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Purpose: To explore the ethical experiences of new nurse managers when working at their units and propose response strategies accordingly. Design and methods: A qualitative approach was taken at a Grade 3A hospital in Shandong, China. Data were collected via semi‐structured long interviews and analyzed using interpretative phenomenological analysis. A total of 19 new frontline nurse managers participated in the study. Findings: The sample consisted of 17 females and two males, with an age range of 40.11 ± 2.71 years and each worked in a variety of units. Trust crisis, tests on capability, and conflicts with the administration were the main ethical issues of new nurse managers, and trust crisis was the most common, especially with nurses in the unit. Eleven subthemes were also involved in these three themes. Conclusions: New nurse managers encountered a variety of ethical conflicts and dilemmas in their first year. They should enhance their leadership to cope with the issues, and policy support at the hospital level is also needed. Clinical relevance: Senior hospital managers could use these findings to design interventions that might solve new frontline nurse managers' ethical issues. And medical staff might understand the ethical experiences of new nurse managers and support them in the most critical period of role transition. Findings are conducted in the hope of facilitating new nurse managers to quickly settle into the new position, establishing a good relationship with physicians and patients and improving the quality of nursing services. [ABSTRACT FROM AUTHOR]

Dengue is considered non-endemic to mainland China. However, travellers frequently import the virus from overseas and local mosquito species can then spread the disease in the population. As a consequence, mainland China still experiences large dengue outbreaks. Temperature plays a key role in these outbreaks: it affects the development and survival of the vector and the replication rate of the virus. To better understand its implication in the transmission risk of dengue, we developed a delay differential equation model that explicitly simulates temperature-dependent development periods and tested it with collected field data for the Asian tiger mosquito, Aedes albopictus. The model predicts mosquito occurrence locations with a high accuracy (Cohen's κ of 0.78) and realistically replicates mosquito population dynamics. Analysing the infection dynamics during the 2014 dengue outbreak that occurred in Guangzhou showed that the outbreak could have lasted for another four weeks if mosquito control interventions had not been undertaken. Finally, we analyse the dengue transmission risk in mainland China. We find that southern China, including Guangzhou, can have more than seven months of dengue transmission per year while even Beijing, in the temperate north, can have dengue transmission during hot summer months. The results demonstrate the importance of using detailed vector and infection ecology, especially when vector-borne disease transmission risk is modelled over a broad range of climatic zones. Author summary: Dengue is a mosquito-borne disease and the transmission of its virus depends on four factors: The presence of 1) the virus, 2) the human host, 3) the mosquito vector, and 4) the suitability of environmental conditions. Mainland China faces regular dengue outbreaks. Because the virus is constantly imported by infected travellers into the susceptible populations of Chinese metropolises, factors 1) and 2) are almost always met. We now investigate factors 3) and 4) to see when and where the risk for outbreaks is greatest. We use a novel model that considers the development of both the mosquitoes and the viruses under different climate conditions. Our findings suggest that the Asian tiger mosquito (Aedes albopictus) can potentially transmit dengue virus over large parts of mainland China; the biggest transmission risk is simulated over southern China where large outbreaks have occurred historically, but also over the temperate north, as far as Beijing, where smaller dengue outbreaks could occur during hot summer months. [ABSTRACT FROM AUTHOR]

Incidence rate of cardiovascular disease (CVD) has significant seasonal trend, being higher in winter. However, the extent to which the seasonal variation of CVD deaths was caused by temperature remains unclear. We obtained daily data on temperature and CVD and myocardial infarction (MI) mortality from nine Chinese mega-cities during 2007-2013. Distributed lag non-linear models were applied to assess the city-specific temperature-related daily excess deaths across lag 0-21 days, using the minimum-mortality temperature as reference. Then, estimates of excess deaths in four seasons were separately aggregated from the daily series, and its ratio to the corresponding total deaths produced seasonal attributable fraction (AF). In total, 1,079,622 CVD and 201,897 MI deaths were recorded in the nine Chinese cities. Significant and non-linear associations between temperature and mortality were observed, with a total of 195,516 CVD and 50,658 MI deaths attributable to non-optimum temperatures. 103,439 (95% empirical CI: 54,475-141,537) CVD and 24,613 (5891-36,279) MI deaths related to non-optimum temperature occurred in winter, compared with 15,923 (1436-28,853) and 4946 (-325-9016) in summer. Temperature-related AFs were higher among MI than CVD, with AFs of 42% (9-62%) and 35% (19-48%) in winter, and 13% (-1-23%) and 8% (1-14%) in summer, respectively. This study may have important implications for developing effective targeted intervention measures on CVD events. [ABSTRACT FROM AUTHOR]

Objective: To estimate the true incidence of pertussis in Chinese adults who are at a childbearing age.Methods: A total of 897 serum samples from healthy individuals aged 20-39 years were selected randomly from a large number of serum samples collected in 2010 in Beijing, China. Anti-pertussis toxin (Ptx) IgG antibodies were determined with the Virion/Serion ELISA kits using purified Ptx as a coating antigen.Results: Only 124 (13.8%) were found to have undetectable anti-Ptx IgG antibodies. The mean concentration was 13.76 IU/ml (95% CI, 12.37-15.15). Forty-six (5.1%) subjects had anti-Ptx IgG levels greater than or equal to 40 IU/ml, indicative of a pertussis infection, and nine (1%) had IgG antibodies greater than or equal to 100 IU/ml, indicative of a recent infection within a year. No significant differences were observed between age groups of 20-29 and 30-39 years, or between genders.Conclusions: Our study showed that about 5% of adults aged 20-39 years had positive anti-Ptx IgG antibodies, suggesting that adult pertussis is common in China. Giving a booster vaccination to pregnant women should possibly be considered in order to protect young infants who are too young to be vaccinated in this country. [ABSTRACT FROM AUTHOR]

With rapid economic development, China has been plagued by choking air pollution in recent years, and the frequent occurrence of haze episodes has caused widespread public concern. The purpose of this study is to describe the sources and formation of haze, summarize the mitigation measures in force, review the relationship between haze pollution and public health, and to discuss the challenges, potential research directions and policy options. Haze pollution has both natural and man-made causes, though it is anthropogenic sources that are the major contributors. Accumulation of air pollutants, secondary formation of aerosols, stagnant meteorological conditions, and trans-boundary transportation of pollutants are the principal causes driving the formation and evolution of haze. In China, haze includes gaseous pollutants and fine particles, of which PM 2.5 is the dominant component. Short and long-term exposure to haze pollution are associated with a range of negative health outcomes, including respiratory diseases, cardiovascular and cerebrovascular diseases, mental health problems, lung cancer and premature death. China has paid increasing attention to the improvement of air quality, and has introduced action plans and policies to tackle pollution, but many interventions have only temporary effects. There may be fierce resistance from industry groups and some government agencies, and often it is challenging to enforce relevant control measures and laws. We discuss the potential policy options for prevention, the need for wider public dialogue and the implications for scientific research. [ABSTRACT FROM AUTHOR]

Background: Understanding the genetic improvement patterns of agronomic traits in Chinese wheat (Triticum aestivum L.) breeding is essential for devising future breeding strategies. However, a systematic analysis of the genetic improvement of important traits in Chinese wheat is lacking. This study aimed to provide insights into the improvement progress of yield-related traits in the Chinese wheat breeding process and clarify the selection pressure on important agronomic traits in different agroecological zones. Phenotypic evaluations of 481 wheat accessions including 157 Chinese landraces (CLs) and 324 modern Chinese cultivars (MCCs), were carried out in multiple locations and years., Results: The population structure analyses showed that all accessions could be basically divided into CLs and MCCs subpopulations. Pearson correlation analysis revealed that the negative correlation between grain number per spike and thousand-grain weight gradually decreased while thousand-grain weight, grain number per spike, and effective tiller number exhibited synergistic improvements during the modern breeding process. Phenotypic differences among MCCs released from the 1950s to the 2000s indicated that grain number per spike and grain weight-related traits increased linearly, whereas plant height and effective tiller number decreased significantly. Furthermore, since the 1950s, the heading date, flowering date, and maturity date have become earlier, while the spike length and spikelet number per spike have not changed significantly with the advancement of breeding years. The annual genetic gain analysis of agronomic traits showed that plant height had the greatest increase (‒0.96%), followed by thousand-grain weight (0.38%), while the lowest for grain number per spike (0.13%). Phenotypic difference analysis of CLs and MCCs with different geographical origins further revealed that heading date, flowering date, plant height, thousand-grain weight, grain width, and grain thickness experienced strong selection with the same trend in seven agroecological zones. Among zones, the northern winter wheat zone experienced the strongest selection pressure, and plant height and thousand-grain weight were strongly selected in all zones., Conclusions: This study reveals that CLs and MCCs in China with obvious phenotypic differences, plant height and thousand-grain weight were strongly selected during wheat breeding, and further improvement of wheat in China will inevitably involve a continuous increase in grain number per spike., Competing Interests: Declarations. Ethics approval and consent to participate: Not Applicable. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests. Declaration of competing interest: The authors declare no competing interests., (© 2024. The Author(s).)

Fiddler crabs (Uca) are ecosystem engineers in coastal ecosystems. Many anthropogenic and natural factors can affect the time allocated to various behaviours in Uca. However, the behaviour of U. arcuata, a widely distributed fiddler crab in Asia, has not been studied in mainland China. Here, we used binoculars to record the time budget of ten behaviours of U. arcuata to investigate the potential effects of sex, tides, and pollution on these behaviours. We found that the crabs spent 42.3%, 27.0%, and 10.6% of their time on feeding, feeding while walking, and stationary respectively. The crabs spent <1.5% of their time on copulation and grooming. The total foraging time (feeding + feeding while walking) did not differ among the three polluted sites. However, crabs spent more time on feeding but less time on feeding while walking. The feeding rate and probability of burrowing and grooming decreased while the possibility of locomotion and stay in burrow increased with increasing nutrient concentration. Females spent 13.9% more time on feeding and fed 54.9% faster than males. Males had a higher tendency to grooming and combat while they were less likely to walk than females. Regarding to the influence of tide, fiddler crabs fed 11.2% faster at ebb tides than at flood tides, and they were more likely to walk and stay in burrows at flood tides than at ebb tides. Our results indicated that nutrient pollution had stronger impacts on the behaviours of crabs than sex and tide. In polluted mangroves, increasing nutrient concentration reduced the quantity of sediment processed by fiddler crabs due to their smaller feeding area, slower feeding rate, and reduced frequency of burrowing activities. These results imply that mitigating nutrient pollution in mangroves may benefit the restoration and management of coastal ecosystems through the enhanced engineering functions of fiddler crabs., 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 © 2020 Elsevier B.V. All rights reserved.)

The trace elements contamination of agricultural soils near petrochemical industry complexes is a concern due to the risk of accumulating in food systems and subsequently affecting human health. We measured representative trace elements (Cu, Ni, Cr, Pb, Zn, Pb, Hg and As) through the soil-plant (maize)-human contamination pathway near a petrochemical industry complexes in an agricultural region from September 20 to 28, 2016. We found that the soil was mildly to moderately polluted by multiple trace elements, which was also confirmed by the contamination factor and enrichment factor values. Cd (enrichment factor = 2.28), Cu (2.75), Zn (1.85) and Pb (1.70) should be given more attention and prioritized over the other trace elements due to their higher potential risks. Furthermore, the trace elements contamination in maize grains was lower than the corresponding limits. The sequence of the transfer coefficient values was Zn > Cd > Cu > Hg > Ni > As > Cr > Pb. Maize grain safety was threatened mainly by Zn, Cd and Cu. There was no risk to humans through soil ingestion, while a potential health risk from maize grain consumption existed. Children were more sensitive than adults to the non-carcinogenic risks of maize grain consumption. Trace element As was found to be the priority metal for risk control. For carcinogenic risk, adults were more sensitive than children; As, Cr and Cd were the priority metals for risk control, with CR maize values exceeding the risk threshold (1 × 10 -4 ). Overall, strict, intensive monitoring, especially of Cr and Cd, and soil protection measures are needed to prevent any furthertrace elements contamination and to ensure food safety. This study also provides a reference for similar studies worldwide., 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 © 2020 Elsevier Ltd. All rights reserved.)

Background: Haemorrhagic fever with renal syndrome (HFRS) is climate sensitive. HFRS-weather associations have been investigated by previous studies, but few of them looked into the interaction of meteorological factors on HFRS in different climate zones., Objective: We aim to explore the interactions and marginal effects of meteorological factors on HFRS in China., Methods: HFRS surveillance data and meteorological data were collected from 254 cities during 2006-2016. A monthly time-series study design and generalized estimating equation models were adopted to estimate the interactions and marginal effects of meteorological factors on HFRS in different climate zones of China., Results: Monthly meteorological variables and the number of HFRS cases showed seasonal fluctuations and the patterns varied by climate zone. We found that maximum lagged effects of temperature on HFRS were 1-month in temperate zone, 2-month in warm temperate zone, 3-month in subtropical zone, respectively. There is an interaction effect between mean temperature and precipitation in temperate zone, while in warm temperate zone the interaction effect was found between mean temperature and relative humidity., Conclusion: The interaction effects and marginal effects of meteorological factors on HFRS varied from region to region in China. Findings of this study may be helpful for better understanding the roles of meteorological variables in the transmission of HFRS in different climate zones, and provide implications for the development of weather-based HFRS early warning systems., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Toll-like receptors (TLRs) play a key role in innate and adaptive immunity, protecting the host from viral pathogens. We studied the effect of TLR7 polymorphisms on disease susceptibility and progression of chronic hepatitis B (CHB) infection in Chinese adults. Blood samples were taken from 612 patients with confirmed CHB, hepatitis B virus (HBV)-related liver cirrhosis (LC) or hepatocellular carcinoma (HCC) and 293 controls. TLR7 polymorphisms (rs179010-C > T, rs2074109-T > C, and rs179009-A > G) were analyzed by PCR-based sequencing. A significantly higher frequency of TLR7 rs179010 C allele was found in male CHB patients than in controls (74.8% vs 59.5%, P = 0.002). The frequency of rs179009 G allele was markedly increased with disease progression when male patients with CHB, LC and HCC were compared (P = 0.012). The haplotype CTA was significantly associated with an increased susceptibility to CHB among male patients (P = 0.000). Frequency of the haplotype CTG was higher in male patients with HCC than CHB (P = 0.005). No such differences in these allele frequencies were found between female patients and controls. Our results indicated that TLR7 polymorphisms play an important role in disease susceptibility and the progression of CHB infections in Chinese adults, and may partly explain the high incidence of HBV related diseases in Chinese men.