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The main aim of this study was to determine whether the use of contrast-enhanced ultrasound (CEUS) could improve the categorization of suspicious breast lesions based on the Breast Imaging Reporting and Data System (BI-RADS), thereby reducing the number of benign breast lesions referred for biopsy. This prospective study, conducted between January 2017 and December 2018, enrolled consenting patients from eight teaching hospitals in China, who had been diagnosed with solid breast lesions classified as BI-RADS 4 using conventional ultrasound. CEUS was performed within 1 wk of diagnosis for reclassification of breast lesions. Histopathological results obtained from core needle biopsies or surgical excision samples served as the reference standard. The simulated biopsy rate and cancer-to-biopsy yield were used to compare the accuracy of CEUS and conventional ultrasound (US). Among the 1490 lesions diagnosed as BI-RADS 4 with conventional ultrasound, 486 malignant and 1004 benign lesions were confirmed based on histology. Following CEUS, 2, 395, and 211 lesions were reclassified as CEUS-based BI-RADS 2, 3, and 5, respectively, while 882 (59%) remained as BI-RADS 4. The actual cancer-to-biopsy yield based on US was 32.6%, which increased to 43.4% when CEUS-based BI-RADS 4A was used as the cut-off point to recommend biopsy. The simulated biopsy rate decreased to 73.4%. Overall, in this preselected BI-RADS 4 population, only 2.5% (12/486) of malignant lesions would have been miscategorized as BI-RADS 3 using CEUS-based reclassification. The diagnostic accuracy, sensitivity, and specificity of contrast-enhanced ultrasound reclassification were 57.65%, 97.53%, and 38.35%, respectively. Our collective findings indicate that CEUS is a valuable tool in further triage of BI-RADS category 4 lesions and facilitates a reduction in the number of biopsies while increasing the cancer-to-biopsy yield. [ABSTRACT FROM AUTHOR]

Background: Unfavourable lipid and glucose levels may play a crucial role in the pathogenesis of gestational diabetes mellitus (GDM). However, there is a lack of prospective studies on the relationship between lipid profiles, lipid ratios and GDM during pregnancy. Aims: To prospectively investigate the relationship between lipid profile and lipid ratios in early and mid-pregnancy and their pattern of change from early to mid-pregnancy and the risk of GDM. Methods: This nested case-control study was based on maternal and child healthcare hospitals from Fujian Province, China. We included pregnant women who delivered in the hospital from January 2021 to June 2023. Lipid profiles (TC, TG, ApoA1, ApoB, HDL-c, LDL-c) and fasting glucose were measured before 14 weeks of gestation and between 20 and 28 weeks of gestation, and lipid ratios (triglyceride glucose index, TG/HDL-c and TC/HDL-c) was constructed. Logistic regression was used to assess the relationship between lipid profile, lipid ratios and GDM. Results: Of 1586 pregnant women, 741 were diagnosed with GDM. After adjusting for potential confounders, TG, ApoA1, ApoB, LDL-c, triglyceride glucose index, TG/HDL-c, and TC/HDL-c in early pregnancy were positively associated with the risk of GDM (odds ratios [95% CI] for extreme interquartile comparisons were 2.040 (1.468–2.843), 1.506 (1.091–2.082), 1.529 (1.110–2.107), 1.504 (1.086–2.086), 1.952 (1.398–2.731), 2.127 (1.526–2.971), and 2.370 (1.700-3.312), all trend P < 0.05). HDL-c was negatively associated with the risk of GDM (0.639: 0.459–0.889, trend P all less than 0.05). Similarly, in mid-pregnancy, lower levels of HDL-c, higher levels of triglyceride glucose index, TG/HDL-c ratio, and TC/HDL-c ratio were associated with increased risk of GDM (all trends P < 0.05). Stably high levels (both ≥ median for early and mid-pregnancy) of triglyceride glucose index, TG/HDL-c and TC/HDL-c were associated with increased risk of GDM (OR [95% CI]: 2.369 (1.438–3.940), 1.588 (1.077–2.341), 1.921 (1.309–2.829), respectively). The opposite was true for HDL-c, where stable high levels were negatively associated with GDM risk (OR [95% CI]: 0.599 (0.405–0.883)). Conclusion: Increases in triglyceride glucose index, TG/HDL-c ratio, and TC/HDL-c ratio in early and mid-pregnancy, as well as their stable high levels from early to mid-pregnancy, are associated with a higher risk of GDM. In contrast, increased levels of HDL-c, both in early and mid-pregnancy, and their stable high levels from early to mid-pregnancy were associated with a lower risk of GDM. That highlighted their possible clinical relevance in identifying those at high risk of GDM. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the factors influencing glycemic control in patients with type 2 diabetes mellitus (T2DM). Methods: Baseline data, encompassing basic information, lifestyle habits, and treatment of 305 T2DM patients from March 2021 to January 2023, were collected and analyzed using SPSS 26.0 software. Results: Univariate and multivariate logistic regression analyses identified insulin therapy (OR = 2.233; 95%Cl = 1.013–4.520; P = 0.026) and regular clinic visits (OR = 0.567; 95%Cl = 0.330–0.973; P = 0.040) as independent factors influencing glycemic control. No observed interactions between the two variables were noted. Conclusion: History of insulin therapy and regular clinic visits were significantly and independently associated with glycated hemoglobin control in T2DM patients. Tailored interventions based on individual circumstances are recommended to optimize glycemic control. [ABSTRACT FROM AUTHOR]

Depressive symptoms and aggression often co-occur, and previous studies have found different bidirectional links between depressive symptoms and aggression, suggesting inconsistent developmental cascades. Moreover, it is unclear whether different functions of aggression are differentially associated with depressive symptoms over time. The present study examined the longitudinal associations of reactive and proactive aggression with depressive symptoms in early adolescence. Adolescents (n = 942, 50.7% girls; mean age = 12.54 years, SD = 0.42) were surveyed annually over three years (2019–2021). Random-intercept cross-lagged panel models were used to disentangle between- and within-person effects. The results showed moderate between-person associations of depressive symptoms with the two aggressive functions. And depressive symptoms were more highly associated with reactive aggression than with proactive aggression. However, the state-level bidirectional cross-lagged associations between reactive and proactive aggression and depressive symptoms were not significant. This study highlights the stable trait-like association between depressive symptoms and reactive aggression, and the absence of state-level bidirectional cross-lagged associations challenges previous developmental cascades in adolescents. [ABSTRACT FROM AUTHOR]

Background: There may be unexplored interactions between family health, personality, and smoking that could help provide new perspectives on tobacco control. Objective: To examine the relationship between the health of one's family and their smoking habits, as well as investigate the potential influence of personality on this relationship. Methods: For this cross-sectional investigation, a national survey conducted in China in 2022 recruited a total of 21,916 individuals. The Family Health Scale was utilized to assess the health of the family. The 10-item Big Five Inventory scale was utilized to assess the Big five personality traits. The relationship between big five personality, family health, and smoking were investigated using binary and linear logistic regression. The indirect effects mediated by Big five personality were analyzed using mediation analysis with Sobel tests, and the indirect effects were composited using the Karlson-Holm-Breen method. Results: The overall prevalence of smoking in the study population was 14.87%, 26.19% for males and 3.54% for females. Urban and rural smoking prevalence was 13.81% and 16.10% respectively. Binary logistic regression analysis revealed a significant negative relationship between smoking and family health (odds ratio 0.964, 95% CI 0.959, 0.970, P < 0.001) with covariates controlled. The Karlson-Holm-Breen composition facilitated the connection between extraversion (47.81%) and nervousness (52.19%). Conclusions: Preventive interventions for smoking behavior should prioritize family health and the Big five personality as significant areas to focus on. According to this study, in addition to implementing various interventions for different personalities, family health should be strengthened to reduce smoking behavior. [ABSTRACT FROM AUTHOR]

The co-allocation of photovoltaic arrays with crops presents a promising strategy to mitigate the conflict between photovoltaics and agricultural land. However, there is a notable lack of quantitative research on the impact of agrivoltaic system on land quality in fragile areas. In this study, peanuts (Arachis hypogaea) and ryegrass (Lolium perenne) were cultivated in photovoltaic array in the dry–hot valley of southwest China, with an off-site native land serving as the control. Sixteen soil physicochemical and biochemical parameters were measured in the gap and under-panel and control area. Results demonstrated that the agrivoltaic system significantly enhanced soil moisture, organic carbon, nitrogen–phosphorus–potassium nutrients, microbial biomass, and urease activity. It also led to varying degrees of increase in soil pH and electrical conductivity, along with reduced soil sucrase and phosphatase activity. In comparison to the control, the agrivoltaic system notably improved soil quality and multifunctionality. Specially, gap cultivation had a more pronounced positive impact on soil quality than under-panel cultivation, and the cultivation of peanuts had a greater effect on soil quality and multifunctionality improvement than ryegrass. This study provides fundamental data to support the improvement of land quality in photovoltaic developed regions, and to alleviate the conflict between photovoltaics and agricultural land. [ABSTRACT FROM AUTHOR]

Background: Higher vocational education is an essential part of the higher education system that complements conventional education. In the context of information and communication technology (ICT) development and academic competition, more and more literature has proved the importance of ICT use in educational development (academic achievement and mental health) and the relationship between information literacy and the educational development of higher vocational students. Objectives: Based on one of the most extensive surveys of higher vocational students, the study combined the Opportunity‐Propensity (O‐P) framework and ecological model to explore the direct effects of different types of ICT use on educational development and the indirect effects from psychological and social factors. Methods: The data involved 28,956 students from seven higher vocational colleges. The class fixed effect and causal mediation analysis models verified the results. Results and Conclusion: The results found differential effects of different types of ICT use on academic achievement and mental health. Information literacy ability can improve the academic achievement of higher vocational students, but at the cost of mental health. ICT use not only directly impacts the academic achievement and mental health, but also has an indirect impact through psychological factors represented by self‐efficacy and technostress and social factors represented by social support. Implications: This study promotes integrating and expanding the O‐P framework and ecological model, enriching the relevant research in ICT use and educational development. Meanwhile, it also provides practical suggestions for realizing rational interventions in ICT use and improving the educational development level of higher vocational students. Lay Description: What is already known about this topic: Information and communication technology (ICT) use is closely related to the educational development of higher vocational students.The trend of ICT use in higher vocational education has become increasingly apparent.The effects of ICT use are heterogeneous among groups with different information literacy. What this paper adds: O‐P framework and ecological model provide the perspective of theoretical integration.The impact of different types of ICT use on educational development varies.Information literacy can improve academic achievement at the cost of mental health.Psychological and social factors play a mediating role in educational development. Implications for practice and/or policy: The research is helpful to guide students to allocate their time reasonably for different ICT uses.Mental health counselling should be strengthened while cultivating information literacy ability.Develop appropriate ICT usage strategies for students with different information literacy.It is helpful to develop appropriate interventions from a psychological and social perspective. [ABSTRACT FROM AUTHOR]

Although metacognition plays a pivotal role in theoretical accounts of mind wandering, their longitudinal relationships have not yet been investigated during the important developmental period of early adolescence. This study aimed to examine the developmental trajectories of spontaneous and deliberate mind wandering and the dynamic associations between metacognition and two types of mind wandering in early adolescence. A sample of 4302 Chinese students beginning in Grade 4 (47.4% female; initial Mage = 9.84, SDage = 0.47) completed questionnaires on five occasions over 2.5 years. The results showed that deliberate mind wandering, but not spontaneous mind wandering, gradually increased from Grade 4 to Grade 6. Metacognition was negatively related to spontaneous mind wandering but positively related to deliberate mind wandering. These findings provide empirical evidence for theoretical viewpoints from both individual differences and developmental perspectives. [ABSTRACT FROM AUTHOR]

Structured marine clay is commonly encountered in offshore engineering projects and engineers are concerned about its impact on the engineering properties of marine clay as well as its correlation with index properties. Current research has emphasized the role of soil structure in these aspects of marine clay. In this study, we investigated the influence of depositional environment and oxidation-induced evolution of clay microstructure on the formation of clay structure in structured clay from Zhanjiang area, a coastal city located in South China. The distinct soil structure observed in marine-terrigenous clay deposited under different environments exhibited sensitivity ranging from 1.6 to 8.9 at varying moisture content levels. The wide range of sensitivity observed in structured marine-terrigenous clay was attributed to free iron oxide derived from siderite present in an acidic environment. Compared to other regions, Zhanjiang marine clay demonstrated favorable mechanical properties but poor physical properties due to its unique clay structure characteristics. Based on these findings, we proposed a modified approach for correlating index properties with engineering properties that yielded good predictions. [ABSTRACT FROM AUTHOR]

International student mobility (ISM) to China is an underexplored topic, especially as it relates to mobility emanating from the Global North. Between 2019 and 2020, we interviewed 25 international students originally from Europe, North and South America, and Oceania and, using thematic analysis, analysed their decisions to study in China. The results show that these young people’s international migration patterns were motivated by a strong desire to search for a sense of home, cultural adventure, personal growth, authenticity, and abundant opportunities in China. In this light, we argue that international students’ migration decision‐making is intertwined with their imaginaries of and imaginative frames for China, which various agents formulate at the intersection of global, national, and local contexts. In the process, we reveal a geographical imaginary of ISM that has been overlooked in the existing literature. [ABSTRACT FROM AUTHOR]

This study aims to investigate the factors affecting student teachers’ acceptance intention of a gamified classroom response system (CRS) named Bodoudou. Combining the attributes of innovation (AOI) theory with the well-known technology acceptance model (TAM), we raised 19 hypotheses that explain the relationships among eight factors. The proposed model was tested with survey data collected from 240 English-as-a-second-language (ESL) student teachers in China. We first conducted a scale evaluation, which removed eight items measuring a technology’s compatibility and observability, then ran a structural equation modeling (SEM) test to explore the relationships among other factors. Findings revealed that student teachers’ intention to use CRS is mainly determined by the technology’s perceived usefulness (PU), perceived ease of use (PEoU), relative advantages (ADV), complexity (CPL), and trialability (TRI). Moreover, complexity is not a precise antonym to perceived ease of use in the current context, and trialability is not statistically related to perceived ease of use. The underlying reasons need further exploration. Future studies need to validate the scale measuring the five attributes of innovation, as well as the rationale of adding the AOI theory to the TAM model when investigating users’ technology acceptance intention. [ABSTRACT FROM AUTHOR]

There are no nationwide surveys on antihypertensive drugs in China. In order to assess the current status of antihypertensive drug therapy in patients with hypertension and analyzed factors that may affect combination therapy, using convenience sampling, we recruited 305,624 patients with hypertension from the Chinese Cardiovascular Association Database‐Hypertension Center between January 2019 and December 2021. Chi‐squared test was performed to analyze the administered antihypertensive drug types and their combinations in different hospital settings. Logistic regression was used to assess the factors influencing combination therapy. We found around 33.1% of the participants had stage 2 and above hypertension, of which 67.9% were treated with combination therapy. In community or general hospitals, the most common monotherapy was calcium channel blockers (CCB), angiotensin‐converting enzyme inhibitor/angiotensin II receptor inhibitor (ACEI/ARB) and diuretic were the main single‐pill combinations (SPCs), and ACEI/ARB and CCB were the main free combination. From 2019 to 2021, the rates of combination therapy increased (58.8%–64.1%) with SPCs from 25.9% to 31.0% and free combination from 31.9% to 32.6%. Patients aged < 60 years, with stage 2 and above hypertension, with an education level of high school and above, visiting general hospitals, living in the eastern region of China, with hypertension risk factors and comorbidities, and without anxiety or depression were more likely to receive combination therapy (all P < .05). The combination therapy use rate increased yearly and the rate of SPCs rose obviously. Individual, hospital, and regional differences in patients with hypertension influenced combination therapy. [ABSTRACT FROM AUTHOR]

In the study of urban development, it is very important to evaluate the influence of production factors reasonably and efficiently for the region to achieve efficient development. The principal aim of this investigation is to amalgamate the conventional measurement model characterized by robust interpretability with the non-parametric model characterized by limited interpretability, thereby enhancing the precision of research outcomes. Towards this objective, the study employs an optimized directional distance function integrated with a global Malmquist–Luenberger index to formulate a comprehensive total factor productivity measurement framework. In elucidating the homogeneous attributes of regions, departing from prior methodologies reliant on manual or direct algorithmic partitioning, this paper employs the K-means clustering algorithm for index discernment, abstracting the concept of K-means clustering centroids to encapsulate regional homogeneity, thereby delineating results through the visualization of regional development potential maps and the evolution of centroid-based clustering trend maps. The findings of the investigation illuminate common patterns of change across disparate regions, proposing a strategy for leveraging regional resource endowments towards a cohesive framework, thereby transcending constraints imposed by production efficiency limitations. Amidst the backdrop of the COVID-19 pandemic, this study draws upon provincial-level data spanning from 2000 to 2018 in China. The conclusive analytical outcomes underscore the pivotal role of energy factors in regional development efficiency, particularly within high-potential development regions, followed by the capital and labor factors. Concurrently, the study discerns a discernible hierarchical pattern among areas of development potential, which exhibits correlation with factor mobility dynamics. [ABSTRACT FROM AUTHOR]

Amid the increasing global internet penetration, understanding the impact of internet use on residents' health is crucial. This aids in formulating more effective health policies and provides empirical evidence for promoting health equity and improving overall public health. Drawing on the China Health and Retirement Longitudinal Study (CHARLS), this paper employs the Propensity Score Matching-Difference in Differences (PSM-DID) method to examine the impact of the internet on individual health and further explores the pathways through which the internet affects health. We introduce the research background and significance in the introduction. Then, in the theoretical analysis, it incorporates internet variables into the Becker health demand model to analyze changes in health demand and impact pathways. The empirical analysis tests the theoretical findings, leading to empirical results. Finally, the study discusses the results and provides relevant recommendations. The findings indicate significant positive effects of the internet on both physical and psychological health. These effects are realized through reducing health information asymmetry, lowering health costs, and increasing exposure to health-promoting environments. In the heterogeneity analysis, economic-related internet content shows a significant positive impact on resident health. Intensive internet use adversely affects psychological health. The beneficial effects of the internet on health are more pronounced among older individuals, those covered by medical insurance, and regions with higher levels of digital economy. Based on these findings, the study offers policy recommendations concerning individuals' internet use patterns, the digital evolution of the healthcare industry, and government infrastructure development. [ABSTRACT FROM AUTHOR]

Freckle is a prevalent pigmentary dermatosis with an obvious hereditary component. Dozens of freckles risk loci have been discovered through research on multiple traits or other diseases, rather than as an independent trait. To discover novel variants associated with freckles, we performed GWAS and meta‐analysis in 4813 Chinese individuals. We conducted GWAS and meta‐analysis of two cohorts: 197 patients and 1603 controls (Cohort I), and 336 patients and 2677 controls (Cohort II), both from China. Then we performed linkage disequilibrium (LD) analysis, eQTL study, and enrichment analysis with association results for functional implications. Finally, we discovered 59 new SNPs and 13 novel susceptibility genes associated with freckles (Pmeta <5 × 10−8), which has enriched the genetic research on freckles. [ABSTRACT FROM AUTHOR]

Camping has become a popular outdoor activity in China. However, the long and scorching summers in China's hot and humid regions pose challenges for campsites in maintaining thermal comfort. Therefore, we explored the impact of tree species and planting methods on the thermal comfort of urban campsites in hot and humid areas using the ENVI-met model to simulate the conditions of the study area. The reliability of the model was validated by comparing the simulated values of air temperature (Ta) and relative humidity (RH) with field measurements. We conducted an in-depth analysis of common trees in hot and humid areas and analyzed the effects of five tree species and four tree planting forms on the microclimate of campsites in such areas, using the physiological equivalent temperature (PET) as the evaluation index of thermal comfort. The results indicated that: (1) trees with larger crown widths were most effective in improving outdoor thermal comfort. The ability of trees to regulate microclimate was more influenced by crown width than by leaf area index (LAI), and (2) trees planted in patches provided the highest level of thermal comfort, whereas single trees provided the lowest. However, relying solely on tree planting made it difficult to significantly reduce outdoor heat stress. Therefore, other methods such as increasing ventilation or mist spray should be adopted to modify camping area. This study provides a reference for the planting design of outdoor campsites in hot and humid regions of China. [ABSTRACT FROM AUTHOR]

The primary catalyst for nonalcoholic fatty liver disease (NAFLD) is widely recognized as the induction of lipotoxicity in hepatocytes by an excess of fatty acids. In China, Penthorum chinense Pursh (PcP) is commonly employed as a functional food due to its known hepatoprotective properties. The present study aimed to investigate the influence of PcP extract on in vivo and in vitro models of NAFLD. We found that PcP extract can attenuate palmitic acid (PA)‐induced lipotoxicity in HepG2 cells. PA was observed to trigger pyroptosis, as indicated by the increased expression of NLRP3 and GSDMD/N, activation of Caspase‐1, and subsequent release of IL‐1β and IL‐18. However, these changes were reversed after PcP was administered. Furthermore, the application of an NLRP3 agonist inhibited the protective effects of PcP on lipotoxicity, indicating that PcP decreased lipotoxicity by inhibiting the NLRP3/Caspase‐1/GSDMD pathway. Ultimately, we established a rat model of NAFLD through the administration of a high‐fat diet (HFD), followed by the oral delivery of PcP extracts. The results demonstrated that the administration of PcP extract effectively decreased dyslipidemia and hepatic steatosis, which coincided with a decrease in hepatic pyroptosis through modulation of the NLRP3/Caspase‐1/GSDMD pathway in liver tissues. Overall, our findings provide insight into the mechanism by which PcP extracts alleviate hepatic steatosis, highlighting the potential significance of modulating the NLRP3/Caspase‐1/GSDMD pathway in the context of pyroptosis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to elucidate the connection between osteoclastic forkhead transcription factor O1 (FoxO1) and periodontitis and explore the underlying mechanism by which FoxO1 knockdown regulates osteoclast formation. Materials and Methods: A conventional ligature‐induced periodontitis model was constructed to reveal the alterations in the proportion of osteoclastic FoxO1 in periodontitis via immunofluorescence staining. Additionally, RNA sequencing (RNA‐seq) was performed to explore the underlying mechanisms of FoxO1 knockdown‐mediated osteoclastogenesis, followed by western blotting, quantitative polymerase chain reaction, and enzyme‐linked immunosorbent assay. Results: FoxO1+ osteoclasts were enriched in the alveolar bone in experimental periodontitis. Moreover, FoxO1 knockdown led to impaired osteoclastogenesis with low expression of osteoclast differentiation‐related genes, accompanied by an insufficient osteoclast maturation phenotype. Mechanistically, RNA‐seq revealed that the nuclear factor kappa B (NF‐κB) and nucleotide‐binding oligomerization domain‐like receptor family pyrin domain containing 3 (NLRP3) inflammasome signaling pathways were inhibited in FoxO1‐knockdown osteoclasts. Consistent with this, MCC950, an effective inhibitor of the NLRP3 inflammasome, substantially attenuated osteoclast formation. Conclusions: FoxO1 knockdown contributed to the inhibition of osteoclastogenesis by effectively suppressing NF‐κB signaling and NLRP3 inflammasome activation. This prospective study reveals the role of FoxO1 in mediating osteoclastogenesis and provides a viable therapeutic target for periodontitis treatment. [ABSTRACT FROM AUTHOR]

This paper introduces an innovative cooperative model for energy efficiency retrofitting that incorporates carbon emission rights, addressing critical financial constraints in Energy Performance Contracting (EPC). By employing the fuzzy analytic hierarchy process (F-AHP) to evaluate risk assessment indicators and stakeholder contributions and utilizing the enhanced Shapley method for equitable benefit distribution, the model demonstrates significant improvements in financing and efficiency for energy conservation projects. The findings are as follows: (1) the energy efficiency retrofit model, which integrates carbon emission rights, effectively alleviates the financial constraints and fosters energy conservation and emission reduction in guaranteed-savings EPC projects; (2) the enhanced Shapley method is deemed appropriate for the equitable distribution of energy-saving benefits among stakeholders; (3) when compared with the traditional model and the benefit allocation-absent carbon rights, the energy-saving benefits of the energy efficiency retrofit model incorporating carbon emission rights are higher in individual and overall terms. The findings of this study offer a viable solution to financing challenges faced by stakeholders in such projects and delineate a pragmatic approach for enterprises to enhance energy efficiency and reduce emissions. [ABSTRACT FROM AUTHOR]

The relationship between bone mineral density and type 2 diabetes is still controversial. The aim of this study is to investigate the relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) in elderly men and postmenopausal women. The participants in this study included 692 postmenopausal women and older men aged ≥ 50 years, who were divided into the T2DM group and non-T2DM control group according to whether or not they had T2DM. The data of participants in the two groups were collected from the inpatient medical record system and physical examination center systems, respectively, of the Tertiary Class A Hospital. All data analysis is performed in SPSS Software. Compared with all T2DM group, the BMD and T scores of lumbar spines 1–4 (L1–L4), left femoral neck (LFN) and all left hip joints (LHJ) in the non-T2DM group were significantly lower than those in the T2DM group (P < 0.05), and the probability of major osteoporotic fracture in the next 10 years (PMOF) was significantly higher than that in T2DM group (P < 0.001). However, with the prolongation of the course of T2DM, the BMD significantly decreased, while fracture risk and the prevalence of osteoporosis significantly increased (P < 0.05). We also found that the BMD of L1-4, LFN and LHJ were negatively correlated with homeostatic model assessment-insulin resistance (HOMA-IR) (P = 0.028, P = 0.01 and P = 0.047, respectively). The results also showed that the BMD of LHJ was positively correlated with indirect bilirubin (IBIL) (P = 0.018). Although the BMD was lower in the non-T2DM group than in the T2DM group, the prolongation of the course of T2DM associated with the lower BMD. And the higher prevalence of osteoporosis and fracture risk significantly associated with the prolongation of the course of T2DM. In addition, BMD was significantly associated with insulin resistance (IR) and bilirubin levels in T2DM patients. Registration number: China Clinical Trials Registry: MR-51-23-051741; https://www.medicalresearch.org.cn/search/research/researchView?id=c0e5f868-eca9-4c68-af58-d73460c34028. [ABSTRACT FROM AUTHOR]

Objective: Adverse childhood experiences (ACEs) have been associated with a range of adverse health outcomes, with pain being potentially one of them. This population-based cross-sectional study aimed to investigate the associations between Adverse Childhood Experiences (ACEs) and pain in Chinese adults and evaluate whether physical activity and demographic and socioeconomic characteristics modify this associations. Methods: Cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), were utilized in this study. A total of 9923 respondents with information on 12 ACE indicators and 15 self-reported body pains were included. Logistic regression models were used to assess associations of the ACEs and pain. Modification of the associations by physical activity, demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. Results: Among the 9923 individuals included in the primary analyses, 5098 (51.4%) males and the mean (SD) age was 61.18 (10·.44) years. Compared with individuals with 0 ACEs, those who with ≥ 5 ACEs had increased risk of single pains and multiple pain. A dose–response association was found between the number of ACEs and the risk of pain (e.g. neck pain for ≥ 5 ACEs vs. none: OR, 1.107; 95% CI, 0.903–1.356; p < 0.001 for trend). In the associations of each body pain with each ACE indicator, most ACE indicators were associated with an increased risk of pain. In addition, physical activity, sociodemographic and socioeconomic characteristics, such as age, sex, educational level, area of residence, childhood economic hardship, did not demonstrate a significant modify on the associations between ACEs and pain. Conclusions: These findings indicate that cumulative ACE exposure is associated with increased odds of self-reported pain in Chinese adults, regardless of adult physical activity, sociodemographic and socioeconomic characteristics. [ABSTRACT FROM AUTHOR]

Tropical and subtropical trees provide key ecosystem services but are facing global population decline due to logging, habitat degradation, land conversion, and climate change. Vatica guangxiensis used to be a characteristic timber species of China's tropical forests but is now terminally endangered (280 individuals) and fragmented into three relictual populations in southwest China. Generating genome‐wide DNA for ∼82% of all living tree individuals of this species complex, we found evidence for a late Pliocene division into two species‐level lineages that have not had gene flow for approximately 3 million years. All three relictual populations exhibited a loss of genetic diversity and recent bottlenecks. In addition, forward simulations indicated a likely population collapse in all three populations within the next century. Our study generates a model framework for the integration of genomic evidence—including evolutionary history, current genetic variation, and future projections—into conservation planning. [ABSTRACT FROM AUTHOR]

Based on survey data covering 309 family grain farms in China, a structural equation model was used to conduct an empirical study on the relationship between ecological cognition, digital agricultural technology adoption, and the sustainable development of family grain farms in China. The results are in the following: Ecological cognition has a significant positive effect on the sustainable development of family grain farms. And digital agricultural technology adoption has a partial mediating effect on the influence of ecological cognition on the sustainable development of family grain farms. The ecological cognition level of farmers should be continuously improved, and more support should be given to adopt digital agricultural technology to effectively promote the sustainable development of family grain farms in China. [ABSTRACT FROM AUTHOR]

As they represent an important form of agricultural operation, the sustainable development of family farms is not only an objective necessity for promoting comprehensive rural revitalization in China, but also an imperative strategy for accelerating the construction of agricultural power in China. Based on the survey data of 357 family grain farms in China, this paper uses a structural equation model to empirically analyze the relationship between market-oriented perceptions, organizational resilience, and the sustainable development of family grain farms. The results show that market-oriented perceptions have a significant positive impact on the sustainable development of family grain farms; additionally, organizational resilience plays a mediating role in the impact of market-orientation perceptions on the sustainable development of family grain farms. Based on this, the paper proposes a two-fold approach to the sustainable development of family farms: improving the level of market-orientation perceptions of family farmers and enhancing the organizational resilience of family grain farms. [ABSTRACT FROM AUTHOR]

Following a burgeoning literature on private actors under digital authoritarianism, this study aims to understand the role played by social media users in sustaining authoritarian rule. It examines a subcultural community—the queer-fantasy community—on Chinese social media to expound how members of this community interpreted China's censorship policy, interacted based on the interpretation, and participated in censorship. Integrating structural topic modeling and emergent coding, this study finds that a political environment of uncertainty fostered divergent imaginaries about censorship. These imaginaries encouraged participatory censorship within the online community, which strengthened the political control of the Internet in the absence of the state. This study illuminates how participatory censorship works, especially in non-professional and non-politically mobilized online communities. With a focus on social media users, it also offers a lens for future research to compare peer-based surveillance and content moderation in authoritarian and democratic contexts. [ABSTRACT FROM AUTHOR]

Persistent organic pollutants pose a great threat to amphibian populations, but information on the bioaccumulation of contaminants in amphibians remains scarce. To examine the tissue distribution and maternal transfer of organic halogenated pollutants (OHPs) in frogs, seven types of tissues from black‐spotted frog (muscle, liver, kidney, stomach, intestine, heart, and egg) were collected from an e‐waste–polluted area in South China. Among the seven frog tissues, median total OHP concentrations of 2.3 to 9.7 μg/g lipid weight were found (in 31 polychlorinated biphenyl [PCB] individuals and 15 polybrominated diphenyl ether [PBDE], dechlorane plus [syn‐DP and anti‐DP], bexabromobenzene [HBB], polybrominated biphenyl] PBB153 and ‐209], and decabromodiphenyl ethane [DBDPE] individuals). Sex‐specific differences in contaminant concentration and compound compositions were observed among the frog tissues, and eggs had a significantly higher contaminant burden on the whole body of female frogs. In addition, a significant sex difference in the concentration ratios of other tissues to the liver was observed in most tissues except for muscle. These results suggest that egg production may involve the mobilization of other maternal tissues besides muscle, which resulted in the sex‐specific distribution. Different parental tissues had similar maternal transfer mechanisms; factors other than lipophilicity (e.g., molecular size and proteinophilic characteristics) could influence the maternal transfer of OHPs in frogs. Environ Toxicol Chem 2024;43:1557–1568. © 2024 SETAC [ABSTRACT FROM AUTHOR]

AbstractLive streaming has been increasingly popular worldwide, with gift-giving emerging as a pivotal revenue stream for many streamers. While prior research has delved into the influence of streamers’ emotions and viewer-streamer interaction on viewers’ gift-giving behaviors, we suggest that peer viewers also play an essential role. In line with the principles of social influence and herding theory, the behaviors of peer viewers and the size of the viewing group are integral factors shaping individual behaviors. Hence, in the context of lives streaming, we focus on examining the impact of peer viewers’ gift-giving behaviors and the audience size on the gift-giving behaviors of individual viewers, respectively. Additionally, we examine the moderating role of viewers’ identities. We collected data from a popular live streaming platform in China and employed a panel regression model based on a sample of 651,678 viewers. This study contributes to the gift-giving literature by revealing the influence of peer viewers on focal viewers’ likelihood of gifting, gifting frequency and gifting value, and the moderating effect of viewers’ identities. Overall, these results have significant implications for both the theoretical understanding of social influence and herding in online setting, as well as the practical implications for future live streaming management. Future research could delve deeper into understanding the impact of various types of live streaming content and cultural differences on individual’s gift-giving behavior. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors. Materials and methods: An online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023. Results: In this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work–family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout. Conclusions: Fatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China. [ABSTRACT FROM AUTHOR]

The conversion of coal-fired power plants to nuclear power stations is a potential method for decarbonizing coal power and offers a pathway for low-carbon development in China's power industry. This paper focuses on retrofitting China's coastal coal-fired power stations and compares the potential nuclear reactor technologies for the retrofit: China's mainstream pressurized water reactor and the commercially operated fourth-generation high-temperature gas-cooled reactor (HTGR). The analysis compares the degree of matching between the two technologies and coal-fired power stations in terms of unit capacity, thermal system parameters, unit speed, structural dimensions, and weight, which significantly impact the retrofit scheme. The results indicate that HTGR is more compatible with coal-fired power plants and is recommended as the type of nuclear reactor technology to be retrofitted. The study selected the 210 MWe High-Temperature Gas-Cooled Reactor Pebble-Bed Module (HTR-PM) as the reactor technology for retrofitting a typical 300 MW class subcritical coal-fired unit. Based on the concept of subcritical parameters upgrading, the potential analysis and strategy study of retrofit is carried out in terms of the turbine, the main heat exchange equipment, the main pumps, and the main thermal system pipelines in the conventional island. The results indicate that the conventional island of the HTR-PM nuclear power plant has significant potential for retrofitting, which can be a crucial research direction for nuclear retrofitting of coal-fired power plants. [ABSTRACT FROM AUTHOR]

Background: The incidence of rabies exposure is high and increasing in China, leading to an urgent demand of rabies post-exposure prophylaxis (PEP) clinics for the injured. However, the spatial accessibility and inequality of rabies-exposed patients to rabies PEP clinics is less known in China. Methods: Based on rabies exposure data, PEP clinic data, and resident travel origin-destination (OD) matrix data in Guangzhou City, China, we first described the incidence of rabies exposure in Guangzhou from 2020 to 2022. Then, the Gaussian two-step floating catchment area method (2SFCA) was used to analyze the spatial accessibility of rabies-exposed patients to rabies PEP clinics in Guangzhou, and the Gini coefficient and Moran's I statistics were utilized to evaluate the inequality and clustering of accessibility scores. Results: From 2020 to 2022, a total of 524,160 cases of rabies exposure were reported in Guangzhou, and the incidence showed a significant increasing trend, with an average annual incidence of 932.0/100,000. Spatial accessibility analysis revealed that the overall spatial accessibility scores for three scenarios (threshold of driving duration [d0] = 30 min, 45 min, and 60 min) were 0.30 (95% CI: 0.07, 0.87), 0.28 (95% CI: 0.11, 0.53) and 0.28 (95% CI: 0.14, 0.44), respectively. Conghua, Huangpu, Zengcheng and Nansha districts had the higher accessibility scores, while Haizhu, Liwan, and Yuexiu districts exhibited lower spatial accessibility scores. The Gini coefficient and Moran's I statistics showed that there were certain inequality and clustering in the accessibility to rabies PEP clinics in Guangzhou. Conclusions: This study clarifies the heterogeneity of spatial accessibility to rabies PEP clinics, and provide valuable insights for resource allocation to achieve the WHO target of zero human dog-mediated rabies deaths by 2030. [ABSTRACT FROM AUTHOR]

This study examined the mediating role of intergroup orientation in the relationship between ethnic and national identification. Our participants were 1320 Yi minority youths from a secondary school located in the Yi ethnic autonomous prefecture of southwest China. The participants completed three self-report questionnaires measuring ethnic and national identification, and intergroup orientation, respectively. Structural equation modeling was employed to determine the relationships between ethnic and national identification and intergroup orientation, and to explore the mechanism underlying the association between ethnic and national identification. The results showed that Yi minority youths with a stronger sense of ethnic identity had a stronger sense of national identity. The results further indicated that stronger ethnic identity led to a more positive intergroup orientation, which in turn predicted a stronger national identity. Our findings may facilitate the cultivation of positive attitudes between national subgroups in multiethnic countries and help ethnic minority youth develop a stronger awareness of national identity while retaining their ethnic identity. [ABSTRACT FROM AUTHOR]

Reconstruction and governance in rural China have been a recurring theme for the last century. This article presents case studies based on Art-Oriented Rural Reconstruction Movement (ARRM) projects in Guangdong Province to analyze their modes of reconstruction, the themes they chose to engage with and their social impact, and the various social actors that dominated these projects. This study aims to answer whether ARRM provides a better mechanism as a creative mode of rural governance and whether other desired benefits, such as attracting economic resources toward the preservation of local culture or invigorating the local community, are better achieved. The cases help shed light on the question of the performativity of ruralism in connection with China’s contemporary urban practices in Shenzhen and a series of government-led art events of rural revitalization in the countryside. In doing so, they help identify what ARRM means to the ‘self-governed’ and the imagined ‘harmonious’ rural society, as well as what both mean to China. [ABSTRACT FROM AUTHOR]

Background: Although China has a long history of using insects as food and medicine and has developed numerous associated knowledge and practices, especially in its rural and mountainous areas, systematic surveys concerning this subject are limited. In-depth ethnobiological research is needed to compile a comprehensive database of edible and medicinal insects and record the associated knowledge of these food and medicinal resources. Methods: Data on edible and medicinal insects and associated knowledge about them were collected by interviewing 216 local villagers in a mountainous territory in southeast Guangxi Zhuang Autonomous Region, China. Results: Local villagers used at least 16 edible and 9 medicinal insects, of which 4 wasp species were used in both entomophagy and medicinal practices. Parapolybia varia, Polistes olivaceus, and Anomala chamaeleon were newly recorded edible insects in China. The wasps, Euconocephalus sp., Gryllotalpa orientalis, and Cyrtotrachelus longimanus, were preferred and culturally important edible insects. Populations of Euconocephalus sp. and G. orientalis were reported to have substantially decreased in recent years. Wasps and a bamboo bee were used to treat rheumatism, while cockroaches and antlions were used to treat common cold symptoms in infants. Insect-related knowledge was positively correlated with the interviewees' age. Conclusions: Villagers have accumulated considerable local and traditional knowledge of entomophagy and entomo-therapeutic practices. However, this knowledge is in danger of being lost, which highlights the urgent need to document this information. Edible insects enrich local diets, and a more sustainable supply (such as through insect farming) could maintain local entomophagy practices. Medicinal insects are a part of local folk medicine, and pharmacological and chemical techniques could be applied to identify various biologically active substances in these insects. [ABSTRACT FROM AUTHOR]

Inter-city population mobility, a critical phenomenon in the modern urbanisation process, is closely related to urban industrial structure and socioeconomic development. This paper aims to investigate the dynamics of population flows and their intricate ties to industrial structure, so we employ the graph neural networks (GNNs) method to simulate inter-city population flows in China, which efficiently integrates demographic and socioeconomic data with Tencent migration big data while accounts for geographical relationships between cities. The results show that the model's predictive accuracy using the CPC index was high for road and rail traffic and moderate for air transportation. A comparison with real-world data verified the model's effectiveness in predicting the urban hierarchy and regional aggregation of flows. Using GNNExplainer, the results indicated that population size positively influenced population flow, while developed manufacturing reduced population mobility for road and rail traffic but increased it for air transportation. By conducting scenario simulations in Northeast China, we found that enhancing the region's industry and consumer service industry could mitigate negative population outflows. The conclusions drawn from this study offer valuable perspectives to policymakers and urban planners, enabling them to make well-informed and judicious choices concerning urban planning, transportation, and resource allocation. [ABSTRACT FROM AUTHOR]

Information and communication technologies (ICTs) in basic education, i.e. K12 education, have often been constrained by sociocultural context and limited to pedagogical aspects, and these innovations have not yet catalyzed curriculum reform as expected. To address this research gap, this study adopted a key-competence-based subject knowledge learning tool, i.e. Smart Learning Partner (SLP), and conducted a quasi-experimental study to evaluate its effects among middle school students. A total of 400 participants in Grade 7 from four schools were followed for a period of two and a half years. The results on online learning engagement indicated that the manipulation generally succeeded in promoting students' use of SLP in the experimental schools. Furthermore, the results on academic performance showed that SLP could not only directly benefit students' learning in the first academic year but also continued to have an effect within the following one and a half years. This study contributes to the existing knowledge in two aspects: first, it extends the use of an adaptive learning cognitive map and shows positive effects in supporting the implementation of the whole curriculum; second, it presents a long-term and large-scale example of successfully integrating ICTs into the key-competence-based curriculum reform in the Chinese context. [ABSTRACT FROM AUTHOR]

Background: Accurately stratifying patients with pulmonary arterial hypertension (PAH) is very important, and traditional risk scores still have internal heterogeneity. This study aimed to construct a risk stratification model that can accurately identify clinical worsening (CW) events in conventional low‐intermediate risk patients with pulmonary hypertension under targeted drug treatment by using echocardiographic parameters. Methods: This study is a single‐center, prospective study, including 105 PAH patients who underwent regular follow‐up at Guangdong Provincial People's Hospital from October 2021 to April 2023. The primary endpoint was the occurrence of CW, including death, hospitalization due to pulmonary hypertension, escalation of targeted drug therapy, and worsening of PAH. The predictive value of the echocardiography‐based three‐strata risk model was assessed using Kaplan‐Meier curves and COX regression analysis. Results: A total of 98 PAH patients were ultimately included in this study. The median follow‐up duration was 26 months (range 7–28 months). The echocardiography‐based three‐strata model included the ratio of tricuspid annular plane systolic excursion and pulmonary artery systolic pressure (TAPSE/PASP) and inferior vena cava (IVC). The echocardiography‐based three‐strata model had higher diagnostic value (C‐index =.76) compared to the 2022 ESC/ERS three‐strata model and four‐strata model (C‐index =.66 and C‐index =.61, respectively). PAH patients with lower TAPSE/PASP and wider IVC showed a higher CW rate compared to patients with higher TAPSE/PASP and normal IVC (HR = 15.1, 95%CI:4.4‐51.9, p <.001). Conclusion: The echocardiography‐based three‐strata model based on TAPSE/PASP and IVC can effectively improve the stratification of low‐intermediate risk PAH patients under targeted treatment. [ABSTRACT FROM AUTHOR]

This paper complicates the classic security dilemma by considering the notions of ontological security and relational deterrence. It studies how the ontological security dilemma has emerged between the US, China, and Taiwan from the relational perspective and how these spiral chains will further develop in the future. The paper incurs the literature on relational analysis to expound on how different ontological security concerns allude to relational deterrence between the three actors. Taiwan's separatism is more of a threat to China's relational self than to physical security because the separatist does not belong to any already agreed relationship. A geometric model and a few simulations yield three unconventional findings. 1) The less advantaged the US military is over China, the less likely armed unification will occur. 2) The US anti-Chinese tendency is irrelevant in determining the probability of armed unification. 3) What may escalate the spiral are China's anti-Taiwan independence and Taiwan's anti-unification. Case sensitivity indicates the ontological sensibilities of a security dilemma. [ABSTRACT FROM AUTHOR]

Objectives Nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3-associated autoinflammatory disease (NLRP3 -AID) is a rare autosomal dominant systemic autoinflammatory disease. We aimed to summarize the phenotypic and genotypic features of Chinese adult NLRP3 -AID patients with hearing loss. Methods A retrospective cohort study of twenty-one adult patients with NLRP3 -AID was conducted in Peking Union Medical College Hospital between July 2015 and March 2023. All patients underwent whole exome sequencing and otorhinolaryngologic assessments. Clinical features and therapeutic data were collected and analysed. Results We found that 13/21 (61.90%) of patients had hearing loss with high-frequency impairment in the majority, and most patients presented with vestibular dysfunction as a new finding. The NLRP3 -AID patients with early-onset, cold or stress triggered episodes, red eyes, fatigue, hypopsia and mutations located in the NACHT domain of the NLRP3 protein were more likely to suffer from hearing loss, especially sensorineural hearing loss, perhaps as a result of pathogenic variants of high penetrance. By a series of audiological evaluations, TNF-α inhibitors were confirmed to improve or reverse hearing loss. Conclusions We reported the first cohort of Chinese adult NLRP3 -AID patients with hearing loss and characterized vestibular dysfunction, highlighted the necessity for attention to high-frequency hearing and provided potential alternative treatment. [ABSTRACT FROM AUTHOR]

Objective: The volume based procurement (VBP) program in China was initiated in 2022. The cost‐effectiveness of robotic arm assisted total knee arthroplasty is yet uncertain after the initiation of the program. The objective of the study was to investigate the cost‐effectiveness of robotic arm‐assisted total knee arthroplasty and the influence of the VBP program to its cost‐effectiveness in China. Methods: The study was a Markov model‐based cost‐effectiveness study. Cases of primary total knee arthroplasty from January 2019 to December 2021 were included retrospectively. A Markov model was developed to simulate patients with advanced knee osteoarthritis. Manual and robotic arm‐assisted total knee arthroplasties were compared for cost‐effectiveness before and after the engagement of the VBP program in China. Probability and sensitivity analysis were conducted. Results: Robotic arm‐assisted total knee arthroplasty showed better recovery and lower revision rates before and after initiation of the VBP program. Robotic arm‐based TKA was superior to manual total knee arthroplasty, with an increased effectiveness of 0.26 (16.87 vs 16.61) before and 0.52 (16.96 vs 16.43) after the application of Volume‐based procurement, respectively. The procedure is more cost‐effective in the new procurement system (17.13 vs 16.89). Costs of manual or robotic arm‐assisted TKA were the most sensitive parameters in our model. Conclusion: Based on previous and current medical charging systems in China, robotic arm‐assisted total knee arthroplasty is a more cost‐effective procedure compared to traditional manual total knee arthroplasty. As the volume‐based procurement VBP program shows, the procedure can be more cost‐effective. [ABSTRACT FROM AUTHOR]

T lymphoblastic leukemia /lymphoma (T-ALL/LBL) is a rare and highly aggressive neoplasm of lymphoblasts. We evaluated 195 T-ALL/LBL adolescent and adult patients who received ALL-type chemotherapy alone (chemo,n = 72) or in combination with autologous hematopoietic stem cell transplantation(auto-HSCT,n = 23) or allogeneic hematopoietic stem cell transplantation(allo-HSCT,n = 100) from January 2006 to September 2020 in three Chinese medical centers. 167 (85.6%) patients achieved overall response (ORR) with 138 complete response (CR) patients (70.8%) and 29 partial response (PR) patients (14.8%). Until October 1, 2023, no difference was found in 5-year overall survival (5-OS) and 5-year progression free survival(5-PFS) between allo-HSCT and auto-HSCT (5-OS 57.9% vs. 36.7%, P = 0.139, 5-year PFS 49.4% vs. 28.6%, P = 0.078) for patients who achieved CR, for patients who achieved PR, allo-HSCT recipients had higher 5-OS compared with chemo alone recipients (5-OS 23.8% vs. 0, P = 0.042). For patients undergoing allo-HSCT, minimal residual disease (MRD) negative population showed better 5-OS survival compared with MRD positive patients (67.8% vs. 19.6%, p = 0.000). There were no significant differences between early T-cell precursor (ETP), NON-ETP patients with or without expression of one or more myeloid-associated or stem cell-associated (M/S+) markers (NON-ETP with M/S+, NON-ETP without M/S+) groups in allo-HSCT population for 5-OS. (62.9% vs. 54.5% vs.48.4%, P > 0.05). Notch mutations were more common in patients with non-relapsed/refractory disease than relapsed/refractory disease (χ² =4.293, P = 0.038). In conclusion, Allo-HSCT could be an effective consolidation therapy not just for patients with CR, but also for those who achieved PR. The prognosis is significantly improved by obtaining MRD negative prior to allogeneic transplantation. [ABSTRACT FROM AUTHOR]

In contrast to Western platforms, which are dominated by crowdsourced labour, China's food-delivery platforms rely heavily on outsourced couriers to provide high-quality services. The conflicts emerging from outsourced labour relations have been inadequately examined. Based on extensive fieldwork in south China, this study reveals an intriguing fact: the outsourcing model frequently triggers yet largely conceals couriers' strikes. This study uses the work regime approach and labour bargaining power theory to analyse the complex dynamics created by the platforms. By scrutinizing state institutions, relationships among various organizations and workplace interactions, this study finds that the platform firms have dominant power but that inherent tensions exist between outsourcing platform firms, outsourced agencies, human supervisors and workers, forming a regime that this study calls "contentious despotism." Importantly, labour conflict is alive and potentially enduring in China's gigantic platform economy. [ABSTRACT FROM AUTHOR]

Bay areas have experienced a rapid development in their city integration and tourism industry over the past decade. However, city integration has rarely been studied in the tourism literature along with its dimensions and impact on tourism development. Therefore, this study examines city integration and its effects on tourism development from the perspective of residents in the Greater Bay Area, China. Through a qualitative research method with 73 semi-structured interviews, this study identified five dimensions of the effects of city integration on tourism development were also determined, including resource, community, product, marketing and economic dimensions. The theoretical contributions and practical implications of the findings were also discussed. [ABSTRACT FROM AUTHOR]

Improving corporate carbon performance is imperative for sustainable economic and social development. Using a sample of Chinese A-share-listed manufacturing firms from 2012 to 2019, this study explores how government environmental subsidies affect corporate carbon performance. The baseline results show that government environmental subsidies are positively associated with corporate carbon performance, suggesting an improving effect of government environmental subsidies on corporate carbon performance. These results are robust to a set of sensitivity tests. Further, the channel analyses show that government environmental subsidies improve corporate carbon performance by alleviating financial constraints and enhancing environmental information disclosure. Moreover, cross-sectional analyses show that the improving effect of government environmental subsidies on corporate carbon performance is stronger in state-owned enterprises, in firms with higher executive environmental awareness, and in firms with higher media attention. This study provides meaningful insights for the government seeking to promote low-carbon development through environmental subsidies. [ABSTRACT FROM AUTHOR]

A new loach species, Oreonectes andongensis sp. nov. is described from the Guangxi Zhuang Autonomous Region, China. The new species can be differentiated from other members of the genus by combinations of characters: a developed posterior chamber of the swim bladder, 13–14 branched caudal-fin rays, 8–16 lateral-line pores, body width 12–15% of standard length (SL), interorbital width 42–47% of head length (HL), and caudal peduncle length 11–16% of SL. Bayesian inference phylogenetic analysis based on mitochondrial Cyt b provided strong support for validity of O. andongensis sp. nov. (uncorrected p-distance 6.0–7.5%). [ABSTRACT FROM AUTHOR]

Our aim in this study was to translate and psychometrically evaluate a Chinese version of the Behavioral Regulation in Sport Questionnaire (BRSQ). Participants were Chinese collegiate athletes (N = 361) who were competitive in their respective sports. We examined the construct validity of the Chinese BRSQ using alternative structural equation models and evaluated convergent validity, factor score reliability, and measurement invariance of the optimal model. Due to insufficient score reliability for some subscales, our initial Chinese BRSQ was deemed problematic. A modified version of the questionnaire with a four-factor structure (amotivation, external regulation, introjected regulation, and autonomous motivation) demonstrated excellent construct validity, convergent validity, and score reliability. There was measurement invariance across athlete level and sex. This tool provides a valuable resource for practitioners and sport psychology researchers for assessing sport motivation among competitive university athletes in China. [ABSTRACT FROM AUTHOR]

• A CO 2 combined oxidant method for PRB regeneration is proposed for leachate–contaminated areas near landfill. • CO 2 well-washing technology is used for improving PRBs permeability. • The optimal ratios of oxidants and PRB fillers are proposed to achieve the best regeneration effect. Groundwater contamination near landfills is commonly caused by leachate leakage, and permeable reactive barriers (PRBs) are widely used for groundwater remediation. However, the deactivation and blockage of the reactive medium in PRBs limit their long-term effectiveness. In the current study, a new methodology was proposed for the in situ regeneration of PRB to remediate leachate-contaminated groundwater. CO 2 coupled with oxidants was applied for the dispersion and regeneration of the fillers; by injecting CO 2 to disperse the fillers, the permeability of the PRB was increased and the oxidants could flow evenly into the PRB. The results indicate that the optimum filler proportion was zero-valent iron (ZVI)/zeolites/activated carbon (AC) = 3:8:10 and the optimum oxidant proportion was COD/Na 2 S 2 O 8 /H 2 O 2 /Fe2+ = 1:5:6:5; the oxidation system of Fe2+/H 2 O 2 /S 2 O 8 2− has a high oxidation efficiency and persistence. The average regeneration rate of zeolites was 72.71%, and the average regeneration rate of AC was 68.40%; the permeability of PRB also increased. This technology is effective for the remediation of landfills in China that have large contaminated areas, an uneven pollutant concentration distribution, and a long pollution duration. The purification mode of long-term adsorption and short-time in situ oxidation can be applied to the remediation of long-term high-concentration organically polluted groundwater, where pollution sources are difficult to cut off. [ABSTRACT FROM AUTHOR]

The short-term adverse effects of ambient fine particulate matter (PM 2.5) and ozone (O 3) on anxiety disorders (ADs) remained inconclusive. We applied an individual-level time-stratified case-crossover study, which including 126,112 outpatient visits for ADs during 2019–2021 in Guangdong province, China, to investigate the association of short-term exposure to PM 2.5 and O 3 with outpatient visits for ADs, and estimate excess outpatient visits in South China. Daily residential air pollutant exposure assessments were performed by extracting grid data (spatial resolution: 1 km × 1 km) from validated datasets. We employed the conditional logistic regression model to quantify the associations and excess outpatient visits. The results of the single-pollutant models showed that each 10 μg/m3 increase of PM 2.5 and O 3 exposures was significantly associated with a 3.14 % (95 % confidence interval: 2.47 %, 3.81 %) and 0.88 % (0.49 %, 1.26 %) increase in odds of outpatient visits for ADs, respectively. These associations remained robust in 2-pollutant models. The proportion of outpatient visits attributable to PM 2.5 and O 3 exposures was up to 7.20 % and 8.93 %, respectively. Older adults appeared to be more susceptible to PM 2.5 exposure, especially in cool season, and subjects with recurrent outpatient visits were more susceptible to O 3 exposure. As our study subjects were from one single hospital in China, it should be cautious when generalizing our findings to other regions. Short-term exposure to ambient PM 2.5 and O 3 was significantly associated with a higher odds of outpatient visits for ADs, which can contribute to considerable excess outpatient visits. • Exposure to ambient PM 2.5 and O 3 was associated with an increased odds of outpatient visits for anxiety disorders. • PM 2.5 and O 3 exposures were attributable to considerable excess outpatient visits. • Older adults were more susceptible to PM 2.5 exposure, especially in cool season. • Subjects with recurrent outpatient visits were more susceptible to O 3 exposure. [ABSTRACT FROM AUTHOR]

The consideration of the fairness to local communities in the development of public facilities is not only a moral imperative, but also essential for achieving social performance of projects. Despite acknowledging the importance of identity influence, existing literature remains a significant dearth in examining the influence of diverse stakeholders on local residents' (un)fairness perceptions toward public projects, as well as an excessive reliance on self-reported methods. Therefore, this study adopted a judge-advisor-system to investigate neural and behavioral responses during the assessment of perceived unfairness caused by an assumptive newly planned waste-to-energy (WTE) project near communities of participants. Event-related potentials were measured, while participants judged the degree of two kinds of perceived unfairness (i.e., economy and health) under the influence of three stakeholders (i.e., governments, experts, and local residents). The neurocognitive results show that local individuals experienced negative emotions triggered by moral dilemmas of tradeoff between self- and other-interests when assessing both economic and health unfairness, with stronger ambivalence under economic conditions. Then, it is found that participants devoted more motivated cognitive effort into governments as authority to seek advice for addressing the dilemma in economic unfairness, yet, for treating health unfairness, they attached greater attention to both external experts as authority and local residents as ingroup members. This study contributes to the understanding of the emotions and cognitions of disadvantaged groups in the context of facilities, such as WTE, and opens a new avenue of research in infrastructure and stakeholder management to explore neurocognitive mechanisms of local residents' unfairness perception under the influence of different stakeholders. The findings yield valuable inputs for developing socially and morally responsible policies and strategies that consider and respect the concerns of local communities in public projects by leveraging the power of identity-based group influence. [ABSTRACT FROM AUTHOR]

Objective: To understand the epidemiological distribution characteristics of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in Yangquan City, Shanxi Province, China, from 2006 to 2021, to explore the influencing factors leading to the re-emergence of the epidemic, and to provide a basis for the formulation of targeted control strategies. Methods: Case information spanning from 2006 to 2021 in Yangquan City was collected for a retrospective case-control study conducted from June to September 2022. A 1:3 matched ratio was employed. A questionnaire was utilized to gather data on basic information, demographic characteristics, awareness of MT-ZVL knowledge, residence, and dog breeding and living habits. The study employed a multifactorial conditional stepwise logistic regression model to analyze the influencing factors. Results: A total of 508 subjects was analyzed. Risk factors for MT-ZVL included the use of soil/stone/concrete as building materials (OR = 3.932), presence of nearby empty/stone stack houses (OR = 2.515), dog breeding (OR = 4.215), presence of stray dogs (OR = 2.767), and neighbor's dog breeding (OR = 1.953). Protective factors comprised knowledge of MT-ZVL (OR = 0.113) and using mosquito repellents (OR = 0.388). The findings indicate significant associations between environmental and behavioral factors and MT-ZVL incidence in Yangquan City, Shanxi Province, China, from 2006 to 2021. These results underscore the importance of public awareness campaigns and targeted interventions aimed at reducing exposure to risk factors and promoting protective measures to mitigate the re-emergence of MT-ZVL outbreaks. Conclusion: House building materials, presence of neighboring empty houses, breeding domestic dogs and distribution of stray dogs surrounding the home are risk factors for MT-ZVL. Awareness of MT-ZVL and implementation of preventive measures during outdoor activities in summer and autumn are protective and may reduce the risk of MT-ZVL. Author summary: In recent years, a rapid reemergence of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) has been seen in the extension region of the Loess Plateau that had previously achieved elimination in China. In this study, we investigate the epidemiological characteristics of MT-ZVL and identify the factors associated with the rapid rise in MT-ZVL epidemics using a case-control design. A questionnaire was used to collect basic information, demographic characteristics, awareness of MT-ZVL knowledge, residence, and dog breeding and living habits. A multifactorial conditional stepwise logistic regression model was used to analyze the influencing factors. The study revealed that there has been a rising trend in the MT-ZVL endemic areas. House building materials, presence of neighboring empty houses, breeding domestic dogs and distribution of stray dogs surrounding the home are risk factors for MT-ZVL. Awareness of MT-ZVL and implementation of preventive measures during outdoor activities in summer and autumn are protective and may reduce the risk of MT-ZVL. We believe that our study makes a significant contribution to the literature to develop strategy for control the ongoing local transmission of MT-ZVL in hill districts. By analyzing the epidemiological characteristics and influencing factors of MT-ZVL, this research provides a basis for further optimizing the targeted control strategies. [ABSTRACT FROM AUTHOR]