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3D Real Scene is an important part of new infrastructure construction, which provides a unified spatial base for economic and social development and informatization of various departments. According to the demand of real 3D Real Scene digital construction, this paper aims to study the method of indoor and outdoor structured monomer reconstruction of city 3D Real Scene, develop digital twin platform, and strive to lead the development of 3D Real Scene. The main research contents of this paper are as follows: 1) Spatio-temporal-spectral-angular remote sensing observation system and data fusion model; 2) Rapid construction method of vector monomer 3D model of indoor and outdoor entity object; 3) 3D structural reconstruction technology of urban component level based on vector images; 4) A universal digital twins platform, LuojiaDT. The technologies we have developed have been widely used in the national 3D Real Scene construction of China, including smart city, smart transportation, cultural heritage protection, public security and police, urban underground pipe network, indoor and outdoor location service. This research will promote the continuous development of digital twins technology. [ABSTRACT FROM AUTHOR]

This study assessed the contamination by toxic elements (TEs), including lead (Pb), cadmium (Cd), chromium (Cr), zinc (Zn), copper (Cu) and arsenic (As), and their accumulation characteristics in soilcrop systems in Xingren, Guizhou, southwest China, by using the target hazard quotient (THQ) to evaluate the possible health risk in the target area. The mean value of the geo-accumulation index (Igeo; 1.95, 1.89 and 1.96 for rice, maize and Coix lacryma-jobi L., respectively) shows As in partial contamination level. The potential ecological risk index (RI) values show that 90% of samples exceed in considerable ecology risk level (120 < RI 240). The concentration of investigated TEs (except Zn) in the edible part of the three crops tended to be lower than in other tissues: root > stalk > leaf > husk >edible part. Maize showed a major restriction in TE intake compared to rice and Coix lacryma-jobi L. The THQ of As was from 0 to 6.33 in all the plant samples, which indicates that the THQ exceeded the safe limit (THQ=1) in some samples. The total THQs (TTHQ) had a similar trend as RI, further indicating the potential health risk of the elements in combination. These data indicate that local people experience significant health risks if they ingest crops from the investigated area. [ABSTRACT FROM AUTHOR]

In this study we investigate vegetation changes using the normalized difference vegetation index (NDVI) in the Huai River basin during 1982–2013, where double cropping (DC) systems are widespread. The seasonal cycle of NDVI shows a bimodal distribution with two obvious peaks in May and August, respectively. By contrast, both precipitation and temperature reach their maxima in July, which suggests that the seasonal vegetation cycle is dominated by the DC ecosystems. During 1982–2013, annual NDVI has a significant (p < 0.1) positive trend at the rate of 1.360 × 10–3year−1. We define the winter and summer cropping seasons (WCS and SCS) as November to May and June to October based on the agriculture calendar. NDVI trends are found to be asymmetric in these two cropping seasons. NDVI shows a positive trend with an increase of 2.314 × 10–3year−1(p < 0.1) during WCS, but during SCS, NDVI does not show a significant trend. No significant trend is found in precipitation. Meanwhile, temperature increases significantly in both cropping seasons, and is suggested to cause the asymmetric trends in NDVI because warming stimulates growth in the WCS more than SCS. Our results highlight the stimulative effect of temperature on vegetation growth even in warm regions dominated by multiple cropping ecosystems. [ABSTRACT FROM AUTHOR]

The impact of air temperature in early growing season on the carbon sequestration of a subtropical coniferous plantation was discussed through analyzing the eddy flux observations at Qianyanzhou (QYZ) site in southern China from 2003 to 2008. This site experienced two cold early growing seasons (with temperature anomalies of 2-5 °C) in 2005 and 2008, and a severe summer drought in 2003. Results indicated that the low air temperature from January to March was the major factor controlling the interannual variations in net carbon uptake at this site, rather than the previously thought summer drought. The accumulative air temperature from January to February showed high correlation (R² = 0.970, p < 0.001) with the annual net ecosystem production (NEP). This was due to the controls of early-month temperature on the plant phenology developing and the growing season length at this subtropical site. The cold spring greatly shortened the growing season length and therefore reduced the carbon uptake period. The eddy flux observations showed a carbon loss of 4.04 g C m-2 per growing-season day at this coniferous forest site. On the other hand, the summer drought also reduced the net carbon uptake strength because the photosynthesis was more sensitive to water deficit stress than the ecosystem respiration. However, the impact of summer drought occurred within a relatively shorter period and the carbon sequestration went back to the normal level once the drought was relieved. [ABSTRACT FROM AUTHOR]

The version 2 Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) dust layer detection method, which is based only on lidar measurements, misclassified about 43% dust layers (mainly dense dust layers) as cloud layers over the Taklamakan Desert. To address this problem, a new method was developed by combining the CALIPSO Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) and passive Infrared Imaging Radiometer (IIR) measurements. This combined lidar and IR measurement (hereafter, CLIM) method uses the IIR tri-spectral IR brightness temperatures to discriminate between ice cloud and dense dust layers, and lidar measurements alone to detect thin dust and water cloud layers. The brightness temperature difference between 10.60 and 12.05 μm (BTD11-12) is typically negative for dense dust and generally positive for ice cloud, but it varies from negative to positive for thin dust layers, which the CALIPSO lidar correctly identifies. Results show that the CLIM method could significantly reduce misclassification rates to as low as ∼7% for the active dust season of spring 2008 over the Taklamakan Desert. The CLIM method also revealed 18% more dust layers having greatly intensified backscatter between 1.8 and 4 km altitude over the source region compared to the CALIPSO version 2 data. These results allow a more accurate assessment of the effect of dust on climate. [ABSTRACT FROM AUTHOR]

Estuarine ecosystems have been threatened by increasing anthropogenic and natural pressures, yet the integral understanding of their stability characteristics of microbial communities at taxonomic, habitat, and spatial scales remains limited. In this study, the Mulan River estuary in southeastern China was selected to compare the stability characteristics of bacterial and protistan communities in water and sediments over three hydrological periods, and to explore their spatial variations along the estuarine continuum from river to ocean. The potential driving mechanisms of stability characteristics were also explored. Results revealed that the estuarine ecosystem displayed varied stability at taxonomic, habitat, and spatial scales, separately. On the whole, protistan communities had a lower stability than bacterial communities in both water and sediments, with the higher coefficients of variation in alpha diversity (av. 0.82), the higher Bray-Curtis distances of community compositions (av. 0.98), and the lower robustness of networks (av. 0.23). Compared to the sediments, the lower stabilities of two taxa in water were also indicated via the above three indices. Along the estuarine continuum, the stability of bacterial communities in the middle reach was lowest, but the stability of protistan communities was lowest in the up reach. The null model and network analysis suggested that the assembly processes with stronger variable selection and homogeneous selection, coupled with higher positive interaction (r > 0.7) of microbial communities jointly accounted for the lower stabilities in the up and middle estuarine reaches. The partial least squares path model suggested that total nitrogen, total phosphorus, and dissolved oxygen controlled the community stability by influencing microbial assembly and interaction in the up and middle reaches. This study provides new insights on the varied stability characteristics of different microbial communities along the estuarine continuum, which are helpful for maintaining estuarine ecological function and formulating management strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Green-gray infrastructure is promising to control urban runoff and pollution, thereby mitigating the impacts of urbanization and climate change on urban water systems. In this study, we developed a novel spatiotemporal optimization framework for planning the construction of green-gray facilities. Construction timing was incorporated as an optimization variable within the framework. An integrated water quality model was established to capture water quality response, which served as the primary decision-making criterion instead of conventional focus on runoff volume or pollutant load reduction. A machine-learning-based emulator, developed based on numerical models, acted as the lake module within the integrated water quality model, thereby ensuring an acceptable runtime for the optimization framework. Compared to traditional ones, our framework could achieve synchronized optimization of the construction timing, location, type, and size of the facilities, ensuring cost-efficiency throughout the planning horizon. This methodology was applied in the Caohai catchment, China, providing Pareto-optimal construction plans of green-gray facilities. Our results reveal the diverse suitability and synergistic interactions within facilities in mitigating water pollution across the area. Broad construction across facility types proved more effective than focusing on a few. Optimal construction timing patterns varied across facilities, shaped by unique cost dynamics and the pressures exerted on each facility by rising levels of urbanization. This underscores the significance of incorporating strategic timing into the planning of green-gray infrastructure. Overall, our novel optimization framework provides an integrated ecological and engineering approach for cost-effective urban green-gray infrastructure planning, thereby advancing sustainable urban growth., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: This study aims to investigate the association of the genetic variations in IGF2BP2 and CAPN10 as well as gene-environment interactions with the risk of gestational diabetes (GDM) in Chinese women., Materials and Methods: A total of 1,566 pregnant Chinese women participated in this case-control study. We employed targeted next-generation sequencing to analyze specific SNPs in IGF2BP2 (rs11927381, rs1470579, rs4402960, rs7640539) and CAPN10/rs2975760. Various genetic models were used to assess the associations of these polymorphisms with GDM risk. Gene-gene and gene-environment interactions were examined using GMDR to identify interaction models, Subsequently, logistic regression was employed to confirm the significance of these models and to evaluate their impact on GDM susceptibility., Results: Our study identified significant associations between the C allele of IGF2BP2/rs11927381 and an increased GDM susceptibility in both dominant (P = 0.031, OR = 1.247) and heterozygote (P = 0.043, OR = 1.239) gene models. Conversely, the heterozygote TC genotype of CAPN10/rs2975760 was associated with a reduced risk of GDM (P = 0.046, OR = 0.766). Increased BMI and O 3 levels were linked to a higher GDM susceptibility. We discovered interactions between CAPN10/rs2975760 CC and IGF2BP2/rs11927381 TC genotype that exacerbated GDM risk (P = 0.022, OR = 11.337). Furthermore, interactions between IGF2BP2/rs11927381 and environmental factors were observed, indicating increased GDM risks (BMI: P = 0.004, OR = 1.011; O 3 : P = 0.013, OR = 1.002; PM 2.5 : P = 0.042, OR = 1.005；BC: P = 0.048, OR = 1.094; NO 3 - :P = 0.045, OR = 1.024)., Conclusion: GDM is significantly associated with IGF2BP2/rs11927381 and CAPN10/rs2975760 polymorphisms as well as exposure to O 3 . Furthermore, the interaction between the CAPN10/rs2975760 CC genotype and IGF2BP2/rs11927381 TC genotype, as well as environmental factors (O 3 , PM 2.5 , BMI), significantly increases the risk of GDM in Chinese women., 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 © 2025 Elsevier B.V. All rights reserved.)

Background: Numerous studies have explored the relationship between sleep quality and internalizing symptoms (i.e., depression and anxiety), but there is uncertainty about their directional pathways. Here, we investigated the longitudinal associations between sleep quality and internalizing symptoms and tested the potential mediation effect of perceived stress., Methods: A longitudinal survey of Chinese healthcare students (N = 343) was conducted at three time points: Time 1 (baseline), Time 2 (1 week later), and Time 3 (3 weeks after Time 2). Participants completed the Sleep Quality Questionnaire (SQQ), Perceived Stress Questionnaire-30 (PSQ-30), and the Patient Health Questionnaire-4 (PHQ-4) at each time point, where each asked about participants' experiences over the past week. A higher SQQ score indicated poorer sleep quality, while higher scores on the PHQ-4 and PSQ-30 indicated more severe internalizing symptoms and perceived stress. Using autoregressive cross-lagged panel modeling (CLPM), we examined the bidirectional relationships among sleep quality, internalizing symptoms, and perceived stress., Results: CLPM revealed that baseline sleep quality negatively predicted subsequent changes in internalizing symptoms, and vice versa. While perceived stress mediated the relationship between sleep quality and internalizing symptoms at the 3-week follow-up (β = 0.017, p = .038), it did not mediate the reverse relationship between internalizing symptoms and sleep quality., Conclusions: There was a negative bidirectional relationship between sleep quality and internalizing symptoms. Furthermore, perceived stress mediated the effect of poor sleep quality on internalizing symptoms, suggesting that good-quality sleep may enhance stress resilience and alleviate symptoms of depression and anxiety, thereby improving overall wellbeing., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. The funding sources provided financial support for the research activities, including data collection, analysis, and manuscript preparation. The funders had no role in study design, data interpretation, or decision to publish. The contents do not represent the views of the National Sleep Foundation., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Atmospheric particulate pollution generated by traffic activities poses a threat to human health. Due to their unique structure and function, plant leaves efficiently capture and accumulate atmospheric particulate matter, acting as natural particulate collectors. This study focuses on leaf samples from different functional zones in Jinhua City, Zhejiang Province, employing environmental magnetism methods to explore dust retention differences among zones and the impact of green belt spatial layouts on dust retention. The results indicate that leaf magnetism is an effective method for monitoring traffic-related particulate pollution. The saturation isothermal remanent magnetization per unit area (2D-SIRM) values of leaf samples from traffic zones were significantly higher than those from residential areas; the 2D-SIRM value of tree leaves increases with higher traffic volume, indicating more dust retention, suggesting that traffic activities are a major source of particulate pollution. Leaf height (height above the ground), distance from roads, and orientation significantly influence dust retention, with higher magnetic mineral concentrations found in leaves facing roads, closer to roads, and at a height of 2 m, suggesting that traffic-emitted particulates tend to accumulate in these areas. There are differences in dust retention capacities among tree species; Osmanthus and Loropetalum chinense perform better than Golden Privet and Red Tip Photinia. The research results provide some reference for the design of roadside green vegetation systems in Jinhua City and other cities in subtropical monsoon climate zones., Competing Interests: Declarations. Ethical approval: Not applicable. Consent to participate: All authors consented to participate in the manuscript. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background and Aim: The prevalence of childhood leukemia in China has been on the rise, imposing significant psychological burden on parents. Currently, few studies have explored the dyadic coping status of parents of children with leukemia and its influencing factors. This study aimed to investigate the associations among dyadic coping, self-efficacy, anxiety and depression in parents of children with leukemia., Methods: A cross-sectional design was performed to conveniently sample 342 parents from the pediatric hematology ward of Peking University People's Hospital. The general demographic information, dyadic coping inventory, general self-efficacy scale, and hospital anxiety and depression scale were collected and analyzed using SPSS.22.0 software., Results: The average age of the parents was (37.29 ± 5.73) years, while the total score of dyadic coping was 122.95 ± 16.68, the self-efficacy score was 25.03 ± 3.93, anxiety score was 15.58 ± 3.59, and depression score was 16.27 ± 3.86. Dyadic coping was significantly positively correlated with self-efficacy (r = 0.386, P < 0.01), and negatively correlated with parental anxiety and depression scores (r=-0.372; r=-0.264; P < 0.01). Multiple linear regression revealed that self-efficacy(β = 0.262), anxiety(β=-0.242), income per month (RMB,β = 0.182), knowledge of the child's illness(β = 0.138), number of relapses(β=-0.135), current treatment programs(β=-0.149), education level(β = 0.101) and the duration of diagnosis(β = 0.092) were significant factors influencing the parents' dyadic coping level (R 2  = 0.378, P < 0.01)., Conclusion: The dyadic coping level of parents of children with leukemia is generally moderate, is positively correlation with self-efficacy and negatively correlated with anxiety. Therefore, interventions targeting dyadic interactions between parents should be established to improve parental communication, foster coping mechanisms under stress, and alleviate the negative emotional responses., Competing Interests: Declarations. Ethics approval and consent to participate: This project (RDN2021-18) supported by Peking University People’s Hospital Scientific Research Development Funds. Ethical approval was obtained from the Ethics Committee of Peking University People’s Hospital. Our study was compliant with the Helsinki Declaration, and all participants signed informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: HIV-1 subtype B, introduced to mainland China at an early stage, rapidly spread among commercial plasma donors and heterosexuals (HETs) during the 1990s. It was first identified in Hainan, which has a population of 10 million, in 2007. Nevertheless, there is a paucity of data about the molecular-epidemiological characteristics, spatial origins, and transmission patterns of this strain on the island of China., Methods: Pol sequences for HIV-1 subtype B from Hainan Island (2007-2024) were obtained from our research and global databases. An analysis of phylogenetic data, molecular clock models, and a Bayesian coalescent-based approach was performed to investigate how HIV-1 subtype B was introduced and disseminated on this island., Results: A total of 76 sequences were obtained from Hainan Island, of which 52.63% were collected from men who have sex with men (MSM). Phylogenetic analysis demonstrated that HIV-1 subtype B circulating on the island was closely related to HIV-1 sequence lineages in Guangdong (22.84%, 127/556), Hubei (12.59%, 70/556), and Beijing (14.03%, 78/556), indicating multiple introductions from various cities in China. Bayesian time-scaled phylogenetic reconstructions revealed that 27 Hainan sequences were together in clusters [posterior probability (PP) > 0.90], and 18 Hainan sequences were intermixed in larger clades containing sequences from other provinces (PP > 0.90). Bayes factors (BF) demonstrated that subtype B on the Island originated from Guangdong Province (BF > 100) in 1999.9 (95% HPD:1996.7, 2002.7) and Hubei Province (BF > 100) in 2007.9 (95% HPD:2004.4, 2011.2). Subsequently, HIV-1 subtype B was introduced to Beijing from the island (BF > 100). The analysis of viral migration patterns among risk subgroups revealed that subtype B was introduced to the island by MSMs (BF > 100). Within the island, this strain was from MSM to HETs (BF > 100)., Conclusion: Using Hainan Island as a case study, our findings shed light on the intricate evolution and transmission dynamics of HIV-1 subtype B on the island, revealing crucial insights for HIV prevention efforts in the future., Competing Interests: Declarations. Ethics approval and consent to participate: This study received approval from the Ethical Committee of Hainan Medical University, Hainan, China (HYLL-2022-422). The methods employed adhered to pertinent guidelines and regulations. All participants were fully informed about the study’s content and objectives and provided their informed consent prior to participation.This study adhered to the Declaration of Helsinki to this effect. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Survivors of childhood cancer (CCS) and hematopoietic stem cell transplantation (HSCT) recipients are at increased risk of human papillomavirus (HPV)-associated malignancies. Although HPV vaccination is recommended for these groups, parental acceptance remains uncertain., Procedure: We recruited caregivers of female CCS/HSCT aged ≥9 years from the Shanghai Children's Medical Center (SCMC) vaccination clinic. Caregivers of females who were at least 6 months post treatment, off immunosuppressants, and disease-free were eligible. Caregivers completed a questionnaire assessing demographics, HPV knowledge, and their willingness to vaccinate their daughters., Results: Of the 219 caregivers enrolled, 195 (89.0%) completed the survey. Among the children of caregivers who responded, 44.6% (87/195) had undergone HSCT. All respondent caregivers lacked awareness that the HPV vaccine was recommended for their daughters. Willingness to vaccinate was endorsed by 65.1% (127/195) of caregivers, and was significantly associated with a household income over ¥50,000 (p = 0.02), the mother's HPV vaccination status (p < 0.001), and their daughter receiving any vaccination post therapy (p = 0.02). The most common reasons for vaccine refusal included concerns about its impact on the child's primary disease (64.7%, 44/68), vaccine safety (58.8%, 40/68), and the belief that their child was too young for HPV vaccination (50.0%, 34/68). Only 15 of the 127 (11.8%) caregivers who initially expressed willingness to vaccinate their children had actually initiated vaccination., Conclusion: A substantial minority of Chinese caregivers of female CCS/HSCT are hesitant to vaccinate their daughters against HPV. Addressing caregivers' knowledge deficits and misperceptions about vaccine safety and barriers to accessing HPV vaccination is important to improve uptake., (© 2025 Wiley Periodicals LLC.)

The apple aphid, Aphis spiraecola, is an important pest in apple orchards. Pyrethroids had been widely used for the control of apple aphid. To verify the resistance level of A. spiraecola against pyrethroid insecticides, 35 field populations from main apple-producing areas of China were collected, and the susceptibility to type I and type II pyrethroids were assessed. Bioassays showed that six populations were highly resistant to bifenthrin (RR = 40.97-93.88 fold), and 12 populations showed the extremely high resistance against permethrin (RR = 161.17-349.27-fold). Moreover, all field populations developed high to extremely high resistance against lambda-cyhalothrin, fenvalerate and deltamethrin, except the HNLY and SXYL populations. Toxicity assays indicated that A. spiraecola field populations have developed serious resistance to multiple pyrethroids, and the relative highest resistance occurred in SXQX population. Pre-exposure to different synergists did not significantly increased the toxicity of pyrethroids to SXQX population, indicating a minor role of metabolic resistance in the resistant A. spiraecola. Sequencing of voltage-gated sodium channel (VGSC) genes revealed two homozygous mutations (918V/V and 1014F/F) and six heterozygous mutations (918M/V, 1014L/F, 918M/V+1014L/F, 918V/V+1014L/F, 918M/V+1014F/F and 918M/L+1014L/F) in A. spiraecola. Moreover, 1014L/F and 918M/V+1014L/F mutations were the dominant genotypes with frequencies of 26.67 % and 33.33 % in field populations, respectively. These results indicate that A. spiraecola in China has developed resistance against pyrethroids, and the resistance are mainly caused by mutations in VGSC. Pyrethroid insecticides should not be employed in these fields-evolved resistance, where the practical resistance management is urgently needed., (Copyright © 2025. Published by Elsevier Inc.)

Semi-arid regions, such as the Yellow River Basin in China, are highly sensitive to environmental changes due to their scarce water resources and fragile ecosystems. This study explores the response mechanisms of eukaryotic plankton community structure to environmental conditions in the Dahei River Basin, a representative semi-arid region in central-western Inner Mongolia, across different seasons (spring, summer, autumn) and regions (hills, plain, urban). Our results reveal significant temporal and spatial variability in water resources and quality factors, which in turn affect eukaryotic plankton community structure. Using distance decay relationship (DDR) modeling and random forest analysis, we demonstrate that water quality factors, especially water temperature, are the primary factors influencing community composition in urban regions, where human activities such as industrial thermal discharges and urban heat island effects elevate water temperatures. In summer, increased water volume and flow velocity enhanced river connectivity, promoting greater community structure similarity across the basin, while in autumn, reduced flow and connectivity led to spatial heterogeneity and increased growth of the pollutant-tolerant species like Desmodesmus and Stephanocyclus. The synergistic effects of low flow rates and deteriorating water quality during the dry period intensified the influence of environmental factors on phytoplankton, decreasing community stability and increasing deterministic processes in community assembly. This shift towards determinism, especially in urban regions heavily impacted by human activities, highlights the sensitivity of semi-arid aquatic ecosystems. Co-occurrence network analysis further reveals that urban regions exhibit lower network complexity and stability, underscoring the heightened ecological sensitivity in these regions. In conclusion, the study highlights the critical role of water volume and quality in shaping eukaryotic plankton communities and elucidates how environmental changes, exacerbated by human activities and climate change, disrupt ecosystem stability. These findings offer essential insights for managing and conserving aquatic ecosystems in semi-arid regions facing dual pressures of climate change and human activity., 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 © 2025 Elsevier Ltd. All rights reserved.)

Carbonyl compounds are critical air pollutants with adverse impacts on regional air quality and human health. This study presents a pioneering analysis of spatiotemporal distribution, source appointment, and health risk assessments of carbonyl compounds in the coastal marine atmosphere. By combining ship-borne and ground-based sampling followed with enhanced chemical analysis, 39 carbonyls were identified and quantified in the coastal Hong Kong. Carbonyl concentrations were generally higher in late summer/autumn with lower levels in winter, correlating with their secondary formation rates from precursors. Most species exhibited higher concentrations in open waters than in the fairway and sea channels, due to prominent photochemical formation from regional outflows in the Pearl River Estuary. In contrast, α, β-unsaturated aliphatic aldehydes and acetone were elevated in harbor areas, highlighting the influence of ship emissions on these compounds. Source analysis further indicated a notable contribution from ocean emissions to long-chain aldehydes (C ≥ 6), acetone and di-aldehydes. Health risk assessment demonstrated that carbonyl compounds pose substantial carcinogenic and non-carcinogenic risks to maritime workers and other exposed populations, even exceeding risks faced by road workers. These findings underscore the necessity of considering carbonyl compounds in occupational exposure risk assessments. Overall, this study provides a comprehensive overview of carbonyl compounds in the coastal marine atmosphere, shedding light on the interactions among ship emissions, ocean activities and coastal urban emissions on airborne carbonyls and emphasizing the associated health implications., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Zhe Wang reports financial support was provided by National Natural Science Foundation of China. Zhe Wang reports financial support was provided by Research Grants Council (RGC) of Hong Kong Special Administrative Region. Zhe Wang reports financial support was provided by Hong Kong Environmental Protection Department (EPD). If there are other authors, they 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 © 2025 Elsevier Ltd. All rights reserved.)

In recent years, ozone (O 3 ) pollution in many Chinese cities has worsened. Several cities have also experienced incidents where nocturnal O 3 concentrations did not decrease as expected, and instead remained at high levels (above 50 ppb). However, there have been few detailed studies on the causes of these events. The present study used air quality and meteorological monitoring data, along with the Hybrid Single-Particle Lagrangian Integrated Trajectory model, to investigate the causes contributing to nocturnal O 3 remaining at high values (NORHV) in Linfen City, a typical basin city in the Fenhe River Basin, characterized by severe O 3 pollution. These events are influenced by the individual or combined impacts of mountain-valley breezes, along with vertical and horizontal transport of O 3 -rich air masses. In addition, the influencing mechanisms of three NORHV events were identified as: 1) the alternating effect of the descent of upper-level air masses enriched with O 3 , CO, and SO 2 and downslope mountain breezes carrying the O 3 -rich air mass; 2) the interaction between the transport of polluted air masses across mountains and downslope mountain breezes on both sides of the two mountains in urban areas; and 3) the O 3 -rich air mass from high-altitude regions descended into the urban area following two LLJ events. These conclusions were supported by vertical distributions of O 3 concentrations in the three cases simulated using the WRF-CMAQ model. In addition, the NORHV events resulted in higher initial O 3 concentrations on the following day compared to normal days, exacerbating O 3 pollution. The results of this study demonstrate the significant contributions of complex synergistic effects, such as mountain-valley breezes and vertical transport, to the occurrence of NORHV events in basin cities. These findings may be applicable to other basin cities around the world., 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 © 2025 Elsevier Ltd. All rights reserved.)

Context: Compared with younger traumatic spinal cord injury (TSCI) patients, the elderly had longer delays in admission to surgery, higher proportion of incomplete injury, and longer hospital stays. However, in China, the country with the largest number of TSCI patients, there have been no large-scale reports on their age differences., Objectives: To explore the age-based differences among TSCI inpatients, focusing on the demographic and clinical characteristics, treatment status, and economic burden., Methods: We collected the medical records of 13,334 inpatients with TSCI in the 30 hospitals of China, from January 1, 2013 to December 31, 2018. Trends are expressed as annual percentage changes (APCs) and 95% confidence intervals (CIs)., Results: A total of 13,334 inpatients were included. Both the number and proportion of the elderly showed an increasing trend. The APC of the number and proportion in patients ≥85 years were 39.5% (95% CI, 14.3 to 70.3; P   < 0.01) and 30.5% (95% CI, 8.6 to 56.9; P   < 0.01), respectively. Younger patients were more likely to undergo decompression surgery, and older patients were more likely to receive high-dose methylprednisolone sodium succinate/methylprednisolone (MPSS/MP). Of the patients ≥85 years, none underwent decompression surgery within 8 h, and only 1.4% received a high dose of MPSS/MP within 8 h after injury. Elderly patients had lower hospitalization costs than younger. The total and daily medical costs during hospitalization of patients ≥85 years were 8.06 ± 18.80 (IQR: 5.79) and 0.61 ± 0.73 (IQR: 0.55) thousands dollars, respectively., Conclusions: As the first study to focus on age differences of TSCI patients in China, this study found many differences, in demographic and clinical characteristics, treatment status, and economic costs, between older and younger TSCI patients. The number and proportion of elderly patients increased, and the rate of early surgery for elderly patients is low.

Purpose: To investigate the potential mediating effect of remnant cholesterol (RC) in the associations between angiopoietin-like 8 (ANGPTL8) and the risk of all-cause, cardiovascular disease (CVD), and cancer death., Methods: This prospective observational study included 3278 individuals from China. Binary logistic regression and mediation analyses were conducted to investigate the mediating effect of RC in the associations between ANGPTL8 and all-cause, CVD, and cancer death., Results: During up to 5-year follow-up, a total of 265 deaths (8.08%) were documented. Both increased levels of ANGPTL8 and RC were associated with a higher risk of death for all-cause, CVD, and cancer risk. The level of RC ≥ 33 mg/dL could identify individuals at a higher risk of death independent of low-density lipoprotein cholesterol (LDL-C) levels in Chinese general populations. Furthermore, RC significantly mediated the relationship between increased ANGPTL8 levels and higher risk of all-cause, CVD, and cancer death (proportion of mediation effect: 13.10%, 9.22%, and 6.07%, respectively, all p < 0.05)., Conclusion: Both increased circulating levels of ANGPTL8 and RC are the risk factors for all-cause, CVD, and cancer death and RC partially mediates the association between ANGPTL8 and death risk., Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Ethics: The study protocol was approved by the institutional ethics review board of the sponsoring hospital., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Research Objective: Early adulthood students are at the peak of their rapid psychological development and face an important transition from "mere cognition" to "social cognition" and experiences or guidance during this period are particularly important for psychological quality. From a positive psychology perspective, this study examines the impact of art and design competencies in college students on their positive psychological qualities and analyzes the mediating roles of teacher support and learning adaptability., Methods: Using the Art and Design Competencies Scale for College Students, the Chinese College Students' Positive Psychological Qualities Scale, the Learning Adaptability Scale, and the Teacher Support Scale, a survey was conducted among 950 college students majoring in art., Results: (1) Art and design competencies significantly predicts both teacher support and learning adaptability (p < 0.01). Art and design competencies, teacher support, and learning adaptability can also simultaneously predict positive psychological qualities significantly (p < 0.01). (2) Teacher support has a mediating effect between art and design competencies and positive psychological qualities, with an effect ratio of 17.35 %. (3) Learning adaptability has a mediating effect between art and design competencies and positive psychological qualities, with an effect ratio of 4.89 %. (4) Both teacher support and learning adaptability mediate the relationship between art and design competencies and positive psychological qualities with a combined effect ratio of 22.02 %., Findings: College students' art and design competencies not only directly influences their positive psychological qualities but also indirectly affects them through the mediating roles of teacher support and learning adaptability. These findings highlight the critical role of art and design education in fostering students' psychological well-being and resilience. By enhancing teacher support and learning adaptability, educational institutions can better prepare students to face the challenges of early adulthood, contributing to their overall development and success. At the same time, the research informs the optimization plan for the art and design program., 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 © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Background and Objectives: The efficacy and safety of modified-release methylphenidate (MPH-MR) in the treatment of attention-deficit/hyperactivity disorder (ADHD) have been shown in both pediatric and adult Caucasian patients. The objective of this study was to assess the efficacy and safety of MPH-MR in Chinese children and adolescents with ADHD., Methods: MICCA was a randomized, double-blind, placebo-controlled trial conducted at 19 sites in China from September 2018 to July 2021. The study enrolled children and adolescents aged 6 to < 18 years with a primary diagnosis of ADHD according to the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). Patients were randomized 1:1 to once-daily MPH-MR (10-60 mg) or placebo. The study included an up-titration phase of up to 5 weeks and a dose maintenance phase of 4 weeks. The primary efficacy endpoint was the change in the ADHD Rating Scale-IV (ADHD-RS-IV) total score from baseline to the end of the maintenance phase (EoM). Secondary endpoints included the change from baseline to EoM in Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) total score, and Clinical Global Impression-Improvement (CGI-I) scores at EoM. Safety assessments included treatment-emergent adverse events (TEAEs) and vital signs., Results: A total of 221 patients were randomized (MPH-MR: n = 110; placebo: n = 111). The change in the ADHD-RS-IV total score from baseline to EoM was significantly greater for MPH-MR versus placebo, with a least squares (LS) mean (95% confidence interval [CI]) treatment difference of - 4.6 (- 6.92, - 2.30) (p < 0.001). The mean (95% CI) treatment difference for the WFIRS-P total score change from baseline to EoM also significantly favored MPH-MR over placebo (- 6.46 [- 10.57, - 2.34]; p = 0.002). The CGI-I score at EoM was significantly lower in the MPH-MR group compared to the placebo group (2.2 vs 2.5; p = 0.002). Treatment-emergent adverse events were reported for 74 (67.3%) patients in the MPH-MR group and 55 (49.1%) patients in the placebo group. Most TEAEs were mild to moderate in severity. The most common TEAEs for MPH-MR were decreased appetite, nausea and upper respiratory tract infection. Treatment-emergent adverse events leading to study drug discontinuation/study withdrawal were reported in 4 (3.6%) patients in the MPH-MR group and 1 (0.9%) patient in the placebo group. No clinically relevant changes in vital signs were observed during the study., Conclusions: Modified-release methylphenidate was superior to placebo in improving ADHD symptoms and functioning in Chinese pediatric patients with ADHD. Modified-release methylphenidate had a good safety and tolerability profile. Trial Registration http://www.chinadrugtrials.org.cn/ Identifier: CTR20180056 (registered on 21 May 2018)., Competing Interests: Declarations. Funding: This study was funded by MEDICE Arzneimittel Pütter GmbH & Co. KG. Open access publication was also funded by MEDICE Arzneimittel Pütter GmbH & Co. KG. No funding was received to assist with the preparation of this manuscript. Conflict of interest: Yi Zheng, Huaqing Liu, Xiuxia Wang and Haibo Li have no conflicts of interest to declare in relation to this work. Michaela Ruhmann, Anke Mayer and Oliver Dangel are employees of MEDICE Arzneimittel Pütter GmbH & Co. KG. Richard Ammer is managing owner of MEDICE Arzneimittel Pütter GmbH & Co. KG. Ethics approval: The study protocol, amendments and informed consent form were reviewed and/or approved by Independent Ethics Committees (ECs) according to local regulations before study initiation for each participating study site: Beijing Anding Hospital of Capital Medical University [submission acceptance no.: (2018)clinical review No.(08)], Peking University Sixth Hospital [no.: (2018)ethics review No.(21)], Children’s Hospital of Fudan University [no.: (2018)ethics review No.(192)], The second Xiangya Hospital of Central South University [no.: (2018)ethics review (drug) No.(092)], The First Hospital of Peking University [EC review no.: (2018)drug register No.(36)], Renmin Hospital of Wuhan University [approval no.: WDRY2018-Y054], Beijing Huilongguan Hospital [no.: 2018-28], Children’s Hospital of Shanxi [approval no.: IRB-YL-2018-003], Jiangxi Provincial Children’s Hospital [EC approval no.: PJ2018019], Xiangya Hospital Central South University [no.: Ethics review expedited No.(201809130)], Guangzhou Huiai Hospital [approval no.: (2018) No.(016)], The second affiliated Hospital of Shantou University Medical college [no.: (2018)ethics review No.(6)], Hunan provincial Children’s Hospital [EC approval no.: HNSETYYLL2018001], Guangzhou Women and Children’s Medical Center [no.: GCP (IEC) Approval [2018] No.10], The second affiliated Hospital of Xinxiang University [no.: 2018 ethics review (drug) No.2], The first affiliated Hospital of Jilin University [no.: 18Y164-002], The second Hospital of Hebei Medical University [project no.: 2018EC07-01-1], Children’s Hospital Capital Institute of Pediatrics [base drug (ethics) review no.: [2018]-004], The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University [EC approval no.: drug ethics review No.(2020-041)]. The study was conducted in accordance with the Declaration of Helsinki and its later amendments, the International Council for Harmonization Guideline for Good Clinical Practice, and local regulations. Consent to participate: All parents/guardians and patients aged 8 to <18 years provided written informed consent before screening. Consent for publication: Not applicable. Availability of data and material: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Code availability: Not applicable. Author contributions: YZ, AM, OD and RA participated in the conception and design of the study. YZ served as principal investigator for the study. YZ, HL, XW and HL contributed to data collection. All authors contributed to interpretation of data. MR drafted the manuscript. All authors have read and approved the final submitted manuscript and agree to be accountable for the work., (© 2024. The Author(s).)

Estuaries significantly affect the transport of dissolved organic matter (DOM) from land to ocean. While the transport and composition of estuarine DOM have been extensively studied, the direct link between DOM chemistry and its age remains unclear, limiting a comprehensive understanding of the dynamics and fate of estuarine DOM under severe conditions (e.g., floods). This study applied radiocarbon and ultrahigh-resolution mass spectrometry analysis to investigate the correlation between DOM chemistry and apparent radiocarbon age of 102 samples collected from the Yangtze River Estuary during both non-flood and flood periods. The results showed that young estuarine DOM are characterized by low-molecular-weight, unsaturated molecules, while aged estuarine DOM are relatively saturated with high-molecular-weight molecules. Phosphorus and nitrogen-containing compounds were key to DOM aging, potentially increasing the lability of aged DOM. Floods significantly impact DOM by introducing more labile aged DOM and young terrestrial DOM. Furthermore, floods enhanced the flux of aged DOM transported to the East China Sea by approximately 1.4 times. Our findings contribute to the study of estuarine DOM and its response during severe floods. Additionally, incorporating apparent radiocarbon age evidence improves the understanding of terrigenous DOM and its fate in large river estuaries before it contributes to the ocean carbon reservoir., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The potential modifying roles of dietary patterns in the association between body mass index (BMI) and mortality in older adults remain unclear. This study aimed to examine the stratified and combined associations of dietary patterns and BMI with all-cause, cancer and cardiovascular disease (CVD) mortality., Methods: This prospective cohort study included 3982 Chinese community-dwelling older adults between 2001 and 2003. A 280-item validated food frequency questionnaire was used to calculate five dietary indies: Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), Mediterranean Diet Score (MDS), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. Higher DQI-I scores indicate better overall diet quality, while higher DII scores represent a pro-inflammatory diet. Higher MDS, DASH, and MIND scores indicate greater adherence to these healthy dietary patterns. Mortality data were obtained from official records. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional hazards models., Results: Over a median follow-up of 16.8 years, there were 1879 all-cause deaths, 561 cancer deaths, and 386 CVD deaths. The J-shaped associations between BMI with all-cause and cancer mortality were weaker in healthier dietary patterns (DQI-I, MDS, DASH, MIND ≥median or DII

Fifteen new aliphatic metabolites, 2-methylpyrimidin-4(3H)-ones (1,2), 2-methoxy-2-methyl-1,2-dihydro-3H-pyrrol-3-ones (4a/4b, 5a/5b), butyrolactones (6-9), and aliphatic metabolites (16-20) as well as known pyridin-2(1H)-one (3) and butyrolactone analogues (10-15) were obtained from the fermentation broth of Streptomyces antifungus isolated from the forest soil sample collected in Tengchong, China. Pyrimidin-4(3H)-one derivatives (1, 2) with an individual 2-methylpyrimidin-4(3H)-one skeleton is a kind of rarely reported compound and were firstly obtained from natural source. The structures of the new metabolites were elucidated by comprehensive spectroscopic analysis including data from experimental and calculated ECD spectra as well as Mosher's reagent derivative method. Compounds 1, 2, 18, and 19 exhibited optimal activity against Staphylococcus aureus with MIC values ranged from 12.5 to 50 μg/mL. Further investigation revealed that 1 effectively inhibited biofilm formation and destroyed the preformed biofilm of S. aureus through oxidative damage, thereby exerting antibacterial effect., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Aim: Autotaxin is an adipokine involved in metabolic disorders. The aim of the current study was to evaluate serum autotaxin levels in hypertensive postmenopausal women and establish a relationship between autotaxin and other comorbidities in this special group., Methods: This single-center study included postmenopausal women who received annual health examinations at the First Affiliated Hospital, College of Medicine, Zhejiang University in Zhejiang, China. The metabolic and demographic characteristics of the subjects, including age, sex, height, weight, blood pressure, and biochemical indices, were collected. The serum autotaxin level was measured via ELISA. The Kolmogorov-Smirnov test, Student's t test, Mann-Whitney U test, χ2 test, receiver operating characteristic (ROC) curve analysis, Spearman correlation analysis and multivariate logistic regression analysis were adopted for statistical analysis., Results: This pilot observational study included 25 hypertensive postmenopausal women and 25 age-matched normotensive controls. Hypertensive patients presented significant metabolic disturbances with greater comorbidities such as nonalcoholic fatty liver disease, obesity, overweight, diabetes, hypertriglyceridemia and hyperuricemia ( P  < 0.05), impaired renal health with higher uric acid levels ( P  < 0.001), and slightly elevated creatinine levels ( P  = 0.156) with lower estimated glomerular filtration rates (eGFRs) ( P  = 0.195). The serum autotaxin level was markedly greater in the hypertensive group (239.0±59.6 ng/ml vs. 192.7 ± 49.0 ng/ml; P  < 0.01) and was positively associated with systolic blood pressure; diastolic blood pressure; and alanine transaminase, triglycerides (TG), creatinine, and uric acid levels and inversely associated with the eGFR ( P  < 0.05) among postmenopausal women. Serum autotaxin levels positively predicted hypertension, with an AU-ROC of 0.750 [95% confidence interval (CI): 0.613-0.888] and a Youden index of 0.480 at a cutoff of 225 ng/ml. In the multivariate logistic regression analysis, after adjustment for demographic and metabolic parameters (including age, BMI, ALT, TB, uric acid, FBG, TG, LDL and creatinine), autotaxin (ATX) remained independently positively correlated with the risk of hypertension [odds ratio: 1.016, 95% CI 1.001-1.031; P  < 0.05)., Conclusions: Among postmenopausal women, the serum autotaxin level is significantly elevated in the hypertensive group compared with age-matched normotensive controls. ATX is related to multiple metabolic disorders and renal health, suggesting that autotaxin has potential as a multiorgan therapeutic target for cardiovascular-metabolic-renal disorders., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Selenium (Se) is physiologically essential for thyroid function. However, epidemiological studies on the association between Se status and thyroid function are limited and the results are inconsistent. Therefore, we explored this association in an elderly Chinese population sample. Participants in the cross-sectional study were people aged 65 years or older who provided fingernail and whole blood samples. Hyperthyroidism and hypothyroidism were defined by serum thyroid hormones concentrations, including thyroid stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT3), and free thyrotropin (FT4). Significant positive association was observed between whole blood and fingernail Se concentrations (r = 0.672, P < 0.001). Compared with the lowest Se quartile (Q1), the other fingernail Se quartile groups had lower TSH, higher FT3 and FT4 levels, and Q2 had higher TT3 levels after adjusting for covariates; the other whole blood Se quartile groups had lower TSH levels, Q2 had higher FT3, FT4 and TT3 levels, Q3 had higher FT3 levels, and Q4 had higher FT4 levels after adjusting for covariates. Compared with Q1, the adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) of hypothyroidism for Q4 of whole blood Se was 0.141 (0.029,0.675), and the adjusted OR (95%CIs) of hyperthyroidism for Q2 and Q3 of fingernail Se were 4.121 (1.233,13.733) and 3.614 (1.095,11.926). Higher Se levels were significantly associated with lower TSH levels and higher levels of TT3, FT3 and FT4. Meanwhile, higher Se levels were associated with lower risk of hypothyroidism and higher risk of hyperthyroidism., Competing Interests: Declarations. Ethical Approval: The study was approved by the Ethics Review Committee of National Institute for Environmental Health, Chinese Center for Disease Control and Prevention. Informed Consent: All participants provided their written informed consent prior to participating in the study. Conflict of Interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Climate-induced droughts exert a significant influence on the connectivity of river systems. It is estimated that about 25% of the world's rivers ran dry before reaching the ocean due to climate change and human activities. Ecological water replenishment is an effective measure for restoring aquatic ecosystems damaged by drought. It is urgently needed to quantitatively assess the aquatic ecosystems in rewetted dry river channels after water replenishment. This study investigated the variations in phytoplankton, zooplankton, benthic macroinvertebrates, and benthic bacterial communities in the rewetted dry river channel of Yongding River after water replenishment. In comparison with the water column communities, the benthic macroinvertebrates were identified as limiting factors for ecological restoration in rewetted dry river channels. In the absence of a certain recovery time for benthic macroinvertebrates, the benthic bacterial-based index of biological integrity, especially calculated based on their intrinsic properties, can properly assess aquatic ecosystems in rewetted dry river channels., (© 2024. The Author(s) under exclusive licence to Royal Swedish Academy of Sciences.)

Background: Although the information on the validation status of electronic sphygmomanometer (ES) devices in use in health care institutions and households is much more clinically relevant than that of ES models available on the market, it remains insufficient., Methods: A national survey was conducted across all administrative regions of mainland China to assess the validation status of ESs. Fifty-eight cities were selected with stratification by municipality, provincial capital, and other cities, and health care institutions and households in each city were chosen by convenience to identify ES devices in use according to the study protocol. Information on devices' model, type, was collected. The validation status of each device was ascertained through searching international online registries of its models., Results: A total of 3230 ES devices (1924 from health care institutions and 1306 from households), encompassing 498 ES models, were actually selected. The weighted proportion of accuracy-validated devices was significantly higher in health care institutions (33.9% [95% CI, 31.8-36.0%]) compared with households (23.0% [95% CI, 20.8-25.4%]; P <0.001), and both exceeded the proportions for models (17.7% [95% CI, 13.7-22.6%] and 12.5% [95% CI, 9.5-16.3%], respectively). Regional economic development, device type, and years in use were associated with the proportion of accuracy-validated devices. Notably, 8.8% of devices used in secondary hospitals were wrist type., Conclusions: The accuracy validation status of ESs in China in the number of devices in use shows a more favorable situation than that in the number of models but remains low and concerning. Policies are urgently needed to promote the widespread adoption of accuracy-validated models among all users., Competing Interests: All authors are the members of the Health Risk Assessment and Control Committee of the Chinese Preventive Medicine Association.

Purpose: To estimate the time trend in the prevalence of suicidal behaviors including ideation and attempts in Chinese adolescents; to examine the association between suicidal behaviors and overweight (OW)/obesity (OB) and self-perceived weight status., Methods: Data from Youth Risk Behavior Surveys conducted in Ningbo in 2007, 2012, 2017 and 2022 were used for the study. A multistage sampling procedure was used to select respondents aged 12 to 19 years who participated in each survey. Repeated cross-sectional data of anthropometry, weight perception and suicidal behaviors were collected through self-administered questionnaires. A generalized linear model was used to assess associations of ideation and attempts, and weight status and self-perceived weight status., Results: The sample sizes for each survey wave were 937, 889, 1528 and 2655. The prevalence of ideation increased from 11.95% in 2007 to 18.15% in 2022, while the prevalence of attempts remained stable (4.48%-4.26%). An increasing trend in ideation and attempts was found in adolescents who were OW/obese and self-perceived OW/OB from 2007 to 2022. Self-perceived OW/OB adolescents had a significant increase in ideation. Girls had higher likelihood of ideation and attempts for both weight status and self- perceived weight status. While, adolescents aged 12.0-15.9 years had higher odds of ideation than those aged 16.0-19.9 years., Conclusion: Adolescents' self-weight perception, rather than actual weight status, is a critical risk factor of increased likelihood of ideation and attempts in Chinese adolescents. Our findings can support to promote self-esteem growth in school-based health education programmes for prevention of suicidality and psychological health problems., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

In recent years, the infection rate of avian reovirus (ARV) in chicks has been continuously increasing, seriously endangering the healthy development of China's chicken farming industry. However, the pathogenicity of this virus in immune organs has been less studied. In this study, an ARV strain (Chicken/XJ/China/2022/01/16) was isolated from arthritic broiler chicks in Xinjiang province and whole genome sequencing of the ARV strain was performed using next generation sequencing (NGS) technology, and sequence analysis showed that the strain was a type V variant of the ARV gene. In order to further understand the pathogenicity of this strain in terms of immune organs, we randomized 120 healthy 1-day-old broilers equally into 3 groups (oral, footpad inoculation and control), where 2 experimental groups were inoculated with 0.2 mL of ARV (TCID 50 of 10 5.5 /0.1 mL) and the control group was inoculated with an equal amount of sterile saline. The results showed that the footpad inoculation group showed more severe symptoms, which, in addition to causing chick dwarf syndrome and viral arthritis, would also cause serious effects on the immune organs of the chicks. Among them, the spleen and bursa were most seriously damaged, the symptoms of arthritis appeared relatively late, which indicated that the spleen and bursa might be the main target organs preferentially attacked by avian reovirus. This study provides a rationale for the prevention and control of emerging avian reovirus and adds to the evidence of the effects of ARV on immune organs, with the expectation that it will be useful in understanding the immune response-related aspects of the disease in subsequent studies., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

The optimal breast cancer (BC) screening age in China remains uncertain. In this study, we evaluated the benefits, harms, and cost-effectiveness of lowering the screening starting age from 45 to 35 years and extending the stopping age from 64 to 79 years in Chinese women at an average risk of progressing BC. Biennial screening showed a lower incremental cost-effectiveness ratio (ICER) compared to annual screening. Extending the screening age beyond 45-64 years in certain scenarios increased the number of false-positive results and each averted breast cancer deaths. Specifically, extending the starting age to 35 years reduced overdiagnosis rate to 10.8 % and had an incremental cost ratio of US$12,746 per quality-adjusted life year (QALY), falling below the cost-effectiveness threshold of US$18,346 per QALY. Regarding the ceasing age, the status quo (age 64 years) was found to be the optimal choice as it was proved to yield the majority of benefits with reduced harm and be the only option under the cost-effectiveness threshold. In summary, biennial screening for average-risk women aged 35-64 years is the most cost-effective approach strategy, aligning with The National Health Commission's screening program for cervical and breast cancer., 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 © 2025 Elsevier B.V. All rights reserved.)

Reservoirs around the world have significantly altered the natural transport of nutrients in rivers. However, the specific effects of the cascade damming on the migration, transformation, and environmental consequences of these nutrients remain unclear. To address this knowledge gap, we analyzed spatiotemporal variations in water chemistry, nutrient concentrations, stable isotope of dissolved inorganic carbon (δ 13 C DIC ) and nitrate isotope (δ 15 N-NO 3 - ) in seven cascade reservoirs along the Wujiang River, each characterized by different regulatory regimes. Our findings reveal that the average absolute changes in concentrations of total nitrogen (TN), total phosphorus (TP), and silicon dioxide (SiO 2 ) during the wet season (WS, spring and summer) were 2.4, 1.4, and 1.1 times higher than those observed in the dry season (DS, autumn and winter). During the WS, the average apparent retention efficiency (*RET f ) values in the Hongjiadu reservoir were 97 % for TN, 98 % for TP, and 95 % for SiO 2 , indicating substantial nutrient consumption in the cascading reservoirs. Conversely, during the DS, the *RET f values for TN, TP, and SiO 2 were negative, suggesting notable nutrient accumulation within the reservoirs. The nutrient fluxes released downstream from the cascade reservoirs in the Wujiang River were significantly greater than the upstream inflow fluxes. These findings help demonstrate how downstream discharge across cascade reservoirs amplifies nutrient flux disparities due to dam construction. Our study enhances the understanding of how cascade dam construction impacts nutrient dynamics, supporting the optimization of reservoir operation models and advancing scientific water resource management and conservation efforts., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The purpose of this study was to determine whether our new thinking guidance named OPACCUS (oxygen metabolism, perfusion, arterial tension, cardiac output, systemic congestion, unregulated host response and search for inciting illness event) with 7 questions you need to ask before shock therapy and evidences provided by critical ultrasound considering hemodynamics, the unregulated host response and inciting illness event would improve mortality in shock patients., Design: A multicenter, prospective, observational cohort study., Setting: Intensive care units of 20 hospitals in Southwest China., Patients: Shock patients between October 2022 and February 2024 were divided into three groups, namely, the full-compliance group (n = 171), moderate-compliance group (n = 149) and low-compliance group (n = 220), according to the compliance rate with the OPACCUS guidance., Interventions: Adoption of the OPACCUS guidance in every repeat assessment MEASUREMENTS AND MAIN RESULTS: Demographics, clinical information, hemodynamics parameters and critical care ultrasound evaluations were recorded. The primary outcome was all-cause mortality within 30 days. A total of 540 patients completed the study and were ultimately included in the analysis. After multivariate regression adjustment, the 30-day mortality of shock patients in the full-compliance group (21.05 %) was significantly lower than that in the low-compliance group (36.82 %) (HR=1.646*, RMST=-3.223*). Restricted mean survival time (RMST) univariate analysis showed that the higher the OPACCUS compliance rate was, the longer the survival time. ICU and hospital costs were lower in the full-compliance group than in the moderate-compliance group., Conclusions: Compliance to the new OPACCUS guidance could improve 30-day mortality and reduce costs for shock patients., Trial Registration: ClinicalTrials.gov Identifier: ChiCTR2200061952. Registration date: 13/07/2022., Competing Interests: Declaration of competing interest All the authors have no conflict of interest to declare., (Copyright © 2024. Published by Elsevier B.V.)

Background: The emergence of tick-borne pathogens poses a serious threat to both human and animal health. There remains controversy about virome diversity in relation to tick genus and ecogeographical factors., Results: We conducted the meta‑transcriptomic sequencing of 155 pools of ticks encompassing 7 species of 3 genera collected from diverse geographical fauna of Ningxia Province, China. Two species of Dermacentor genus were distributed in the predominantly grassland areas of the central and eastern regions, with the lowest viral diversity. Two species of Hyalomma ticks were found in the predominantly desert areas of the northern regions, with intermediate viral diversity. Three species of Haemaphysalis ticks were concentrated in the predominantly forested areas of the southern regions, exhibiting the highest viral diversity. We assembled 348 viral genomes of 63 species in 14 orders, including 26 novel viruses. The identified viruses were clearly specific to tick genus: 22 virus species were exclusive to Dermacentor, 12 to Hyalomma, and 27 to Haemaphysalis., Conclusions: The associations between tick genera and geographical distribution, viral richness, and composition provide new insights into tick-virus interactions, offering clues to identify high-risk regions for different tick-borne viruses. Video Abstract., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The occurrence of public health emergency in China often makes nurses more susceptible to anxiety. The present study aimed to investigate the prevalence of anxiety among Chinese nurses during the public health emergency and explore the association between family function and anxiety and its underlying mechanisms. Family care index questionnaire, Connor-Davidson Resilience scale, physical activity rating scale and 7-item Generalized Anxiety Disorder Scale were employed to measure family function, resilience, physical activity and anxiety among 779 Chinese nurses during public health emergency. The prevalence of anxiety among nurses during public health emergency was 29.9%. Resilience partially mediated the association of anxiety with family function. Physical activity moderated the direct and indirect effects of family function on anxiety. The direct effect became insignificant when the standard scores of physical activity were 0.629 and over. In contrast, the indirect effect of family function on anxiety through resilience was stronger when the levels of physical activity increased. The present study suggested for nurses with low levels of physical activity, intervention enhancing family function should be designed to prevent anxiety. For those with higher levels of physical activity, programs aimed at strengthening family function and supporting resilience should be developed to manage anxiety., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All methods in the present study were carried out in accordance with relevant guidelines and regulations. The study involving human participants were reviewed and approved by ethics committee of Second Military Medical University. The participants provided their written informed consent to participate in this study., (© 2025. The Author(s).)

Background: Improving primary health care (PHC) physician's capacity has been identified as an important area in the healthcare reform. The continuing medical education (CME) training programs are conducive to enhancing competence of PHC physicians. But few studies have explored PHC physicians' needs and preferences for CME training programs. This study aimed to explore the preferences for CME training programs from the perspective of PHC physicians, and to understand the willingness, tendency, and needs in CME., Methods: A Discrete Choice Experiment (DCE) was developed based on literature review and semi-structured interviews with 4 general practitioners to identify key attributes of CME programs. The DCE survey was administered to 360 PHC physicians in Jiangsu Province, China, in August 2023, to elicit preferences for: training frequency, training time, training duration, training location, training content of basic medical services, and training content of basic public health services. A total of 281 valid responses were included after the quality control test, which involved checking completion time and consistency in repeated choice tasks. DCE data were analyzed using Mixed Logit, and Latent Class Models to explore preference heterogeneity and class membership., Results: PHC physicians showed strong preference for CME training programs that were conducted during working hours on weekdays, once a year, at a local meeting place and training on health management of patients with multiple chronic diseases. Latent class analysis identified 2 preference classes, with half (51.2%) of the respondents focused only on training frequency and time while the rest considered training logistic arrangement as well as training content. These preferences could be explained by some observed characteristics of PHC physicians such as age and professional level., Conclusions: Overall, PHC physicians valued the convenience of participation in CME training programs and training on health management of patients with multiple chronic disease. Our findings can be used to inform the design of CME training programs for PHC physicians in China., Competing Interests: Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the Medical Ethics Committee of Nanjing Medical University (NMU Ethical Review (2023) No. 556), and followed the ethical principles of the Declaration of Helsinki. The informed consent from each participant were obtained before the survey began. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Ovarian cancer (OC) poses a significant threat to women's health due to its insidious onset, tendency to metastasize, and high recurrence rate. These characteristics significantly impede early diagnosis and effective interventions. The current lack of effective screening and prognostic tools necessitates urgent solutions. The Shanghai Ovarian Cancer and Family Care Project (SOCFCP) is an ongoing cohort study aiming to address these challenges by identifying factors and biomarkers associated with OC onset, treatment, and prognosis. The ultimate goal is to develop predictive models and assessments crucial for diagnosing, treating, and prognosing the disease., Methods: During the study period from 2023 to 2028, the SOCFCP aims to recruit over 2000 patients with ovarian lesions, 900 high-risk individuals, and 3000 healthy controls in Shanghai, China, with long-term follow-up. The study comprises three cohorts: (1) a bidirectional patients cohort, comprising those diagnosed with ovarian disease and treated at the department of gynecologic oncology at Shanghai first maternity and infant hospital since 2013; (2) a prospective high-risk cohort, consisting of family members of ovarian and/or breast cancer patients, or individuals with related gene mutations; and (3) a healthy control cohort, drawn from women undergoing health examination at hospitals or participating in community gynecologic cancer screenings. Participants will attend regular visits for questionnaire surveys, anthropometric measurements, and the collection of biological specimens, such as blood, fecal, and tissue samples. Collected data encompass baseline information, sociodemographic details, hospital admission records, and biological and clinical parameters, alongside treatment information. Primary outcomes for the patient cohort include mortality, tumor recurrence, major complications, and changes in health-related quality of life post-diagnosis. For the high-risk and healthy cohorts, ovary-related diseases will serve as the primary outcome. Various predictive models, such as multivariate logistic models, Cox regression, and linear mixed-effects regression models, will be employed to analyze various endpoints appropriately., Discussion: This extensive cohort study integrates a diverse range of information, including lifestyle factors, environmental influences, genetic characteristics, and clinical features, alongside an extensive collection of biological samples. The resources generated by this project will provide valuable foundations for a comprehensively understanding of the etiology, treatment, and prognosis of OC. The SOCFCP is poised to foster cutting-edge multidisciplinary research on OC, spanning both fundamental and clinical studies., Trial Registration: NCT06118307 in ClinicalTrials.gov. Registration Date: November 7, 2023., Competing Interests: Declarations. Ethical approval and consent to participate: The study design, protocol, investigation tools and guidelines for implementation were approved by Medical Research Ethics Committee, Shanghai First Maternity and Infant Hospital on July 28th, 2023 (Ethical approval number: KS23259). This approval covers all study sites. All study participants will provide written informed consent before any study-related procedures are performed. The Ethics Committees will be informed about any protocol modifications for approval. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Early diagnosis of Kawasaki disease (KD) allows timely treatment to be initiated, thereby preventing coronary artery aneurysms in children. However, it is challenging due to the subjective nature of the diagnostic criteria. This study aims to develop a machine learning prediction model using routine blood tests to distinguish children with KD from other febrile illnesses in Chinese children within the first five days of fever onset. The retrospective cross-sectional data for this study was collected from the records of Guangzhou Women and Children's Medical Center, spanning January 1, 2020, to April 30, 2024. A retrospective analysis was performed using three machine learning models and five ensemble models based on this dataset. This study included 1,089 children with KD (mean age 32.8 ± 27.0 months; 34.5% female) and a control group of 81,697 children without KD (mean age 45.3 ± 33.6 months; 42.8% female). The supervised method, Xtreme Gradient Boosting (XGBoost), was applied. It was tested without feature selection, achieved an area under the ROC curve (AUC) of 0.9999, sensitivity of 0.9982, specificity of 0.9975, F1 score of 0.9979, accuracy of 0.9979, positive predictive value (PPV) of 0.9975, and negative predictive value (NPV) of 0.9982. The SHapley Additive exPlanations (SHAP) summary plot identified the top five significant features, which were the percentage of eosinophils (EO%), hematocrit (HCT), platelet crit (PCT), gender, and absolute basophil count (BA#). This study demonstrates that the application of the machine learning model, XGBoost, on routine blood test results can predict KD., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was granted by the Ethics Committee of Guangzhou Women and Children’s Medical Center in July 2024, waiving the need for informed patient consent. All procedures and methods were conducted in compliance with Chinese national legislation, institutional guidelines, and the Declaration of Helsinki. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

As a new generation of assessment instrument, cognitive diagnosis integrates the measurement objectives into the cognitive model to diagnose the fine-grained knowledge of students. Taking the PISA 2012 dataset in mathematics from Shanghai, Hong Kong, Macau and Taiwan as the research subject, this study constructed a cognitive model with the attributes of Mathematical Abstraction, Logical Reasoning, Mathematical Modeling, Intuitive Imagination, Mathematical Operation and Data Analysis, and made an analysis of the mastery of students' mathematical competencies of different attributes in four regions, and the learning paths of the students' mathematical competencies were constructed. The results showed that Shanghai had the obvious advantages in each attribute; the mastery mode of Hong Kong, Macau and Taiwan showed a common trend, and they all indicated a relatively low percentages of competencies in Logical Reasoning and Intuitive Imagination. In terms of the learning paths, the learning paths in the four regions reflected diversities, but obvious main learning paths existed. Majority of the knowledge states' abilities were below 0. While in Hong Kong, Taiwan, and Macau, more knowledge states' abilities were above 0. This research provided a reference for the systematic analysis of students' knowledge status and learning path., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Acute coronary syndrome (ACS) patients without standard modifiable cardiovascular risk factors (SMuRFs) have a higher risk of early mortality. However, little is known about their long-term outcomes, especially for patients undergoing percutaneous coronary intervention (PCI). This study aims to explore the long-term outcomes and identify independent factors associated with adverse clinical outcomes in patients with ACS undergoing PCI without SMuRFs., Methods: This study used data from Optimal antiPlatelet Therapy for Chinese patients with Coronary Artery Disease (OPT-CAD) registry study. Clinical characteristics and outcomes of patients with and without SMuRFs were examined. The primary outcomes were major adverse cardia-cerebrovascular events (MACCE). The long-term (5 years) outcomes were compared between the without and with SMuRFs group in such cohort. An exploratory Cox proportional hazards regression was performed to identify the independent demographic and clinical predictors of the adverse clinical outcomes in the SMuRFs-absent cohort., Results: Among 5688 patients with ACS undergoing PCI, 392 (6.9%) were in the absence of SMuRFs and 5296 (93.1%) were in the presence of SMuRFs. There were no significant differences in MACCE rates between the two cohorts (9.44% vs. 9.76%, log-rank P = 0.90). Cox proportional hazards regression indicated that age (HR, 1.06; 95% CI, 1.03-1.10; P = 0.001) and thrombus lesions (HR, 2.58; 95% CI, 1.24-5.40; P = 0.011) were independently associated with MACCE in the SMuRFs-absent cohort., Conclusions: Among patients with ACS undergoing PCI, SMuRFs-absent patients had similar MACCE rates when compared with those with one or more SMuRFs at 5 years. This suggests that effective intervention strategies and updated risk assessment models are urgently needed in the SMuRFs-absent cohort., Competing Interests: Declarations. Ethics approval and consent to participate.: This study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki, as reflected in a priori approval from the institution’s human research committee. This study was also approved by the Research Ethics Committee of the General Hospital of Northern Theater Command, China. Informed consent was obtained from all patients. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: Sleep disorders affect approximately one-fifth of the global elderly population, with poor sleep quality among old adults linked to an increased risk of chronic conditions such as cardiovascular disease, diabetes, and hypertension. Chinese traditional ethnic sports have garnered significant attention for their potential to enhance sleep quality in older adults; however, the effectiveness of these interventions remains controversial. This meta-analysis sought to evaluate the impact of Chinese traditional sports on the quality of sleep among older adults., Methods: A systematic search of databases, including Web of Science, Pubmed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP), was conducted to identify randomized controlled trials (RCTs) examining the effects of Chinese traditional ethnic sports on sleep quality in older adults. Two independent researchers screened the literature, extracted relevant data, and conducted a quantitative meta-analysis using Stata17 software. Subgroup analyses were performed, including forest and funnel plot generation, heterogeneity analysis, sensitivity analysis, and publication bias assessment., Results: A total of ten studies met the inclusion criteria. The meta-analysis revealed that older adults who participated in Chinese traditional ethnic sports showed significantly lower total PSQI score s relative to non-participants (Hedges's g = -0.60, 95% CI [-0.89 to -0.31], P  < 0.05). Egger's test suggested no significant publication bias. Sensitivity analyses revealed that the age of participants, intervention mode, frequency, and duration did not substantially affect the combined effect size. Significant improvements were observed in sleep quality (Hedges's g = -1.06, 95% CI [-2.00 to -0.13], P  < 0.05), sleep duration (Hedges's g = -0.52, 95% CI [-0.87 to -0.17], P  < 0.05), and sleep efficiency (Hedges's g = -0.50, 95% CI [-0.81 to -0.18], P  < 0.05)., Conclusion: Chinese traditional ethnic sports are highly effective in improving the sleep quality of older individuals, demonstrating significant benefits in sleep quality, duration, and efficiency. Additionally, these interventions may reduce the reliance on sleep medications., Competing Interests: The authors declare there are no competing interests., (©2025 Liu et al.)

Background: Occupational stigmatization in Chinese healthcare institutions has intensified due to negative public events (e.g., kickbacks, bribes, and patient conflicts). While previous studies have mainly focused on the negative effects of stigma on practitioners' physiological and psychological states of practitioners with low prestige, little attention has been given to the moral psychological mechanisms involved or the potential positive outcomes. This study aims to explore the moral mechanisms of healthcare professionals' perceived occupational stigma on organizational citizenship behavior (OCB), with a specific focus on the potential effects of moral credibility loss, moral sensitivity, and occupational prestige., Methods: This study employed a hierarchical regression method to test the theoretical model, using data from 554 healthcare professionals (including 311 physicians and 243 nurses) from 7 hospitals in China. Confirmatory factor analysis, hierarchical regression, bootstrapping analysis (= 5000 times) and simple slope test using SPSS and AMOS were employed., Results: The empirical results demonstrate that healthcare professionals' occupational stigma enhances OCB by increasing moral credibility loss, with moral sensitivity playing a moderating role. Additionally, this study categorizes healthcare professionals into two groups based on occupational prestige: physicians (high occupational prestige) and nurses (relatively lower occupational prestige). The findings indicate that occupational prestige not only moderates the positive relationship between occupational stigma and moral credibility loss but also moderates the relationship between moral credibility loss and OCB., Conclusions: This study comprehensively explores healthcare professionals' occupational stigma and reveals its positive moral effects, specifically in enhancing OCB through the moral cleansing perspective. These findings offer a novel understanding of occupational stigma, providing practical guidance for improving professional ethics and OCB., Competing Interests: Declarations. Ethics approval and consent to participate: The research protocol received approval from the Ethics Committee of School of Economics and Management (No. EA202301019), Beijing Information Science and Technology University. The study design and ethical considerations were thoroughly examined and endorsed by the committee to ensure compliance with ethical standards, including the principles of the Declaration of Helsinki. All participants were provided with comprehensive information about the research, and their informed consent was obtained prior to their involvement. Written consent was obtained from each participant, emphasizing their voluntary participation and understanding of the study’s objectives. Measures were implemented to uphold data privacy and confidentiality throughout the study. The research procedures strictly adhered to relevant guidelines and regulations, demonstrating our commitment to conducting the study ethically and responsibly. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Cognitive training has been confirmed to significantly improve the overall cognitive function in patients. For patients with coronary heart disease, in addition to controlling common risk factors, there is a lack of effective evidence for the treatment of cognitive function in patients with coronary heart disease and its effectiveness. This randomized controlled study was designed to evaluate the effectiveness of computer-based cognitive training for improving cognitive function in such patients., Methods: COG-T CHD is a multicenter, double-blind, parallel-designed, randomized controlled trial. The patients will be divided 1:1 into two groups by a central randomized system, a cognitive digital therapy group or a positive control group. Patients assigned to the cognitive digital therapy group will undergo computer-based cognitive training for 30 min at least five times a week for 12 weeks. At the end of the 12 weeks, the subjects were randomly divided into two groups. One group continued the 12 weeks of cognitive digital therapy training and the other group stopped the training. Patients assigned to the positive control group will undergo computer-based cognitive training with little or no difficulty changes for 30 min at least five times a week for 12 weeks. The study will last approximately 2 years, with enrollment completed in approximately 18 months, with the last enrolled patient followed for at least 24 weeks. The primary outcome is the proportion of improvement in overall cognitive function at 12 weeks, using the Basic Cognitive Ability Test (BCAT). Secondary outcomes are the proportion of improvement in the overall cognitive function from baseline at 24 weeks, the change in overall cognitive function scores at 12 and 24 weeks, and the proportion of improvement in each cognitive domain, General Self-Efficacy Scale score, EuroQol five-dimension three-level questionnaire score, and Generalized Anxiety Disorder-7 score at 12 and 24 weeks from baseline. The investigational outcome is the change in head MRI structure and function from baseline at weeks 12/24., Discussion: COG-T CHD is the first clinical trial to evaluate the efficacy of computer-based cognitive training in patients with coronary heart disease, filling an important gap in the treatment evidence for cognitive digital therapy., Trial Registration: ClinicalTrials.gov, NCT05735041. Registered on Jan. 18, 2023., Competing Interests: Declarations. Ethics approval and consent to participate {24}: The research protocol has been reviewed and approved by the Ethics Committee of Beijing Anzhen Hospital affiliated to Capital Medical University (Ethics code: (2022) Research Review No. (17–2)). All eight centers (Beijing Anzhen Hospital affiliated to Capital Medical University, Peking University Third Hospital, The Second Hospital of Chifeng, The First Affiliated Hospital of Hebei North University, Handan Central Hospital, The First Hospital of Hebei Medical University, Beijing Sixth Hospital, Inner Mongolia Ordos Central Hospital Kangbashi Department) involved in the study have received ethical approval. The design, implementation, and reporting of this study protocol shall comply with ICH-GCP, applicable local regulations and the ethical provisions of the World Medical Association (WMA) Declaration of Helsinki. Prior to subject registration, the Ethics Committee overseeing the study will review and approve the study protocol, information about the subjects expected to be enrolled, informed consent, and any subsequent modifications. Prior to the start of the study, the principal investigator must sign the Study Protocol Signature page confirming that he/she agrees to conduct the study in accordance with the study documentation and the instructions and procedures in this study protocol, and to provide all relevant data and records to the auditors, inspectors, IRB/ECs, and regulatory authorities as required. If regulators require an inspection of a participating clinical center, the investigator must notify the CRO immediately. Consent for publication {32}: Not applicable. Competing interests {28}: The authors declare that they have no competing interests., (© 2025. The Author(s).)

Objective: To explore the impact of life rules (including individual's life habits and life patterns, such as diet, sleep, and learning styles) on mental health and behavioral problems among adolescent and youth students after the lifting of COVID-19 restrictions in Sichuan, China and analyze the influencing factors of life rules., Methods: An online survey was conducted in middle schools, high schools, colleges and universities in Sichuan Province, China, from December 14, 2022, to February 28, 2023. Demographic information, COVID-19 epidemic-related questions, behavioral and mental health information were collected. Pearson chi-square tests and One-way ANOVA were used to compare the differences of drinking/smoking, suicidal ideation and attempts, internet addiction, anxiety, depression and PTSD among groups with different life rules. Multiple logistic regression analysis was used to analyze the influencing factors of life rules., Results: A total of 82,873 eligible participants (aged 12-24 years) were included in this study, 40,519 participants (48.9%) reported that their life rules were partially impacted by the COVID-19 pandemic, and 6,461 participants (7.8%) reported that their life rules were severely disrupted. A total of 61.2% of participants partially recovered their life rules, and 8.6% of participants did not recover their life rules. There were statistically significant differences among different groups in terms of drinking/smoking habits, frequency of drinking/smoking in the past year, volume of drinking/smoking, internet addiction, anxiety and depression symptoms, PTSD, suicidal ideation and attempts (all P < 0.01). There were significant differences in the degree of impact and recovery of life rules among different genders, residence, grade, family economic level, home study status, academic level, infection and isolation status (all P < 0.01)., Conclusions: Adolescent and youth students with disrupted life rules during and after the COVID-19 pandemic had significantly more mental health and behavioral problems. Targeted and specific psychosocial interventions should be urgently needed to reduce the mental health and behavioral problems among students., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by the Biomedical Research Ethics Committee of West China Hospital, Sichuan University (No: 2022–1790). Written informed consent had be obtained from all participants and their schools. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021-2030. Snail control is an important measure but has not yet been systematically evaluated at a country scale. Here, we report the findings from a nationwide survey to demonstrate the dynamics of Oncomelania and its potential role in transmission interruption of schistisomiasis in the People's Republic of China (P.R. China)., Methods: Between March 2016 and December 2017, we conducted a nationwide census on Oncomelania snail habitats in P.R. China. All historically recorded snail habitats were identified and reviewed. Information on habitat attributes, including the infestation of snails, was collected. The shape of habitats was determined using global positioning system and geographical information system technologies. The relationship between snail control and schistosomiasis elimination was established in 378 endemic counties. The comparison of accumulated snail-infested range (ASR) and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test (Mann-Whitney) with a significance level of 0.05., Results: Overall, 15,377.7 million m 2 of potential snail habitats with a total of 356,550 snail habitats were identified in P.R. China. The ASR amounted to 86.0% of the total area. Most of the ASR (94.9%) and habitats (68.5%) were distributed in the middle and lower reaches of the Yangtze River. Snail habitats were found up to an altitude of 2859 m above the mean sea level. By 2017, 85.1% of habitats (73.0% of the ASR) had been eliminated with almost half of them eliminated between 1965 and 1982. The elimination of snail habitats promoted transmission interruption of schistosomiasis, but showed variable patterns in different landscapes. The ratio of eliminated ASR was 99.6 and 91.4% in water network and hilly areas, respectively, while it was only 64.8% in marshland areas, particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R. China are located. Marshland habitats were seen as the most difficult for transmission interruption, which calls for additional control measures in these settings., Conclusions: Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved. The nationwide, high-resolution map of Oncomelania snail habitats in P.R. China will support further efforts to eliminate schistosomiasis., Competing Interests: Declarations. Ethics approval and consent to participate: The survey was approved by the National Health Commission (Division of Endemic and Parasitic Diseases [2016] 30) and the study did not involve endangered or protected species. The collectors wore gloves and rubber boots in the field survey in order to avoid infection by S. japonicum. All collectors were listed as the co-authors or in the acknowledgements and fully aware of the research. Consent for publication: Not applicable. Competing interests: Xiao-Nong Zhou is the Editor-in-Chief of the journal Infectious Diseases of Poverty. Jürg Utzinger is the deputy Editor-in-Chief of the journal Infectious Diseases of Poverty. They are not involved in the peer-review or handling of the manuscript. The other authors have no other competing interests to disclose., (© 2025. The Author(s).)

Purpose: Research from Western societies indicates pervasive public stigma against people with alcohol use disorders (AUDs). However, there is a lack of knowledge about the interactions between different components of stigma and their contribution to discriminatory behaviour towards individuals with AUDs within the Chinese cultural context. The aim of the present study was therefore to investigate the relationships of (mis-)conceptions, stereotypes, emotional reactions, perceived public stigma and their contribution to the desire for social distance among the Chinese adults., Methods: (Mis-)conceptions, stereotypes, emotional responses, willingness to help and avoid, perceived stigma, and the desire for social distance from individuals with AUDs were assessed via a cross-sectional online survey with a sample of 1,100 adults from the Chinese population., Results: Three-fourth of the participants recognised AUDs as mental illnesses, though 70% of the sample did not support health insurance coverage for the treatment of AUDs. A stronger desire for social distance was associated with greater recognition of alcohol use disorders as mental illnesses, heightened perceptions of dangerousness and personal responsibility, increased fear, and more willingness to avoid and withhold help, controlling for age, gender, education, employment, mental health service utilisation, and alcohol consumption. Fear fully mediated the effects of perceptions of dangerousness and responsibility on the desire for social distance., Conclusions: To improve social integration for individuals with AUDs in China, culturally tailored anti-stigma programmes are needed to reduce negative attitudes and discriminatory behaviours among the Chinese population., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was fully reviewed and approved by the Research & Ethics Committee of Peking University Clinical Medical School, Beijing Huilongguan Hospital, China. All methods were carried out in accordance with the Declaration of Helsinki. Prospective research participants were informed of the study aims and asked to sign an online consent form to participate in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable., (© 2025. The Author(s).)

Background: Although students' mental health might be impacted severely during the COVID-19 pandemic, there is still limited clarity regarding mental health problems among students in different learning stages after the lifting of COVID-19 restrictions in China. This study aimed to explore the long-term effects of COVID-19 on students' mental health at different learning stage and provide recommendations on education and health policies after the lifting of COVID-19 constrictions., Method: This large sample, cross-sectional, online survey was conducted among students (N = 82873) in 162 schools from December 14, 2022 to February 28, 2023 in Sichuan, China. The online self-report questionnaires were sent firstly to school teachers or professors, then these teachers or professors sent the questionnaires directly to their students at schools. The scales included the Chinese version of 9-item Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Insomnia Severity Index (ISI), the PTSD Checklist for DSM-5 (PCL-5). All the mentioned instruments showed satisfactory reliability and validity., Results: The prevalence of depression symptom in middle school group, high school group and college group was 28.5%, 45.0%, 37.3%, the anxiety symptom was 24.0%, 38.4%, 29.7% and the PTSD was 25.7%, 40.6%, 32.1%, respectively. Among the 3 groups, the high school group had the highest rate of depression symptom (45.0%), anxiety symptom (38.4%), PTSD (40.6%), insomnia (39.9%) and lifetime suicidal ideation (28.9%). For all the three groups, there were same factors increased the risk of depression and anxiety symptoms, such as academy dissatisfaction, higher score of Internet Addiction Test (IAT), ISI, cyberbullying and traditional bullying et al., while higher score of Social Support Rating Scale (SSRS) decreased the risk. In addition, each group had unique risk factors for depression and anxiety symptoms., Conclusion: This study revealed that students at different learning stage were still experiencing serious mental health problem even after the lifting of COVID-19 restrictions in China. Special attention should be paid to the mental health of students, especially high school students. Education and health policies and psychosocial interventions should be developed according to the characteristics and various influencing factors of students at different learning stages., Competing Interests: Declarations. Ethical approval and consent to participate: This study complied with the content and requirements of the Helsinki Declaration and was reviewed and approved by the Medical Ethics Committee of West China Hospital of Sichuan University. Informed consent was obtained online before the completion of the survey using two questions in the questionnaire: (1) I am voluntarily participating in this research; (2) I am not willing to participate in this research. Only the participants who were willing to participate continued to do the scales. Parents were allowed to choose whether to participate in the study if the participants were under the age of 18. The participants were told they can stop their participation at any time without having to give explanations and all information they provide will be kept confidential and their identity will never be disclosed. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Foreign pseudohistory, as one format of conspiracy theories, is an unverified discourse explicitly stating that a culture, civilization, or achievement outside one's homeland country did not exist, does not have historical continuity, or was plagiarized from this homeland country. The current study analyzed 302 videos about foreign pseudohistory from a popular Chinese video-sharing website (Bilibili) and found 213 videos supporting foreign pseudohistory and 89 videos opposing foreign pseudohistory. Videos opposing foreign pseudohistory attract more viewers and comments than videos supporting foreign pseudohistory, but the latter videos are posted by a smaller group of core creators and also attract considerable numbers of views. The inductive thematic analysis identified three major themes from these videos, including: 1) how foreign civilizations and history were based on fabrication and plagiarism; 2) promoting foreign pseudohistory as a way to fight against Western-centrism; and 3) refuting and mocking foreign pseudohistory and enlightening the public about the real history. The implications of this study were discussed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Zhu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The Comprehensive Complication Index (CCI) is an internationally recognised indicator of postoperative complications. During the perioperative period, patients with diabetes mellitus (DM) or impaired glucose tolerance (IGT) may experience a significant increase in the CCI associated with glucose-related complications and increased mortality. Continuous glucose monitoring (CGM) offers advantages such as portability, accuracy, real-time monitoring and rich information. However, few large-scale studies have investigated the effectiveness and safety of CGM in reducing CCI during major surgeries., Methods and Analysis: This study is a multicentre, parallel-arm, randomised pragmatic trial to investigate whether CGM improves clinical outcomes in patients with type 1 or type 2 DM or IGT undergoing major surgery relative to conventional monitoring. This study is planned to be conducted in 50 secondary or tertiary hospitals in China. Eligible patients aged 18 years or older with DM or IGT undergoing elective major surgery will be recruited during a baseline screening period of 3 days before surgery. Eligible patients will be randomly assigned to receive CGM or conventional monitoring in a 1:1 ratio. The primary endpoint measure is the CCI score within 30 postoperative days. The margin of superiority is -12.0. A total of 10 168 participants will achieve 90% power to detect a clinically important difference of -13.0 between the means in the primary outcome. This trial includes multiple statistical analysis steps. For the primary outcome, a covariance model will be used to compare the difference in CCI within 30 days postoperatively between the two groups after adjusting for baseline and centre effects., Ethics and Dissemination: This trial has been approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital (No. 23684-0-02) and its corresponding branch centres. Informed consent will be obtained from all subjects involved in the study. The primary trial results will be submitted for publication to a peer-reviewed journal., Trial Registration Number: NCT06331923., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: This retrospective cohort study aimed to investigate the correlation between vaginal infections and adverse pregnancy outcomes in a Chinese obstetric population., Methods: This study was conducted at the International Peace Maternity and Child Health Hospital in Shanghai from 2021 to 2023. The primary objective was to assess the incidence of various vaginal infections and their associations with preterm birth (PTB), low birth weight (LBW), and preterm premature rupture of membranes (PPROM). Data were collected from medical records, with vaginal infection diagnoses confirmed through standard laboratory procedures. This study included women who registered and delivered at our hospital between 2021 and 2023. Strict exclusion criteria were applied to control confounding factors, excluding women with a history of syphilis, human immunodeficiency virus infection, hepatitis virus infection, or non-live birth outcomes. Continuous variables were analyzed using the Mann-Whitney U test, whereas categorical variables were assessed using the Pearson chi-square test or Fisher exact test. Logistic regression analysis was employed for multivariate assessments to determine whether vaginal infections were independent risk factors for adverse pregnancy outcomes., Results: Vaginal infections were significantly associated with adverse pregnancy outcomes. Women with vaginal infections had higher rates of PTB (15.65% vs. 9.16%, P < 0.001), LBW (10.82% vs. 5.93%, P < 0.001), and PPROM (7.41% vs. 5.31%, P < 0.001) compared with their uninfected counterparts. Mixed vaginitis demonstrated a stronger association with these adverse outcomes compared with single infections. The timing of infection during pregnancy emerged as a critical determinant of the risk of adverse outcomes., Conclusions: The study underscores the critical need for comprehensive screening and management of vaginal infections during pregnancy to improve maternal and neonatal health. Targeted interventions, particularly in the later stages of pregnancy, are essential to mitigate the risks associated with vaginal infections. Future research should focus on developing more effective screening methods and therapeutic strategies to address the specific types of vaginal infections and their effects on pregnancy outcomes., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Medical Research Ethics Committee of IPMCH. Individual data were collected anonymously, and the requirement for informed written consent was waived. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)