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This study examined the relationships between students' foreign language classroom anxiety and cognitive test anxiety and their College English Test Band 4 (CET-4) performance. A questionnaire was distributed to 921 Chinese university students to understand the nature and degree of the examined relationships. Follow-up interviews with 12 students were used to shed further light on uncovering mechanisms of relationships found in the survey. Results revealed three factors of anxiety, explaining 43.14% of the total variance examined in the quesionnaire items. Means, standard deviations, the internal consistency for each factor, and zero-order correlations among the three factors were calculated. Correlation and multiple regression of the anxiety factors and test scores were then conducted. Results confirmed that cognitive test anxiety factor was a significant negative predictor of language achievement. Interview results did not fully support the relationships found in the survey. Most students did not perceive themselves to be very anxious in their university settings, either in classrooms or in testing situations. However, they did express their anxiety toward English speaking skills in the classroom. The differential perspectives of anxiety revealed from both analyses indicate that a better understanding of language classroom anxiety and cognitive test anxiety can help students and teachers optimize their foreign language learning and teaching practices.

Background: The involvement of quality of life as the UNAIDS fourth 90 target to monitor the global HIV response highlighted the development of patient-reported outcome (PRO) measures to help address the holistic needs of people living with HIV/AIDS (PLWHA) beyond viral suppression. This study developed and tested preliminary measurement properties of a new patient-reported outcome (PROHIV-OLD) measure designed specifically to capture influences of HIV on patients aged 50 and older in China. Methods: Ninety-three older people living with HIV/AIDS (PLWHA) were interviewed to solicit items and two rounds of patient cognitive interviews were conducted to modify the content and wording of the initial items. A validation study was then conducted to refine the initial instrument and evaluate measurement properties. Patients were recruited between February 2021 and November 2021, and followed six months later after the first investigation. Classical test theory (CTT) and item response theory (IRT) were used to select items using the baseline data. The follow-up data were used to evaluate the measurement properties of the final instrument. Results: A total of 600 patients were recruited at the baseline. Of the 485 patients who completed the follow-up investigation, 483 were included in the validation sample. The final scale of PROHIV-OLD contained 25 items describing five dimensions (physical symptoms, mental status, illness perception, family relationship, and treatment). All the PROHIV-OLD dimensions had satisfactory reliability with Cronbach's alpha coefficient, McDonald's ω, and composite reliability of each dimension being all higher than 0.85. Most dimensions met the test-retest reliability standard except for the physical symptoms dimension (ICC = 0.64). Confirmatory factor analysis supported the structural validity of the final scale, and the model fit index satisfied the criterion. The correlations between dimensions of PROHIV-OLD and MOS-HIV met hypotheses in general. Significant differences on scores of the PROHIV-OLD were found between demographic and clinical subgroups, supporting known-groups validity. Conclusions: The PROHIV-OLD was found to have good feasibility, reliability and validity for evaluating health outcome of Chinese older PLWHA. Other measurement properties such as responsiveness and interpretability will be further examined. [ABSTRACT FROM AUTHOR]

The West Liaohe River Basin (WRLB) is a typical agro-pastoral interlaced zone in Northeast China where excessive economic development activities brought great pressure on the ecosystem and caused a series of ecological problems, having a negative effect on regional ecological carrying capacity (ECC). The rational construction of ecological security pattern (ESP) is an effective way to improve regional ECC and alleviate the contradiction between ecological protection and economic development. In this study, taking the WLRB as an example, spatiotemporal changes of ECC in the WLRB from 2000 to 2020 were explored by using spatial principal component analysis (SPCA). Furthermore, ecological sources were determined by coupling ECC evaluation results with important ecological patches such as natural protected areas, and the minimum cumulative resistance (MCR) model combined with the circuit theory method were employed to identify ecological security zoning, ecological corridors and key ecological nodes. Then a comprehensive ESP of the basin was constructed. The results show as follows: 1) The ECC of the overall WLRB was at medium carrying level, yet was spatially differentiated, which decreased from the periphery to the center of the basin in general. ECC showed a fluctuating upward trend from 2000 to 2020. 2) The ecological source area of the WLRB was 21926.91 km2, accounting for 17.33% of the total study area. The ecological sources were seriously fragmentated and mainly distributed in the mountain area. The area of ecological conservation zone, optimized buffer zone, ecological transition zone, ecological prevention and control zone were 55672.69 km2, 32662.24 km2, 23862.84 km2 and 12021.04 km2, accounting for 44.82%, 26.29%, 19.21% and 9.68%, respectively. We also extracted 95 ecological corridors (with a total length of 3130.97 km), 49 ecological pinch points (with a total area of 200.33 km2) and 30 ecological barrier points (with a total area of 318.30 km2), constituting a "pointslines-planes" comprehensive ecological security pattern. This research can provide scientific reference for the protection and restoration of ecological environment and regional sustainable development. [ABSTRACT FROM AUTHOR]

Background and purpose: Follow-up data of 6 737 patients undergoing surgery for gastric cancer were collected based on hospital registration, and the 1-, 3- and 5-years observed overall survival (OS) rates and disease-free survival (DFS) rates were analyzed to provide real-world research evidence for the prevention and control of gastric cancer and policy making in China. Methods: A total of 6 737 gastric cancer patients who underwent surgical treatment at Fudan University Shanghai Cancer center from 2015 to 2020 were included in this study. Clinical information and the follow-up endpoint data were collected through medical records review, telephone visits and death registry data linkage. The last follow-up date was November 30, 2023. Kaplan-Meier method was applied in evaluating the 1-, 3- and 5-year OS rate and DFS rate, and survival data were described by different subgroups including age group, gender, treatment period, tumor staging, and pathological characteristics. Results: With a median follow-up time of 50.99 months, the 5-year OS rate of surgically resected gastric cancer patients was 70.37%, and 5-year DFS rate in I-III stage cases was 69.46%. The 5-year OS rates of stage I, II, III and IV were 94.32%, 82.56%, 51.01% and 23.97%, respectively. The differences in survival among patients with different age, tumor location, gross classification, Borrmann classification and Lauren classification were significant. Conclusion: Staging is an important factor directly affecting the survival of gastric cancer patients. Screening and early diagnosis and treatment in large population, especially high-risk group, should be strengthened to further improve the patients' survival. [ABSTRACT FROM AUTHOR]

Background: This is a sub‐analysis of the Personalized Antithrombotic Therapy for Coronary Heart Disease after PCI (PATH‐PCI) trial in China to explore the relationship between smoking and outcomes following personalized antiplatelet therapy (PAT) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI). Methods: As a single‐center, prospective, randomized controlled and open‐label trial, the PATH‐PCI trial randomized CCS patients undergoing PCI into standard group or personalized group guided by a novel platelet function test (PFT), from December 2016 to February 2018. All patients were divided into smokers and nonsmokers according to their smoking status. Subsequently, we underwent a 180‐day follow‐up evaluation. The primary endpoint was the net adverse clinical events (NACE). Results: Regardless of smoking status, in the incidence of NACE, there was a reduction with PAT but that the reductions are not statistically significant. In the incidence of bleeding events, we found no statistically significant difference between two groups (smokers: 2.0% vs. 1.4%, HR = 1.455, 95% confidence interval [CI]: 0.595−3.559, p =.412; nonsmokers: 2.2% vs. 1.8%, HR = 1.228, 95% CI: 0.530−2.842, p =.632). In smokers, PAT reduced major adverse cardiac and cerebrovascular events (MACCE) by 48.7% (3.0% vs. 5.9%, HR = 0.513, 95% CI: 0.290−0.908, p =.022), compared with standard antiplatelet therapy (SAT). PAT also reduced the major adverse cardiovascular events (MACE) but there was no statistically difference in the reductions (p >.05). In nonsmokers, PAT reduced MACCE and MACE by 51.5% (3.3% vs. 6.7%, HR = 0.485, 95% CI: 0.277−0.849, p =.011) and 63.5% (1.8% vs. 4.9%, HR = 0.365, 95% CI: 0.178−0.752, p =.006), respectively. When testing p‐values for interaction, we found there was no significant interaction of smoking status with treatment effects of PAT (pint‐NACE =.184, pint‐bleeding =.660). Conclusion: Regardless of smoking, PAT reduced the MACE and MACCE, with no significant difference in bleeding. This suggests that PAT was an recommendable regimen to CCS patients after PCI, taking into consideration both ischemic and bleeding risk. [ABSTRACT FROM AUTHOR]

Natural bioactive compounds (NBCs) are widely used in clinical treatment. For example, Tripterygium wilfordii Hook f. is commonly known in China as Lei-Gong-Teng which means thunder god vine. This herb is widely distributed in Eastern and Southern China, Korea, and Japan. The natural bioactive compounds of this herb can be extracted and made into tripterygium glycoside tablets. It is one of the most commonly used and effective traditional Chinese herbal medicines against rheumatoid arthritis (RA), nephrotic syndrome (NS), autoimmune hepatis (AIH), and so on. However, many NBCs are difficult to reliably quantify in the serum due to the effects of matrix and RSD. In addition, the targeted compound's internal standard (IS) is rarely sold due to the complex isotope internal standard synthesis pathway. In this study, a new quantitation method for 18O labeling combined with off-line SPE was formulated. We contrasted the recoveries and matrix effects of various separation methods in order to choose the best method. Furthermore, we optimized the conditions for SPE loading and washing. An isotopic internal standard was prepared by the 16O/18O exchanging reaction in order to eliminate the matrix effects. The method's accuracy and precision met the requirements for method validation. The recovery of this method was close to 60%. The relative standard deviation (RSD) of the high-concentration sample was 2%, and the limit of detection (LOD) was 1 ng/mL. This method could be used to analyze the clinical serum concentration of demethylzeylasteral. Sixty samples were collected from 10 patients with diabetes nephropathy. The quantitation results of demethylzeylasteral in patients' serum obtained using this method exhibited a correlation between therapeutic drug monitoring (TDM) and decreased urinary protein. This work may have broad implications for the study of drug metabolism in vivo and the clinical application of low-abundance and difficult-to-quantify NBCs. [ABSTRACT FROM AUTHOR]

Elaeagnus oldhamii Maximowicz 1870 is an important medicinal plant mainly distributing in the southeastern coastal region of China. However, the complete chloroplast genome of E. oldhamii has never been studied at present. We obtained the complete chloroplast genome of E. oldhamii, which was 152,283 bp in length, with a typical quadripartite structure that includes a large single-copy region of 82,229 bp, a small single-copy region of 18,256 bp, and 2 inverted repeat (IR) regions of 25,899 bp. The genome contained 128 unique genes with a GC content of 37%, including 83 protein-coding genes, 37 tRNAs, and 8 rRNAs. Phylogenetic analysis suggested that E. oldhamii was closely related to E. glabra and E. macrophylla. [ABSTRACT FROM AUTHOR]

Critical Zone Science (CZS) explores the deep evolution of landscapes from the base of the groundwater or the saprolite‐rock interface to the top of vegetation, the zone that supports all terrestrial life. Here we propose a framework for CZS to evolve further as a discipline, building on 1st generation CZOs in natural systems and 2nd generation CZOs in human‐modified systems, to incorporate human behaviour for more holistic understanding in a 3rd generation of CZOs. This concept was tested in the China‐UK CZO programme (2016–2020) that established four CZOs across China on different lithologies. Beyond conventional CZO insights into soil resources, biogeochemical cycling and hydrology across scales, surveys of farmers and local government officials led to insights into human‐environment interactions and key pressures affecting the socio‐economic livelihoods of local farmers. These learnings combined with the CZS data identified knowledge exchange (KE) opportunities to unravel diverse factors within the Land‐Water‐Food Nexus, that could directly improve local livelihoods and environmental conditions, such as reduction in fertilizer use, contributing toward Sustainable Development Goals (SDGs) and environmental policies. Through two‐way local KE, the local cultural context and socio‐economic considerations were more readily apparent alongside the environmental rationale for policy and local action to improve the sustainability of farming practices. Seeking solutions to understand and remediate CZ degradation caused by human‐decision making requires the co‐design of CZS that foregrounds human behavior and the opinions of those living in human modified CZOs. We show how a new transdisciplinary CZO approach for sustainable Earth futures can improve alignment of research with the practical needs of communities in stressed environments and their governments, supporting social‐ecological and planetary health research agendas and improving capacity to achieve SDGs. Plain Language Summary: Critical Zone Science (CZS) explores how landscapes evolve from below the Earth's surface to the top of trees, supporting life on Earth. CZS was established by studying pristine landscapes, with little or no human modification of the land, water and soil. These pristine natural systems are rare in our modern world. In this paper, we have proposed a new approach to CZS for studying the human‐modified landscapes that dominate our world. To help explain why this is needed, we have re‐drawn a diagram explaining how the critical zone works to show the role of humans. We also give examples of research in three regions of China where we learned from local farmers living in our study areas, to improve our scientific understanding and to try to align our research process to address the biggest pressures affecting their lives. This new approach to CZS can help focus research to directly support local people and improve our ability to achieve the United Nations Sustainable Development Goals. Key Points: Integrating local knowledge with critical zone science can improve interpretation of scientific findings and delivery of Sustainable Development GoalsThird generation science can improve alignment of research with the practical needs of communities and governmentsA new conceptual diagram for human‐modified critical zones is produced to illustrate transdisciplinary Critical Zone Observatories for sustainable Earth futures [ABSTRACT FROM AUTHOR]

There is a growing global emphasis on sustainable agriculture to reduce human impacts and improve delivery of Sustainable Development Goals (SDGs). With increasing investment in critical zone observatories (CZOs), it becomes important to understand how sustainable agricultural knowledge is produced, shared and used between different groups including farmers, scientists and government. To explore these issues, scientists leading the knowledge exchange (KE) component of a China‐UK CZO program studied three farming regions with contrasting geologies and varying economic levels, using a practice‐based research method. We demonstrate how additional funding for social science research allowed us to understand how farmers access and share farming knowledge through bonding, bridging and linking networks, and how this varies spatially, using interviews and survey questionnaires. Knowledge flows, barriers and opportunities for designing locally suited two‐way KE activities were identified. First, we highlight the need for a more locally, socially embedded and reflexive approach to build trust and better address pressing local environmental challenges. Second, we show how social science can usefully inform KE for collaborative, international development science, to draw on local knowledge, promote research impacts and capacity building while avoiding knowledge mismatches. Lastly, a blueprint for the design and funding of future CZOs, social‐ecological and planetary health research agendas that combine science, social science, local knowledge and KE is presented, including the need for substantive social science research to take place in addition to science research in human‐modified landscapes—enabling the CZ science to be better grounded in, informed by and useful to local communities. Plain Language Summary: There is a growing global need for sustainable agriculture to reduce human impacts on the environment. To do this, we need to have a better understanding of how sustainable agricultural knowledge is produced, shared and used between different groups including farmers, scientists and government. In this paper, we explored these issues in three farming regions in China, using a practice‐based research method where we interviewed and surveyed several 100 farmers. We found that in two of the three regions, farmers access and share farming knowledge through family networks, whilst in the third region farmers learned from a broader range of groups including scientists and government. We recommend that future science studies in stressed agricultural landscapes use a more local approach to build trust and carry out science that better addresses pressing local environmental challenges. This requires us to study people, the residents in these landscapes, using social science, alongside understanding how the landscape is functioning ecologically. Lastly, we propose a new "blueprint" for funding of future science, social‐ecological and planetary health research agendas that combine science, social science, local knowledge and knowledge exchange. This will enable environmental science to be better grounded in, informed by and useful to local communities. Key Points: A blueprint for future critical zone observatories and planetary health research is presented that combines science, social science and local knowledgeWe show how social science can usefully inform knowledge exchange (KE) for collaborative science, to build capacity while avoiding knowledge mismatchesSpatial variations in how farmers learn through bonding, bridging and linking networks exist, showing the need for a local approach to KE [ABSTRACT FROM AUTHOR]

Background: Several studies have explored the connection between follicle-stimulating hormone (FSH) and nonalcoholic fatty liver disease (NAFLD). However, the impact of FSH elevation on NAFLD remains a topic of debate. Hence, this investigation aimed to evaluate the potential correlation between FSH levels and NAFLD in the aging population. Methods: This was a retrospective observational cross-sectional study between July 2017 and August 2018 in our hospital. We used data obtained from 455 patients over 60 years old. Anthropometrics and laboratory tests were performed for each patient. NAFLD was diagnosed by sonographic features and the fatty liver index (LFI). Results: Of the 455 patients, 200 (43.96%) had NAFLD on their ultrasound and 169 (37.14%) had NAFLD according to the LFI. An intraclass correlation coefficient of the two methods was 80.4% (P < 0.001). People with NAFLD on their ultrasound showed lower FSH levels (52.68 vs. 61.39 IU/L) and more unfavorable metabolic profiles. FSH was negatively correlated with age, alanine aminotransferase, estradiol, testosterone, systolic blood pressure, waist, body mass index, fasting blood glucose, postload plasma glucose and positive associated with total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol by Spearman correlation analysis (all P < 0.05). By controlling for all confounding factors, the odds ratios (OR) of FSH for NAFLD were determined in elderly individuals, both men and women, aged 60–70 years and over 70 years. These ORs were found to be 0.937, 0.982, 0.983, and 0.973, respectively, with corresponding 95% confidence intervals (CI) of 0.892–0.984 (P = 0.009), 0.971–0.993 (P = 0.002), 0.967–0.999 (P = 0.033), and 0.958–0.989 (P = 0.001). In addition, our findings demonstrated no significant correlation between FSH and advanced fibrosis when adjusting for potential covariates. The OR for advanced fibrosis was 0.979 (95% CI, 0.938–1.022, P = 0.339). Additionally, ROC curve analysis showed an optimal cut-off value of 66.91 for women and 15.25 for men for NAFLD diagnosis. Conclusions: There was an inverse relationship observed between levels of FSH in the blood serum and NAFLD in the elderly population. These findings suggest that reduced FSH levels might serve as a potential risk factor or biomarker for NAFLD in the elderly. [ABSTRACT FROM AUTHOR]

Fructus Aurantii (FA) is the dry and immature fruit of Citrus aurantium L. and its rutaceous cultivars. FA has been widely used to treat digestive system diseases since ancient China, and it promotes gastrointestinal (GI) motility in functional dyspepsia (FD), but its potential therapeutic mechanisms remain unclear. We examined the effects of FA ethanol extracts in an iodoacetamide (IA)-induced FD rat model. Firstly, key FA therapy targets for FD were gathered using systematic pharmacology. Combined with systemic pharmacological analyses, plasma metabolomics based on UPLC-QTOF-MS were conducted. Then, MetaboAnalyst was used to jointly analyze systemic pharmacology targets and metabolomic metabolites to select key metabolic pathways. Finally, the key path is verified by experiments. FA exerted distinct therapeutic effects in anti-inflammation and promoting gastrointestinal motility in our IA-induced FD rat model. When compared with the model group, FA down-regulated the inflammatory factors interleukin 1β and tumor necrosis factor-α. At the same time, FA up-regulated tight junction proteins in the intestinal epithelial barrier. Through the integrated analysis of metabolomics and systemic pharmacology, we conducted experimental verification on Fc epsilon RI signaling pathway. When compared with the model group, FA down-regulatedphospho-mitogen activated protein kinase, phospho-extracellular signal regulated kinase1/2, myosin light chain kinase, and phospho-myosin regulatory light chain protein levels. Thus, FA ameliorated FD by regulating the Fc epsilon RI signaling pathway. Our integrated strategy identified underlying FA mechanisms toward FD treatment and provided a foundation for FA development as a clinical agent for FD. [ABSTRACT FROM AUTHOR]

In the year 2023, 1 958 310 new cancer cases and 609 820 cancer deaths are projected to occur in the United States, estimated by Cancer Statistics, published by American Cancer Society. An accelerated decline in mortality rate of cancer continues since it reached the peak in 1991. The treatment advance brought survival benefit to patients which mainly contribute to the decline along with tobacco control and screening. COVID-19 pandemic caused 350 831 mortality and ranked 3rd in cause of death in 2020, and the mortality had a significant increase in multiple causes of death including cancer. By comparing the data of China and the United States released by GLOBOCAN database in 2020, it is found that, although the influence of the pandemic on cancer has not been evaluated. Although the incidence and mortality of cancer differ between US and China, the experiences are worth learning. Improving the standardization of diagnosis and treatment, enhancing the accessibility of cancer health care, upgrading the coverage of screening and increasing the human papillomavirus (HPV) vaccination rate are proven to be effective ways to reduce the mortality of cancer. [ABSTRACT FROM AUTHOR]

Tropical mountain ecosystems are usually colonized by numerous invasive plant species and represent an ideal 'natural laboratory' to study the effects of altitude on plant invasion. The aim of this study was to investigate the soil chemical and microbiological properties along an altitudinal gradient on a mountain colonized by the invader Ageratina adenophora. Rhizosphere soil of A. adenophora was collected over an altitudinal gradient (1400–2400 m) in Ailao Shan, China. We determined soil organic carbon (C), nutrient contents, enzyme activities, bacterial community composition as well as C and nitrogen (N) contents of the plant roots. Ecoenzymatic stoichiometric indices were calculated to estimate the relative C, N or P limitations of the microbial community. There was a significant effect of altitude on soil organic C in the rhizosphere, and a turning point in these measured variables was detected at an altitude of 2000 m. At low elevations, the rapid growth of invasive plants depleted the deficient phosphorus (P) in tropical soils, leading to microbial P limitation; at high elevations, microbes invested more energy to obtain C from resistant litter, leading to microbial C limitation. Bacterial beta diversity and soil pH contributed most to the altitudinal differences in ecoenzymatic stoichiometry, and Proteobacteria and Acidobacteria were the dominant bacterial phyla that determined the nutrient uptake status of microorganisms. These results demonstrate how microbial nutrient acquisition belowground of A. adenophora along an altitudinal gradient, which could contribute to further knowledge about the effects of altitude on biological invasion. [ABSTRACT FROM AUTHOR]

Background: Gynecologic cancers are among the most prevalent malignancies in China. Cervical and uterine cancer respectively account for the sixth and eighth highest incidence of cancer among Chinese women. Abdominal surgery is one of the important treatment methods for gynecological tumors. However, the tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in the Chinese population. The study aimed to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version of MDASI-PeriOp-GYN.Methods: The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the nine items were translated back into English by two different bilingual translators. After discussion and revision, the four translators reached an agreement. Finally, the finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. The reliability and validity of the translated version were assessed.Results: Overall, 324 women with gynecologic cancers were enrolled. Cronbach's α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test-retest reliability values were 0.885, 0.873, and 0.914 for symptom severity, PeriOp-GYN, and interference scales. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (- 0.608-0.871, P < 0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P < 0.01).Conclusions: The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients' health and quality of life data. [ABSTRACT FROM AUTHOR]

This article takes the musical characteristics of Haoyang songs in Pingchang County, Sichuan Province, China" as the research object. The purpose of this article is to analyze the musical element characteristics of Haoyang songs based on field investigations and using qualitative research methods. The conclusions of this article The following are: 1) Further analysis of the melody characteristics of Haoyang songs. 2) Further analysis of the characteristics of Haoyang songs' rhythm and tempo changes. 3) Analysis of the tunes of Haoyang songs. 4) The singing method of Haoyang songs needs further analysis. [ABSTRACT FROM AUTHOR]

Background: Little is known about the prognostic advantage of sex for pulmonary adenocarcinoma among Chinese patients. In this study, we aimed to investigate the true sex differences in prognosis by adjusting for confounders and to explore whether the differences were time‐varying. Methods: We identified 4438 lung adenocarcinoma patients who underwent surgery at a regional Cancer Center of China from 2008 to 2016, retrospectively. Sex, age group, smoking history, year of diagnosis and pathological stage were collected. Time‐dependent Cox regression models with inverse probability of treatment weighting (IPTW) based on propensity score were used to assess the effect of sex and account for confounders. Landmark analyses were conducted to assess survival before, and after, five years. Results: Of these patients, 1761 (39.7%) were men and 2677 (60.3%) were women. Median follow‐up time was 52.6 months. After IPTW adjustment, women were found to have significantly better survival than men varying with time in both crude and IPTW models (hazard ratio [HR] [t] = 0.453*1.015t, where t is the length of time from treatment and its unit is month, p < 0.001). Women had significantly better survival than men within 0–5 years after surgery (HR = 0.763, 95% CI: 0.649–0.897, p = 0.001), whereas there was no difference after five years (HR = 1.135, 95% CI: 0.803–1.605, p = 0.472). In subgroup analysis, women in the 61–71+ age group, in the more than 20 year packs group, pathological stage 0–IB group, and 2013–2016 diagnosis period group revealed the same prognostic pattern. Conclusions: Compared with men, women had better survival after surgical resection of lung adenocarcinoma, especially those who were older and nonsmokers or heavy‐smokers and were pathological stage 0–IB in early years, while the advantage for women diminished with time. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the factors influencing brachial-ankle pulse wave velocity (baPWV) in an apparently healthy Chinese population, especially the associations between baPWV and indices of blood pressure (BP). Methods. A total of 1123 participants with no history of hypertension were enrolled in this study, and the baPWV and BP of all four limbs were measured along with other covariates. Correlation analyses and multivariate linear regression models were used to identify factors associated with baPWV. Results. A total of 1123 participants (male 43.3%, mean age: 58.4 ± 13.9 years) were included. The average baPWV was 14.87 ± 3.21 m/s, and no difference was found between the sexes. Age was positively correlated with baPWV (r = 0.65 , p < 0.01), especially in females (r = 0.71 versus 0.56 in males). The correlation coefficient between age and baPWV increased markedly after the age of 65 years. In addition, the resting heart rate (RHR), waist-hip ratio, glomerular filtration rate, and plasma glucose level were significantly correlated with baPWV (r = 0.25 , 0.22, -0.43, and 0.25, respectively; p < 0.01). BP parameters were highly positively correlated with baPWV, especially systolic BP (SBP) and pulse pressure (PP). Multivariate regression revealed that age, BP parameters, and RHR were independently correlated with baPWV (p < 0.01) after adjusting for confounding factors. The standardized coefficients of SBP were greater than those of PP, followed by diastolic BP (DBP). Conclusion. BaPWV increased with age, especially after 65 years. Age, BP, and RHR were independent factors associated with baPWV. The effect of SBP on baPWV was more prominent than that of PP. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the current status and trends in antidepressant use and expenditure in China from 2013 to 2018. The study had a retrospective design based on prescribing data on antidepressant drugs, which was sourced from the Hospital Prescription Analysis Cooperative Project. The trends in hospital visits and corresponding expenditure on antidepressant drugs were examined. Subgroup analyses were carried out by sex, age, and drug class. A total of 1,795,230 outpatient prescriptions were collected from 79 hospitals in six major cities in China. Hospital visits with antidepressant prescriptions rose significantly from 244,626 in 2013 to 348,718 in 2018, reflecting a 42.6% increase (P < 0.05). The antidepressant expenditure also rose, increasing from 48.0 million Chinese yuan in 2013 to 64.8 million Chinese yuan in 2018. There were approximately 1.6 times more antidepressant prescriptions written for women than for men. The most frequent age category for antidepressant prescriptions was 45–64 years. The most commonly prescribed antidepressants were selective serotonin reuptake inhibitors (N06AB) and other antidepressants (N06AX), whereas tricyclic antidepressants (N06AA) accounted for only a small part of the total antidepressant prescriptions. Flupentixol/melitracen and escitalopram were the most frequently prescribed antidepressants. Antidepressant prescribing rates continue to increase in China, although the prescribing patterns have changed over the past few years. The wide use of expensive antidepressants and those with weak clinical evidence raises concerns regarding the rational use of antidepressants. This study provides a basis for future stewardship by the government and medical institutions. [ABSTRACT FROM AUTHOR]

Based on legitimacy and stakeholder theory, we investigate whether there is an association between the disclosure of corporate social responsibility reports and a firm's sales performance in China. The empirical results reveal that the return on sales and sales growth are positively associated with the level of corporate social responsibility reporting in China. This positive association is strengthened when firms have concentrated customers. Firms use corporate social responsibility reports to improve sales performance and attract customers, who are one of their major stakeholders, and retain their legitimacy. [ABSTRACT FROM AUTHOR]

Background: Primary percutaneous coronary intervention (PPCI) plays a pivotal role in the treatment of ST-segment elevation myocardial infarction (STEMI). However, it remains controversial whether PCI delayed beyond the recommended time window of 12 h after the onset of symptoms is applicable to STEMI.Objective: The acute myocardial infarction (AMI) registration study in Xinjiang, China, is a real-world clinical trial (retrospective cohort study) that includes hospitalized patients. The purpose of this study was to compare delayed PCI and medication therapy beyond the recommended time window of 12 h after the onset of symptoms on the outcomes of STEMI patients.Methods and Results: From May 2012 to December 2015, a total of 1072 STEMI patients received delayed PCI (n=594) or standard medication therapy (MT) (n=478) more than 12 h after the onset of symptoms. The number of all-cause deaths in the delayed PCI group and that in the MT group were 55 (9.3%) and 138 (28.9%), respectively, and a significant difference between the groups was indicated for this variable (P<0.001). The number of cardiac deaths in the delayed PCI group and that in the medication therapy group were 47 (7.9%) and 120 (25.1%), respectively, and a significant difference between the groups was indicated for this variable (P<0.001). We also found that the MACE incidence in the delayed PCI group was significantly higher than it was in the MT group (32.2% versus 43.5%, P<0.001). Propensity score matching (PSM) analyses remained significant differences between the delayed PCI group and the MT group, respectively, in all-cause deaths (9.3% versus 25.8%, P<0.001) and cardiac death (8.7% versus 21.6%, P<0.001).Conclusion: Compared to medication therapy, PCI for STEMI delayed beyond 12 h after the onset of symptoms can better reduce mortality and the incidence of MACEs.Trial Registration: This study is registered with the following: Trial Registration: clinicaltrials.gov; Identifier: NCT02737956. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • We developed criteria to assess KM interactions that can be applied more widely. • Limited research has examined KM across the environment-policy interface in China. • Why was KM undertaken? Mainly to develop solutions and change agricultural practice. • How was KM done? Science-policy interactions were mainly one-way and/or ICT-based. • Future Chinese KE research would help inform evidence-based environmental policy. Abstract Global to local environmental policy-making is increasingly evidenced-based. Knowledge management (KM) is increasingly used by environmental scientists and policymakers, to deliver evidence-based policy and practice. There is thus an urgent need to identify whether and how knowledge is exchanged between knowledge producers and users in environmental science fields. Here we apply an assessment framework developed in social medicine to identify what forms of environmental knowledge are exchanged, and why and how they are exchanged. We focussed on China, as international research to better manage Chinese ecosystem services is rapidly-increasing, yet, how to best integrate this into political decision-making and the public realm remains a challenge. How KM is practiced in China is unknown. We addressed this through: 1) a systematic analysis of published KM research in China compared to global trends; 2) evaluating KM for environmental policy and management in China; 3) quantitative surveys of Chinese (n = 72) and British (n = 16) scientists researching Chinese environmental problems. The systematic literature review of two databases identified two key findings. One, of 291 papers that considered KM there were no papers in the environmental sector examining the science-policy-practice interface in China. Two, only 13 of 423 potentially relevant papers explicitly examined KM for environmental topics, notably for agriculture and information exchange (the 'What?'). Most papers reported a one-way interaction between scientists and users (the 'How?'), used to change practice (the 'Why?'). Our survey showed significantly-less awareness and use of two-way knowledge exchange (KE) methods by Chinese scientists. The paucity of documented KM research and limited evidence for two-way interaction show KE at the environmental science-policy-practice interface in China is limited. Promotion of KE practice may benefit environmental policy-making in China. We have also shown that conceptual frameworks for mapping and assessing KE practice from social medicine can be usefully adapted for examining environmental science – policy interfaces. [ABSTRACT FROM AUTHOR]

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Background: To provide a comprehensive overview of temporal trends in cancer incidence during 1973-2010 in urban Shanghai.Methods: The estimated annual percent changes (EAPCs) for the whole period and for the time segments in age-standardized incidence rates (ASR) were evaluated with Joinpoint analysis. Age-period-cohort (APC) models were modeled to examine the effects of age, period and birth cohort on cancer incidence.Results: The overall ASR decreased slightly and significantly in males (EAPC of -0.41) but increased significantly in females (EAPC of 0.57) during 1973-2010 in urban Shanghai. The incidence trend was not linear and varied by time segments. During the most recent 10 years (2001-2010), the ASR in males decreased by 1.65% per year and stabilized in females. Incidence rates continued to decline during 1973-2010 for esophagus, stomach, and liver cancer in both sexes, as well as male lung cancer and cervix cancer. It should be noted that it was the first time to document a significant decline in lung cancer incidence among males during 1973-2010 with EAPC of -0.58%, and a notable upward for cervix cancer since 1996 with EAPC of 8.94%. Unfavorable trends in incidence were observed for the most common cancer sites in the 38 years period: colorectum, gallbladder & biliary tract, pancreas, kidney, bladder, brain & central nervous system (CNS), thyroid, non-Hodgkin's lymphoma (NHL), prostate, female breast, corpus uteri, and ovary. APC analysis showed age, period and birth cohort yielded different effects by cancer sites.Conclusions: The observed trends primarily reflect dramatic changes in socioeconomic development and lifestyles in urban Shanghai over the past four decades. [ABSTRACT FROM AUTHOR]

This paper investigates intra-industry spillover effects of corporate scandals in China. We demonstrate how a contagion effect spreads to peer firms depending upon the quality of corporate governance and their political connections. Good corporate governance in peer firms reduces the contagion effect of scandals. External governance has a stronger influence on reducing the contagion effect of both financial and non-financial scandals, while ownership concentration and the quality of auditors play a more pronounced role in mitigating the contagion effect of financial scandals. State ownership helps to mitigate the negative influence of non-financial scandals in individual-owned firms, but not in state-owned enterprises. [ABSTRACT FROM AUTHOR]

Two complete chloroplast genomes of Hippuris vulgaris (H. vulgaris_A and H. vulgaris_B), representing two distinct clades in China, were sequenced and assembled in this study. The circular genomes were 152,763 and 152,713 bp in length and exhibit a typical quadripartite structure of the large single-copy (LSC, 82,983/82,949 bp) and small single-copy (SSC, 18,294/18,278 bp) regions, separated by a pair of inverted repeats (IRs, both 25,743 bp). Both two cp genomes identically contain 133 genes, including 88 protein-coding genes, 37 tRNA, and eight rRNA genes. The phylogenetic analysis within Plantaginaceae demonstrated Hippuris an independent clade included in the expanded Plantaginaceae. [ABSTRACT FROM AUTHOR]

Genome-wide association studies have identified approximately 20 susceptibility loci for breast cancer. A cumulative genetic risk score (GRS) was constructed from 10 variants with replicated associations among participants of the Shanghai Breast Cancer Genetics Study (Shanghai, China, 1996–1998 and 2002–2005). Interactions between the GRS and 11 breast cancer risk factors were evaluated. Among the 6,408 study participants, no evidence of effect modification was found with the GRS for age at menarche, age at menopause, age at first live birth/parity, total months of breastfeeding, family history of breast cancer, history of benign breast disease, hormone replacement therapy, body mass index, waist/hip ratio, or regular physical activity. The effect of the GRS was least homogeneous by duration of menstruation; further analysis indicated a nominally significant interaction with one genetic variant. The mitochondrial ribosomal protein S30 gene (MRPS30) rs10941679 was associated with breast cancer risk only among women with more than 30 years of menstruation (odds ratio = 1.15, 95% confidence interval: 1.05, 1.26). Although this multiplicative interaction reached a nominal significance level (P = 0.037), it did not withstand correction for multiple comparisons. In conclusion, this study revealed no apparent interactions between genome-wide association study-identified genetic variants and breast cancer risk factors in the etiology of this common cancer.Abbreviations: CI, confidence interval; GRS, genetic risk score; OR, odds ratio; SNP, single nucleotide polymorphism. [ABSTRACT FROM PUBLISHER]

Etiologic differences between subtypes of breast cancer defined by estrogen receptor (ER) and progesterone receptor (PR) status are not well understood. The authors evaluated associations of hormone-related factors with breast cancer subtypes in a population-based case-control study involving 1,409 ER-positive (ER+)/PR-positive (PR+) cases, 712 ER-negative (ER−)/PR-negative (PR−) cases, 301 ER+/PR− cases, 254 ER−/PR+ cases, and 3,474 controls aged 20–70 years in Shanghai, China (phase I, 1996–1998; phase II, 2002–2005). Polytomous logistic regression and Wald tests for heterogeneity across subtypes were conducted. Breast cancer risks associated with age at menarche, age at menopause, breastfeeding, age at first livebirth, waist-to-hip ratio, and oral contraceptive use did not differ by hormone receptor status. Among postmenopausal women, higher parity (≥2 children vs. 1) was associated with reduced risk (odds ratio (OR) = 0.69, 95% confidence interval (CI): 0.52, 0.91) and higher body mass index (BMI; weight (kg)/height (m)2) with increased risk (highest quartile: OR = 2.40, 95% CI: 1.65, 3.47) of the ER+/PR+ subtype but was unrelated to the ER−/PR− subtype (for parity, Pheterogeneity = 0.02; for BMI, Pheterogeneity < 0.01). Hormone replacement therapy (OR = 2.25, 95% CI: 1.40, 3.62) and alcohol consumption (OR = 1.59, 95% CI: 1.01, 2.51) appeared to be preferentially associated with the ER+/PR− subtype. These findings indicate that BMI, parity, hormone replacement therapy, and alcohol consumption may play different roles in subtypes of breast cancer. More research is needed to better understand the etiology of 2 relatively rare subtypes, ER+/PR− tumors and ER−/PR+ tumors. [ABSTRACT FROM PUBLISHER]

In previous studies among 1,144 cases and 1,256 controls recruited in stage 1 of the Shanghai Breast Cancer Study (SBCS I; 1996–1998), 18 known or potentially functional single nucleotide polymorphisms (SNPs) in 16 genes were found to be associated with breast cancer risk. The authors evaluated these associations among 1,918 cases and 1,819 controls recruited in stage 2 of the SBCS (SBCS II; 2002–2005) using genetic effect models and subgroup analyses predetermined from SBCS I results. Five SNPs (AHR rs2066853, ATM rs1003623, ESR1 rs2234693, GSTP1 rs1695, and SHBG rs6259) showed generally consistent results in SBCS I and SBCS II and statistically significant associations with breast cancer risk in combined analyses, mostly in subgroups defined by age or menopausal status. Further, the relation between breast cancer risk and SHBG rs6259 was found to vary by body mass index (weight (kg)/height (m)2) (P for interaction = 0.003). The strongest reduction in risk associated with SHBG rs6259 was found for lean (body mass index <23) postmenopausal minor allele carriers (odds ratio = 0.6, 95% confidence interval: 0.5, 0.8; P = 4.6 × 10−4). This biologically plausible and highly significant finding provides strong evidence for a true association among Asian women. This study also highlights the value of gene-environment interaction analyses in evaluating genetic factors for complex diseases. [ABSTRACT FROM PUBLISHER]

The fibroblast growth factor receptor 2 gene (FGFR2) has been associated with the risk of breast cancer in multiple ethnic populations, and its effect has been suggested to be hormone-dependent. A large, 2-stage, population-based case-control study was conducted in urban Shanghai, China, during the periods of 1996–1998 and 2002–2005. Exposure and genotyping information from 2,073 patients with breast cancer and 2,084 age-matched population controls was available for evaluation of the interactions between FGFR2 polymorphisms and exogenous estrogen exposure in the development of breast cancer. A logistic regression model was used to compute adjusted odds ratios and 95% confidence intervals. Of 20 genotyped and 25 imputed single nucleotide polymorphisms (SNPs), 22 were significantly associated with breast cancer. Three genotyped SNPs in close linkage disequilibrium, rs2303568, rs3135730, and rs1078806, and an imputed SNP of rs755793 in complete linkage disequilibrium with other 8 SNPs were observed to interact significantly with oral contraceptive (OC) use. The SNP-cancer association was evident only among OC users, and the OC use was only associated with the risk of breast cancer among carriers of these minor alleles at these loci. These findings suggest that genetic variants in FGFR2 may modify the role of OC use in causing breast cancer in Chinese women. [ABSTRACT FROM PUBLISHER]

The article presents a study on the endophytic bacterial strain identified as Bacillius subtilis from the interior of the eggplant stem as an alternative tool to control vascular wilt disease caused by verticillium dahliae in Jiangsu Province, China. It notes that bacteria strain Jass ed1 was an internal colonizer within the eggplant without causing harmful side effects. The results show that the strain which produces antifungal substance had the biocontrol potential.

Since 2006, canine distemper outbreaks have occurred in rhesus monkeys at a breeding farm in Guangxi, People's Republic of China. Approximately 10,000 animals were infected (25%-60% disease incidence); 5%-30% of infected animals died. The epidemic was controlled by vaccination. Amino acid sequence analysis of the virus indicated a unique strain. [ABSTRACT FROM AUTHOR]

Background and Objectives: Poor nutritional status is a common finding in pulmonary tuberculosis (TB) patients with and without type 2 diabetes mellitus (T2DM), thiamin (VB-1) and riboflavin (VB-2) are coenzymes important for the activation of many enzymes involved in improving nutritional status. We aimed to investigate enzymatic activities and the associations between VB-1 and VB-2, and their relations to nutritional status in TB and TB+T2DM patients.Methods and Study Design: This was a cross-sectional study that prospectively enrolled TB 40 patients with or without T2DM respectively from the Chest Hospital of Qingdao and 76 healthy controls with similar age and gender distributions were recruited from the medical center of the affiliated hospital of Qingdao Medical College. The erythrocyte transketolase activation coefficient (ETKac, for VB-1 deficiency), the glutathione reductase activation coefficient (EGRac, for VB-2 deficiency), and metabolic enzyme activities were analyzed.Results: VB-1 and VB-2 deficiency rates were higher, and enzyme activities were lower in TB and TB+T2DM relative to control group. ETKac and EGRac were negatively correlated with enzyme activities, either with body mass index (BMI), while enzyme activities were positively associated with BMI.Conclusions: VB-1 and VB-2 concentrations were lower in TB patients with or without T2DM relative to controls, with concomitant reductions in the activity levels of key metabolic enzymes. Significant correlations were observed between VB-1 and VB-2 concentrations and the activity of these metabolic enzymes, they all correlated with nutrition status. VB-1 and VB-2 concentrations may thus impact metabolic enzyme activity and thereby influence nutritional status. [ABSTRACT FROM AUTHOR]

• Overt and occult hepatitis B infections among pregnant women were still prevalent during the transition period in China. • Separation of occult hepatitis B infection from "healthy" subjects tended to increase the effectiveness estimates of current neonatal vaccination against hepatitis B virus. • Pregnant women with overt hepatitis B infection primarily transmitted the virus, which resulted in an overt or occult infection in their infants. Intensive prenatal screening of hepatitis B surface antigen for pregnant women is essential. • A high rate of loss-to-follow-up could not be ignored in this study. Overt and occult hepatitis B infection (HBI) among mothers and infants were investigated, and the effectiveness of vaccination against HBI was evaluated based on transmission types. A hospital-based cohort was built with 2,734 mothers and 330 mother-infant pairs. Their demographic data were collected. Serological HBV markers, nested-PCR for HBV genes, viral load detection, and phylogenetic analysis were done. The overall prevalence of HBI among mothers was 12.1% (330/2,734), with 10.4% for the overt type and 1.8% for the occult type. In 330 out of 1,650 (20%) mother-infant pairs, the overall, type-I (from overt mother to overt infant), type-II (from overt mother to occult infant), and type-Ⅲ (from occult mother to occult infant) transmissions were 1.9% (1/54), 5.6% (3/54) and 0.0% (0/7). The refinement of HBI classification improved the estimate of vaccine effectiveness against HBI from 74.4%–80.9% to 94.4%, which was more prominent for type-II. One mother-infant pair with type-II transmission shared nearly identical complete sequences. However, the high rate of lost-to-follow-up could not be ignored. During the transition period, HBV is mainly transmitted from the overt type of HBI mother to infant. Intensive prenatal screening for mothers is vital. [ABSTRACT FROM AUTHOR]

Evaluating the effectiveness and functional boundary of different types of industry policies and their mixes on the innovation performance of wind power enterprises (WPEs) is an important but unresolved key issue. This study, based on dual perspectives of regional innovation environment and enterprise ownership, empirically examines the impacts of different types of industry policies and their mixes on enterprise innovation. The results show that different types of policies have significantly different effects on innovation performance of WPEs; policy mixes have a significant synergy but may not be fully effective, and environmental-side policy and demand-side policy mixes still show significant inhibition. Taking into account boundary conditions, this study finds that policy mixes are implemented better in regions with weak innovation environments, especially in terms of the innovation performance of private-owned WPEs in the region. However, there is no significant impact for WPEs located in regions with strong innovation environments and state-owned enterprises in regions with weak innovation environments. This study expands an understanding of external boundaries for the effective implementation of different industry policies and their mixes, and has important implications for China in improving the applicability and matching ability of policies in the wind power industry. • The impact of different single policies and policy mixes on enterprise innovation is analyzed. • The synergistic effects of policy mixes have significant difference. • This study empirically tests the functional boundary of policy mixes on enterprise innovation. • Regional innovation environment and enterprise ownership significantly affect the effectiveness of policy mixes. [ABSTRACT FROM AUTHOR]

[Display omitted] • We firstly reported the ore ages of the newly discovered Li-rich pegmatite in the NQT. • The newly discovered pegmatites have similar ages to the pegmatite in the MYK. • The pegmatites in the NQT may be formed in a continental collision setting. Lithium–(beryllium) are important strategic metals in modern industries. The Markam–Yajiang–Karakoram (MYK) giant Li ore belt (>14 Mt Li 2 O) is located in the central Qinghai–Tibetan Plateau, and is a world-class Li deposit belt. The reported pegmatite deposits in the belt are mainly found in the Tianshuihai–Songpan–Garzê Terrane (TSGT) and are generally considered to be related to Late Triassic S-type granites and flysch sedimentary rocks. Recently, abundant pegmatite veins have also been discovered in an adjacent terrane (i.e., the North Qaidam Terrane) to the north of the MYK belt, but it is unclear whether these newly discovered pegmatites are genetic related to the MYK belt. Here, we report high-precision columbite–tantalite (i.e., coltan) U–Pb ages and muscovite–lepidolite 40Ar/39Ar ages for the Li–(Be) rare-element pegmatites from the North Qaidam Terrane (NQT) in the Chakabeishan area of the Zongwulong orogenic belt. Coltan grains from three spodumene-bearing pegmatite samples yielded weighted-mean 207Pb-corrected U–Pb ages of 214.9 ± 1.7, 217.0 ± 2.3, and 215.0 ± 1.5 Ma. Muscovite 40Ar/39Ar dating of two spodumene-bearing pegmatite samples and one barren pegmatite sample yielded plateau ages of 213.00 ± 0.97, 211.67 ± 0.35, and 211.78 ± 0.29 Ma, respectively. A lepidolite 40Ar/39Ar age for a lepidolite-bearing pegmatite is 216.62 ± 0.88 Ma. The subtle age differences obtained by the different methods are within reasonable error estimates or may be due to different closure temperatures. The ore-forming ages of the Chakabeishan Li–(Be) rare-element pegmatites are similar to those of Li–(Be) pegmatite deposits in the MYK belt. This and data from previous studies suggest that the Chakabeishan Li–(Be) rare-element pegmatites were also formed in a post-collisional setting after the closure of the Paleo-Tethys (Anyemaqen) Ocean. This study has important implications for understanding the origins of the MYK Li ore belt, indicating that the formation of these Li deposits was not solely associated with the Late Triassic S-type granites and flysch sedimentary rocks. Our results may also have implications for exploration, which extends the potential area of Li deposits from the Tianshuihai–Songpan–Garzê Terrane to the North Qaidam Terrane. [ABSTRACT FROM AUTHOR]