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Background: As adequate support, virtual reality (VR) has been increasingly introduced into the classroom to help students learn a new language. However, empirical studies exploring the educational potential of using 360° spherical video-based virtual reality (SVVR) in high-school Chinese language classrooms are still lacking. Objectives: A mind mapping-based SVVR learning system is proposed for international high-school students' Chinese courses and examines its effects on improving Chinese learning achievements and perceptions among Grade 10 students who learn Chinese as a foreign language. Methods: This study adopted a quasi-experiment design. Participants (N = 66) were assigned to one of three conditions: mind mapping-based SVVR (MMBSVVR), conventional SVVR (CSVVR), or traditional lecturing (TL). Our mixed-method approach employed pre-and post-tests to measure Chinese learning achievements, questionnaires to measure Chinese learning motivation, problem-solving ability, and self-efficacy, and semi-structured interviews to further explore students' feelings and attitudes about Chinese courses in corresponding learning environments. Results and Conclusions: The results showed that the MMBSVVR classroom significantly improved high students' Chinese learning achievements in Chinese vocabulary and making sentence, problem-solving ability, and self-efficacy. Moreover, SVVR stimulates students' learning interest and class participation, and mind mapping provides students with a clear guide to arrange the knowledge. These findings help interpret the relationships between MMBSVVR and learning achievements, Chinese learning motivation, problem-solving ability, and self-efficacy in an international high school Chinese courses, thus providing insight on integrating MMBSVVR into existing classrooms.

In recent years, several researchers have introduced spherical video-based virtual reality (SVVR) into classroom teaching to help students learn different subjects. In SVVR learning, learners are typically presented with great autonomy over their learning process. Therefore, learners should engage in self-regulated strategy (SRS) learning in order to successfully study in SVVR. However, learners often struggle to self-regulate their learning. Therefore, we implemented a SRS intervention in SVVR. In this study, a SVVR environment was developed to situate students in art history contexts; moreover, the SRS was employed to guide students to improve their performance and to make reflections on their own performance. In order to evaluate the proposed approach's effectiveness, we carried out an experiment in a university art history class. The experiment results reveal more positive effects of the SRS-based SVVR approach compared with the non-SRS-based SVVR approach in terms of the learners' learning achievements, self-regulation, meta-cognitive awareness, as well as self-efficacy. In addition, this study specified that this approach would not have an effect on students' cognitive load. As a result, the SRS-based SVVR approach proposed in the current study was effective in art history education.

According to previous studies, traditional laboratory safety courses are delivered in a classroom setting where the instructor teaches and the students listen and read the course materials passively. The course content is also uninspiring and dull. Additionally, the teaching period is spread out, which adds to the instructor's workload. As a result, students become less motivated to learn. In contrast, artificially intelligent educational robots (AIERs), help students learn while lessening the workload on instructors by enhancing teaching strategies, using robots to substitute for teachers, giving students access to a variety of instructional content, and improving interaction with students through the use of intelligent voice interactions and Q&A systems to promote student engagement in learning. If the robot is used for a long time for learning, it may lead to a decrease in students' interest in learning. Therefore, this study introduces the GAFCC model (the theory-driven gamification goal, access, feedback, challenge, collaboration design model) as an instructional design model to guide the development of a gamified AIER system, aiming to improve students' motivation and learning effectiveness for laboratory safety courses. To test the effectiveness of the system, this study conducted an experimental study at a university in China in the summer of 2022. 53 participants participated in the research, with a random sample taken from each group. Each participant was able to choose the time of their free time to engage in the experiment. There were 18, 19, and 16 participants in experimental group 1, experimental group 2, and the traditional group, respectively. Students in experimental group 1 learned using the gamified AIER system, students in experimental group 2 learned on a general anthropomorphic robot system and the control group received traditional classroom learning. The experimental results showed that compared to the other two groups, the gamified AIER system guided by the GAFCC model significantly improved students' learning achievement and enhanced their learning motivation, flow experience, and problem-solving tendency. In addition, students who adopted this approach exhibited more positive behaviors and reduced cognitive load in the learning process.

Background: Mitochondrial DNA (mtDNA) variants have been implicated in keratoconus (KC). The present study aimed to characterize the mtDNA heteroplasmy profile in KC and explore the association of mitochondrial heteroplasmic levels with KC. Methods: Mitochondrial sequencing of peripheral blood samples and corneal tomography were conducted in 300 KC cases and 300 matched controls. The number of heteroplasmic and homoplasmic variants was calculated across the mitochondrial genome. Spearman's correlation was used to analyze the correlation between the number of heteroplasmic variants and age. The association of mtDNA heteroplasmic level with KC was analyzed by logistic regression analysis. Moreover, the relationship between mitochondrial heteroplasmic levels and clinical parameters was determined by linear regression analysis. Results: The distribution of mtDNA heteroplasmic variants showed the highest number of heteroplasmic variants in the non-coding region, while the COX3 gene exhibited the highest number in protein-coding genes. Comparisons of the number of heteroplasmic and homoplasmic non-synonymous variants in protein-coding genes revealed no significant differences between KC cases and controls (all p > 0.05). In addition, the number of heteroplasmic variants was positively associated with age in all subjects (r = 0.085, p = 0.037). The logistic regression analyses indicated that the heteroplasmic levels of m.16180_ 16181delAA was associated with KC (p < 0.005). Linear regression analyses demonstrated that the heteroplasmic levels of m.16180_16181delAA and m.302A>C were not correlated with thinnest corneal thickness (TCT), steep keratometry (Ks), and flat keratometry (Kf) (all p > 0.05) in KC cases and controls separately. Conclusion: The current study characterized the mtDNA heteroplasmy profile in KC, and revealed that the heteroplasmic levels of m.16180_16181delAA were associated with KC. [ABSTRACT FROM AUTHOR]

Promoting growth in patent activity was an important stated goal of China's Medium- and Long-Term Plan for Science and Technology Development (2006–20) , and it was a successful one. By the end of this ambitious blueprint, China had witnessed enormous growth in the number of granted patents, especially those granted to public universities. This vital role played by universities in technology innovation justifies further research on the role of academia with respect to the development of technology. However, most studies on patenting by Chinese universities are limited in terms of research scale and context, and patent performance is seldom investigated in great detail. This study first presents an overall analysis of the utility patents granted to Chinese public universities (not utility model patents). Then, we compare the patent performance of two elite university groups: Project 985 universities in China and member institutions of the Association of American Universities (AAU) in the USA. Our results show that Chinese universities account for a high proportion of the total patents granted in China, and the number of patents granted to universities has grown rapidly in recent decades, making them a very substantial contributor to China's innovation system. However, the value of patents did not improve as their counts surged. Compared to AAU universities, the technological and economic value of patents held by Project 985 universities is considerably lower, even for the top-patenting universities in China. These findings extend our understanding of technological innovation activity in China's academic landscape and might inspire future policies toward patent quality and impact. [ABSTRACT FROM AUTHOR]

Background: As adequate support, virtual reality (VR) has been increasingly introduced into the classroom to help students learn a new language. However, empirical studies exploring the educational potential of using 360° spherical video‐based virtual reality (SVVR) in high‐school Chinese language classrooms are still lacking. Objectives: A mind mapping‐based SVVR learning system is proposed for international high‐school students' Chinese courses and examines its effects on improving Chinese learning achievements and perceptions among Grade 10 students who learn Chinese as a foreign language. Methods: This study adopted a quasi‐experiment design. Participants (N = 66) were assigned to one of three conditions: mind mapping‐based SVVR (MMBSVVR), conventional SVVR (CSVVR), or traditional lecturing (TL). Our mixed‐method approach employed pre‐and post‐tests to measure Chinese learning achievements, questionnaires to measure Chinese learning motivation, problem‐solving ability, and self‐efficacy, and semi‐structured interviews to further explore students' feelings and attitudes about Chinese courses in corresponding learning environments. Results and Conclusions: The results showed that the MMBSVVR classroom significantly improved high students' Chinese learning achievements in Chinese vocabulary and making sentence, problem‐solving ability, and self‐efficacy. Moreover, SVVR stimulates students' learning interest and class participation, and mind mapping provides students with a clear guide to arrange the knowledge. These findings help interpret the relationships between MMBSVVR and learning achievements, Chinese learning motivation, problem‐solving ability, and self‐efficacy in an international high school Chinese courses, thus providing insight on integrating MMBSVVR into existing classrooms. Lay Description: What is Already Known about this Topic: By creating fully immersive 3D environments, 360° spherical video‐based virtual reality (SVVR) in promoting language learning has been confirmed by many scholars with a focus on English language learning.Mind mapping effectively enables second language learners to review and retain new words in the target language meaningfully. Also, it can create a more vivid learning atmosphere through images and graphics and promote learners' memory and learning motivation. What This Paper Adds: A mind mapping‐based SVVR learning system has been developed with the support of the constructivism theory.A mind mapping‐based SVVR learning system is proposed to facilitate international students' Chinese learning performance in Chinese vocabulary acquisition and sentence construction.In addition to promoting international students' learning outcomes, the proposed approach indicated promising results in learning motivation, problem‐solving ability, and self‐efficacy. Implications for Practice and/or Policy: This study provides an evidence base for further research through the utilization of VR learning environments in Chinese language classrooms.This study advocates introducing SVVR technology in the Chinese learning classrooms to increase the learning context for international students. It is also worth encouraging scholars to design VR learning systems with different learning strategies.Due to the cognitive requirements of the Chinese language learning process, it is necessary to introduce mind maps in the SVVR learning system to assist students in constructing knowledge and combining prior and new knowledge to generate long‐term memory. [ABSTRACT FROM AUTHOR]

According to previous studies, traditional laboratory safety courses are delivered in a classroom setting where the instructor teaches and the students listen and read the course materials passively. The course content is also uninspiring and dull. Additionally, the teaching period is spread out, which adds to the instructor's workload. As a result, students become less motivated to learn. In contrast, artificially intelligent educational robots (AIERs), help students learn while lessening the workload on instructors by enhancing teaching strategies, using robots to substitute for teachers, giving students access to a variety of instructional content, and improving interaction with students through the use of intelligent voice interactions and Q&A systems to promote student engagement in learning. If the robot is used for a long time for learning, it may lead to a decrease in students' interest in learning. Therefore, this study introduces the GAFCC model (the theory-driven gamification goal, access, feedback, challenge, collaboration design model) as an instructional design model to guide the development of a gamified AIER system, aiming to improve students' motivation and learning effectiveness for laboratory safety courses. To test the effectiveness of the system, this study conducted an experimental study at a university in China in the summer of 2022. 53 participants participated in the research, with a random sample taken from each group. Each participant was able to choose the time of their free time to engage in the experiment. There were 18, 19, and 16 participants in experimental group 1, experimental group 2, and the traditional group, respectively. Students in experimental group 1 learned using the gamified AIER system, students in experimental group 2 learned on a general anthropomorphic robot system and the control group received traditional classroom learning. The experimental results showed that compared to the other two groups, the gamified AIER system guided by the GAFCC model significantly improved students' learning achievement and enhanced their learning motivation, flow experience, and problem-solving tendency. In addition, students who adopted this approach exhibited more positive behaviors and reduced cognitive load in the learning process. [ABSTRACT FROM AUTHOR]

Background: Alpha-fetoprotein (AFP) is a well-identified biomarker in hepatocellular carcinoma (HCC). However, only limited AFP-related studies have evaluated its early response to systemic therapy. This study was performed with the aim of assessing the value of early AFP response in predicting overall survival (OS) and progression-free survival (PFS) in advanced HCC patients receiving systemic therapy. Methods: This cohort study included HCC patients with baseline AFP = 200 ng/ml and no prior treatment history. A > 20% decline in the serum AFP level from baseline to the first follow-up (i.e., 4~6 weeks after treatment) was defined as an early AFP response. Patient demographic information, clinical characteristics, radiological response, and survival rates were compared between patients with early AFP response and patients without early AFP response. We further utilized multivariate Cox regression to seek characteristics related to OS and PFS. Results: Among 154 patients, 69 patients (44.8%) showed an early AFP response. The disease control rate (76.8 vs. 54.1%; P = 0.003) and objective response rate (38.4 vs. 11.8%; P = 0.001) were significantly higher in patients with an early AFP response. By performing multivariate analysis, early AFP response remained a prognostic factor for longer PFS (HR 0.546; 95% CI 0.371-0.804; P = 0.002) and longer OS (HR 0.529; 95% CI 0.335-0.834; P = 0.006). Conclusion: An early AFP response is correlated with longer overall survival and progression-free survival for advanced HCC patients receiving systemic therapy. Moreover, an early AFP response is an independent prognostic factor for longer OS and PFS. [ABSTRACT FROM AUTHOR]

The ageing of orchards is common in the apple planting process, which affects the yield and quality of apples, as well as the development of the apple industry and local economy. The investigation of soil properties is important to the improvement and soil management of aged apple orchards. In this study, we investigated the spatial distribution, correlation and clustering of soil properties (nutrients, pH, enzymes and microorganisms) in aged and non‐aged apple orchards, as well as soil microbial communities in aged orchards with and without biofertilizer (Bacillus mucilaginosus + N, P, K) in Luochuan, Loess Plateau. The results showed that most soil properties, except for pH and catalase activity, decreased gradually with depth of soil and were highest in the 0–40 cm layer in both the aged and non‐aged orchards. However, there were no obvious differences in the horizontal direction, especially in the aged orchards, indicating that the fertilizer application site was randomly located in the aged orchards. The significant correlations between soil nutrients and microbes, available phosphorus and tree age, and the clustering of orchards as aged and non‐aged groups by soil properties, indicated that soil properties should be monitored in a timely manner to assess fertilizer application and predict the ageing of orchards. Additionally, the biofertilizer might make the aged orchard soil tend to non‐ageing by increasing beneficial and reducing harmful microbes, which suggested that biofertilizers should be widely used in future fertilizer application management of aged orchards to delay ageing. [ABSTRACT FROM AUTHOR]

Background: Clinical staging is essential for clinical decisions but remains imprecise. We purposed to construct a novel survival prediction model for improving clinical staging system (cTNM) for patients with esophageal adenocarcioma (EAC). Methods: A total of 4180 patients diagnosed with EAC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and included as the training cohort. Significant prognostic variables were identified for nomogram model development using multivariable Cox regression. The model was validated internally by bootstrap resampling, and then subjected to external validation with a separate cohort of 886 patients from 2 institutions in China. The prognostic performance was measured by concordance index (C-index), Akaike information criterion (AIC) and calibration plots. Different risk groups were stratified by the nomogram scores. Results: A total of six variables were determined related with survival and entered into the nomogram construction. The calibration curves showed satisfied agreement between nomogram-predicted survival and actual observed survival for 1-, 3-, and 5-year overall survival. By calculating the AIC and C-index values, our nomogram presented superior discriminative and risk-stratifying ability than current TNM staging system. Significant distinctions in survival curves were observed between different risk subgroups stratified by nomogram scores. Conclusion: The established and validated nomogram presented better risk-stratifying ability than current clinical staging system, and could provide a convenient and reliable tool for individual survival prediction and treatment strategy making. [ABSTRACT FROM AUTHOR]

Background and objective The clinical trials of new anti-tumor drugs are prospering in China. The acceptance of clinical trials in patients is an important factor affecting the speed and quality of clinical trials. Previous studies have investigated the acceptance of clinical trials in those cancer patients, who have never participated in a trial. This study is designed to investigate and compare the acceptance and related causes of clinical trials in cancer patients who have once participated in a clinical trial or not. Methods From June 2018 to April 2019, a standardized questionnaire-based survey was conducted among two groups of cancer patients classified by history of clinical trial participation in Cancer hospital, Chinese Academy of Medical Science, mainly focusing on their overall acceptance of clinical trials and related considerations, including the role of attending doctors, as well as group differences between the two participants. Results A total of 538 patients were enrolled with an average age of 53.5 years old, 51.1% of whom were males, and 43.3% of whom have never participated in a clinical trial. Overall, 502 patients (93.3%) were willing to or recommend their relatives or friends to participate in clinical trials, and patients with history of clinical trial participation had higher willingness (96.6% vs 90.8%, P=0.008). Patients were most likely to be motivated by expectation of optimal treatment (100.0% vs 99.3%) for both those who had once participated in a clinical trial or those not, respectively followed by financial burden reduction (56.0%) and recommendation by attending doctor (43.7%). The main reasons for unwillingness-to-participate for those who had once participated in a clinical trial were abandoning other treatment options, divided into control group or additional visits, while for those who had never participated in a clinical trial, ineffective treatment or serious adverse reactions were their main concerns. In the decision-making of clinical trial participation, 88% patients highly valued the role of recommendation by attending doctors. Among patients without trial participation history, 60.9% of those had no unwillingness-to-participate expressed that recommendation by attending doctors would change their decisions. The study also reported patients' preferences for information and access to clinical trials. Conclusion The acceptance of clinical trials in cancer patients in our hospital is generally high, especially in patients who had a history of trial participation. It's of substantial significance to give full play to the role of doctors in improving the acceptance of clinical trials of cancer patients in China. [ABSTRACT FROM AUTHOR]

Background and objective Early investigation suggested patients' level of awareness regarding clinical trials was related with willingness to participation. This study was intended to evaluate the level of awareness of cancer patients regarding clinical trials and related influencing factors, and to compare the differences of awareness between patients who attended clinical trials before and not. Methods From Jun, 2018 to April, 2019, standardized question-naires were gathered from cancer patients (attended clinical trials vs not attended clinical trials) in our hospital regarding basic information and 10 other questions about awareness. The level of awareness was evaluated and patients were classified into "low cognition" and "high cognition" groups. Logistic regression analysis was performed to determine whether certain characteristics would predict for awareness. Results Of the 617 participants, 38.6% have attended clinical trials before. 338 (54.6%) patients had a correct overall understanding of clinical trials, while 44 (7.1%) patients still thought participants were the victim of scientific research. Except for the compensation of medical expenses (51.5% vs 48.7%) and related laws of clinical trials (52.3% vs 45.5%), other parts of understanding were elevated in patients attended clinical trials before comparing with patients who didn't, including significance (86.2% vs 77.6%), risk disclosure (91.2% vs 71.6%), confidentiality (73.2% vs 59.7%), voluntariness (95.8% vs 76.3%), withdrawal (86.6% vs 68.2%) and expenses (62.8% vs 39.2%). The proportion of participants who understand these components did not increase even in 239 patients who had attended clinical trials before. Participants who attended clinical trials before (OR=1.83, 95%CI: 1.11-3.00), unmarried/divorced (OR=5.04, 95%CI: 1.73-14.66), retired (OR=2.53, 95%CI: 1.16-5.50) had a higher level of awareness, while patients who had bad impression with doctors (OR=0.43, 95%CI: 0.26-0.72) had lower awareness. Conclusion The current level of awareness for clinical trials of cancer patients in our hospital was relatively low, even in patients who had attended clinical trials before. It's necessary to improve patients' awareness of clinical trial by promoting harmony relationship between patients and doctors, as well as by enhancing related propagation. Strengthening the adequacy and efficacy of informed consent in clinical trials also needs to be achieved in the future. [ABSTRACT FROM AUTHOR]

BACKGROUND: Household air pollution (HAP) from solid fuel use for cooking affects 2.5 billion individuals globally and may contribute substantially to disease burden. However, few prospective studies have assessed the impact of HAP on mortality and cardiorespiratory disease. OBJECTIVES: Our goal was to evaluate associations between HAP and mortality, cardiovascular disease (CVD), and respiratory disease in the prospective urban and rural epidemiology (PURE) study. METHODS: We studied 91,350 adults 35-70 y of age from 467 urban and rural communities in 11 countries (Bangladesh, Brazil, Chile, China, Colombia, India, Pakistan, Philippines, South Africa, Tanzania, and Zimbabwe). After a median follow-up period of 9.1 y, we recorded 6,595 deaths, 5,472 incident cases of CVD (CVD death or nonfatal myocardial infarction, stroke, or heart failure), and 2,436 incident cases of respiratory disease (respiratory death or nonfatal chronic obstructive pulmonary disease, pulmonary tuberculosis, pneumonia, or lung cancer). We used Cox proportional hazards models adjusted for individual, household, and community-level characteristics to compare events for individuals living in households that used solid fuels for cooking to those using electricity or gas. RESULTS: We found that 41.8% of participants lived in households using solid fuels as their primary cooking fuel. Compared with electricity or gas, solid fuel use was associated with fully adjusted hazard ratios of 1.12 (95% CI: 1.04, 1.21) for all-cause mortality, 1.08 (95% CI: 0.99, 1.17) for fatal or nonfatal CVD, 1.14 (95% CI: 1.00, 1.30) for fatal or nonfatal respiratory disease, and 1.12 (95% CI: 1.06, 1.19) for mortality from any cause or the first incidence of a nonfatal cardiorespiratory outcome. Associations persisted in extensive sensitivity analyses, but small differences were observed across study regions and across individual and household characteristics. DISCUSSION: Use of solid fuels for cooking is a risk factor for mortality and cardiorespiratory disease. Continued efforts to replace solid fuels with cleaner alternatives are needed to reduce premature mortality and morbidity in developing countries. [ABSTRACT FROM AUTHOR]

Background: Alpha A-crystallin (CRYAA) is considered critical for the maintenance of lens transparency and is related to the pathogenesis of age-related cataracts (ARCs), especially the nuclear subtype. As the 5' untranslated region (5' UTR) modulates gene expression, the purpose of current study was to investigate whether single nucleotide polymorphisms (SNPs) in the 5' UTR of CRYAA were associated with susceptibility to ARC in a Han Chinese population and to clarify the mechanism of this association.Methods: SNPs in the 5' UTR (-1 to -1000) of CRYAA were identified in 243 nuclear ARC patients and 263 controls using polymerase chain reaction and DNA sequencing. Allele and genotype frequencies were calculated and compared between two groups. Haploview 4.2 was used to calculate the linkage disequilibrium index, and the SHEsis analysis platform was used to infer haplotype construction. A dual-luciferase reporter gene assay was used for transcription of CRYAA in the presence of a protective haplotype with individual SNP alteration, Chromatin immunoprecipitation (ChIP) was employed to determine whether SNPs regulated CRYAA expression by altering the binding affinity of transcription factors.Results: Three polymorphisms were identified in the 5' UTR of CRYAA: rs3761381 (P = 0.000357, odds ratio [OR] = 1.837), rs13053109 (P = 0.788, OR = 1.086), and rs7278468 (P = 0.00136, OR = 0.652). The haplotype C-G-T (P = 0.0014, OR = 1.536) increased the risk of nuclear ARC, whereas the haplotype T-G-G (P = 0.00029, OR = 0.535) decreased the risk. The haplotype C-G-T decreased CRYAA transcription through rs7278468, which is located in the binding site of specificity protein 1 (Sp1). Furthermore, the G allele of rs7278468 increased CRYAA transcription by enhancing the binding affinity of Sp1.Conclusions: These data indicate that the CRYAA polymorphism is a genetic marker of inter-individual differences in the risk of nuclear ARC. [ABSTRACT FROM AUTHOR]

To identify township-level high-risk foci of malaria transmission in Yunnan Province, China, along the international border, we retrospectively reviewed data collected in hospitals and clinics of 58 townships in 4 counties during 2011-2013. We analyzed spatiotemporal distribution, especially hot spots of confirmed malaria, using geographic information systems and Getis-Ord Gi*(d) cluster analysis. Malaria incidence, transmission seasonality, and Plasmodium vivax:P. falciparum ratio remained almost unchanged from 2011 to 2013, but heterogeneity in distribution increased. The number of townships with confirmed malaria decreased significantly during the 3 years; incidence became increasingly concentrated within a few townships. High-/low-incidence clusters of P. falciparum shifted in location and size every year, whereas the locations of high-incidence P. vivax townships remained unchanged. All high-incidence clusters were located along the China-Myanmar border. Because of increasing heterogeneity in malaria distribution, microgeographic analysis of malaria transmission hot spots provided useful information for designing targeted malaria intervention during the elimination phase. [ABSTRACT FROM AUTHOR]

Background Malaria within the Greater Mekong sub-region is extremely heterogeneous. While China and Thailand have been relatively successful in controlling malaria, Myanmar continues to see high prevalence. Coupled with the recent emergence of artemisinin-resistant malaria along the Thai-Myanmar border, this makes Myanmar an important focus of malaria within the overall region. However, accurate epidemiological data from Myanmar have been lacking, in part because of ongoing and emerging conflicts between the government and various ethnic groups. Here the results are reported from a risk analysis of malaria slide positivity in a conflict zone along the China-Myanmar border. Methods Surveys were conducted in 13 clinics and hospitals around Laiza City, Myanmar between April 2011 and October 2012. Demographic, occupational and educational information, as well as malaria infection history, were collected. Logistic models were used to assess risk factors for slide positivity. Results Age patterns in Plasmodium vivax infections were younger than those with Plasmodium falciparum. Furthermore, males were more likely than females to have falciparum infections. Patients who reported having been infected with malaria during the previous year were much more likely to have a current vivax infection. During the second year of the study, falciparum infections among soldiers increased signficiantlyConclusions These results fill some knowledge gaps with regard to risk factors associated with malaria slide positivity in this conflict region of north-eastern Myanmar. Since epidemiological studies in this region have been rare or non-existent, studies such as the current are crucial for understanding the dynamic nature of malaria in this extremely heterogeneous epidemiological landscape. [ABSTRACT FROM AUTHOR]

The article focuses on the performance of rapid diagnostic tests (RDT) for diagnosis of malaria at the China-Myanmar border area. It discusses the importance of RDT in malaria control and management programmes in the world. It states that the performance of RDT under different endemic conditions suggests its requirement for malaria diagnosis. It reports the effect of humidity and extreme temperatures on the performance of RDT.

Drug resistance has always been one of the most important impediments to global malaria control. Artemisinin resistance has recently been confirmed in the Greater Mekong Subregion (GMS) and efforts for surveillance and containment are intensified. To determine potential mechanisms of artemisinin resistance and monitor the emergence and spread of resistance in other regions of the GMS, we investigated the in vitro sensitivity of 51 culture-adapted parasite isolates from the China-Myanmar border area to four drugs. The 50% inhibitory concentrations (IC50s) of dihydroartemisinin, mefloquine and lumefantrine were clustered in a relatively narrow, 3- to 6-fold range, whereas the IC50 range of artesunate was 12-fold. We assessed the polymorphisms of candidate resistance genes pfcrt, pfmdr1, pfATP6, pfmdr6 and pfMT (a putative metabolite/drug transporter). The K76T mutation in pfcrt reached fixation in the study parasite population, whereas point mutations in pfmdr1 and pfATP6 had low levels of prevalence. In addition, pfmdr1 gene amplification was not detected. None of the mutations in pfmdr1 and pfATP6 was associated significantly with in vitro sensitivity to artemisinin derivatives. The ABC transporter gene pfmdr6 harbored two point mutations, two indels, and number variations in three simple repeats. Only the length variation in a microsatellite repeat appeared associated with altered sensitivity to dihydroartemisinin. The PfMT gene had two point mutations and one codon deletion; the I30N and N496- both reached high levels of prevalence. However, none of the SNPs or haplotypes in PfMT were correlated significantly with resistance to the four tested drugs. Compared with other parasite populations from the GMS, our studies revealed drastically different genotype and drug sensitivity profiles in parasites from the China-Myanmar border area, where artemisinins have been deployed extensively for over 30 years. [ABSTRACT FROM AUTHOR]

• Proposed a knowledge transfer method to promote the utilization of emergency experience and get it reused. • Adaptively combined policy distillation with actor-critic structured multi-agent reinforcement learning algorithm. • Developed a fast emergency decision making method for freeway accident optimal onsite disposal. • Established an MDP model to simulate task-level accident disposal, modelled commonality among different freeway accidents. A large number of freeway accident disposals are well-recorded by accident reports and surveillance videos, but it is not easy to get the emergency experience reused from past recorded accidents. To reuse emergency experience for better emergency decision-making, this paper proposed a knowledge-based experience transfer method to transfer task-level freeway accident disposal experience via multi-agent reinforcement learning algorithm with policy distillation. First, the Markov decision process is used to simulate the emergency decision-making process of multi-type freeway accident scene at the task level. Then, an adaptive knowledge transfer method named policy distilled multi-agent deep deterministic policy gradient (PD-MADDPG) algorithm is proposed to reuse experience from past freeway accident records to current accidents for fast decision-making and optimal onsite disposal. The performance of the proposed algorithm is evaluated on instantiated cases of freeway accidents that occurred on the freeway in Shaanxi Province, China. Aside from achieving better emergency decisions performance than various typical decision-making methods, the result shows decision maker with transferred knowledge owns 65.22%, 11.37%, 9.23%, 7.76% and 1.71% higher average reward than those without in the five studied cases, respectively. Indicating that the emergency experience transferred from past accidents contributes to fast emergency decision-making and optimal accident onsite disposal. [ABSTRACT FROM AUTHOR]

Vegetation phenology, a regular and periodic phenomenon in nature, is an important indicator for natural environment, especially climate change. The study of spatiotemporal variations of vegetation phenology is of great significance for monitoring the changes of terrestrial vegetation. In this study, the Savitzky-Golay (S-G) filtering method was used to reconstruct time-series MODIS enhanced vegetation index (EVI) data in the Qinling Mountains from 2001 to 2018. The dynamic threshold method was used to extract the spring phenological parameter (start of growth season, SOS). The correlation between multi-year mean SOS and interannual variation with altitude and slope was analyzed. The results showed that SOS was delayed by 1.82 d with every 100 m increase in altitude in the Qinling Mountains. The interannual change trends of SOS mainly concentrated in 0-5 d·(10 a) -1 . The pixels with delaying trend were mainly distributed in low-altitude regions, with the delaying degree being gradually decreased with the elevation. The interannual change trend of SOS in high-altitude regions was more complex than that in lower-altitude regions. The multi-year average SOS in the northern slope was approximately 2.9 d earlier than that of the southern slope, whereas the southern slope had a more significant advancing trend. The interannual change trends of SOS in both north and south slopes showed a delaying trend in low-altitude, with little difference between north and south slopes. The advancing trend in middle and high altitude was significantly different.

Background: The downstaging of hepatocellular carcinoma (HCC) has been confirmed to benefit liver transplantation (LT) patients whose tumors are beyond the transplantation criteria. Milan criteria (MC), a tumor size and number-based assessment, is currently used as the endpoint in these patients. However, many studies believe that tumor biological behavior should be added to the evaluation criteria for downstaging efficacy. Hence, this study aimed to explore the feasibility of Hangzhou criteria (HC), which introduced tumor grading and alpha-fetoprotein in addition to tumor size and number, as an endpoint of downstaging., Methods: We performed a multicenter and retrospective study of 206 patients accepted locoregional therapy (LRT) as downstaging/bridge treatment prior to LT in three centers of China., Results: Recipients were divided into four groups: failed downstaging to the HC (group A, n = 46), successful downstaging to the HC (group B, n = 30), remained within the HC all the time (group C, n = 113), and tumor progressed (group D, n = 17). The 3-year HCC recurrence probabilities of groups B and C were not significantly different (10.3% vs. 11.6%, P = 0.87). The HCC recurrent rate was significantly higher in group A (52.3%) compared with that in group B/C (P < 0.05). Seven patients (7/76, 9.2%) whose tumor exceeded the the HC were successfully downstaged to the MC, and 39.5% (30/76) to the the HC. In group B, 23 patients remained beyond the MC and their survivals were as well as those of patients within the MC., Conclusions: Compared to the MC, HC downstaging criteria can give more HCC patients access to LT and furthermore, the outcome of these patients is the same as those matching MC downstaging criteria. Hangzhou downstaging criteria therefore is applicable in clinical practice., (Copyright © 2020. Published by Elsevier B.V.)

Circulating tumor cells (CTCs) serve as valuable biomarkers. However, MutL homolog 1 (MLH1)-negative CTCs and their clinical significance in lung cancer are nearly unknown.Here, bioinformatic analysis of MLH1 expression and its clinical significance was conducted using the Oncomine, Ualcan, and Kaplan-Meier plotter websites. Size-based isolation and RNA in situ hybridization assays were used to identify CTCs and evaluate MLH1 and mesenchymal marker expression in CTCs. MLH1 was downregulated in lung cancer patients. Patients with lower MLH1 expression levels had worse prognoses. In a cohort of 32 randomly selected patients with lung cancer, the patients with poorer treatment responses had more MLH1-negative CTCs. The total CTCs, MLH1-negative CTCs and mesenchymal markers-expressing CTCs levels were negatively correlated with prognosis in the lung cancer patients.Our data showed the clinical significance of MLH1 expression in lung cancer tissues. The characterization and numeration of CTCs based on the expression of MLH1 and mesenchymal markers may be a convenient approach for predicting treatment response and prognosis in lung cancer.

Previously, we developed and validated a multiplex assay of 27 ancestry-informative markers (AIMs) for analyzing African (AFR), European (EUR), and East Asian (EAS) ancestry components. In this study, we typed and collectively analyzed a large Uyghur sample of 979 individuals to estimate the genetic coefficients of the 27 AIMs and investigate differentiation parameters between Uyghur and Han. The Uyghur allele frequencies ranged from 0.243 to 0.952, and heterozygosities ranged from 0.091 to 0.500. Values of F st 3 and I n 3 for EUR, Uyghur, and EAS ranged from 0.028 to 0.550 and 0.0002 to 0.345, respectively. The Uyghur population displays a substantial ancestry contribution of 50.3:49.7 (EUR:EAS) and was efficiently discriminated from Han Chinese with an accuracy of 99.285 %. All populations were clustered into AFR, EUR, EAS, and admixture groups of these three ancestries. Central Asian was obviously stratified from the other admixture populations of South Asians, North Asians, and the Americans. The 27 SNPs yield a circle with an average distance of 0.936 from the center (0, 0) in PCA analysis. Using this set, Chinese Uyghur and Han populations achieved accurate differentiation, and our updated genotype database (by citing 1000 Genomes data) of 43 worldwide populations is a useful resource for forensic applications and disease association studies.

Objective: To validate the efficiency of 27-plex single nucleotide polymorphism (SNP) multiplex system for ancestry inference., Methods: The 27-plex SNP system was validated for its sensitivity and species specificity. A total of 533 samples were collected from African, Southern Chinese Han, China's ethic minorities (Yi, Hui, Miao, Tibet, and Uygur), European, Central Asian, Western Asian, Southern Asian, Southeast Asian and South American populations for clustering analysis of the genotypes by citing 3 representative continental ancestral groups [East Asia (CHB), Europe (CEU), and Africa (YRI)] from HapMap database., Results: The system sensitivity is 0.125 ng. Twenty and six genotypes were detected in chimpanzee and monkeys, respectively. Except in rs10496971, no more products were found in other animals. The system was capable of differentiating intercontinental populations but not of distinguishing between East Asian and Southeast Asian population or between Southern Chinese Han population and Chinese Ethnic populations (Hui, Miao, Yi and Tibet). This system achieved a 100% accuracy for intercontinental population source inference for 46 blind test samples., Conclusion: 27-plex SNPs multiplex system has a high sensitivity and species specificity and can correctly differentiate the ancestry origins of individuals from African, European and East Asian for criminal case investigation. But this system is not capable of distinguishing subpopulation groups and more specific ancestry-informative markers are needed to improve its recognition of Southeast Asian and Chinese ethnic populations.

Some studies suggested that adequate vitamin D might reduce inflammation in adults. However, little is known about this association in early life. We aimed to determine the relationship between cord blood 25-hydroxyvitamin D (25(OH)D) and C-reactive protein (CRP) in neonates. Cord blood levels of 25(OH)D and CRP were measured in 1491 neonates in Hefei, China. Potential confounders including maternal sociodemographic characteristics, perinatal health status, lifestyle, and birth outcomes were prospectively collected. The average values of cord blood 25(OH)D and CRP were 39.43 nmol/L (SD = 20.35) and 6.71 mg/L (SD = 3.07), respectively. Stratified by 25(OH)D levels, per 10 nmol/L increase in 25(OH)D, CRP decreased by 1.42 mg/L (95% CI: 0.90, 1.95) among neonates with 25(OH)D <25.0 nmol/L, and decreased by 0.49 mg/L (95% CI: 0.17, 0.80) among neonates with 25(OH)D between 25.0 nmol/L and 49.9 nmol/L, after adjusting for potential confounders. However, no significant association between 25(OH)D and CRP was observed among neonates with 25(OH)D ≥50 nmol/L. Cord blood 25(OH)D and CRP levels showed a significant seasonal trend with lower 25(OH)D and higher CRP during winter-spring than summer-autumn. Stratified by season, a significant linear association of 25(OH)D with CRP was observed in neonates born in winter-spring (adjusted β = -0.11, 95% CI: -0.13, -0.10), but not summer-autumn. Among neonates born in winter-spring, neonates with 25(OH)D <25 nmol/L had higher risk of CRP ≥10 mg/L (adjusted OR = 3.06, 95% CI: 2.00, 4.69), compared to neonates with 25(OH)D ≥25 nmol/L. Neonates with vitamin D deficiency had higher risk of exposure to elevated inflammation at birth.

Background: Little is known about the relation between vitamin D status in early life and neurodevelopment outcomes., Objective: This study was designed to examine the association of cord blood 25-hydroxyvitamin D [25(OH)D] at birth with neurocognitive development in toddlers., Methods: As part of the China-Anhui Birth Cohort Study, 363 mother-infant pairs with complete data were selected. Concentrations of 25(OH)D in cord blood were measured by radioimmunoassay. Mental development index (MDI) and psychomotor development index (PDI) in toddlers were assessed at age 16-18 mo by using the Bayley Scales of Infant Development. The data on maternal sociodemographic characteristics and other confounding factors were also prospectively collected., Results: Toddlers in the lowest quintile of cord blood 25(OH)D exhibited a deficit of 7.60 (95% CI: -12.4, -2.82; P = 0.002) and 8.04 (95% CI: -12.9, -3.11; P = 0.001) points in the MDI and PDI scores, respectively, compared with the reference category. Unexpectedly, toddlers in the highest quintile of cord blood 25(OH)D also had a significant deficit of 12.3 (95% CI: -17.9, -6.67; P < 0.001) points in PDI scores compared with the reference category., Conclusions: This prospective study suggested that there was an inverted-U-shaped relation between neonatal vitamin D status and neurocognitive development in toddlers. Additional studies on the optimal 25(OH)D concentrations in early life are needed., (© 2015 American Society for Nutrition.)

Objectives: To compare simple conventional treatment with the addition of hyperbaric oxygen therapy (HBOT) to conventional therapies in the treatment of Fournier's gangrene (FG)., Methods: A retrospective study of clinical data was performed by reviewing 28 cases of FG from January 2004 to December 2013 at Xiangya Hospital, Central South University. Among them, 12 patients were treated with the conventional therapy (non-HBOT group) and the other 16 cases were combined with hyperbaric oxygen therapy besides conventional therapy (HBOT group). All patients were followed up for 2 months to assess the therapeutic effect. The analyzed data included age, Fournier gangrene severity index (FGSI) score, number of surgical debridement, indwelling drainage tube time, length of stay (LOS), effective time, and curative time., Results: The mortality rate was lower in the HBOT group at 12.5% (2/16) compared to the non-HBOT group, which was 33.3% (4/12). The difference in the number of surgical debridement, indwelling drainage tube time, and curative time between were significantly lower in the HBOT group compared to the non-HBOT group., Conclusions: Our preliminary research suggests that the effect of combining hyperbaric oxygen therapy with conventional therapy offers considerable advantage in the management of Fournier's gangrene. Multicenter studies with a larger sample size are required to confirm these observations., (© 2015 S. Karger AG, Basel.)

The prevalence of irritable bowel syndrome (IBS) and associated factors, especially psychological and lifestyle factors, in nurses in China have not been investigated previously. The aims of this study were to assess the prevalence of IBS in nurses, to evaluate whether factors, such as psychological disorders, are associated with IBS, and to determine whether psychological disorders can influence the severity of symptoms of IBS and quality of life (QOL). A cross-sectional study was conducted for Chinese nurses from November 2012 to February 2013. Participants were asked to complete questionnaires. The prevalence of IBS was 17.4%. The revised symptom checklist 90 (SCL-90-R) scores were significantly higher for nurses with IBS than for those without IBS (P<0.001), and no difference in scores between IBS subtypes was found (F=1.893, P=0.142). The scores of QOL for nurses with and without IBS were 77.18±21.93 and 88.44±11.89 (P<0.001), respectively. Psychological disorders did not show statistically significant correlations with severity of symptoms of IBS or QOL. Alcohol consumption, low level of exercise, and psychological disorders were risk factors for IBS. In summary, nurses in China show a high prevalence of IBS. Psychological disorders and some related lifestyle factors are probably responsible for the development of IBS in nurses.

Reducing China's population has formerly been considered a good thing because of the perceived environmental and social risks of overpopulation, but it has recently become apparent that the resulting population decline may create problems that will become increasingly serious in the future. The results of a survey of 4600 women in nineteen Chinese provinces in 2005 indicated that young age, high income, high education level, urban location and good employment all decreased a woman's willingness to bear children. The risks created by declining fertility in these groups have been intensified by China's 'one child' family planning policy. However, as a result of current trends and China's policies, the country's population will continue to age, leading to social problems and difficulties for sustainable development both in China and around the world. Therefore, China's policy-makers must begin planning to adjust their policy by encouraging women to give birth to more than one child.

The petroleum ether, chloroform, and methyl alcohol extracts of wild and cultivated Rhodiola saccharinensis A. Bor and Rhodila angusta Nakai taken from Changbai Mountains, and obtained by the same isolation procedure, were for the first time studied with Fourier transform infrared spectrometry(FTIR), and the spectra obtained were compared with those of a sort of goods named Rhodiola Cake (Hong Jing Tian Kuai). It was shown that the infrared spectra of the wild and cultivated Rhodiola saccharinensis A. Bor and Rhodila angusta Nakai are different, which can be used to determine and evaluate their respective species.