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In this mixed-method investigation, the researchers delved into the intricate dynamics underlying Chinese postgraduates' procrastination behavior, academic engagement, and self-confidence, unveiling a multifaceted interplay among these factors. Quantitative findings revealed an intermediate-high level of procrastination, particularly in relation to writing assignments, exam preparations, and weekly reading tasks, while attendance tasks and general school activities elicited lower procrastination levels. Further analysis elucidated a substantial negative correlation between procrastination behaviors and both academic engagement and self-confidence, indicating the pernicious influence of this pervasive phenomenon on students' academic experiences. Qualitative insights garnered through thematic analysis explicated the complex reasons behind procrastination, including being overwhelmed by intricate tasks, lack of genuine interest, competitive milieu, insecurities, distractions, cultural and familial pressures, and struggles with time management, prioritization, and perfectionism. Furthermore, inadequate mentorship and anxiety surrounding future career prospects emerged as significant contributors to procrastination. Evidently, this detrimental factor not only impeded postgraduates' academic immersion but also eroded their self-confidence, exacerbating the detrimental repercussions on their scholarly performance. Thus, the findings underscore the imperative for targeted interventions, encompassing mentorship, time management skills, and emotional support, to mitigate the deleterious effects of procrastination on Chinese postgraduates' academic engagement and self-confidence.

Conventional macrolide-lincosamide-streptogramin B-ketolide (MLSBK) antibiotics are unable to counter the growing challenge of antibiotic resistance that is conferred by the constitutive methylation of rRNA base A2058 or its G2058 mutation, while the presence of unmodified A2058 is crucial for high selectivity of traditional MLSBK in targeting pathogens over human cells. The absence of effective modes of action reinforces the prevailing belief that constitutively antibiotic-resistant Staphylococcus aureus remains impervious to existing macrolides including telithromycin. Here, we report the design and synthesis of a novel series of macrolides, featuring the strategic fusion of ketolide and quinolone moieties. Our effort led to the discovery of two potent compounds, MCX-219 and MCX-190, demonstrating enhanced antibacterial efficacy against a broad spectrum of formidable pathogens, including A2058-methylated Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, and notably, the clinical Mycoplasma pneumoniae isolates harboring A2058G mutations which are implicated in the recent pneumonia outbreak in China. Mechanistic studies reveal that the modified quinolone moiety of MCX-190 establishes a distinctive secondary binding site within the nascent peptide exit tunnel. Structure-activity relationship analysis underscores the importance of this secondary binding, maintained by a sandwich-like π–π stacking interaction and a water–magnesium bridge, for effective engagement with A2058-methylated ribosomes rather than topoisomerases targeted by quinolone antibiotics. Our findings not only highlight MCX-219 and MCX-190 as promising candidates for next-generation MLSBK antibiotics to combat antibiotic resistance, but also pave the way for the future rational design of the class of MLSBK antibiotics, offering a strategic framework to overcome the challenges posed by escalating antibiotic resistance. [ABSTRACT FROM AUTHOR]

The lived experience of tinnitus has biopsychosocial characteristics which are influenced by sociocultural factors. The main purpose of this study is to investigate how tinnitus affects people in their everyday life in China. A deductive qualitative analysis examined whether an a priori Western-centric conceptual framework could extend to an Asian context. A large-scale prospective survey collected patient-reported problems associated with tinnitus in 485 adults attending four major ENT clinics in Eastern and Southern mainland China. The evidence suggests that patients in China express a narrower range of problem domains associated with the lived experience of tinnitus. While 13 tinnitus-related problem domains were confirmed, culture-specific adaptations included the addition uncomfortable (a novel concept not previously reported), and the potential exclusion of concepts such as intrusiveness, loss of control, loss of peace and loss of sense of self. The sociocultural context of patients across China plays an important role in defining the vocabulary used to describe the patient-centred impacts of tinnitus. Possible explanatory factors include cultural differences in the meaning and relevance of certain concepts relating to self and in help-seeking behaviour, low health literacy and a different lexicon in Chinese compared to English to describe tinnitus-related problems. [ABSTRACT FROM AUTHOR]

Background: Edaravone dexborneol and dl-3-n-butylphthalide are two innovative brain cytoprotective drugs from China that have been approved and widely prescribed for acute ischemic stroke, and the cost of the two drugs are partially paid by the Chinese medical insurance system. This study aimed to investigate and compare the cost-effectiveness of edaravone dexborneol versus dl-3-n-butylphthalide for acute ischemic stroke from the Chinese healthcare system's perspective. Methods: A model combining a short-term decision tree model with 90 days and a long-term Markov model with a life-time horizon (40 years) was developed to simulate the cost-effectiveness of edaravone dexborneol versus dl-3-n-butylphthalide for acute ischemic stroke over a lifetime horizon. Since the absence of a head-to-head clinical comparison of two therapies, an unanchored matching-adjusted indirect comparison (MAIC) was conducted by adjusting the patient characteristics using individual patient data from pivotal phase III trial of edaravone dexborneol and published aggregated data of dl-3-n-butylphthalide. Health outcomes were measured in quality-adjusted life years (QALYs). Utilities and costs (Chinese Yuan, CNY) were derived from publications and open-access database. One-way and probabilistic sensitivity analyses were performed to evaluate the robustness of results. Results: Compared with patients in dl-3-n-butylphthalide arm, edaravone dexborneol arm was found to be cost-effective in 90 days and highly cost-effective as the study horizons extended. With a similar direct medical cost, patients in edaravone dexborneol arm slightly gained an additional 0.1615 QALYs in life-time. In the long term (40 years), patients in edaravone dexborneol arm and dl-3-n-butylphthalide arm yielded 8.0351 and 7.8736 QALYs with the overall direct medical cost of CNY 29,185.23 and CNY 29,940.28, respectively. The one-way sensitivity analysis suggested that the incremental cost-effectiveness ratio was most sensitive to the price of edaravone dexborneol and dl-3-n-butylphthalide. Conclusion: Edaravone dexborneol is a cost-effective alternative compared with dl-3-n-butylphthalide for acute ischemic stroke patients in current medical setting of China. [ABSTRACT FROM AUTHOR]

This research aims to explore petroleum resource distribution characteristics in the Yingen-Ejinaqi Basin and provide a basis for assessing the prospect of petroleum potential in the region. Based on recent and previous gravity and aeromagnetic data obtained in the basin, anomalies including regional and residual gravity and magnetic anomalies, various derivative anomalies, and anomalies in structure-enhancing filtering were determined using multiple techniques. By analysing gravity, magnetic, and seismic anomaly characteristics of existing typical oil and gas wells, the petroleum resource distribution was studied by combining such data with exploration results arising from wells where oil and gas have been discovered. The research shows that the distribution ranges of the sags revealed by seismic profiles correspond to those of negative residual gravity anomalies; the distribution ranges of rock masses identified in the sags along the seismic profiles show some correspondence to the positive residual magnetic anomalies. Analysis indicates that various sags corresponding to areas where negative residual gravity anomalies appear in the north and south of the basin are the primary and secondary favourable areas for oil and gas exploration in Mesozoic–Upper Palaeozoic strata. Therefore, breakthroughs in oil and gas exploration should be made by focusing on these sags in the region. The positive residual magnetic anomalies in the basin can reflect the distribution of concealed rocks in the region, while concealed rocks in sags are an important area for oil and gas exploration in igneous rocks in the basin. [ABSTRACT FROM AUTHOR]

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

A modified version of a seismic risk assessment method is presented that generalises original risk analytical processes, constructs interrelationships among hazard variables in pre-assign weight-based formats, and establishes priorities to address potentially vulnerable dams. The concerned parameter values contained in each component are labelled based on adjusted grading standards, respecting the regional difference in hydraulic structure attributes and safety acceptability ranges. The cascade dams in Dadu River, China, are selected to test the applicability of the proposed method. We systematically investigate potential seismic hazards to demonstrate the implications of earthquake on dam safety. The results indicate that the adapted parameter ranges correspond with the physical aspects of the dams and potential social-economic consequences in seismic-prone regions. Correspondingly, the hazard recognition levels accommodate their local near-source earthquake conditions. Moreover, the investigation guides local emergency services with warnings of potential dam damages and ensuing floods when encountering critical earthquake shaking. [ABSTRACT FROM AUTHOR]

A land resource asset (LRA) table is highly valued by the Chinese government for resource management. However, most of China's researches on LRA table focused on theoretical construction. The difficulty in obtaining data hinders the practice and promotion of existing methods, and it limits the selection of data for many practical studies. Thus, this study proposes a land value quantification (LVQ) model that is suitable for a large spatio–temporal scale background to solve the above problems. Based on this model, the LRA table in the middle reaches of the Yellow River was successfully compiled. The results indicated that: (1) the assets of regional land resources were in an unbalanced development state; (2) the LRAs in the middle Yellow River had changed frequently; (3) there were significant spatial differences in the distributions of various types of LRAs in the middle reaches of the Yellow River; and (4) topography and soil erosion were the main factors restricting optimal regional land resource spatial allocation. Based on the research findings, this study provides scientific policy recommendations for the optimal allocation and sustainable development of land resources in the middle reaches of the Yellow River. Moreover, the LVQ model proposed in this research provides a model reference for LRA accounting with large spatial and temporal scales in China and similar regions. [ABSTRACT FROM AUTHOR]

Reservoirs are susceptible to interference from inter-basin water transfer projects intended to relieve serious water shortages. The Central Route of the South-to-North Water Division Project in China has altered the hydrological conditions and water storage status of the terminal reservoir, the Miyun Reservoir, thereby affecting the flood control reliability in the Chaobai River Basin. In this study, a dual-objective five-reservoir operation model was developed, in which reservoir releases are obtained through piecewise linear operating rules. The model considers the flooding risks both downstream of the basin and in the Miyun reservoir area. A parameterization-simulation-optimization approach was employed to obtain the Pareto-optimal front, providing decision-makers with a list of optimal rule parameters to select and match their own risk preferences. All optimized rules could ensure safe operation during the designed floods to be expected once (or more than once) every thousand years. In contrast, the current flood operation schemes largely ignore the water transfer between basins but primarily concentrate on storing water from floods. Thus, the Miyun Reservoir, whose design return period is 1000 years, can easily become filled during a 100-year flood, impeding the system's flood control capacity. Compared to the operating rule optimized in this study, the current schemes result in a 10.5% higher upstream inundation loss and an unsatisfactory 17 million CNY of equivalent water transfer loss. [ABSTRACT FROM AUTHOR]

To explore trajectories of receptive and expressive vocabulary in Mandarin-speaking children under the age of 4 years, fitted with cochlear implants (CIs). Vocabulary trajectories were measured at baseline, 3, 6, and 12 months after implantation using the Chinese version of the MacArthur-Bates Communicative Development Inventory. There were 216 children with CIs in West China Hospital who took part and were divided into three groups based on age at first CI. Receptive and expressive vocabulary scores of the younger implantation group were significantly different from the older groups at baseline. After 12 months of implant use, there were no significant differences between all groups. Furthermore receptive vocabulary trajectories for all children with CIs were not significantly different from those of children with normal hearing. However, expressive vocabulary trajectories were poorer when compared to children with normal hearing. Significant differences were seen between receptive and expressive vocabulary in all age groups. This study suggests no differences in vocabulary trajectories in Mandarin-speaking children whether they received their first CI at 1, 2, or 3 years of age. It is important that clinicians convey realistic expectations about potential differences in receptive vs. expressive trajectories for Mandarin-speaking children fitted with CIs. [ABSTRACT FROM AUTHOR]

Antidepressant medications are widely used by patients with depression or a depressive disorder. In spite of a generally favorable safety profile of selective serotonin reuptake inhibitors or serotonin - norepinephrine reuptake inhibitors (SSRI/SNRI), several cases of a possible connection between SSRI/SNRI and hyponatremia have been reported. To describe the clinical characteristics of patients with hyponatremia after SSRI/SNRI exposure, and to examine the association between SSRI/SNRI exposure and the presence of hyponatremia in a Chinese population. A retrospective single-center case series study. We performed a retrospective evaluation of inpatients with SSRI/SNRI-induced hyponatremia from a single institution in China between 2018 and 2020. Clinical data were obtained through review of medical records. Patients who met the initial inclusion criteria but did not develop hyponatremia acted as controls. The study was approved by the Clinical Research Ethics Board of Beijing Hospital (Beijing, P.R. China). We identified 26 patients with SSRI/SNRI-induced hyponatremia. The incidence rate of hyponatremia was 1.34% (26/1937) in the study population. The mean age at diagnosis was 72.58 (±12.84) years, with a male: female ratio of 1:1.42. The duration between SSRI/SNRI exposure and the onset of hyponatremia was 7.65 (±4.88) days. The minimum serum sodium level was 2328.23 (±107.25) mg/dL in the study group. Seventeen patients (65.38%) received sodium supplements. Four patients (15.38%) switched to another antidepressant. Fifteen patients (57.69%) recovered by the time of discharge. There were significant differences in serum potassium, serum magnesium and serum creatinine level between the two groups (p < 0.05). The rate of use of sertraline was significantly higher in the study group compared with the control group (p < 0.05). This pattern was not found in other SSRI/SNRI (p > 0.05). The results of our study show that SSRI/SNRI exposure, in addition to hyponatremia, may also affect the level of serum potassium, serum magnesium and serum creatinine. A history of hyponatremia and exposure to SSRI/SNRI may be potential risk factors for the development of hyponatremia. Future prospective studies are needed to validate these findings. [ABSTRACT FROM AUTHOR]

The Jinsha River basin, full of hydropower resources, is the largest hydropower energy base in China. From 2005 to 2018, four giant cascade hydropower stations (Wudongde, Baihetan, Xiluodu, and Xiangjiaba) were built along the Jinsha River. The reservoir area of four hydropower stations involves 26 counties (districts). The ecological environment of the reservoir area has a close relationship with hydropower projects, and ecosystem service value is an important standard to measure the quality of the ecological environment. Taking the reservoir area formed by four cascade hydropower stations in Jinsha River (Jinsha River Reservoir Area, JRRA) as the research object, the essay analyzed the spatial and temporal pattern of ecosystem service value in the reservoir area in 2005, 2010, 2015, and 2018. The results showed that (1) The ecosystem service value of JRRA reached 94 billion yuan in 2018, and the forestland took the largest proportion of ecosystem service value, accounting for 46.93%, followed by grassland, water area, cropland, and unused land. (2) From 2005 to 2018, the total ecosystem service value in JRRA increased by 3.374 billion yuan, and the spatial pattern of ecosystem service value showed a spatial distribution characteristic of high in the middle and low on both sides, and the spatial distribution had significant positive autocorrelation. (3) Because the area of water increased a lot, the ecosystem service value of JRRA showed a trend of overall increase which mainly occurred in the 3-km buffer zone along the river. The results further proved that the implementation of hydropower projects could improve the ecosystem service function in the reservoir area and provide technical support for the sustainable utilization of land resources and ecological compensation in the reservoir area. [ABSTRACT FROM AUTHOR]

Background: Drug shortages significantly threaten public health and medical service provision worldwide. Research evidence on the complete picture of drug shortages is currently scant in China. This study aimed to provide a descriptive overview and a reference for alleviating of drug shortages in China. Methods: National and provincial lists of drug shortages issued in China from 2018 to 2021 were collected and summarized. The information on essential medicines, medical insurance drugs, emergency drugs, and volume-based purchasing drugs was then matched with a drug shortage list to analyse the characteristics, proportion and incidence of drug shortage on each list based on the analysis of information such as dosage form, shortage frequency, and Anatomical Therapeutic Chemical (ATC) classification of the drugs in shortage. Results: A total of 24 provinces issued drug shortages lists involving 408 drugs from 2018 to 2021. All 58 drugs in the national drug list were included on the provincial drug shortage list. Among all the drugs in shortage, the most significant shortage involved injections, accounting for 45.3% (185/408). Ninety-five drugs (23.3%) were in shortage 5 times (annual shortage > 1 time) or more in the provincial lists, and 199 drugs (48.8%) were on the shortage list only once. In terms of therapeutic property, nearly all categories of drugs had been reported in shortage, among which cardiovascular drugs, nervous system drugs, anti-tumor and immunomodulatory drugs, and blood and hematopoietic organ drugs accounted for more than 10%. There is no significant difference in drug shortage among economic regions. Comparing drugs in shortage and various lists, 81.9% (334/408), 51.0% (208/408) and 67.9% (277/408) fell on the National Medical Insurance Drug List, National Essential Medicines List, and WHO Model List of Essential Medicines, respectively, while the volume-based purchasing drugs accounted for 3.4% (14 drugs). The incidence of drug shortages on NEML, WHO Model List of Essential Medicines and medical insurance category A was significantly higher than that of medical insurance category B and volume-based purchasing drugs (P < 0.05). Of the Emergency Drugs List, 72.0% (36/50) also experienced shortages, significantly higher than all the above categories (P < 0.05). Conclusions: In China, drug shortages were severe and complicated. Drug shortages vary among economic regions but are not significant. In comparison, the national procurement pattern of volume-based drug purchasing may be conducive to alleviating the drug shortage problem. Collaboration of all partners was recommended to ensure the supply of clinically necessary drugs. [ABSTRACT FROM AUTHOR]

Background: To explore the sources of information on antireflux surgery for patients undergoing this surgery in China. Methods: Patients who underwent antireflux surgery in the Gastroesophageal Reflux Center of the Zhejiang Provincial People's Hospital from January 2016 to June 2021 were selected as survey subjects, and a questionnaire survey was conducted by telephone. Results: A total of 358 questionnaires were distributed, and 320 valid questionnaires were recovered, yielding a 89.4% completion rate. Among patients' sources of information about antireflux surgery, the media was the primary source (33.8%) followed by recommendations from relatives or friends (27.8%), referrals from physicians (23.4%) and other sources (15.0%). Patients of different ages and educational levels have different sources for obtaining information about the procedure. Most of the information on surgery for patients aged 20 to 49 years was derived from recommendations from friends or relatives, whereas most of the information on surgery for patients aged 50 to 80 years was obtained from the media. Most of the information on surgery for patients with a primary school education or less was derived from physicians' recommendations, whereas most of the information for patients with a junior secondary school education or higher was obtained from the media. The recommendation of patients for surgery varied among the different departments (X2 = 36.011, p < 0.001), and a two-to-two comparison found that the recommended rates for cardiology and gastroenterology differed from the rates of other groups (p < 0.001, Table 2). Conclusions: The results of this investigation show that a large number of patients who underwent antireflux surgery learned about the operation through the media and recommendations from relatives or friends rather than physicians at the hospital. Notably, physicians specializing in GERD need to increase their knowledge of the disease and surgical treatment options to provide correct medical information to patients and to conduct media campaigns. [ABSTRACT FROM AUTHOR]

Fish-livestock integrated farming is a traditional practice in South China and Southeast Asia. The administration of antimicrobial agents in livestock may potentially facilitate the spread of antimicrobial resistance to aquaculture through the drainage of livestock manure. Aeromonas spp. are fish pathogens that are the predominant bacteria in water bodies. The aim of this study was to characterize multiple-drug-resistantAeromonas spp. isolated from integrated and nonintegrated fish-livestock farms and to investigate the occurrence of class 1 integrons. Of the 481 Aeromonas strains examined in this study, isolates from pig manure, fish, and environmental samples from pig-fish or goose-fish integrated farms were significantly more resistant to various antimicrobial agents than those from nonintegrated farms P < 0.05 . High rates of resistance to nalidixic acid and sulfamonomethoxine were observed in the isolates from the integrated farm. Fifty Aeromonas isolates (10.4%) from integrated farms contained class 1 integrons. In addition, 96.0% (48/50) of the integron-positive strains displayed multiple-drug resistance. Ten types of gene cassette arrays were determined by sequencing, including dfrA17, dfrA12-orfF-aadA2, catB8, dfrB4-catB3-aadA1, aac6(6′)-Ib-cr-arr-3, aac-II-blaOXA-21-catB3, aar2-aacA4-drfA1-orfC, aac(6′)-Ib-cr, dfrA15, and dfrB4-catB3-blaOXA-10-aadA1. Notably, among the 50 integron-positive isolates, twenty isolates showed integrons located in plasmids, which may facilitate the transmission of resistance in integrated farms. Our investigation confirmed the high prevalence of multiple antimicrobial resistances mediated by class 1 integrons in Aeromonas isolates from integrated farms. Therefore, it is necessary to establish a risk assessment method for antimicrobial resistance in aquaculture. [ABSTRACT FROM AUTHOR]

Urbanization is one of the major threats to the dynamic inheritance of the agricultural heritage system (AHS). The ability to achieve sustainable development in intra-urban areas is an essential proposition related to the innovation of AHS conservation principles. The Haizhu high bed-low ditch agroecosystem (HHBLDA), a China-Nationally Important Agricultural Heritage System site located at the center of Guangzhou City, is taken as an example in this study. The effect of implementing the Land Acquisition to Keep Agricultural Use (LAKAU) on intra-urban AHS conservation is assessed through literature collection and review, field survey, and in-depth interviews. The results show that the LAKAU was implemented because of a three-decades-long struggle between ecological conservation and urban sprawl. Because of the important functions of ecosystem services, the AHS can coexist with urban land use in the course of rapid urbanization. The LAKAU mode can ensure that the nature of farmland remains unchanged, which is an effective strategy for the conservation of an urban AHS. The resulting problems, such as high operating costs, insufficient agricultural outputs, and insufficient local farmers in the AHS site because of off-farm opportunities, should be addressed by establishing an effective self-sustaining mechanism. Realizing the compatibility of management concepts between the AHS and nature reserves, adapting to the changing role of farmers, and strengthening the acceptance of the AHS by urban managers should attract the attention of decision-makers. [ABSTRACT FROM AUTHOR]

Objective: To explore the acceptability and influencing factors of an Internet-based Tinnitus Multivariate Integrated Sound Therapy (iT-MIST). The individually tailored sound therapy used narrowband noise centered on the patient's tinnitus frequency in combination with natural sounds and relaxing music. Design: Patients with tinnitus were given a 1-week trial of iT-MIST. Semistructured interviews were then carried out and a thematic analysis used to analyze, identify, organize, and report factors discovered in the data. Study Sample: Semistructured interviews were carried out with 11 participants, 2 women and 9 men, mean age 39.82 years. Results: The first theme identified from patient interview analysis was their motivation to undertake and expectations of iT-MIST. Nearly half of the participants indicated that advice from the physician was considered very important and professional. Benefits acknowledged by most participants from their iT-MIST experience were accessibility, convenience, time- and cost-effectiveness, and emotional benefit. However, a few participants with poor understanding of tinnitus and iT-MIST showed a negative acceptability with doubtful thoughts and complaints about technical issues such as being easily interrupted by messages and phone calls. Conclusion: Patients with tinnitus in this study were not universally accepting of the iT-MIST therapy. Concerns about their tinnitus and ability to comply with doctor's recommendations were the main influencing factors. Attitude or willingness to explore new therapies facilitated its use. Emotional benefits, for example, relaxation and comfort, were seen to sustain motivation, while doubtful thoughts and technical problems negatively affected acceptability. [ABSTRACT FROM AUTHOR]

With the rapid development of the automobile industry in recent years, China has become a big country of automobile production and consumption. The development of China's auto industry is currently at an important turning point, and accelerating the development of new energy vehicles has become a major national strategic measure. This research mainly discusses the energy-saving intelligent manufacturing optimization scheme of new energy vehicles. With the rapid growth of the global car ownership, from the perspective of sustainable development, the automobile industry must solve the four major automobile public hazards in the world: energy, pollution, safety and congestion. In view of this, the state regards energy-saving and new energy vehicles as the main strategic direction for the transformation and upgrading of China's automobile industry. This paper uses industrial engineering theory and lean management concept, and through the application of new intelligent manufacturing mode, realizes the design and manufacture of energy-saving and new energy vehicle lightweight body, and creates a reliable, comprehensive and feasible manufacturing collaborative management MES platform. It solves the problem of integration and interconnection of enterprise information platforms, realizes the intelligence and flexibility of stamping and welding automated production lines, shortens the development cycle, and meets the diverse needs of products. The first is to organize research on lean production theory, analyze the scope of application of theoretical tools, summarize theoretical tools suitable for lightweight intelligent manufacturing of automobiles, and provide theoretical support for lean and intelligent manufacturing research and on-site improvement; the second is to integrate and optimize the production process and process design through quantitative analysis and qualitative analysis, integrating theories such as production takt management and pull production, and analyze and study future on-site improvements, and discuss the lean path of smart factories; the third is to plan and design technical routes such as stamping and welding according to the process flow optimized by digital simulation, propose an overall solution for lean intelligent factory, analyze the advanced and innovative nature of the solution, and compare the comprehensive indicators with the expected goals, to evaluate the research results. During the research process, the energy consumption of output value was reduced by 8% than expected. This research helps to provide new ideas for intelligent manufacturing optimization of new energy vehicles. In the design of the program route of the intelligent manufacturing factory, the concept of lean production is introduced in the whole process, in order to provide a useful reference for similar enterprises in the industry in the application practice of intelligent manufacturing + lean production. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review and critically appraise the literature describing the phonetic characteristics and accuracy of the consonants, vowels and tones produced by Mandarin-speaking children with cochlear implants (CIs). The protocol in this review was designed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. EBSCOhost, PubMed, Scopus, PsycINFO, ProQuest Central databases were searched for relevant articles which met the inclusion criteria. A total of 18 journal papers were included in this review. The results revealed that Mandarin-speaking children with CIs perform consistently more poorly in their production of consonants, in particular on fricatives, have a smaller and less well-defined vowel space, and exhibit greater difficulties in tone realisation, notably T2 and T3, when compared to their normal-hearing (NH) peers. The results from acoustic and accuracy analyses are negatively correlated with CI implantation age, but largely positively correlated with hearing age. Findings of this review highlight the factors that influence consonant, vowel and tone production in Mandarin-speaking children with CIs, thereby providing critical information for clinicians and researchers working with this population. [ABSTRACT FROM AUTHOR]

In this paper, according to the characteristics of rock salt deposits and surrounding rock in the Ningjin area of Hebei, China, layered transfer theory and modified probability integral theory are used to conduct an in-depth study and quantitative evaluation of the surface deformation characteristics of the study area. The main conclusions are as follows: the calculation results of the layered transfer model show that as the cavity increases, the settlement of the center point of the surface increases from 59 to 227 mm in the range of 100–1500 m, and the maximum influence area of the surface reaches 1.30 × 107 m2. The calculation results of the modified probability integral theory model show that as the mined cavity increases, the settlement of the surface center point increases from 23 to 351 mm in the range of 100–1500 m, and the maximum surface influence area reaches 1.04 × 107 m2. The results of the two theoretical calculations accurately indicate the relationship between the mining cavern and the surface subsidence and the influence range of the surface, which has important guiding significance for the safe mining of Ningjin salt mines. [ABSTRACT FROM AUTHOR]

Conventional neural networks (NNs) have been extensively used to model the spatial heterogeneity of rock properties from seismic inversion. Nevertheless, these generic NNs have a single network structure, which leads to overfitting and convergence difficulties. Furthermore, for stable predictions, conventional NNs highly depend on the initial weights and bias values. This research focuses on resolving the key problems of the existing NNs. In this paper, we propose and apply a novel neural network based on a multilayer linear calculator (MLLC) to estimate seismic anisotropy and fracture porosity in structurally complex and deeply buried carbonate reservoirs. This method, unlike conventional NNs, develops a nonlinear projection relationship between seismic and well log parameters to predict the spatial variation of seismic anisotropy and fracture porosity. We evaluate inversion effectiveness further by optimizing the MLLC with the particle swarm optimization (PSO) algorithm. We evaluate this new kind of MLLC neural network using computer-based simulations of complex models. After verifying the model′s reliability, we used it to estimate anisotropy and fracture porosity in two case studies from separate regions of China. Focused on anisotropy and fracture porosity estimations, the MLLC neural network outperformed the conventional NNs using backpropagation (BP) neural networks in simulation and field studies. The results indicate that the proposed methodology is considered valid for the anisotropic and porosity prediction of fractured reservoirs in other basins in China with similar geological settings and analogous basins anywhere in the world. [ABSTRACT FROM AUTHOR]

The problem of algal bloom caused by eutrophication has attracted global attention. Many scholars have studied the problem associated with algae bloom, but few have carried out dynamic monitoring, instead focusing on the formation mechanism of cyanobacteria. For our study of the Taihu Lake in China, we used Moderate-Resolution Imaging Spectroradiometer (MODIS) and Landsat remote sensing image data from 2017 to establish a prediction model. First, we used MODIS data to retrieve the concentration of N, P, and chlorophyll a in water. Then, we applied the analytic hierarchy process (AHP) model to the inversion results to construct the diffusion potential index. Finally, we used C# to compile the cellular automata (CA) model. We found that the distribution of cyanobacteria predicted by our method was consistent with the algal bloom situation of Taihu Lake in 2017. The results showed that the method effectively predicts the dynamic transfer of cyanobacteria from outbreak to diffusion in a short period of time, which can help decision-makers monitor lake health. [ABSTRACT FROM AUTHOR]

Aim: The article presents the results of a study of psychological factors of consumer loyalty concerning electric vehicles. An electric scooter was used as an example of an electric vehicle. The study involved a total of 165 people in China and 150 people in Russia. The study aimed to compare the psychological characteristics of Russian and Chinese consumers based on their attitudes toward an innovative product such as the electric scooter. Hypotheses: (1) The identity of Russian and Chinese consumers and the perceived individuality of the product (electric scooter) differ significantly; (2) The proximity of the consumer's identity and the image of the product (electric scooter) enhances the positive attitude toward the product; (3) Risk strategies of consumer behavior of Chinese and Russians differ. Methods: The questionnaire included the scales: (1) "Measuring brand personality" by J. Aaker, (2) "Measuring consumer identity" elaborated by Morozova and Antononva, (3) The risk behavior scale by Vasilenko, Tkachenko. Results: (1) The first hypothesis was confirmed: there were revealed differences in the consumer behavior of the respondents of these two groups concerning in their self-perception, as well as in the perception of electric scooters. The Russians perceive an electric scooter as energetic, young, extravagant, modern, and unusual; the Chinese are down-to-earth, family-oriented, real. (2) The hypothesis that the correlation of the consumer's identity and the individuality of the product is one of the psychological factors that determine the consumer's loyalty to a product is also confirmed. (3) The Chinese consumers' identity is more close to the product individuality and their loyalty to the product is higher. (4) Risk strategies of consumer behavior of Chinese and Russians significantly differ in terms of satisfaction with choosing of vehicle, the frequency of its use, and the importance of family approval of the choice of vehicle. The results can be used in the marketing strategy development. From the scientifical perspective, these results contribute to an understanding of the consumer loyalty mechanisms associated with consumer identity. [ABSTRACT FROM AUTHOR]

In recent years, China's air quality problem is very serious. Among them, carbon dioxide emissions have been high, which has caused a series of ecological and environmental problems. In order to deeply study the relevant problems, this paper selects the information priority damping gray model to study and predict the carbon emissions of thirty-one provinces and municipalities in China. The model can give priority to new information and adjust the prediction trend, the accuracy of the model is verified by several cases. Through the data collection and data analysis of relevant provinces and cities, it is concluded that a total of twenty-one provinces and municipalities can reach the carbon peak in 2030, of which the carbon dioxide emission of Beijing is expected to drop to 51.3774 million tons by 2030. Ten provinces will not be able to reach the carbon peak by 2030. Among them, by 2030 the carbon dioxide emission of Jiangsu Province is expected to increase to 84.4668 million tons, but the growth rate is declining. The research results can be used as a reference for relevant departments. [ABSTRACT FROM AUTHOR]

High-intensity and large-scale resource development seriously threatens the fragile ecological environment in the red soil hilly region in southern China. This paper analyzes the eco-geological environmental problems and factors affecting Ganzhou, a mining city in the red soil hilly region, based on field survey and literature. The eco-geological environment quality (EGEQ) assessment system, which covered 11 indicators in physical geography, mining development, geological hazards, as well as water and soil pollution, was established through multi-source data utilization such as remote sensing images, DEM (Digital Elevation Model), field survey and on-site monitoring data. The comprehensive weight of each indicator was calculated through the Analytic Hierarchy Process (AHP) and entropy method. The eco-geological environment assessment map was developed by calculating the EGEQ value through the linear weighted method. The assessment results show that the EGEQ was classified into I-V grades from excellent to worse, among which, EGEQ of I-II accounted for 29.88%, EGEQ of III accounted for 32.35% and EGEQ of IV-V accounted for 37.77%; the overall EGEQ of Ganzhou was moderate. The assessment system utilized in this research provides scientific and accurate results, which in turn enable the proposal of some tangible protection suggestions. [ABSTRACT FROM AUTHOR]

Genomic loss of mismatched human leukocyte antigen (HLA loss) is one of the most vital immune escape mechanisms of leukemic cells after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the methods currently used for HLA loss analysis have some shortcomings. Limited literature has been published, especially in lymphoid malignancies. This study aims to evaluate the incidences, risk factors of HLA loss, and clinical outcomes of HLA loss patients. In all, 160 patients undergoing partially mismatched related donor (MMRD) transplantation from 18 centers in China were selected for HLA loss analysis with the next-generation sequencing (NGS)-based method, which was validated by HLA-KMR. Variables of the prognostic risk factors for HLA loss or HLA loss–related relapse were identified with the logistic regression or the Fine and Gray regression model. An HLA loss detection system, HLA-CLN [HLA chimerism for loss of heterozygosity (LOH) analysis by NGS], was successfully developed. Forty (25.0%) patients with HLA loss were reported, including 27 with myeloid and 13 with lymphoid malignancies. Surprisingly, 6 of those 40 patients did not relapse. The 2-year cumulative incidences of HLA loss (22.7% vs 22.0%, P = 0.731) and HLA loss–related relapse (18.4% vs 20.0%, P = 0.616) were similar between patients with myeloid and lymphoid malignancies. The number of HLA mismatches (5/10 vs <5/10) was significantly associated with HLA loss in the whole cohort [odds ratio (OR): 3.15, P = 0.021] and patients with myeloid malignancies (OR: 3.94, P = 0.021). A higher refined-disease risk index (OR: 6.91, P = 0.033) and donor–recipient ABO incompatibility (OR: 4.58, P = 0.057) contributed to HLA loss in lymphoid malignancies. To sum up, HLA-CLN could overcome the limitations of HLA-KMR and achieve a better HLA coverage for more patients. The clinical characteristics and outcomes were similar in patients with HLA loss between myeloid and lymphoid malignancies. In addition, the results suggested that a patient with HLA loss might not always relapse. [ABSTRACT FROM AUTHOR]

Background: Founder events have been observed among numerous plants and animal species living on oceanic islands due to the geographic separation of these islands and the small amount of original life they harbor. However, there has been little research on the ecological characteristics of pathogenic microorganisms on islands. Trichophyton rubrum ranks the most common isolated dermatophyte causing dermatophytosis in clinic and has become an epidemic strain worldwide in recent decades. Objective: To study the phylogenetic characteristics and the distribution pattern of genetic polymorphism of T. rubrum in China, which further provide theoretical basis for the prevention and control of T. rubrum. Methods: In the present study, we sequenced and analyzed the genetic characteristics of 204 T. rubrum isolates from Hainan Island and other sites in China. Phylogenetic analysis and genetic polymorphisms were studied based on a total of 41,409 high-quality whole-genome SNPs. Results: The majority of the isolates from Hainan Island clustered together. Mixed T. rubrum population differentiation was observed among the strains of different geographical origins. In addition, the genetic diversity (π) of the Hainan isolates was low and showed no significant difference from that of isolates from other sites. Conclusion: This study is the first to discuss general ecological and evolutionary principles related to pathogenic fungi. Our findings reveal a founder effect during the origination of T. rubrum on Hainan Island and provide guidance regarding prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Research on tight gas reservoirs in the eastern margin of the Ordos Basin, China, has recently become a hot spot. This paper mainly studies the reservoir characteristics of tight sandstone in the north-central area close to the provenance in eastern Linxing. Cast thin section, scanning electron microscopy, high-pressure mercury injection, and X-ray diffraction (XRD) were applied to discriminate the tight sandstone reservoir differences between the Permian Taiyuan and Shanxi formations in the study area. The results show that the deltaic tight sandstones in the Shanxi Formation are dominated by lithic quartz sandstone and lithic sandstone with an average porosity of 2.3% and permeability of 0.083 mD. The epicontinental tight sandstones in the Taiyuan Formation are mainly lithic sandstone and lithic quartz sandstone, with average porosities and permeabilities of 6.9% and 0.12 mD, respectively. The pore type is dominated by secondary dissolution pores, containing a small number of primary pores, and fractures are not developed. The capillary pressure curves of the Taiyuan Formation sandstone are mainly of low displacement pressure, high mercury saturation, and mercury withdrawal efficiency, while the Shanxi Formation sandstone is mainly of high displacement pressure, low mercury saturation, and withdrawal efficiency. The diagenetic evolution of sandstone in the Shanxi Formation is in meso-diagenesis stage A, and the Taiyuan Formation has entered meso-diagenesis stage B. The siliceous cement in the Taiyuan Formation sandstone enhanced the sandstone resistance to compaction and retained some residual intergranular pores. The pore types in the Shanxi Formation sandstone are all secondary pores, while secondary pores in the Taiyuan Formation sandstone account for approximately 90%. The results can be beneficial for tight gas production in the study area and similar basins. [ABSTRACT FROM AUTHOR]

Background: Part of tuberculosis (TB) patients were missed if symptomatic screening was based on the main TB likely symptoms. This study conducted to compare the yield and relative costs of different TB screening algorithms in active case-finding in the whole population in China.Methods: The study population was screened based on the TB likely symptoms through a face-to-face interview in selected 27 communities from 10 counties of 10 provinces in China. If the individuals had any of the enhanced TB likely symptoms, both chest X-ray and sputum tests were carried out for them furtherly. We used the McNemar test to analyze the difference in TB detection among four algorithms in active case-finding. Of four algorithms, two were from WHO recommendations including 1a/1c, one from China National Tuberculosis Program, and one from this study with the enhanced TB likely symptoms. Furthermore, a two-way ANOVA analysis was performed to analyze the cost difference in the performance of active case-finding adjusted by different demographic and health characteristics among different algorithms.Results: Algorithm with the enhanced TB likely symptoms defined in this study could increase the yield of TB detection in active case-finding, compared with algorithms recommended by WHO (p < 0.01, Kappa 95% CI: 0. 93-0.99) and China NTP (p = 0.03, Kappa 95% CI: 0.96-1.00). There was a significant difference in the total costs among different three algorithms WHO 1c/2/3 (F = 59.13, p < 0.01). No significant difference in the average costs for one active TB case screened and diagnosed through the process among Algorithms 1c/2/3 was evident (F = 2.78, p = 0.07). The average costs for one bacteriological positive case through algorithm WHO 1a was about two times as much as the costs for one active TB case through algorithms WHO 1c/2/3.Conclusions: Active case-finding based on the enhanced symptom screening is meaningful for TB case-finding and it could identify more active TB cases in time. The findings indicated that this enhanced screening approach cost more compared to algorithms recommend by WHO and China NTP, but the increased yield resulted in comparative costs per patient. And it cost much more that only smear/bacteriological-positive TB cases are screened in active case-finding. [ABSTRACT FROM AUTHOR]

In the context of global warming, people are paying more attention to environmental protection and sustainable development. Energy consumption intensity reflects the level of sustainable development to a certain extent. As the "world factory" and the important energy consumption market, China has good research value. China has added the index of energy intensity in the 14th Five-Year Plan, and plans to achieve the goal of reducing energy intensity by 13.5% compared with 2020 by 2025. The composite cumulative grey model(CGM(1,1)) was used to predict the total energy consumption and GDP of 30 provinces and municipalities in China. Then, it can be determined whether they can achieve the target by calculating the energy consumption intensity by 2025. Subsequently, the applicability and accuracy of the model were also verified through multiple cases. The research suggests that 23 provinces and municipalities can achieve the goal of reducing energy intensity by 2025. Among them, Inner Mongolia experienced the largest decline, with a decrease of 57.99%. The research results can provide reference for relevant departments. • The exponential accumulation grey multivariate convolution model is proposed. • China's natural gas consumption will account for 21.8% of the total domestic consumption by 2030. • China's natural gas consumption will account for 27.4% of the world. [ABSTRACT FROM AUTHOR]

Background: Adenylyl cyclase type 9 (ADCY9) modulates signal transduction by producing the second messenger cyclic AMP. It has been reported that ADCY9 gene polymorphisms were associated with cancer development. The aim of this study was to investigate whether ADCY9 gene polymorphisms could contribute to the susceptibility of hepatocellular carcinoma (HCC) in the Chinese Han population. Methods: In the present study, five single-nucleotide polymorphisms (SNPs) in ADCY9 were genotyped using Agena MassARRAY platform in 876 subjects from China. Logistic regression was used to assess the effects of SNPs on HCC risk. Associations were also evaluated for HCC risk stratified by age and gender. False discovery rate (FDR) was used to correct multiple testing. Results: After adjusting for age and gender, we found a significant relationship between heterozygous genotypes of rs2531995 and HCC risk (OR = 1.34, 95% CI = 1.01–1.77, p = 0.045). ADCY9 rs2230742 had a strong relationship with lower risk of HCC in allele (p = 0.006), co-dominant (p = 0.023), dominant (p = 0.010), and additive (p = 0.006) models. Stratified analysis showed that rs879620 increased HCC risk and rs2230742 was associated with lower risk of HCC in the individuals aged 55 or younger, rs2531992 significantly decreased HCC risk in the elder group (age > 55). For women, rs2230742 and rs2230741 were significantly associated with HCC risk in multiple models (p < 0.05). FDR analysis showed that rs2230742 could protect individuals from HCC risk in the allele model (FDR -p = 0.030). In addition, haplotype analysis indicated that Crs879620Ars2230742Ars2230741 haplotype was a protective factor for HCC (OR = 0.67, 95% CI = 0.50–0.89, p = 0.007, FDR -p = 0.028). Conclusion: Our findings suggest that ADCY9 gene polymorphisms are associated with HCC risk in the Chinese Han population. [ABSTRACT FROM AUTHOR]

Background: Early neurological deterioration (END) has been recognized as a serious neurological complication after acute ischemic stroke. However, to date, the WORSEN score was the only one scoring system specifically developed to detect END events in acute ischemic stroke patients. The purpose of this study was to investigate the WORSEN score's utility in China, and to determine the potential predictors of END in acute stroke patients. Methods: Consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Aerospace Center Hospital between March 2015 to February 2017 were recruited into the study's cohort and divided into two groups: patients with and without END. END was defined as either an increase in two or more NIHSS points, an increment of at least one point in motor power or a description of fluctuating of clinical symptoms in medical reports during the first 7 days after admission. Severe END was defined as an increase of NIHSS ≥ 4 points from baseline during the first 7 days after admission. Results: Three hundred fifty four patients with acute ischemic stroke were enrolled in the present study and 67.5% were male. END occurred in 90 of these patients and severe END occurred in 55 of these patients. Logistic regression analysis showed that an initial NIHSS score ≥8, diameter of infarction, striatocapsular infarction, and TOAST type of large arterial atherosclerosis were independent predictors for END. The area under the ROC curve (AUC) of the WORSEN score for the prediction of END was 0.80 (95%CI 0.75–0.84), with a sensitivity of 62.22%, a specificity of 88.26%, positive predictive values of 64.37% and negative predictive values of 87.27%. Meanwhile, the AUC of the WORSEN score for the prediction of severe END was 0.82 (95%CI 0.78–0.86), with a sensitivity of 70.91%, specificity of 83.95%, positive predictive values of 44.83% and negative predictive values of 94.01%. Conclusion: END is a relatively common neurological complication in patients with acute ischemic stroke. Our findings showed that the WORSEN score had a good predictive value for identifying patients with END in a Chinese population. Moving forward, multi-center studies are required for further validations [ABSTRACT FROM AUTHOR]

Background: Lipin-1, encoded by LPIN1 gene, serves as an enzyme and a transcriptional co-regulator to regulate lipid metabolism and mitochondrial respiratory chain. Autosomal recessive mutations in LPIN1 were recognized as one of the most common causes of pediatric recurrent rhabdomyolysis in western countries. However, to date, there were only a few cases reported in Asian group. This study aims to report the first pediatric case of recurrent rhabdomyolysis with a novel LPIN1 mutation in China mainland in order to raise the awareness of both pediatricians and patients.Case Presentations: Here we report a Chinese pediatric case of recurrent rhabdomyolysis with compound heterozygous variants (p.Arg388* and p.Arg810Cys) in the LPIN1 gene. The c.2428C > T was a novel missense variant involved Arg-to-Cys substitution at position 810 (p.Arg810Cys), located in the highly conserved region which predicted to be damaging by multiple algorithms. The patient manifested as cola-colored urine, muscle weakness and tenderness, as well as acute kidney injury with peak blood creatine kinase level 109,570 U/l in 19-month old. In his second episode of 9 years old, the symtoms were relatively milder with peak creatine kinase level 50,948 U/l. He enjoyed quite normal life between the bouts but slightly elevation of serum creatine kinase level during the fever or long-term exercises. Prolonged weight training combined with calorie deprivation were speculated to be the triggers of his illness. Prompt symptomatic therapy including fluid therapy and nutritional support was given and the patient recovered soon.Conclusions: LPIN1-related rhabdomyolysis is still quite new to physicians due to its seemly low-incidence especially in Asian countries. In the future, more active genetic test strategy and detailed prophylactic care education should be taken in patients with severe recurrent rhabdomyolysis, who are the high risk group of LPIN1 genetic defects. [ABSTRACT FROM AUTHOR]

It has been recognized that people with obesity are more likely to have low growth hormone secretion. Recent studies have also confirmed that the abnormalities of the growth hormone/insulin-like growth factor 1 axis were associated with cardiovascular complications in people with obesity. However, little is known about whether recombinant human growth hormone therapy could improve cardiovascular and metabolic risks in obese children. This study aims to evaluate the effect of one-year growth hormone therapy on obesity-related comorbidities and to assess the safety in Chinese boys with obesity. Eighteen boys with obesity were treated with recombinant human growth hormone for one year. Anthropometric measurements, endocrine testing, and cardiovascular risk markers were performed in all obese boys in baseline, and follow-up visits were performed at 3 months, 6 months, 9 months, and one year, respectively. After one year of recombinant human growth hormone treatment, the body mass index standard deviation scores decreased (P < 0.001) and insulin-like growth factor 1 levels increased (P < 0.001). GH treatment also reduced low density lipoprotein cholesterol (P < 0.001), total cholesterol (P < 0.001), triglycerides (P = 0.042), and alanine aminotransferase (P = 0.027) when compared with the baseline. One-year of recombinant human growth hormone treatment could improve cardiometabolic risk markers, without adverse effects on glucose homeostasis in boys with obesity. [ABSTRACT FROM AUTHOR]

Background: China is facing challenges of the shifting presentation of tuberculosis (TB) from younger to elderly due to an ageing population, longer life expectancy and reactivation disease. However, the burden of elderly TB and influence factors are not yet clear. To fill the gap, we generated a cohort study to measure the magnitude of TB incidence and associated factors among the elderly population aged 65 years and above in China. Methods: In this cohort established in 2013 through a prevalence survey conducted in selected sites, a total of 34 076 elderlies without TB were enrolled into two-year follow-up. We used both active and passive case findings to find out all TB patients among them. The person-year (PY) incidence rates for both bacteriologically positive TB and active TB were calculated. Cox proportional regression model was performed to test effect of risk factors, and the population attributable fraction (PAF) of each risk factor contributing to incident TB among elderlies was calculated. Results: Over the two-year follow-up period, a total of 215 incident active TB were identified, 62 of which were bacteriologically positive. The incidence rates for active TB and bacteriologically positive TB were 481.8 per 100 000 PY (95% CI: 417.4–546.2 per 100 000 PY) and 138.9 per 100 000 PY (95% CI: 104.4–173.5 per 100 000 PY), respectively. Incident cases detected by active case finding were significantly higher (P < 0.001). Male, non-Han nationality, previously treated TB, ex/current smoker and body mass index (BMI) < 18.5 presented as independent predictors for developing TB disease. For developing bacteriologically positive TB, the biggest contribution was from self-reported ex or current smoker (18.06%). And, for developing active TB, the biggest contribution was from non-Han nationality (35.40%), followed by male (26.80%) and age at 75 years and above (10.85%). Conclusions: Ageing population in China had a high TB incidence rate and risk to develop TB disease, implying that National TB Program (NTP) needs to prioritize for elderly. Active case finding should be applied capture more active TB cases among this particular population, especially for male, non-Han nationality, and those with identified risk factors. [ABSTRACT FROM AUTHOR]

Arbuscular mycorrhizal fungi (AMF) are considered to be natural biofertilizers because they provide the host with mineral nutrients, particularly phosphorus. However, there is insufficient information on AMF community compositions and their determining factors in pear orchard soils. In this study, hypotheses tested were that both soil characteristics and geographical distance influence the variation in AMF community composition. The community composition and diversity of AMF were examined using MiSeq sequencing in nine pear orchard soils in Jiangsu Province, China. Our data showed that a total of 108 operational taxonomic units (OTUs) were identified, with the majority belonging to Glomus (>90%). Nonmetric multidimensional scaling (NMDS) plots and PERMANOVA based on Bray-Curtis distance showed a clear separation of soil samples, suggesting significant dissimilarities in the AMF communities among the nine sampling sites. Distance-decay relationship (DDR) curves revealed that both geographical distance and soil chemical properties affect AMF community composition. Canonical correspondence analysis (CCA) and forward selection were used to examine the significance of environmental factors in more detail, and found that soil chemical properties and geographical distance correlated with AMF community composition. Particularly, pH, available phosphorus (AP) and Cu were the most significant soil properties that affected AMF communities. Partial CCA demonstrated that soil chemical properties exerted the primary influence on the assembly of the AMF communities in pear orchard soils, while geographical distance was less influential, which was supported by a partial Mantel analysis. Overall, we concluded that soil chemical properties and geographical distance were important parameters that affected AMF communities in Jiangsu Province, China, and the soils with moderate level of AP and low contents of heavy metals may preserve diverse AMF communities. • Glomus is the dominant group in pear orchard soils in Jiangsu Province, China. • Both soil properties and geographical distance affected AMF community composition. • Soil properties contributed to a greater degree than geographical distance. • pH, AP and Cu were the most important soil chemical properties affecting AMF communities. [ABSTRACT FROM AUTHOR]

The present study was carried out in the biggest tributary of Ussuri River of boundary between China and Russia. The Muling River basin has undergone a long-term dredging works, and waterbody became seriously turbid. The succession of phytoplankton functional groups succession and environmental factors in the river were sampled in 2015. We totally identified 83 species, belonging to 17 functional groups which 5 were predominant, including group F, M, MP, P and Y. The seasonal succession of phytoplankton functional groups was M/P-F/MP/P-MP/P. Results of Spearman correlation analysis and canonical correspondence analysis (CCA) revealed that phytoplankton functional groups were mainly influenced by nutrient concentrations and light availability including total nitrogen (TN), ammonium nitrogen (NH4+–N), nitrate nitrogen (NO3−–N), N:P ratio (N:P), water depth (D) and transparency (SD) in the basin. The concept of functional feeding groups was used to classify and reveal the seasonal variation of phytoplankton functional groups in relation to environmental parameters. Phytoplankton species were grouped into 17 functional groups that vary significant spatially and seasonally. The pattern of phytoplankton functional groups seasonal successions decided by the five predominant functional groups. Total nitrogen, ammonium nitrogen, nitrate nitrogen, N:P ratio, water depth and transparency were the major factor influencing phytoplankton community in this basin. [ABSTRACT FROM AUTHOR]

To investigate the risk factors of dapagliflozin-associated diabetic ketosis/ketoacidosis (DK/DKA) in patients with type 2 diabetes mellitus (T2DM). A case-control study was conducted in a general hospital in China from 2018 to 2021. T2DM patients who developed DK/DKA after dapagliflozin treatment were identified. Each patient in the DA/DKA group was matched with a patient in the non-DK/DKA group in terms of the baseline characteristics. Receiver operating characteristic (ROC) curve analysis and logistic regressions were performed. Out of 1,684 hospitalized patients taking dapagliflozin, 170 were diagnosed with dapagliflozin-associated DK/DKA. A total of 137 cases were matched with 137 controls. The mean time-to-onset (TTO) of DK/DKA was 28.59 days. Logistic regression showed that current drinking (OR = 7.656, p < 0.001), T2DM duration ≥ 7.625 years (OR = 2.399, p = 0.017), acute ST-elevations myocardial infarction (STEMI) (OR = 12.770, p = 0.028), acute infection (OR = 2.862, p = 0.043), insulin dose reduction/cessation before dapagliflozin exposure (OR = 6.751, p < 0.001), and a major plus or major operation (OR = 2.652, p = 0.022) were risk factors for dapagliflozin-associated DK/DKA. Furthermore, T2DM duration ≥ 7.625 years (p = 0.046) and acute STEMI (p < 0.001) were independently associated with more severe DK/DKA. Current drinking, long T2DM duration, STEMI, acute infection, insulin deficiency, and major operation are the risk factors associated with DK/DKA in T2DM patients. Furthermore, long T2DM duration and STEMI were associated with more severe DK/DKA situations. [ABSTRACT FROM AUTHOR]

Atmospheric nitrogen dioxide (NO 2) is an important reactive gas pollutant harmful to human health. The spatiotemporal coverage provided by traditional NO 2 monitoring methods is insufficient, especially in the suburban and rural areas of north China, which have a high population density and experience severe air pollution. In this study, we implemented a spatiotemporal neural network (STNN) model to estimate surface NO 2 from multiple sources of information, which included satellite and in situ measurements as well as meteorological and geographical data. The STNN predicted NO 2 with high accuracy, with a coefficient of determination (R2) of 0.89 and a root mean squared error of 5.8 μg/m3 for sample-based 10-fold cross-validation. Based on the surface NO 2 concentration determined by the STNN, we analyzed the spatial distribution and temporal trends of NO 2 pollution in north China. We found substantial drops in surface NO 2 concentrations ranging between 9.1% and 33.2% for large cities during the 2020 COVID-19 lockdown when compared to those in 2019. Moreover, we estimated the all-cause deaths attributed to NO 2 exposure at a high spatial resolution of about 1 km, with totals of 6082, 4200, and 18,210 for Beijing, Tianjin, and Hebei Provinces in 2020, respectively. We observed remarkable regional differences in the health impacts due to NO 2 among urban, suburban, and rural areas. Generally, the STNN model could incorporate spatiotemporal neighboring information and infer surface NO 2 concentration with full coverage and high accuracy. Compared with machine learning regression techniques, STNN can effectively avoid model overfitting and simultaneously consider both spatial and temporal correlations of input variables using deep convolutional networks with residual blocks. The use of the proposed STNN model, as well as the surface NO 2 dataset, can benefit air quality monitoring, forecasting, and health burden assessments. [Display omitted] • Spatiotemporal Neural Network predicts NO 2 with R2 = 0.89 of cross-validation. • High spatial coverage of surface NO 2 is achieved via residual networks. • Surface NO 2 dropped by 9.1–33.2% for megacities in the COVID-19 lockdown. • The NO 2 -related mortality is estimated at 28492 in north China in 2020. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper was to highlight the importance of cultural infl uence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and ' theories related to cross-culture ' is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the infl uence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed. [ABSTRACT FROM AUTHOR]

Background: China is a high tuberculosis (TB) burden country. More than half of acute TB cases first seek medical care in village doctors’ clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI) among village doctors in China. Methods and Findings: A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST) and QuantiFERON-TB Gold in-tube assay (QFT-GIT) was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs) for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03–2.04) and smoking (OR = 1.69, 95%CI 1.17–2.44). Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63–2.89), below college education (OR=1.42, 95%CI 1.01–1.97), and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12–2.39). The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39–4.97) and having BCG scar (OR = 0.53, 95%CI 0.28–1.00). Conclusions: Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Dramatic development and changes in lifestyle in many low and middle-income countries (LMIC) over the past three decades may have affected mental health of their populations. Being the largest country and having the most striking record of development, industrialization and urbanization, China provides an important opportunity for studying the nature and magnitude of possible effects.Methods: We reviewed CNKI, WanFang and PubMed databases for epidemiological studies of schizophrenia in mainland China published between 1990 and 2010. We identified 42 studies that reported schizophrenia prevalence using internationally recognized diagnostic criteria, with breakdown by rural and urban residency. The analysis involved a total of 2 284 957 persons, with 10 506 diagnosed with schizophrenia. Bayesian methods were used to estimate the probability of case of schizophrenia ("prevalence") by type of residency in different years.Findings: In urban China, lifetime prevalence was 0.39% (0.37-0.41%) in 1990, 0.57% (0.55-0.59%) in 2000 and 0.83% (0.75-0.91%) in 2010. In rural areas, the corresponding rates were 0.37% (0.34-0.40%), 0.43% (0.42-0.44%) and 0.50% (0.47-0.53%). In 1990 there were 3.09 (2.87-3.32) million people in China affected with schizophrenia during their lifetime. The number of cases rose to 7.16 (6.57-7.75) million in 2010, a 132% increase, while the total population increased by 18%. The contribution of cases from urban areas to the overall burden increased from 27% in 1990 to 62% in 2010.Conclusions: The prevalence of schizophrenia in China has more than doubled between 1990 and 2010, with rates being particularly high in the most developed areas of modern China. This has broad implications, as the ongoing development in LMIC countries may be increasing the global prevalence of schizophrenia. [ABSTRACT FROM AUTHOR]

• Sedimentological and geochemical variability indicate a range in depositional environments from distal to proximal facies for two sections. • Fe–Nd isotope variability is indicative of mixing between detrital and hydrothermal components for the iron formation. • The Cryogenian Fulu iron formation formed during an interglacial rather than synglacial period. Iron formations reappeared globally in the Cryogenian geological record associated with the Sturtian glaciation (ca. 720–660 Ma), and are interpreted to have been deposited during a critical period of extreme climate change that preceded the Ediacaran appearance of metazoans in the fossil record. The origin of Cryogenian iron formations has been hotly debated, as they have been variously interpreted as the products of submarine hydrothermalism related to tectonic activity or the oxidation of ferruginous seawater related to widespread ice cover during the "Snowball Earth" event. These end-member hypotheses have different implications for our understanding of seawater chemistry in the Cryogenian. The Cryogenian Fulu iron formation from South China is central to this debate as it can provide a test of the different genetic models for Cryogenian iron formations. In this study, we combine major and trace element data and Fe–Nd isotope systematics to constrain the genesis of the Fulu iron formation. We document geochemical variability within the Fulu iron formation and argue that this is caused by mixing between detrital and hydrothermal components. Further, we suggest that the sedimentology of the Fulu Formation is incompatible with a synglacial origin for the iron formation. A model of interglacial Fe2+ oxidation is proposed to account for the sedimentological and geochemical characteristics of the Fulu iron formation. In this model, the Fe2+-rich Cryogenian seawater was partially oxidized upon deglaciation, leading to the deposition of hematite-rich sedimentary layers with heavy Fe isotope compositions. Meanwhile, a significant amount of continental debris was delivered into the ocean via meltwater from deglaciation. This interglacial model is consistent with earlier models for Cryogenian iron formations but stands in contrast to more recent synglacial models. [ABSTRACT FROM AUTHOR]

Corallodiscus flabellatus is a medicinal plant commonly used in southwest of China. In this study, we sequenced the complete chloroplast (cp) genome sequence of C. flabellatus to investigate its phylogenetic relationship in the family Gesneriaceae. The chloroplast genome of C. flabellatus was 156,614 bp in length with 43.2% overall GC content, including a large single copy (LSC) region of 87,429 bp, a small single copy (SSC) region of 17,871 bp and a pair of inverted repeats (IRs) of 25,657 bp. The cp genome contained 112 genes, including 79 protein coding genes, 29 tRNA genes, and 4 rRNA genes. The phylogenetic analysis indicated C. flabellatus was closely related to Oreocharis mileensis. [ABSTRACT FROM AUTHOR]

Roscoea alpina is a medicinal plant commonly used in southwest of China. In this study, we sequenced the complete chloroplast (cp) genome sequence of R. alpina to investigate its phylogenetic relationship in the family Zingiberaceae. The chloroplast genome of R. alpina was 163,395 bp in length with 58.9% overall GC content, including a large single copy (LSC) region of 87,739 bp, a small single copy (SSC) region of 16,086 bp and a pair of inverted repeats (IRs) of 29,785 bp. The cp genome contained 113 genes, including 79 protein coding genes, 30 tRNA genes, and 4 rRNA genes. The phylogenetic analysis indicated Roscoea was closely related to Curcuma. [ABSTRACT FROM AUTHOR]

This research presents an evaluation of glacier recession and glacial-lake expansion in the Rongxer basin in the Mount Qomolangma National Reserve of central Himalaya. Changes in glacier and glacial-lake surface areas in the Reserve between 1975, 1992 and 2005 have been estimated using remote sensing and GIS techniques that have integrated field data from 2009, 1:50,000 scale topographic maps, ASTER satellite data from 2009, and Landsat MSS/TM images in 1975, 1992 and 2005. By 2005, the glacier surface area had declined from 596.52 to 451.58 km with a total area loss of 144.94 km, and glacial lakes had increased from 3.55 to 7.87 km, an increase of 121.69 %. The volume of glaciers was reduced by 69.99 km from 1975 to 2005. The observed changes in the extent of glaciers are in line with the observed atmospheric warming in the Rongxer basin. Records from the Tingri station and Nyalam station have revealed warming during the ablation season since the 1970s at a rate of 0.03-0.04 °C a in the northern and central Rongxer basin. At higher elevations in the study area, represented by the Tingri and Nyalam meteorological stations, the summer warming was accompanied by negative anomalies in annual precipitation since the 1970s, likely enhancing glacier retreat and glacial lake expansion. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR) is an independent risk factor for atherosclerosis or cardiovascular events and renal function impairment. The aim of this study was to investigate IR in children with primary nephrotic syndrome (NS). Methods: One-hundred and nineteen primary NS patients with normal renal function and 125 normal controls were studied. Fasting blood glucose, fasting serum insulin, and fasting serum C-peptide were measured. The Homa index of insulin resistance (HOMA-IR), Islet B cell function, and insulin sensitivity index were calculated. Correlations were assessed between HOMA-IR, fasting serum C-peptide, blood pressure, blood lipids, renal function, coagulation, clinical disease type, pathology and the early therapeutic effectiveness of high-dose glucocorticoids. Results: There was no evidence of IR in the primary NS group. Although levels of fasting blood glucose, fasting serum insulin and fasting serum C-peptide were all within the normal ranges, fasting serum C-peptide was significantly higher compared to the controls. There was no disorder of carbohydrate metabolism in different hormone therapy efficacy and pathological diagnosis. Although IR was not detected, a significant increase in blood pressure, uric acid, blood lipids and coagulability was observed in the primary NS group. Conclusion: A correlation observed between HOMA-IR, age, blood pressure, serum creatinine (Cr) and triglyceride may suggest that insulin sensitivity will emerge as renal disease progresses. Fasting serum C-peptide levels were increased in the primary NS group, suggesting that fasting serum C-peptide may be a protective factor. [ABSTRACT FROM AUTHOR]

Background: The World Bank Loan Project (WBLP) for controlling schistosomiasis in China was implemented during 1992–2001. Its short-term impact has been assessed from non-spatial perspective, but its long-term impact remains unclear and a spatial evaluation has not previously been conducted. Here we compared the spatial distribution of schistosomiasis risk using national datasets in the lake and marshland regions from 1999–2001 and 2007–2008 to evaluate the long-term impact of WBLP strategy on China's schistosomiasis burden. Methodology/Principal Findings: A hierarchical Poisson regression model was developed in a Bayesian framework with spatially correlated and uncorrelated heterogeneities at the county-level, modeled using a conditional autoregressive prior structure and a spatially unstructured Gaussian distribution, respectively. There were two important findings from this study. The WBLP strategy was found to have a good short-term impact on schistosomiasis control, but its long-term impact was not ideal. It has successfully reduced the morbidity of schistosomiasis to a low level, but can not contribute further to China's schistosomiasis control because of the current low endemic level. A second finding is that the WBLP strategy could not effectively compress the spatial distribution of schistosomiasis risk. To achieve further reductions in schistosomiasis-affected areas, and for sustainable control, focusing on the intermediate host snail should become the next step to interrupt schistosomiasis transmission within the two most affected regions surrounding the Dongting and Poyang Lakes. Furthermore, in the lower reaches of the Yangtze River, the WBLP's morbidity control strategy may need to continue for some time until snails in the upriver provinces have been well controlled. Conclusion: It is difficult to further reduce morbidity due to schistosomiasis using a chemotherapy-based control strategy in the lake and marshland regions of China because of the current low endemic levels of infection. The future control strategy for schistosomiasis should instead focus on a snail-based integrated control strategy to maintain the program achievements and sustainably reduce the burden of schistosomiasis in China. Author Summary: Schistosomiasis japonica is an important disease in China with a documented history of more than 2,100 years. The World Bank Loan Project (WBLP) implemented during 1992–2001 contributed greatly to China's schistosomiasis control. This study shows that the long-term impact of WBLP strategy on schistosomiasis control was not ideal. It can only maintain the morbidity of schistosomiasis at a low level, but can not reduce it further. Also, the WBLP strategy could not effectively compress the spatial distribution of schistosomiasis risk. To achieve further reductions in schistosomiasis-affected areas, and for sustainable control, focusing on controlling the intermediate host snail in the lake and marshland regions was suggested to be the next step to interrupt schistosomiasis transmission within the two most affected regions surrounding the Dongting and Poyang Lakes. While in the lower reaches of the Yangtze River, the WBLP's morbidity control strategy may need to continue for some time until snails in the upriver provinces have been well controlled. [ABSTRACT FROM AUTHOR]

Abstract: With the proposed low-carbon economy, there is growing concern about the impact of carbon emissions on global warming. China''s traditional manufacturing is a pillar industry of national economy and its carbon emissions account for a great proportion in the whole country''s carbon emissions. This paper makes a comparative analysis to study the differences between developing countries and china in energy consumption, energy consuming structure, energy consumption per unit of GDP and the proportion of carbon emissions in the world. It also studies the low carbon driving factors of China''s traditional manufacturing and proposes the corresponding countermeasures. [Copyright &y& Elsevier]