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The study aimed to analyze the applicability of the World Health Organization's exclusionary guidelines for Urinary creatinine (Ucr) in the general Chinese population, and to identify Ucr related factors. We conduct a cross-sectional study using baseline data from 21,167 participants in the China National Human Biomonitoring Program. Mixed linear models and restricted cubic splines (RCS) were used to analyze the associations between explanatory variables and Ucr concentration. The geometric mean and median concentrations of Ucr in the general Chinese population were 0.90 g/L and 1.01 g/L, respectively. And 9.36% samples were outside 0.3–3.0 g/L, including 7.83% below the lower limit and 1.53% above the upper limit. Middle age, male, obesity, smoking, higher frequency of red meat consumption and chronic kidney disease were associated significantly with higher concentrations of Ucr. Results of the RCS showed Ucr was positively and linearly associated with body mass index, inversely and linearly associated with systolic blood pressure, diastolic blood pressure, triglycerides level, and glomerular filtration rate, and were non-linearly associated with triiodothyronine. The age- and gender-specific cut-off values of Ucr that determine the validity of urine samples in the general Chinese population were recommended. To avoid introducing bias into epidemiologic associations, the potential predictors of Ucr observed in the current study should be considered when using Ucr to adjust for variations in urine dilution. [ABSTRACT FROM AUTHOR]

This study aims to explore the influence of emotion regulation on empathic ability among undergraduate nursing students, as well as the mediating role of emotional intelligence and self-consistency congruence. A cross-sectional study was employed to examine the relationship between the emotion regulation and empathic ability in Chinese nursing students. A total of 761 undergraduate nursing students were surveyed using the Interpersonal Reactivity Index (Chinese version), the Gross Emotion Regulation Questionnaire, Wang and Law's Emotional Intelligence Scale and the Self-Harmony Scale. There was a significant positive correlation between emotion regulation, empathic ability and self-harmony. Significant positive correlations were also found between emotion regulation, empathic ability and emotional intelligence. Mediation analysis revealed that self-harmony and emotional intelligence partially mediated the predictive relationship between emotion regulation and empathic ability, with self-harmony showing a more significant mediating effect. The findings suggest that emotion regulation among undergraduate nursing students indirectly influences their empathic ability through parallel mediating effects of self-harmony and emotional intelligence. [ABSTRACT FROM AUTHOR]

Background: There has been increased recognition that prenatal or perinatal nutrition has an effect on the development of type 2 diabetes (T2D) in adulthood, although studies that have directly examined whether the effect could be transmitted to the next generation remain sparse. Objective: We investigated the role of prenatal exposure to the Chinese famine in affecting future T2D risk in adulthood in 2 consecutive generations. Design: A total of 1034 families, including 2068 parents [parental generation (F1)] and 1183 offspring [offspring generation (F2)], were recruited from the Suihua rural area that was affected by the Chinese Famine of 1959-1961. Participants born between 1 October 1959 and 30 September 1961 were defined as famine exposed, and those born between 1 October 1962 and 30 September 1964 were defined as nonexposed. The F2 were classified as having 1) no parent exposed to famine,) only a mother exposed to famine, 3) only a father exposed to famine, or 4) both parents exposed to famine. Classical risk factors for T2D as well as fasting-glucose- and oral-glucosetolerance tests were measured in both the F1 and F2. Results: Prenatal exposure to famine was associated with elevated risks of hyperglycemia (multivariable-adjusted OR: 1.93; 95% CI: 1.51, 2.48) and T2D (OR: 1.75; 95% CI: 1.20, 2.54) in adulthood in F1. Furthermore, compared with the offspring of nonexposed parents, the F2 with exposed parents-- especially both exposed parents--had increased hyperglycemia risk (OR: 2.02; 95% CI: 1.12, 3.66) in adulthood. Conclusion: Prenatal exposure to famine remarkably increases hyperglycemia risk in 2 consecutive generations of Chinese adults independent of known T2D risk factors, which supports the notion that prenatal nutrition plays an important role in the development of T2D across consecutive generations of Chinese adults. [ABSTRACT FROM AUTHOR]

Background: Clinical trials assessing the effects of salt substitutes on blood pressure (BP) have reported mixed results. Objectives: A meta-analysis of randomized controlled trials was conducted to evaluate the effect of salt substitutes on BP, including systolic BP (SBP) and diastolic BP (DBP). Design: Studies were identified via systematic searches of the PubMed, Embase, Cochrane Library, Wanfang Data, and the China National Knowledge Infrastructure databases through December 2013. Random-effects models were used to estimate pooled mean differences in SBP and DBP. Results: Six cohorts from 5 articles (1 trial enrolled 2 cohorts for independent intervention) consisting of 1974 participants were included. Pooled results showed that salt substitutes had a significant effect on SBP (mean difference: -4.9 mm Hg; 95% CI: -7.3, -2.5; P < 0.001) and DBP (mean difference: -1.5 mm Hg; 95% CI: -2.7, -0.3; P = 0.013). Significant heterogeneity was found for both SBP (I² = 76.7%) and DBP (I² = 65.8%). The sensitivity analysis indicated that the pooled effects of salt substitutes on SBP and DBP were robust to systematically dropping each trial. Furthermore, no evidence of significant publication bias from funnel plots or Egger's tests (P = 0.17 and 0.22 for SBP and DBP, respectively) was found. Conclusion: This meta-analysis showed that salt-substitution strategies are effective at lowering SBP and DBP, which supports a nutritional approach to preventing hypertension. [ABSTRACT FROM AUTHOR]

Background: Several studies have focused on the effects of calcium intake on serum lipid concentrations in postmenopausal women. However, many premenopausal women are taking calcium supplements in China. To our knowledge, no studies have assessed whether the effects of calcium supplementation on blood lipids are similar between premenopausal and postmenopausal women. Objective: We assessed the effects of calcium supplementation on blood lipid concentrations in premenopausal and postmenopausal women with dyslipidemia. Design: A total of 190 premenopausal women (30-40 y old) and 182 postmenopausal women (50-60 y old) with dyslipidemia were given 800 mg Ca/d or a placebo for 2 y in a double-blind, randomized, placebo-controlled trial. Blood pressure, fasting glucose and serum lipid concentrations, carotid intima-media thickness (CIMT), dietary nutrient intakes, and physical activity levels were determined at baseline and after 2 y. Results: There was a significant interaction between calcium supplementation and menopausal status on serum cholesterol concentrations (P < 0.001) and CIMT (P = 0.017). Serum cholesterol concentrations and CIMT were significantly increased in postmenopausal women (P < 0.01) after 2 y. Serum triglyceride, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol concentrations were not affected after 2 y. Conclusions: Calcium supplementation in postmenopausal women with dyslipidemia increases serum total cholesterol concentrations and CIMT. In postmenopausal women with dyslipidemia, calcium supplements should be prescribed with caution. This trial was registered at http://www.chictr.org/cn/ as ChiCTR-TRC-12002806. [ABSTRACT FROM AUTHOR]

Background: The effects of fish oil on heart rate variability in humans remain unclear. Objective: A meta-analysis of randomized controlled trials was performed to investigate the influence of fish oil on heart rate variability. Design: Human intervention studies were identified by systematic search of PubMed, Embase, The Cochrane Library, and references of related reviews and studies. A random-effects model was applied to estimate the pooled results. Results: Fifteen studies were included. Results of the meta-analysis showed that the SD of normal-to-normal interval [standardized mean difference (SMD) = 0.10, P - 0.35] and square of successive differences (SMD = 0.05, P = 0.35), 2 of the time-domain parameters of heart rate variability, were not significantly influenced by fish-oil supplementation. For the frequency-domain parameters, the high-frequency power (HF), a surrogate of vagal function, was significantly increased by fish-oil supplementation (SMD = 0.30, P = 0.005), the low-frequency power (LF) was not significantly affected (SMD = 0.03, P = 0.79), and the ratio of LF to HF (LF/HF) showed a trend of reduction (SMD = -0.22, P = 0.08). The trend for a treatment effect on LF/HF became significant at P = 0.01 when the 2 studies with a dose <1000 mg/d were omitted. Subgroup analyses according to predefined study characteristics showed no significant results. Conclusion: Short-term fish-oil supplementation may favorably influence the frequency domain of heart rate variability, as indicated by an enhanced vagal tone, which may be an important mechanism underlying the antiarrhythmic and other clinical effects of fish oil. [ABSTRACT FROM AUTHOR]

Abstract: On the basis of analyzing the actual state of resource utilization of construction waste in Beijing, the limiting measures and supportive policies were studied intensively. A series of policies were proposed, such as landfill ban, recycling management model of construction project, adjustment measures of project cost components, examination and approval system of resource utilization of construction waste enterprises, declaration and approval system of resource utilization of construction waste at the construction field, preferential policy of resource utilization of construction waste, funded capital of resource utilization of construction waste and supportive policies like incentive measures of recycle products promotion of construction waste in Beijing. [Copyright &y& Elsevier]

Abstract: According to the current management situation of construction waste, the current laws and regulations of construction waste management was analyzed according to the current management situation of construction waste in Beijing. At last put forward the problems and solutions for the current management policy of construction waste in Beijing to provide conductive effects for the revision and consummation of laws and regulations of construction waste management in Beijing. [Copyright &y& Elsevier]

Abstract: Combining with empirical method, sector classification, locations of catering industry and comprehensive method, it curve fits and calculates the discharge of Beijing restaurant wastewater from 2004 to 2007 by four fitting formula, logarithm, Linear, power exponent and exponent, and then analyze the precision, propose the best calculation way of each forecast method. Compared with the curve fitting, the pessimistic modeling is more precise. It is suitable to forecast the discharge of Beijing restaurant wastewater. Finally, it got the prediction of the discharge of restaurant wastewater from 2008 to 2012 in Beijing, and provides a basis for forecasting the discharge and treating the restaurant wastewater. [Copyright &y& Elsevier]

Abstract: Background: The epidemiological characteristics of drug-resistant tuberculosis (DR-TB) is fundamental to improving the prevention and control of DR-TB. Mutations in katG3l5 is thought to be the most predictive molecule markers for Isoniazid (INH) resistance in Mycobacterium tuberculosis (MTB). However, mutations to these genes have not been thoroughly studied in China, and epidemiological evidence of their expression levels are especially lacking in the southwest of China, which has a high TB burden within the population. Methods: MTB isolates were obtained from patients with active pulmonary tuberculosis at the TB dispensary and Chest hospital in Chongqing city between June 2003 and June 2006. Proportion methods were used to test the sensitivity to INH, RFP, SM and EMB of cultured MTB. A total of 100 MTB isolates were also randomly selected for analysis of the molecular mutation spectrum katG by DNA sequencing. Results: Totally 1 089 MTB isolates that completed positive sputum cultures and evaluated for their sensitivity to the four first-line drugs among 2 777 patients with TB. The prevalence of DR-TB and multi-drug resistant tuberculosis (MDR-TB) were 27.7% (302/1 089) and 7.3% (79/1 089), respectively. The resistance to anti-TB drugs was found to be highest for SM (163%) and INH (140%). There was also a significant increase in the prevalence of resistance to RFP and EMB (P>0.01), and an increase in MDR-TB between June 2003 and June 2004 and between July 2005 and June 2006. The total mutation rate of katG315 was 75-5% (37/49) in INH-resistant MTB, and mutation sites included S315T, S315N and S315I with mutation rates of 81-1% (30/37), 13-5% (5/37) and 5-4% (2/37), respectively. No katG315 mutants were found in any of the 48 INH-sensitive MTB. Our preliminary diagnostic results suggest that mutations in katG315 may potentially serve as molecular markers that can be used to diagnose the resistance to anti-TB drug of INH. Conclusion: In the Chongqing, DR-TB and MDR-TB are increasing, and are becoming key problems for tuberculosis control. The use of katG315 mutations as potential molecule markers for drug resistance to INH may help improve patient treatment and decrease the spread of the disease. [Copyright &y& Elsevier]

Abstract: Tourism marketing information system (Tour MIS) is system engineering. This system engineering is a marketing decision support system that supports the tourism industry and educational and research institutions in collecting, storing, processing, and disseminating information. Austria developed Tour MIS which should meet the need of decision-maker of tourism enterprise and tourism destination. Tourism is developing very fast in China. It is necessary to set up a Tour MIS of China. In this article, Tour MIS of Austria will be analysed so as to provide some lessons of China. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this preliminary qualitative study was to gain insight into community health needs in order to develop health program for community in Chongqing. Methods: Totally 40 participants were assigned into 6 focus group discussions. All groups were led by local language speakers, and their talking was recorded after gaining informed consent. Transcribed data were coded and subjected to thematic analysis. Results: The main obtained themes were that community health problems were chronic noncommunicable disease, main health service needs included regularly free check-up and health education, and perceived health risk factors were unhealthy lifestyle and behavior as well as environment problems. Conclusion: Our community health needs assessment (CHNA) with FGDs indicate that residents realize the importance of prevention of disease. Our study identifies that primarily community health promotion is one of the priorities of community health service needs, including reorienting health service, health education, guiding behavior or lifestyle, and creating healthy environments. The findings of this study can provide guidance to the development of more effective and pertinent health program in this community. [Copyright &y& Elsevier]

Abstract: The zonal displacement of the western Pacific subtropical high remarkably influences the climate anomalies in China. In this paper, a new zonal index of the subtropical high is defined by modifying previous indices, and is used to investigate the relationship between the zonal displacement of the subtropical high and the dominant modes of 850-hPa circulations. It is found that the zonal displacement of the subtropical high is significantly correlated with the first two leading modes of circulations. In particular, the correlation coefficient between the index and the time series associated with the second mode is as high as 0.78 in 1958–2003 (46years). Since the second mode is not associated with significant anomalies of sea surface temperatures, the above results imply the difficulty in seasonal forecasting of the zonal displacement of the subtropical high. In addition, the interannual variability in the zonal displacement of the subtropical high has been considerably enhanced since 1978, due to the effects of both dominant modes, especially the second mode. This is likely to account for the frequent occurrence of anomalous climate in China during the recent two decades. [Copyright &y& Elsevier]

Objective To investigate the plasma lipid levels in a national representative sample of subjects and to determine the prevalence of dyslipidemia in the Chinese population. Methods Plasma lipid profile was analyzed using the data obtained during the Chinese national nutrition and health survey (CNHS) in 2002 which involved 14 252 participants at the age of 18 years or older. Results The mean levels of total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) in the participants were 3.81 mmol/L, 1.10 mmol/L, and 1.30 mmol/L, respectively. In the groups of participants at the age of 18–44 years, 45–59 years, and over 60 years the mean TC level was 3.70 mmol/L, 4.09 mmol/L and 4.21 mmol/L, respectively, and the mean TG level was 07 mmoI/L, 1.21 mmol/L, 1.20 mmol/L, 1.29 mmol/L, 1.33 mmol/L, and 1.33 mmol/L, respectively. The prevalence of dyslipidemia in Chinese adults was 18.6% and 22.2% in males and 15.9% in females. Dyslipidemia prevalence was higher in urban districts than in rural areas (21.0% vs. 17.7%). The prevalence of hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol was 2.9%, 11.9%, and 7.4% respectively among the participants. Conclusion Dyslipidemia has become one of the important health risk factors in the Chinese population. There is no significantly difference in the prevalence of dyslipidemia between the groups of participants at the age of 45–59 years and over 60 years. This study provides important lipid profile data for policy making and guideline development for the prevention of dyslipidemia in the Chinese population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate serum 25-hydroxyvitamin D [25(OH)D] level and its association with adiposity, inflammation, and oxidative stress in schoolchildren. Methods: A total of 1488 schoolchildren ages 7 to 11 y were recruited in Harbin, China (latitude: 44°04'N-46°40'N) in May. Serum 25(OH)D, which is an indicator of vitamin D status, was determined. Anthropometric data were collected following general physical examinations. Serum lipids, glucose metabolism indices, inflammatory molecules, and oxidative stress markers were determined. Dietary intake and physical activity also were assessed. Results: The median serum 25(OH)D concentration was 18.4 ng/mL. Of the 1488 schoolchildren included, 839 (56.4%) had vitamin D deficiency [25(OH)D < 20 ng/mL]. Children in the vitamin D deficiency group had significantly higher body weight (34.1 ± 3.8 versus 31.5 ± 3.3 kg; P < 0.001), body mass index (18.4 ± 2.2 versus 16.8 ± 1.7 kg/m²; P < 0.001), waist circumference (60.1 ± 8.5 versus 57.2 ± 7.7 cm; P < 0.001), percentage of body fat (20.2% ± 2.6% versus 19.1% ± 2.4%; P < 0.001), and significantly lower concentrations of serum superoxide dismutase (95.38 ± 12.22 versus 127.62 ± 15.98 U/mL; P < 0.001) compared with those in the vitamin D sufficiency group. After adjusting for sex, age, body mass index, and percentage of body fat, a positive association between serum 25(OH)D and superoxide dismutase was found (β = 0.230; P < 0.001). Conclusions: Vitamin D deficiency is common in Harbin schoolchildren. Serum 25(OH)D is closely associated with adiposity and superoxide dismutase in schoolchildren, suggesting that vitamin D deficiency potentially increases the risk for diseases caused by higher adiposity and oxidative stress. [ABSTRACT FROM AUTHOR]

Isolated islands are vulnerable to shortages in water availability, necessitating the use of hybrid water sources. There is a knowledge gap of unknown microbial diversity in the hybrid sources. The present study collected water samples from different water sources and water treatment processes on an isolated island in the South China Sea to explore microbial diversity in a full-element hybrid water supply system and analyze the effects of environmental factors. The primary conclusions were as follows: (a) Currently, chemical indices generally pass the WHO standards, except for high pH levels. (b) The driving factors for microbial diversity followed the order of type of source water > temperature > UV 254 > turbidity > materials of containers > oxidation-reduction potential > pH > OD 600 > ion concentration. Microbial dissimilarity was primarily affected by temperature and organic matter, while distribution distance had a slight effect on the dissimilarity in the small-scale ecosystem. (c) Biological and chemical safety standards restrict the application of atmospheric water using metal-organic frameworks while the balance of water influences the exploitation of freshwater lenses on the isolated island. [Display omitted] [ABSTRACT FROM AUTHOR]

Reproductive concerns significantly affect the mental health of people, causing more serious psychological stress than disease. The reproductive concerns faced by women with schizophrenia are issues that have been neglected in the areas of psychiatry and women's health. To explore the experience of reproductive concerns through the perspective of women with schizophrenia. Descriptive phenomenology interview study. Data collection was carried out in a psychiatric hospital in China. 15 women with schizophrenia were recruited with a prospective sampling. All participants were 26–40 years old. The interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework. The process employed NVivo 12 software. Data analysis identified 9 subthemes falling into the 4 macrothemes: (a) Potential risks of reproduction; (b) The difficulties in raising children; (c) Significance of reproduction; (d) Multiparty cooperation is needed to relieve reproductive concerns. Women with schizophrenia have reproductive concerns under the conflict between the significance of reproduction and obstacles. Interventions to address the reproductive problems of women with schizophrenia should be developed in three areas: the women themselves, the women's spouses and the medical staff. [ABSTRACT FROM AUTHOR]

The Hong Kong Zhuhai Macao Bridge (HZMB) link is currently one of the largest fixed links ever realised. The link comprises various bridges, causeways, artificial islands and tunnels and has a total length of more than 55 km with an investment of about RMB 120billion (approx. €15 billion). The Link accommodates a dual carriageway with three traffic lanes in each direction. The construction of the Link started at the end of 2010 and was opened to traffic in October 2018. The HZMB Link is internationally regarded as one of the most challenging sea crossing projects in China and a demonstration of China's comprehensive breakthrough in technology, scientific research and other related fields. The offshore part of the HZMB Link, crossing the Pearl River Estuary involves one of the world's longest and deepest immersed tunnels. The tunnel was designed and constructed to meet state-of-the-art requirements and challenging structural, geotechnical and marine/offshore conditions. The HZMB tunnel won the ITA Tunnelling Award Major Project of the Year 2018. This paper presents the project from the Client perspective. The paper will give a general introduction of the project, will provide information regarding the challenging environment in which the tunnel had to be realized and the high demanding design criteria that were applicable. Furthermore, the evaluation of the various technical options will be discussed, ultimately leading to the selection of the immersed tunnel option. The paper will also look into the background of selecting the Design & Build contract approach for this project and the experiences that were built up using this type of contract, new to China on this scale. Finally, the paper introduces how operation and maintenance of the tunnel is planned and executed so as to guarantee the 120-year design lifetime. In Ref. (The Islands and Tunnel Project of HZM Link et al., 2022) more details of the project are discussed from the D&B contractors' perspective. [ABSTRACT FROM AUTHOR]

Abstract: Clusterin gene (CLU), also known as apolipoprotein J (ApoJ), is a strong candidate gene for late-onset Alzheimer''s disease (LOAD) according to the Alzgene database. To further characterize this association and to isolate the variants contributing to the pathogenesis of LOAD in Han Chinese, we first sequenced a small sample (n = 100) to discover variants in the promoter, exons, the 5′ and 3′ untranslated regions, and exon–intron boundaries of CLU. Follow-up genotyping of identified variants in a larger sample (n = 1592). Sequencing analysis identified 18 variants. Analysis in the larger population revealed that only the rs9331949 C allele was significantly associated with an increased risk of LOAD, even after adjusting for multiple testing (p = 0.026). Logistic analysis identified the rs9331949 polymorphism was still strongly associated with LOAD (additive model: p = 0.004, odds ratio = 1.274; dominant model: p = 0.039, odds ratio = 1.239; recessive model: p = 0.002, OR = 1.975) after adjusting for sex, age, and APOE ε4 status. Our findings implicate CLU as a susceptibility gene for LOAD in Han Chinese. [Copyright &y& Elsevier]

Abstract: Objectives: Chengdu, China, is facing challenges from the growth of the elderly population. There are nursing homes in Chengdu, but there is no study on the current status of these nursing homes and their residents. The present study was conducted to investigate the current situation of nursing homes in Chengdu. Design, Setting, and Participants: This cross-sectional study randomly selected 10 nursing agencies from the 110 agencies in Chengdu (5 main zones and districts) using a cluster random sampling method. Descriptive statistics were used to analyze the data. Results: Ten agencies (10%) were surveyed: 5 government-run social welfare, 2 collective run, and 3 private institutions. The basic service in the nursing home includes personal care, basic medical care, room cleaning, meals, and laundry. Standard setting, assessment, rehabilitation therapy, and some equipment and volunteer service monitoring are inadequate. Most care staff receive little training in elder care. Some have no qualified certification and they have low income, heavy work, and insufficient knowledge. The whole team has a high mobility. Conclusions: Nursing homes in Chengdu are at a lower level than those in developed countries. [Copyright &y& Elsevier]