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Moso bamboo forests, recognized as a distinctive and significant forest resource in subtropical China, contribute substantially to efficient carbon sequestration. The accurate assessment of the aboveground biomass (AGB) in Moso bamboo forests is crucial for evaluating their impact on the carbon balance within forest ecosystems at a regional scale. In this study, we focused on the Moso bamboo forest located in Shanchuan Township, Zhejiang Province, China. The primary objective was to utilize various data sources, namely UAV-LiDAR (UL), Sentinel-2 (ST), and a combination of UAV-LiDAR with Sentinel-2 (UL + ST). Employing the Boruta algorithm, we carefully selected characterization variables for analysis. Our investigation delved into establishing correlations between UAV-LiDAR characterization parameters, Sentinel-2 feature parameters, and the aboveground biomass (AGB) of the Moso bamboo forest. Ground survey data on Moso bamboo forest biomass served as the basis for our analysis. To enhance the accuracy of AGB estimation in the Moso bamboo forest, we employed three distinct modeling techniques: multivariate linear regression (MLR), support vector regression (SVR), and random forest (RF). Through this approach, we aimed to compare the impact of different data sources and modeling methods on the precision of AGB estimation in the studied bamboo forest. This study revealed that (1) the point cloud intensity of UL, the variables of canopy cover (CC), gap fraction (GF), and leaf area index (LAI) reflect the structure of Moso bamboo forests, and the variables indicating the height of the forest stand (AIH1, AIHiq, and Hiq) had a significant effect on the AGB of Moso bamboo forests, significantly impact Moso bamboo forest AGB. Vegetation indices such as DVI and SAVI in ST also exert a considerable effect on Moso bamboo forest AGB. (2) AGB estimation models constructed based on UL consistently demonstrated higher accuracy compared with ST, achieving R2 values exceeding 0.7. Regardless of the model used, UL consistently delivered superior accuracy in Moso bamboo forest AGB estimation, with RF achieving the highest precision at R2 = 0.88. (3) Integration of ST with UL substantially improved the accuracy of AGB estimation for Moso bamboo forests across all three models. Specifically, using RF, the accuracy of AGB estimation increased by 97.7%, with R2 reaching 0.89 and RMSE reduced by 124.4%. As a result, the incorporation of LiDAR data, which reflects the stand structure, has proven to enhance the accuracy of aboveground biomass (AGB) estimation in Moso bamboo forests when combined with multispectral remote sensing data. This integration serves as an effective solution to address the limitations of single optical remote sensing methods, which often suffer from signal saturation, leading to lower accuracy in estimating Moso bamboo forest biomass. This approach offers a novel perspective and opens up new possibilities for improving the precision of Moso bamboo forest biomass estimation through the utilization of multiple remote sensing sources. [ABSTRACT FROM AUTHOR]

Pine wood nematode (PWN) is an invasive species which causes pine wilt disease (PWD), posing a significant threat to coniferous forests globally. Despite its destructive nature, strategies for the management of PWD spread lack a comprehensive understanding of the occurrence pattern of PWNs. This study investigates the outbreak timing and spread distances of PWD on a monthly scale. Two regions (A and B) in southeastern China, characterized by varying mixed ratios of coniferous and broadleaf trees, were examined. Infected trees were classified into early, middle, late, and dead stages. Monthly unmanned aerial vehicle (UAV) RGB data covering one year and three deep learning algorithms (i.e., Faster R-CNN, YOLOv5, and YOLOv8) were employed to identify the stress stages and positions of the trees. Further, each month, newly infected trees were recorded to calculate spread distances from the location of surrounding trees. The results indicate that the YOLOv5 model achieved the highest accuracy (mean average precision (mAP) = 0.58, F1 = 0.63), followed by Faster R-CNN (mAP = 0.55, F1 = 0.58) and YOLOv8 (mAP = 0.57, F1 = 0.61). Two PWD outbreak periods occurred between September–October and February of the following year, with early and middle-stage outbreaks in August and September and late and dead-tree outbreaks occurring between October and February of the following year. Over one year, the nearest spread distance for PWD-infected trees averaged 12.54 m (median: 9.24 m) for region A in September and 13.14 m (median: 10.26 m) for region B in October. This study concludes that February through August represents the optimal period for PWD control. Additionally, mixed conifer–broadleaf forests with a higher proportion of broadleaf trees prove beneficial in mitigating PWD outbreaks and reducing the number of infected trees. This work demonstrates the effectiveness of integrating monthly UAV-based imagery and deep learning algorithms for monitoring PWD outbreak times and spread distances, offering technical support for forest pest prevention and management. [ABSTRACT FROM AUTHOR]

Purpose: The present study investigated the age of diagnosis, treatment and demographic factors of Chinese children with autism spectrum disorders (ASD), to provide a scientific basis for the early detection, diagnosis, and intervention of ASD. Patients and Methods: A total of 1500 ASD children aged 2– 7 years old from 13 cities in China were administered questionnaires to examine their diagnosis, treatment, and basic family information. The Childhood Autism Rating Scale (CARS) was used to measure the symptoms and severity of ASD children, and the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was utilized to measure neurodevelopmental levels of ASD children. Results: We found that for children with ASD, the median (p25, p75) age for the initial detection of social behavioral developmental delay was 24 (18, 30) months, while the age for the initial diagnosis was 29 (24, 36) months and the age for the beginning of intervention was 33 (27, 42) months. Multiple linear regression (MLR) analysis suggested that in children with ASD whose parents were divorced, separated, or widowed, or whose mothers were engaged in physical work, the initial detection of social behavioral developmental delay happened later. For the children with ASD who lived in urban areas, had higher levels of ASD symptom severity or whose parents were not divorced or separated, the age for the initial diagnosis was earlier. For the children with ASD who lived in urban areas or whose mothers had received higher level of education, the earlier age for the beginning of intervention was observed, while for those with ASD whose mothers were engaged in physical work, the age for the beginning of training was later. Conclusion: It is recommended to actively carry out health education of ASD and strengthen the support for ASD families to enhance their rehabilitation level. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is a group of clinically heterogenic neurodevelopmental disorders, with intellectual disability being one of its common comorbidities. No large-sample, multicenter study has focused on the neurodevelopmental aspect of preschoolers with ASD. This study investigated the neurodevelopmental characteristics of preschoolers with ASD in China and explored the association between them and the core symptoms. Methods: We enrolled 1019 ASD preschoolers aged 2–7 years old from 13 cities around China between May 2018 and December 2019, and used the revised Children Neuropsychological and Behavior Scale (CNBS-R2016) to assess their neurodevelopment. Their autistic core behaviors were evaluated based on their Social Responsiveness Scale (SRS), Autism Behavior Checklist (ABC), Child Autism Rating Scale (CARS), and communication warning behavior (CWB) scores in the CNBS-R2016. Results: Based on general developmental quotient (GQ) < 70, 68.4% of the preschoolers with ASD had a developmental delay (DD), rated mild in 32.7% of them. The highest DD rate (> 70%) was found in language and personal-social skills, followed by fine motor skills (68.9%). Gross motor skills had the lowest DD rate (34.0%). We found that fine motor, language, and personal-social developmental quotients (DQs) were significantly lower than gross motor skills in no DD (GQ > 70), mild DD (GQ 55–69), and moderate and below DD groups (GQ ≤ 54). Furthermore, the DQs for language and personal-social skills were significantly lower than for gross and fine motor skills in both DD groups. The ABC, SRS, CARS, and CWB scores in the no DD group were the lowest, moderate in the mild DD group, and highest in the moderate and below DD group. Besides, negative correlations were found between the DQs of the four domains and the ABC, SRS, CARS, and CWB scores, of which the language and personal-social skills DQs had the strongest correlations. Conclusions: Preschoolers with ASD had unbalanced neurodevelopment domain patterns and their neurodevelopmental levels were negatively correlated with the autism core symptoms. Hence, pediatricians should actively evaluate the neurodevelopment of children with ASD and conduct long-term follow-up during their early childhood to promote early diagnosis and develop personalized intervention plans. Trial registration: ChiCTR2000031194, registered on 03/23/2020. [ABSTRACT FROM AUTHOR]

Background: Emerging mite-borne pathogens and associated disease burdens in recent decades are raising serious public health concerns, yet their distributions and ecology remain under-investigated. We aim to describe the geographical distributions of blood-sucking mites and mite-borne agents and to assess their ecological niches in China. Methods: We mapped 549 species of blood-sucking mites belonging to 100 genera at the county level and eight mite-associated agents detected from 36 species of blood-sucking mites in China during 1978–2020. Impacts of climatic and environmental factors on the ecology of 21 predominant vector mites and a leading pathogen, Orientia tsutsugamushi, were assessed using boosted regression tree (BRT) models, and model-predicted risks were mapped. We also estimated the model-predicted number, area and population size of affected counties for each of the 21 mite species in China. Results: Laelaps echidninus is the leading mite species that potentially affects 744 million people, followed by La. jettmari (517 million) and Eulaelaps stabularis (452 million). Leptotrombidium scutellare is the mite species harboring the highest variety of mite-borne agents including four Rickettsia species and two viruses, followed by Eu. stabularis (2 agents), L. palpale (2) and La. echidninus (2). The top two agents that parasitize the largest number of mite species are O. tsutsugamushi (28 species) and hantavirus (8). Mammalian richness, annual mean temperature and precipitation of the driest quarter jointly determine the ecology of the mites, forming four clusters of major mite species with distinct geographic distributions. High-risk areas of O. tsutsugamushi are mainly distributed in southern and eastern coastal provinces where 71.5 million people live. Conclusions: Ecological niches of major mite species and mite-borne pathogens are much more extensive than what have been observed, necessitating expansion of current filed surveillance. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the prevalence of developmental regression in children with Autism Spectrum Disorder (ASD) and to explore its relationship with disease severity. Methods: We finally included 1,027 ASD children aged 2–5 years from 13 cities in China: 138 with regressive ASD and 889 with non-regressive ASD. The Social Responsiveness Scale (SRS), Autism Behavior Checklist (ABC), Child Autism Rating Scale (CARS), and Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) were used to evaluate the core symptoms and developmental status of children in the two groups. Results: Among the 1,027 ASD children eventually included, 138 (13.44%) cases showed regressive behavior and the average regression occurring age was 24.00 (18.00–27.00) months. Among the regressive children, 105 cases (76.09%) had language regression, 79 cases (57.25%) had social regression, and 4 cases (2.90%) had motor regression. The total scores of ABC and the sub-score of sensory and stereotypic behavior (β = 5.122, 95% CI: 0.818, 9.426, P < 0.05; β = 1.104, 95% CI: 0.120, 2.089, P < 0.05; β = 1.388, 95% CI: 0.038, 2.737, P < 0.05), the SRS total scores and the sub-score of autistic mannerisms (β = 4.991, 95% CI: 0.494, 9.487, P < 0.05; β = 1.297, 95% CI: 0.140, 2.453, P < 0.05) of children in the regressive group were all higher than the non-regressive group. The total developmental quotient (DQ) of CNBS-R2016 and the DQ of gross motor, fine motor, adaptive behavior, language (β = −5.827, 95% CI: −11.529, −0.125, P < 0.05) and personal society in the regressive group were lower than the non-regressive group and the proportion of children with intelligent developmental impairment was higher the non-regressive group. Conclusion: Regressive autism is mainly manifested as language and social regression. Children with regressive ASD have more severe core symptoms, lower neurodevelopmental level DQ, and more serious disease degree than children with non-regressive ASD, which requires further etiological examinations and more clinical attention. [ABSTRACT FROM AUTHOR]

Background: High prevalence of sleep problems have been reported in children with Autism Spectrum Disorder (ASD). This study aims to investigate the sleep conditions of ASD children in China, and explore the relationship between the common sleep problems and core symptoms and developmental levels. Methods: Using a cross-sectional design, we included 2 to 7-year-old children from 13 cities in China: 1310 with ASD and 1158 with typically-developing (TD) children. The neurodevelopmental level was evaluated with the revised Children Neuropsychological and Behavior Scale (CNBS-R2016). ASD were diagnosed with DSM-5 and Child Autism Rating Scale (CARS). the Social Responsiveness Scale (SRS), the Autism Behavior Checklist (ABC) and the communication warning behavior sub-scale in CNBS-R2016 valued autism behaviors. The children' s sleep habits questionnaire (CSHQ) assessed sleep conditions. Results: The prevalence of sleep disorders in ASD children was significantly higher than that in TD (67.4% vs. 51%, p < 0.01), and among them the four dimensions with the highest prevalence of sleep problems were bedtime resistance (25.6%), sleep anxiety (22.7%), sleep onset delay (17.9%) and daytime sleepiness (14.7%). ASD children with sleep onset delay or sleep anxiety had higher ABC, SRS scores and higher scores on communication warning behavior with sleep anxiety, with daytime sleepiness had higher ABC, SRS and CARS scores, and with bedtime resistance had higher SRS total scores. Differences in the neurodevelopmental level were not significant. Conclusion: Children with ASD have a higher prevalence of sleep problems. Bedtime resistance, anxiety, sleep onset delay and daytime sleepiness may be related to the core symptoms, but not be related to the developmental level in ASD children. In the clinic, sleep assessment should be included in the routine of ASD visits, and during the intervention, sleep hygiene education is as important as the treatment of biological factors. Trial registration: The study was approved by the ethics committee of the Children's Hospital of Chongqing Medical University, Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194). [ABSTRACT FROM AUTHOR]

The degradation of chlorpyrifos (CP) by an endophytic bacterial strain (HJY) isolated from Chinese chives (Allium tuberosumRottl. ex Spreng) was investigated. Strain HJY was identified asSphingomonassp. based on morphological, physiological, and biochemical tests and a 16S rDNA sequence analysis. Approximately 96% of 20 mg L−1CP was degraded by strain HJY over 15 days in liquid minimal salts medium (MSM). The CP degradation rate could also be increased by glucose supplementation. The optimal conditions for the removal of 20 mg L−1CP by strain HJY in MSM were 2% inoculum density, pH 6.0, and 30–35°C. The CP degradation rate constant and half-life were 0.2136 ± 0.0063 d−1and 3.2451 ± 0.0975 d, respectively, under these conditions, but were raised to 0.7961 ± 0.1925 d−1and 0.8707 ± 0.3079 d with 1% glucose supplementation. The detection of metabolic products and screening for degrading genes indicated thatO,O-diethylO-3,5,6-trichloropyridinol was the major degradation product from CP, while it was likely that some functional genes were undetected and the mechanism responsible for CP degradation by strain HJY remained unknown. Strain HJY is potentially useful for the reduction of CP residues in Chinese chives and may be used for thein situphytoremediation of CP. [ABSTRACT FROM PUBLISHER]

Abstract: China has strived to develop new and renewable energy resources to meet its energy demands due to issues of pollution, sustainability, and climate change related to the consumption of fossil fuels. Offshore wind power development in coastal China has attracted more and more attention because it can not only utilize the abundant natural resources but also relieve power constraint in coastal China. This paper studies the development of offshore wind power in China, providing information including the wind resources in China''s coastal areas, policies promulgated by the central government to favor the sound development of offshore wind power, regional planning and progress of offshore wind power, R&D of offshore wind power technology and theory, as well as the pilot projects set up in Shanghai and Jiangsu. In addition, challenges related to offshore wind power development are depicted, and recommendations are provided. [Copyright &y& Elsevier]

• Street view data are used to quantify the green view of the cities the Pearl River Delta Urban Agglomeration. • The accuracy of calculating method for GV is improved; • The GV values in old urban and CBD zone are higher than other urban areas; • GV is significantly positive correlated with social-economic indicators; • GV discorrelated with average area of green space. The quality and aesthetic ecosystem services of urban green spaces can be assessed by green view (GV), which is an indicator to quantify the percentage of green area visually sensed by human eyes. There are several case studies on estimating GV at city-scale, however, the relationship between GV values and socio-economic & morphologic profiles of cities was rarely discussed. In this work, we analyzed the GV values and their potentially influential factors by adopting an internet data crawling approach, obtaining 36,654 panoramic Street View images from Baidu Map, in the urban zones at the Pearl River Delta Urban Agglomeration (PRDUA), China. We calculated the GV value of each panoramic image using MATLAB 2015a, extracting the value of the hue channel from the digital image and then calculating pixel ratio according the color spectrum. Results show that: (1) The overall GV in PRDUA is 11.3 ± 7.5%, lower than the cases of the developed countries; (2) More green could be sensed on the streets at the old central districts and the central business district in the cities in PRDUA; (3) The GV value is positively affected by public revenue per unit area, but is uncorrelated to green space coverage ratio, at the district-level. It indicates that an improved design and increasing monetary investment of urban green space may obtain higher people-oriented green quantity in cities. These findings can be useful for drafting more appropriate urban green space planning policies regarding the green view. [ABSTRACT FROM AUTHOR]

Objectives: This study explored the clinical characteristics of vestibular migraine in Chinese subjects and performed a field test of the criteria of the International Classification of Headache Disorders 3rd edition beta version.Methods: Consecutive patients with vestibular migraine were surveyed and registered in a headache clinic during the study period. The diagnosis of vestibular migraine was made according to International Classification of Headache Disorders 3rd edition beta version. Assessments included standardized neuro-otology bedside examination, pure-tone audiogram, bithermal caloric testing, neurological imaging, cervical X-ray or magnetic resonance imaging, Doppler ultrasound of cerebral arteries and laboratory tests.Results: A total of 67 patients (62 female/five male, 47.8 ± 10.3 years old) were enrolled in this study. The mean ages of migraine and vertigo onset were 32.2 ± 11.5 and 37.9 ± 10.1 years, respectively. The most common migraine subtype was migraine without aura (79%), followed by migraine with aura (12%) and chronic migraine (9%). The duration of vertigo attacks varied from seconds to days and 25% of patients had attacks that lasted less than 5 minutes. Among the patients with short-lasting attacks, 75% of these patients had ≥5 attacks per day within 72 hours. Auditory symptoms were reported in 36% of the patients. Migraine prophylactic treatments were effective in 77% of the patients.Conclusions: Our study showed that the clinical features of vestibular migraine in China were similar to those of Western studies. The definition of vertigo episodes and migraine subtypes of vestibular migraine in International Classification of Headache Disorders 3rd edition beta version might be modified further. More than five vertigo attacks per day within 72 hours might be helpful as far as identifying vestibular migraine patients with short-lasting attacks. [ABSTRACT FROM AUTHOR]

• The first multicenter study to explore the relationship between serum 25(OH)D levels and symptoms in children with ASD. • Lower serum 25(OH)D levels might be associated with ASD diagnosis in children. • Serum 25(OH)D levels were negatively associated with core symptoms in children with ASD. • Children with ASD with relatively lower serum 25(OH)D levels displayed worse autistic symptomatology. • Whether vitamin D supplementation should be considered as a potential treatment requires further controlled clinical trials. We aimed to investigate the relationship between vitamin D status and core symptoms and neurodevelopmental levels in children with ASD with a multicenter survey. We enrolled 1321 ASD children and 1279 typically developing (TD) children aged 2–7 years from 13 cities in China. ASD symptoms were assessed with the Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS), and neurodevelopmental levels were evaluated with the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016). Children with ASD had lower serum 25(OH)D levels than TD children. Serum 25(OH)D levels were negatively associated with CARS and communication warning behavior of CNBS-R2016 scores, and were not associated with the development quotients of ASD children. ASD Children were grouped based on the quartiles for 25(OH)D levels in the controls, and children in the first to third quartiles had higher SRS social communication and/or CARS and communication warning behavior of CNBS-R2016 scores than those in the fourth quartile. Serum 25(OH)D levels were primarily associated with core symptoms in children with ASD, and individuals with relatively lower 25(OH)D levels displayed worse autistic symptomatology. More research is needed to determine whether vitamin D supplements would be a useful treatment for ASD. [ABSTRACT FROM AUTHOR]

Background: Although several pharmacoeconomic studies have assessed the cost-effectiveness of maintenance immunosuppressive regimens for heart transplant recipients, economic comparisons between various combination drug therapies remain sparse., Aim: This study used an economic evaluation based on network meta-analysis to assess the cost-effectiveness of four immunosuppressive regimens for adult heart transplant recipients in China., Method: We conducted a systematic search for clinical trials in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database. A validated Markov model was adapted to reflect the Chinese medical landscape. Four maintenance immunosuppression regimens were considered: tacrolimus/mycophenolate mofetil (TAC/MMF), cyclosporine/mycophenolate mofetil (CSA/MMF), everolimus/cyclosporine (EVL/CSA), and sirolimus/tacrolimus (SRL/TAC). The probabilities of health events were derived from a comprehensive literature review. Direct medical costs, adjusted for 2022 values, were from public documents and websites, while utilities for quality-adjusted life-years (QALYs) were taken from previous studies. Primary outcomes were mean lifetime cost, QALYs, and cost-effectiveness, with a willingness-to-pay (WTP) threshold set at three times China's GDP per capita in 2022. Sensitivity analyses were conducted to test the robustness of the results., Results: The base case analysis identified TAC/MMF as the most cost-effective regimen, producing a mean of 6.31 QALYs per patient at a cost of Chinese Yuan (CNY) 534,182.89. Sensitivity analyses consistently reinforced TAC/MMF as the most cost-effective and robust choice., Conclusion: TAC/MMF is the most cost-effective maintenance immunosuppressive regimen for heart transplant recipients within the Chinese health system. The study findings are reinforced by sensitivity analyses, affirming their robustness amid various uncertainties., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Developmental dyslexia (DD) is a prevalent neurodevelopmental disease that poses challenges in both early intervention and long-term development for children with DD. However, there is a lack of a standardized and comprehensive tool for the diagnosis of DD in Mainland China., Aim: To develop a standardized tool (i.e., Developmental Dyslexia Scale for Standard Mandarin [DDSSM]) for the diagnosis of DD in Mainland China and evaluate its reliability and validity., Methods and Procedures: DDSSM consists of 10 subtests. The initial draft was created after Delphi expert consultation, and the final version was revised to improve discriminability with a pilot study involving 450 children from grades 1-3. The reliability and validity were then confirmed with 53 children from grades 1-2., Outcomes and Results: The Delphi expert consultation demonstrated that the expert panel had good authority, and that all agreed on the subtest setup. The DDSSM exhibited great internal consistency. Confirmatory factor analysis revealed that the model aligns with the theoretical structure (P > 0.05, χ 2 /df < 2.00, root-mean-square error of approximation (RMSEA) < 0.08, comparative fit index (CFI) > 0.90, TLI > 0.90). The Dyslexia Checklist for Chinese Children and children's academic performance agreed well with the DDSSM., Conclusions and Implications: The DDSAM is reliable and valid for assessing and diagnosing DD in Standard Mandarin-speaking primary school children from grades 1-2. WHAT THIS PAPER ADDS?: Although a number of scales and tools have been proposed for assessing developmental dyslexia (DD) in Chinese, there is still a lack of diagnostic tools for Mandarin Chinese in Mainland China. In this study, we developed one of the most comprehensive diagnostic tools for DD in Mandarin Chinese for lower graders. We included visual-spatial attention (VA) and compounding awareness (CA), two tests that have been recently suggested as reliable measures for identifying DD in the Chinese language. This assessment tool has been verified for robust reliability and validity. This study also provided confirmation of the core deficits of DD in Chinese, which were orthographic awareness (OA). In addition, VA, rapid automatized naming (RAN) and morphological awareness (MA) were found to be the most important cognitive abilities for word reading in Chinese lower graders in this study., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause difficulty with communication and social interactions as well as complicated family dynamics. Digital health interventions can reduce treatment costs and promote healthy lifestyle changes. These therapies can be adjunctive or replace traditional treatments. However, issues with cooperation and compliance prevent preschool patients with ASD from applying these tools. In this open-label, randomized controlled trial, we developed a nonwearable digital therapy called virtual reality-incorporated cognitive behavioral therapy (VR-CBT)., Objective: The aim of this study was to assess the adjunctive function of VR-CBT by comparing the effects of VR-CBT plus learning style profile (LSP) intervention with those of LSP-only intervention in preschool children with ASD., Methods: This trial was performed in China on 78 preschool children (age 3-6 years, IQ>70) diagnosed with ASD who were randomized to receive a 20-week VR-CBT plus LSP intervention (intervention group, 39/78, 50%) or LSP intervention only (control group, 39/78, 50%). The primary outcome was the change of scores from baseline to week 20, assessed by using the parent-rated Autism Behavior Checklist (ABC). Secondary outcomes included the Childhood Autism Rating Scale (CARS), Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), and behavioral performance data (accuracy and reaction time) in go/no-go tasks. All primary and secondary outcomes were analyzed in the intention-to-treat population., Results: After the intervention, there was an intervention effect on total ABC (β=-5.528; P<.001) and CARS scores (β=-1.365; P=.02). A similar trend was observed in the ABC subscales: sensory (β=-1.133; P=.047), relating (β=-1.512; P=.03), body and object use (β=-1.211; P=.03), and social and self-help (β=-1.593; P=.03). The intervention also showed statistically significant effects in improving behavioral performance (go/no-go task, accuracy, β=2.923; P=.04). Moreover, a significant improvement of ADHD hyperactivity-impulsivity symptoms was observed in 53 children with comorbid ADHD based on ADHD-RS-IV (β=-1.269; P=.02). No statistically significant intervention effect was detected in the language subscale of ABC (β=-.080; P=.83). Intervention group girls had larger improvements in ABC subscales, that is, sensory and body and object use and in the CARS score and accuracy of go/no-go task (all P<.05) than the control group girls. Statistically significant intervention effects could be observed in hyperactivity-impulsivity symptoms in the intervention group boys with comorbid ADHD compared with those in the control group boys (β=-1.333; P=.03)., Conclusions: We found potentially positive effects of nonwearable digital therapy plus LSP on core symptoms associated with ASD, leading to a modest improvement in the function of sensory, motor, and response inhibition, while reducing impulsivity and hyperactivity in preschoolers with both ASD and ADHD. VR-CBT was found to be an effective and feasible adjunctive digital tool., Trial Registration: Chinese Clinical Trial Registry ChiCTR2100053165; http://www.chictr.org.cn/showproj.aspx?proj=137016., (©Liting Chu, Li Shen, Chenhuan Ma, Jinjin Chen, Yuan Tian, Chuncao Zhang, Zilan Gong, Mengfan Li, Chengjie Wang, Lizhu Pan, Peiying Zhu, Danmai Wu, Yu Wang, Guangjun Yu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 24.08.2023.)

Under the global implementation of a low-carbon economy, the treatment of municipal plastic solid waste (PSW) has become an important task to be solved urgently. In the actual decision-making process of PSW treatment, the evaluation information is usually fuzzy, and the decision-makers (DMs) are bounded rational. For selecting the most appropriate PSW treatment technology, we propose a multi-criteria decision-making (MCDM) method based on cumulative prospect theory and fuzzy decision-making trail and evaluation laboratory (DEMATEL). Firstly, we construct the criteria system of PSW treatment that consists of 9 sub-criteria from the perspectives of environment, economy, society, and technology. Then, considering the interdependences and interactions between these evaluation criteria and allowing multiple stakeholders to participate in decision-making, we propose a fuzzy DEMATEL method to deal with the fuzziness of evaluation in the decision-making process and determine the weights of the evaluation criteria. Subsequently, taking into account the different opinions of different stakeholders and psychological factors such as risk preference and loss aversion of stakeholders, we aggregate the evaluation information of different stakeholders and develop the PSW treatment alternatives to rank the orders by using the proposed multi-actor cumulative prospect theory (CPT) method. We study seven alternative processes for PSW treatment by the developed model, including landfill, recycling, pyrolysis, incineration, and the combination of landfilling and recycling, landfill and incineration, and recycling and pyrolysis. According to the ranking results, we find the combination of recycling and incineration is the best treatment alternative. We take the seven PSW treatment technologies in Shanghai as the case study to verify the effectiveness and feasibility of the proposed method. Through the sensitivity analysis and comparison analysis with fuzzy similarity to ideal solution (FTOPSIS) method and an acronym in Portuguese of the interactive and multi-criteria decision-making (TODIM) method, we illustrate the effectiveness and superiority of the proposed method. This research provides significant references for the PSW treatment technology selection problems under uncertain environments and extends the methods in the decision-making field., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Anthropogenic activities can adversely impact biogeochemical processes essential for maintaining ecosystem health in semi-enclosed bays. However, the influence of anthropogenic contaminants such as potentially toxic elements on microbial communities that regulate biogeochemical cycles in semi-enclosed bays is poorly understood. We determined the concentrations of four potentially toxic elements (Cu, Zn, Pb, and As) in sediments from a typical tropical semi-enclosed bay in Guangdong, China. Source apportionment using Pearson's correlation analysis revealed that aquaculture activities were probably the primary source of Cu, Zn, and Pb. Using high-throughput sediment DNA sequencing, we found that Proteobacteria was the dominant phylum in sediments. There was no evidence suggesting site-specific variation in microbial function even though sediments adjacent to aquaculture discharge points had higher microbial diversity. In contrast, pollutant-specific variations were observed; for example, Zn and Pd showed potential adverse effects on the environmental information processing function, while As showed a negative correlation with metabolic function. Based on different environmental characteristics, future research should consider the impact of multiple factors on the bacterial community in aquaculture systems., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Too fast or slow weight gain in infancy is bad for health in later life. In this study, we aim to investigate the optimal weight gain pattern during the first 2 y of life for term small-for-gestational-age (SGA) infants., Method: We employed data from a longitudinal, community-based cohort study on the growth and development of SGAs collected between 2004 and 2010 in Shanghai, China. Latent class growth analysis (LCGA) was applied to identify weight gain patterns among 3004 SGAs. BMI curves for each latent class from 1 mo to 5 y were produced through mixed-effects regression analysis. Multivariable regression was performed to examine the association between various classes and adverse outcomes (overweight/obesity/ malnutrition) during 2-5 y., Result: Five weight gain patterns aged 0-2 y of 3004 term SGAs were identified and labeled as follows--class 1: excessively rapid catch-up growth (10.7%); class 2: rapid catch-up growth (19.7%); class 3: appropriate catch-up growth (55.7%); class 4: slow catch-up growth (10.2%); class 5: almost no catch-up growth (3.7%). A decreasing age at adiposity rebound (AR) and an increasing BMI value were observed from class 5 to 1. Class 1 and 2 showed an early appearance of AR (< 4 y). SGAs in class 1 and 2 had a higher BMI in 2-5 y of life. After adjustment for potential confounding variables, class 1 and 2 were found to have an increased risk of being overweight/ obese. At the same time, we found the risk of malnutrition was especially prominent among SGAs in classes 4 and 5., Conclusion: Our results suggest that for term SGA infants, catch-up growth that crossing two centile levels, that is, from < 10th to the interval between 25th and 50th (ΔWAZ> 1.28) in the first several months, along with on track growth and maintenance at a median level by age 2 may be the optimal catch-up growth trajectory, minimizing risk of childhood adverse health outcomes.

Objective Tension-type headache is *These authors contributed equally to this work. usually manifested as head pain without associated symptoms, and the validation of diagnostic criteria presented are lacking and highly required in the International Classification of Headache Disorders. The aim of the present study was to explore the diagnosis criteria of tension-type headache in a multicenter-based sample from Chongqing, China. Methods Clinical characteristics and demographics were systematically and prospectively collected between March 2014 and December 2015 from 15 participating hospitals in Chongqing, using a semi-structured face-to-face interview. All patients were asked to complete a headache diary for at least 4 weeks. Results Out of 1832 patients with headache, 150 patients (97 female/53 male, 44.56 ± 11.9 years old) were diagnosed with tension-type headache based on the standard International Classification of Headache Disorders, 3rd edition beta version, and interestingly, 114 (76%) patients were diagnosed with tension-type headache based on the alternative criteria. One patient was excluded because only two of the four characteristics were fulfilled. Thirty-five (23.3%) patients did not meet the alternative criteria because of associated symptoms, including mild nausea (n = 6), photophobia (n = 1), and phonophobia (n = 28). All patients with TTH had mild or moderate headaches, 98.0% of patients suffered from non-pulsating headaches, 99.3% of patients said their headaches were not aggravated by routine physical activity, and 77.3% of patients had bilateral headache. Conclusions Non-pulsating headaches and headaches that are not aggravated by routine physical activity may represent core criteria for screening patients with tension-type headache. Nausea might not be an exclusion feature for diagnosis of TTH, but an important criterion for screening. Further studies are needed.