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We report a rare case of Cushing's syndrome induced by an ectopic adrenocortical adenoma. A 57-year-old woman was diagnosed with adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome based on clinical manifestation and laboratory information. She was found to have a mass in the left renal hilum via contrast-enhanced computed tomography (CT). The mass was negative, as seen in somatostatin receptor imaging with 99mTc-hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC), and showed mild fluorodeoxyglucose (FDG) activity via positron emission tomography (PET)/CT. The results of adrenal venous sampling suggested a left-side adrenal origin of hypercortisolism, possibly secreted by the mass in the renal hilum. Histopathology after surgical resection of the mass confirmed an ectopic adrenocortical adenoma, which was responsible for the patient's Cushing's syndrome. During the 8-month follow-up after surgery, no recurrence of Cushing's syndrome was found. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a machine learning model based on radiomic features derived from 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) images to preoperatively predict the pathological grade in patients with pancreatic ductal adenocarcinoma (PDAC). Methods: A total of 149 patients (83 men, 66 women, mean age 61 years old) with pathologically proven PDAC and a preoperative 18F-FDG PET/CT scan between May 2009 and January 2016 were included in this retrospective study. The cohort of patients was divided into two separate groups for the training (99 patients) and validation (50 patients) in chronological order. Radiomics features were extracted from PET/CT images using Pyradiomics implemented in Python, and the XGBoost algorithm was used to build a prediction model. Conventional PET parameters, including standardized uptake value, metabolic tumor volume, and total lesion glycolysis, were also measured. The quality of the proposed model was appraised by means of receiver operating characteristics (ROC) and areas under the ROC curve (AUC). Results: The prediction model based on a twelve-feature-combined radiomics signature could stratify PDAC patients into grade 1 and grade 2/3 groups with AUC of 0.994 in the training set and 0.921 in the validation set. Conclusion: The model developed is capable of predicting pathological differentiation grade of PDAC based on preoperative 18F-FDG PET/CT radiomics features. [ABSTRACT FROM AUTHOR]

Reconstructed hydroclimatic spatial patterns from historical documents, the chronology of El Niño events since 1525, Meiyu (a unique rainy season dominated by the East Asian summer monsoon in eastern China) series since 1736, and a 1000-year control simulation using the Community Earth System Model were used to analyze the occurrence of anomalous summer precipitation patterns over eastern China with El Niño events. The results show that the frequency of the south-flood north-drought during 1525–2005 was significantly higher during El Niño episodes. Specifically, the occurrences of the triple pattern with floods in the Yangtze River Valley but droughts in its north and south (FYRDNS) as well as the dipole pattern with floods in the south but droughts in the north (FSDN) divided by the Yangtze River both increased in El Niño developing years, while the occurrence of FSDN increased in El Niño decaying years. Among 44 severe and extreme Meiyu events over the middle and lower reaches of the Yangtze River in 1736–2016, 75% of events occurred during El Niño episodes. Especially, 80% of extreme Meiyu events occurred in El Niño decaying years. The 1000-year control simulation captured well the reconstructed triple pattern of FYRDNS in developing years and the dipole pattern of FSDN in decaying years, with more noticeable precipitation anomalies for developing years of very strong and extremely strong El Niño events. These results implicated that the El Niño is likely an early signal for the occurrence of the south-flood north-drought over eastern China. [ABSTRACT FROM AUTHOR]

Based on observational data and Asian monsoon intensity datasets from China, the relationships between the East Asian winter monsoon index and winter temperature, the East Asian summer monsoon index and Meiyu precipitation over the middle and lower reaches of the Yangtze River, were analyzed. We found that the monsoon signals were reflected in the temperature and Meiyu precipitation variations. Thus, we used the reconstructed Meiyu precipitation and winter temperature series for the past 300 years and detected the summer/winter monsoon intensity signals using multi-taper spectral estimation method and wavelet analysis. The main periodicities of Meiyu precipitation and winter temperature, such as interannual cycle with 2–7-year, interdecadal-centennial cycles with 30–40-year and 50–100-year, were found. The good relationships between the East Asian summer and winter monsoons suggested that they were in phase at 31-year cycle, while out of phase at 100-year cycle, but with 20-year phase difference. In addition, the winter monsoon intensity may be regulated by the North Atlantic Oscillation, the Arctic Oscillation and the Atlantic Multidecadal Oscillation, and the summer monsoon is closely related to the signal intensities of the Pacific Decadal Oscillation. [ABSTRACT FROM AUTHOR]

Proxy-based precipitation reconstruction is essential to study the inter-annual to decadal variability and underlying mechanisms beyond the instrumental period that is critically needed for climate modeling, prediction and attribution. Based on 2912 annually resolved proxy series mainly derived from tree rings and historical documents, we present a set of standard precipitation index (SPI) reconstructions for each year (November–October), covering the whole of Asia, and for the wet season (i.e., November–April for western Asia and May–October for the others) since 1700, with the spatial resolution of 2.5 ∘. To screen the optimal candidate proxies for SPI reconstruction in each grid from available proxies in its connected region with a homogeneous rainfall regime and similar precipitation variability, a new approach is developed by adopting the grid-location-dependent division derived from the instrumental SPI data. The validation shows that these reconstructions are effective for most of Asia. The assessment of data quality compared with gauge precipitation before calibration time indicates that our reconstruction has high quality to show the precipitation variability in most of the study areas, except for a few grids in western Russia, the coastal area of southeast Asia and northern Japan. The full dataset can be obtained from https://doi.org/10.57760/sciencedb.01829 (Y. Liu et al., 2022). [ABSTRACT FROM AUTHOR]

Lateral movement of soil organic carbon (SOC) induced by soil erosion and runoff changes spatial distributions of SOC, and further changes the land‐atmosphere CO2 exchange and terrestrial carbon budget. However, current ecosystem models do not or only poorly integrate the process of SOC lateral movement and cannot simulate the impacts of soil erosion on the carbon cycle. This study integrated SOC erosion and deposition processes into a process‐based ecosystem model (i.e., Integrated BIosphere Simulator (IBIS)), and separately simulated the lateral movements of dissolved organic carbon (DOC) and particulate organic carbon (POC). The model was evaluated in three river basins in Northeast China that are dominated by cropland, forest, and grassland. The results showed that the model reproduced well the production, erosion, and deposition of DOC and POC. The annual SOC lateral movement (1.34–7.22 g C m−2 yr−1) induced by erosion in the three tested basins was 0.27%–1.45% of the annual net primary production. The model developed in this study has great implications for simulating the lateral movements of SOC in terrestrial ecosystems, which can improve model performance in projecting the terrestrial carbon budget. Plain Language Summary: Lateral movement of soil organic carbon (SOC) with soil erosion and runoff is an important process in estimating land carbon budget. However, the current ecosystem models are not or poorly integrated this process, and cannot simulate the impacts of lateral movement of SOC on carbon cycle. This study integrates SOC erosion and deposition processes into a process‐based ecosystem model (Integrated BIosphere Simulator (IBIS)), and separately simulates the lateral movements of dissolved organic carbon (DOC) and particulate organic carbon (POC). The model was evaluated at three river basins in Northeast China dominated by cropland, forest and grassland, respectively. The results showed the model can reproduce well the production, erosion, deposition of DOC and POC. The model developed in this study has great implications for simulating the lateral movements of SOC in terrestrial ecosystem, which can improve model performance on projecting terrestrial carbon budget. Key Points: Current ecosystem models inadequately depict the lateral movement of SOC, causing uncertainties in terrestrial carbon cycle modelingWe integrated SOC erosion and deposition into a process‐based ecosystem model and evaluated it in three Chinese river basinsModel simulations well represented observed data for the production, erosion, and deposition of organic carbon [ABSTRACT FROM AUTHOR]

Background: The 70-gene signature (70-GS, MammaPrint) test has been recommended by the main guidelines to evaluate prognosis and chemotherapy benefit of hormonal receptor positive human epidermal receptor 2 negative (HR + /Her2−) early breast cancer (BC). However, this expensive assay is not always accessible and affordable worldwide. Based on our previous study, we established nomogram models to predict the binary and quartile categorized risk of 70-GS. Methods: We retrospectively analyzed a consecutive cohort of 150 female patients with HR + /Her2− BC and eligible 70-GS test. Comparison of 40 parameters including the patients' medical history risk factors, imaging features and clinicopathological characteristics was performed between patients with high risk (N = 62) and low risk (N = 88) of 70-GS test, whereas risk calculations from established models including Clinical Treatment Score Post-5 years (CTS5), Immunohistochemistry 3 (IHC3) and Nottingham Prognostic Index (NPI) were also compared between high vs low binary risk of 70-GS and among ultra-high (N = 12), high (N = 50), low (N = 65) and ultra-low (N = 23) quartile categorized risk of 70-GS. The data of 150 patients were randomly split by 4:1 ratio with training set of 120 patients and testing set 30 patients. Univariate analyses and multivariate logistic regression were performed to establish the two nomogram models to predict the the binary and quartile categorized risk of 70-GS. Results: Compared to 70-GS low-risk patients, the high-risk patients had significantly less cardiovascular co-morbidity (p = 0.034), more grade 3 BC (p = 0.006), lower progesterone receptor (PR) positive percentage (p = 0.007), more Ki67 high BC (≥ 20%, p < 0.001) and no significant differences in all the imaging parameters of ultrasound and mammogram. The IHC3 risk and the NPI calculated score significantly correlated with both the binary and quartile categorized 70-GS risk classifications (both p < 0.001). The area under curve (AUC) of receiver-operating curve (ROC) of nomogram for binary risk prediction were 0.826 (C-index 0.903, 0.799–1.000) for training and 0.737 (C-index 0.785, 0.700–0.870) for validation dataset respectively. The AUC of ROC of nomogram for quartile risk prediction was 0.870 (C-index 0.854, 0.746–0.962) for training and 0.592 (C-index 0.769, 0.703–0.835) for testing set. The prediction accuracy of the nomogram for quartile categorized risk groups were 55.0% (likelihood ratio tests, p < 0.001) and 53.3% (p = 0.04) for training and validation, which more than double the baseline probability of 25%. Conclusions: To our knowledge, we are the first to establish easy-to-use nomograms to predict the individualized binary (high vs low) and the quartile categorized (ultra-high, high, low and ultra-low) risk classification of 70-GS test with fair performance, which might provide information for treatment choice for those who have no access to the 70-GS testing. [ABSTRACT FROM AUTHOR]

Using the southern limit of snowfall recorded in Chinese documents, chronologies of tree-ring width, and tree-ring stable oxygen isotope (δO), the annual temperature anomaly in southern China during 1850-2009 is reconstructed using the method of signal decomposition and synthesis. The results show that the linear trend was 0.47°C (100 yr) over 1871-2009, and the two most rapid warming intervals occurred in 1877-1938 and 1968-2007, at rates of 0.125°C (10 yr) and 0.258°C (10 yr), respectively. The decadal variation shows that the temperature in the moderate warm interval of the 1910s-1930s was notably lower than that of the 1980s-2000s, which suggests that the warming since the 1980s was unprecedented for the past 160 years, though a warming hiatus existed in the 2000s. Additionally, there was a rapid cooling starting from the 1860s, followed by a cold interval until the early 1890s, with the coldest years in 1892 and 1893. A slight temperature decline was also found from the 1940s to the late 1960s. This study provides an independent case to validate the global warming for the past 160 years and its hiatus recently, because the proxy data are not affected by urbanization. [ABSTRACT FROM AUTHOR]

We reconstructed the annual temperature anomaly series in Xinjiang during 1850–2001 based on three kinds of proxies, including 17 tree-ring width chronologies, one tree-ring δ13C series and two δ18O series of ice cores, and instrumental observation data. The low- and high-frequency signal decomposition for the raw temperature proxy data was obtained by a fast Fourier transform filter with a window size of 20 years, which was used to build a good relationship that explained the high variance between the temperature and the proxy data used for the reconstruction. The results showed that for 1850–2001, the temperature during most periods prior to the 1920s was lower than the mean temperature in the 20th century. Remarkable warming occurred in the 20th century at a rate of 0.85°C/100a, which was higher than that during the past 150 years. Two cold periods occurred before the 1870s and around the 1910s, and a relatively warm interval occurred around the 1940s. In addition, the temperature series showed a warming hiatus of approximately 20 years around the 1970s, and a rapid increase since the 1980s. [ABSTRACT FROM AUTHOR]

Background: SSaSS (Salt Substitute and Stroke Study), a 5-year cluster randomized controlled trial, demonstrated that replacing regular salt with a reduced-sodium, added-potassium salt substitute reduced the risks of stroke, major adverse cardiovascular events, and premature death among individuals with previous stroke or uncontrolled high blood pressure living in rural China. This study assessed the cost-effectiveness profile of the intervention.Methods: A within-trial economic evaluation of SSaSS was conducted from the perspective of the health care system and consumers. The primary health outcome assessed was stroke. We also quantified the effect on quality-adjusted life-years (QALYs). Health care costs were identified from participant health insurance records and the literature. All costs (in Chinese yuan [¥]) and QALYs were discounted at 5% per annum. Incremental costs, stroke events averted, and QALYs gained were estimated using bivariate multilevel models.Results: Mean follow-up of the 20 995 participants was 4.7 years. Over this period, replacing regular salt with salt substitute reduced the risk of stroke by 14% (rate ratio, 0.86 [95% CI, 0.77-0.96]; P=0.006), and the salt substitute group had on average 0.054 more QALYs per person. The average costs (¥1538 for the intervention group and ¥1649 for the control group) were lower in the salt substitute group (¥110 less). The intervention was dominant (better outcomes at lower cost) for prevention of stroke as well as for QALYs gained. Sensitivity analyses showed that these conclusions were robust, except when the price of salt substitute was increased to the median and highest market prices identified in China. The salt substitute intervention had a 95.0% probability of being cost-saving and a >99.9% probability of being cost-effective.Conclusions: Replacing regular salt with salt substitute was a cost-saving intervention for the prevention of stroke and improvement of quality of life among SSaSS participants. [ABSTRACT FROM AUTHOR]

Zheng, J., Ding, L., Hao, Z. & Ge, Q. 2012 (January): Extreme cold winter events in southern China during AD 1650-2000. Boreas, Vol. 41, pp. 1-12. 10.1111/j.1502-3885.2011.00225.x. ISSN 0300-9483. We defined extreme cold winter events as those with occurrence probabilities lower than the 10th percentile of the probability density function, based on observed winter temperatures in southern China since 1951. Subsequently, we constructed impact severity levels using documentary evidence for those events during 1951-2000, considering three indexes for the freezing of rivers/lakes, widespread snow/ice storms, and cold damage to subtropical/tropical crops. Using these criteria we identified 50 extreme cold winters for the period AD 1650-1949 based on ∼4000 pieces of comparable information extracted from local gazettes in southern China, after verification using data from three weather stations with long records. It was found that the frequencies of the extreme cold winter events since 1650 varied over time. The most frequent occurrences were found during AD 1650-1699 and in the first and second halves of the 19th century, with frequencies twice as high as in the second half of the 20th century. In contrast, the frequencies of extreme winters during the 18th century were close to that in the second half of the 20th century. High frequencies of extreme cold winters in AD 1650-1720 and AD 1795-1835 occurred during the sunspot Maunder and Dalton Minima. The intensities of some historical cold events, such as those during 1653-1654, 1670, 1690, 1861, 1892 and 1929, exceeded those of the coldest winter events since 1951. [ABSTRACT FROM AUTHOR]

Background: 99mTc-PYP scintigraphy provides differential diagnosis of ATTR cardiomyopathy (ATTR-CM) from light chain cardiac amyloidosis and other myocardial disorders without biopsy. This study was aimed to assess the diagnostic feasibility and the operator reproducibility of 99mTc-PYP quantitative SPECT. Method: Thirty-seven consecutive patients who underwent a 99mTc-PYP thorax planar scan followed by SPECT and CT scans to diagnose suspected ATTR-CM were enrolled. For the quantitative SPECT, phantom studies were initially performed to determine the image conversion factor (ICF) and partial volume correction (PVC) factor to recover 99mTc-PYP activity concentration in the myocardium for calculating the standardized uptake value (SUV) (unit: g/ml). SUVmax was compared among groups of ATTR-CM, AL cardiac amyloidosis, and other pathogens (others) and among categories of Perugini visual scores (grades 0–3). The intra- and inter-operator reproducibility of quantitative SPECT was verified, and the corresponded repeatability coefficient (RPC) was calculated. Results: The ICF was 79,327 Bq/ml to convert count rate in pixel to 99mTc activity concentration. PVC factor as a function of the measured activity concentration ratio in the myocardium and blood-pool was [y = 1.424 × (1 − exp(− 0.759 × x)) + 0.104]. SUVmax of ATTR-CM (7.50 ± 2.68) was significantly higher than those of AL (1.96 ± 0.35) and others (2.00 ± 0.74) (all p < 0.05). SUVmax of grade 3 (8.95 ± 1.89) and grade 2 (4.71 ± 0.23) were also significantly higher than those of grade 1 (1.92 ± 0.31) and grade 0 (1.59 ± 0.39) (all p < 0.05). Correlation coefficient (R2) of SUVmax reached 0.966 to 0.978 with only small systematic difference (intra = − 0.14; inter = − 0.23) between two repeated measurements. Intra- and inter-operator RPCs were 0.688 and 0.877. Conclusions: 99mTc-PYP quantitative SPECT integrated with adjustable PVC factors is feasible to quantitatively and objectively assess the burden of cardiac amyloidosis for diagnosis of ATTR-CM. [ABSTRACT FROM AUTHOR]

Changes in climate extremes under 1.5 °C and 2 °C global warming may impact agricultural production across Central Asia. We used the simulated daily data of average temperature, maximum temperature, minimum temperature, and precipitation provided by the Inter-Sectoral Impact Model Intercomparison Project and analyzed the current climate status and future projected changes of a set of climate extreme indices related to agricultural production under 1.5 °C and 2 °C global warming. In addition, the possible impacts of climate change on agricultural production in Central Asia were discussed. The results show that the annual mean temperature in Central Asia will increase by 1.48 °C and 2.34 °C at 1.5 °C and 2 °C warming levels, respectively, compared to the base period (1986–2005), and the increasing trends are significant at the α = 0.01 level for all grids. The number of warm days and growing season length will increase. Under the 1.5 °C scenario, the mean annual total precipitation (PRCPTOT) and heavy precipitation (R95P) will experience increases of 7.68% and 26.55%, respectively, and the consecutive dry days (CDD) will be reduced by 1.1 days. However, the standardized precipitation evapotranspiration index (SPEI) shows significant drought conditions in most of Central Asia (more than 60%). Under the 2 °C scenario, there will be a 3.89% increase in PRCPTOT and a 24.78% increase in R95P. Nevertheless, accompanying the increase in CDD (0.8 day) and the decrease in SPEI, drought conditions will be further exacerbated. These results indicate that Central Asia is likely to face more severe ecological problems in the future, which will threaten the regional agricultural production and the food security. Therefore, adaptation strategies should be implemented immediately to mitigate the negative impacts of climate change on Central Asia's agriculture. [ABSTRACT FROM AUTHOR]

Exploring the impacts of climate change on agriculture is one of important topics with respect to climate change. We quantitatively examined the impacts of climate change on winter wheat yield in Northern China using the Cobb–Douglas production function. Utilizing time-series data of agricultural production and meteorological observations from 1981 to 2016, the impacts of climatic factors on wheat production were assessed. It was found that the contribution of climatic factors to winter wheat yield per unit area (WYPA) was 0.762–1.921% in absolute terms. Growing season average temperature (GSAT) had a negative impact on WYPA for the period of 1981–2016. A 1% increase in GSAT could lead to a loss of 0.109% of WYPA when the other factors were constant. While growing season precipitation (GSP) had a positive impact on WYPA, as a 1% increase in GSP could result in 0.186% increase in WYPA, other factors kept constant. Then, the impacts on WYPA for the period 2021–2050 under two different emissions scenarios RCP4.5 and RCP8.5 were forecasted. For the whole study area, GSAT is projected to increase 1.37°C under RCP4.5 and 1.54°C under RCP8.5 for the period 2021–2050, which will lower the average WYPA by 1.75% and 1.97%, respectively. GSP is tended to increase by 17.31% under RCP4.5 and 22.22% under RCP8.5 and will give a rise of 3.22% and 4.13% in WYPA. The comprehensive effect of GSAT and GSP will increase WYPA by 1.47% under RCP4.5 and 2.16% under RCP8.5. [ABSTRACT FROM AUTHOR]

Background: The capacity of spot urine samples for detecting changes in population sodium and potassium excretion is unclear.Methods: Changes in urinary sodium and potassium excretion, over a 6-month to 2-year interval, were measured from 24-h urine samples and estimated from spot urine samples using several published methods in 3270 Chinese. Additional estimates were made by multiplying individual spot sodium and potassium concentrations by a single estimated 24-h urine volume derived from external data.Results: The measured difference in 24-h urinary excretion between intervention and control groups was -0.35 g (95% CI: -0.68 to -0.02; P = 0.039) for sodium and 0.66 g (95% CI: 0.52 to 0.80; P < 0.001) for potassium, based upon 24-h urine samples. The corresponding estimates of sodium differences for the Tanaka (-0.06 g), Kawasaki (-0.09 g), Intersalt without potassium (-0.09 g) and Intersalt with potassium (-0.14 g) equations were all smaller and identified no reduction in sodium excretion (all P > 0.10). The estimates were -0.65 g for sodium and 1.11 g for potassium using individual spot urine concentrations and an externally derived standard urine volume (both P < 0.01).Conclusions: The published equations were unable to detect the differences in sodium excretion measured by 24-h urine samples. A method based upon spot urine electrolyte concentrations and a standard urine volume may offer an alternative approach to measuring differences in sodium and potassium excretion between population groups without requiring 24-h urine, but will need further investigation. [ABSTRACT FROM AUTHOR]

To limit global warming to well below 2°C in accord with the Paris Agreement, countries throughout the world have submitted their Intended Nationally Determined Contributions (INDCs) outlining their greenhouse gas (GHG) mitigation actions in the next few decades. However, it remains unclear what the resulting climate change is in response to the proposed INDCs and subsequent emission reductions. In this study, the global and regional warming under the updated INDC scenarios was estimated from a range of comprehensive Earth system models (CMIP5) and a simpler carbon-climate model (MAGICC), based on the relationship of climate response to cumulative emissions. The global GHG emissions under the updated INDC pledges are estimated to reach 14.2∼15.0 GtC/year in 2030, resulting in a global mean temperature increase of 1.29∼1.55°C (median of 1.41°C) above the preindustrial level. By extending the INDC scenarios to 2100, global GHG emissions are estimated to be around 6.4∼9.0 GtC/year in 2100, resulting in a global mean temperature increase by 2.67∼3.74°C (median of 3.17°C). The Arctic warming is projected to be most profound, exceeding the global average by a factor of three by the end of this century. Thus, climate warming under INDC scenarios is projected to greatly exceed the long-term Paris Agreement goal of stabilizing the global mean temperature at to a low level of 1.5‐2.0°C above the pre-industrial. Our study suggests that the INDC emission commitments need to be adjusted and strengthened to bridge this warming gap. [ABSTRACT FROM AUTHOR]

This paper presents new high-resolution proxies and paleoclimatic reconstructions for studying climate changes in China for the past 2000 years. Multi-proxy synthesized reconstructions show that temperature variation in China has exhibited significant 50-70-yr, 100-120-yr, and 200-250-yr cycles. Results also show that the amplitudes of decadal and centennial temperature variation were 1.3°C and 0.7°C, respectively, with the latter significantly correlated with long-term changes in solar radiation, especially cold periods, which correspond approximately to sunspot minima. The most rapid warming in China occurred over AD 1870-2000, at a rate of 0.56° ± 0.42°C (100 yr); however, temperatures recorded in the 20th century may not be unprecedented for the last 2000 years, as data show records for the periods AD 981-1100 and AD 1201-70 are comparable to the present. The ensemble means of dryness/wetness spatial patterns in eastern China across all centennial warm periods illustrate a tripole pattern: dry south of 25°N, wet from 25°-30°N, and dry to the north of 30°N. However, for all centennial cold periods, this spatial pattern also exhibits a meridional distribution. The increase in precipitation over the monsoonal regions of China associated with the 20th century warming can primarily be attributed to a mega El Ni˜no-Southern Oscillation and the Atlantic Multidecadal Oscillation. In addition, a significant association between increasing numbers of locusts and dry/cold conditions is found in eastern China. Plague intensity also generally increases in concert with wetness in northern China, while more precipitation is likely to have a negative effect in southern China. [ABSTRACT FROM AUTHOR]

Background: Average sodium intake and stroke mortality in northern China are both among the highest in the world. An effective, low-cost strategy to reduce sodium intake in this population is urgently needed. Objective: We sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China. Design: This study was a cluster-randomized trial done over 18 months in 120 townships (one village from each township) from five provinces. Sixty control villages were compared to 60 intervention villages that were given access to a reduced-sodium, added-potassium salt substitute in conjunction with a community-based health education program focusing on sodium reduction. The primary outcome was the difference in 24-hour urinary sodium excretion between randomized groups. Results: Among 1,903 people with valid 24-hour urine collections, mean urinary sodium excretion in intervention compared with control villages was reduced by 5.5% (-14mmol/day, 95% confidence interval -26 to -1; p = 0.03), potassium excretion was increased by 16% (+7mmol/day, +4 to +10; p<0.001), and sodium to potassium ratio declined by 15% (-0.9, -1.2 to -0.5; p<0.001). Mean blood pressure differences were -1.1 mm Hg systolic (-3.3 to +1.1; p = 0.33) and -0.7 mm Hg diastolic (-2.2 to +0.8, p = 0.35) and the difference in the proportion with hypertension was -1.3% (-5.1 to 2.5, p = 0.56). Conclusion: There were clear differences in population sodium and potassium intake between villages that were most likely a consequence of increased use of salt substitute. The absence of effects on blood pressure reflects the moderate changes in sodium and potassium intake achieved. Trial Registration: Clinicaltrials.gov identifier: . [ABSTRACT FROM AUTHOR]

Modern meteorological observations in South China from 1960 to 2009 show a strong correlation between winter temperatures and two snowfall parameters, the southern boundary of the snow and the number of snowy days. Based on this relationship, the variation in annual winter mean temperature in South China from 1736 to 2009 was reconstructed using data acquired from Chinese historical documents dating from the Qing dynasty, such as memos and local gazettes. The reconstructed time series were used to analyse variations in winter temperature in South China. Significant interannual and interdecadal changes were found. The maximum temperature difference between neighbouring years was 3.1 °C for 1958-2009 and 3.0 °C for 1736-1957, whereas the maximum temperature difference between adjacent decades was 0.8 °C for the 1960s-2000s and 0.6 °C for the 1740s-1950s. The 2000s was the warmest decade; the mean temperature was 1.6 °C higher than that of the 1870s, which was the coldest decade between the 1740s and the 2000s. The mean winter temperature was warmer in the 18th and 20th centuries and coldest in the 19th century. [ABSTRACT FROM AUTHOR]

It still remains uncertainty whether China's future investment is conducive to carbon reduction of Belt and Road (B&R) region or not. Here, the possible impact of China's investment was revealed by comparing the CO 2 emissions of B&R region in different Chinese investment scenarios. The results showed that CO 2 emissions of B&R region will cumulatively increase by 1973 Gt in 2018–2100 in the "No-Chinese Investment Scenario (NIS)". Regionally, the India (IND), Middle East Central Asia (MECAsia), and Southeast Asia and its surrounding (SEAsia) has the largest increment. Comparing with the NIS, the CO 2 emissions of B&R region will cumulatively decrease by 44.16 Gt and 79.48 Gt, respectively, in the "Business-as-usual Chinese Investment Scenario (BIS)" and "Strengthening Chinese Investment Scenario (SIS)". Regionally, the cumulative CO 2 emissions of all subregions will decrease in BIS and SIS, of which SEAsia and MECAsia have the largest decrement. Technique and structural effects of China's investment have positive impact on cumulative CO 2 emission reduction of B&R region, especially in the structural effect. The scale effect has the negative contribution, but it cannot neutralize the positive impact induced from technique and structural effects. As a result, China's future investment is conductive to reducing CO 2 emission of B&R region and holding the temperature increase below 2 °C. [ABSTRACT FROM AUTHOR]