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We conducted a longitudinal cohort study of SARS-CoV-2 and influenza rates in childcare centers and schools in Wuxi, China, collecting 1,760 environmental samples and 9,214 throat swabs from 593 students (regardless of symptoms) in weekly collections during February–June 2023. We estimated a cumulative infection rate of 124.8 (74 episodes)/1,000 persons for SARS-CoV-2 and 128.2 (76 episodes)/1,000 persons for influenza. The highest SARS-CoV-2 infection rate was in persons 18 years of age, and for influenza, in children 4 years of age. The asymptomatic proportion of SARS-CoV-2 was 59.6% and 66.7% for influenza; SARS-CoV-2 symptomatic proportion was lower in 16–18-year-olds than in 4–6-year-olds. Only samples from frequently touched surface tested positive for SARS-CoV-2 (4/1,052) and influenza (1/1,052). We found asynchronous circulation patterns of SARS-CoV-2 and influenza, similar to trends in national sentinel surveillance. The results support vaccination among pediatric populations and other interventions, such as environmental disinfection in educational settings. [ABSTRACT FROM AUTHOR]

Hymenopellis is the genus that exhibits the highest number of species within the Xerula/Oudemansiella complex. Numerous species of Hymenopellis demonstrate edibility, and some of these species have been domesticated and cultivated. During an extensive survey carried out in Henan and Jilin Provinces, China, a substantial quantity of Hymenopellis specimens was gathered as a component of the macrofungal resource inventory. Based on the findings of morphological and molecular phylogenetic studies, a new species, Hymenopellis biyangensis, has been identified. A new record species, Hymenopellis altissima, has been discovered in China. Additionally, two new record species, Hymenopellis raphanipes and Xerula strigosa, have been found in Henan Province. Internal transcribed spacer (ITS) and large subunit ribosomal (nrLSU) were used to establish a phylogeny for species identification. Detailed descriptions, field habitat maps and line drawings of these species are presented. The discussion focuses on the relationships between newly discovered species and other related taxa. Additionally, this study provides and a key to the documented species of Hymenopellis and Xerula found in China. [ABSTRACT FROM AUTHOR]

Background WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness (hospitalisations) every year. We aimed to improve the understanding of influenza-associated hospitalisation estimates at a national and global level. Methods We performed a systematic literature review of English- and Chinese-language studies published between 1995 and 2020 estimating influenza-associated hospitalisation. We included a total of 127 studies (seven in Chinese) in the meta-analysis and analyzed their data using a logit-logistic regression model to understand the influence of five study factors and produce national and global estimates by age groups. The five study factors assessed were: 1) the method used to calculate the influenza-associated hospitalisation estimates (rateor time series regression-based), 2) the outcome measure (divided into three envelopes: narrow, medium, or wide), 3) whether every case was laboratory-confirmed or not, 4) whether the estimates were national or sub-national, 5) whether the rates were based on a single year or multiple years. Results The overall pooled influenza-associated hospitalisation rate was 40.5 (95% confidence interval (CI) = 24.3-67.4) per 100 000 persons, with rates varying substantially by age: 224.0 (95% CI = 118.8-420.0) in children aged 0-4 years and 96.8 (95% CI = 57.0-164.3) in the elderly aged >65 years. The overall pooled hospitalisation rates varied by calculation method; for all ages, the rates were significantly higher when they were based on rate-based methods or calculated on a single season and significantly lower when cases were laboratory-confirmed. The national hospitalisation rates (all ages) varied considerably, ranging from 11.7 (95% CI = 3.8-36.3) per 100 000 in New Zealand to 122.1 (95% CI = 41.5-358.4) per 100 000 in India (all age estimates). Conclusions Using the pooled global influenza-associated hospitalisation rate, we estimate that seasonal influenza epidemics result in 3.2 million cases of severe illness (hospitalisations) per annum. More extensive analyses are required to assess the influence of other factors on the estimates (e.g. vaccination and dominant virus (sub)types) and efforts to harmonize the methods should be encouraged. Our study highlights the high rates of influenza-associated hospitalisations in children aged 0-4 years and the elderly aged 65+ years. [ABSTRACT FROM AUTHOR]

Introduction: Despite the important clinical significance, limited data on the joint contribution of prepregnancy body mass index (BMI) and gestational weight gain (GWG) to preeclampsia, the second leading cause of maternal mortality worldwide. This study aimed to estimate the risk of preeclampsia by GWG among women with varied prepregnancy BMI. Methods: We conducted a retrospective cohort study using data of 117 738 singleton pregnant women aged 18--49 years from 150 maternity hospitals in China between 2015 and 2018. GWG was calculated as the measured weight at the time of preeclampsia assessment minus prepregnancy weight ;GWG velocity was calculated as the GWG divided by the gestational age at weighing. The nonlinear associations of GWG with preeclampsia were examined by restricted cubic spline regression analysis according to prepregnancy BMI. The association of the GWG categories with preeclampsia was further examined by performing robust Poisson regression stratified by the prepregnancy BMI categories. Results: Among participants, 2426 (2.06%) were diagnosed with preeclampsia. Compared to women with normal BMI, those who were overweight and obese had 1.92-fold (95%CI, 1.73--2.14) and 5.06-fold (95%CI, 4.43--5.78) increased risks for preeclampsia, respectively. The association of GWG velocity with preeclampsia was presented as a J-shaped curve with the varied inflexion point (where the rate of preeclampsia was 2%), which was 0.54, 0.38, and 0.25 kg/week in women with normal BMI, overweight, and obesity, respectively; a steep risk rise was observed along with GWG velocity beyond the inflexion points. The overall adjusted relative risk for preeclampsia was calculated among women with the different GWG categories of GWG. Conclusions: The findings highlight that high prepregnancy BMI and exceed GWG contributed to increased risk of preeclampsia with a superimposed effect and underscore the need to optimize the recommendations for GWG for women with different prepregnancy BMI. [ABSTRACT FROM AUTHOR]

Background: The theory of planned behavior (TPB), combined with social support, forms the extended TPB, which has shown to predict adherence to health-related behavior effectively, but few studies have applied it to explain medication adherence in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Objectives: The aim of this study was to explore the factors associated with medication adherence and the underlying mechanisms based on the extended TPB among patients with CHD after PCI. Methods: A cross-sectional descriptive study was conducted among patients with CHD after PCI in 2 major hospitals in Guangzhou, China. Medication adherence was measured with the Medication Adherence Report Scale. Constructs of the TPB contributing to medication adherence were assessed by the Theory of Planned Behavior Questionnaire for Medication Adherence. Social support was measured by the Multidimensional Scale of Perceived Social Support. Structural equation modeling was used to examine the hypotheses based on the extended TPB. Results: A total of 300 patients were surveyed and 26.0% of them were nonadherent. The structural equation modeling had good fit indices and estimated 62.6% of the variance in medication adherence. Regarding the relationships between the extended TPB constructs and medication adherence, "intention" was directly associated with medication adherence, and "perceived behavioral control" positively predicted medication adherence directly and indirectly. "Affective attitude" and "subjective norm" were indirectly associated with medication adherence through "intention." Social support exerted an indirect effect on medication adherence through "subjective norm." Conclusions: The extended TPB is an appropriate model to predict medication adherence and provides an effective framework for adherence-enhancing interventions. [ABSTRACT FROM AUTHOR]

Accurate species delimitation is an important component of pest management. The Euwallacea fornicatus species complex (Coleoptera: Curculionidae: Scolytinae) includes a series of morphologically similar forest pests that cause huge economic losses both in invaded regions and in the native region. The current hypothesis about the species complex postulates the existence of four species: E. fornicatus (Eichhoff), E. fornicatior (Eggers), E. kuroshio Gomez and Hulcr, and E. perbrevis (Schedl). To test the current hypothesis and reveal the diversity in China, we explored the genetic diversity of the Euwallacea fornicatus complex using molecular approaches. Species and clades were delimited (using ABGD, bGMYC, mPTP and BP&P approaches) based on mitochondrial COI and 16S, and nuclear 18S-ITS1-5.8S, 28S and CAD. All specimens from continental China were E. fornicatus, consistently separating into three molecular taxonomic. Of the other species, E. perbrevis was recovered from Hainan. The distribution pattern and genetic diversity of these species contributes to the development of adequate control strategies since different species can cause different damage. [ABSTRACT FROM AUTHOR]

Recent years have witnessed rapid advances in the transportation of Chinese bayberry fruit in China by express delivery (ED). The mainstream express packaging is a fruit basket filled with Chinese bayberry fruit. In order to analyze the vibration, impact and quality changes of bayberry fruit in the actual ED process, BiQi (BQ) and Dongkui (DK) bayberry fruit were selected as experimental objects. Real‐time acceleration and temperature of Chinese bayberry fruit in the package were recorded during ED transportation. Headspace CO2 gas concentration and squeezed juice percentage were measured when unpacking. The firmness and electronic nose (E‐nose) linear discriminant analysis (LDA) statistical results were measured during the 2‐day shelf life. The results show that semivacuum packaging can reduce the vibration intensity of Chinese bayberry fruit in the package. Whether it was BQ or DK bayberry fruit, the fruit quality of Chinese bayberry fruit sent by ED was considerably worse than that of road vehicle (RV) transportation when unpacking. The LDA statistics of E‐nose data showed that ED‐treated bayberry fruit barely constituted the fresh part. However, differences were noticed between the varieties. Compared with DK bayberry fruit, BQ bayberry fruit had more of its juice squeezed; further, its firmness had decreased more. In conclusion, multiple impacts and high‐intensity vibrations are the main reason for Chinese bayberry fruit damage during ED transportation. Compared to BQ bayberry fruit, DK bayberry fruit is more resistant to mechanical damage and is more suitable for ED. Practical Applications: Cultivar Dongkui bayberry is more resistant to mechanical damage than BiQi bayberry after many aspects of comparison, and is suitable for express delivery (ED) transportation. To reduce the mechanical damage of bayberry fruit, it is suggested to improve the impact‐resistant design of existing packaging styles, with simply adding a layer of absorbent pad to the bottom of the fruit basket. The form of foam box semivacuum packaging is not only suitable to bayberry, but also to others such as strawberries during ED transportation. Reason for mechanical damage of bayberry fruit during express delivery (ED) transportation is explained. The quality of BiQi and Dongkui (DK) bayberry fruit when unpacking and shelf life is analyzed from multiple angles. It is concluded that DK bayberry fruit is more resistant to mechanical damage and is more suitable for ED. [ABSTRACT FROM AUTHOR]

In order to reveal the hotspots, evolution and frontiers of health literacy research in mainland China, Using Citespace to conduct a bibliometric analysis of 648CNKI core journal articles in the field of health literacy. The research found that health literacy research can be divided into three stages: initial (2007-2010), slow development (2011-2014), and rapid development (2015-2020); the core academic community is less, and the period is limited. Regional characteristics are obvious; research hotspots include health literacy survey and its influencing factors, evaluation index system and its connotation, disease prevention and intervention, and health management; the frontier of research in this field is electronic health literacy and mental health literacy. The research results are consistent with the existing results, indicating that the bibliometric method are reliable. [ABSTRACT FROM AUTHOR]

Here we report new records of two invasive ambrosia beetles, Xyleborus affinis and X. ferrugineus, in mainland China. For X. affinis, 89 specimens were collected at 12 locations from five hosts (Eucalyptus robusta, Eucalyptus sp., Hevea brasiliensis, Schefflera octophylla and Sindora glabra) during 2014-2019. In 2019, there are only two samples of X. ferrugineus found in a dead log in Guangdong province. We suspected that both were likely introduced to China through international trade, and X. affinis may have arrived by natural dispersal. More investigation and research are needed to determine distribution, biology and ecology of these two Xyleborus species in China. [ABSTRACT FROM AUTHOR]

Study Question: Does the inheritance of polycystic ovary syndrome (PCOS) susceptibility single-nucleotide polymorphism affect the phenotype of offspring?Summary Answer: Male offspring who inherit PCOS-related genetic variations from PCOS mothers were more susceptible to developing the metabolic abnormality in their later life.What Is Known Already: Genetic factors are considered the major etiology of PCOS. Previous studies have highlighted that offspring of women with PCOS had an increased risk of the same disease or PCOS-like symptoms.Study Design, Size, Duration: The study involved 172 children born to women with PCOS and 529 children born to non-PCOS women. All offspring were conceived by assisted reproductive technologies.Participants/materials, Setting, Methods: The offspring ranged from 1 to 8 years old. Metabolic phenotype analyses were performed in offspring aged from 2 to 8 (N = 619). Sanger sequencing, TaqMan and Sequenom MassARRAY were used to sequence the samples.Main Results and the Role Of Chance: In male offspring, the fasting insulin (FINS) (P = 0.037) homeostasis model assessment of insulin resistance (HOMA-IR) (P = 0.038) and the homeostasis model assessment of pancreatic beta-cell function (HOMA-β) (P = 0.038) levels were higher in offspring of PCOS mothers compared to controls. In female offspring, PCOS offspring had a significantly higher anti-Müllerian hormone levels (P = 0.001) compared to those from control mothers. In male offspring of PCOS mothers, subjects with a T allele at rs2349415 in the gene FSHR had higher FINS (P = 0.023), HOMA-IR (P = 0.030) and HOMA-β levels (P = 0.013) than those in the homozygous CC group. The same increased trend in FINS, HOMA-IR and HOMA-β levels could be found in the CC and TC group in rs2268361 located in gene FSHR compared to the TT group (P = 0.029, P = 0.030, P = 0.046, respectively). As for rs10818854 in the DENND1A gene, the AA and AG group had a higher FINS (P = 0.037) and HOMA-β (P = 0.008) levels than the homozygous CC group.Limitations, Reasons For Caution: Firstly, the offspring may be too young to see any phenotype changes. Secondly, this study only analyzed the differences of genotype frequency using the dominant model instead of all three models due to the limited sample size of the homozygous model. The results, therefore, should be replicated and performed in a larger sample size population. Thirdly, environmental impacts cannot be ruled out.Wider Implications Of the Findings: The findings presented in this thesis add to our understanding the changes in offspring born to PCOS women and remind us to consider early intervention to avoid more severe effects.Study Funding/competing Interest(s): This study was supported by the National Key Research and Development Program of China 2017YFC1001000 (to Z.-J.C.), the National Natural Science Foundation of China 81430029 (to Z.-J.C.), 81622021 and 31571548 (to H.Z.), the National Natural Science Foundation of Shandong Province JQ201816 (to H.Z.) and Shandong Provincial Key Research and Development Program 2017G006036 (to L.-L.C.) and 2018YFJH0504 (to Z.-J.C.). There are no conflicts of interest to declare.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

In this study, 615 kindergarten teacher participants completed a survey comprising teacher work stress, psychological capital, social support, and work-related well-being questionnaires. Results showed that participants' occupational stress not only directly affected their workrelated well-being, but their work-related well-being was also affected through the mediating role of psychological capital. The level of participants’ social support also moderated the relationship between their psychological capital and work-related well-being. Results have practical implications for kindergarten teachers in mainland China such that they can be enlightened on how to avoid a stressful work environment, embrace work-related physical and mental well-being, and maintain their psychological capital. [ABSTRACT FROM AUTHOR]

The increase in drug-resistant tuberculosis in China calls for scaling up rapid diagnosis. We evaluated introduction of rapid resistance testing by line-probe assay for all patients with a diagnosis of pulmonary tuberculosis in 2 prefectures in middle and eastern China. We analyzed sputum samples for smear-positive patients and cultures for smear-negative patients. We used a before-after comparison of baseline and intervention periods (12 months each) and analyzed data for 5,222 baseline period patients and 4,364 intervention period patients. The number of patients with rifampin resistance increased from 30 in the baseline period to 97 in the intervention period for smear-positive patients and from 0 to 13 for smear-negative patients, reflecting a low proportion of positive cultures (410/2,844, 14.4%). Expanding rapid testing for drug resistance for smear-positive patients resulted in a 3-fold increase in patients with diagnoses of rifampin-resistant tuberculosis. However, testing smear-negative patients had limited added value because of a low culture-positive rate. [ABSTRACT FROM AUTHOR]

The flying squirrels of the tribe Pteromyini (Family Sciuridae) currently include 15 genera of which the genus Biswamoyopterus comprises two recognized species, B. biswasi Saha, 1981 and B. laoensis Sanamxay et al., 2013. These two species were each described from only one specimen that are separated from each other by 1,250 kilometres in southern Asia, where they occur in northeast India and central Lao PDR respectively. In 2017 and 2018, two specimens of Biswamoyopterus were discovered from Mount Gaoligong, west Yunnan province, southwest China (between the type locality of the two recognized species). This study aimed to evaluate the taxonomic status of these two newly acquired specimens of Biswamoyopterus by comparing their morphology with the two described species of the genus. The results of this study showed that the specimens from Yunnan province (China) differed from both B. laoensis and B. biswasi in both pelage colour and craniology, and should be recognised as a distinct species, B. gaoligongensis sp. nov., which is formally described here. This study contributes to the understanding of the flying squirrels of southern Asia and identifies an additional species that appears to be endemic to southwest China; however, more research is required to provide details of its ecology, distribution, and conservation status. [ABSTRACT FROM AUTHOR]

Background: Sclerosing mesenteritis is a rare fibroinflammatory disorder of unknown etiology that primarily affects the mesentery of the small intestine during late adult life. Only about twenty pediatric cases have been reported to date, but none has been reported in Chinese children.Case Presentation: A 5-year-old Chinese male presented with a 4-week history of recurrent bloating, abdominal pain, anorexia and vomiting. On admission, physical examination showed a severely distended abdomen. Biochemical investigations showed a slightly increased C-reactive protein, and normal serum levels of electrolytes and erythrocyte sedimentation rate. An abdominal film showed small intestine obstruction and massive ascites. An exploratory laparotomy revealed widespread inflammatory fibrotic adhesions between the bowel and the abdominal wall, thickening of the small bowel and massive ascites. During a prolonged hospital course, a 2nd surgery (4 months after 1st exploratory laparotomy) was performed in order to close the ileostomy and revealed that the bowel was still severely edematous, with very tight adhesions between the bowel and the abdominal wall. Histopathological examination of excised mesentery and nodules showed chronic inflammatory cell infiltration, fat necrosis and fibrosis. A diagnosis of sclerosing mesenteritis was finally established. Prednisolone at 2 mg/kg was started and he experienced rapid clinical improvement in 4 weeks.Conclusions: Sclerosing mesenteritis is extremely rare in children and often misdiagnosed due to its nonspecific clinical manifestation. It is important to be aware of sclerosing mesenteritis when evaluating a child with intractable abdominal pain, bloating, intestinal obstruction and massive ascites. [ABSTRACT FROM AUTHOR]

Background. Coronary artery calcification (CAC) contributes to high risk of cardiocerebrovascular diseases in dialysis patients. However, the risk factors for CAC initiation in peritoneal dialysis (PD) patients are not known clearly. Methods. Adult patients with baseline CaCS = 0 and who were followed up for at least 3 years or until the conversion from absent to any measurable CAC detected were included in this observational cohort study. Binary logistic regression was performed to identify the risk factors for CAC initiation in PD patients. Results. 70 patients recruited to our study were split into a noninitiation group (n=37) and an initiation group (n=33) according to the conversion of any measurable CAC during their follow-up or not. In univariate analysis, systolic blood pressure, serum phosphorus, fibrinogen, hs-CRP, serum creatinine, and triglycerides were positively associated with the initiation of CAC, while the high density lipoprotein and nPCR did the opposite function. Multivariate analysis revealed that hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation after adjustments. Conclusions. Hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation in PD patients. These results suggested potential clinical strategies to prevent the initiation of CAC in PD patients. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine whether the Comprehensive Reminder System based on the Health Belief Model improves health belief, health behaviours, medication adherence and blood pressure control as a means of decreasing the rate of stroke recurrence among hypertensive ischaemic stroke. Background Hypertensive patients having experienced recent ischaemic strokes are at high risk for stroke recurrence. Several trials attempted to improve secondary stroke prevention via patient education, however, patient outcomes remained poor. Long-term follow-up studies regarding secondary stroke prevention are limited. Design A multi-centre, 12-month, assessor-blinded, parallel-group, randomized controlled longitudinal trial. Methods Hypertensive patients having experienced an ischaemic stroke are the target population. The intervention consists of health belief education, a calendar handbook, a weekly automated short-message service and four telephone follow-up interviews. Outcomes will be assessed at baseline and at 3, 6 and 12 months following discharge. The primary outcome is blood pressure control. The secondary outcomes include health belief, health behaviours and medication adherence. The clinical endpoint is the rate of stroke recurrence. Discussion Although many efforts to improve secondary stroke prevention have been undertaken, research indicates that improvements remain possible and warranted. This research protocol based on the Health Belief Model will improve our understanding of stroke education and transitional care needed in China and with the world-wide target population. [ABSTRACT FROM AUTHOR]

Aim To make further modifications to and validate the psychometric properties of the Hospitalization Impact Scale. Background A child's repeated and prolonged hospitalization for cancer treatment can result in great changes for the entire family. A hospitalization-specific screening tool is needed to help clinical nurses identify families who are experiencing major impacts during their child's hospitalization. Design A cross-sectional study was employed to examine the psychometric properties of the Hospitalization Impact Scale. Method The sample consisted of 253 families with children hospitalized for cancer treatment in four paediatric oncology departments in four hospitals in mainland China from September 2013 - March 2014. Parents completed the 36-item Hospitalization Impact Scale, demographic measures and the Family Impact Module of the Pediatric Quality of Life Inventory. Reliability, construct validity, known-group validity and concurrent validity were examined. Result The revised Hospitalization Impact Scale included six factors containing 34 items. It demonstrated sound concurrent validity with the Family Impact Module of the Pediatric Quality of Life Inventory and excellent internal consistency. Conclusion The revised Hospitalization Impact Scale met the standard psychometric criteria for reliability and validity. Thus, it could be applied in paediatric oncology departments to help nurses assess and identify families experiencing major impacts during a child's hospitalization for cancer treatment. [ABSTRACT FROM AUTHOR]

Tricyrtis xianjuensis G.Y. Li, Z.H. Chen & D.D. Ma sp. nova (Liliaceae) is described from Zhejiang and illustrated. It resembles especially T. ohsumiensis and T. perfoliata (sect. Flavae), but differs from the former in having ascending stems, 70 cm long, and glabrous; widely-spaced, ovate-oblong and 2-ranked leaves with the apex acuminate to long acuminate, and without oil spots; pedicel 0.5-1.2 cm long; tepals ca. 0.8 cm wide, appealing purple-spotted inside, the outer tepals' mucro less than 1 mm long; and anthers ca. 3 mm long. Tricyrtis xianjuensis differs from T. perfoliata in having ovate-elliptic leaves, clasping at the base, not perfoliate, and without oil spots; axillary flowers, numbering one or two; and 20-25 mm long tepals with slightly larger and scattered spots. The present report extends the known distribution of Tricyrtis sect. Flavae from Japan to China. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to examine the psychometric properties of the 11-item Chinese version of the Career Success Scale. Background Nurses play an important role in the healthcare system. Opportunities to achieve success and satisfaction from one's career affect the retention and stability of the nursing workforce. The Career Success Scale was originally developed in English and has been translated into Chinese. Psychometric testing of the Chinese Career Success Scale for measuring career success in nurses has not been performed. Design A cross-sectional survey was conducted. Method A convenience sample of 1148 clinical nurses were recruited from 10 level-3 hospitals in Guangdong Province, mainland China, from December 2010-December 2011. Results Results indicated that the Chinese Career Success Scale demonstrated good internal consistency and test-retest reliability. Principal component analysis supported the three-factor structure of the original instrument: Career Satisfaction, Perceived within Organization Competitiveness and Perceived External Organization Competitiveness. There were significant correlations among the three factors, which demonstrated the good construct validity of the Chinese version of this scale. Conclusion The Chinese Career Success Scale appears to be a reliable and valid instrument. It has the potential to be used to measure nurses' career success in mainland China. The findings will be useful for nurse leaders and policymakers in the evaluation of nurses' self-perceived career success and to develop strategies to promote nurse retention and career development. [ABSTRACT FROM AUTHOR]

Background: This study provides a comprehensive evaluation of nurse resources in Chinese hospitals and the link between nurse resources and nurse and patient outcomes. Methods: Survey data were used from 9688 nurses and 5786 patients in 181 Chinese hospitals to estimate associations between nurse workforce characteristics and nurse and patient outcomes in China. Nurse and patient assessments in China were compared with a similar study in Europe. Results: Thirty-eight percent of nurses in China had high burnout and 45% were dissatisfied with their jobs. Substantial percentages of nurses described their work environment and the quality of care on their unit as poor or fair (61% and 29%, respectively) and graded their hospital low on patient safety (36%). These outcomes tend to be somewhat poorer in China than in Europe, though fewer nurses in China gave their hospitals poor safety grades. Nurses in Chinese hospitals with better work environments and higher nurse-assessed safety grades had lower odds of high burnout and job dissatisfaction (ORs ranged from 0.56 to 0.75) and of reporting poor or fair quality patient care (ORs ranged from 0.54 to 0.74), and patients in such hospitals were more likely to rate their hospital highly, to be satisfied with nursing communications, and to recommend their hospitals (significant ORs ranged from 1.24 to 1.40). Higher patient-to-nurse ratios were associated with poorer nurse outcomes (each additional patient per nurse increases both burnout and dissatisfaction by a factor of 1.04) and higher likelihoods of nurses reporting poor or fair quality of care (OR = 1.05), but were unrelated to patient outcomes. Higher percentages of baccalaureate nurses were strongly related to better patient outcomes, with each 10% increase in the percent of baccalaureate nurses increasing patient satisfaction, high ratings, and willingness to recommend their hospital by factors ranging from 1.11 to 1.13. Interpretation: Nursing is important in quality and safety of hospital care and in patients' perceptions of their care. Improving quality of hospital work environments and expanding the number of baccalaureate-prepared nurses hold promise for improving hospital outcomes in China. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine the relationship between nurse staffing and patient outcomes in hospitals in mainland China. Methods: The study was conducted in 181 hospitals across all of the eight economic zones in mainland China using a four-stage sampling design. Two instruments, the China Nurse Survey and the patient satisfaction measurement from the Hospital Consumer Assessment of Healthcare Providers and Systems, were employed in data collection. In this article, 7,802 nurse surveys and 5,430 patient surveys from 600 medical and surgical units were analyzed. Results: The adjusted joint effects of nurse staffing on patient outcomes from logistic regression analyses showed that more nursing staff per patient had statistically significant positive effects on all necessary nursing care, nurses' reports of quality of care, their confidence on patients' self-care ability on discharge from the hospital, patient adverse events, as well as patients' report of satisfaction. When the nurse-to-patient ratio (total number of nurses on all shifts on the unit divided by total number of patients who stay on the unit) increased to the 0.5-<0.6 category, most patient outcomes were significantly improved, considering hospital and patient factors and nurse skill mix in the logistic regression models. Conclusions: The findings provide evidence on how inadequate nurse staffing might result in missed but needed nursing care and negative patient outcomes, while better staffing levels could be an effective strategy for improving patient outcomes. Clinical Relevance: We recommend that the nurse-to-patient ratio on medical and surgical units in Chinese hospitals be increased to at least 0.5-0.6 so as to secure patient safety and the quality of health services. Journal of Nursing Scholarship, 2011; XX:X, XXX-XXX. ©2011 Sigma Theta Tau International. [ABSTRACT FROM AUTHOR]

On the morning of 14 April 2010, the Ms 7.1 Yushu earthquake struck the eastern Tibet Plateau and an Ms 6.3 aftershock followed west-southwest of the mainshock epicenter one and a half hours later. The Yushu earthquake occurred on the northwestern continuation of the Ganzi-Xianshuihe fault zone and reactivated two segments of the fault. Ruptures associated with Yushu earthquake span a zone &thkap;70 km long, extending from south of Jielong in the west to south of Gyêgu (Yushu) in the east. Detailed mapping of the surface rupture zone shows that it consists of two strike-slip segments, the western and eastern segments, separated by the Longbao Lake step-over (pull apart) basin. Our analysis suggests that the 18-km-long western segment of the surface rupture south of the Longbao Lake basin may have been associated with the Ms 6.3 aftershock. The eastern rupture segment, which is inferred to be associated with the mainshock, is 32 km long. The main surface rupture can also be divided into two sections, with a 2-km-long gap between them. The surface rupture exhibits left-lateral slip and is localized in a zone about 50 m wide along the present-day trace of the Yushu fault. A single break, without splays or branching traces, characterizes most of the surface rupture zone. The observed magnitudes of surface displacement are typically 0.5-1 m with a maximum slip of &thkap;2 m. Both field observations and seismic inversion results suggest, rupture of Ms 7.1 Yushu earthquake nucleated near the Longbao Lake step-over basin in the west, propagated unilaterally eastward, and terminated within the east segment margin of the Yushu fault. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons. Methods: Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development. Results: Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children''s education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that Chinas investment in child development is much lower than OECD countries. Conclusion: The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education. [Copyright &y& Elsevier]

Background: Abnormal posture and spinal mobility have been demonstrated to cause functional impairment in the quality of life, especially in the postmenopausal osteoporotic population. Most of the literature studies focus on either thoracic kyphosis or lumbar lordosis, but not on the change of the entire spinal alignment. Very few articles reported the spinal alignment of Chinese people. The purpose of this study was threefold: to classify the spinal curvature based on the classification system defined by Satoh consisting of the entire spine alignment; to identify the change of trunk mobility; and to relate spinal curvature to balance disorder in a Chinese population. Methodology/Principal Findings: 450 osteoporotic volunteers were recruited for this study. Spinal range of motion and global curvature were evaluated noninvasively using the Spinal-Mouse® system and sagittal postural deformities were characterized. Results: We found a new spine postural alignment consisting of an increased thoracic kyphosis and decreased lumbar lordosis which we classified as our modified round back. We did not find any of Satoh's type 5 classification in our population. Type 2 sagittal alignment was the most common spinal deformity (38.44%). In standing, thoracic kyphosis angles in types 2 (58.34°) and 3 (58.03°) were the largest and lumbar lordosis angles in types 4 (13.95°) and 5 (28.61°) were the smallest. The range of flexion (ROF) and range of flexion-extension (ROFE) of types 2 and 3 were usually greater than types 4 and 5, with type 1 being the largest. Conclusions/Significance: The present study classified and compared for the first time the mobility, curvature and balance in a Chinese population based on the entire spine alignment and found types 4 and 5 to present the worst balance and mobility. This study included a new spine postural alignment classification that should be considered in future population studies. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to explore and describe the content of telephone intervention conversations conducted by an enterostomal nurse with patients discharged home with a colostomy. Background. People discharged home with a new colostomy often encounter stoma-related difficulties. Postdischarge care with telephone follow-up by an enterostomal nurse is a helpful way to provide support for patients and ensure continuity of care. There is a paucity of studies reporting the content of telephone follow-up of colostomy patients. Information on the content of such follow-up is important in helping to formulate telephone call protocols that can help these patients. Design. A qualitative exploratory study conducted in a university-based cancer centre in China. Methods. The contents of 25 intervention phone calls to colostomy patients from January-August 2009 were subject to qualitative content analysis. Results. Five themes emerged from the qualitative content analysis: 'education for stoma care', 'access to stoma care', 'encouraging stoma self-care', 'resuming normal living' and 'general postoperative problems'. Conclusions. Colostomy patients experienced stoma-related problems and difficulties after discharge, most of which could be effectively managed via telephone follow-up by an enterostomal nurse. The telephone follow-up satisfied patients' need for information and facilitated their adjustment to the permanent stoma. The findings suggested that patients had unmet needs after discharge and needed follow-up on returning home. Relevance to clinical practice. This study provides important information to guide practice and education. The themes extracted from the qualitative content analysis provide a useful framework to guide the nurse in discussing care with the stoma patients and ensuring patients' adjustment to the permanent stoma. Further work can be done using this framework to develop protocols as standards of care and education materials when educating nurse specialists in stoma care. [ABSTRACT FROM AUTHOR]

Objective: To explore illness perception (IP) and its predictors among Chinese patients with myocardial infarction (MI). Methods: The revised Illness Perception Questionnaire (IPQ-R) was used in the present study. A cross-sectional, descriptive design was employed. The study was conducted in four major hospitals in Guangzhou (China) with a sample of 193 MI patients. Pearson''s and Spearman''s correlation, t test, one-way ANOVA, factor analysis and multiple linear regression were used. Results: Among the 12 common symptoms of MI, on average only 3.37 were recognized by the subjects. Among the six factors of the cause dimension, “immune factors” received the highest score, followed by “gene and chance”, “behavioral factors”, “psychological factors”, “environmental factors”, and “physical factors”. Subjects perceived MI as a chronic, cyclic illness with serious consequences that could be controlled through treatment, and believed that they had a negative affective response to MI. Furthermore, the dimensions of patients’ IP were correlated, and illness-related factors and socio-demographic factors acted as predictors of IP. Conclusion: The IP of Chinese patients with MI needs to be improved. Practice implications: Based on our findings, effective interventions can be designed to promote MI patients’ IP to facilitate their coping strategies after an episode of MI. [Copyright &y& Elsevier]

Abstract: The concentration and its distribution characteristics of TN, TP and COD in the ice layer and water layer during the icebound season in the Hulun Lake of Inner Mongolia showed that the pollutants could migrate from the ice layer to the water layer during the freezing process. The process of low temperature freezing has a good concentration effect on the pollutants in water body. A reasonable explanation of frozen concentrate effect was given from three aspects known as the liquid-solid phase equilibrium theory, crystallography theory and thermodynamics theory. Drawing inspiration from the phenomenon and its mechanism of frozen concentration effect, a tentative idea that we can use natural cool energy in wastewater treatment field was put forward. A reasonable technological process of freezing purification was designed, in which, more than 80% of TN, TP and COD in the original water can be removed through single stage frozen; more than 94% of TN, TP and COD can be removed through second stage frozen; more than 97% of TN, TP and COD can be removed through third stage frozen. Furthermore, parts of related parameters are optimized: the best cold area and water depth ratio is 2.22 and the best removing thickness of ice is 13.5cm in the experiment. [Copyright &y& Elsevier]

Pseudostellaria tianmushanensis G. H. Xia & G. Y. Li, collected from the Tianmu Mountains Nature Reserve in northwestern Zhejiang, China, is described and illustrated. This new species is similar to P. rupestris Pax., but differs by having a string of fusiform or ovoid-globose tubers, leaves that are narrow elliptic-lanceolate, glabrous, with cuneate base with scattered multi-nodulate hairs, papillate margins and basipetalous variation in floral morphology. Moreover, the seed tubercle ornamentation also supports the recognition of the new species. A key to the species of Pseudostellaria in Zhejiang province is provided. [ABSTRACT FROM AUTHOR]

The article presents a study on the common variations in the BCL9 gene that confer the risk of schizophrenia. The researchers observed stable inpatients or outpatients from a mental health center in Shanghai, China, all of whom were interviewed by two independent psychiatrists. They found that the BCL9 gene is a good candidate for psychiatric diseases because it can be found within a region affected by variations that represent a risk of schizophrenia. They also discussed the psychotic features of schizophrenia including altered cognitive functioning.

Background: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. Methods: Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. Results: Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. Conclusion: Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study. [ABSTRACT FROM AUTHOR]

Background: Depside salts from Salvia miltiorrhiza, with active components of lithospermic acid B (LSB), rosmarinic acid (RA), and lithospermic acid (LA), are a multicomponent drug marketed in China for the treatment of coronary heart disease. Objectives: The aims of this study were to determine the concentrations of LSB, RA, and LA in human plasma and urine, and to compare the pharmacokinetic properties of depside salts from S miltiorrhiza in healthy Chinese volunteers. Methods: A randomized, open-label, single-dose study was conducted in healthy Chinese volunteers. Participants were randomly assigned to receive a single intravenous infusion of 100 or 200 mg of depside salts from S miltiorrhiza. Blood was collected through a venous cannula prior to study drug administration (0 min) and at 10, 20, 30, 60, 65, 70, 80, and 90 minutes and 2, 3, 4, 6, 8, 12, and 24 hours after study drug administration. Urine samples were taken before study drug administration (0) and at 0 to 12 and 12 to 24 hours after study drug administration. LSB, RA, and LA concentrations in serum and urine were analyzed by an LC-MS/MS method. Tolerability was determined by clinical assessment; vital signs (ie, blood pressure, heart rate, breathing rate, body temperature) monitoring at baseline and at the end of the study, clinical laboratory tests (ie, hematology, blood biochemistry, hepatic function, renal function, urinalysis), 12-lead ECG measurements, and physical examinations at baseline and after completion of the study. Results: Twelve Chinese volunteers (6 males, 6 females; mean [SD] age, 25.2 [3.8] years; mean height, 165.7 [8.9] cm; mean body mass index, 21.6 [2.5] kg/m2) were enrolled in the study. Peak plasma concentrations of LSB, RA and LA were observed at 0.3 to 1 hour following the 1-hour intravenous infusion, with respective mean (SD) Cmax of 4925 (1861), 174 (61), and 361 (101) ng/mL for the 100-mg dose and 10,285 (2259), 308 (77), and 674 (85) ng/mL for the 200-mg dose. The AUClast values for LSB, RA, and LA were 4537 (1265), 129 (28), and 1229 (330) ng/mL/h, respectively, for the 100-mg dose and 10,426 (2589), 260 (53), and 2792 (729) ng/mL/h for the 200-mg dose. No significant difference in pharmacokinetic parameters was observed between male and female subjects. Three metabolites were found in the plasma with low concentrations. The urinary excretion recoveries of LSB, RA, and LA were 0.58% (0.42%), 25.21% (20.61%), and 10.02% (7.72%) for the 100-mg dose and 0.38% (0.18%), 20.11% (10.50%), and 6.34% (3.20%) for the 200-mg dose. No adverse events were reported by the subjects or found by the investigators in the analysis of vital signs, 12-lead ECG measurements, physical examinations, or clinical laboratory tests. Conclusions: Following single intravenous infusion of 100 or 200 mg of depside salts from S miltiorrhiza to healthy Chinese subjects, no statistical differences in pharmacokinetic parameters were observed between males and females. The 2 doses of depside salts from S miltiorrhiza were clinically well tolerated during the study. [Copyright &y& Elsevier]

The article discusses the outbreak of measles in adult populations in northeastern China in 2014. It tackles the measles elimination campaign in China, a decline in measles incidence rate in the country following the introduction of the campaign, risk factors for measles outbreak, and the reasons behind the outbreak in Shenyang.

Background: Randomized trials have yielded mixed results on the effects of treatment for Helicobacter pylori and little information on the effects of vitamins or garlic supplements on precancerous gastric lesions. We conducted a randomized trial to test the effects of one-time H. pylori treatment and long-term vitamin or garlic supplements in reducing the prevalence of advanced precancerous gastric lesions. Methods: Most of the adults aged 35-64 years in 13 randomly selected villages in Linqu County, Shandong Province, China, were identified and given baseline endoscopies in 1994. In 1995, 3365 eligible subjects were randomly assigned in a factorial design to three interventions or placebos: amoxicillin and omeprazole for 2 weeks in 1995 (H. pylori treatment); vitamin C, vitamin E, and selenium for 7.3 years (vitamin supplement); and aged garlic extract and steam-distilled garlic oil for 7.3 years (garlic supplement). Subjects underwent endoscopies with biopsies in 1999 and 2003, and the prevalence of precancerous gastric lesions was determined by histopathologic examination of seven standard biopsy sites. The 3365 eligible randomized subjects represented 93.5% of those with baseline endoscopy and included all baseline histologic categories except gastric cancer. Only 0.18% had normal gastric mucosa. Logistic regression was used to estimate the intervention effects on the odds of advanced precancerous gastric lesions, and t-tests were used to assess effects on histologic severity. All statistical tests were two-sided. Results: H. pylori treatment resulted in statistically significant decreases in the combined prevalence of severe chronic atrophic gastritis, intestinal metaplasia, dysplasia, or gastric cancer in 1999 (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.62 to 0.95) and in 2003 (OR = 0.60; 95% CI = 0.47 to 0.75), and had favorable effects on the average histopathologic severity and on progression and regression of precancerous gastric lesions in 2003. H. pylori treatment did not reduce the combined prevalence of dysplasia or gastric cancer. However, fewer subjects receiving H. pylori treatment (19/1130; 1.7%) than receiving placebo (27/1128; 2.4%) developed gastric cancer (adjusted P= .14). No statistically significant favorable effects were seen for garlic or vitamin supplements. Conclusion: H. pylori treatment reduces the prevalence of precancerous gastric lesions and may reduce gastric cancer incidence, but further data are needed to prove the latter point. Long-term vitamin or garlic supplementation had no beneficial effects on the prevalence of precancerous gastric lesions or on gastric cancer incidence. [ABSTRACT FROM AUTHOR]

A series of studies has been carried out in Linqu County, Shandong Province, China, a high-risk area for gastric cancer, to investigate the risk factors associated with gastric cancer, precancerous lesions and the prevention of gastric cancer. Our studies showed that sour pancakes (a popular local food), salted foods, cigarette smoking, and family history of gastric cancer were risk factors, whereas fresh vegetables, and intake of vitamin C and calcium were inversely associated with the risk of gastric cancer. The prevalence of chronic atrophic gastritis was approximately 20% in an adult population in Linqu County, intestinal metaplasia was approximately 50%, and dysplasia was approximately 20%. A follow-up study showed that the relative risk of developing gastric cancer increased with the severity of gastric lesions, and was associated with dietary factors, cigarette smoking and H. pylori infection in this population. The findings strongly support the idea that gastric cancer is primarily determined by environmental factors and develops in a multistep progression of precancerous lesions. [ABSTRACT FROM AUTHOR]

Liriope zhejiangensis G. H. Xia & G. Y. Li (Asparagaceae), from Zhejiang Province, eastern China, is described and illustrated as a new species. It is similar to L. muscari, but differs by the yellow, fleshy and odorous rhizome; soft and narrow leaves with an acuminate apex and lower surface pale green when dry; articulate pedicel apex; and by the purple filaments, stigma and ovary. [ABSTRACT FROM AUTHOR]

You, L.; Zhang, G., and Wang, L., 2020. Research on the development of marine information technology in the era of big data. In: Gong, D.; Zhang, M., and Liu, R. (eds.), Advances in Coastal Research: Engineering, Industry, Economy, and Sustainable Development. Journal of Coastal Research, Special Issue No. 106, pp. 624–627. Coconut Creek (Florida), ISSN 0749-0208. At present, the marine economy has become a new growth point in China's national economic growth. Using information management technology to develop and protect marine resources reasonably can promote the sustainable development of the marine economy. However, various departments related to marine affairs have different understandings of marine informatization management over the years, resulting in their work being independent with a low degree of information sharing. When establishing the information system, the lack of unified deployment and planning of resources, low use rate of the resources, low processing efficiency of the massive data, the difficulty in system maintenance, and the high cost of independent operation have all seriously affected the efficiency of marine information management. To solve that, this research analyzed marine informatization management based on the era of big data. Marine information sharing technology under big data are discussed. A framework for the sharing of ocean information planning is constructed. This article puts forward the idea of combining marine information technology with cloud computing and relevant suggestions, which provides beneficial references for marine information management. [ABSTRACT FROM AUTHOR]

Background: Vitamin D (VD) insufficiency or deficiency is a frequent comorbidity in Chinese women with postmenopausal osteoporosis (PMO). The present study aimed to investigate 25-hydroxyvitamin D [25(OH) D] improvement and calcium-phosphate metabolism in Chinese PMO patients treated with 70 mg of alendronate sodium and 5600 IU of vitamin D3 (ALN/D5600).Methods: Chinese PMO women (n = 219) were treated with 12-month ALN/D5600 (n = 111) or calcitriol (n = 108). Changes in 25(OH) D at month 12 were post hoc analyzed by the baseline 25 (OH) D status using the longitudinal analysis. The main safety outcome measures included serum calcium and phosphate and 24-h urine calcium, and the repeated measures mixed model was used to assess the frequencies of the calcium-phosphate metabolic disorders.Results: Absolute change in mean serum 25(OH) D level was the greatest in VD-deficient patients and least in VD-sufficient patients at months six and 12 (both, P < 0.01). Serum calcium level remained significantly lower in the ALN/D5600 treatment group than in the calcitriol treatment group throughout the 12 months. Mean 24-h urine calcium slightly increased in the ALN/D5600 treatment group and significantly increased in the calcitriol treatment group (+ 1.1 and + 0.9 mmol/L at months six and 12; both, P < 0.05). Calcitriol treatment was associated with more frequent hypercalciuria at month six (9.4% vs. 18.5%, P = 0.05), but not at month 12 (12.3% vs. 13.0%).Conclusion: Baseline VD status predicted 25(OH) D improvement in PMO patients on 12-month ALN/D5600 treatment. The daily use of 0.25 μg of calcitriol was associated with more frequent hypercalciuria at month six, compared to ALN/5600 treatment, necessitating the safety re-evaluation of calcitriol at a higher dosage. [ABSTRACT FROM AUTHOR]

Presents a study which focuses on the cause and prevention of gastric cancer in Linqu County, Shandong, China. Number of subjects used on the control study of gastric cancer cases; Enumeration of some of the risk factors of the cancer; Similarity between the factors associated with advanced precancerous gastric lesion with those associated with gastric cancer.

Increasing amounts of wastewater are discharged to water bodies, with a risk of exceeding their capacity to cope with such loads. Nutrient discharge forms two types of risk, i.e., economic and excess effluent risks. In this study, a Bayesian dual risk aversion based stochastic programming (BDRSP) is proposed for selecting optimal effluent trading and multi-risk management schemes. The BDRSP framework includes uncertain simulation for nutrient loading, optimization techniques for optimal trading planning, copulas for disclosing spatial correlation of nutrient pollution as well as TOPSIS for selecting optimal risk management schemes. BDRSP is applied to a real case of Daguhe watershed, China for planning of a NH 3 -N trading system. Trading ratios are estimated based on ratio between environmental damages at the watershed outlet that emission discharges in two sources. Optimal effluent trading scheme is obtained considering random pollutant loading and the associated dual risk. The spatial pattern of nutrient pollution risk is identified based on joint probability distributions and the related joint exceedance probability of different locations with copulas. Optimal dual risk management schemes are generated considering system benefit, unit revenue as well as NH 3 -N loading and its spatial pattern. Risk management schemes under high economic and excess effluent risk control levels (i.e. 0.85 ≤ ε ≤ 1, 0. 4 ≤ ρ ≤ 0.6 and 0.85 ≤ ε ≤ 1, 0.8 ≤ ρ ≤ 1) are recommended. [Display omitted] • Dual risk derived from random emissions is considered in effluent trading design. • Planting zone is the main seller; livestock breeding zone is the main buyer. • Multi-dimensional risk of nutrient pollution is analyzed with copulas. • Optimal risk management schemes are generated with TOPSIS. • Risk management under high economic and excess effluent risk levels is recommended. [ABSTRACT FROM AUTHOR]

• Water saving would reduce the quantity of initial water rights. • Water saving decreases demand and supply of water right, shrinking market size. • Water trading would reduce water-saving quantity flowing to enterprise. • Most saved water should be allocated for groundwater and surface water replenishment. • Mechanism with water saving and trading is optimal according to system performance. In this study, a conjunctive water management model based on interval stochastic bi-level programming method (CM-ISBP) is proposed for planning water trading program as well as quantifying mutual effects of water trading and systematic water saving. CM-ISBP incorporates water resources assessment with soil and water assessment tool (SWAT), systematic water-saving simulation combined with water trading, and interval stochastic bi-level programming (ISBP) within a general framework. Systematic water saving involves irrigation water-saving technologies (sprinkler irrigation, micro-irrigation, low-pressure pipe irrigation), enterprise water-saving potential and water-saving subsidy. The CM-ISBP is applied to a real case of a water-scarce watershed (i.e. Dagu River watershed, China). Mutual effects of water trading and water-saving activities are simulated with model establishment and quantified through mechanism analysis. The fate of saved water under the systematic water saving is also revealed. The coexistence of the two systems would increase system benefits by [11.89, 12.19]%, and increase the water use efficiency by [40.04, 40.46]%. Thus mechanism that couples water trading and water saving is optimal and recommended according to system performance. [Display omitted] [ABSTRACT FROM AUTHOR]

A genome-wide association study of Han Chinese subjects was conducted to identify genetic susceptibility loci for nonobstructive azoospermia (NOA). In the discovery stage, 802 azoospermia cases and 1,863 controls were screened for genetic variants in the genome. Promising SNPs were subsequently confirmed in two independent sets of subjects: 818 azoospermia cases and 1,755 controls from northern China, and 606 azoospermia cases and 958 controls from central and southern China. We detected variants at human leukocyte antigen (HLA) regions that were independently associated with NOA (HLA-DRA, rs3129878, pcombine = 3.70 × 10−16, odds ratio [OR] = 1.37; C6orf10 and BTNL2, rs498422, pcombine = 2.43 × 10−12, OR = 1.42). These findings provide additional insight into the pathogenesis of NOA. [Copyright &y& Elsevier]

• The ratio of the two peak intensities and the evolution of the phase separation with the energy of Crab pulsar are studied. • We simulate the eight-wavelength X-ray light curves of Crab pulsar by joint the core gap and annular gap. • The evolution of the Crab pulsar light curve with frequency provides a stronger constraint for the theoretical model. • By simulating the light curve of crab pulsar, the region of each radiation component is deduced. • This research has certain scientific significance for studying the geometry of the pulsar radiation area and discussing the timing noise of pulsar. Multiwavelength observation is an effective way to test and constrain theoretical models of pulsars. X-ray observations reveal that the light curve of the Crab pulsar has two sharp peaks, with a phase separation of ~ 0.4 spin periods between its first peak (P1) and second peak (P2). Using observations from the Hard X-ray Modulation Telescope (Insight -HXMT) of China, we studied eight-wavelength (from 11 keV to 250 keV) X-ray light curves of the Crab pulsar and found that the phase separation has no significant trend with the energy, while the total intensity ratios of the P2 and bridge emission components to the P1 component have a significant increasing trend with increasing energy. We used three-dimensional magnetospheric models for the core gap (CG) and annular gap (AG) to simulate the eight-wavelength X-ray light curves. It was found that the P1, P2 and bridge emission components at each band can be well reproduced by the two models and that the P1 and P2 emissions could be generated in the AG region, whereas the bridge emission could be generated in the CG region. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the correlation between bone mineral density (BMD) and bone resorption markers in postmenopausal women with osteoporosis fractures and identify risk factors for second fractures., Methods: This retrospective analysis of 1,239 older women with fractures with a median age of 70 years who attended Shanghai General Hospital from January 2007 to December 2016, included a first fracture group (1,008 cases) and a second fractures group (231 cases). The risk factors for fractures were analyzed by comparing these groups on clinical characteristics, BMD, and bone metabolism markers stratified by quartiles of serum C-terminal telopeptide of type 1 collagen (CTX). Binary logistic regression analysis was used to identify risk factors for second fractures., Results: In the whole sample, BMD was negatively correlated with age and serum osteocalcin and positively correlated with body mass index (BMI). In women with first fractures, those in the highest quartile of serum CTX had the lowest spine and hip BMD. Second fractures were significantly associated with BMI, lower spine and hip BMD, and higher serum osteocalcin but not CTX. Binary logistic regression analysis showed that high BMI (odds ratio [OR], 1.08 [95% CI, 1.03-1.14]; P = 0.001), low lumbar BMD (OR, 0.24 [95% CI, 0.07-0.82]; P = 0.023), low total hip BMD (OR, 0.05 [95% CI, 0.00-0.88]; P = 0.041), and lack of antiosteoporosis treatment (OR, 2.71 [95% CI, 2.71-4.08]; P < 0.001) were independent risk factors for second fractures., Conclusions: In older women with fractures, BMD was significantly lower in women with second fractures than in those with first fractures. Higher levels of serum CTX and osteocalcin, which indicates increased bone resorption, were negatively correlated with BMD. In women with a first fracture, serum CTX higher than 605 pg/mL was negatively correlated with BMD, whereas no correlation was found between different CTX and BMD in women with second fractures. High BMI and low BMD as well as not receiving antiosteoporosis treatment were independent risk factors for second fractures., Competing Interests: Financial disclosure/conflicts of interest: None reported., (Copyright © 2023 by The Menopause Society.)

Background: As postmenopausal osteoporotic fractures can cause higher rates of disability and mortality in women; it is essential to analyze the factors associated with primary and recurrent fractures in postmenopausal osteoporosis (PMOP) patients., Methods: Retrospective analysis of 2478 PMOP patients aged ≥ 50 years who attended the Shanghai General Hospital from January 2007 to December 2016, including 1239 patients with no fractures and 1239 patients with histories of fractures (1008 in the primary fracture group and 231 in the re-fracture group). All patients' basic clinical data, serum biochemical and bone metabolic markers, bone mineral density (BMD), and other indicators were recorded uniformly. Comparing the differences between the clinical characteristics of patients with primary and recurrent fractures, as well as the differences in the clinical characteristics of patients with primary and recurrent fractures in combination with different diseases, further analyses the risk factors for primary and recurrent fractures in PMOP patients. SPSS.26 was used for statistical analysis., Results: Compared to the unfractured group, the fractured group was older and had lower height and bone mineral density (all P < 0.01), with the re-fractured group having lower BMD at each key site than the primary fracture group (all P < 0.01). Analysis of the combined disease subgroups showed that serum BGP levels were lower in the primary and re-fracture patients with diabetes than in the non-diabetic subgroup (P < 0.05), and serum CTX levels were lower in the re-fracture group with diabetes than in the primary fracture group with diabetes (P < 0.05). Patients with recurrent fractures with cardio-vascular diseases had lower BMD than the subgroup without cardio-vascular diseases (P < 0.05) and also had lower BMD than the group with primary fractures with cardio-vascular diseases (P < 0.05). Multiple logistic regression analysis showed that advanced age, overweight, low lumbar spine and total hip BMD were risk factors for primary and recurrent fractures; and comorbid chronic liver and kidney diseases were risk factors for primary fractures., Conclusion: PMOP patients with advanced age, overweight, low bone mineral density, and comorbid chronic liver and kidney diseases are at greater risk of fractures and require early intervention to reduce fractures occurrence. Moreover, those who are elderly, overweight, and have low bone density should also be aware of the risk of re-fractures., (© 2022. The Author(s).)

The efficacy of generic teriparatide in improving BMD at lumbar spine in patients with osteoporosis was similar to that of alendronate. It provided a new choice for osteoporosis treatment in Chinese population., Introduction: To determine whether the efficacy of generic teriparatide is noninferior to alendronate for Chinese postmenopausal women with osteoporosis., Methods: Eligible patients were randomly assigned (2:1) in a 48-week, open-label design to receive 20 µg sc daily teriparatide or 70 mg oral weekly alendronate. Primary outcome was percentage change in BMD at the lumbar spine from baseline to 48 weeks and was assessed for non-inferiority. The same outcome was further assessed for superiority as a secondary endpoint., Results: Three hundred ninety-one and 196 participants were randomly assigned to the teriparatide or alendronate group, of whom 379 and 194 receiving at least one dose of teriparatide and alendronate treatment were eligible for the efficacy analysis. Teriparatide was non-inferior to alendronate for BMD change at lumbar spine (treatment difference: 0.7%, 95% CI: - 0.3 to 1.7%), which excluded the predefined non-inferiority margin of - 1.5%. However, teriparatide was not statistically superior to alendronate in improving BMD at lumbar spine (P = 0.169). At 48 weeks, changes in BMD at total hip were - 1.0% and 2.2% in teriparatide and alendronate group, respectively (P < 0.001). The incidence of new fracture showed no statistical difference between groups (P = 0.128). Serum P1NP and β-CTX levels significantly increased in the teriparatide group and markedly decreased in alendronate group (all P < 0.001 vs baseline). The adverse events (AEs) and serious AEs were more common in the teriparatide group than in the alendronate group, which were mainly teriparatide-related hypercalcemia, elevated alkaline phosphatase or parathyroid hormone, dizziness, and arthralgia., Conclusions: Teriparatide was not inferior to alendronate in increasing BMD at lumbar spine in Chinese postmenopausal women, and they achieved these effects through different mechanisms., (© 2022. The Author(s).)

Mutations in the methylenetetrahydrofolate reductase (MTHFR) gene can result in a reduced ability to utilize folic acid. The MTHFR 677C>T polymorphism in particular has been linked to both birth defects and pregnancy-associated diseases. This study aimed to evaluate the prevalence of the MTHFR 677C>T mutation among pregnant women in Yunnan Province so as to collect baseline data that may be utilized to guide folic acid supplementation efforts and to support related disease prevention programs. We retrospectively reviewed 3387 pregnant women from Yunnan Province. The MTHFR 677C>T polymorphism was identified using polymerase chain reaction (PCR) and DNA sequencing. In total, 1350 (39.9%) subjects were homozygous for the C allele (CC), 1540 (45.4%) subjects were heterozygous (CT), and 497 (14.7%) subjects were homozygous for the T allele (TT). The MTHFR 677C>T polymorphism was found to be present within the studied population, with ∼60% of these patients being either heterozygous or homozygous for the mutant allele and with an overall T allele frequency of 0.37. The frequency of the T allele was significantly higher among pregnant women with complications relative to women with healthy pregnancies, particularly among women <30 years old. As such, the maternal MTHFR 677C>T polymorphism may be a genetic risk factor associated with pregnancy complications and may help identify pregnant women at a high risk of such complications.

Objective: To investigate the relationship between sleep quality and bone mineral density (BMD) in urban residents., Methods: Data of 28 756 Han adults (14 355 males and 14 401 females), who completed both Pittsburgh sleep quality index (PSQI) assessment and radial BMD tests by dual energy X-ray absorptiometry in the Health Management Center of Southwest China University from June 2012 to June 2019 were retrospectively analyzed. The degree of sleep disorder was determined based on PSQI scores, while osteopenia and osteoporosis was diagnosed according to BMD T-value. The χ 2 test and multiple regression model were used to investigate the relationship between sleep quality and BMD., Results: The numbers of normal BMD, osteoponia and osteoporosis were 17 039 (59.3%), 7916(27.5%) and 3801(13.2%), respectively. The mean PSQI score was 5.6±1.4 points. According to PSQI scores, there were 15 936 subjects without sleep disorder (55.4%), 5965 with mild (20.7%), 4897 with moderate (17.0%) and 1958 with severe sleep disorder (6.8%), respectively. There was no significant difference in osteoponia/osteoporosis rate between subjects with mild sleep disorder and normal ones ( χ 2 =0.948, P >0.05), while the rate of osteoporosis in moderate sleep disorder group was higher than that in mild group ( χ 2 =525.583, P <0.01), and the rate of osteoponia/osteoporosis in severe sleep disorder group was much higher than that in moderate group ( χ 2 =1124.877, P <0.01). Multiple regression results showed that female, elders, mental labor, smoking and higher PSQI scores were independently associated with lower T-value (all P <0.05), while moderate to intense daily physical activity was associated with higher T-value ( P <0.05)., Conclusions: Sleep disturbances may be a major risk factor for BMD loss in urban residents, indicating that it would be a potential target of osteoporosis prevention.