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Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM2.5 and its constituents with the risk of MAFLD and the dose–response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM2.5, SO42−, NO3−, NH4+, OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM2.5 and its constituents. Mixed exposure to SO42−, NO3−, NH4+, OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM2.5 and its constituents increased the risk of MAFLD. [ABSTRACT FROM AUTHOR]

Rural e-commerce has achieved an effective interface between rural specialty industries and large markets. This paper explores the impact of rural e-commerce on the income levels of potato farmers based on field survey data. In addition, the extent of the impact of rural e-commerce on the income levels of potato farmers in the participating and non-participating groups was further explored under the counterfactual assumption. The main findings are as follows. (1) Rural e-commerce can increase the income of potato farmers. Participation in rural e-commerce can increase farmers' income in both the participating and non-participating groups. If the participating group had not previously sold potatoes through rural e-commerce, their per capita household income would have been reduced by 27.22%. Similarly, if the non-participating group had sold potatoes through the rural e-commerce platform, their per capita household income would have increased by 36.35%. (2) Under the counterfactual assumption, the impact of rural e-commerce on the incomes of farmers who have not yet sold potatoes through e-commerce platforms is more profound. The marginal income increasing effect of rural e-commerce is currently at an incremental stage, and selling potatoes through an e-commerce platform can lead to higher returns for farmers. (3) Gender, farm household differentiation, self-employment experience, arable land area, position in village and whether participating in agricultural associations or cooperatives are important factors that simultaneously influence farmers' e-commerce participation decisions and income levels. Education and health level can influence farmers' e-commerce participation decisions. Age, farming years, dependency ratio and accessibility to irrigation can influence farmers' income level. [ABSTRACT FROM AUTHOR]

Studies have demonstrated that fine particulate matter (PM2.5) is an underlying risk factor for type 2 diabetes mellitus (T2DM), but evidence exploring the relationship between PM2.5 chemical components and T2DM was extremely limited, to investigate the effects of long-term exposure to PM2.5 and its five constituents (sulfate [SO42−], nitrate [NO3−], ammonium [NH4+]), organic matter [OM] and black carbon [BC]) on incidence of T2DM. Based on the "Jinchang Cohort" platform, a total of 19,884 participants were selected for analysis. Daily average concentrations of pollutants were gained from Tracking Air Pollution in China (TAP). Cox proportional hazards regression models were utilized to estimate the hazard ratios (HR) and 95% confidence interval (CI) in single-pollutant models, restricted cubic splines functions were used to examine the dose–response relationships, and quantile g-computation (QgC) was applied to evaluate the combined effect of PM2.5 compositions on T2DM. Stratification analysis was also considered. A total of 791 developed new cases of T2DM were observed during a follow-up period of 45254.16 person-years. The concentrations of PM2.5, NO3−, NH4+, OM and BC were significantly associated with incidence of T2DM (P-trend < 0.05), with the HRs in the highest quartiles of 2.16 (95% CI 1.79, 2.62), 1.43 (95% CI 1.16, 1.75), 1.75 (95% CI 1.45, 2.11), 1.31 (95% CI 1.08, 1.59) and 1.79 (95% CI 1.46, 2.21), respectively. Findings of QgC model showed a noticeably positive joint effect of one quartile increase in PM2.5 constituents on increased T2DM morbidity (HR 1.27, 95% CI 1.09, 1.49), and BC (32.7%) contributed the most to the overall effect. The drinkers, workers and subjects with hypertension, obesity, higher physical activity, and lower education and income were generally more susceptible to PM2.5 components hazards. Long-term exposure to PM2.5 and its components (i.e., NO3−, NH4+, OM, BC) was positively correlated with T2DM incidence. Moreover, BC may be the most responsible for the association between PM2.5 constituents and T2DM. In the future, more epidemiological and experimental studies are needed to identify the link and potential biological mechanisms. [ABSTRACT FROM AUTHOR]

Sediment trap efficiency (TE), defined as the sediment trapped in a reservoir divided by the sediment flowing into the reservoir, or the sediment delivery ratio (SDR=100%-TE), has been studied for small or ponded reservoirs, but for large reservoirs it is still not well understood even though it is important for predicting and managing reservoir sedimentation. In this case study, we analyzed the changes in water and sediment regime caused by the operation of two cascade dams (the Sanmenxia and Xiaolangdi Dams just upstream of the lower Yellow River) during 2000–2020. We found that more than 50% of the water discharge (Q) entering and flowing out of the reservoirs was smaller than 1,000 m3/s , while over 85% of the sediment was transported by larger discharges. Among different ranges of Q , the range 2,000–3,000 m3/s transported the most sediment (30%–50%). Due to the Water and Sediment Regulation Scheme of the dams, the maximum sediment concentration of floods tended to lag behind the maximum water discharge. The longer the lag time, the greater the water volume released to the downstream, resulting in a higher SDR of floods. A calculation method for the SDR at the Xiaolangdi Reservoir during floods and flood seasons was proposed by considering the water retention time in the reservoir. The sedimentation delta in the Xiaolangdi Reservoir changed rapidly after the dam closure and gradually became stable, and its geometric changes also impacted sediment transport through the reservoir. This study may shed light on sediment transport through large reservoirs under the operation of water and sediment regulation. [ABSTRACT FROM AUTHOR]

Since the 2008 Wenchuan (Ms. 8.0) Earthquake, the foreland rivers of the Longmen Mountains have suffered from significant bed degradation, among which the Shi‐ting River has experienced the largest local degradation of more than 20 m in 7 years. Potential reasons of the dramatic degradation include: (a) sediment disconnectivity due to in‐channel weirs; (b) the mobilization effect on gravel of an increased sand supply as a result of earthquake‐induced landslides; and (c) sediment extraction due to intensive mining. In this paper, we study the complex interaction among the above‐mentioned factors in the Shi‐ting River, using a one‐dimensional river morphodynamic model. Simulation results show that in‐channel weirs can reduce bedload transport and lead to bed degradation that is proportional to weir height. When coupled with additional sand supply, the weirs preferentially trap gravel and deliver sand, augmenting the downstream mobility of gravel and thus the degradation. For the Shi‐ting River, the simulated bed degradation agrees well with the observation when an annual sediment mining of 16 million tons is implemented in the simulation, along with the effects of in‐channel weirs and sand supply. The contribution of sediment mining is one order of magnitude larger than the coupling effect of weirs and sand supply. Both the simulation and observation show that the largest bed degradation occurs downstream of the Renmin Weir, due to the large spatial interval between the Renmin Weir and the next grade control structure. Key Points: Sediment mining is likely the key factor causing dramatic bed degradation in the Shi‐ting River, ChinaThis degradation was abetted, but not primarily caused by earthquake‐derived sand mobilizing gravel, as proposed previouslyWeirs preferentially trap gravel and deliver sand, which enhances the mobility of gravel by sand [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of temperature variability (TV) on admissions and deaths for cardiovascular diseases (CVDs). Method: The admissions data of CVDs were collected in 4 general hospitals in Jinchang City, Gansu Province from 2013 to 2016. The monitoring data of death for CVDs from 2013 to 2017 were collected through the Jinchang City Center for Disease Control and Prevention. Distributed lag nonlinear model (DLNM) was combined to analyze the effects of TV (daily temperature variability (DTV) and hourly temperature variability (HTV)) on the admissions and deaths for CVDs after adjusting confounding effects. Stratified analysis was conducted by age and gender. Then the attribution risk of TV was evaluated. Results: There was a broadly linear correlation between TV and the admissions and deaths for CVDs, but only the association between TV and outpatient and emergency room (O&ER) visits for CVDs have statistically significant. DTV and HTV have similar lag effect. Every 1 ℃ increase in DTV and HTV was associated with a 3.61% (95% CI: 1.19% ~ 6.08%), 3.03% (95% CI: 0.27% ~ 5.86%) increase in O&ER visits for CVDs, respectively. There were 22.75% and 14.15% O&ER visits for CVDs can attribute to DTV and HTV exposure during 2013–2016. Males and the elderly may be more sensitive to the changes of TV. Greater effect of TV was observed in non-heating season than in heating season. Conclusion: TV was an independent risk factor for the increase of O&ER visits for CVDs, suggesting effective guidance such as strengthening the timely prevention for vulnerable groups before or after exposure, which has important implications for risk management of CVDs. [ABSTRACT FROM AUTHOR]

Aims: Although community psychiatric rehabilitation plays an important role in returning persons with schizophrenia to the society, many patients in China stay in rehabilitation centers for longer periods of time and subsequently fail to integrate. This study is aimed to explore the underlying causes of this trend and identify possible solutions. Methods: This study used a qualitative descriptive design to examine the persons with schizophrenia who stay in rehabilitation centers for longer periods of time. The researchers conducted semi-structured telephone interviews with the patients recruited through purposeful sampling. The audio-recorded interviews were transcribed in transcripts in Chinese. Thematic analysis was performed using Colaizzi's 7-step method. Results: Most patients believe that they have gained knowledge, improved skills, friendship and social circles through community mental rehabilitation, with the sense of belonging and enriched life strongly attracting them to the rehabilitation centers. They felt that the difficulty of further integration into society is mainly because of social prejudice and rejection. In addition, the activities of community mental rehabilitation meet the needs of social communication, which also hinder patients from further entering the society. Conclusions: Persons with schizophrenia with long-term stay in community mental rehabilitation centers meet their friendship, sense of belonging and social needs by participating in rehabilitation activities. Providing special social opportunity for these patients can get them out of the rehabilitation center. Overall, it is possible for patients to gradually return to society in a collective form. [ABSTRACT FROM AUTHOR]

The frozen section (FS) diagnoses of pathology experts are used in China to determine whether sentinel lymph nodes of breast cancer have metastasis during operation. Direct implementation of a deep neural network (DNN) in clinical practice may be hindered by misdiagnosis of the algorithm, which affects a patient's treatment decision. In this study, we first obtained the prediction result of the commonly used patch-DNN, then we present a relative risk classification and regression tree (RRCART) to identify the misdiagnosed whole-slide images (WSIs) and recommend them to be reviewed by pathologists. Applying this framework to 2362 WSIs of breast cancer lymph node metastasis, test on frozen section results in the mean area under the curve (AUC) reached 0.9851. However, the mean misdiagnosis rate (0.0248), was significantly higher than the pathologists' misdiagnosis rate (p < 0.01). The RRCART distinguished more than 80% of the WSIs as a high-accuracy group with an average accuracy reached to 0.995, but the difference with the pathologists' performance was not significant (p > 0.01). However, the other low-accuracy group included most of the misdiagnoses of DNN models. Our research shows that the misdiagnosis from deep learning model can be further enriched by our method, and that the low-accuracy WSIs must be selected for pathologists to review and the high-accuracy ones may be ready for pathologists to give diagnostic reports. [ABSTRACT FROM AUTHOR]

Introduction: It is not clear whether serum uric acid (SUA) levels and their changes over time are associated with the risk of stroke. A 7-year prospective cohort study in northwest China was conducted to analyze effects of SUA and their changes on the risk of stroke. Methods: A total of 23,262 individuals without cardiovascular disease in the Jinchang cohort were followed up for an average of 5.26 years. The Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence interval (95% CI) of stroke incidence to SUA and relative changes in SUA. Sensitivity analysis was performed after controlling the effect of renal insufficiency. Results: Baseline SUA and relative changes in SUA were positively correlated with the incidence of stroke in both males and females (p for overall association <0.0001). Stroke risk increased by 4.6% per 10% increase in the relative change of SUA (HR = 1.046, 95% CI, 1.007–1.086). The fully adjusted regression analysis demonstrated that only the large gain (>30%) in SUA was associated with an increased risk of stroke by 36.5% (95% CI, 1.8–83.0%), compared with the reference group (participants within ±10% changes in SUA). The same trend was observed in people with normal baseline SUA. In the unadjusted model, the risk of stroke associated with elevated SUA was significantly higher in the hyperuricemia group than in the normal SUA group. Conclusion: High initial SUA concentration and an increase in SUA concentration over time would increase the risk of stroke, and this means that there is no safe increase in SUA. [ABSTRACT FROM AUTHOR]

Carbon emission of tourism transportation is one of the important factors leading to global climate change. It is of great social and economic significance to study the spatial differences and influencing factors of tourism transportation carbon emission. This paper takes 30 provincial administrative regions in China as the basic research units, then, based on the construction of measurement model for carbon emission of tourism transportation, and uses the spatial variogram, trend surface analysis and spatial measurement models, to explore the spatial and temporal pattern evolution and influencing factors of tourism transportation carbon emission. It is found as follows. 1) In the period of 2005 to 2018, the carbon emission of China's tourism transportation shows a continuous increase trend, in which the absolute difference of tourism transportation carbon emission increases gradually, and the relative difference shows the characteristics of periodic fluctuation. 2) The overall spatial differentiation of tourism transportation carbon emission is significant, showing a trend of decreasing from east to west. This is basically consistent with China's "strong east and weak west" tourism network pattern, the spatial characteristics of tourist passenger flow and direction which are along the main traffic trunks and aviation hubs. 3) There are spatial interactions and linkage effects in the carbon emissions of provincial tourism transportation in China. In general, the spatial difference tends to increase in the east-west direction, while the spatial differentiation in other directions is small. 4) The regional economic development level, the openness to foreign tourism and scale of tourists are the main factors leading to tourism transportation carbon emission. To a great extent, this has shaped the regional differentiation pattern of the carbon emission of China s tourism transportation, and the development level of service industry, tourism resource, energy intensity and energy structure have various degrees of inducing or inhibiting effects. [ABSTRACT FROM AUTHOR]

The prevalence of CRF07_BC is 39.7% and has become the most infectious HIV strain in China. To study the transmission and diffusion trajectory of CRF07_BC in China and to prevent further expansion of its transmission. A total of 16,635 sequences of the CRF07_BC pol gene were collected from 1997-2020. We characterized the gene subtypes according to a phylogenetic tree analysis. A 0.50% molecular network was constructed to analyze the transmission relationship among different provinces for CRF07_BC and its two epidemic clusters. Spatial and temporal propagation characteristics were analyzed according to phylogeographic analysis. Finally, we evaluated the differences in transmission of CRF07_BC-O, and CRF07_BC-N. Our dataset included 8,816 sequences of CRF07_BC-N and 7,819 sequences of CRF07_BC-O. There were 7,132 CRF07_BC sequences in the molecular network, and the rate of clustered was 42.9%. Compared to CRF07_BC-O, CRF07_BC-N showed significantly (P <0.001) higher transmission-specific rates. CRF07_BC originated among injecting drug users (IDUs), and spread to men who have sex with men (MSMs) and heterosexual individuals (HETs), while MSMs also transmitted directly to HETs. CRF07_BC-O and CRF07_BC-N were prevalent in Xinjiang and Sichuan, respectively, before spreading interprovincially. In modern China, CRF07_BC-N occurs in five of the major economic zones. The CRF07_BC strain, which has contributed to the highest number of HIV infections in China, is divided into two epidemic clusters. Compared with CRF07_BC-O, risk of transmission is much greater in CRF07_BC-N, which is predominantly prevalent in economically developed provinces, and both MSMs and IDUs have transmitted this epidemic cluster to HETs. High-resolution, large-scale monitoring is a useful tool in assessing the trend and spread of the HIV epidemic. The rapidly developing economy of China requires an equally rapid response to the prevention and control of infectious diseases. [ABSTRACT FROM AUTHOR]

Hibiscus latent Fort Pierce virus (HLFPV) is a tobamovirus with a few species of the family Malvaceae as its natural host. Here, we reported the identification of HLFPV in passion fruit (Passilora edulis) in China. The complete genome of the passion fruit isolate of HLFPV (HLFPV-LY) was determined. The genome consists of 6459 nucleotides and contains four ORFs, each encoding a protein of 128, 187, 38 and 18 kDa proteins, respectively. Sequence analysis indicates that HLFPV-LY shares more than 90% (the threshold value of the species demarcation for the genus) whole genome nucleotide sequence identity with five HLFPV isolates and an isolate of Abutilon yellow mosaic virus isolate (AbYMV-ah). Phylogenetic analysis indicates that HLFPV-LY clustered together with the five HLFPV isolates and AbYMV-ah. Taken together, our results suggest that HLFPV-LY and AbYMV-Ah are isolates of HLFPV. To our knowledge, this is the first report of HLFPV infecting passiflora plants and the complete genome sequence of an isolate of Hibiscus latent Fort Pierce virus infecting P. edulis in China. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to screen serum proteins for biomarkers of gestational diabetes mellitus (GDM) and to investigate its pathogenesis by analyzing the differences in serum proteomics between pregnant women with GDM and healthy pregnant women. Methods. Patients who were admitted to the First Affiliated Hospital of Fujian Medical University from June 2019 to January 2020 were included. According to the medical history and the results of the 75 g oral glucose tolerance test (OGTT), they were divided into the normal pregnant women group and GDM pregnant women group. The serum of two groups of patients was collected. High performance liquid chromatography-mass spectrometry was used to identify differentially expressed serum proteins between pregnant women with GDM and healthy pregnant women, and bioinformatics analysis was then performed on the identified proteins. Results. A total of 1152 quantifiable proteins were detected; among them, 15 were upregulated in serum of GDM pregnant women, while 26 were downregulated. The subsequent parallel reaction monitoring (PRM) assay validated the expression levels of 12 out of 41 differentially expressed proteins. Moreover, bioinformatics analysis revealed that the differentially expressed proteins are involved in multiple biological processes and signaling pathways related to the lipid metabolism, glycan degradation, immune response, and platelet aggregation. Conclusions. This study identified 41 serum proteins with differential expression between pregnant women with GDM and healthy pregnant women, providing new candidate molecules for elucidating GDM pathogenesis and screening therapeutic targets. [ABSTRACT FROM AUTHOR]

Some studies suggested that 24-h temperature change (TC24) was one of the potential risk factors for human health. However, evidence of the short-term effect of TC24 on outpatient and emergency department (O&ED) visits and hospitalizations for cause-specific cardiovascular diseases (CVDs) is still limited. The aim of this study is to explore the short-term effects of TC24 on O&ED visits and hospitalizations for CVDs in northwest China which is an area with large temperature variation. The O&ED visits records for CVDs of 3 general hospitals and the inpatient records for CVDs of 4 general hospitals were collected from January 1, 2013, to December 31, 2016, in Jinchang City, northwest China. Meteorological and air pollution data were also obtained during the same study period from local meteorological monitoring station and environmental monitoring station, respectively. A generalized additive model (GAM) with Poisson regression was employed to analyze the effects of TC24 on O&ED visits and hospitalizations for CVDs. V-shaped relationship were found between TC24 and O&ED visits and hospitalizations for CVDs, including total CVD, hypertension, coronary heart disease (CHD) and stroke. Stratified analysis showed that men and patients over 65 years old were more susceptible to temperature changes. The estimates in non-heating months were higher than in full year. TC24 can affect the O&ED visits and hospitalizations for CVDs in this study. This study provides useful data for policy makers to better prepare local responses to the impact of changes in temperature on population health. [ABSTRACT FROM AUTHOR]

Although the story continuation writing task (SCWT) has attracted much research attention, few studies have investigated the construct of the task, particularly with respect to which language competence it focuses on. In addition, although some studies have demonstrated that China's Standards of English Language Ability (CSE) provides comprehensive insights into the development of Chinese learners' English language proficiency, little research has investigated the relationship between CSE and SCWT. This study drew upon the CSE to develop an SCWT language use inventory to address the above research gaps. A total of 358 high school students were asked to complete the questionnaire, of which 277 valid responses were analyzed. Exploratory factor analysis (EFA) on the CSE-based questionnaire revealed the presence of six factors, namely language correctness, language variety, task planning, connecting-and-generating, selecting-and-mining, and organizing. The strategy of connecting-and-generating was the only significant predictor of the learners' SCWT scores. The paper also discusses the findings relating to the SCWT rating and other integrated writing tasks. [ABSTRACT FROM AUTHOR]

The relationship between outdoor temperature and blood pressure (BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season. A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011–2015 were included in the study. A linear mixed-effect model and generalized additive mixed model (GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables. The mean differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between summer and winter were 3.5 mmHg and 2.75 mmHg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mmHg (95% CI : 0.27–0.30) per 1 °C decrease in average temperature for SBP and a 0.16 mmHg (95% CI : 0.15–0.17) per 1 °C decrease in average temperature for DBP, respectively. The effects of the average temperature on both SBP and DBP were stronger in summer than in other seasons. The effects of the average temperature on BP were also greater if individuals were older, male, overweight or obese, a smoker or drinker, or had cardiovascular diseases (CVDs), hypertension, and diabetes. This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics (age, gender, BMI), unhealthy behaviors (smoking and alcohol consumption), and chronic disease status (CVDs, hypertension, and diabetes). [ABSTRACT FROM AUTHOR]

To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy. This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018. Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older (RR : 1.13, 95% CI : 1.08–1.18), had higher education (RR : 1.71, 95% CI : 1.53–1.92), and were residing in urban districts (RR : 1.06, 95% CI : 1.01–1.11) of FA supplementation; female pregnancy planners with alcohol consumption (RR : 0.95, 95% CI : 0.90–0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level (RR : 1.04, 95% CI : 1.03–1.06), who underwent pre-pregnancy examination (RR : 1.02, 95% CI : 1.01–1.03) had higher odds of using an FA supplement; older aged (RR : 0.99, 95% CI : 0.98–0.99), and multigravida (RR : 0.97, 95% CI : 0.96–0.98) had lower odds of FA supplementation. Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation. [ABSTRACT FROM AUTHOR]

A potyvirus (isolate PFV-FJ) infecting passion fruit in China was identified by small-RNA sequencing. The complete genome sequence of PFV-FJ was determined to be 9974 nucleotides, excluding the poly(A) tail. PFV-FJ shares 70–72% nucleotide and 69–74% amino acid sequence identity at the polyprotein level with seven reported potyviruses, but 89% nucleotide and 91% amino acid sequence identity with an unreported potyvirus, tentatively named "passionfruit Vietnam potyvirus" (PVNV-DakNong). This suggests that PFV-FJ and PVNV-DakNong should belong to the same potyvirus species and that PFV-FJ is a new member of the genus Potyvirus. This new potyvirus was tentatively named "passion fruit severe mottle-associated virus". [ABSTRACT FROM AUTHOR]

Microplastics (MPs) are a major global issue in the marine environment, and fish inhabiting coastal environments are susceptible to the ingestion of MPs. Knowledge regarding MPs in fish along the coast of China is very limited. In this study, the characteristics and retention of MPs in 19 fish species in the Yellow Sea were systematically studied. MPs were detected in all of the fish species sampled. Overall, 34% (444/1320) of fish retained plastic, and 552 pieces of plastic were removed from these fish, among which 546 pieces (99%) were microplastics (i.e., <5 mm). Three MP types were found: fibers, pellets, and fragments, which accounted for 67%, 22%, and 11% of the total, respectively. MP length ranged from 16 to 4740 μm, with an average of 941 ± 43 μm. The average lengths of the fibers, pellets, and fragments were 1233 ± 57 μm, 263 ± 24 μm, and 503 ± 91 μm, respectively, and MP length was positively correlated with fish length. Fourteen polymers were detected, with organic oxidation polymers (40%) being most abundant, followed by polyethylene (22%) and polyamide (11%). The retention of MPs in fish was affected by sampling areas and fish weight. Fish collected from the area adjacent to the Bohai Sea and the Yangtze River Estuary were found to possess higher levels of MPs than those collected from the center of the Yellow Sea. The average MP/fish for fish with plastic was negatively correlated with fish body weight. The retention of MPs may affect the quality and quantity of fishery resources in the Yellow Sea, especially the commercial fish. It is suggested that future studies be conducted to determine the ingestion rate, retention time, and egestion rate of MPs by fish to enable a rational risk assessment by combining the field results. Image 1 • A moderate level of microplastic abundance was found in fish from the Yellow Sea. • The dominant MPs in fish from the Yellow Sea were fibers. • The chemical compositions of MPs were diverse, with high density plastics dominant. • Larger fish tended to retain larger MPs, but showed lower amounts of MP/fish. • Fish from areas with heavier human activities showed higher MPs retention. [ABSTRACT FROM AUTHOR]

Background: The healthcare system (HCS) improved in Tibet Autonomous Region (TAR), China. The present study aimed to investigate whether these improvements might alter the clinicopathological characteristics of a Tibetan female with breast cancer (BC) in TAR.Methods: This was a single-center cross-sectional study conducted at TAR People's Hospital. All Tibetan adult women were treated for BC in this hospital between January 1, 1973 and December 31, 2015. The inclusion criteria were as follows: (1) Tibetan adult woman living in Tibet; (2) Histopathology or cytopathology or both confirming primary BC; (3) All the treatments were finished in this hospital. χ2 test and logistic regression were applied, using age group and census register as the two covariates.Results: A total of 273 patients with BC were included in the final analysis. Of these, 14 patients were in the free HCS, 183 patients had medical insurance combined with a new rural cooperative HCS, and 76 were in a rural and urban integration HCS. Currently, a rural and urban integration HCS is an improved system. Consequently, an increase in the proportion patients in the T1-3 stage was observed (0.198; 0.046 to 0.852) between the rural and urban integration HCS and free HCS. The proportion of patients in early (I + II) stage cancer (0.110; 0.019-0.633) also increased between these two HCSs.Conclusion: This was the first report about Tibetan women with BC in Tibet. Some clinicopathological characteristics at the presentation of Tibetan women with BC may improve during different HCSs. The cancer awareness, early detection, and the overall management in patients with advanced stage BC might improve the prognosis of BC in the rural and urban integration HCS. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to review the clinical characteristics and prognosis of children with adrenocortical tumors (ACT).Methods: We retrospectively reviewed the medical records of 28 patients with ACT at our hospital between March 2010 and March 2017.Results: The main clinical presentations were sexual prematurity (n = 17) and Cushing's syndrome (n = 15). All patients without metastasis underwent complete resection by laparotomy (n = 19) or laparoscopic surgery (n = 9). Pathological diagnosis confirmed adrenocortical carcinomas (ACC, n = 12) and adrenocortical adenomas (ACA, n = 16). Dehydroepiandrosterone (939.4 ± 148.2 µg/dl vs 630.9 ± 376.3 µg/dl; p = 0.031) and testosterone (235.7 ± 89.1 ng/dl vs 164.6 ± 47.5 ng/dl; p = 0.012) were significantly increased in ACC compared with ACA. The ACC tumor volumes were larger than those in ACA (107.5 ± 69 vs 25.5 ± 23.1 cm3; average diameter 6 cm vs 4 cm p = 0.001) and the immunochemical expression of Ki-67 was higher in ACC than in ACA (30.2 ± 22.7 vs 9.9 ± 4.9 p = 0.013). The mean follow-up of patients with ACA was 40 ± 23 months without recurrence. Seven patients with ACC had postoperative distant metastases and five patients died within 2 years. Five patients with ACC survived with a median follow-up of 27 months. The 2-year overall survival was 44.6%.Conclusions: Patients with ACC had significantly larger tumor volumes than those with ACA. The discordantly elevated serum levels of sexual corticosteroid hormones and lactate dehydrogenase may predict the malignant nature of these tumors. The prognosis of patients with ACA was good, while those with ACC had high postoperative metastasis and mortality rates. [ABSTRACT FROM AUTHOR]

Background: Previous related studies have mainly focused on renal cell carcinoma (RCC) with venous tumor thrombus, specifically inferior vena cava tumor thrombus with renal vein tumor thrombus (RVTT). However, only a few studies have focused on postoperative long-term survival of RCC patients exclusively with RVTT. Our aim was to investigate the independent prognostic factors for locally advanced RCC with RVTT in China.Methods: Patients with locally advanced RCC with RVTT were enrolled for the study from January 2000 to December 2015. All patients underwent radical nephrectomy. Survival analysis was estimated using Kaplan-Meier. Univariable and multivariable survival analyses were performed using COX. Patients were divided into high-risk, middle-risk, and low-risk groups based on independent prognostic factors and then analyzed for survival.Results: One hundred twenty-eight consecutive patients (103 men & 25 women) were enrolled with a median age of 61 years. Thrombi were all graded 0 using the Mayo system, of which 23 were friable. None of the thrombi detached during surgery. 121 patients were successfully followed up, with a median follow-up period of 47 months. Median overall survival was 127 months (95%CI: 101-153). The 5-year and 10-year cancer-specific survival (CSS) rate was 67.9 and 57.0%. 59 patients had recurrence with median time of 40 months. Friable thrombus, paraneoplastic syndrome (PNS), modified Fuhrman grade 3/4 and perirenal fat invasion were independent prognostic factors (p < 0.05). The 5-year CSS for the Low-risk group (no factors) was 100%, Middle-risk group (1-2 factors) was 68.6%, while the High-risk group (3-4 factors) was 0%.Conclusions: After radical surgery, RCC patients with RVTT had a relatively fair prognosis except for patients with friable thrombus, PNS, higher modified Fuhrman grade and perirenal fat invasion. [ABSTRACT FROM AUTHOR]

The occurrence of earthquakes has the potential to significantly modify river morphology and cause notable effects on the aquatic ecosystem. Prior to the 2008 Wenchuan earthquake with a magnitude of 8.0, the Shiting River located in the upper basin of the Yangtze River was stable. Rapid bed incision or degradation has continued since the earthquake, and weirs and bank revetments were constructed to mitigate degradation. The impacts of channel morphology adjustment and human activities on biodiversity are not clear, which prohibits efficient river restoration. This paper evaluated the morphological quality of the Shiting River by employing the Morphological Quality Index (MQI), an approach recommended in the European Water Framework Directive. Macroinvertebrate diversity was analyzed in relation to the impacts of morphological adjustment and human activities based on field data collected in 2021. The results showed that the channel degraded and deepened after the earthquake, the planform changed from multi-threaded to single-threaded, and swamps on the floodplains disappeared. The quality of channel morphology in 2021 was evaluated using the MQI and was found to be ranging from poor to moderate. The diversity metrics of macroinvertebrates, specifically the Shannon, Simpson, and Evenness indices, exhibited a positive and significant correlation with four MQI sub-indices, which represented channel geomorphological functionality, artificiality, morphological pattern, and substrate, respectively. However, there was no significant correlation observed between the diversity metrics and the overall MQI score. The results imply that channels with superior morphological functionality, slower channel adjustment, and lower levels of anthropogenic disturbances tend to exhibit greater macroinvertebrate diversity. The study found a significant decrease in macroinvertebrate richness downstream of weirs and bridges. The community structures upstream and downstream of weirs and bridges were also significantly different. This study may help inform the ecological response of rivers to dynamic morphological changes and intense anthropogenic disturbances following disastrous earthquakes. • Post-earthquake channel morphological quality was poor to moderate. • Channels with higher morphological quality had higher macroinvertebrate diversity. • Morphology changes and human activities impacted macroinvertebrates. • Higher macroinvertebrate richness upstream of weirs and bridges than downstream. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to determine the predictive index for prognosis in patients with biliary atresia (BA).Methods: A total of 71 patients were divided into two groups. Group A included 39 postoperative BA patients who survived for more than 5 years with normal liver function and did not present cirrhosis, and group B included 32 patients who died from liver failure within 1 year after surgery. The clinical data of the two study groups were compared, and liver pathology was evaluated using a scoring system.Results: The average age and weight were similar in the two groups (64.1 ± 16.8 days vs. 60.7 ± 19.3 days, p > 0.05; 4.9 ± 0.9 kg vs. 4.7 ± 0.8 kg, p > 0.05). There were no significant intergroup differences in preoperative total bilirubin (TB), direct bilirubin (DB), alanine transaminase, aspartate transaminase, and international normalized ratio. The preoperative levels of gamma-glutamyl transpeptidase (γ-GT) and albumin in group A were significantly higher than those in group B (γ-GT: 956.8 ± 503.8 IU/L vs. 620.2 ± 437.1 IU/L, p = 0.00; ALB: 40.8 ± 2.5 g/L vs. 36.8 ± 3.6 g/L, p = 0.04), whereas alkaline phosphatase was significantly lower in group A compared to group B (512.2 ± 224.6 IU/L vs. 631.7 ± 254.7 IU/L, p = 0.02). The postoperative TB and DB after 2 weeks of the Kasai procedure decreased significantly more in group A than in group B (TB: 53.9 vs. 21.4%, p = 0.00; DB: 51.0 vs. 22.7%, p = 0.00), whereas γ-GT increased significantly less in group A than in group B (48.3 vs. 142.1%, p = 0.00). Cystic structures were observed at the porta hepatis on ultrasound in more patients from group A (28.2 vs. 3.2%, p < 0.00). There was no significant difference in the total pathological score between the two groups (p = 0.38) whereas the score of bile plugs was significantly higher in group A (0.95 vs. 0.38, p = 0.03).Conclusion: The cystic structures observed at the porta hepatis on ultrasound preoperatively and the rapid decrease in TB and DB within 2 weeks postoperatively predict good long-term prognosis, whereas a significant increase in γ-GT with a lower preoperative level predicts poor long-term prognosis. The development of bile plugs may be an indicator of favorable prognosis. [ABSTRACT FROM AUTHOR]

Population-based cancer registration data were collected to estimate the cancer incidence and mortality in Wuwei, Hexi Corridor Region, China in 2018. We used the 2011-2013 data to predict the number of new cases and deaths in 2018 and the 2003-2013 data to analyze trends in cancer incidence and mortality. The goal is to enable cancer prevention and control directions. Our results indicated that stomach cancer is the most common cancer. For all cancers combined, the incidence and mortality rates showed significantly increasing trends (+2.63% per year; P < 0.05 and +1.9% per year; P < 0.05). This study revealed a significant cancer burden among the population of this area. Cancer screening and prevention should be performed after an epidemiological study of the cause of the cancer is completed. [ABSTRACT FROM AUTHOR]

Background: Terminal duct lobular unit (TDLU) involution is a physiological process of breast tissue aging characterized by a reduction in the epithelial component. In studies of women with benign breast disease, researchers have found that age-matched women with lower levels of TDLU involution are at increased risk of developing breast cancer. We previously showed that breast cancer cases with core basal phenotype (CBP; estrogen receptor negative [ER-], progesterone receptor-negative [PR-], human epidermal growth factor receptor 2-negative [HER2-], cytokeratins (CK 5 or CK5/6)-positive [CK5/6+] and/or epidermal growth factor receptor-positive [EGFR+]) tumors had significantly reduced TDLU involution compared with cases with luminal A (ER+ and/or PR+, HER2-, CK5/6-, EGFR-) tumors from a population-based case-control study in Poland. We evaluated the association of TDLU involution with tumor subtypes in an independent population of women in China, where the breast cancer incidence rate, prevalence of known risk factors, and mammographic breast density are thought to be markedly different from those of Polish women.Methods: We performed morphometric assessment of TDLUs by using three reproducible semiquantitative measures that inversely correlate with TDLU involution (TDLU count/100 mm2, TDLU span in micrometer, and acini count/TDLU) by examining benign tissue blocks from 254 age-matched luminal A and 250 triple-negative (TN; ER-, PR-, HER2-, including 125 CBP) breast cancer cases treated in a tertiary hospital in Beijing, China.Results: Overall, we found that TN and particularly CBP cases tended to have greater TDLU measures (less involution) than luminal A cases in logistic regression models accounting for age, body mass index, parity, and tumor grade. The strongest association was observed for tertiles of acini count among younger women (aged <50 years) (CBP vs. luminal A; ORtrend 2.11, 95% CI 1.22-3.67, P = 0.008).Conclusions: These data extend previous findings that TN/CBP breast cancers are associated with reduced TDLU involution in surrounding breast parenchyma compared with luminal A cases among Chinese women, providing further support for differences in the pathogenesis of these tumor subtypes. [ABSTRACT FROM AUTHOR]

The prevalence of microplastic pollution in the ocean has caused widespread concern. Many studies have focused on the occurrence of microplastics in the marine environment and organisms, but the fate of microplastics in the ocean is still unclear, and the factors affecting the distribution of microplastics have not yet been consistently concluded. The aims of this study were to estimate the load of microplastics in benthic organisms as a temporary storage and to analyze the factors affecting microplastic ingestion by benthic organisms. For the purpose of this study, the benthic organisms in Jiaozhou Bay, China, were collected quarterly and were divided into the following six groups: polychaetes, mollusks, crustaceans, echinoderms, fish, and others. We concluded that the microplastic abundance in the benthos in Jiaozhou Bay was 1.00 ± 0.11 items/ind. (15.5 ± 3.5 items/g). The total load of microplastics in the benthic fauna in the bay with an area of 374 km2 was estimated to be 36.4 kg. On an individual basis, the fish contained significantly more microplastics than the other taxa. Furthermore, the characteristics of the microplastics in the benthic organisms were mainly fibrous, black, polyethylene, and <500 μm in size. In addition, the microplastic ingestion by benthic organisms was regulated by multiple factors, including biological characteristics and the environment. The masses of the organisms, the ambient seawater and sediment, and the spatial variations all influenced the microplastic ingestion by the organisms. The results of this study demonstrate that benthic organisms are an important storage for microplastics as they transferred through the ocean, and they provide an unbiased comparison of microplastic pollution among multiple organisms and the relevant pollution factors. [Display omitted] • Benthic taxon-based microplastic pollution was studied. • Benthos is a storage for microplastics, which cannot be overlooked. • The benthos microplastic load in a 374 km2 bay area was estimated to be 36.4 kg. • Microplastic abundance in benthos was inverse to population size. [ABSTRACT FROM AUTHOR]

Purpose: Inflammatory myofibroblastic tumor (IMT) is a rare benign neoplasm. The purpose of this study was to review the clinical characteristics, imaging and pathological features, and outcomes of children with IMTs from a single center in China.Methods: A retrospective file review was conducted involving 23 cases of pathologically confirmed IMTs treated at the Children's Hospital between April 2003 and April 2014.Results: The tumor locations included multiple anatomic sites, as follows: abdomen or pelvis (n = 17); lungs (n = 2); head and neck (n = 1); trunk (n = 1); and extremities (n = 2). The tumors were associated with various clinical presentations. The predominant symptoms included an anemic appearance, fevers, and an asymptomatic mass. Computed tomography scanning showed solid, heterogeneous, well-demarcated masses; the appearance of enhancement was variable. MRI appeared hypointense on T1-weighted images and hypointense or hyperintense on T2-weighted images. Immunohistochemical staining revealed anaplastic lymphoma kinase was negative in 11 of 13 cases tested. One patient quit treatment for the unresectable mass after biopsy and died 2 years later, and another patient with incompletely resection is alive at 30 months following chemotherapy. The remaining 21 cases had complete resections; one patient died due to a recurrence, and the other 20 patients survived and were tumor free. The follow-up ranged from 7 to 141 months, with a mean of 56 months. The 3-year OS was 88 % (95 % CI, 57-97 %).Conclusions: IMT is a benign neoplasm that rarely presents with malignant features. Complete resection is curative in most patients. ALK+ is variable for diagnosis. Close follow-up is necessary for patients who undergo surgical resection. [ABSTRACT FROM AUTHOR]

Pierre Robin sequence (PRS) is a congenital abnormality that may cause upper airway obstruction requiring surgical intervention. This preliminary study aimed to examine the feasibility and effectiveness of mandible traction with wires for the treatment of upper airway obstruction caused by PRS in Chinese infants. Measures of interest included transcutaneous oxygen saturation before and after surgery, duration of surgery and traction, complications, and CT findings. Seven infants were included in the study (mean birth weight: 2485 g, range: 2405–2570 g); four were born preterm and three were born full term. Mean age at surgery was 13.7 days (range: 2–28 days), mean duration of surgery was 16.6 min (range: 13–25 min) and mean duration of traction was 26.6 days (range: 21–35 days). Mean follow-up was 6.2 months (range: 1–11 months). No infant experienced severe complications. All infants experienced increases in transcutaneous oxygen saturation after surgery. Mean transcutaneous oxygen saturation was 82% before surgery and 98% after surgery. Follow-up morphology of the mandible was excellent. There was no upper airway obstruction, and short-term growth and development were satisfactory. These preliminary findings suggest that mandibular traction with wires may be an effective treatment for upper airway obstruction caused by PRS in Chinese infants. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the association between body mass index (BMI) and breast cancer with consideration to estrogen/progesterone/human epidermal growth factor type 2 receptor status (ER/PR/HER2) in the breast tissue among Chinese pre- and post-menopausal women. Methods: Four thousand two hundred and eleven breast cancer patients were selected randomly from seven geographic regions of China from 1999 to 2008. Demographic data, risk factors, pathologic features, and biological receptor status of cases were collected from the medical charts. Chi-square test, fisher exact test, rank-correlation analysis, and multivariate logistic regression model were adopted to explore whether BMI differed according to biological receptor status in pre- and post-menopausal women. Results: Three thousand two hundred and eighty one eligible cases with BMI data were included. No statistically significant differences in demographic characteristics were found between the cases with BMI data and those without. In the rank-correlation analysis, the rates of PR+ and HER2+ were positively correlated with increasing BMI among post-menopausal women (rs BMI, PR+ = 0.867, P = 0.001; rs BMI, HER2+ = 0.636, P = 0.048), but the ER+ rates did not vary by increasing BMI. Controlling for confounding factors, multivariate logistic regression models with BMI<24 kg/m2 as the reference group were performed and found that BMI≥24 kg/m2 was only positively correlated with PR+ status among post-menopausal breast cancer cases (adjusted OR = 1.420, 95% CI: 1.116–1.808, Wald = 8.116, P = 0.004). Conclusions: Post-menopausal women with high BMI (≥24 kg/m2) have a higher proportion of PR+ breast cancer. In addition to effects mediated via the estrogen metabolism pathway, high BMI might increase the risk of breast cancer by other routes, which should be examined further in future etiological mechanism studies. [ABSTRACT FROM AUTHOR]

• Delayed channel evolution was revealed at multi-temporal scales. • Retrogressive aggradation migrated upstream beyond the backwater zone. • Conditions in previous ∼4 years cumulatively impact current channel evolution. The delayed response of channel evolution upstream of dams to base-level changes has not yet been thoroughly understood. In this paper, we studied the delayed response of the morphological adjustment at the middle Yellow and lower Wei Rivers upstream of the Sanmenxia Dam, China, based on data of water volume, sediment load, cross-sectional profiles, and erosion/deposition volumes during 1960–2018. Channel evolution upstream of the dam obviously lagged behind the dynamic pool level fluctuation during the first approximately two decades following dam closure, when retrogressive aggradation/erosion phases were identified. The retrogressive aggradation migrated ∼200 km upstream to the tributary of the Yellow River, i.e., the Wei River. The impact of base-level rise may propagate backwards behind the beginning of the backwater reach, reflecting indirect backwater effects. The dam has been operated by the controlled release of "storing the clear water during nonflood seasons and discharging the turbid water during flood seasons" since 1974, and the reservoir has generally been eroded during flood seasons and aggraded during nonflood seasons. The erosion center was defined as the subreach between two adjacent cross-sections with the greatest erosion rate during the flood season, and the aggradation center was defined as that with the greatest aggradation rate during the nonflood season. The results showed that the erosion/deposition centers migrated towards the dam by ∼50–60 km during 1974–2010 and migrated upstream after ∼2010. The location of the erosion/deposition centers was related not only to the water and sediment conditions and backwater length in the current year but also to these conditions in the previous ∼4 years, reflecting the delayed response of channel adjustment or the cumulative impact of pervious conditions on channel morphology. This study helps to inform future reservoir management and the delayed channel response to base level change caused by different natural and anthropogenic disturbances. [ABSTRACT FROM AUTHOR]

Background: Moyamoya disease (MMD) develops mostly in Asian countries including Japan, Korea, mainland China and Taiwan. However, there are few detailed demographic and clinical data about Chinese patients with MMD. Currently, the most effective treatment in adult patients with MMD is unknown. There have only been a few small case series reporting on encephaloduroarteriosynangiosis (EDAS) in an adult population. Here we describe the clinical features, surgical treatment and long-term outcome of adults with MMD treated at a single institution in China. Methods: Our cohort included 470 adult patients with MMD. The demographic and clinical characteristics were obtained by retrospective chart review and long-term outcome was evaluated using the stroke status. The modified Rankin Scale (mRS) was used to determine the neurological functional outcome. Univariate and multivariate logistic regression analyses were performed to determine risk factors for postoperative morbidity and functional outcome. The risk of subsequent stroke was determined using the Kaplan-Meier method and Cox regression was used to determine risk factors for postoperative or subsequent strokes. Results: The median age for the onset of symptoms was 36.8 (range, 18-59) years. The ratio of female to male patients was 1:1 (231/239). Familial occurrence of MMD was 2.3%. The most common initial symptom was a cerebral ischemic event. The incidence of postoperative ischemic events or hemorrhage was 5.9% (9.8% of patients). Older age at symptom onset, posterior cerebral artery (PCA) involvement and the presence of transient ischemic attack (TIA) were identified as predictors of adverse postoperative events. The Kaplan-Meier estimate stroke risk was 10.1% in the first 2 years, and the 5-year Kaplan-Meier risk of stroke was 13% after surgery for all patients treated with surgical revascularization. Older age at symptom onset, PCA involvement and the presence of TIA were identified as predictors of postoperative or subsequent strokes. Overall, 73.2% of patients had an independent life with no significant disability, with the strongest predictor being the preoperative mRS score. Conclusion: Clinical characteristics of adult MMD in China are different from those in other Asian countries. EDAS in adult patients with MMD carries a low risk, is effective at preventing future ischemic events and improves quality of life. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A general framework for modelling morphological responses to perturbation is proposed, based on the underpinning principle that the rates of morphological response in alluvial channels are initially high and then decrease through time as the system relaxes following disturbance. The framework includes three morphological response models, each developed from the fundamental rate law, which has the form of an exponential decay function. These models consider the possibility that characteristic behaviours of the fluvial system, such as delayed response and/or cumulative effects, may affect morphological responses, making them capable of representing relaxation paths and times for a range of morphological response variables, whatever their initial states. To test their utility, the models in the framework were applied to simulate the sequence of geomorphological responses to disruption observed in selected rivers with well-documented histories of morphological perturbation, adjustment and recovery. The results demonstrate that the models in the general framework can successfully simulate temporal and spatial patterns of morphological response in the fluvial system under a range of different circumstances, while also indicating how their reliability could be further improved. [ABSTRACT FROM PUBLISHER]

Background/purpose: Neutropenic enterocolitis (NE) is clinically defined by the triad of neutropenia, abdominal pain and fever. This retrospective study is to review 24 cases of NE in a single Chinese tertiary center, to elucidate clinical feature, treatments and outcome for this dangerous gastrointestinal complication of neutropenia.Patients and Methods: The medical records of pediatric patients who were diagnosed with neutropenic enterocolitis from 2000 to 2009 were reviewed.Results: Of 24 cases, the ratio of male to female was 2:1, the mean age was 7.2 years. There were eight cases of acute lymphocytic leukemia, eight cases of acute non-lymphocytic leukemia, four cases of non-Hodgkin's lymphoma, one case of severe aplastic anemia, one case of neuroblastoma and two cases of simple neutropenia without underlying cause. The hematologic malignancy was significantly associated with the occurrence of NE (OR = 19.4). Seventeen cases developed NE during anticancer chemotherapy (chemo group), four cases presented with leukemia and one case presented with aplastic anemia before the initiation of chemotherapy and their presenting event leading to diagnosis. Two cases simply presented with NE without definitive reasons (no chemo group). All the patients had the typical clinical presentation, six cases had disseminated peritonitis, toxic shock, and assisted ventilations were necessary in three of these six cases. CT or ultrasound demonstrated bowel wall thickness, paucity of air in the cecum and/or right colon, pneumatosis or pneumoperitoneum. There was no difference in the nadir neutrophil count in patients, who received chemotherapy versus those who did not (P = 0.001), but the recovering time from NE in chemo group (9.3 ± 1.9) was shorter than non-chemo group (10.7 ± 5.3, P = 0.034). Sixteen (88.8%) cases have been successfully managed medically, using aggressive hemodynamic support, bowel rest, and broad-spectrum antibiotic therapy with surgical intervention reversed only for the more severe six cases (25%). Two cases died.Conclusion: NE is a life-threatening gastrointestinal complication of neutropenia. Physicians might remain vigilant and consider NE in any neutropenic patient rather than only in oncologic patients. It has typical clinical presentation and CT can provide clear delineation for diagnosis. Early recognition and progressed management have reduced mortality. Most children with NE may be treated without surgery with favorable outcome. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between long-term exposure to ambient PM 10 and risk of diabetes incidence, based on the "Jinchang Cohort" platform in the Northwest of China. We selected 19884 subjects who had not yet developed diabetes in the baseline and had completed survey information from "Jinchang Cohort". The residential address was used to match the nearest pollution monitoring station for each subject, and the average concentration of PM 10 from baseline to follow-up were used as an estimate of individual exposure level. Cox regression model and restricted cubic splines functions were used to evaluate the effects of PM 10 on the incidence of diabetes and the dose-response relationship after adjusting for confounding covariates. We observed 791 new-onset diabetics with a total follow-up of 45254.16 person-years (incidence rate of 17.48 per 1000 person-years). The risk of diabetes incidence increased by 17% (HR = 1.17, 95%CI: 1.08–1.26) per 10μg/m3 increase in environmental PM 10 , and the risk rises gradually with the rise of PM 10 concentration. Comparing with the first quartile of PM 10 , the fully adjusted HRs (95%CI) for incident diabetes from the second to the fourth quartile of PM 10 were 1.15 (95%CI: 0.93–1.43), 1.50 (95%CI: 1.22–1.84) and 1.44 (95%CI: 1.15–1.79), respectively (P for trend<0.001). Stratified analyses suggested that the risk of diabetes incidence associated with ambient PM 10 was higher in female, young to middle-aged people, overweight and obese subjects, and subjects with FPG level at baseline lower than 5.6 mmol/L. Long-term exposure to ambient PM 10 significantly associated with a higher risk of diabetes development. Some urgent strategies may be advocated to reduce air pollution that can aid in preventing the prevalence of diabetes in the population. • To assess the association between exposure to ambient PM 10 and diabetes incidence. • Ambient PM 10 is positively associated with diabetes incidence. • The risk of diabetes incidence rise gradually with the increase of PM 10. • Female, younger age, higher BMI and FPG<5.6mmol/L were more susceptible to PM 10. [ABSTRACT FROM AUTHOR]

Background: The concordance rate of human epidermal growth factor receptor 2 (HER2) status between core needle biopsy (CNB) and subsequent excisional biopsies of the same tumor varies from 81 to 96%, which may cause inappropriate neoadjuvant therapy that impair the potential benefit from HER2 targeted therapy for patients. This study aimed to establish a nomogram to predict the HER2 status pre-operatively as an auxiliary diagnosis to CNB assessment. Methods: Among 4211 breast cancer patients cataloged in the Nation-wide Multicenter 10-year Retrospective Clinical Epidemiological Study of Breast Cancer in China, 2291 patients with complete relevant information were included in this study, which were further randomized 3:1 and divided into a training set and a validation set. The nomogram was established based on independent predictors of HER2 positivity recognized by logistic regression analysis and further validated internally and externally. Results: The multivariate logistic regression analysis showed that T-stage, N-stage, estrogen receptor (ER) status, progesterone receptor (PR) status were independent predictors for HER2 status. The nomogram was thereby constructed by those independent predictors as well as histology type. The areas under the receiver operating characteristic curve (AUC) of the training set and the validation set were 0.636 and 0.681, respectively. The calibration plots demonstrated good fitness of the nomogram for HER2 status prediction. With the optimal cutoff value, the nomogram yielded 80.0% sensitivity, 43.1% specificity in the training set and 81.1% sensitivity, 49.8% specificity in the validation set. Conclusions: The present nomogram can provide valuable information on HER2 status and combined with standard CNB assessment, clinicians could make more appropriate decision on neoadjuvant therapy of breast cancer. [ABSTRACT FROM AUTHOR]

The authors reflect on the status of donation after cardiac death (DCD) in children in China, which provides most promising donor organ resource in the country. The authors mention that attending doctors are responsible for recognizing potential donors, according to the Chinese guidelines for DCD. They add that low donation rate, which is only 0.03 per million is the most important obstacle for DCD in the country.

The Sanmenxia Dam built in 1960 in the middle reach of the Yellow River has experienced severe sedimentation problems, not only in the reservoir area itself but also extending hundreds of kilometers in the backwater region. Morphological responses in the middle Yellow River and its tributary, the Wei River, upstream of the dam have generally lagged behind the causal changes in upstream and downstream controls. Based on the geometrical characteristics of a wedge-shaped sedimentation body, a method was derived for calculating equilibrium values of the accumulated sedimentation volume in the channel reaches. Combining the method for calculating with rate law models for channel morphological adjustment, a method for calculating the accumulated deposition volumes was derived. The results showed that the proposed method can accurately simulate sedimentation processes in the study reaches during 1960 and 2011, in the response to the integrated impacts of base level fluctuations and changes in incoming water and sediment discharges. The characteristics of the potential adjusted (equilibrium) morphology was analyzed and it is shown that while the nature of the adjusted (or equilibrium state) of the fluvial system varies dynamically with external conditions, it generally acts as the target for the observed channel adjustments, although the actual values of variables defining the fluvial system seldom adjust to their corresponding equilibrium values due to the effects of multiple disruptions, continuously varying water and sediment inputs, and delayed responses in the fluvial system. [ABSTRACT FROM AUTHOR]

Background To our knowledge, no previous study has described the nationwide epidemiologic features of moyamoya disease (MMD) in China. We describe the epidemiologic features including the relative prevalence, age distribution, gender distribution, and initial clinical manifestations of patients with MMD treated at a single institution in China. Methods Our cohort included 4128 patients with MMD. Their demographic and clinical characteristics were obtained by retrospective chart review. Results The median age for the onset of symptoms was 30.36 years. The age distribution of patients with MMD was bimodal, with the highest peak detection rate at 35–45 years of age and a smaller peak at 5–9 years of age. The ratio of female-to-male patients was 1:1. The disease occurred mainly in the Han people and was rarely seen in minority nationalities. In our cohort, transient ischemic attack was the most common initial clinical manifestation (48.13%). The other initial manifestations included infarction (22.62%), hemorrhage (16.45%), and headache 230/4128 (5.57%). In north and northeast China, the ischemic type was more predominate while the hemorrhagic type was relatively rare. However, the percentage of hemorrhagic type in East China was higher than anywhere else in China. Conclusions This study confirmed some unique epidemiologic features as the studies previously reported in China, but it also revealed some new sight and tendency about moyamoya in China. As a lack of national epidemiologic studies, this study indicated the outline of moyamoya in China. [ABSTRACT FROM AUTHOR]

Shallow lakes are vulnerable to eutrophication because of abundant phytoplankton and significant nutrient input from sediments. Previous studies have researched the effect of environmental factors on phytoplankton and phosphorus release from sediment. However, few studies have simultaneously evaluated the interactive effects of environmental factors on phytoplankton communities and the interactions among different sediment nutrients. This paper reports on a 2016 investigation that examined the phytoplankton community and physical and chemical factors in both the water column and sediments in a Chinese shallow lake and its adjoining rivers. Our results indicated that rivers with water gates and lake areas had greater Chlorophyll a concentrations (Chl a ) than natural rivers with similar total phosphorus (TP) concentrations; this indicates the importance of residence time on phytoplankton biomass. Although temperature impacted Chl a less than nutrients, its effects were highly species-specific, modulating relationships between nutrients and the abundance of different phytoplankton taxa. The effects of nutrients changed based on phytoplankton biomass and community composition, suggesting that different phytoplankton taxa have different nutrient demands. We predict that increasing residence time, temperature, and nutrients will increase phytoplankton biomass and increase the future dominance of Chlorophyta and Cyanophyta . In the interstitial water, there were no significant seasonal differences in TP, total nitrogen, and soluble reactive silica concentrations. However, ammonia concentrations were higher in the spring and lower in other seasons; nitrate and sulfate were abundant when the ammonia concentration was low. The total iron level in sediments was significantly negatively related with TP at low ammonia and silica concentrations and at high nitrate and sulfate concentrations in the interstitial water. These results indicated that nutrients are closely coupled in the sediments, highlighting the importance of oxidation-reduction potentials on internal nutrient balance. [ABSTRACT FROM AUTHOR]

Extensive research has established the link between PM 2.5 exposure and blood pressure (BP) levels among normal individuals. However, the association between PM 2.5 components and BP levels in hypertensive patients has not been fully explored. In this study, 12 971 hypertensive cases from Jinchang cohort (in Jinchang City, China) with nearly 9 years of follow-up were enrolled. Based on the linear mixed-effect model, the effects of fine particulate matter (PM 2.5 ) and five major components [sulfate (SO 4 2- ), nitrate (NO 3 - ), ammonium (NH 4 + ), black carbon (BC) and organic matter (OM)]on BP [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP)]were evaluated by single-component model, component-joint model and component-residual model, respectively. A positive correlation was found between PM 2.5 as well as its components (SO 4 2- , NO 3 - , NH 4 + , BC and OM) exposure and BP levels. The effects of SO 4 2- , BC and OM on BP were observed to be the most robust among the three models. Based on the results of interaction effects and stratified analysis, the effect of BC exposure on SBP, and the effect of PM 2.5 and its five components on PP were greater in female than in males. Compared with elderly hypertensive patients, OM had more significant effects on SBP, DBP and MAP in young and (or) middle-aged hypertensive patients. During the heating season, the effect of PM 2.5 and its components on BP was grater compared to the non-heating season. Meanwhile, PM 2.5 and its components have a greater influence on BP in patients with hypertension combined with diabetes. Therefore, the findings suggested that both PM 2.5 exposure and its components had a significant effect on BP in patients with hypertension. Women and young and middle-aged hypertensive patient were the sensitive population. The implementation of source control and reduction of PM 2.5 emission (mainly for SO 4 2- , BC and OM) may be of great significance to control BP level and could reduce the risk of cardiovascular disease in patients with hypertension., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Little evidence exists about whether a combination of healthy lifestyle factors is associated with a lower risk of depressive symptoms among Chinese population. We aimed to investigate the association between combined healthy lifestyle factors and risk of depressive symptoms., Methods: We conducted a baseline survey from July 2021 to December 2023, including 53,642 Chinese adults from general population. A healthy lifestyle score was constructed based on six lifestyle factors (physical activity, smoking status, alcohol consumption, diet, sleep duration, and body mass index). Logistic regression models were used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) adjusted for confounding variables., Results: Each additional healthy lifestyle score was associated with a 20 % lower risk of having depressive symptoms (OR (95 % CI): 0.80 (0.78-0.81)). Compared with individuals with ≤2 healthy lifestyle factors, individuals with all the six healthy lifestyle factors had a 58 % reduced risk of having depressive symptoms (0.42 (0.37-0.47)). After stratification by gender, education and urbanization, the significant inverse association with healthy lifestyle score was stronger in women, individuals with high education, and urban residents. Besides, the significant negative association between healthy lifestyle score and depressive symptoms remained for different severity of depressive symptoms., Limitations: Given the cross-sectional nature of data, we cannot make causal inferences., Conclusions: Our study indicated that adherence to healthy lifestyle factors was associated with a reduced risk of having depressive symptoms among Chinese adults. The observed associations were modified by gender, education and urbanization. These findings warrant further verification in interventional studies., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Backgrounds: This investigation seeks to explore the correlation between nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVDs), and to to provide evidence for the prevention and treatment of CVDs., Methods: This study utilized data from the Jinchang cohort platform, including 19,399 participants without pre-existing major CVDs. Based on the general population and gender stratification, Cox models were used to analyze the risk of NAFLD for CVDs. The combined effect of NAFLD and different obesity indicators on CVDs was analyzed by additive and multiplicative interaction models and subgroups., Results: There were 3129 NAFLD patients out of 19399 subjects, and 723 (23.11%) of them had the CVD. After adjusting for multiple confounding factors, the Cox model revealed a 1.17-fold increase in the risk of CVDs among patients with NAFLD compared to those without NAFLD. Moreover, there was no notable disparity in CVDs risk among most NAFLD patients at the same level of obesity. The results indicated no additive interaction between NAFLD and obesity concerning CVDs risk, but rather a positive multiplicative interaction. Using the normal population as a reference, it was found that people with both obesity and NAFLD significantly increased the risk of developing CVDs, with HRs and 95% CIs of 1.790 (1.508, 2.126), 1.356 (1.213, 1.517), and 1.807 (1.503, 2.174), respectively, for BMI, WC, and the combination of BMI and WC., Conclusions: NAFLD and obesity are independent risk factors for CVDs. The synergy of obesity and NAFLD implies that NAFLD patients should control weight gain. Larger BMI and WC values may increase the CVDs risk for NAFLD patients, especially women., (© 2024. The Author(s).)

Microplastics (MPs) are widely distributed in marine environments and ingested by marine organisms, especially zooplankton. Chaetognaths, typical carnivorous zooplankton, are pivotal in the food chain from secondary producers, such as copepods, to higher trophic level species. However, little is known about their MP ingestion. In this study, based on field observation data, for the first time, we studied seasonal characteristics and risks of MPs ingested by chaetognaths in Jiaozhou Bay and assessed effects of key prey copepods on MP ingestion by chaetognaths. MP/chaetognath values in February, May, August, and November were 0.19, 0.17, 0.15, and 0.39, respectively, showing no significant seasonal variation. Chaetognaths predominantly ingested MPs that were fiberous in shape, 101-400 µm in size and polyester in polymer type, with no significant seasonal variations. The risk of MP load in chaetognaths was low, but there are higher polymeric hazards and potential ecological risks. MP/chaetognath values were positively correlated with the copepod abundance and MP/copepod values. The characteristics of MPs ingested by chaetognaths were also highly similar to those of MPs ingested by copepods. However, the overall risk of biomagnification in the copepod-chaetognath food chain was low. This study provided field evidence for MP transfer in the planktonic food chain., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Demographic characteristics and clinical data of all newly diagnosed biliary atresia patients in Shanghai were collected from 1 January 2015 to 31 October 2016. The total number of live births was 377 420 during the study period, and the incidence of biliary atresia in Shanghai was 10.86 per 100 000 (95% CI 7.8 to 17.74), with 62.9% and 45.7% cases retaining native liver survival at 2 and 5 years after Kasai procedure, respectively. Implementation of systematic screening measures for biliary atresia in China is needed., Competing Interests: Competing interests: None., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Silicon (Si) utilization is not limited to eukaryotes. Recent research has suggested that the pattern of a large contribution of picocyanobacteria to biogenic silica (bSi) stocks might be widespread in the oligotrophic open ocean. We are the first to measure the size-fractionated bSi standing stocks and production rates in the oligotrophic South China Sea (SCS), which has obvious characteristics of oligotrophic waters. The 150 m integrated bSi standing stocks in the pico-sized fractions averaged 23 % of the total; the contribution of picoplankton to the total bSi production rate was 44 %. Interestingly, our estimated contributions of Synechococcus alone to the <2 μm bSi standing stock and < 2 μm bSi production rates averaged 14 % and 66 %, respectively, indicating that the significant and persistent contribution of bSi was strongly associated with marine picocyanobacteria. Furthermore, the dynamic changes in nutrient concentrations, especially in DIN and DIP, also potentially affected the variability in picoplankton bSi stocks and production rates, while the effects of temperature and salinity were not obvious. In this study, we have provided new information on measurable bSi in the picoplankton size fraction and its production rate in the SCS. We have demonstrated that picoplankton contributes a measurable, and at times significant, proportion to both the total bSi standing stock and its production rate in the SCS. A high silicon content within picocyanobacteria has important implications for understanding both their ecology and their contribution to biogeochemistry., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: As persistent organic pollutants (POPs), perfluoroalkyl substances (PFAS) may potentially impact human health. Our study aimed to investigate the prospective association between PFAS exposure and the incidence risk of breast cancer in females., Methods: By fully following the Jinchang Cohort after a decade, we conducted this nested case-control study with 135 incidence cases of breast cancer (BC) and 540 bias-paired controls. The PFAS levels were tested by baseline serum samples. Conditional logistic regression and a restricted cubic spline model were employed to investigate the BC incidence risks and the dose-response associated with single PFAS component exposure. Furthermore, the Quantile g-computation model (Qgc), random forest model (RFM), and bayesian kernel machine regression models (BKMR) were integrated to estimate the mixed effects of PFAS exposure on the incidence risk of BC., Results: Exposures to specific PFAS components were positively associated with an increased incidence risk of breast cancer. By grouping the study population into different baseline menopausal statuses, PFHxS, PFNA, PFBA, PFUdA, PFOS, and PFDA demonstrated a similarly positive correlation with BC incidence risks. However, the increased incidence risks of BC associated with PFOA, PFOS, PFUdA, and 9CL-PF3ONS exposure were exclusively found in the premenopausal population. Both BKMR and Qgc revealed that exposure to mixed PFAS was associated with an increased risk of breast cancer, with Qgc specifically indicating an odds ratio (OR) of 2.21 (95% CI: 1.53, 3.19). Random forests showed that PFBA, PFOS, PFHxS, and PFDA emerged as predominant factors potentially influencing breast cancer incidence., Conclusion: Our findings suggest a strong association between PFAS exposure and the incidence of breast cancer. Premenopausal women should exercise more caution regarding PFAS exposure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Background: Leukemia imposes a large healthcare burden both in China and the United States (US). The disease burden differs greatly between the two countries, but related research is limited. We explored the differences in leukemia incidence and mortality between China and the US., Methods: Data on leukemia in China and the US from 1990 to 2021 were collected from the Global Burden of Disease 2021 database. Incidence and mortality were used to estimate the disease burden, and joinpoint regression was performed to compare their secular trends. We used an age-period-cohort model to analyze the effects of age, period, and birth cohort and project future trends in the next 15 years., Results: In 2021, the age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) of leukemia were lower in China than in the US. However, the incidence and mortality of acute lymphoblastic leukemia (ALL) was considerably higher in China. In the past decades, the ASIR showed decreased tendency in the US, while ASIR showed stable in China. The ASDR tended to decrease in both countries from 1990 to 2021. Males have higher rates of incidence and mortality than females in two countries. The age effects showed that children and older individuals have higher RRs for incidence and mortality in China, while the RRs for incidence and mortality in the US particularly increased in the older population. The disease burden of leukemia in children is obviously greater in China. The ASIRs and ASDRs of leukemia will continue to decline in the next 15 years in China and the US, with the US experiencing a more obvious downtrend., Conclusions: Over the past decades, the ASDRs in two countries both tended to decrease. And compared to the US, China had lower leukemia incidence and mortality, However, the ASIRs in China tended toward stable, which it was showed downtrend in the US. Children have obviously greater RRs for incidence and mortality in China. The incidence and mortality will decrease continuously in two countries. Effective intervention measures are needed to reduce the burden of leukemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ge, Zhang, Zhang, Feng, Yang, Tong, Zheng and Tan.)

Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM 2.5 and its constituents with the risk of MAFLD and the dose-response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM 2.5 , SO 4 2- , NO 3 - , NH 4 + , OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM 2.5 and its constituents. Mixed exposure to SO 4 2- , NO 3 - , NH 4 + , OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM 2.5 and its constituents increased the risk of MAFLD., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)