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While previous studies have largely focused on anthropogenic warming characterized by surface air temperature, little is known about the behaviors of human‐perceived temperature (HPT), which describe the "feels‐like" equivalent temperature by considering the joint effects of temperature, humidity and/or wind speed. Here we adopted an optimal fingerprinting method to compare seasonal mean HPTs in China with those from simulations conducted with multiple climate models participating in the Coupled Model Intercomparison Project Phase 6. We found clear anthropogenic signals in the observational records of changes in both summer and winter HPTs over the period 1971–2020. Moreover, the anthropogenic greenhouse gas influence was robustly detected, with clear separation from natural and anthropogenic aerosol forcings. The anthropogenic greenhouse gas forcing plays the dominant role (>90%) of human‐perceived warming. Urbanization effects contribute slightly and moderately to the estimated trends in summer and winter HPTs, respectively, in addition to the effects of external forcing. Plain Language Summary: Human influences have been identified in the observed warming quantified by surface air temperature (SAT), but SAT alone is inadequate as a metric for human thermal comfort. Here we focus on human‐perceived temperature (HPT), which describes the "feels‐like" equivalent temperature by considering the joint effects of temperature, humidity, and/or wind speed. We isolate anthropogenic impacts on the observed increase in summer and winter HPTs in China during 1971–2020 by comparing observations with state‐of‐the‐art climate models. Results show that the influence of anthropogenic greenhouse gas is detected, with clear separation from other external forcings such as solar and volcanic activities and anthropogenic aerosols. The human‐induced greenhouse gas increases are also found to explain most (>90%) of the observed human‐perceived warming. Along with the effects of large‐scale anthropogenic forcing, urbanization effects also have a slight to moderate influence on the estimated trends in summer and winter HPTs. Our work is an early attempt to provide quantitative evidence for the physiological impacts of anthropogenic global warming and local urbanization on human beings. Key Points: The warming is quantified by human‐perceived temperature that considers the joint effects of temperature, humidity and/or wind speedHuman influence could be robustly detected in both summer and winter human‐perceived warmingThe observed increase in human‐perceived temperature is mostly attributed to anthropogenic greenhouse gas increases [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine the question, "How do firm-level, home-country and host-country environmental performance (EP) affect the outward foreign direct investment (OFDI) of Chinese multinational enterprises (MNEs)?" Design/methodology/approach: The authors examine the relationships between EP and OFDI propensity and between EP and OFDI intensity using a sample of 359 Chinese firms in industries with a significant environmental footprint between 2009 and 2019 (2,002 firm-year observations) and a Heckman two-stage model. Findings: This study shows that the propensity for OFDI by Chinese MNEs is significantly and positively related to the firm's prior EP and the country-level EP of China. However, the amount of FDI invested is significantly and positively related to the firm's prior EP and negatively related to the EP of the host country. Research limitations/implications: The findings suggest that FDI in a country by an MNE is determined by a combination of firm-level EP, home-country EP and host-country EP. This study finds that the decision to undertake FDI (propensity) and the decision about how much to invest (intensity) are determined by different factors. The propensity for FDI is determined by the home-country EP and firm-level EP. However, the intensity of FDI is determined by a combination of the host country EP and firm-level EP. A limitation is that this study only examines MNEs in China, so the findings may not apply to other countries. Originality/value: This paper shows that MNEs' EP is positively related to the propensity and intensity of their OFDI decisions. However, this paper shows that the home-country and host-country EP may also play an important role in determining the propensity or intensity of OFDI. [ABSTRACT FROM AUTHOR]

Purpose: Based on a theoretical framework of ambidexterity in technology sourcing beyond organizational and technological boundaries, this study aims to explore how start-ups balance technology sourcing in organizational ambidexterity (TSOA) to produce high venture performance. Design/methodology/approach: A questionnaire survey is distributed among start-ups in the science and technology park of a university in eastern China, producing a total of 45 valid responses. The fuzzy-set approach to qualitative comparative analysis is used in this study. Findings: The findings show that start-ups achieve high venture performance through external technology sourcing (external exploration and exploitation) in the initial stage. In the growth stage, start-ups adopt external and internal technology sourcing (internal exploration and exploitation) to produce high venture performance. The technology sourcing strategy in ambidextrous activity for start-ups is punctuated equilibrium and evolving from the external ambidexterity to internally and externally coordinate ambidexterity at entrepreneurial stages. Originality/value: This study creatively adopts configuration-based thinking to investigate how to balance TSOA for high venture performance, extending the literature on technology sourcing and contributing to the balance theory of exploration and exploitation. [ABSTRACT FROM AUTHOR]

Is Long COVID-19 under-diagnosed? The definition of this new condition has received many contributions, and it is still under development as a great variety of symptoms have been associated to it. This study explores the possibility that there are non-diagnosed cases among individuals who have been infected by SARS-CoV-2 and have not been vaccinated. The long-term symptoms identified among a sample 255 individuals have been associated to Long COVID-19 by recent literature. The study relates these symptoms to risk factors and health-related quality of life (HRQoL) negative impacts. The individuals were screened 1 year after discharge to explore its potential relation to Long COVID-19. Patients diagnosed with COVID-19 and discharged from designated hospitals in a Chinese province between January and April 2020 were included in this study. They received computed tomography (CT) scans one month after discharge. One year after discharge, patients were invited to physical examination and interviewed with questionnaire on health-related quality of life (HRQoL) and post-COVID-19 symptoms. Tobit regression and Logistic regression were applied to evaluate the risk factors for health utility value and pain/discomfort and anxiety/depression. One year after discharge, 39.61% patients complained of several of the symptoms associated to Long COVID-19. More than half had abnormal chest CT. Previous studies focused on the post-COVID-19 symptoms and chest CT findings of patients, but few studies have assessed the COVID-19-associated risk factors for health-related quality of life. [ABSTRACT FROM AUTHOR]

Rice bean (Vigna umbellata) is an underexploited domesticated legume crop consumed for dietary protein in Asia, yet little is known about the genetic diversity of this species. Here, we present a high-quality reference genome for a rice bean landrace (FF25) built using PacBio long-read data and a Hi-C chromatin interaction map, and assess the phylogenetic position and speciation time of rice bean within the Vigna genus. We sequence 440 landraces (two core collections), and GWAS based on data for growth sites at three widely divergent latitudes reveal loci associated with flowering and yield. Loci harboring orthologs of FUL (FRUITFULL), FT (FLOWERING LOCUS T), and PRR3 (PSEUDO-RESPONSE REGULATOR 3) contribute to the adaptation of rice bean from its low latitude center of origin towards higher latitudes, and the landraces which pyramid early-flowering alleles for these loci display maximally short flowering times. We also demonstrate that copy-number-variation for VumCYP78A6 can regulate seed-yield traits. Intriguingly, 32 landraces collected from a mountainous region in South-Central China harbor a recently acquired InDel in TFL1 (TERMINAL FLOWER1) affecting stem determinacy; these materials also have exceptionally high values for multiple human-desired traits and could therefore substantially advance breeding efforts to improve rice bean. Rice bean is an underexploited legume crop that has many desirable properties against bio and abiotic stresses. Here, the authors report the genome assembly of this species, conduct population genetics studies and reveal the genetic variations associated with adaptation and yield traits. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the nonlinear relationship between environmental regulations and enterprise innovation performance, as well as pay attention to the boundary condition of political connections. The data we applied in this paper are listed Chinese industrial firms during 2012–2017 to test the effect of environmental regulations on enterprises innovation performance, the moderating effect of political connections and the mediating effect of Research and Development (R&D) investments. The results show that (1) environmental regulations have a U-shaped relationship with enterprises innovation performance in which the R&D investments play a mediating role. (2) Political connections negatively moderate the relationship between environmental regulations and enterprises innovation performance via R&D investments. Except political connections' moderating effect on the relationship between environmental regulations and R&D investments, (1) & (2) are demonstrated in a much more apparent manner among non-state-owned enterprises than that among state-owned enterprises. We also examined hypotheses among different regions of China in our studies. [ABSTRACT FROM AUTHOR]

Astroviruses (AstVs) are among the most important viruses causing diarrhea in human infants and many animals, posing a threat to public health safety and a burden on the economy. Five porcine AstV (PAstV) genotypes have been identified in various countries, including China. However, the epidemiology of PAstV in Yunnan province, China, remains unknown. In this study, 489 fecal samples from pigs in all 16 prefectures/cities of Yunnan were collected between April and August of 2020 for epidemiological investigation. The total infection rate of PAstV-2 or PAstV-5 was 39.9%, with suckling piglets having the highest infection rate (62.3%). The ORF2 genes of seven PAstV-2 and 10 PAstV-5 isolates were sequenced and phylogenetically analyzed. In addition to coinfections with PAstV-2 and PAstV-5, coinfections of PAstV with other diarrhea-inducing viruses (e.g., porcine bocavirus) were also discovered. A comparison of ORF2-encoded capsid protein sequences revealed that there were multiple insertions and deletions in the seven Yunnan PAstV-2 sequences, while point mutations, but no deletions or insertions, were found in the 10 Yunnan PAstV-5 sequences, which were very similar to the reference sequences. This is the first epidemiological investigation and genetic characterization of PAstV-2 and PAstV-5 in Yunnan province, China, demonstrating the current PAstV infection situation in Yunnan. [ABSTRACT FROM AUTHOR]

Study Question: What are the genetic causes of total fertilization failure (TFF) in a proband suffering from male infertility?Summary Answer: Novel compound heterozygous variants (c.[463C>T];[1084G>A], p.[(Arg155Ter)];[(Gly362Arg)]) in actin-like protein 7A (ACTL7A) were identified as a causative genetic factor for human TFF.What Is Known Already: ACTL7A, an actin-related protein, is essential for spermatogenesis. ACTL7A variants have been reported to cause early embryonic arrest in humans but have not been studied in human TFF.Study Design, Size, Duration: We recruited a non-consanguineous family whose son was affected by infertility characterized by TFF after ICSI. Whole-exome sequencing was used to identify the potential pathogenic variants. Artificial oocyte activation (AOA) after ICSI was performed to overcome TFF and any resulting pregnancy was followed up.Participants/materials, Setting, Methods: Sanger sequencing was performed to validate the variants. Pathogenicity of the identified variants was predicted by in silico tools. The ultrastructure of spermatozoa was studied by transmission electron microscopy (TEM). Immunofluorescence staining and western blotting were used to investigate the mechanism of the variants on the affected spermatozoa.Main Results and the Role Of Chance: Novel compound heterozygous variants in ACTL7A (c.[463C>T];[1084G>A], p.[(Arg155Ter)];[(Gly362Arg)]) were identified in a family with TFF after ICSI. In silico analysis predicted that the variants lead to a disease-causing protein. TEM showed that the ACTL7A variants caused ultrastructural defects in the acrosome and perinuclear theca. Protein expression of ACTL7A and phospholipase C zeta, a key sperm-borne oocyte activation factor, was significantly reduced in the affected sperm compared to healthy controls, suggesting that the ACLT7A variants lead to an oocyte activation deficiency and TFF. AOA by calcium ionophore (A23187) after ICSI successfully rescued the TFF and achieved a live birth for the patient with ACTL7A variants.Limitations, Reasons For Caution: Given the rarity of sperm-associated TFF, only one family with an only child carrying the ACTL7A variants was found. In addition, the TFF phenotype was not assessed in two or more ICSI cycles, due to the intervention in ICSI with AOA after one failed ICSI cycle. Further studies should validate the ACTL7A variants and its effect on male infertility in larger independent cohorts.Wider Implications Of the Findings: : Our findings revealed a critical role of ACTL7A in male fertility and identified bi-allelic variants in ACTL7A associated with human TFF, which expands the genetic spectrum of TFF and supports the genetic diagnosis of TFF patients. We also rescued TFF by AOA and obtained a healthy live birth, which provides a potentially effective intervention for patients with ACTL7A pathogenic variants.Study Funding/competing Interest(s): This work was supported by the National Natural Science Foundation of China (81971374 and 81401267). No conflicts of interest were declared.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background Choline and betaine have been suggested to play a pivotal role in neurotransmitter synthesis, cell membrane integrity, and methyl-group metabolism, exerting neuroprotective effects in patients with various neurological disorders. However, population-based evidence on choline and betaine with subsequent cardiovascular events after stroke is rare. Objectives We aimed to prospectively investigate the relationships of circulating choline and betaine with cardiovascular events and recurrent stroke in patients with ischemic stroke. Methods We performed a nested case-control study within the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 323 cardiovascular events (including 264 recurrent strokes) and 323 controls (free of recurrent cardiovascular events) matched for age (±1 y), sex, and treatment group were included. The primary endpoint was a composite of cardiovascular events after ischemic stroke. Plasma choline and betaine were measured at baseline by ultra-high-performance LC-MS/MS. Conditional logistic regression models were applied, and discrimination, reclassification, and calibration of models with choline pathway metabolites were evaluated. Results Plasma choline and betaine were inversely associated with cardiovascular events and recurrent stroke after ischemic stroke. Specifically, in fully adjusted models, each additional SD of choline and betaine was associated with 35% (95% CI: 20%–48%) and 30% (95% CI: 14%–43%) decreased risks of subsequent cardiovascular events, respectively, and 34% (95% CI: 16%–48%) and 29% (95% CI: 12%–43%) decreased risks of recurrent stroke, respectively. In addition, both choline and betaine offered substantial risk discrimination and reclassification improvement for cardiovascular events and recurrent stroke beyond traditional risk factors, as evidenced by an increase in C statistics, the net reclassification index, and integrated discrimination improvement. Conclusions Plasma choline pathway metabolites, including choline and betaine, were associated with decreased risks of cardiovascular events and recurrent stroke and provided incremental value in risk discrimination and stratification in patients with ischemic stroke. This nested case-control study was based on the China Antihypertensive Trial in Acute Ischemic Stroke, which is registered at clinicaltrials.gov as NCT01840072. [ABSTRACT FROM AUTHOR]

Childhood maltreatment has been extensively linked to adult psychopathology, but the specificity and heterogeneity within this association remains inadequately understood. Research with non-Western samples also remains sparse. Using data from Chinese male adult drug users (N = 239) and utilizing both variable-centered and person-centered approaches, this study examined the link between childhood maltreatment (i.e., physical abuse and neglect, emotional abuse and neglect, and sexual abuse) and adult psychopathology (i.e., depressive symptoms, anxious symptoms, and severity of drug addiction). Variable-centered analyses indicated that when different types of maltreatment were considered in a single model, only emotional maltreatment stood out as a risk predictor for psychopathology, especially emotional abuse. Person-centered analyses identified three groups in which various types of maltreatment were configurated within individuals in distinctive patterns: the "rarely maltreated", the "multiply abused", and the "highly neglected" groups. Adult psychopathology varied across profiles. This study highlights the importance of utilizing both variable-centered and person-oriented approaches for a more complete delineation of the link between childhood maltreatment and adult psychopathology. Whereas variable-centered approaches are helpful for obtaining increased specificity, the person-oriented approaches are useful for tackling the heterogeneity. The findings have implications for interventions aimed at assisting drug users in Chinese cultural contexts. [ABSTRACT FROM AUTHOR]

Income inequality generates structural barriers that prevent people especially those from disadvantaged backgrounds from accessing key resources. However, extant research on income inequality has mostly investigated its impact on limiting access to material but not digital resources. Digital resources have become more critical in the twenty-first century. The current research aims to explore whether income inequality is associated with individuals' internet use. Based on an investigation of a nationally representative study of children and adolescents (n = 10,386; Mage = 11.61) from 25 provinces in China, we found that children and adolescents in more unequal provinces engaged in less internet use. Moreover, this relationship was moderated by socioeconomic background. In more unequal provinces, only children and adolescents from low-income families reported lower internet use but those from high-income families did not. These findings indicate the significance of income inequality and of the moderating role of socioeconomic condition in shaping access to digital resources. [ABSTRACT FROM AUTHOR]

• Juvenile COVID-19 patients had faster times to re-detectable positive (RP) results than any other age groups. • Sampling from the digestive tract may be better for identifying RP. • No marked difference in imaging changes between RP and no RP patients were observed. • Nearly three-quarters of patients had protective antibodies 6 months post-discharge. • The disappearance rate of antibodies was more rapid in juveniles than adults. Almost a year after the outbreak of coronavirus disease 2019 (COVID-19), many hospitalized COVID-19 patients have recovered. However, little is known about the long-term follow-up (> 2 months) of discharged patients. This study enrolled 527 discharged COVID-19 patients from 05 February to 11 March 2020. Basic characteristics, imaging features, nucleic acid detection results, and antibody levels of these patients were retrospectively reviewed. Of the 527 discharged patients, 32 (6.1%) had re-detectable positive (RP) nucleic acid results for SARS-CoV-2 during follow-up examinations, with 11 and four detections entailing stool samples and anal swabs, respectively, rather than respiratory samples. Juveniles were more susceptible to "infection recurrence" than other age groups, with shorter time spans for re-detectable positive (RP) RNA tests (an average of 8.8 days [6.0–9.0 days]), while the reverse was true for the middle-aged group (17.5 days on average [14.0–17.5 days]). Similar improvements in the imaging features of both RP and no RP (NRP) groups were observed. Negative antibody detections in patients at 3 and 6 months after discharge were 14.2% and 25.0%, respectively. Cases evidencing negative antibodies were more common among juvenile patients (40% vs. 15.6%, P = 0.03) 6 months post-discharge. A total of 6.1% of 527 discharged patients showed RP status, which may be easier to be identified from stool samples than from other samples. Given the dropping rate of SARS-CoV-2 antibodies, reinfection may happen, especially in juvenile patients (aged < 18 years). These findings have implications for the long-term management of recovered COVID-19 patients. [ABSTRACT FROM AUTHOR]

The previous research on personality and problematic Internet use (PIU) has predominantly, if not exclusively, focused on their direct associations with cross-sectional designs. Based on four annual waves of data from 2,516 Chinese college students, this study examined the mediating role of maladaptive cognitions over Internet use in the associations between personality traits (i.e., neuroticism, extraversion, and psychoticism) and PIU. Results indicated that these personality traits assessed at year 2 (i.e., the second college year) were indirectly associated with PIU at year 4 via maladaptive cognitions over Internet use at year 3. The indirect associations were robust after controlling for PIU at year 2, depression and anxiety at year 4, and a series of demographic covariates at year 1. Such findings highlight various personality traits as critical antecedents of PIU. Furthermore, identifying maladaptive cognitions over Internet use as a mechanism explaining the associations between personality traits and PIU may facilitate more targeted and effective intervention efforts. [ABSTRACT FROM AUTHOR]

Heatwaves describe prolonged periods of excessive heat. The increasing trend in heatwave frequency, duration, and magnitude in a warmer future has been extensively investigated. However, the vast majority of traditional studies on heatwaves consider only the role of air temperature, which is inadequate as a metric for human heat stress. While reported worsening levels in heat stress with global warming are concerning, the changes in heatwaves may not be directly comparable to the temperature increase. The reliable information on future changes in human-perceived heatwaves is still fairly limited. Given this context, we quantified future changes in human-perceived heatwaves in eastern China, where the population is dense and the summers are often sultry, based on dynamic downscaling climate projections and a human thermal comfort index that combines the effect of temperature and humidity. We demonstrated that under the 3.0 °C of global warming (similar to late-century warming projected based on current mitigation policies), the frequency, duration, and magnitude of human-perceived heatwaves in eastern China would increase approximately 5, 4, and 20 times, respectively, relative to the reference period (1986–2005). Human-perceived heatwaves are projected to increase more rapidly than heatwaves solely based on the temperature definition, implying that the escalating heat risk for humans may have been underestimated by previous studies. Moreover, extra cautions need to be given to low-latitude regions, where the smallest changes in the mean temperature will probably be accompanied by the most pronounced increases in human-perceived heatwaves. Our results suggest the urgent demand of reducing greenhouse gas emissions toward mitigating persistent thermal discomfort in the future. Although here we focused on eastern China, our approach to assessing heatwaves can also be readily generalized to address similar problems worldwide. [Display omitted] • Wet bulb globe temperature is a better metric than T max for human heat stress. • Heatwave characteristics are defined by wet bulb globe temperature in our work. • Human-perceived heatwaves increase more rapidly than temperature-based heatwaves. • Lower latitudes in eastern China will experience the most pronounced increase. [ABSTRACT FROM AUTHOR]

High yields, high stress resistance, and wide adaptability are important cultivar traits, especially for crops sensitive to the photoperiod and temperature. Mung bean (Vigna radiata) is a typical short-day plant, traditionally cultivated in Asian countries, and consumed all over the world. However, there has long been relatively little research regarding its genetic improvement until in recent decades. Zhonglv 5 is a mung bean cultivar that was developed via crossbreeding in China in the early part of this century. It has since played an important role in improving mung bean production in the country because of its high yields, high stress tolerance, and wide adaptability. We herein describe the development of Zhonglv 5, summarize its yield performance and adaptability in diverse eco-regions within China, and predict its potential future uses to provide information relevant for mung bean breeding, production, trade, and related industries. [ABSTRACT FROM AUTHOR]

Objective. The current study was designed to explore the effect of future orientation in mediating the relationship between traumatic events and mental health in children affected by HIV/AIDS in rural China. Methods. Cross-sectional data were collected from 1221 children affected by HIV/AIDS (755 AIDS orphans and 466 vulnerable children). Future orientation among children was measured using three indicators (future expectation, hopefulness toward the future, and perceived control over the future). Measures of mental health consisted of depression, loneliness, and self-esteem. Children's experience of any traumatic events was measured using a modified version of the Life Incidence of Traumatic Events-Student Form. Mediation analysis was conducted using structural equation modeling (SEM) methods. Results. Among the children surveyed, most of the traumatic indicators were negatively associated with future expectation, hopefulness, perceived control, and self-esteem, and positively associated with depression and loneliness. The SEM of mediation analysis demonstrated an adequate fit. Future orientation fully mediated the relationship between traumatic events and mental health and accounted for 67.9% of the total effect of traumatic events on mental health. Conclusions. Results of this study support the positive effect of future expectation in mediating the relationship between traumatic events and mental health among children affected by HIV/AIDS in China. Future mental health promotion and intervention efforts targeting children affected by HIV/AIDS should include components that can mitigate the negative impact of traumatic events on their lives. These components may aim to develop children' positive future expectations, increase their hopefulness toward the future, and improve their perceived control over the future. [ABSTRACT FROM AUTHOR]

To avoid more severe impacts from climate change, countries worldwide pledged to implement intended nationally determined contributions (INDCs) for emission reductions (as part of the Paris Agreement). However, it remains unclear what the resulting precipitation change in terms of regional extremes would be in response to the INDC scenarios. Here, we analyzed China's extreme precipitation response of the next few decades to the updated INDC scenarios within the framework of the Paris Agreement. Our results indicate increases in the intensity and frequency of extreme precipitation (compared with the current level) in most regions in China. The maximum consecutive five-day precipitation over China is projected to increase ~16%, and the number of heavy precipitation days will increase as much as ~20% in some areas. The probability distributions of extreme precipitation events become wider, resulting in the occurrence of more record-breaking heavy precipitation in the future. We further considered the impacts of precipitation-related extremes and found that the projected population exposure to heavy precipitation events will significantly increase in almost all Chinese regions. For example, for heavy precipitation events that exceed the 20 year baseline return value, the population exposure over China increases from 5.7% (5.1–6.0%) to 15.9% (14.2–16.4%) in the INDC-pledge scenario compared with the present-day level. Limiting the warming to lower levels (e.g., 1.5 °C or 2.0 °C) would reduce the population exposure to heavy precipitation, thereby avoiding impacts associated with more intense precipitation events. These results contribute to an improved understanding of the future risk of climate extremes, which is paramount for the design of mitigation and adaptation policies in China. [ABSTRACT FROM AUTHOR]

• The enhanced salinity-gradient solar pond with a nucleation matrix aids crystallization of lithium carbonate. • Influences of matrix materials and spatial distribution on crystallization of lithium carbonate were investigated. • Application of an enhanced salinity-gradient solar pond can improve crystallization efficiency of lithium carbonate. • A nucleation matrix should be made of tumbleweed or a nested three-dimensional space. The utilization of salinity-gradient solar ponds (SGSPs) to extract lithium from salt lake brine is one of the most direct and effective uses of solar energy. The Qinghai-Tibet Plateau in China is rich in unique solar energy resources, as well as various types of salt lakes with abundant lithium resources. Among them, Zabuye salt lake in Tibet is a typical lithium-rich carbonate salt lake, and it has successfully realized the industrialization of lithium extraction from brine for the first time by using the SGSP. In recent years, with the continuous improvement of lithium resource market, the demand for lithium has further grown. There are some bottleneck problems restricting the lithium carbonate production in the lithium extraction technology with traditional SGSPs, which must be overcome, such as the slower heating rate, smaller heating amplitude, longer production cycle, lower crystallization efficiency and so on. From the angle of green environmental protection and high-efficiency technology, this research focused on the temperature field and salinity field distribution of the traditional SGSP and the special crystallization behavior of lithium carbonate, and carried out experimental research on process optimization in Zabuye mining area. Based on the heterogeneous nucleation theory, the use of an enhanced SGSP with a nucleation matrix for assisting the crystallization of lithium carbonate was proposed. The change of crystallization behavior of lithium carbonate, the influence of matrix materials and the spatial distribution on the crystallization effect were investigated. The results show that the enhanced SGSP with the nucleation matrix has a significant effect of increasing the production of lithium carbonate, and the lithium mixed salt attached to the nucleation matrix is of a higher grade and a lower moisture content. The yield per unit area of lithium carbonate on the nucleation matrix made of the gauze and plastic net is equivalent to that on the slope and bottom of the solar pond, and the grade of lithium carbonate approaches 80 %. The yield per unit area of lithium carbonate on the nucleation matrix made of tumbleweed is about four times as much as is achieved with other materials and the crystallization exceeds expectations. It is concluded that the application of the enhanced SGSP with the nucleation matrix can improve the crystallization efficiency, the output and the grade of lithium carbonate to a certain extent and this optimization technique will provide an important theoretical basis and application support for green, efficient development of lithium resources from salt lake brine. [ABSTRACT FROM AUTHOR]

Based on 4 annual waves of data from a large sample of Chinese college students (N = 2,329, Mage = 18.40 years old, SD =.85; 63.10% females), this study examines the within-person and between-person effects in the association between problematic Internet use (PIU) and mental health issues. Results of analyses using the developmental equilibrium model (i.e., an autoregressive, cross-lagged panel model) demonstrate a reciprocal positive association between PIU and mental health issues consistently across waves. In contrast, results of analyses utilizing the random intercept, cross-lagged panel model (i.e., a model that can disaggregate within-person and between-person effects) indicate a unidirectional positive within-person effect from PIU to mental health issues (rather than the reverse) consistently over time, while controlling for the between-person effects that exist when comparing different individuals. Such findings highlight the importance of disaggregating within-person and between-person effects in understanding the nature of the temporal dynamics of the association between PIU and mental health. [ABSTRACT FROM AUTHOR]

Abstract Although affiliation with deviant peers is among the most salient risk factors for college students' maladjustment, few studies have examined the possible peer contagion processes for problematic Internet use and the underlying mechanisms explaining how peer factors may shape the development of problematic Internet use. Based on data from 2516 Chinese undergraduate students (mean age = 18.56 years, SD = 0.84; 38.16% female) across their four college years and utilizing lagged latent difference score analyses, this study tested a process model to elucidate how peer Internet overuse and peer pressure on Internet use may contribute to Chinese undergraduates' problematic Internet use via shaping their maladaptive cognitions over Internet use. Results indicated that peer Internet overuse predicted subsequent increases in students' peer pressure on Internet use, which in turn, were linked with students' elevated problematic Internet use via maladaptive cognitions over Internet use. This dynamic cascade process was robust even after considering a series of potential confounding variables and the prospective associations among the key variables of interest. Such findings shed light on the peer contagion processes for the development of Chinese college students' problematic Internet use, and provide empirical evidence supporting the call for integrating peer factors into prevention and intervention programs aimed at reducing the incidence and severity of college students' problematic Internet use. Highlights • Peer contagion processes for problematic Internet use were examined. • A latent difference scores model based on four annual waves of data were used. • Peer Internet overuse predicted Chinese college students' problematic Internet use. • Peer pressure was identified as a significant mediator. • Maladaptive cognitions was identified as a more proximal predictor. [ABSTRACT FROM AUTHOR]

Parenting behaviors play critical roles in the etiology of adolescents' problematic cellphone use (PCU). However, research on the associations between cellphone-specific parenting behaviors and adolescents' PCU still remains sparse. Moreover, the extant few studies have been over-reliant on variable-centered approaches, which fall short of adequately revealing the heterogeneity within the configurations of parenting behaviors and their implications for adolescents' PCU. Utilizing latent profile analyses with survey data from a nationwide representative sample of 8261 Chinese parent–adolescent dyads (M age = 12.86, SD = 1.75; 42.8% females), this study examined the configuration patterns of various cellphone-specific parenting behaviors and their relations with adolescents' PCU. Seven distinct profiles were identified: the " Ambivalent-Overcontrolling " (AMBO) profile, " Ambivalent-Controlling " (AMBC), " Ambivalent-Knowledgeable " (AMBK), " Acquaintance Monitoring " (AM), " Hands-on-Authoritative " (HAUTHE), " Allround-Authoritative " (AAUTHE), and " Authoritarian " (AUTHN). Adolescents in the "HAUTHE" group reported significantly lower levels of PCU than did those in the "AMBK" and "AAUTHE" groups, followed by the "AMBO," "AMBC," "AM," and "AUTHN" groups. Such results highlighted the utility of person-centered approaches in more fully revealing the underexplored heterogeneity in the configural patterning of cellphone-specific parenting behaviors and its implications for adolescents' PCU. Our findings also have practical insights. It is important to train parents with a variety of cellphone-specific parenting strategies and also educate them about the more adaptive combinations of such strategies in preventing and reducing adolescents' PCU. To tailor interventions to satisfy different families' unique needs, practitioners should attend to the variability in the configuration patterns of cellphone-specific parenting strategies across families. • Cellphone-specific parenting behaviors and adolescents' problematic cellphone use (PCU) were examined. • Survey data from a nationwide representative sample of 8261 Chinese parent–adolescent dyads were used. • Seven distinct profiles of cellphone-specific parenting behaviors were identified using the latent profile analyses. • Adolescents' PCU varies significantly across the identified latent profiles of parenting behaviors. [ABSTRACT FROM AUTHOR]

Background: Depression and suicidal ideation often co-occur in children and adolescents, yet they possess distinct characteristics. This study sought to identify the different related factors associated with depression and suicidal ideation., Methods: A nationwide cross-sectional survey collected data from Chinese children and adolescents aged 8 to 18 (N = 160,962; 48.91 % girls). The survey included inquiries about demographics, depression, suicidal ideation, anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, bullying, and being bullied. Fifteen machine learning algorithms were conducted to identify the different related factors associated with depression and suicidal ideation. Additionally, we conducted external validation on an independent sample of 1,812,889 children and adolescents., Results: Our findings revealed seven related factors linked to depression and six associated with suicidal ideation, with average accuracy rates of 86.86 % and 85.82 %, respectively. For depression, the most influential factors were anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, experience of bullying, and age. Similarly, anxiety, non-suicidal self-injury, perceived stress, internet addiction, academic burnout, and age emerged as paramount factors for suicidal ideation. Moreover, these related factors showed notable variations in their predictive capacities for depression and suicidal ideation across different subgroups., Conclusion: Anxiety emerged as the predominant shared factor for both depression and suicidal ideation, whereas the other related factors displayed distinct predictive patterns for each condition. These findings highlight the critical need for tailored strategies from public mental health service providers and policymakers to address the pressing concerns of depression and suicidal ideation., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The adsorption and desorption of phosphorus (P) in soil constitute a crucial internal cycle that is closely associated with soil fertility, exerting direct influence on the quantity, form, and availability of P within the soil. The vertical spatial variation characteristics of soil adsorption and desorption were investigated for the 0-100 cm soil layer in the northeast black soil region in this study. The maximum adsorption capacity (Qmax) and maximum adsorption buffer capacity (MBC) of black soil in the study area ranged from 313.8 to 411.9 mg kg-1 and from 3.1 to 28.8 L kg-1, respectively, within the soil layer of 0-100 cm depth, exhibiting an increasing trend with greater soil depth. The degree of P adsorption saturation (DPS) exhibited a contrasting trend with the variations in Qmax and MBC, ranging from 3.8% to 21.6%. The maximum desorption capacity (Dmax) and desorption rate (Dr) of soil P ranged from 112.8 to 215.7 mg kg-1 and 32.1% to 52.5%, respectively, while the readily desorbable P (RDP) in soil was within the range of 1.02 to 3.35 mg kg-1. Both Dmax, Dr, and RDP exhibited a decreasing trend with increasing soil depth before showing an upward trend. These research findings not only provide essential background data for the systematic investigation of soil P in the black soil region but also serve as a valuable reference for assessing soil quality in this area., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zhao 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.)

Objective: Childhood emotional maltreatment (CEM) has been widely linked to later affective symptoms. What still remains inadequately understood are the potential nuanced differences in the consequences of childhood emotional abuse (CEM-A) versus childhood emotional neglect (CEM-N) and the implicated mechanisms. Research with non-Western, clinical samples also remains scarce. Thus, we examined the associations of CEM-A and CEM-N with later affective symptoms among Chinese male drug users and tested impulsivity and psychological resilience as potential mediators and moderators., Method: Structural equation modeling analyses were conducted with survey data obtained from 239 Chinese male adult drug users who were in a rehabilitation center., Results: The mediating rather than the moderating hypotheses were supported. CEM-A was found to be positively associated with subsequent depressive and anxious symptoms through a positive association with impulsivity. In contrast, CEM-N was positively associated only with subsequent depressive symptoms via a negative association with psychological resilience. In addition, CEM-A was also found to be directly associated with later depressive and anxious symptoms., Conclusions: CEM may pose a threat to later affective well-being partly through contributing to intrapersonal vulnerabilities as well as compromising intrapersonal strengths. Differentiating CEM-A and CEM-N appears to be critical for revealing the understudied specificity and nuance that may be inherently within such effects. Drug use treatment services should sensitively attend to the affective sequelae of CEM. Interventions targeted at the modification of impulsivity and the facilitation of psychological resilience may be effective in diminishing the affective consequences of CEM among drug users. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Soluble suppression of tumorigenesis-2 (sST2) was reported to be associated with cognitive performance and risk of incident stroke. However, the impact of sST2 on cognitive function after ischemic stroke is unclear. We aimed to assess the association of sST2 and cognitive impairment at 3 months in acute ischemic stroke patients., Methods: Baseline plasma sST2 levels were measured in 619 ischemic stroke patients (mean age: 60.0 ± 10.5 years) from 7 participating hospitals of the China Antihypertensive Trial in Acute Ischemic Stroke. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to assess cognitive status. Cognitive impairment was defined as a MoCA score < 23 or MMSE score < 27. The association between sST2 and cognitive impairment was evaluated by logistic regression analysis., Results: 325 (52.5%) or 323 (52.2%) participants developed cognitive impairment according to MoCA or MMSE. After adjustment for age, sex, education, and other covariates, the odds ratio for the highest vs lowest quartile of sST2 was 2.38 (95% CI, 1.42-4.00) and 1.82 (95% CI 1.09-3.03) risk of cognitive impairment defined by MoCA and MMSE score, respectively. Incorporation sST2 into a model containing conventional risk factors significantly improved reclassification., Conclusions: Elevated plasma sST2 levels were significantly associated with post-stroke cognitive impairment.

Background and Purpose: Choline metabolism was suggested to play pathophysiological roles in nervous system and atherosclerosis development. However, little is known about the impacts of choline pathway nutrients and metabolites on poststroke cognitive impairment. We aimed to prospectively investigate the relationships between circulating choline, betaine, and trimethylamine N-oxide with cognitive impairment among acute ischemic stroke patients., Methods: We derived data from CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). Plasma choline, betaine, and trimethylamine N-oxide concentrations at baseline were measured in 617 participants. Cognitive impairment was evaluated using the Mini-Mental State Examination and the Montreal Cognitive Assessment. Reclassification and calibration of models with choline-related biomarkers were evaluated., Results: Plasma choline and betaine were inversely associated with cognitive impairment. Compared with the lowest tertile, adjusted odds ratios of Mini-Mental State Examination-defined cognitive impairment for participants in the highest tertiles of choline and betaine were 0.59 (95% CI, 0.39-0.90) and 0.60 (95% CI, 0.39-0.92), respectively. In addition, both choline and betaine offered incremental predictive ability over the basic model with established risk factors, shown by increase in net reclassification improvement and integrated discrimination improvement. There were similar significant relationships between choline and betaine with cognitive impairment as defined by the Montreal Cognitive Assessment. However, plasma trimethylamine N-oxide was only associated with cognitive impairment evaluated using the Mini-Mental State Examination; the adjusted odds ratio was 1.33 (95% CI, 1.04-1.72) for each 1-SD increment of trimethylamine N-oxide., Conclusions: Patients with higher choline and betaine levels had lower risk of cognitive impairment after ischemic stroke, supporting promising prognostic roles of choline pathway nutrients for poststroke cognitive impairment.

Background: To assess the potential incremental utility of multiple biomarkers reflecting several pathological pathways for the risk prediction of depression after stroke., Methods: We used data from the China Antihypertensive Trial in Acute Ischemic Stroke, and a panel of 13 circulating biomarkers were measured. The study outcome was depression (24-item Hamilton Depression Rating Scale score≥8) at 3 months after ischemic stroke. Logistic regression models were performed to evaluate the risk of depression associated with multiple biomarkers. Discrimination and risk reclassification for depression were analyzed., Results: Among 631 included ischemic stroke patients, elevated growth differentiation factor-15, anticardiolipin antibodies, antiphosphatidylserine antibodies and matrix metalloproteinase-9 were individually associated with increased risks of depression after stroke. The multiple biomarker analysis showed a clear gradient in the risk of depression with increasing numbers of elevated biomarkers, and multivariate adjusted odds ratio (95% confidence interval) of patients with 4 elevated biomarkers was 6.52 (2.24-18.95) compared with those without elevation in any of 4 biomarkers. The simultaneous inclusion of all 4 biomarkers to the conventional model significantly improved discrimination (C statistic increased from 0.702 to 0.748, P=0.004) and risk reclassification (net reclassification improvement 45.0%; integrated discrimination improvement 6.2%; both P<0.001) for depression after stroke., Limitations: We selected biomarkers that had previously been reported to be promising predictors of depression after stroke, while other novel biomarkers not tested might have additional predictive value., Conclusions: Simultaneously adding multiple biomarkers from several pathophysiological pathways to traditional risk factors provided substantial incremental utility of the risk stratification for depression after stroke., (Copyright © 2020. Published by Elsevier B.V.)

The Dulong nationality is one of the 5 smallest ethnic minorities in China. The suicide rate among people of the Dulong nationality is very serious. To address this issue, we conducted cross-sectional epidemiological studies on the prevalence of mental disorders in ethnic groups. Studying the unique situation of ethnic minorities can help us better understand their mental state and improve their quality of life.We conducted a cross-sectional epidemiological survey on a minority group in Southwest China. We used the cluster sampling method, and 2129 people were included in the study.The highest 1-month disorder prevalence was for alcohol dependence/abuse (4.16%), and the prevalence of lifelong mood disorders was 9.82%. The results of multivariate analysis showed that women faced a higher risk of mood disorders and anxiety disorders.This epidemiological survey of the prevalence of mental disorders in ethnic minorities in Southwest China provides a significant reference for mental health interventions for other ethnic minorities around the world.

Background and Aims: Previous studies on smartphone use motivation (SUM) and problematic smartphone use (PSU) have been limited in the utilization of regional samples of emerging adults (e.g., college students) and also in the foci on the direct association between SUM and PSU. To address such gaps, using data from a large, national representative sample of Chinese young adolescents and their parents this study examined the associations between adolescents' various types of SUM and their PSU, and also tested the potential mediating roles of smartphone use time (SUT) that adolescents spent on various activities in such associations., Methods: A nationwide representative sample of 8,261 Chinese adolescents (Mage = 12.86 years old, SD = 1.76; 42.6% females) and their parents (49% mothers) participated in this survey study., Results: Instrumental SUM (i.e., to expand knowledge or acquire information) was associated negatively with PSU via longer SUT spent on learning and shorter SUT spent on entertainment and communication. Self-expression SUM (i.e., to gain acceptance and recognition of others by maintaining or improving self-images) was associated with longer SUT spent on both learning and entertainment, which, in turn, predicted lower and higher levels of PSU, respectively. Last, hedonic SUM (i.e., to gain pleasure) was associated positively with PSU via longer SUT spent on entertainment and communication., Discussion: These findings contribute to the literature by adding greater specificity in our understanding of the implications of SUM and SUT in the etiology of PSU during the critical life stage of adolescence in a Chinese cultural context.

The cognitive disease consensus was prepared by panels of health and public representatives based on actual clinical practice in Geriatric Departments in Chinese hospitals and a systematic literature review. This consensus reflects the medical knowledge accumulated by those experts and provides information about professional medical care and advice. A multidisciplinary panel of specialists (neurologists, psychiatrists, and nursing specialists) reports an expert consensus on the medical knowledge accumulated from those experts and provides information about professional medical care and advice. The recommendations focus on the care and management of older adults with mild cognitive impairment, the objectives and methods of maintaining cognition and training, the assessments and measures of daily care for patients at different stages of dementia, the assessments and coping strategies for the behavioral and psychological symptoms of dementia, principles and suggestions for an appropriate living environment, arrangements for recreational activities, the care and management of patients with end-stage dementia, and suggestions for addressing stress in caregivers.

Background: Matrix metalloproteinase-9 (MMP-9), a key determinant of extracellular matrix degradation, might cause cerebral damage after stroke and be involved in the development of depressive symptoms. This study aimed to evaluate the association of serum MMP-9 levels and post-stroke depression (PSD).Methods and Results:Serum MMP-9 levels were determined in 558 acute ischemic stroke patients from 7 hospitals comprising the China Antihypertensive Trial in Acute Ischemic Stroke. We assessed depression status using the 24-item Hamilton Depression Rating Scale and defined PSD as a cutoff score of 8. Logistic regression was performed to estimate the risk of PSD associated with serum MMP-9. Discrimination and reclassification for PSD by MMP-9 were analyzed. A total of 222 (39.8%) stroke patients were categorized as PSD within 3 months. Serum MMP-9 concentrations were higher among PSD patients than those without PSD (658.8 vs. 485.7 ng/mL; P<0.001). The multiple-adjusted odds ratio (95% confidence interval) for the highest MMP-9 quartile compared with the lowest quartile was 4.36 (2.49-7.65) for PSD, and 1 standard deviation higher log-MMP-9 was associated with 68% (37-106%) increased odds of PSD. Adding MMP-9 to the conventional risk factors model substantially improved discrimination and reclassification for PSD (all P<0.05)., Conclusions: Elevated serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of PSD, suggesting an important prognostic role of MMP-9 for PSD.

Background: Antiphospholipid activity was reported to be increased in depressive patients, while the impact of antiphospholipid antibodies (aPLs) on post-stroke depression (PSD) is unclear. We aimed to investigate the associations of aPLs, including antiphosphatidylserine (aPS) and anticardiolipin (aCL) antibodies with depression after acute ischemic stroke., Methods: aPS and aCL were measured in 497 ischemic stroke patients recruited from 7 of 26 participating hospitals of China Antihypertensive Trial in Acute Ischemic Stroke. 24-item Hamilton Depression Rating Scale was used to evaluate PSD status at 3 months after stroke., Results: Compared with aPS-negative or aCL-negative, the adjusted odds ratios (ORs) [95% confidence intervals (CIs)] associated with aPS-positive or aCL-positive were 1.77 (1.07-2.92) or 2.06 (1.11-3.80) for risk of PSD. On continuous analyses, per 1-SD increment of aPS and aCL were associated with 29% (OR 1.29, 95% CI 1.06-1.58) and 30% (OR 1.30, 95% CI 1.06-1.60) increased risks for PSD, respectively. Adding aPLs to conventional risk factors models significantly improved risk reclassification for PSD (net reclassification improvement index = 21.87%, P = 0.016 for aPS; net reclassification improvement index = 32.24%, P = 0.0004 for aCL)., Limitations: aPLs levels were tested only at baseline without serial measurements, and we were unable to detect the association between aPLs changes and PSD., Conclusions: Higher aPS and aCL levels in the acute phase of ischemic stroke were associated with increased risk of 3-month PSD, suggesting that aPLs may play an important role in post-stroke depression prediction., (Copyright © 2019. Published by Elsevier B.V.)

Background and Aims: We aimed to evaluate the ability of multiple novel biomarkers representing several pathophysiological pathways to improve risk prediction of post-stroke cognitive impairment., Methods: We conducted a prospective multicenter study in 638 ischemic stroke patients with elevated blood pressure based on a random subsample from China Antihypertensive Trial in Acute Ischemic Stroke and measured 12 circulating biomarkers in these participants. Cognitive impairment was assessed at 3 months after stroke with definitions of Mini-Mental State Examination (MMSE) score <27 or Montreal Cognitive Assessment (MoCA) score <25., Results: According to MMSE score, 1 SD increase of rheumatoid factor (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.02-1.46), matrix metalloproteinase-9 (OR 1.47, 95% CI 1.22-1.77) and total homocysteine (OR 1.22, 95% CI 1.01-1.49) after log transformation was significantly associated with the risk of post-stroke cognitive impairment. The ORs associated with their simultaneously high levels were 4.89 (95% CI, 2.31-10.35; p trend <0.001) and 3.09 (95% CI, 1.60-5.98; p trend <0.001) for cognitive impairment and the severity of cognitive impairment, respectively. Adding these 3 biomarkers to conventional model significantly improved the risk prediction of cognitive impairment (C statistic 0.729 vs. 0.688, p = 0.004; net reclassification improvement = 33.67%, p < 0.001; integrated discrimination index = 4.61%; p < 0.001). Similar significant findings were observed when cognitive impairment was defined by MoCA score., Conclusions: Combination of rheumatoid factor, matrix metalloproteinase-9 and total homocysteine can improve the risk prediction of cognitive impairment among ischemic stroke patients with elevated blood pressure. Further studies are warranted to validate our findings and explore their roles as potential therapeutic targets., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The effect of serum rheumatoid factor (RF) on poststroke cognitive impairment remains unknown. We aimed to investigate the association of serum RF in the acute phase with cognitive impairment at 3 months after ischemic stroke onset., Methods: Our study was based on a random sample from the China Antihypertensive Trial in Acute Ischemic Stroke, a total of 582 patients from 7 of 26 participating sites of the trial with serum RF levels were included in this analysis. Cognitive impairment was defined as Mini-Mental State Examination less than 27 or Montreal Cognitive Assessment less than 25., Results: According to Mini-Mental State Examination score, the multivariate-adjusted odds ratio and 95% confidence interval of cognitive impairment for the highest tertile of serum RF was 1.79 (1.08-2.99) compared with the lowest tertile. Each standard deviation increase of log-transformed RF was associated with 33% (95% confidence interval: 7%-66%) increased risk of cognitive impairment, and a linear association between serum RF and risk of poststroke cognitive impairment was observed (P for linearity < .01). Adding log-transformed RF to a model containing conventional risk factors improved the predictive power for poststroke cognitive impairment (net reclassification improvement: 26.21%, P < .01; integrated discrimination index: 1.24%, P = .02). Similar significant findings were observed when cognitive function was defined by Montreal Cognitive Assessment score., Conclusions: Elevated serum RF levels in the acute phase were independently associated with 3-month cognitive impairment among ischemic stroke patients. Further studies are needed to replicate our findings and to clarify the potential mechanisms., (Copyright © 2019. Published by Elsevier Inc.)

Background: Optimal blood pressure (BP) levels during acute ischemic stroke have not been established. We studied associations between systolic BP trajectories during acute phase and subsequent clinical outcomes among patients with ischemic stroke., Methods: A total of 4,036 patients with acute ischemic stroke and elevated BP from the China Antihypertensive Trial in Acute Ischemic Stroke trial were included in this analysis. Three BPs were measured every 2 hours in day 1, every 4 hours during days 2 and 3, and every 8 hours thereafter until hospital discharge or death. Clinical outcomes were assessed at 3, 12, and 24 months. Latent variable mixture modeling was used to identify subgroups that share a similar underlying trajectory of systolic BP during the first 7 days after stroke onset. Logistic regression and Cox proportional hazards models were used to examine the associations between systolic BP trajectories and clinical outcomes during follow-up., Results: We identified 5 systolic BP trajectories of high, high-to-moderate-low, moderate-high, moderate-low, and low. Compared to participants in high trajectory, multiple-adjusted odds ratios (95% confidence interval) of all-cause mortality at 3 months for individuals in high-to-moderate-low, moderate-high, moderate-low, and low were 0.34 (0.15-0.77), 0.58 (0.32-1.04), 0.29 (0.15-0.56), and 0.56 (0.26-1.19), respectively. Likewise, the corresponding hazard ratios for all-cause mortality in 24 months were 0.66 (0.44-1.00), 0.74 (0.53-1.05), 0.45 (0.32-0.66), and 0.61 (0.40-0.93), respectively. Similar associations were observed for recurrent stroke and cardiovascular disease, and in both the intervention and control groups., Conclusions: Patients with moderate-low systolic BP during acute ischemic stroke had a lower risk of adverse clinical outcomes.

Eradication of Helicobacter pylori colonization has been reported to affect the progression of gastric cancer. A comprehensive literature search was performed from 1997 to 2017 using electronic databases. All randomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCT) evaluated the effect of H. pylori eradication on development of gastric cancer. Four RCTs and 9 non-RCTs were included (n = 40,740 participants; 321,269 person-years). Overall, H. pylori eradication therapy was associated with a significantly reduced risk of gastric cancer (incidence rate ratio (IRR) = 0.52, 95% confidence interval (CI): 0.41, 0.65). Results of mixed-effect Poisson regression meta-analysis were similar to those of traditional meta-analyses. In stratified analyses, the IRRs were 0.59 (95% CI: 0.41, 0.86) in RCTs and 0.48 (95% CI: 0.36, 0.64) in non-RCTs. The IRRs were 0.45 (95% CI: 0.34, 0.61) in patients and 0.63 (95% CI: 0.44, 0.90) in the general population. Moreover, the relative risk reduction was approximately 77% on the development of noncardiac gastric cancer with H. pylori eradication therapy in China. Attributable risk percentage and population attributable risk percentage for Chinese patients were 77.08% and 75.33%, respectively, and for Japanese patients were 57.80% and 45.99%, respectively. H. pylori eradication therapy reduces the risk of noncardiac gastric cancer development. The findings indicate the importance of early intervention with H. pylori eradication therapy from the perspective of epidemiology., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Internet addiction has been typically conceptualized as either a continuous construct or a dichotomous construct. Limited research has differentiated adolescents with problematic Internet use (PIU) from the Internet addiction group (IA) and/or nonproblematic Internet use group (NPIU) and examined the potential correlates. To fill this gap, based on data obtained from 956 Chinese adolescents (11-19 years, 47% male), this study examined if adolescents with PIU is a distinctive group from the IA and NPIU. This study also examined factors from different ecological levels that may differentiate among the three groups, including individual, parental, peer, and sociodemographic factors. Results indicated that IA, PIU, and NPIU differed significantly on scores of Young's Diagnostic Questionnaire (YDQ). Critical factors emerging from different ecological levels could differentiate between PIU and NPIU and between IA and NPIU. Such findings suggest that PIU may represent a distinct, intermediate group of Internet users. The potential theoretical and practical implications of identifying PIU were also discussed. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Introduction: The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain., Methods: We collected data from 3098 patients with AD in 81 representative centers across China and estimated AD costs for individual patient and total patients in China in 2015. Based on this data, we re-estimated the worldwide costs of AD., Results: The annual socioeconomic cost per patient was US $19,144.36, and total costs were US $167.74 billion in 2015. The annual total costs are predicted to reach US $507.49 billion in 2030 and US $1.89 trillion in 2050. Based on our results, the global estimates of costs for dementia were US $957.56 billion in 2015, and will be US $2.54 trillion in 2030, and US $9.12 trillion in 2050, much more than the predictions by the World Alzheimer Report 2015., Discussion: China bears a heavy burden of AD costs, which greatly change the estimates of AD cost worldwide., (Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Background: The impact of serum matrix metalloproteinases-9 (MMP-9) on cognitive impairment after ischemic stroke is unclear. We aimed to investigate the association between serum MMP-9 in the short-term acute phase of ischemic stroke and cognitive impairment at 3 months., Methods and Results: Our study was based on a subsample from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke); a total of 558 patients with serum MMP-9 levels from 7 of 26 participating sites of the trial were included in this analysis. Cognitive impairment severity was categorized as severe, mild, or none (Mini-Mental State Examination score, <23, 23-26, or ≥27, respectively; Montreal Cognitive Assessment score, <20, 20-24, or ≥25, respectively). Cognitive impairment was defined as a score of <27 for Mini-Mental State Examination or <25 for Montreal Cognitive Assessment. According to Mini-Mental State Examination score, 143 participants (25.6%) had mild cognitive impairment and 153 (27.4%) had severe cognitive impairment at 3 months. After adjustment for age, National Institutes of Health stroke score, education, and other covariates, the odds ratio for the highest quartile of serum MMP-9 compared with the lowest quartile was 3.20 (95% confidence interval, 1.87-5.49) for cognitive impairment. Multiple-adjusted spline regression model showed a linear association between MMP-9 levels and cognitive impairment ( P <0.001 for linearity). Sensitivity and subgroup analyses further confirmed these results. Similar significant findings were observed when cognitive impairment was defined by Montreal Cognitive Assessment score., Conclusions: Increased serum MMP-9 levels in the short-term phase of ischemic stroke were associated with 3-month cognitive impairment, independently of established risk factors., (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Background and Purpose: Antiphosphatidylserine antibodies (aPS) have been associated with the risk of ischemic stroke. However, it remains unclear whether aPS will influence clinical outcomes in patients with acute ischemic stroke., Methods: A total of 3013 patients with acute ischemic stroke recruited from 26 hospitals across China from August 2009 to May 2013 were included in the study The primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke. Secondary outcomes included death, major disability, recurrent stroke, and vascular events., Results: Composite outcome of death and major disability rates were 29.1% versus 23.9% in aPS-positive and aPS-negative groups. Compared with aPS-negative, adjusted odds ratios or hazard ratios (95% confidence interval) associated with aPS-positive were 1.35 (1.07-1.71), 1.63 (0.99-2.69), and 1.25 (0.98-1.59) for composite outcome of death or major disability, death, and major disability, respectively. For 1 interquartile range increase of aPS, the adjusted odds ratios or hazard ratios were 1.10 (1.01-1.20), 1.19 (1.05-1.35), and 1.05 (0.96-1.14), respectively. Adding aPS status to a model containing conventional risk factors improved risk prediction for composite outcome of death or major disability (net reclassification improvement index=11.3%, P=0.006; integrated discrimination improvement=0.2%, P=0.04). There was no significant association between aPS and risks of recurrent stroke and vascular events., Conclusions: We found that positive aPS increased risks of death or major disability at 3 months after an acute ischemic stroke, suggesting that aPS might be a prognostic marker for ischemic stroke., (© 2016 American Heart Association, Inc.)

The psychosocial wellbeing of the children affected by Acquired Immune Deficiency Syndrome (AIDS) receives growing international attention. However, limited data in this area are available in China, which hosts an estimate of 100,000 AIDS-orphaned children. The study aims to examine the relationship between perceived social support (PSS) and psychosocial wellbeing among children affected by AIDS. A cross-sectional survey was administered to 1,625 children (aged 6-18 years) in Henan Province, an area with a large number of HIV cases due to unhygienic commercial blood/plasma collection. Our sample included 296 double orphans (i.e., children who lost both parents to AIDS), 459 single orphans (children who lost one parent to AIDS), 466 vulnerable children (children living with HIV-infected parents) and 404 comparison children (children who did not experience HIV-related illness and death in family). Data suggest that vulnerable children reported the lowest level of PSS compared to AIDS orphans and comparison children. Level of PSS was significantly and positively associated with psychosocial wellbeing even after controlling for potential confounders. The study underscores the importance of providing social support and mental health services for children affected by AIDS in China.

Objective: To examine the effect of expectation-reality discrepancy in mediating the relationship between discrimination experience and quality of life (QOL) among rural-to-urban migrants in China., Methods: A cross-sectional survey was conducted among 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. QOL was measured using the Chinese version of the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF). The migrants were also asked to report their experience of being discriminated against in the urban areas (i.e., discrimination experience), and their perceived difference between premigratory expectation and postmigratory reality in the city (i.e., expectation-reality discrepancy). Structural equation modeling (SEM) method was employed to assess the mediation effect., Results: Discrimination experience not only had a direct significant negative effect on QOL among rural-to-urban migrants, but also had an indirect effect through expectation-reality discrepancy on their QOL. Migrants' expectation-reality discrepancy exerted a partially mediation effect in the relationship between discrimination experience and QOL., Conclusions: Health promotion and prevention programs in the future to improve migrants' QOL should pay more attention to reducing the discrimination against migrants as well as helping migrants to reduce discrepancy between premigratory expectation and postmigratory reality.

Purpose: To gather information on inter-relationships among risk factors affecting adolescent smoking for tobacco control in China, the world's largest tobacco producer and consumer., Method: Longitudinal data were collected six months apart in 2003 from 813 students in grades 7, 8, 10, and 11 from two schools in Beijing, China. Linear regression was used to assess both the direct effect from predictor variables (smoking among influential others, pro-tobacco media, and attitudes toward smoking) on cigarette use and the indirect effect mediated through the perceived smoking norms (percentage of smokers among peers)., Results: Among the 803 subjects (mean age of 15.5 years, SD = 1.7; 52.1% female), 18.3% of males and 1.7% of females smoked in the past 30 days. Smoking among influential others (best friends, father, mother, male teachers, female teachers, and adults in general) and perceived positive psychological and social rewards from smoking at baseline were associated with number of cigarettes smoked at follow-up, whereas exposure to pro-tobacco media was not significantly associated with smoking. The mediated effect was greater for adult smoking (70% to 90%) than for best friend smoking (11% to 16%)., Conclusion: Smoking among influential others and attitudes toward smoking influence adolescent smoking both directly and indirectly. The finding of the indirect effect mediated through perceived smoking norms expands our knowledge on smoking etiology. Effective adolescent smoking intervention programs in China need to include a component targeting adult smoking to reduce perceived smoking norms.