make a substantial contribution towards the strategic goal of carbon neutrality. Building energy consumption carbon emission (BECCE) is highly correlated with microclimate. Green space has long been recognized as the natural way to improve the microclimate and reduce BECCE. However, the effective distance and optimized configuration of green space for the reduction in BECCE are hardly known. To this purpose, we developed a green space compactness (GSC) index as an indicator of microclimate around the People's Bank, located in 59 cities across China, and used statistical, deep learning, and spatial analysis methods to obtain the most effective distance with respect to the effect of GSC on BECCE. We used hot and cold spot spatial analysis methods to detect the spatial heterogeneity of BECCE and analyzed the corresponding GCS to discover the optimal way for BECCE reduction. The results clearly showed that BECCE was highly correlated with the GSC, and the influence of GSC on BECCE was the highest at the distance of 250 m from the building. The hot and cold spots analysis suggested that BECCE has a significant spatial heterogeneity, which was much higher in the north part of China. Improving the configuration of green space for certain cities could lead to considerable emission reductions. If the BEECE is reduced from 4675 tons to 486 tons, the GSC needs to be increased from 0.39 to 0.56. The study suggests that 250 m is the most effective distance to reduce BECCE, and optimal green space configuration can provide a feasible way to mitigate carbon emissions and valuable information for the development of low-carbon cities. [ABSTRACT FROM AUTHOR]

The process of pursuing high-quality economic development involves many moving parts, and economic agglomeration (EA) is an essential element that can significantly affect green total factor productivity (GTFP). This study uses SBM and GML models to calculate GTFP of 99 cities in the Yellow River Basin from 2004 to 2017. Then, based on the panel data of these cities, the SYS-GMM and the mediating effect model are used to empirically test the influence and action path of EA on GTFP. The conclusions are as follows: There is an evident inverted U-shaped link between EA and GTFP in the YRB. The development level of the upper and middle reaches of the YRB is lower than the "agglomeration inflection point" (CNY 1.231 billion/KM2), while the downstream region has crossed this inflection point and has a crowding effect. In addition, EA affects GTFP through labor pool, intermediate input sharing and knowledge technology spillover. This study concludes that, in order to boost GTFP in the YRB, diversified strategies based on regional development are required to avoid the crowding impact. [ABSTRACT FROM AUTHOR]

Decomposition is vital for nutrient cycling and is sensitive to atmospheric nutrient depositions. However, the influences and underlying mechanisms of nutrient deposition on the long-term decomposition of leaves and absorptive roots remain unclear. Here, we explored the responses of leaves and absorptive roots to nutrient deposition (control, +N, +P, and +NP) in Pinus massoniana and Schima superba forests in subtropical China based on two stages (early-stage (1-year) and late-stage (3-year)) of a decomposition experiment. The chemical factions (acid-unhydrolysable residue (AUR), cellulose, and hemicellulose concentrations) and microbial enzymatic activities (hydrolase and oxidase) were also determined. The +N treatment had persistent negative effects on absorptive root decomposition, except for P. massoniana during the late stage. The +P treatment had a positive effect on leaf decomposition in all stages. The +NP treatment had a positive effect on leaf decomposition during the late stage. The increasing decomposition rates of foliar under +P treatment were more correlated with the increasing acid phosphatase activity than chemical factions, indicating a microbial mechanism. The decreasing decomposition rates of roots under +N treatment were weakly correlated with increasing AUR concentrations and strongly correlated with decreasing oxidase activity during the late stage, indicating both chemical and microbial mechanisms. Overall, our findings highlight that, despite contrasting responses to nutrient deposition, the mechanisms underlying aboveground and belowground decomposition tend to converge as decomposition progresses. [ABSTRACT FROM AUTHOR]

As an important energy base in China, the high-quality development of the Yellow River Basin plays an important role in achieving the goal of "carbon peak and carbon neutrality" in China. Based on the theoretical framework of industrial structure, environmental regulation and carbon emission, a panel vector autoregressive model is adopted to examine the dynamic relationship between environmental regulations, carbon emissions, and industrial structure with the panel data of 79 prefecture-level cities in the Yellow River Basin from 2004 to 2019. The findings indicate that: (1) On the whole, the effect of environmental regulation on carbon emissions is initially boosted, then prevented. Industrial structure has an inhibitory influence on carbon emissions, but this inhibitory effect is with apparent lag. Environmental regulation prevents industrial structure upgrading in the near term. (2) From the regional viewpoint, it can be seen that the degree of coordination between the upper, middle and down reaches of the Yellow River Basin steadily diminishes from east to west during the period of 2004-2019. The down reaches areas basically achieved the coordinated development of among the three. In the middle reaches, the environmental regulation has the most obvious effect on reducing carbon emissions reduction, but the incentive effect on industrial structure upgrading is not obvious, and industrial structure upgrade is clearly insufficient to reduce carbon emissions. In the upper reaches, the effect of industrial structure upgrading on carbon emission reduction is clear, but the effect of environmental control on carbon emission reduction is significantly less than that of industrial structure upgrading. Finally, this study puts forward concrete policy recommendations to achieve the high-quality development in the Yellow River Basin. [ABSTRACT FROM AUTHOR]

Facing skyrocketing housing prices, the Chinese government implemented a policy of home purchase limits to maintain stability and sustainability in the residential property market. This paper aims at gauging the causal effect of the home purchase limits policy on housing prices, by replicating a quasi-experimental test with yearly data on 287 Chinese cities from 2007 to 2013. Based on a difference-in-differences matching estimator to control for observed and time-invariant unobserved city heterogeneity, we find that the policy led to decreased housing prices, and the decrease was contingent on the level of enforcement of the policy. The more strictly the policy was enforced, the more the housing prices dropped. Overall, our analyses highlight the importance of government intervention in the property market. [ABSTRACT FROM AUTHOR]

Background: Chronic stress-induced diarrhea is a common clinical condition, characterized by an abnormal bowel movement and loose stools, which lacks effective treatment in the clinic. Si-Ni-San (SNS) is a compound traditional Chinese medicine extensively used in China for stress-related diarrhea. However, the mechanism is unclear. Methods: Male Wistar rats (200 ± 20 g) were placed in a restraint cylinder and fixed horizontally for 3 h once daily for 21 consecutive days to establish a chronic restraint stress (CRS) rat model. SNS (0.6944 g/kg or 1.3888 g/kg) was given by gavage 1 h before the restraint once daily for 21 consecutive days. We examined the fecal score, dopamine ß hydroxylase (DßH), and c-fos expression in locus coeruleus, norepinephrine (NE) content in ileum and plasma, expression of a1 adrenergic receptors, MLCK, MLC, and p-MLC in the colon and mesenteric arteries, contraction of isolated mesenteric arteries, The expression of subunit d of ATP synthase (ATP5D) in intestinal tissues, ATP, ADP, and AMP content in the ileum and colon, occludin expression between ileum epithelial cells, the number of enterochromaffin cells (ECs) and mast cells (MCs) in the ileum, and 5-hydroxytryptamine (5-HT) content in the ileum and plasma. Results: After SNS treatment, the fecal score was improved. The increased expression of DßH and c-fos in locus coeruleus was inhibited. SNS suppressed the increased NE content in the ileum and plasma, down-regulated a1 adrenergic receptors in mesenteric arteries and MLCK, MLC, p-MLC in the colon and mesenteric arteries, and inhibited the contraction of mesenteric arteries. SNS also increased the ATP content in the ileum and colon, inhibited low expression of ATP5D in intestinal tissues, inhibited the decrease of ATP/ADP in the ileum and ATP/AMP in the colon, and up-regulated the occludin expression between ileum epithelial cells. In addition, SNS inhibited the increase of ECs and MCs in the ileum and the increase of 5-HT content in the ileum and plasma. Conclusion: This study demonstrated that SNS could improve CRS-induced abnormal feces in rats. This effect was related to the inhibition of CRS-induced increased expression of DßH and c-fos in the locus coeruleus, NE content in the ileum and plasma, and the contraction of isolated mesenteric arteries; inhibition of energy metabolism abnormality and decreased occludin expression; inhibition of increased ECs and MCs in the ileum, and 5-HT content in the ileum and plasma. [ABSTRACT FROM AUTHOR]

Summary: The root economics space (RES) is multidimensional and largely shaped by belowground biotic and abiotic influences. However, how root–fungal symbioses and edaphic fertility drive this complexity remains unclear.Here, we measured absorptive root traits of 112 tree species in temperate and subtropical forests of China, including traits linked to functional differences between arbuscular mycorrhizal (AM) and ectomycorrhizal (ECM) hosts.Our data, from known mycorrhizal tree species, revealed a 'fungal‐symbiosis' dimension distinguishing AM from ECM species. This divergence likely resulted from the contrasting mycorrhizal evolutionary development of AM vs ECM associations. Increased root tissue cortical space facilitates AM symbiosis, whereas increased root branching favours ECM symbiosis. Irrespective of mycorrhizal type, a 'root‐lifespan' dimension reflecting aspects of root construction cost and defence was controlled by variation in specific root length and root tissue density, which was fully independent of root nitrogen content. Within this function‐based RES, we observed a substantial covariation of axes with soil phosphorus and nitrate levels, highlighting the role played by these two axes in nutrient acquisition and conservation.Overall, our findings demonstrate the importance of evolved mycorrhizal symbiosis pathway and edaphic fertility in framing the RES, and provide theoretical and mechanistic insights into the complexity of root economics. [ABSTRACT FROM AUTHOR]

Background We aimed to describe the epidemiological, virological, and serological features of coronavirus disease 2019 (COVID-19) cases in people living with human immunodeficiency virus (HIV; PLWH). Methods This population-based cohort study identified all COVID-19 cases among all PLWH in Wuhan, China, by 16 April 2020. The epidemiological, virological, and serological features were analyzed based on the demographic data, temporal profile of nucleic acid test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the disease, and SARS-CoV-2–specific immunoglobin (Ig) M and G after recovery. Results From 1 January to 16 April 2020, 35 of 6001 PLWH experienced COVID-19, with a cumulative incidence of COVID-19 of 0.58% (95% confidence interval [CI],.42–.81%). Among the COVID-19 cases, 15 (42.86) had severe illness, with 2 deaths. The incidence, case-severity, and case-fatality rates of COVID-19 in PLWH were comparable to those in the entire population in Wuhan. There were 197 PLWH who had discontinued combination antiretroviral therapy (cART), 4 of whom experienced COVID-19. Risk factors for COVID-19 were age ≥50 years old and cART discontinuation. The median duration of SARS-CoV-2 viral shedding among confirmed COVID-19 cases in PLWH was 30 days (interquartile range, 20–46). Cases with high HIV viral loads (≥20 copies/mL) had lower IgM and IgG levels than those with low HIV viral loads (<20 copies/ml; median signal value divided by the cutoff value [S/CO] for IgM, 0.03 vs 0.11, respectively [ P  < .001]; median S/CO for IgG, 10.16 vs 17.04, respectively [ P  = .069]). Conclusions Efforts are needed to maintain the persistent supply of antiretroviral treatment to elderly PLWH aged 50 years or above during the COVID-19 epidemic. The coinfection of HIV and SARS-CoV-2 might change the progression and prognosis of COVID-19 patients in PLWH. [ABSTRACT FROM AUTHOR]

Background To assess the case fatality risk (CFR) of COVID-19 in mainland China, stratified by region and clinical category, and estimate key time-to-event intervals. Methods We collected individual information and aggregated data on COVID-19 cases from publicly available official sources from 29 December 2019 to 17 April 2020. We accounted for right-censoring to estimate the CFR and explored the risk factors for mortality. We fitted Weibull, gamma, and log-normal distributions to time-to-event data using maximum-likelihood estimation. Results We analyzed 82 719 laboratory-confirmed cases reported in mainland China, including 4632 deaths and 77 029 discharges. The estimated CFR was 5.65% (95% confidence interval [CI], 5.50–5.81%) nationally, with the highest estimate in Wuhan (7.71%) and lowest in provinces outside Hubei (0.86%). The fatality risk among critical patients was 3.6 times that of all patients and 0.8–10.3-fold higher than that of mild-to-severe patients. Older age (odds ratio [OR], 1.14 per year; 95% CI, 1.11–1.16) and being male (OR, 1.83; 95% CI, 1.10–3.04) were risk factors for mortality. The times from symptom onset to first healthcare consultation, to laboratory confirmation, and to hospitalization were consistently longer for deceased patients than for those who recovered. Conclusions Our CFR estimates based on laboratory-confirmed cases ascertained in mainland China suggest that COVID-19 is more severe than the 2009 H1N1 influenza pandemic in hospitalized patients, particularly in Wuhan. Our study provides a comprehensive picture of the severity of the first wave of the pandemic in China. Our estimates can help inform models and the global response to COVID-19. [ABSTRACT FROM AUTHOR]

This study aimed to assess the potential of neck circumference (NC) and neck-to-height ratio (NHR) as predictors of future cardiovascular disease (CVD) mortality in a general population from Northeastern China. A multi-center prospective study was conducted in Northeastern China, involving 18, 796 participants. The associations between NC or NHR and the incidence of overall CVD mortality, stroke mortality, and coronary heart disease (CHD) mortality were examined using multivariate Cox regression models. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were calculated. Reclassification analyses were conducted to determine the incremental predictive value of NC or NHR. NC was significantly associated with the risk of CVD mortality, independent of other anthropometric measurements for obesity. Individuals in the highest quartile of NC had a 1.83-fold (95% CI 1.29 to 2.61) and a 2.40-fold (95% CI 1.45 to 4.00) higher risk of overall CVD mortality and CHD mortality, respectively. Larger NC was significantly related to a heightened risk of ischemic stroke mortality, although no such association was observed with hemorrhagic stroke mortality. Furthermore, the risk of overall CVD mortality, stroke mortality, and CHD mortality increased by approximately 1.21 to 1.25 times per 1-SD change in NC. Similar findings were observed for NHR. The percentages of correct classification of overall CVD mortality improved by 12.1% and 16.3% after the addition of NC or NHR into established models, respectively. NC and NHR might be promising predictors of CVD mortality, with higher values indicating greater risk. • Limited prospective studies on NC and cardiovascular events have been conducted. • No studies have examined NHR's impact on the risk of cardiovascular events. • The overall CVD mortality risk increased 1.22 times per 1-SD change in NC and NHR. • NC and NHR's predictive value for CVD mortality is independent of BMI and WHR. [ABSTRACT FROM AUTHOR]

Background: Aseptic meningitis is most often caused by enteroviruses (EVs), but EVs associated with aseptic meningitis have not yet been reported in Liaocheng. The aim of this study was to determine the prevalence and genetic characteristics of EVs causing aseptic meningitis in children in Liaocheng.Methods: We reviewed the epidemiological and clinical characteristics of 504 paediatric cases of aseptic meningitis in Liaocheng from 2018 to 2019 and analysed the phylogeny of the predominant EV types causing this disease.Results: A total of 107 children were positive for EV in cerebrospinal fluid samples by nested PCR. Most of the positive patients were children 13 years old or younger and had symptoms such as fever, headache and vomiting (P < 0.05). The seasons with the highest prevalence of EV-positive cases were summer and autumn. The 107 EV sequences belonged to 8 serotypes, and echovirus types 18, 6 and 11 were the three dominant serotypes in Liaocheng during the 2-year study period. Phylogenetic analyses demonstrated that the E18 and E6 isolates belonged to subgenotype C2, while the E11 isolates belonged to subgenotype D5. VP1 analysis suggested that only one lineage of these three types was cocirculating in the Liaocheng region.Conclusions: This study demonstrated the diverse EV genotypes contributing to a large outbreak of aseptic meningitis in Liaocheng. Therefore, large-scale surveillance is required to assess the epidemiology of EVs associated with aseptic meningitis and is important for the diagnosis and treatment of aseptic meningitis in Liaocheng. [ABSTRACT FROM AUTHOR]

Summary: Traits are critical in predicting decomposition that fuels carbon and nutrient cycling in ecosystems. However, our understanding of root trait–decomposition linkage, and especially its dependence on mycorrhizal type and environmental context, remains limited.We explored the control of morphological and chemical (carbon‐ and nutrient‐related) traits over decomposition of absorptive roots in 30 tree species associated with either arbuscular mycorrhizal (AM) or ectomycorrhizal (ECM) fungi in temperate and subtropical forests in China.Carbon‐related traits (acid‐unhydrolysable residue (AUR) and cellulose concentrations) had predominant control of root decomposition in AM species while nutrient‐related traits (magnesium concentration) predominately controlled that in ECM species. Thicker absorptive roots decomposed faster in AM species as a result of their lower AUR concentrations, but more slowly in ECM angiosperm species potentially as a result of their higher magnesium concentrations. Root decomposition was linked to root nutrient economy in both forests while root diameter–decomposition coordination emerged only in the subtropical forest where root diameter and decomposition presented similar cross‐species variations.Our findings suggest that root trait–decomposition linkages differ strongly with mycorrhizal type and environment, and that root diameter can predict decomposition but in opposing directions and with contrasting mechanisms for AM and ECM species. [ABSTRACT FROM AUTHOR]

Objective: To gain more comprehensive understanding of metabolic syndrome (Mets) among in general Chinese population.Design: Cross-sectional study. Mets was defined by three widely accepted definitions including modified Adults Treatment Panel (ATP) III criteria, International Diabetes Federation (IDF) criteria and harmonized definition. Risk factors were evaluated by using multivariate logistic regression.Setting: Nineteen rural villages in northeast China.Participants: The survey was conducted in September 2017 and May 2018 on 10 926 individuals.Results: According to modified ATP III criteria, IDF criteria and harmonised definition, the overall prevalence of Mets was 41·3 % (95 % CI 40·3, 42·2), 34·2 % (95 % CI 33·2, 35·1) and 44·1 % (95 % CI 43·1, 45·1), respectively. Females had a higher prevalence, and elevated blood pressure was the most frequent. Age, female sex, non-peasant worker, higher BMI and lower-annual income were independent risk factors of Mets in all three definitions (all ps < 0·05). Based on modified ATP III criteria and harmonised definition, heavy drinking was positively correlated with Mets. In contrast, former drinking was inversely associated with Mets.Conclusions: Mets is highly prevalent in rural areas of northeast China. Its independent risk factors include higher age, female sex, non-peasantry worker, higher BMI and lower-annual income. Modified ATP III criteria and harmonised definition may be superior definitions of Mets. [ABSTRACT FROM AUTHOR]

Background: China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China.Methods: We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold.Results: Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19,812 (95% uncertainty interval, 7150-35,783) influenza-like-illness outpatient consultations per year, 9418 (3386-17,068) severe acute respiratory infection hospitalizations per year, and 8800 (5300-11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106-93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460-8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08-13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness.Conclusions: Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low- and middle-income countries where such analysis is limited. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the epidemiology of atrial fibrillation (AF) in northeast China.Methods: This cross-sectional survey using a multistage, stratified and cluster random sampling method was conducted in Liaoning Province between September 2017 and March 2019. A total of 18 796 participants (28.9% urban, 71.1% rural) aged ≥40 years were included. All participants completed a questionnaire and underwent a physical examination and ECG. AF was diagnosed according to history and ECG findings.Results: The overall AF prevalence was 1.1%; it increased steeply with age. AF was more prevalent in men than in women (1.5% vs 0.9%, p<0.001); however, the difference between urban and rural areas was not significant (1.3% vs 1.1%, p=0.228). Among the AF population, the overall AF awareness rate was 52.6%, higher in women than in men (61.5% vs 44.1%, p=0.011); however, the difference between areas was not statistically significant (60.0% vs 49.0%, p=0.129). According to the CHA2DS-VASc score, almost all (90.2%, 194/215) of our subjects required oral anticoagulant (OAC) therapy; however, only 4.1% actually received it. Moreover, hypertension (66.5%), dyslipidaemia (32.6%) and diabetes (24.2%) were highly prevalent in patients with AF, but their control rates were unacceptably low (7.0%, 8.6% and 28.8%, respectively).Conclusions: The burden of AF in northeast China was substantial. Underuse of OAC therapy and uncontrolled comorbidities will likely contribute to the cardiovascular outcomes of patients with AF in the coming decades. Long-term management strategies for AF and related risk factors are required in northeast China. [ABSTRACT FROM AUTHOR]

Background: First-degree atrioventricular block (AVB) has traditionally been regarded as a benign condition but recent studies have challenged this conception. Prevalence of 1-2% have been reported in developed countries in Asia. However, no epidemiologic studies have established the prevalence of first-degree AVB in developing countries. The aim of the study was to investigate the prevalence of first-degree AVB in rural northeast China and identify the associated risk factors.Methods: This cross-sectional study was undertaken from September 2017 to May 2018 in rural areas of Liaoning Province. It involved 10,926 participants aged ≥40 years (85.3% of those who were eligible). First-degree AVB was confirmed by at least two independent cardiologists. Risk factors were evaluated using stepwise logistic regression.Results: The prevalence of first-degree AVB was 3.4% (95% confidence interval [CI]: 3.0-3.8%). Males had a higher prevalence than females (5.1% vs. 2.2%, p < 0.001). The regression model involving all participants showed that age (odds ratio [OR]: 1.32; p <0.001), male sex (OR: 1.72; p = 0.001), height (OR: 1.25; p = 0.008), systolic blood pressure (SBP) (OR: 1.15; p = 0.003), triglycerides (TG) (OR: 1.10; p < 0.001), high-density lipoprotein cholesterol (HDL-C) (OR: 0.73; p < 0.001), heart rate (OR: 0.78; p < 0.001), and exercising regularly (OR: 0.73; p = 0.030) were independent risk factors.Conclusions: First-degree AVB is highly prevalent in rural areas of northeast China. The associated independent risk factors include being male, older, and taller, higher SBP and TG, lower HDL-C and heart rate, and lack of exercise. [ABSTRACT FROM AUTHOR]

Background: To investigate the status of hypertension and related risk factor disparities between urban and rural areas of northeast China. Methods: A multi-stage, stratified, and cluster random sampling method was used to conduct the cross-sectional survey in Liaoning Province in 2017–2019. Finally, included 18,796 participants (28.9% urban, 71.1% rural) aged ≥40 years. The prevalence and control rate of hypertension were estimated based on Chinese hypertension guidelines and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Results: The mean age of the population was 60.4±9.9 years, and 61.0% were women. The overall prevalence of hypertension was 56.8%. Compared to urban areas, hypertension was more prevalent, but the awareness, treatment, and control rates were lower in rural areas (59.2 vs 50.2, 52.5% vs 47.0%, 46.9% vs 34.9%, and 11.4% vs 3.7%, P<0.001, respectively). Multivariate regression analysis identified that the lack of exercise (odds ratio (OR), 1.24; 95% confidence interval (CI), 1.10–1.38) in rural areas, whereas overweight/obesity (OR, 2.01; 95% CI, 1.79–2.27) and alcohol consumption (OR, 1.20; 95% CI, 1.01–1.41) in urban areas were specific risk factors for hypertension, besides common risk factors. Under the 2017 ACC/AHA guidelines, the prevalence of hypertension was 80.6% (urban 76.6%, rural 82.2%), increased 1.4-fold compared with the current Chinese guidelines, with increased rates of 27.9% in urban areas and 25.7% in rural areas. Conclusion: A highly diverse prevalence for hypertension was found between urban and rural areas in northeast China. Region-specific strategies targeting the prevention and management of hypertension should be highlighted. [ABSTRACT FROM AUTHOR]

Objective. To investigate the epidemiological features of obesity in rural Northeast China. Design. This was a 2017–2018 cross-sectional study of 10,891 participants aged ≥40 years that was designed to investigate the prevalence of obesity in rural areas of Liaoning Province. Demographic data, biochemical parameters, and physical examinations were completed by well-trained personnel. Logistic regression analyses were then carried out to investigate independent risk factors and associated cardiometabolic comorbidities of obesity. Results. The proportions of general obesity only, central obesity only, and combined obesity were 1.0%, 31.3%, and 17.4%, respectively. Overall, 49.8% of our subjects were obese. Female gender, being married, being separated/divorced/widowed, or eating more meat were significantly associated with obesity. Smoking, higher family income, or regular physical exercise were negatively associated with obesity. General obesity only was significantly correlated with hypertension, diabetes, and high triglycerides (OR = 2.79, OR = 2.79, and OR = 3.37, resp.). General obesity only was irrelevant to high total cholesterol, low high-density lipoprotein cholesterol, and high low-density lipoprotein cholesterol, although central obesity only, or combined obesity, was relevant to these factors. Prehypertension and prediabetes showed a positive association with different types of obesity. Conclusions. We identified a high prevalence of general and central obesity in rural Northeast China, with similar independent risk factors. Participants with combined obesity had the highest risk of cardiometabolic comorbidities, indicating that the combined use of both waist circumference and body mass index is useful in practice. [ABSTRACT FROM AUTHOR]

Everbright Securities Ltd. erroneously submitted huge quantities of buy orders on SSE180 constituent stocks from 11:05 through 11:07 on 16 August 2013. This fat finger accident had a pronounced impact on the Chinese stock markets. This paper uses the accident to study market quality and investors' responses. We show that the Chinese stock markets were robust enough to stand the trial, exhibiting deep depths and strong resiliency. However, the markets performed poorly in terms of aggregating information because there were large price swings after the erroneous orders were executed. Moreover, investors quickly change their beliefs as to the reasons to the dramatic price jumps, consistent with information cascade theory. [ABSTRACT FROM AUTHOR]

Recent studies confirm that weather affects the Chinese stock markets, based on a linear model. This paper revisits this topic using DCCA cross-correlation coefficient (ρDCCA(n)), which is a nonlinear method, to determine if weather variables (i.e., temperature, humidity, wind and sunshine duration) affect the returns/volatilities of the Shanghai and Shenzhen stock markets. We propose an asymmetric ρDCCA(n) by improving the traditional ρDCCA(n) to determine if different cross-correlated properties exist when one time series trending is either positive or negative. Further, we improve a statistical test for the asymmetric ρDCCA(n). We find that cross-correlation exists between weather variables and the stock markets on certain time scales and that the cross-correlation is asymmetric. We also analyze the cross-correlation at different intervals; that is, the relationship between weather variables and the stock markets at different intervals is not always the same as the relationship on the whole. [ABSTRACT FROM AUTHOR]

Chronic renal failure (CRF) is a serious disease related to increasing incidence and prevalence as well as decline in quality of life. Bu-Shen-Huo-Xue formula (BSHX), one of traditional herbal formulations, has been clinically employed to treat CRF for decades, but the mechanisms involved have not been investigated. In the present study, we investigated the effects of BSHX on some closely related parameters in 5/6 nephrectomy CRF rats. Rats with CRF were divided into five groups, namely, one control group, one enalapril group, and three BSHX treatment groups (0.25, 0.5, and 1 g/kg·d). The rats subjected to sham operation were used as a normal control. After eight weeks of treatment, BSHX significantly decreased the levels of Scr and BUN, downregulated themRNA expression levels of TGF-β1, CTGF, NF-κB, TNF-α, and OPN, upregulated the mRNA expression of PPARβ, and reduced in situ expression of fibronectin and laminins. Histological findings also showed significant amelioration of the damaged renal tissue. BSHX protects 5/6 nephrectomy rats against chronic renal failure probably via regulating the expression of TNF-α, NF-κB, TGF-β 1, CTGF, PPARγ, OPN, fibronectin, and laminins and is useful for therapy of CRF. [ABSTRACT FROM AUTHOR]

Introduction The relationship between admission time and intensive care unit (ICU) mortality is inconclusive and influenced by various factors. This study aims to estimate the effect of admission time on ICU outcomes in a tertiary teaching hospital in China by propensity score matching (PSM) and stratified analysis. Methods A total of 2,891 consecutive patients were enrolled in this study from January 1, 2009 to December 29, 2011. Multivariate logistic regression and survival analysis were performed in this retrospective study. PSM and stratified analysis were applied for confounding factors, such as Acute Physiologic and Chronic Health Evaluation II (APACHE II) score and admission types. Results Compared with office hour subgroup (n = 2,716), nighttime (NT, n = 175) subgroup had higher APACHE II scores (14 vs. 8, P < 0.001), prolonged length of stay in the ICU (42 vs. 24 h, P = 0.011), and higher percentages of medical (8.6% vs. 3.3%, P < 0.001) and emergency (59.4% vs. 12.2%, P < 0.001) patients. Moreover, NT admissions were related to higher ICU mortality [odds ratio (OR), 1.725 (95% CI 1.118-2.744), P = 0.01] and elevated mortality risk at 28 days [14.3% vs. 3.2%; OR, 1.920 (95% CI 1.171-3.150), P = 0.01]. PSM showed that admission time remained related to ICU outcome (P = 0.045) and mortality risk at 28 days [OR, 2.187 (95% CI 1.119-4.271), P = 0.022]. However, no mortality difference was found between weekend and workday admissions (P = 0.849), even if weekend admissions were more related to higher APACHE II scores compared with workday admissions. Conclusions NT admission was associated with poor ICU outcomes. This finding may be related to shortage of onsite intensivists and qualified residents during NT. The current staffing model and training system should be improved in the future. [ABSTRACT FROM AUTHOR]

Tree sparrows (Passer montanus) are widely distributed in all seasons in many countries. In this study, a survey and relevant experiments on avian influenza (AI) in tree sparrows were conducted. The results suggested that the receptor for avian influenza viruses (AIVs), SAα2,3Gal, is abundant in the respiratory tract of tree sparrows, and most of the tree sparrows infected experimentally with two H5 subtype highly pathogenic avian influenza (HPAI) viruses died within five days after inoculation. Furthermore, no AIVs were isolated from the rectum eluate of 1300 tree sparrows, but 94 serological positives of AI were found in 800 tree sparrows. The serological positives were more prevalent for H5 subtype HPAI (94/800) than for H7 subtype AI (0/800), more prevalent for clade 2.3.2.1 H5 subtype HPAI (89/800) than for clade 2.3.4 (1/800) and clade 7.2 (4/800) H5 subtype HPAI, more prevalent for clade 2.3.2.1 H5 subtype HPAI in a city in southern China (82/800) than in a city in northern China (8/800). The serological data are all consistent with the distribution of the subtypes or clades of AI in poultry in China. Previously, sparrows or other passerine birds were often found to be pathogenically negative for AIVs, except when an AIV was circulating in the local poultry, or the tested passerine birds were from a region near waterfowl-rich bodies of water. Taken together, the data suggest that tree sparrows are susceptible to infection of AIVs, and surveys targeting sparrows can provide good serological data about the circulation of AIVs in relevant regions. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma genitalium (MG) is one of the common causes of non-gonococcal urethritis (NGU) in men and is associated with cervicitis, endometritis, and pelvic inflammatory diseases (PID) in women. The prevalence of MG infection has been reported to be high among female sex workers (FSWs) in many countries, but limited information is known among this population in China. Methods: From July to September 2009, venue-based FSWs were recruited in two cities (Wuzhou and Hezhou) of Guangxi Autonomous Region in southwest China. Information of socio-demographic and behavioral characteristics was collected by a questionnaire-based interview. Cervical specimens were obtained for detection of MG using a real-time polymerase chain reaction (PCR) assay targeting mgpA gene. Results: The overall prevalence of MG infection among 810 FSWs was 13.2% (95% CI = 10.87%-15.52%). MG infection was significantly associated with less education (adjusted odds ratio (AOR) = 2.36, 95% CI = 1.15-4.87) consisting of junior high school or below, being single (AOR = 2.27, 95% CI = 1.42-3.62), migrant background (AOR = 2.03, 95% CI = 1.29-3.20), and absence of any STI symptoms in the previous year (AOR = 1.66, 95% CI = 1.09-2.52). Conclusions: MG infection was prevalent among FSWs in the study areas. This pattern of infection suggests that an increasing attention should be paid to MG screening and treatment in this high risk population. [ABSTRACT FROM AUTHOR]

Water resources management has been of concern for many researchers since the contradiction between increased water demand and decreased water supply has become obvious. In the real world, water resources systems usually have complexities among social, economic, natural resources and environmental aspects, which leads to multi-objective problems with significant uncertainties in system parameters, objectives, and their interactions. In this paper, a multi-objective linear programming model with interval parameters has been developed wherein an interactive compromising algorithm has been introduced. Through interactive compromising conflicts among multi-objectives, a feasible solution vector can be obtained. The developed model is then applied to allocation of multi-source water resources with different water qualities to multiple users with different water quality requirements for the Dalian city for 2010, 2015 and 2020 planning years. The model pursues the maximum synthesis benefits of economy, society and the environment. The results indicate that the proportion of reused water to the total water amount is gradually increasing, and the proportion of agricultural water consumption to the total water consumption is gradually decreasing. The allocation of multi-source water resources to multiple users is improved due to incorporation of uncertain factors into the model that provide useful decision support to water management authorities. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the impact of Copper2+-loaded silicate (CLS) on the growth performance and microflora of crucian carp Carassius auratus in China. For the study, researchers used bentonite as the primary ingredient of the silicate sample and 225 native wild crucian carp at an average initial body weight of 20 grams. Researchers found that lactobacilli counts of the intestine significantly grew. They also found that CLS initiated an antimicrobial activity in vitro, which may aid in protecting the intestinal mucosa from invasion of pathogenic bacteria and their toxins.

The article presents information on a study which analyzes the clinical features and survival data of Chinese patients with idiopathic pulmonary arterial hypertension (PAH) and familial PAH. The study included 72 patients with idiopathic PAH and familial PAH. The results say that poor survival rate was related to lack of effective treatment in China.

Cities are growing higher and denser, and understanding and constructing the compact city form is of great importance to optimize sustainable urbanization. The two-dimensional (2D) urban compact form has been widely studied by previous researchers, while the driving mechanism of three-dimensional (3D) compact morphology, which reflects the reality of the urban environment has seldom been developed. In this study, land surface temperature (LST) was retrieved by using the mono-window algorithm method based on Landsat 8 images of Xiamen in South China, which were acquired respectively on 14 April, 15 August, 2 October, and 21 December in 2017, and 11 March in 2018. We then aimed to explore the driving mechanism of the 3D compact form on the urban heat environment (UHE) based on our developed 3D Compactness Index (VCI) and remote sensing, as well as Geo-Detector techniques. The results show that the 3D compact form can positively effect UHE better than individual urban form construction elements, as can the combination of the 2D compact form with building height. Individually, building density had a greater effect on UHE than that of building height. At the same time, an integration of building density and height showed an enhanced inter-effect on UHE. Moreover, we explore the temporal and spatial UHE heterogeneity with regards to 3D compact form across different seasons. We also investigate the UHE impacts discrepancy caused by different 3D compactness categories. This shows that increasing the 3D compactness of an urban community from 0.016 to 0.323 would increase the heat accumulation, which was, in terms of satellite derived LST, by 1.35 °C, suggesting that higher compact forms strengthen UHE. This study highlights the challenge of the urban 3D compact form in respect of its UHE impact. The related evaluation in this study would help shed light on urban form optimization. [ABSTRACT FROM AUTHOR]

Background: The prevalence of syphilis is very high in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), and effective interventions are needed to educate HIV-positive individuals about behavioral and biological risk factors. Therefore, we developed a standard case management process and conducted a randomized controlled study to investigate the impact on risky sexual behaviors and syphilis in HIV-positive MSM.Methods: Men who have sex with men (n = 220) were enrolled and randomized to the case management intervention group and the control group between May 2016 and January 2017. The control group received routine HIV-related care. In addition to routine HIV-related care, those in the intervention group regularly received extended services from a well-trained case manager. Epidemiological information was collected during the baseline face-to-face interviews by a trained investigator. Serological tests for syphilis and assessments of risky sexual behaviors were performed at baseline and 6 and 12 months after the initiation of treatment.Results: The syphilis incidence rates in the intervention and control groups were 11.3 per 100 person-years and 20.6 per 100 person-years, respectively. The multivariable-adjusted hazard ratio (95% confidence inter) for syphilis in case management group was 0.34 (0.14-0.87). The percentages of participants who resumed risky sexual behaviors in both groups were significantly reduced (P < 0.05) but did not significantly differ between the 2 groups.Conclusions: A case management intervention reduced the incidence of syphilis in HIV-positive MSM. We should further increase the content of case management on the basis of providing routine HIV-related care to those people. [ABSTRACT FROM AUTHOR]

Based on Landsat 8-OLI (operational land imager) images and field surveys, we mapped soil salinization across seven ecosystems in the Manas River basin (MRB), and two models of soil salinization (namely an index model and a sensitivity model) were constructed on a regional scale and on the scale of a unit. ArcGIS ordinary Kriging interpolation was used to determine the spatial distribution of the sensitivity of each ecosystem to soil salinity. The ecosystems differed markedly in their sensitivity: the grassland ecosystem was the most sensitive and the farmland ecosystem was the least sensitive; the other five ecosystems, in descending order of their sensitivity, were desert, urban, forest, wetland, and shrubland. In terms of area, the ecosystems less sensitive to salinity accounted for 40% of the total area; those slightly sensitive accounted for approximately 24%; moderately sensitive, 12%; highly sensitive, 14.5%; and extremely sensitive, 9.5%. The extremely sensitive areas were mostly distributed around Lake Manas while the highly sensitive areas were mainly downwind of the lake. The moderately sensitive areas were occupied mainly by the wetlands and grasslands, the slightly sensitive areas by the deserts, and the least sensitive areas by the farmlands. [ABSTRACT FROM AUTHOR]

In recent years, notified pertussis cases have been increasingly documented in China. It raised a new public health concern of potential optimization in immunization strategy. This study was aimed to determine the cost-effectiveness of different immunization strategies against pertussis-containing vaccines for 6-year-old pre-school children in Shanghai. A Markov-decision tree model was applied to evaluate two pertussis immunization strategies for 6-year-old pre-school children as following: (1) 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster vaccinated at 6 years of age, and (2) no booster at 6 years of age regimen. Primary outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICUR). Sensitivity analyses were performed. The analysis was conducted over a study period of 14 years from a societal perspective. Compared to no booster immunization strategy, administering 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster at 6 years of age, resulted in an average cost reduction of CNY 814.16 (USD 116) per individual, an increase in QALYs by 0.00066, and a rise in per capita net monetary benefit (NMB) by CNY 933.51 (USD 132). The total costs over the study period were reduced by CNY 160.59 million (USD 23 million), utility increased by 130.49 QALYs, and NMB increased by CNY 184.14 million (USD 26 million). Implementing acellular pertussis booster immunization for 6-year-old pre-school children in Shanghai emerges as a cost-saving immunization strategy, with both cost savings and utility gains. [ABSTRACT FROM AUTHOR]

With the aging of the population, the prevalence of osteoporosis (OP) is rising rapidly, making it an important public health concern. Early screening and effective treatment of OP are the primary challenges facing the management of OP today. Quanduzhong capsule (QDZ) is a single preparation composed of Eucommia ulmoides Oliv., which is included in the Pharmacopoeia of the People's Republic of China. It is used to treat OP in clinical practice, but its mechanisms are unclear. This study involved 30 patients with OP, 30 healthy controls (HC), and 28 OP patients treated with QDZ to identify potential biomarkers for the early diagnosis of OP and to investigate the potential mechanism of QDZ in treating OP. The serum samples were analyzed using targeted amino acid metabolomics. Significant differences in amino acid metabolism were identified between the OP cohort and the HC group, as well as between OP patients before and after QDZ treatment. Compared with HC, the serum levels of 14 amino acids in OP patients changed significantly. Kynurenine, arginine, citrulline, methionine, and their combinations are expected to be potential biomarkers for OP diagnosis. Notably, QDZ reversed the changes in levels of 10 amino acids in the serum of OP patients and significantly impacted numerous metabolic pathways during the treatment of OP. This study focuses on screening potential biomarkers for the early detection of OP, which offers a new insight into the mechanism study of QDZ in treating OP. • Osteoporosis patients had dysfunctions in amino acid metabolic profiles. • The combination of four potential biomarkers is potential as diagnostic biomarkers. • Quanduzhong capsules reversed the clinical symptoms of osteoporosis. • Quanduzhong capsules reversed the changes in the amino acid profile of osteoporosis. [ABSTRACT FROM AUTHOR]

Chlorinated paraffins (CPs) in poultry feed and the farm environment might bioaccumulate in poultry eggs. Unlike chickens, which are mostly raised in cages, ducks are commonly raised free range. This would expose ducks to CPs in the environment. However, information on the presence of CPs on duck farms is scarce. In the present study, samples of duck eggs, duck feathers, poultry feed, and soil were collected from 25 duck farms in South China. Forty-eight congener groups of short- and medium-chain CPs (SCCPs and MCCPs) were detected in the samples. Interestingly, relatively high concentrations of SCCPs and MCCPs were found in the duck feathers. The median concentrations of SCCPs and MCCPs in the duck eggs, feathers, feed and soil were: 46 and 18 ng/g wet weight, 2460 and 992 ng/g, 103 and 47 ng/g, and 24 and 10 ng/g dry weight, respectively. The dominant groups of SCCPs and MCCPs were C 10 Cl 6–7 and C 14 Cl 7–8 , respectively. The close relationship between duck feathers and poultry feed indicated that the duck feathers might act as a bioindicator for the exposure of ducks to CPs. The margin of exposure approach was used to assess the health risk, with the results showing that the consumption of duck eggs posed a low risk to different age groups from exposure to SCCPs and MCCPs. [Display omitted] • Higher concentrations of CPs were found in duck feathers than eggs, feed and soil. • The dominant CPs had short carbon chains and low levels of chlorine. • There was a close relationship between CPs in the feathers and feed. • The human exposure risk to CPs through duck egg consumption was low. [ABSTRACT FROM AUTHOR]

[Display omitted] • We develop 3D landscape indices including characteristic, shape, and compactness. • 3D compactness index has the strongest interpretation of land surface temperature. • Overly compact 3D green space may cause increased land surface temperature in summer. • Terrain interacts more strongly with 3D form of green space than with 2D form. Climate change and urbanization have led to an increase in extreme weather and urban heat islands. Green space can help regulate the thermal environment, but previous studies have focused on two-dimensional (2D) indicators, neglecting the intrinsic three-dimensional (3D) characteristics of green space. Therefore, we developed a set of 3D landscape indices to define green space configurations, including characteristic, shape, and compactness, based on landscape ecology and the law of universal gravity, and quantify its benefits for the thermal environment. We collected high-resolution LiDAR point cloud data from Siming Mountain, China, to calculate both 2D and 3D green space landscape patterns and investigate their effects on land surface temperature (LST) using correlation analysis and spatial statistical methods. Our study revealed: (1) All the selected green space landscape indices had a significant negative effect on LST, with a non-linear enhancement when 2D or 3D indices interacted. (2) The 3D compactness index (VCI) could be the most reliable and concise index to explain LST spatial distribution. Adjusting the VCI allowed us to reduce the LST of the study area by up to 3.71 °C in summer and 2.14 °C in winter. However, an overly compact 3D green space above the threshold could lead to higher LST in summer. (3) Terrain had a weaker effect on LST in winter than in summer, and it showed a stronger interaction with the 3D form of green space than with the 2D form. We concluded that the 3D compact form of green space can be utilized as the key factor in maximizing its cooling effect, by taking into account both terrain factors and seasonal variations. Our study can shed light on the scientific planning of green space aiming at optimizing the thermal environment for more sustainable forest and urban habitats. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to gain information on the antimicrobial susceptibility and molecular epidemiological typing of Neisseria gonorrhoeae (NG) isolates in China in 2012.Methods: A total of 244 NG isolates were consecutively recovered from patients with uncomplicated gonorrhea attending sexually transmitted disease clinics in 3 Chinese cities-Guangzhou, Nanjing, and Tianjin-in 2012. Neisseria gonorrhoeae susceptibilities to penicillin and tetracycline were examined by detecting penicillinase-producing NG (PPNG) and high-level tetracycline-resistant NG, and NG susceptibilities to ciprofloxacin, spectinomycin, ceftriaxone, and cefixime were determined using an agar dilution method. Neisseria gonorrhoeae isolates were typed by multiple-locus variable number tandem repeat analysis. We conducted a χ analysis to compare clusters with Bonferroni correction and Kruskal-Wallis test.Results: Neisseria gonorrhoeae isolates gathered from the 3 cities differed significantly in the prevalence of tetracycline-resistant NG (P < 0.001) and NG treated with ceftriaxone with a minimum inhibitory concentration of 0.125 mg/L or higher (P < 0.001). The analysis of the combination of the 7 variable number of tandem repeats loci for all of the 244 isolates yielded 110 multiple-locus variable number tandem repeat analysis types falling into 5 clusters. Cluster III was associated with PPNG, whereas cluster II was associated with non-PPNG (P < 0.05) and NG treated with ceftriaxone with a minimum inhibitory concentration of 0.125 mg/L or higher (P < 0.05).Conclusions: Antimicrobials that can be used with confidence to treat NG infection currently in China include ceftriaxone and spectinomycin, but not penicillin, tetracycline, ciprofloxacin, and cefixime. Moreover, some of the resulting clusters were associated with PPNG and NG with decreased ceftriaxone susceptibility. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Polymorphisms in the TCRA and P2RY11, two immune related genes, are associated with narcolepsy in Caucasians and Asians. In contrast, CPT1B/CHKB polymorphisms have only been shown to be associated with narcolepsy in Japanese, with replication in a small group of Koreans. Our aim was to study whether these polymorphisms are associated with narcolepsy and its clinical characteristics in Chinese patients with narcolepsy. Methods: We collected clinical data on 510 Chinese patients presenting with narcolepsy/hypocretin deficiency. Patients were included either when hypocretin deficiency was documented (CSF hypocretin-1⩽110pg/ml, n =91) or on the basis of the presence of clear cataplexy and HLA-DQB1∗0602 positivity (n =419). Genetic data was compared to typing obtained in 452 controls matched for geographic origin within China. Clinical evaluations included demographics, the Stanford Sleep Inventory (presence and age of onset of each symptom), and Multiple Sleep Latency Test (MSLT) data. Results: Chinese narcolepsy was strongly and dose dependently associated with TCRA (rs1154155C) and P2RY11 (rs2305795A) but not CPT1B/CHKB (rs5770917C) polymorphisms. CPT1B/CHKB polymorphisms were not associated with any specific clinical characteristics. TCRA rs1154155A homozygotes (58 subjects) had a later disease onset, but this was not significant when corrected for multiple comparisons, thus replication is needed. CPT1B/CHKB or P2RY11 polymorphisms were not associated with any specific clinical characteristics. Conclusions: The study extends on the observation of a strong multiethnic association of polymorphisms in the TCRA and P2RY11 with narcolepsy, but does not confirm the association of CPT1B/CHKB (rs5770917) in the Chinese population. [Copyright &y& Elsevier]

Abstract: In this study, the Daily Air Pollution Index (DAPI) of 81 cities in China from June 2004 to June 2007 was used to study the air pollution of city clusters. The cluster analysis results show that the DAPI of 71 cities in central and eastern China is divided into two regimes, the north regime and the south regime along the Qinling Mountain and its eastern extension to Huaihe River. The demarcation line between the two DAPI regimes duplicates the demarcation line of the watersheds of the northern and southern climate regions and the DAPI were statistically negatively correlated to the amount of rainfall, suggesting that precipitation could play an important role in determining the two regimes. The two DAPI regimes are further divided into seven city clusters mainly associated with emissions of air pollutants and geographical distributions, supported by remote sensing data of aerosol optical depth (AOD), NO2 and emission inventories of air pollutants in China in 2006 reported in the literature. DAPI of three city clusters in the north regime exhibited a similar seasonal trend, which was different from the four city clusters in the south regime. Outbreak of dust storms in spring and an increase in emissions due to space-heating impacted the DAPI of the northern city clusters. Although the consumption of electricity decreased in the southern city clusters in the fall and winter, the reported high DAPI were the result of less rainfall and poor dispersion. Seven cities in western China were classified into two groups associated with their unique nature environments. Three cities were not allocated to any of the city clusters. [Copyright &y& Elsevier]

Introduction: Emergency medical service (EMS) serves as a pivotal role in linking injured road users to hospitals via offering first aid measures and transportation. This paper aims to investigate the effect of emergency medical service (EMS) response time on the fatality risk of freeway crashes., Methods: Crash injury severity data from Kaiyang Freeway, China in 2014 and 2015 are employed for the empirical investigation. A Bayesian random parameters spatial logistic model is developed for analyzing crash severity., Results: Bayesian inference of the random parameters spatial logistic model demonstrates the importance of reducing EMS response time on minimizing the fatality risk of freeway crashes. Fatality odds would increase by 2.6% for 1 min increase in EMS response time. Additionally, vehicle type, crash type, time of day, horizontal curvature, vertical grade, and precipitation are also found to have significant effects on the fatality probability of freeway crashes., Conclusion: It is crucial to reduce EMS response time to decrease the fatality likelihood of freeway crashes. Some countermeasures have been proposed to shorten EMS response time., Competing Interests: PH, SO, and HY were employed by Guangzhou Expressway Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Huang, Ouyang, Yan, Wang, Lee and Zeng.)

The goal of environmental management in China is transitioning from pollution control to the improvement of ecological quality. The establishment of regional differential water quality standards can better adapt to the ecological characteristics and development needs of different regions. Given the shortcomings of current water quality standards and the needs of technological development, this study analyzed the causes and influencing factors of regional differences in water quality standards and summarized China's regional variations in areas such as the characteristics of receiving water bodies, social attributes, climate conditions, physicochemical properties of water, and aquatic biotic populations. It also examined the impact of regional characteristics on the assessment of biological toxicity. Based on these analyses, the study identified key scientific questions that may arise in the development of regional differential water quality standards in China and outlined future critical research directions in this field. These directions include developing theories and methods for determining the effluent dilution coefficient, establishing methods for identifying regional key water quality indicators and assessing their impact on water quality standards, determining regional characteristic species and their influence on water quality standards, and formulating theories and methods for categorizing different regions across the country. The aim of the study was to provide a reference for the scientific establishment of water quality standards in China.

Background: Preoperative visit-care for transcatheter aortic valve replacement (TAVR) plays a crucial role in improving the quality of care and patient safety. However, preoperative care for TAVR patients is still in its early stages in China, with the care often being experience-based. The application of relevant evidence in nursing practice is necessary. Little is known regarding the facilitators and barriers to apply and compliance to the evidences about preoperative visit-care for TAVR in nursing., Methods: The Nurse's Compliance Checklist was used to investigate the evidence-based compliance of nurses (n = 21) who worked in the TAVR team in the evidence-based implementation setting. Meanwhile, an Evidence-Based Practice Beliefs Scale, and Influencing Factors Checklist were used to investigate all nurses (n = 66) who work in the same setting. Stakeholders (Middle and senior-level nursing administrators, frontline clinical nurses, and patients) interview was carried out to further disclose the barriers and facilitators in the process of evidence-based practice., Results: The results of this study showed that only 1 evidence implemented fully (100%) by nurses, 3 evidences with 0% implementation rate, and implementation rate of the other evidences were 9.5∼71.4%. The overall score of nurses' evidence-based nursing belief level was (3.52 ± 0.82). Three domains of barriers were identified: the Context Domain included lack of nursing procedures, inadequate health education materials, insufficient training; the Practitioner Domain included insufficient attention, lack of relevant knowledge, high work pressure and uncertainty of expected results, and Patient Domain included lack of relational knowledge. Facilitating factors included leadership support, nurse' high evidence-based nursing belief, high executive ability and enthusiasm for learning., Conclusion: The study indicated that the nurses' compliance of evidence-based practice in preoperative visit-care for TAVR was in lower level. There were some factors influencing the application of the evidences. The study revealed potential modifiable barriers to the successful implementation of evidence-based preoperative visit-care, including a lack of preoperative visit- care routine, related knowledge and training. Leadership support and nurse training should be considered to improve nurses' compliance with evidence-based practice., (© 2024. The Author(s).)

Purpose: The debate over the causal and longitudinal association between cystatin C and stroke in older adults persists. Our aim was to assess the link between cystatin C levels, both measured and genetically predicted, and stroke risk., Methods: This study employed a retrospective cohort design using samples of the China Health and Retirement Longitudinal Study (CHARLS), which is a nationally representative cohort recruiting individuals aged 45 years or above. A multivariate logistic model and the two-sample Mendelian randomization framework were used to investigate the longitudinal and genetically predicted effect of serum cystatin C on stroke., Results: The study population had a mean age of 59.6 (SD ±9.5), with 2,996 (46.1%) women. After adjusting for confounding factors, compared to those in the first quartile of cystatin C, those in the last quartile had the greatest risk of stroke incidence [odds ratio (OR), 1.380; 95% confidence interval (CI), 1.046-1.825]. The Mendelian randomization analysis showed that a genetically predicted cystatin C level was positively associated with total stroke (OR by inverse variance-weighted method, 1.114; 95% CI, 1.041-1.192)., Conclusions: This national cohort study suggests that higher serum cystatin C is associated with an increased risk of total stroke, which is further supported by Mendelian randomization., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Qi, Shang, Han, Han, Jiang, Yan, Yue, Sun, Liu and Cui.)

Reclaimed water with nitrogen, phosphorus, and other contaminants may trigger algal blooms during its ecological utilization in replenishing rivers or lakes. However, the effect of reclaimed water on algal growth rates is not well understood. In this study, the growth potentials of algae in terms of Cyanophyta, Chlorophyta, and Bacillariophyta, as well as mixed algae in both regular culture medium and reclaimed water produced from treatment plants in Beijing with similar N and P concentrations, were compared to evaluate whether reclaimed water could facilitate algal growth. In addition, reclaimed water was also sterilized to verify the impact of bacteria's presence on algal growth. The results indicated that most algae grew faster in reclaimed water, among which the growth rate of Microcystis aeruginosa even increased by 5.5 fold. The growth of mixed algae in reclaimed water was not enhanced due to the strong adaptive ability of the community structure. Residual bacteria in the reclaimed water were found to be important contributors to algal growth. This work provided theoretical support for the safe and efficient utilization of reclaimed water., 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 B.V. All rights reserved.)