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This study offers additional evidence on the self-employment of rural-to-urban migrants from the perspective of cultural barriers in China. By employing seven waves of the China Migrants Dynamic Survey data from 2010 to 2016, we find that cultural distance has a negative and significant effect on the self-employment of rural-to-urban migrants in eight subdivision industries. In particular, such negative effect is greater in the service sectors. [ABSTRACT FROM AUTHOR]

In order to explore the causal relationship between the level of urban digital construction and urban economic growth, this paper takes 280 cities in China as the research object and constructs a comprehensive indicator evaluation system covering digital infrastructure, overall economic level, innovation development level, digital industry development status, and ecological environment conditions. Using the entropy method to weigh various indicators, this paper has obtained the evaluation results of the digital construction level of each city from 2011 to 2021. Furthermore, a panel data regression model is used to empirically analyze the impact of urban digital construction level on urban economic growth. The results show that for every 1% increase in the level of urban digital construction, the GDP will increase by 0.974. Through the above research, we hope to further enrich the theoretical and empirical research in the field of the digital economy, provide a scientific and reasonable method for quantitatively evaluating the level of urban digital construction, and provide decision-making references for improving the level of urban digital construction and promoting sustainable urban development. [ABSTRACT FROM AUTHOR]

Fujian province, an important tea-producing area in China, has abundant tea cultivars. To investigate the genetic relationships of tea plant cultivars in Fujian province and the characteristics of the tea plant varieties, a total of 70 tea cultivars from Fujian and other 12 provinces in China were subjected to restriction site-associated DNA sequencing (RAD-seq). A total of 60,258,975 single nucleotide polymorphism (SNP) sites were obtained. These 70 tea plant cultivars were divided into three groups based on analyzing the phylogenetic tree, principal component, and population structure. Selection pressure analysis indicated that nucleotide diversity was high in Southern China and genetically distinct from cultivars of Fujian tea plant cultivars, according to selection pressure analysis. The selected genes have significant enrichment in pathways associated with metabolism, photosynthesis, and respiration. There were ten characteristic volatiles screened by gas chromatography–mass spectrometry (GC–MS) coupled with multivariate statistical methods, among which the differences in the contents of methyl salicylate, 3-carene, cis-3-hexen-1-ol, (E)-4-hexen-1-ol, and 3-methylbutyraldehyde can be used as reference indicators of the geographical distribution of tea plants. Furthermore, a metabolome genome-wide association study (mGWAS) revealed that 438 candidate genes were related to the aroma metabolic pathway. Further analysis showed that 31 genes of all the selected genes were screened and revealed the reasons for the genetic differences in aroma among tea plant cultivars in Fujian and Southern China. These results reveal the genetic diversity in the Fujian tea plants as well as a theoretical basis for the conservation, development, and utilization of the Fujian highly aromatic tea plant cultivars. [ABSTRACT FROM AUTHOR]

The agricultural subsidy is an important policy instrument that aims to maintain food security and promote agricultural development in several countries. China introduced its first nationwide agricultural subsidy (i.e., the direct grain subsidy) for farmers in 2004. This study examines the impacts of direct grain subsidies on rural residents' food consumption patterns and nutritional intake on an individual basis. Based on a nationally representative sample of rural households from the National Rural Fixed Observation Points Survey data collected by the Ministry of Agriculture and Rural Affairs of China between 2003 and 2015, high‐dimensional fixed‐effects estimates show that the direct grain subsidy has boosted rural residents' grain consumption but reduced aquatic products, eggs, and dairy consumption in China. Specifically, an increase of 100 Chinese Yuan in per capita subsidies is associated with a rise of 14.94 g in daily grain consumption but a decrease of 0.57, 0.46, and 0.90 g in aquatic products, eggs, and dairy consumption, respectively. Furthermore, direct grain subsidies intensified rural residents' dietary imbalance and declined their dietary diversity. Observed dietary imbalance can be primarily attributed to the subsidy encouraging households' self‐sufficient grain consumption, leading to excessive cereal consumption and relatively lower consumption of meat, eggs, and milk. Our findings suggest that direct grain subsidies emphasizing the production of staple grains may inadvertently skew farmers' food consumption and nutritional intake, which may require consideration when evaluating the overall costs and benefits of agricultural subsidy policies. [EconLit Citations: D12, H20, I12, Q18]. [ABSTRACT FROM AUTHOR]

In recent years, with the rapid expansion of commercial banks' non-standardized business, the systematic correlation between shadow banking and commercial banks in China has been gradually enhanced, which enables the partial liquidity crisis of shadow banking to spread rapidly to commercial banks, leading to the increased vulnerability of China's financial system. Based on this, we built shadow banking indexes of trusts, securities, private lending and investments, introduced the dynamic correlation coefficient calculated by the dynamic conditional correlation multivariate GARCH model into the improved CoVaR model, and used the DCC-BEKK-MVGARCH-Time-Varying CoVaR Model to measure the risk overflow contribution of shadow banking in China. We find that shadow banking and commercial banks have an inherent relationship. Due to their own risks, different types of shadow banking contribute to the risk spillover to commercial banks in different degrees. The risk correlation between shadow banking and commercial banks fluctuates. Securities, trusts, private lending and investments shadow banking have different degrees of risk spillover contributions to commercial banks. Securities shadow banking has the highest risk spillover contribution. The next is trusts shadow banking. The risk spillover contributions from private lending and investments shadow banking are lower, but their volatilities are higher. The supervising department should standardize the information disclosure system of shadow banking and establish the risk firewall of commercial banks and shadow banking from the perspective of the risk spillover contribution. [ABSTRACT FROM AUTHOR]

Habitat fragmentation is altering species interactions worldwide. However, the mechanisms underlying the response of network specialization to habitat fragmentation remain unknown, especially for multi-trophic interactions. We here collected a large dataset consisting of 2670 observations of tri-trophic interactions among plants, sap-sucking aphids and honeydew-collecting ants on 18 forested islands in the Thousand Island Lake, China. For each island, we constructed an antagonistic plant–aphid and a mutualistic aphid–ant network, and tested how network specialization varied with island area and isolation. We found that both networks exhibited higher specialization on smaller islands, while only aphid–ant networks had increased specialization on more isolated islands. Variations in network specialization among islands was primarily driven by species turnover, which was interlinked across trophic levels as fragmentation increased the specialization of both antagonistic and mutualistic networks through bottom-up effects via plant and aphid communities. These findings reveal that species on small and isolated islands display higher specialization mainly due to effects of fragmentation on species turnover, with behavioural changes causing interaction rewiring playing only a minor role. Our study highlights the significance of adopting a multi-trophic perspective when exploring patterns and processes in structuring ecological networks in fragmented landscapes. [ABSTRACT FROM AUTHOR]

Background: Pembrolizumab is superior to chemotherapy as a first-line treatment for patients with mismatch-repair-deficient (dMMR) or microsatellite-instability-high (MSI-H) advanced or metastatic colorectal cancer (CRC), with a significant long-term survival benefit according to the KEYNOTE-177 trial. The current study aimed to determine whether pembrolizumab is a cost-effective treatment for patients with dMMR/MSI-H advanced or metastatic CRC in China. Methods: A partitioned survival model (PSM) was developed to simulate patients with dMMR/MSI-H advanced or metastatic CRC based on progression-free survival (PFS), progressive disease (PD) and death. The model was designed using a lifetime horizon, a 6-week cycle, and a 5% discount rate. The patients in the model had metastatic dMMR/MSI-H CRC and had not previously received treatment; these characteristics were similar to those of patients in KEYNOTE-177, a phase 3, open-label randomized clinical trial. The health outcomes and utilities were based on the KEYNOTE-177 trial and published data, respectively. Costs were calculated based on local charges (2022) and published literature. A treatment was deemed cost-effective in China if the incremental cost-effectiveness ratio (ICER) value was less than U.S.$38,142.56 per quality-adjusted life-year (QALY). The robustness of the results was assessed via one-way deterministic and probabilistic sensitivity analyses. Results: Baseline analysis revealed that pembrolizumab provided an additional 2.58 QALYs (3.00 life-year) at an incremental cost of U.S.$78,286.04, resulting in an ICER of U.S.$30,330.15 per QALY, which was below the willingness-to-pay threshold of U.S.$38,142.56 per QALY. When the patient assistance program (PAP) was considered, the ICER became U.S.$1,730.67 per QALY, manifesting absolute cost-effectiveness. The results of sensitivity analyses demonstrated that pembrolizumab was cost-effective in most cases. Conclusions: Pembrolizumab is a cost-effective first-line treatment for dMMR/MSI-H advanced or metastatic CRC patients in China, especially considering the PAP. [ABSTRACT FROM AUTHOR]

Purpose: Food choices profoundly affect one's dietary, nutritional and health outcomes. Using alcoholic beverages as a case study, the authors assess the potential of genetic data in predicting consumers' food choices combined with conventional socio-demographic data. Design/methodology/approach: A discrete choice experiment was conducted to elicit the underlying preferences of 484 participants from seven provinces in China. By linking three types of data (—data from the choice experiment, socio-demographic information and individual genotyping data) of the participants, the authors employed four machine learning-based classification (MLC) models to assess the performance of genetic information in predicting individuals' food choices. Findings: The authors found that the XGBoost algorithm incorporating both genetic and socio-demographic data achieves the highest prediction accuracy (77.36%), significantly outperforming those using only socio-demographic data (permutation test p-value = 0.033). Polygenic scores of several behavioral traits (e.g. depression and height) and genetic variants associated with bitter taste perceptions (e.g. TAS2R5 rs2227264 and TAS2R38 rs713598) offer contributions comparable to that of standard socio-demographic factors (e.g. gender, age and income). Originality/value: This study is among the first in the economic literature to empirically demonstrate genetic factors' important role in predicting consumer behavior. The findings contribute fresh insights to the realm of random utility theory and warrant further consumer behavior studies integrating genetic data to facilitate developments in precision nutrition and precision marketing. [ABSTRACT FROM AUTHOR]

Soil carbon persistence in forests plays a pivotal role in regulating terrestrial feedback to climate change. However, the relative contributions of biotic and abiotic factors in controlling geographic variation of forest soil carbon turnover time (τsoc) remains unclear. Here, we first sampled soils from 12 permanent forest plots across eastern China and detected higher radiocarbon‐derived mean turnover time of soil organic carbon in the deep (30–100 cm; 2,087 ± 246 years) than the surface (0–30 cm; 249 ± 80 years) layer. Further analyses based on the partial Mantel test and structural equation model illustrated that the interactions of climate, vegetation, and soil factors are more complex in deep than surface soils. Then, we established a global database of radiocarbon‐derived τsoc from 1897 forest soil samples. On the global scale, τsoc was significantly higher in the deep (3,081 ± 398 years) than the surface (332 ± 56 years) layer. Soil depth alone explained 11.7% of the spatial variation in τsoc, and the interactions between climate, stand age, and soil depth account for 68.6% of the variation. These findings highlight the joint control of climate, vegetation, and soil depth in the spatial variation of soil carbon persistence in global forests. Plain Language Summary: The soil in the forest ecosystem plays a vital role in modulating feedback between the atmosphere and biosphere under climate change. However, the underlying mechanism of climatic, vegetation, and soil properties regulating soil carbon turnover time (τsoc) at a geographic scale is still unclear. Here, we established a local data set by collecting soil samples from 12 permanent forest plots in eastern China. The statistical results showed significantly longer τsoc in the deep layer than in the surface layers and different processes at two depths. We then established a global database of forest stand age and radiocarbon‐derived τsoc. This study provides fundamental evidence of joint control of climate, vegetation, and soil factors in the spatial variation of soil carbon persistence in global forests. Key Points: Vegetation, climatic, and soil properties jointly dominated the geographic pattern of soil carbon persistence on a regional and global scaleSoil depth and forest stand age are important factors regulating the spatial variation of τsoc at global and regional scalesOur study calls for more efforts on the mechanisms underlying the multiple in driving soil carbon persistence in global forests [ABSTRACT FROM AUTHOR]

Green innovation is an important driving force for sustainable development. However China often imposes a wide variety of government regulations on green innovation One important reason behind these government regulations is the confinement of the cultural market. However, does this confinement actually affect the green innovation in China? By employing a 278 Chinese cities' dataset, we examine the effect of cultural reform pilot project on green innovation. Through the spatial difference-in-difference approach with the time trend, our results show that cultural reform pilot project (CRPP) is a significant determinist affecting the green innovation in China. Specifically, implementing CRPP promote green innovation in pilot cities which resulting from labour productivity exaltation, marketization rate increasing. The CRPP also have a spatial ripple effect which resulting from economic density promotion. Furthermore, the green innovation promotion is greater in cities which participating into World Technopolis Association, being included in the National Historical and Cultural Cities List and having high political hierarchy. Our conclusions still robustness after adopting a series of tests and alternative analyses. This paper not only provide evidence for the further implementation of cultural reform pilot project nationwide, but also provide policy implications on sustainable development in the post Covid-19 era. • Based on the theory of economic geography and the perspective of deregulation. • Examine both the direct and indirect effects of CRPP on green innovation via SDID approach. • Implement CRPP promotes green innovation both in pilot cities and neighbouring cities. • CRPP exalt ate labour productivity, increase marketization rate and promote economic density. • Effect of CRPP on green innovation exhibits heterogeneity on cities. [ABSTRACT FROM AUTHOR]

Fire is a common disturbance in many biomes, with both beneficial and detrimental effects on soil biology, which largely depend on fire intensity. However, little is known about the impact of fire on soil nematode communities in terrestrial ecosystem. In the present study, we investigated the effects of short‐term prescribed fire on soil nematode communities and soil properties in an old‐field grassland in Northern China. The results showed that burning significantly increased soil nematode abundance by 77% and genus richness by 49% compared to the control. Burning also decreased taxon dominance by 45% (Simpson's D) and increased nematode diversity by 31% (Shannon‐Weaver H'). However, burning increased plant parasites (particularly genera Cephalenchus and Pratylenchus) and shifted community to more bacterial‐feeding genera (i.e., decreased Channel Index). Generally, burning increased soil bio‐available nitrogen (NH4+–N and NO3−–N) content, which would be the main drivers causing nematode community to flourish via a "bottom‐up" effect. These results suggest that prescribed fire increases nematode diversity and alters community composition toward more plant parasites and bacterial feeders. Our findings highlight the importance of prescribed fire management in shaping short‐term nematode community structure and function, but the long‐term effects and impacts of these changes on soil nutrient and carbon cycling remain unknown. [ABSTRACT FROM AUTHOR]

Pressure injury is a serious and preventable problem in intensive care units. Translating guidelines into clinical practice can reduce the incidence of pressure injury. Identifying clinical status, barriers and facilitators contribute to guideline implementation. To identify the knowledge, attitudes, and practices of pressure injury prevention in Chinese critical care nurses. Secondary data were extracted from a multicentric clinical trial. Knowledge and attitudes toward pressure injury prevention were assessed by a fourteen‐item questionnaire. The observed practices were recorded using a case report form. The report complies with the STROBE statement. A total of 950 critical care nurses in 15 hospitals from six provinces of China were investigated. A total of 53.1% of nurses received a median score of 6 points or less. Knowledge regarding the repositioning procedure, risk assessment, and heel pressure injury prevention was insufficient. Over 99% of nurses strongly or somewhat agreed that pressure injury prevention was very important and that they were willing to take measures to prevent pressure injury. A total of 27 781 patient days of pressure injury prevention practice were recorded. Repositioning was the most commonly used prevention measure, followed by support surfaces and prophylactic dressings. A combination of repositioning, support surface, and prophylactic dressing was lacking. Chinese critical nurses showed a low level of knowledge and a positive attitude toward pressure injury prevention. Practices of pressure injury prevention were unsatisfactory. There is a clear gap between the guidelines and clinical practices. The barrier (low‐level knowledge) and facilitator (positive attitude) were identified in this study. According to these findings, strategies need to be developed to promote guideline implementation. [ABSTRACT FROM AUTHOR]

China's large-scale construction has led to massive energy consumption and carbon emissions. The embodied carbon emissions (ECs) of China's building sector play a key role in realizing national emission reduction targets. Currently, the understanding of the status quo of ECs is vague and inconsistent, and the existing accounting models still have several limitations. Therefore, this study develops two improved models (i.e., the process-based and the input-output-based life cycle assessment models) and dynamic accounting datasets to reveal historical trends and emission characteristics of ECs from 2005 to 2020. The results show that the total ECs in 2020 were as high as 2.28 billion tCO2, accounting for 25.2% of China's total energy-related carbon emissions. The indirect ECs are the largest contributor, representing 95.9% of the total building ECs. The ECs increased quickly at first and entered a plateau, stable at about 2.2 billion tCO2 after 2015. From 2005 to 2020, the total building ECs contributed 38.7% to the national carbon emission growth, while the intensity of ECs showed a downward trend, indicating that the increase in China's building ECs is scale-driven. This study provides sound methodological, and data support for emission tracing and the low-carbon development of China's building sector. [ABSTRACT FROM AUTHOR]

As one of the severe natural disasters, typhoon hazard brings tremendous tragedy to human beings. The foreland in the southeast of China is one of the most typhoon prone areas in the world. There are amount of damage of civil engineering structures induced by typhoon every year. Especially for the spacious villages, the low-rise buildings are vulnerable to typhoon so that many of them are destroyed regionally. The typhoon vulnerability assessment of civil engineering structures is a classical multiple attribute group decision making (MAGDM) issues. In this paper, the 2-tuple linguistic neutrosophic number grey relational analysis (2TLNN-GRA) method is built based on the grey relational analysis (GRA) and 2-tuple linguistic neutrosophic sets (2TLNSs) with incomplete weight information. For deriving the weight information of the attribute, an optimization model is built on the basis of the GRA, by which the attribute weights can be decided. Then, the optimal alternative is chosen through calculating largest relative relational degree from the 2-tuple linguistic neutrosophic number positive ideal solution (2TLNNPIS) which considers both the largest grey relational coefficient (GRC) from the 2TLNNPIS and the smallest GRC form 2-tuple linguistic neutrosophic number negative ideal solution (2TLNN NIS). Then, combine the traditional fuzzy GRA model with 2TLNNSs information, the 2TLNN-GRA method is established and the computing steps for MAGDM are built. Finally, a numerical example for typhoon vulnerability assessment of civil engineering structures has been given and some comparisons is used to illustrate advantages of 2TLNN-GRA method. [ABSTRACT FROM AUTHOR]

Background: Pressure injury is a common problem in intensive care units. Critical care nurses play an important role in multidisciplinary teams performing pressure injury treatment. Identifying the clinical status of pressure injury treatment may contribute to improving care quality. Aim: To identify the knowledge, attitudes, and practices regarding pressure injury treatment in critical care nurses. Design: A cross-sectional survey. Methods: Secondary data were extracted from a multicenter clinical trial. Knowledge and attitudes toward pressure injury treatment were assessed through a self-administered eight-item questionnaire. The observed practices were recorded using a case report form. The report was in accordance with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. Results: A total of 950 critical care nurses in 15 hospitals from six provinces/municipalities of China were investigated. The mean knowledge score was 2.89 ± 1.16 (95% confidence interval: 2.82– 2.97) out of a possible total of 5 points. The correct rates of selecting wound dressings and pain management were 34.4% and 45.6%, respectively. The mean attitude score was 9.07 ± 1.09 (95% confidence interval: 9.00– 9.13) out of a possible total of 12 points. A total of 2092 patient days of pressure injury treatment practices were observed and recorded. Repositioning was the most commonly employed treatment measure (98.8%). Foam dressing was the common dressing for stage I (53.6%), stage II (47.5%), and more severe pressure injury (67.9%), including stage III, IV, unstageable, and suspected deep tissue injury. Conclusion: Critical care nurses exhibited a generally low level of knowledge and moderate attitudes regarding pressure injury treatment. Practices of pressure injury treatment were generally acceptable. [ABSTRACT FROM AUTHOR]

The rapid expansion of urban areas has caused a series of impacts on the ecological environment. Exploring the effects of urban sprawl on carbon emissions and its mechanisms is crucial for realizing sustainable development patterns and low-carbon city planning. This study integrates used nighttime light data and population grid data to construct an Urban Sprawl Index. It employs a spatial Durbin model to analyze the spatial impact of urban sprawl on carbon emissions, examining the mechanisms from the perspective of local land transfers. The research reveals the following findings: (1) Urban sprawl significantly contributes to a positive spatial spillover effect on carbon emissions, leading to increased emission levels in surrounding cities. (2) The overall local impact of urban sprawl on urban areas is not significant. It suppresses carbon emissions in municipal districts but increases them in counties, with these effects counterbalancing each other. (3) Mechanism analysis indicates that different types of land transfers have varied effects on carbon emissions in districts and counties, and the regulation of the floor area ratio regulation strengthens the impact of land transfers. (4) Heterogeneity analysis shows that the size of urban populations significantly reduces the local effects of sprawl on carbon emissions, while environmental regulations strength attenuate the impact of urban sprawl on carbon emissions in municipal districts. The findings of this study provide practical references and policy implications for formulating reasonable urban development and land use plans, facilitating the achievement of peak carbon and carbon neutrality goals. [Display omitted] • Urban sprawl significantly contributes to a positive spatial spillover effect on carbon emissions. • The overall local impact of urban sprawl on urban areas is negligible. • Urban sprawl cuts emissions in districts but raises them in counties, offsetting overall. • Different types of land transfers have varied effects on carbon emissions in districts and counties. • Floor area ratio rules heighten land transfer impacts on emissions. [ABSTRACT FROM AUTHOR]

Although arboreal camera trapping is a growing field, it has rarely been used for monitoring plant‐frugivore interactions in the trees. Frugivore foraging behavior generally occurs in trees, hence arboreal camera trapping can be a potentially useful tool for frugivory research. We developed a camera trap sampling method to monitor plant‐frugivore interactions during mature fruiting periods. We used this method to monitor 318 individuals (camera sites) of 18 fleshy‐fruit plant species on 22 subtropical land‐bridge islands in the Thousand Island Lake, China. We recorded a total of at least 52 frugivorous animals, including a ground‐foraging bird species (Lophura nycthemera) and several mammals with foraging behaviors in the trees. We also recorded 4399 independent interaction events, including 275 unique plant‐bird interactions. We proposed a framework to classify interaction types and performed a sampling completeness test. We found that a sampling strategy that covered approximately a third of the fruit maturation period when most fruits were ripe was sufficient to sample plant‐frugivore interactions. Our results demonstrated that our sampling method with camera transects is reliable to monitor plant‐frugivore interactions in a fragmented landscape. This study helps to lay the methodological foundation for building networks of plant‐frugivore interactions with arboreal camera trapping on large spatial/temporal scales. As a non‐invasive, labor‐saving, and largely unbiased sampling method, the field application of arboreal camera trapping in different regions can advance the technology of biodiversity monitoring and lead to more accurate biodiversity inventories in arboreal environments. [ABSTRACT FROM AUTHOR]

Introduction: Frailty has gained increasing attention as it is by far the most prevalent geriatric condition amongst older patients which heavily impacts chronic health status. However, the relationship between frailty and adverse health outcomes in China is far from clear. This study explored the relation between frailty and a panel of adverse health outcomes. Methods: We performed a multicentre cohort study of older inpatients at 6 large hospitals in China, with two-stage cluster sampling, from October 2018 to April 2019. Frailty was measured according to the FRAIL scale and categorized into robust, pre-frail, and frail. A multivariable logistic regression model and multilevel multivariable negative binomial regression model were used to analyse the relationship between frailty and adverse outcomes. Outcomes were length of hospitalization, as well as falls, readmission, and mortality at 30 and 90 days after enrolment. All regression models were adjusted for age, sex, BMI, surgery, and hospital ward. Results: We included 9,996 inpatients (median age 72 years and 57.8% male). The overall mortality at 30 and 90 days was 1.23 and 1.88%, respectively. At 30 days, frailty was an independent predictor of falls (odds ratio [OR] 3.19; 95% CI 1.59–6.38), readmission (OR 1.45; 95% CI 1.25–1.67), and mortality (OR 3.54; 95% confidence interval [CI] 2.10–5.96), adjusted for age, sex, BMI, surgery, and hospital ward clustering effect. At 90 days, frailty had a strong predictive effect on falls (OR 2.10; 95% CI 1.09–4.01), readmission (OR 1.38; 95% CI 1.21–1.57), and mortality (OR 6.50; 95% CI 4.00–7.97), adjusted for age, sex, BMI, surgery, and hospital ward clustering effect. There seemed to be a dose-response association between frailty categories and fall or mortality, except for readmission. Conclusions: Frailty is closely related to falls, readmission, and mortality at 30 or 90 days. Early identification and intervention for frailty amongst older inpatients should be conducted to prevent adverse outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Lactate dehydrogenase (LDH) is an important oxidoreductase in the anaerobic metabolic pathway. The role of LDH in arterial stiffness (AS) and 10-year cardiovascular disease (CVD10) risk has not been established. Methods: This retrospective, cross-sectional, and observational study evaluated the relationships between the LDH level and AS and CVD10 risk in 12,597 health-examined people (6988 men and 5609 women; mean age, 49.49 years) in China. Brachial–ankle pulse wave velocity (baPWV) was used to estimate AS. The Framingham CVD 10-year risk prediction model was used to calculate the CVD10 risk score. Results: In both sexes, an increased LDH level was associated with increased AS and CVD10 (men: β = 0.032, P < 0.001; women: β = 0.025, P < 0.001). Half of the population with a high LDH level (≥ 172 U/L) showed significantly increased AS and CVD10 risk score. Men and women with baPWV ≥ 1400 cm/s had a higher LDH level, and the latter was significantly different from that of the group with baPWV < 1400 cm/s (men: 176.93± 30.99 vs 173.00± 33.36, P < 0.001; women: 189.10± 34.20 vs 171.39± 31.08, P < 0.001). In both sexes, a higher level of LDH was noted in groups with higher CVD10 risk score (men: 176.65± 32.51 vs 172.94± 32.46, P < 0.001; women: 202.51± 44.05 vs 175.73± 32.39, P < 0.001). Discussion: An increased LDH level may be associated with AS and CVD10 risk. The LDH level could be a new predictor of AS and CVD10 risk in health-examined populations. [ABSTRACT FROM AUTHOR]

Cardiovascular and cerebrovascular diseases are characterized by high rates of morbidity and mortality. Microbiota is closely associated with cardiovascular disease. We aimed to comprehensively analyze the microbiotas of 300 healthy controls, 300 patients with high blood pressure (HBP), and 300 patients with coronary heart disease (CHD). The results indicated no significant difference in microbiota diversity among the three groups (P > 0.05). However, differences in microbiota richness among the three groups were significant (P < 0.05). Bacteroidetes and Bacteroidia were the dominant bacteria in the CHD group, Enterobacteriales and Escherichia-shigella in the HBP group, and Acidaminococcaceae and Phascolarctobacterium in the healthy control group. The prediction results of the random forest model indicated that the population with CHD displayed prominent features with high sensitivity, indicating that microbiota detection might become a novel clinical indicator to predict and monitor the risk of cardiovascular events. The prediction of microbiota function suggested differences in oxygen supply and chronic inflammation between populations with HBP/CHD and healthy populations. Although there is no difference in gut microbiota diversity among the three groups, each group has its dominant microbiota in terms of richness. [ABSTRACT FROM AUTHOR]

Objective: The CAMEL clinical trial (412 patients were randomly assigned to either camrelizumab plus chemotherapy (n = 205) or chemotherapy alone (n = 207)) demonstrated that camrelizumab plus chemotherapy (CC) improved the overall survival time (OS) and progression-free survival time (PFS) of patients with metastatic nonsquamous non-small cell lung cancer (non-sq NSCLC) without epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations (EGFRm and ALKm) vs. chemotherapy (C) alone. Our objective was to conduct a cost-effectiveness analysis of CC vs. C from a perspective of health - care system in China with a lifetime horizon to identify whether it will be cost-effective. Materials and Methods: A partitioned survival model (PSM) was applied for patients with IIIB–IV non-sq NSCLC without EGFRm and ALKm. Transition parameters and proportions of three health states were derived from the CAMEL trial. The model was designed using a lifetime horizon, a 21-day cycle, and a 5% discount rate of costs and outcomes. It was deemed cost-effective in China if the incremental cost-effectiveness ratio (ICER) value is less than $32,457 per quality adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses were performed to verify the influence of parameter uncertainty on the results. Results: In the base-case analysis, we found that the ICER of CC compared with C is $-7,382.72/QALY which meant that CC had lower costs and better outcomes. The results of the sensitivity analyses demonstrated that the result was robust for the ICERs never transcending the willingness-to-pay (WTP) threshold. Conclusion: Camrelizumab plus chemotherapy is an obviously cost-effective therapeutic regime for patients of IIIB–IV non-sq NSCLC without EGFRm and ALKm in China at a $32,457 WTP threshold. [ABSTRACT FROM AUTHOR]

We theoretically study the stationary entanglement of two charged nanomechanical oscillators coupling via Coulomb interaction in an optomechanical system with an additional Kerr medium. We show that the degree of entanglementbetween two nanomechanical oscillators is suppressed by Kerr interaction dueto photon blockade and enhanced by Coulomb coupling strength. We also show other parameters for adjusting and obtaining entanglement, such as the driving power and the frequencies of the two oscillators, and the entanglement is robust against temperature. Our study proves a way for adjusting stationary entanglement between two optomechanical oscillators by Coulomb interaction and Kerr medium. [ABSTRACT FROM AUTHOR]

Background: Perioperative patients are at risk of developing stress ulcers (SU), which can cause clinically important bleeding. Stress ulcer prophylaxis (SUP) is widely applied to the patients in Intensive care unit (ICU) as well as the general ward, so it may lead to overmedication. However, there have been no surveys regarding SUP knowledge or prescribing habits.Objective: Our study assessed the knowledge, attitudes, and prescribing behavior of the surgeons toward perioperative patients regarding SUP and determined factors associated with low knowledge and high level of prescribing behaviors.Methods: We performed a cross-sectional survey using questionnaires, randomly sampling 1266 surgeons on their current SUP practices.Results: Proton pump inhibitors for SUP were used the most (94%); 43% used lansoprazole. Guideline awareness was inconsistent; the most familiar guideline was the National Medical Journal of China, and 46% were unaware of any guidelines. The predictors of low knowledge score regarding SUP in multivariable analysis were the hospital grade (p = 0.000), the type of hospital (p = 0.044), attendance at continuing education programs (p = 0.037), the awareness of clinical practice guidelines (CPGs) for SUP (p = 0.000). Twenty-one percent of physicians were high prescribers. High prescribing behavior was associated with hospital grade(p = 0.000), education level(p = 0.010) and attendance at continuing education programs (p = 0.000).Conclusion: We found that most surgeons used SUP, primarily proton pump inhibitors. However, surgeons knew little about the SUP guidelines, which may lead to insufficient SUP knowledge and overmedication. In addition, hospital grade, the type of hospital and attendance at continuing education programs may also affect the low knowledge of SUP. Hospital grade, education level and attendance at continuing education programs may affect high prescribing behavior. [ABSTRACT FROM AUTHOR]

Aim: To measure nurses' turnover intention and identify associated factors in general hospitals in China. Background: Understanding nurses' turnover intention is important to retain nurses, but factors associated with turnover intention require elucidation. Method: A cross‐sectional survey was conducted across 23 hospitals in China to investigate nurses' (N = 12,291) turnover intention and its associated factors. Associated factors were explored by univariate and multilevel multiple logistic regression analysis. Results: The mean total score for nurses' turnover intention was 13.97 ± 3.63. High proactive personality score, a seriously ill family member, experience of negative workplace events, high work pressure and high work–family conflict increased the risk for turnover intention. A low turnover intention was associated with being a non‐local resident nurse, position title, high salary level, good person–organisation fit and person–group fit, and high family–work facilitation. Conclusion: Nurses with a proactive personality, heavy family care burden, experience of negative workplace events, no position title and a low salary may merit special consideration. Implications for Nursing Management: Nurses' personality traits should be further focused on, and it is important to build a nurse‐oriented organisation atmosphere, including protecting nurses from workplace violence, establishing friendly relationships with their families and expanding career paths. [ABSTRACT FROM AUTHOR]

Background: The serum surfactant protein D (SP-D) level is suggested to be a useful biomarker for acute lung injuries and acute respiratory distress syndrome. Whether the serum SP-D level could identify the severity of coronavirus disease 2019 (COVID-19) in the early stage has not been elucidated.Methods: We performed an observational study on 39 laboratory-confirmed COVID-19 patients from The Fourth People's Hospital of Yiyang, Hunan, China. Receiver operating characteristic (ROC) curve analysis, correlation analysis, and multivariate logistic regression model analysis were performed.Results: In the acute phase, the serum levels of SP-D were elevated significantly in severe COVID-19 patients than in mild cases (mean value ± standard deviation (SD), 449.7 ± 125.8 vs 245.9 ± 90.0 ng/mL, P<0.001), while the serum levels of SP-D in the recovery period were decreased dramatically than that in the acute phase (mean value ± SD, 129.5 ± 51.7 vs 292.9 ± 130.7 ng/ml, P<0.001), and so were for the stratified patients. The chest CT imaging scores were considerably higher in the severe group compared with those in the mild group (median value, 10.0 vs 9.0, P = 0.011), while markedly lower in the recovery period than those in the acute phase (median value, 2.0 vs 9.0, P<0.001), and so were for the stratified patients. ROC curve analysis revealed that areas under the curve of lymphocyte counts (LYM), C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), and SP-D for severe COVID-19 were 0.719, 0.833, 0.817, 0.837, and 0.922, respectively. Correlation analysis showed that the SP-D levels were negatively correlated with LYM (r = - 0.320, P = 0.047), while positively correlated with CRP (r = 0.658, P<0.001), IL-6 (r = 0.471, P = 0.002), the duration of nucleic acid of throat swab turning negative (r = 0.668, P<0.001), chest CT imaging score on admission (r = 0.695, P<0.001) and length of stay (r = 0.420, P = 0.008). Multivariate logistic regression model analysis showed that age (P = 0.041, OR = 1.093) and SP-D (P = 0.008, OR = 1.018) were risk factors for severe COVID-19.Conclusions: Elevated serum SP-D level was a potential biomarker for the severity of COVID-19; this may be useful in identifying patients whose condition worsens at an early stage. [ABSTRACT FROM AUTHOR]

The construction sector is a key actor in fighting climate change. A clear and comprehensive accounting of its carbon emission responsibility is the basis for effective emission mitigation actions. The intersectoral and interregional trade of the construction sector complicates emission responsibility allocation. Neglecting such trade flows or measuring them from a single perspective may cause the sector's emission status to be misinterpreted. Hence, based on the environmentally extended multiregional input-output model, this paper establishes the construction sector's multiprinciple emission responsibility accounting framework and conducts multiple accounting for China's construction sector. The emission distribution and transfer across regions and sectors are systematically revealed, and various accounting principles, regional clusters, and corresponding policy implications are compared and discussed. The results show significant differences in the emission responsibilities of the construction sector under different principles, indicating that the choice of principles will greatly affect the determination of responsibility and corresponding policy priorities, which requires careful consideration. The emission responsibilities in different regions also have notable heterogeneity under each principle and are further clustered into three main emission patterns, suggesting that classified and targeted emission mitigation strategies should be adopted. The emission transfer analysis demonstrates that the construction sector is a typical end-of-chain sector with high emission-pulling effects on upstream industries and tiny emission-pushing effects on downstream industries, resulting in varied incentive impacts under each principle. Overall, this study contributes extensive insights into the emission responsibility of the construction sector, supporting common but differentiated emission reduction targets and policy settings. • A multiprinciple carbon accounting model for the construction sector is developed. • The emission distribution and transfer across regions and sectors are explored. • Accounting principles, emission patterns, and policy implications are compared. • Great disparities under various principles alert multiperspective strategy setting. • Regional heterogeneity in emissions emphasizes differentiated mitigation actions. [ABSTRACT FROM AUTHOR]

Habitat changes can alter animal behaviors, especially of large-bodied animals. Landfowl (Galliformes) are a phylogenetically diverse group of large-bodied ground-dwelling birds that are generally considered reluctant flyers. However, some species of landfowl have also been found to forage in arboreal habitats, which could be particularly advantageous under declining habitat quality. However, the prevalence of arboreal foraging behavior (AFB) and how it relates to habitat changes are still unexplored. Here, we reviewed life-history traits associated with foraging behaviors in 305 species of landfowl worldwide and examined the prevalence of AFB across the global landfowl phylogeny. We also collected data from arboreal camera traps on 22 subtropical reservoir islands and six nearby mainland sites in the Thousand Island Lake region of China to assess AFB of Silver Pheasant (Lophura nycthemera), the largest landfowl in this lake system, with island area and isolation. Globally, at least 84 species of landfowl (28%) showed evidence of AFB, with a strong phylogenetic signal. Camera trapping revealed that Silver Pheasant tended to have AFB on small and isolated islands, as evidenced by the increased arboreal sampling efforts. Our study reveals that landfowl's AFB is much more widespread than previously recognized, and suggests the importance of prioritizing large, connected habitats for the conservation of large-bodied animals like Silver Pheasant in the fragmented landscape. Finally, camera trapping emerges as a promising tool for recording landfowl's life history and uncommon behaviors that can help us understand landfowl's threats and aid conservation programs. • Arboreal foraging behavior is widespread in Galliformes worldwide. • Large and connected habitats should be prioritized for conservation actions. • Camera trapping emerges as a promising tool for understanding landfowl's threats and aiding conservation programs. • Fundamental research on life history are still needed for wildlife conservation. [ABSTRACT FROM AUTHOR]

Prior research has documented that crowdedness or high-density environments relate to stress and defensive responses of consumers, including reduced satisfaction and avoidance motivations from laboratory evidence. The current study builds on the results of previous studies to investigate how crowdedness may influence consumers' food spending and choice in natural restaurant settings. Through collaboration with a major restaurant chain in China, we gained access to a proprietary dataset that covers over 3.8 million actual dining orders made in 2015 and 2016. Applying a high-dimensional fixed effects model, we demonstrate that high levels of physical density can provoke higher food spending and nutrients ordered in restaurant environments, and the impact is robust across subsamples and measures of physical density. Cross-city analyses illustrate heterogeneous responses of customers to physical density, which can be partly explained by cultural differences. Heterogeneity analyses illustrate that customers with lower per person spending are affected more by elevated levels of physical density. Additionally, we show that the effect of physical density can be moderated by the size of dining parties. • We use a proprietary dataset with over 3.8 million actual dining orders made in 2015 and 2016. • High levels of physical density can provoke higher food spending and nutrients ordered in restaurant environments. • Cross-city analyses illustrate heterogeneous responses of customers to physical density. • Customers with lower per person spending are affected more by elevated levels of physical density. • The effect of physical density can be moderated by the size of dining parties. [ABSTRACT FROM AUTHOR]

Using a balance panel dataset of 278 Chinese cities, this study is the first to employ a spatial difference-in-differences (SDID) approach to investigate both the direct and indirect effects of low-carbon pilot policy on technological innovation. A series of robustness tests including the parallel trend test, placebo test and using SDID with propensity score matching to alleviate spatial sample selection bias are performed. Furthermore, mechanism and heterogeneity analyses are conducted by using mediation effect and moderation effect models, respectively. The results show that implementing low-carbon pilot policy have a significant promotion effect on technological innovation both in pilot cities and neighbouring cities, resulting from enhancing green total factor productivity, optimizing the industrial structure, alleviating financing constraints, and enhancing economic density. Moreover, the technological innovation increasing effect is more significant in cities with higher CO 2 emissions, more cultural diversity, higher political hierarchy, lower terrain relief and more integrated market. However, low-carbon pilot policy which implementing in cities with higher CO 2 emissions would not help to promoting technological innovation in neighbouring cities. In addition, low-carbon pilot policy increase technological innovation within 700 km of the coastline, whereas the beyond 800 km, the reduction effect is dominant. • Based on the market-based environmental regulation and agglomeration economic theory • Examine both the direct and indirect effects of LCCP on technological innovation via SDID approach. • Implement LCCP promotes technological innovation both in pilot cities and neighboring cities • LCCP enhance green TFP, optimize industrial structure, alleviate financing constraints and enhance economic density • Effect of LCCP on technological innovation exhibits spatial attenuation [ABSTRACT FROM AUTHOR]

Contrary to ongoing declines in per capita milk consumption in the United States and Europe, per capita milk consumption in China is experiencing dramatic increases, making China one of the most dynamic global dairy markets. Meeting the rapid growth in milk demand presents environmental challenges under current dairy farm production in China. This article measures Chinese consumer valuation of environmentally sustainable milk and of correlated attributes such as food safety and geographic origin. The authors used a discrete choice experiment to collect survey data from a stratified sample of respondents in 5 cities. Applying a mixed logit demand model to the data, they estimated the probability of choosing sustainably produced UHT pasteurized milk over conventional milk, as well as consumers' willingness to pay for the sustainably produced milk. Empirical results confirm that, overall, consumers value sustainably produced milk as they are willing to pay a premium of $2.01/L, well above the cost of conventional milk. Consumer segments more likely to purchase sustainably produced milk include the young, males, and childless households, as well as those already concerned about the environment and food safety. In addition, this article also finds that consumers exhibit a strong degree of home bias in that they prefer domestic brands with domestically sourced raw milk. Valuable new knowledge is provided for policy makers, producers, and marketers interested in designing marketing strategies, and for other researchers interested in general food sustainability issues. [ABSTRACT FROM AUTHOR]

• Factors influencing embodied carbon emissions of building sector are analyzed. • Six indicators are adopted to construct three extended STIRPAT models. • Identified factors all have significantly positive impacts. • Technical factors have a double-edged effect and rebound effects do exist. As China urbanizes, the embodied carbon emissions (EC) of its building sector continue to rise; analyzing the influencing factors (IFs) of building EC can indicate a direction for China's greenhouse gas mitigation strategy. Based on the Stochastic Impacts by Regression on Population, Affluence, and Technology model and comprehensively considering the characteristics of the building construction sector, this study identifies the IFs of building EC in terms of demand and supply and adopts six indicators to construct three extended analysis models. Both the direct and the indirect EC of the building sector are explored. The results show that six identified factors all have significantly positive impacts. Among them, the building construction area and indirect emission intensity have the greatest influence on EC and indirect EC. For changes in direct EC, total factor productivity and energy intensity are also non-ignored IFs. In addition, the analysis shows that technical factors have a double-edged effect and that rebound effects do exist in the building construction sector. Therefore, controlling building scale, reducing building material supply-side emission, improving technology and preventing rebound are keys to alleviating building EC. [ABSTRACT FROM AUTHOR]

BACKGROUND Simnotrelvir is an oral 3-chymotrypsin--like protease inhibitor that has been found to have in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and potential efficacy in a phase 1B trial. METHODS In this phase 2-3, double-blind, randomized, placebo-controlled trial, we assigned patients who had mild-to-moderate coronavirus disease 2019 (Covid-19) and onset of symptoms within the past 3 days in a 1:1 ratio to receive 750 mg of simnotrelvir plus 100 mg of ritonavir or placebo twice daily for 5 days. The primary efficacy end point was the time to sustained resolution of symptoms, defined as the absence of 11 Covid-19--related symptoms for 2 consecutive days. Safety and changes in viral load were also assessed. RESULTS A total of 1208 patients were enrolled at 35 sites in China; 603 were assigned to receive simnotrelvir and 605 to receive placebo. Among patients in the modified intention-to-treat population who received the first dose of trial drug or placebo within 72 hours after symptom onset, the time to sustained resolution of Covid-19 symptoms was significantly shorter in the simnotrelvir group than in the placebo group (180.1 hours [95% confidence interval {CI}, 162.1 to 201.6] vs. 216.0 hours [95% CI, 203.4 to 228.1]; median difference, -35.8 hours [95% CI, -60.1 to -12.4]; P=0.006 by Peto--Prentice test). On day 5, the decrease in viral load from baseline was greater in the simnotrelvir group than in the placebo group (mean difference [±SE], -1.51±0.14 log10 copies per milliliter; 95% CI, -1.79 to -1.24). The incidence of adverse events during treatment was higher in the simnotrelvir group than in the placebo group (29.0% vs. 21.6%). Most adverse events were mild or moderate. CONCLUSIONS Early administration of simnotrelvir plus ritonavir shortened the time to the resolution of symptoms among adult patients with Covid-19, without evident safety concerns. [ABSTRACT FROM AUTHOR]

Understanding the effects of land-use changes on arbuscular mycorrhizal fungal (AMF) communities may greatly benefit ecosystem conservation and restoration. However, how AMF communities respond to anthropogenetic land-use change (e.g., from natural ecosystems to farmland ecosystems) is still under debate. To enhance the preservation of vegetation diversity in ancient tea forest (ATF) regions and understand how land-use changes influence the AMF community in acidic soils, the AMF community composition and assembly processes in the ATF region (soil pH: 3.5–4.2) were investigated. Our results showed that AMF α-diversity indices in ATF were significantly higher than those in conventional tea plantations (CTP) and Forest. Moreover, number of indicator species (as virtual taxa, VTX) showed a remarkable decrease when ATF (12 VTXs) changed to Forest (8 VTXs) and CTP (3 VTXs). In addition, neutral processes dominated the AMF community assembly, and Acaulospora was the dominant genus of AMF indicator species in ATF. Moreover, land-use changes eliminated the neutral process of AMF community assembly in CTP and Forest by enhancing the environmental filtering effects. The concentrations of soil nitrate, TK, Mg2+, and Cu2+ were important factors accounting for the AMF community change. In addition, we found that high acidity soils may exert an ecological selection on the AMF community, as only species that adapt to strongly acidic soils persisted. Overall, our results indicated that mitigating soil acidification has potential as a method of improving the AMF community diversity and conserving and restoring ATF ecosystems in southwest China. • Land-use changes enhanced the environmental filter effect. • Neutral processes dominated the AMF community assembly. • Neutral processes diminished because of strong environmental filter. • Human disturbance and land-use change decreased the AMF diversity. • Acaulospora spp. are more adaptable to highly acidic soils. [ABSTRACT FROM AUTHOR]

Varying concentrations of H 2 S have been found in the carbonate reservoir, Puguang gas field, China. Thermochemical sulfate reduction (TSR) is considered the most important process to generate a high level of hydrogen sulfide (H 2 S) in the reservoir. Although TSR has been intensively studied in this field, it is still not clear on (1) the controls of H 2 S concentration variations in the reservoir, (2) effects of variable gas and water saturations and reservoir heterogeneity on the TSR reactions, (3) reservoir quality changes during the TSR reactions, (4) potential sources and sinks of sulfur and carbon and their quantification. In this study, we conducted reactive transport modeling to quantitatively simulate the TSR and H 2 S generation processes in the Upper Permian Changxing Formation and Lower Triassic Feixianguan Formation in Puguang gas field, using log-based depth and thickness, paleo mineralogy assemblages and paleo temperature in late Jurassic, and hydrostatic pressure. The modeling results are relatively reliable as the predicted H 2 S and CO 2 concentrations are comparable with the observed ones in the wells after calibration. The results indicated that both mineralogical composition and gas saturation in the reservoir affect the local efficiency and extent of TSR reactions, of which the abundance of effective anhydrite is an important control on the extent of the TSR reactions. The modeling durations of TSR reactions were ∼6 m.y. and TSR had a small impact on the reservoir porosity (porosity changes generally less than 0.1 porosity unit). The sources and sinks of carbon and sulfur were locally balanced with each other, respectively, and the minor imbalances were likely due to the molecular diffusion. The calibrated models have predictive potential on the H 2 S and CO 2 concentrations changes and porosity modifications during the TSR processes in the subintervals with limited samples. The validated TSR models will facilitate the investigation of organic-inorganic interactions and their impacts on both non-hydrocarbon (H 2 S and CO 2) generation and reservoir qualities. • Presented a reactive transport model of TSR reaction in a real-world context example. • Investigated the effects of variable gas and water saturations and reservoir heterogeneity on TSR processes. • Explored the potential sources and sinks of carbon and sulfur during the TSR reactions. • Simulated the H 2 S and CO 2 concentrations and porosity changes during the TSR processes. [ABSTRACT FROM AUTHOR]

In light of China's rapid advancement in the digital economy and the implementation of the "Healthy China" initiative, it is crucial to assess the impact of the digital economy on residents' health. This study analyzes data from the 2012, 2014, and 2016 China Labor Force Dynamics Survey (CLDS) to evaluate the health of residents using both subjective and objective criteria. Furthermore, it calculates the digital economy development index for Chinese cities and investigates its influence on the subjective and objective health of residents, along with the underlying mechanisms. The empirical results reveal a U-shaped pattern in the effect of the digital economy on health levels, initially detrimental but subsequently beneficial. The analysis of mechanisms shows that the digital economy's development initially increases and then decreases environmental pollution, impacting health through environmental changes. Additionally, the study finds variations in this impact based on age and urban-rural differences, with more pronounced effects on rural and older adult populations, who also experience the U-shaped curve's turning point more rapidly. These findings highlight the necessity of advancing digital economy infrastructure to positively influence environmental quality and improve public health. The study emphasizes the urgent need for policymakers to invest in digital infrastructure to foster a sustainable and healthy future. This requires a holistic approach to development, focusing on both urban and rural areas, to promote inclusive growth and reduce the digital divide., 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 © 2023 Zhu, Wang, Sun and Yue.)

Background: Low-dose computed tomography (LDCT) screening is effective in reducing lung cancer mortality in smokers; however, the evidence in nonsmokers is scarce., Objective: This study aimed to evaluate the participant rate and effectiveness of one-off LDCT screening for lung cancer among smokers and nonsmokers., Methods: A population-based prospective cohort study was performed to enroll participants aged between 40 and 74 years from 2013 to 2019 from 4 cities in Zhejiang Province, China. Participants who were evaluated as having a high risk of lung cancer from an established risk score model were recommended to undergo LDCT screening. Follow-up outcomes were retrieved on June 30, 2020. The uptake rate of LDCT screening for evaluated high-risk participants and the detection rate of early-stage lung cancer (stage 0-I) were calculated. The lung cancer incidence, lung cancer mortality, and all-cause mortality were compared between the screened and nonscreened groups., Results: At baseline, 62.56% (18,818/30,079) of smokers and 6% (5483/91,455) of nonsmokers were identified as high risk (P<.001), of whom 41.9% (7885/18,818) and 66.31% (3636/5483) underwent LDCT screening (P<.001), respectively. After a median follow-up of 5.1 years, 1100 lung cancer cases and 456 all-cause death cases (116 lung cancer death cases) were traced. The proportion of early-stage lung cancer among smokers was 60.3% (173/287), which was lower than the proportion of 80.3% (476/593) among nonsmokers (P<.001). Among smokers, a higher proportion was found in the screened group (72/106, 67.9%) than the nonscreened group (56/114, 49.1%; P=.005), whereas no significance was found (42/44, 96% vs 10/12, 83%; P=.20) among nonsmokers. Compared with participants who were not screened, LDCT screening in smokers significantly increased lung cancer incidence (hazard ratio [HR] 1.39, 95% CI 1.09-1.76; P=.007) but reduced lung cancer mortality (HR 0.52, 95% CI 0.28-0.96; P=.04) and all-cause mortality (HR 0.47, 95% CI 0.32-0.69; P<.001). Among nonsmokers, no significant results were found for lung cancer incidence (P=.06), all-cause mortality (P=.89), and lung cancer mortality (P=.17)., Conclusions: LDCT screening effectively reduces lung cancer and all-cause mortality among high-risk smokers. Further efforts to define high-risk populations and explore adequate lung cancer screening modalities for nonsmokers are needed., (©Le Wang, Youqing Wang, Fei Wang, Yumeng Gao, Zhimei Fang, Weiwei Gong, Huizhang Li, Chen Zhu, Yaoyao Chen, Lei Shi, Lingbin Du, Ni Li. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 14.03.2023.)

Alcohol consumption has been associated with the risk of mild cognitive impairment (MCI) in observational studies. The result is inconsistent and whether the association is causal remains unknown. To examine the causal effect of alcohol consumption on MCI in rural China, this study used a cross-sectional dataset that included 1966 observations collected in rural China, of which 235 observations' genotyping were collected. All participants accepted the MCI evaluation using Mini-Cog and were asked about the participants' alcohol consumption behavior. The causal effect of alcohol consumption on MCI was investigated by Mendelian randomization (MR) of genetic variation in the aldehyde dehydrogenase 2 ( ALDH2 rs671) gene. The risk of MCI in Chinese rural areas was 43%. Alcohol consumption was causally associated with a higher risk of MCI under MR design. Parameter estimates of drinking or not ( b = 0.271, p = 0.007, 95% CI = 0.073 to 0.469), drinking frequency during the past 30 days ( b = 0.016, p = 0.003, 95% CI = 0.005 to 0.027), and the weekly ethanol consumption ( b = 0.132, p = 0.004, 95% CI = 0.042 to 0.223) were all positive and statistically significant at the 5% level. In conclusion, there was a high risk of MCI in rural China, and alcohol consumption was causally associated with a higher risk of MCI.

Background: In the neonatal population, individual calculation and adjustment of vancomycin (VCM) doses has been recommended based on population pharmacokinetics (PPK) methods., Objective: Our previous study established a Chinese neonatal VCM PPK model. The main goal of this study was to evaluate the predictive performance of this PPK model for VCM trough concentration., Methods: The data on neonatal severe infection patients treated with VCM were retrospectively collected. The predictive performance of this PPK model was expressed using mean prediction error (MPE), mean absolute prediction error (MAPE), sensitivity and specificity. Linear regression analysis was used to compare predicted and measured VCM concentrations. We drew the receiver operating characteristic (ROC) curve to evaluate the predictive efficacy of the ratio of area under the concentration-time curve over 24 hours to minimum inhibitory concentration (AUC 0-24 /MIC) and trough concentration for clinical efficacy., Results: A total of 40 neonates with Gram-positive bacterial sepsis were included. After VCM treatment, 32 (80%) neonates were clinically cured. Eight cases were a clinical failure: the trough concentrations and AUC 0-24 were lower than that of the clinical cure patients (8.70±4.30 vs 14.30±4.50 mg/L, p=0.003; 404.30±122.80 vs 515.40±131.70, p=0.037). The measured and predicted trough concentration were 11.16 (5.96, 16.53) mg/L and 10.13 (6.61, 15.73) mg/L, respectively. The MPE and MAPE were 4.62% and 13.26% (5.30%, 25.88%), respectively. The proportion of MAPE <30% in the adjusted regimen was higher than the initial regimen (89.66% vs 65.00%, p=0.039). Predictions of sensitivity and specificity by this PPK model were 88.24% and 94.29%, respectively. The coefficients of determination of linear regression analysis were 0.9171 and 0.9009 for the initial and adjusted regimen, respectively. The AUC 0-24 was correlated with the trough concentration (r=0.587, p<0.001). The ROC curve indicated that the optimal cut-off points for predicting clinical efficacy were AUC 0-24 /MIC >425.47 and trough concentration >9.45 mg/L., Conclusion: This PPK model has good predictive performance in Chinese neonatal patients. Both AUC 0-24 /MIC and trough concentration can predict the clinical efficacy of antibacterial treatment., Competing Interests: Competing interests: None declared., (© European Association of Hospital Pharmacists 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Inflammasome signaling is a reaction cascade that influences immune response and cell death. Although the inflammasomes participate in tumorigenesis, their role as an oncogenic booster or a tumor suppresser is still controversial. Therefore, it is important to comprehensively investigate the inflammasome signaling status across various cancers to clarify its clinical and therapeutic significance. Methods: A total of 9881 patients across 33 tumor types from The Cancer Genome Atlas database were included in this study. Five gene sets were identified to step-wisely profile inflammasome signaling. Unsupervised clustering was used for sample classification based on gene set enrichment. Machine learning and in vitro and in vivo experiments were used to confirm the implications of inflammasome classification. Results: A hundred and forty-one inflammasome-signaling-related genes were identified to construct five gene sets representing the sensing, activation, and termination steps of the inflammasome signaling. Six inflammasome clusters were robustly established with distinct molecular, biological, clinical, and therapeutic features. Importantly, clusters with inflammasome signaling activation were found to be immunosuppressive and resistant to ICB treatment. Inflammasome inhibition reverted the therapeutic failure of ICB in inflammasome-activated tumors. Moreover, based on the proposed classification and therapeutic implications, an open website was established to provide tumor patients with comprehensive information on inflammasome signaling. Conclusions: Our study conducted a systematical investigation on inflammasome signaling in various tumor types. These findings highlight the importance of inflammasome evaluation in tumor classification and provide a foundation for improving relevant therapeutic regimens., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Background: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and can lead to heart failure (HF), stroke, pulmonary embolism (PE), and other complications, seriously affecting people's quality of life and health. Western medicine is limited in the treatment of AF, while Traditional Chinese Medicine (TCM) has unique advantages, such as less side effects, low toxicity, long effect duration, and high compliance. The prescription of HTDJ is a common prescription for the treatment of atrial fibrillation in Longhua Hospital, Shanghai University of Traditional Chinese Medicine. It has been used for many years and has a large number of clinically effective cases. It has a good clinical application prospect, but there is a lack of effective evaluation of its clinical efficacy., Method: This study adopts a randomized double-blind, single-simulated, placebo-controlled research method. Participants were randomly assigned in a 1:1 ratio through a centrally controlled, computer-generated, simple randomization schedule. Participants would take the medicine for 1 month, and the curative effect would be evaluated. Subsequently, the participants would not take TCM and only receive western medicine treatment. They would be followed up for another 8 weeks, and a clinical evaluation would be conducted. The secondary outcomes include echocardiography, Hamilton Anxiety Scale, Hamilton Depression Scale, rate of increase and decrease of anti-arrhythmia western medicine, the MOS 36-item short-form health survey, N-terminal-pro hormone B-type natriuretic peptide level, and integral TCM syndrome score. Adverse events will be monitored throughout the trial. Cases are from outpatient and inpatient with atrial fibrillation in the Cardiology Department of Longhua Hospital. Evaluations will be conducted at baseline and at weeks 4 and 12 after randomization., Discussion: In this study, the efficacy and safety of HTDJ plus western medicine in the treatment of atrial fibrillation (qi deficiency and phlegm opacities) will be evaluated, so as to provide medical evidence of short-term and medium-term clinical efficacy for the treatment of atrial fibrillation with integrated traditional and western medicine and lay a foundation for further clinical development and application., Trial Registration: ClinicalTrials.gov ChiCTR2000030517 . Registered on March 5, 2020, with the Chinese Clinical Trial Registry., (© 2021. The Author(s).)

The objective of this study was to investigate antibacterial activities and action mode of alkyl gallates against three food-related bacteria. Results show that the length of the alkyl chain plays a critical role in eliciting their antibacterial activities and octyl gallate (GAC8) exhibited an outstanding bactericidal effect against these strains. A possible bactericidal mechanism of GAC8 against E. coli was fully elucidated by analyzing associated changes in cellular functions of E. coli, including assessments of membrane modification and intracellular oxidation state. Our data strongly suggested that GAC8 functions outside and inside the bacterial membrane and causes increased intracellular reactive oxygen species (hydroxyl radicals) and subsequent oxidative damage. We demonstrated that the hydroxyl radical formation induced by GAC8 is the end product of an oxidative damage cellular death pathway involving a transient depletion of NADH, the tricarboxylic acid cycle, intrinsic redox cycling activities, and stimulation of the Fenton reaction. Also, chitosan-based edible films containing GAC8 have unique superiorities for icefish preservation at 4 °C. This research highlights the effectiveness of GAC8 as an attractive antibacterial, which possesses both antioxidant and antibacterial activities and can be used as a multifunctional food additive combined with the benefit of active packaging for food preservations., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Backgrounds: Cancer is one of the main causes of death worldwide, seriously threatening human health and life expectancy. We aimed to analyze the cancer incidence and mortality rates during 2016 in Zhejiang Province, Southeast China., Methods: Data were collected from 14 population-based cancer registries across Zhejiang Province of China. Cancer incidence and mortality rates stratified by sex and region were analyzed. The crude rate, age-standardized rate, age-specific and region-specific rate, and cumulative rate were calculated. The proportions of 10 common cancers in different groups and the incidence and mortality rates of the top five cancers in different age groups were also calculated. The Chinese national census of 2000 and the world Segi population was used for calculating the age-standardized incidence and mortality rates., Results: The 14 cancer registries covered a population of 14,250,844 individuals, accounting for 29.13% of the population of Zhejiang Province. The total reported cancer cases and deaths were 55,835 and 27,013, respectively. The proportion of morphological verification (MV%) was 78.95% of the population, and percentage of incident cases identified through death certificates only (DCO%) was 1.23% with a mortality-to-incidence ratio (M/I ratio) of 0.48. The crude incidence rate in Zhejiang cancer registration areas was 391.80/105; the age-standardized incidence rate of the Chinese standard population (ASIRC) and the age-standardized incidence rate of the world standard population (ASIRW) were 229.76/105 and 220.96/105, respectively. The incidence rate in men was higher than that in women. The incidence rate increased rapidly after 45 years of age and peaked in individuals aged 80 to 84 years. The top 10 incidence rates of cancers were lung cancer, female breast cancer, thyroid cancer, colorectal cancer, stomach cancer, liver cancer, prostate cancer, cervical cancer, esophageal cancer, and pancreatic cancer (from highest to lowest). The crude mortality rate in Zhejiang cancer registration areas was 189.55/105; the age-standardized mortality rate of the Chinese standard population (ASMRC) and the age-standardized mortality rate of the world standard population (ASMRW) were 94.46/105 and 93.42/105, respectively. The mortality rate in men was higher than that in women, and the male population in rural areas was higher than that in urban areas. The cancer mortality rate increased rapidly after 50 years of age and peaked in individuals aged 85+ years. The top 10 mortality rates of cancers were lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, esophageal cancer, female breast cancer, prostate cancer, lymphoma, and leukemia (from highest to lowest)., Conclusions: Lung cancer, female breast cancer, thyroid cancer, colorectal cancer, prostate cancer, liver cancer, and stomach cancer were the most common cancers in Zhejiang Province. Effective prevention and control measures should be established after considering the different characteristics of cancers in urban and rural areas., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)