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Due to COVID-19, the primary teaching method has changed from traditional face-to-face teaching to online teaching. The present study explored the correlates between two personality traits, Neuroticism and Extraversion, and two types of self-efficacy, Internet self-efficacy and academic self-efficacy, on practical performance anxiety. Data from 273 technical college students were collected. Structural equation modeling analysis was performed. Results show that Neuroticism and Extraversion can predict students' practical performance anxiety through Internet and academic self-efficacy. Moreover, Neuroticism can negatively predict Internet and academic self-efficacy. Extraversion can positively predict Internet and academic self-efficacy. The two types of self-efficacy can positively predict practical performance anxiety. According to the results, it seems necessary to reduce students' practical performance anxiety by paying attention to their personality features and their self-efficacy.

With the outbreak of COVID-19, more online learning has been adopted for distance learning. However, the effectiveness of online learning for those students engaged in it for the first time has not been discussed. This study aims to investigate perceived ineffectiveness of online learning and its antecedents related to cognitive and affective factors. Internet self-efficacy (ISE) and Self-efficacy of interacting with learning content (SEILC) were hypothesized to have a correlation with perceived ineffectiveness of online learning (PIOL) mediated by participants' Internet cognitive fatigue (ICF) and mind-unwandered, while ICF was hypothesized to have a correlation with mind-unwandered. Data of 251 students collected from high schools in China during the lockdown period of COVID-19 were subjected to confirmatory factor analysis via AMOS. Results indicated that participants' ISE and SEILC were positively related to mind-unwandered, but negatively related to ICF during online learning, while ICF was positively associated with PIOL. On the other hand, mind-unwandered was negatively associated with PIOL. Furthermore, students' ISE and SEILC indirectly affected their PIOL mediated by ICF. Findings suggest that an enhancement of learners' ISE and SEILC could have reduced the level of PIOL the first time that online learners experienced under the COVID-19 lockdown to promote their learning effectiveness. This understanding will be useful in case of another pandemic outbreak.

Bacterial drug resistance is becoming increasingly serious, this study aims to investigate the relationship between the resistance rate of erythromycin-resistant Streptococcus pneumoniae (SP) and reasons for the epidemic under complex geographical and climatic factors in China. Data spanning from 2014 to 2021, including drug resistance rates, isolate rates, meteorological variables, and demographic statistics, were collected from the China Antimicrobial Resistance Monitoring System, the China Statistical Yearbook and China Meteorological Website. Our analysis involved nonparametric tests and the construction of multifaceted regression models for rigorous multivariate analysis. Single-factor analysis revealed significant differences in the resistance rate and isolate rate of erythromycin-resistant SP across different regions characterized by Hu Huanyong lines or different climate types. Multivariate regression analysis indicated positive correlations between the drug resistance rate and temperature, Subtropical climate, Gross Domestic Product (GDP), Hu Huanyong line, and the highest temperature in the past period (Tm); the isolate rate showed a positive correlation with regional GDP and a negative correlation with monsoon climate. The model developed in this study provides valuable insights into the resistance rate and potential relationships of erythromycin-resistant SP under complex meteorological conditions in China. [ABSTRACT FROM AUTHOR]

The current one-size-fits-all screening strategy for lung cancer is not suitable for personalized screening. What is the risk-adapted starting age of lung cancer screening with comprehensive consideration of risk factors? The National Lung Cancer Screening program, a multicenter, population-based, prospective cohort study, was analyzed. Information on risk factor exposure was collected during the baseline risk assessment. A Cox proportional hazards model was used to estimate the association between risk factors and lung cancer incidence. Age-specific 10-year cumulative risk was calculated to determine the age at which individuals with various risk factors reached the equivalent risk level as individuals aged ≥ 50 years with active tobacco use and a ≥ 20 pack-year smoking history. Of the 1,031,911 participants enrolled in this study, 3,908 demonstrated lung cancer after a median follow-up of 3.8 years. We identified seven risk factors for lung cancer, including pack-years of smoking, secondhand smoke exposure, family history of lung cancer in first-degree relatives, history of respiratory diseases, occupational hazardous exposure, BMI, and diabetes. The 10-year cumulative risk of lung cancer for people aged ≥ 50 years with active tobacco use and a ≥ 20 pack-year smoking history was 1.37%, which was treated as the risk threshold for screening. Individuals who never smoked and those with active tobacco use and a < 30-pack-year history of smoking reached the equivalent risk level 1 to 14 years later compared with the starting age of 50 years. Men with active tobacco use, a ≥ 30-pack-year history of smoking, and concurrent respiratory diseases or diabetes should be screened 1 year earlier at the age of 49 years. The personalized risk-adapted starting ages for lung cancer screening, based on the principle of equal management of equal risk, can served as an optimized screening strategy to identify high-risk individuals. [ABSTRACT FROM AUTHOR]

Background: Bacterial drug resistance represents a significant global concern, with vancomycin-resistant Enterococcus faecalis posing a particularly grave threat to contemporary healthcare systems. This study aims to reveal the reasons for the prevalence of VRE in China. Methods: This study collected data from the China Antimicrobial Resistance Detection System, China Statistical Yearbook, and China Meteorological Network. The collected data are meticulously organized and subjected to both single-factor and multi-factor analyses. An accurate multiple linear regression model was developed by utilizing this comprehensive dataset. Results: Single-factor analysis revealed significant regional variations in the resistance rate of vancomycin-resistant Enterococcus faecalis (P = 0.003). Specifically, there were noteworthy disparities observed between regions experiencing temperate and monsoon climates (P = 0.029; P = 0.005). Furthermore, multi-factor regression analysis demonstrated a negative correlation between the drug resistance rate and both rainfall and rGDP, while a positive correlation was observed with nPI. Conclusion: We successfully established a prediction model for the VRE and found that the resistance rate was low in areas with high rainfall and high per capita economic income, but high in areas with many specialized public health institutions. This is critical for public health strategies and helps policymakers and healthcare practitioners tailor antibiotic resistance approaches to local geography, meteorology, economic conditions. [ABSTRACT FROM AUTHOR]

Background: Head and neck dermatofibrosarcoma protuberans (HNDFSP) is extremely rare and not entirely understood. Objective: To investigate the clinicopathological features of HNDFSP and identify the expression of its clinically relevant indicators, with the expectation of improving the existing treatment strategies. Methods: A long‐term follow‐up of patients with HNDFSP who received treatment between 2000 and 2021 at Shanghai Ninth People's Hospital was conducted. The clinical, histological, and immunohistochemical data of the patients were retrieved and analyzed. The endpoint of the study was the incidence of significant disease‐related clinical events (recurrences or metastasis). Results: A total of 49 patients with HNDFSP were included in the study, with males (92.7%) predominating than females (7.3%). Eighteen patients developed recurrent disease (36.8%) after surgery, and the median time of recurrence was 48 months (interquartile, 20–74 months). Metastasis occurred in two cases (4.1%). Two patients died during follow‐up, both with local recurrence, and one of them with intestinal metastasis. Post‐operation radiotherapy was administered to eight patients (16.3%) and the effect in local control was remarkable. Age, tumor size, and negative margins with sufficient safety width were the main independent factors affecting the disease‐free survival. Several potential targeted therapeutic indicators, including EZH2 (80.0%), EGFR (91.4%), PDGF (97.1%), PD‐L1 (77.1%), and VEGF (77.1%), were positively expressed in most tumor samples. Conclusion: HNDFSP is rare, significantly challenging to control locally, and has a worse prognosis with current treatment strategies. Wide local excision and long‐term follow‐up are needed. Radiotherapy could improve the prognosis of patients with HNDFSP. [ABSTRACT FROM AUTHOR]

Background: Screening reduces colorectal cancer (CRC) burden by allowing early resection of precancerous and cancerous lesions. An adequate selection of high-risk individuals and a high uptake rate for colonoscopy screening are critical to identifying people more likely to benefit from screening and allocating healthcare resources properly. We evaluated whether combining a questionnaire-based interview for risk factors with fecal immunochemical test (FIT) outcomes for high-risk assessment is more efficient and economical than a questionnaire-based interview-only strategy. Methods and findings: In this multicenter, population-based, prospective cohort study, we enrolled community residents aged 40 to 74 years in 29 provinces across China. From 2016 to 2020, a total of 1,526,824 eligible participants were consecutively enrolled in the Cancer Screening Program in Urban China (CanSPUC) cohort, and 940,605 were enrolled in the Whole Life Cycle of Cancer Screening Program (WHOLE) cohort, with follow-up to December 31, 2022. The mean ages were 56.89 and 58.61 years in CanSPUC and WHOLE, respectively. In the WHOLE cohort, high-risk individuals were identified by combining questionnaire-based interviews to collect data on risk factors (demographics, diet history, family history of CRC, etc.) with FIT outcomes (RF–FIT strategy), whereas in the CanSPUC cohort, high-risk individuals were identified using only interview-based data on risk factors (RF strategy). The primary outcomes were participation rate and yield (detection rate of advanced neoplasm, early-stage detection rate of CRCs [stage I/II], screening yield per 10,000 invitees), which were reported for the entire population and for different gender and age groups. The secondary outcome was the cost per case detected. In total, 71,967 (7.65%) and 281,985 (18.47%) individuals were identified as high-risk and were invited to undergo colonoscopy in the RF–FIT group and RF group, respectively. The colonoscopy participation rate in the RF–FIT group was 26.50% (19,071 of 71,967) and in the RF group was 19.54% (55,106 of 281,985; chi-squared test, p < 0.001). A total of 102 (0.53%) CRCs and 2,074 (10.88%) advanced adenomas were detected by the RF–FIT, versus 90 (0.16%) and 3,593 (6.52%) by the RF strategy (chi-squared test, both p < 0.001). The early-stage detection rate using the RF–FIT strategy was significantly higher than that by the RF strategy (67.05% versus 47.95%, Fisher's exact test, p = 0.016). The cost per CRC detected was $24,849 by the RF–FIT strategy versus $55,846 by the RF strategy. A limitation of the study was lack of balance between groups with regard to family history of CRC (3.5% versus 0.7%). Conclusions: Colonoscopy participation and screening yield were better with the RF–FIT strategy. The association with CRC incidence and mortality reduction should be evaluated after long-term follow-up. Author summary: Why was this study done?: ➢ The burden of colorectal cancer (CRC) in China has been growing in recent years. ➢ More specific selection of individuals to undergo colonoscopy, based on both questionnaire-based risk assessment and fecal immunochemical test (FIT) results, could result in more efficiency allocation of colonoscopy resources. ➢ There is limited evidence on the colonoscopy screening yield when combining FITs and risk assessment through questionnaires. What did the researchers do and find?: ➢ We calculated the baseline screening yield, participation, and cost per case detected in a national CRC screening program with a combined questionnaire-based risk assessment–FIT strategy. ➢ The baseline screening yield and participation rate were improved in the combined risk assessment–FIT group compared with risk factor assessment only group. ➢ The cost per CRC detected was $24,849 by the combined risk factor–FITs strategy, which was much lower than by the risk factor strategy ($55,846). What do these findings mean?: ➢ A combined CRC screening strategy is feasible in China. ➢ The association between the combined RF-FIT strategy with CRC incidence and mortality reduction should be evaluated after long-term follow-up. [ABSTRACT FROM AUTHOR]

Background: Tumor immunotherapy can not only eliminate the primary lesion, but also produce long-term immune memory, effectively inhibiting tumor metastasis and recurrence. However, immunotherapy also showed plenty of limitations in clinical practice. In recent years, the combination of nanomaterials and immunotherapy has brought new light for completely eliminating tumors with its fabulous anti-tumor effects and negligible side effects. Methods: The Core Collection of Web of Science (WOSCC) was used to retrieve and obtain relevant literatures on antitumor nano-immunotherapy since the establishment of the WOSCC. Bibliometrix, VOSviewer, CiteSpace, GraphPad Prism, and Excel were adopted to perform statistical analysis and visualization. The annual output, active institutions, core journals, main authors, keywords, major countries, key documents, and impact factor of the included journals were evaluated. Results: A total of 443 related studies were enrolled from 2004 to 2022, and the annual growth rate of articles reached an astonishing 16.85%. The leading countries in terms of number of publications were China and the United States. Journal of Controlled Release, Biomaterials, Acta Biomaterialia, Theranostics, Advanced Materials, and ACS Nano were core journals publishing high-quality literature on the latest advances in the field. Articles focused on dendritic cells and drug delivery accounted for a large percentage in this field. Key words such as regulatory T cells, tumor microenvironment, immune checkpoint blockade, drug delivery, photodynamic therapy, photothermal therapy, tumor-associated macrophages were among the hottest themes with high maturity. Dendritic cells, vaccine, and T cells tend to become the popular and emerging research topics in the future. Conclusions: The combined treatment of nanomaterials and antitumor immunotherapy, namely antitumor nano-immunotherapy has been paid increasing attention. Antitumor nano-immunotherapy is undergoing a transition from simple to complex, from phenotype to mechanism. [ABSTRACT FROM AUTHOR]

Options for treatment of chronic spontaneous urticaria beyond antihistamines are limited. This multicenter, randomized, sham-controlled trial from 3 teaching hospitals in China compared acupuncture, sham acupuncture, and waitlist control for treatment of chronic spontaneous urticaria. Visual Abstract. Efficacy of Acupuncture for Chronic Spontaneous Urticaria: Options for treatment of chronic spontaneous urticaria beyond antihistamines are limited. This multicenter, randomized, sham-controlled trial from 3 teaching hospitals in China compared acupuncture, sham acupuncture, and waitlist control for treatment of chronic spontaneous urticaria. Background: The effectiveness of acupuncture for patients with chronic spontaneous urticaria (CSU), reported in a few small-scale studies, is not convincing. Objective: To investigate whether acupuncture leads to better effects on CSU than sham acupuncture or waitlist control. Design: A multicenter, randomized, sham-controlled trial. (Chinese Clinical Trial Registry: ChiCTR1900022994) Setting: Three teaching hospitals in China from 27 May 2019 to 30 July 2022. Participants: 330 participants diagnosed with CSU. Intervention: Participants were randomly assigned in a 1:1:1 ratio to receive acupuncture, sham acupuncture, or waitlist control over an 8-week study period (4 weeks for treatment and another 4 weeks for follow-up). Measurements: The primary outcome was the mean change from baseline in the Weekly Urticaria Activity Score (UAS7) at week 4. Secondary outcomes included itch severity scores, self-rated improvement, and Dermatology Life Quality Index scores. Results: The mean change in UAS7 (range, 0 to 42) for acupuncture from baseline (mean score, 23.5 [95% CI, 21.8 to 25.2]) to week 4 (mean score, 15.3 [CI, 13.6 to 16.9]) was −8.2 (CI, −9.9 to −6.6). The mean changes in UAS7 for sham acupuncture and waitlist control from baseline (mean scores, 21.9 [CI, 20.2 to 23.6] and 22.1 [CI, 20.4 to 23.8], respectively) to week 4 (mean scores, 17.8 [CI, 16.1 to 19.5] and 20.0 [CI, 18.3 to 21.6], respectively) were −4.1 (CI, −5.8 to −2.4) and −2.2 (CI, −3.8 to −0.5), respectively. The mean differences between acupuncture and sham acupuncture and waitlist control were −4.1 (CI, −6.5 to −1.8) and −6.1 (CI, −8.4 to −3.7), respectively, which did not meet the threshold for minimal clinically important difference. Fifteen participants (13.6%) in the acupuncture group and none in the other groups reported adverse events. Adverse events were mild or transient. Limitation: Lack of complete blinding, self-reported outcomes, limited generalizability because antihistamine use was disallowed, and short follow-up period. Conclusion: Compared with sham acupuncture and waitlist control, acupuncture produced a greater improvement in UAS7, although the difference from control was not clinically significant. Increased adverse events were mild or transient. Primary Funding Source: The National Key R&D Program of China and the Science and Technology Department of Sichuan Province. [ABSTRACT FROM AUTHOR]

Simple Summary: The roughskin sculpin (Trachidermus fasciatus) was previously a locally abundant species in China, but the habitat required for the survival and breeding of this species has been seriously damaged. Its resources have been almost depleted, and it has been listed as a national second-class protected animal. In recent years, the population of roughskin sculpin has recovered in the natural environment through enhancement programs and the release of juveniles. However, the effects of released roughskin sculpin on wild populations' genetic structure and diversity remain unclear. In this study, the whole-genome resequencing of two cultured populations and one wild population showed that the two cultured populations have similar genetic diversity compared with the wild population. In addition, artificial feeding affected the formation of traits of roughskin sculpin. The finding provides data support for the resource recovery of roughskin sculpin. The roughskin sculpin (Trachidermus fasciatus) is an endangered fish species in China. In recent years, artificial breeding technology has made significant progress, and the population of roughskin sculpin has recovered in the natural environment through enhancement programs and the release of juveniles. However, the effects of released roughskin sculpin on the genetic structure and diversity of wild populations remain unclear. Studies on genetic diversity analysis based on different types and numbers of molecular markers have yielded inconsistent results. In this study, we obtained 2,610,157 high-quality SNPs and 494,698 InDels through whole-genome resequencing of two farmed populations and one wild population. Both farmed populations showed consistent levels of genomic polymorphism and a slight increase in linkage compared with wild populations. The population structure of the two farmed populations was distinct from that of the wild population, but the degree of genetic differentiation was low (overall average Fst = 0.015). Selective sweep analysis showed that 523,529 genes were selected in the two farmed populations, and KEGG enrichment analysis showed that the selected genes were related to amino acid metabolism, which might be caused by artificial feeding. The findings of this study provide valuable additions to the existing genomic resources to help conserve roughskin sculpin populations. [ABSTRACT FROM AUTHOR]

The energy sector plays a crucial role in facilitating the low‐carbon energy transition. However, in the absence of appropriate environmental regulation, managerial opportunistic behavior in energy firms can manipulate ethical investor perceptions and hinder the real transition process towards clean energy. Using Chinese listed energy firms as the research setting, this paper examines the impact of investor attention on energy firms' earnings management practices. In both clean and traditional energy firms, the results show a significant U‐shaped association between investor attention and earnings management, with the U‐shaped curve for clean energy firms being smoother. This U‐shaped relationship is more pronounced in energy firms with larger size and weaker external monitoring. Moreover, the mediating analysis shows that internal control quality transmits the impact of investor attention onto earnings management practices in the energy sector. Our key findings remain robust to a battery of robustness tests and endogeneity controls. Therefore, given the growing attention on the energy sector, this study extends the existing literature on energy firms' managerial opportunistic behavior by analyzing the nonlinear effect for investor attention and provides practical implications for curbing energy firms' managerial opportunistic activities and guiding managerial attention towards making real sustainable investments, thereby promoting clean energy transition and sustainable development. [ABSTRACT FROM AUTHOR]

Objectives: Tracheobronchial foreign body aspiration (TFBA) is a major cause of accidental death in children. Lower respiratory tract infection (LRTI) may be caused by TFBA, but there are few reports about LRTI associated with TFBA. This study collected TFBA cases in our hospital to analyze LRTI and determine its risk factors. Methods: A total of 194 children who underwent tracheobronchial foreign body (TFB) extraction in The Children's Hospital of Zhejiang University School of Medicine from June 2019 to April 2020 were enrolled. CT chest is routinely used in the workup of suspected airway FB at our institution to evaluate for patients, a FB was already highly suspected. The retention time was defined as from the time of TFB inhalation or presentation (if there was no history of TFBA) to the time of TFB removal. General characteristics including weight, clinical symptoms, operative records, cervicothoracic CT, retention time, type of TFB and postoperative hospitalization time were collected. Chi-square tests, rank sum tests and multivariate logistic regression analyses were performed. Results: The incidence of LRTI was 46.6%, 68.6%, and 68.6% when the retention time was within 24 hours, between 24 hours and up to 1 week and more than 1 week, respectively. Postoperative hospitalization time of LRTI group was significantly longer than that of non-LRTI group. Findings for cervicothoracic CT as pneumonia, emphysema, atelectasis meant more serious clinical manifestations and the retention time was longer in the LRTI group than in the non-LRTI group. There was a positive correlation between the retention time of a TFB and LRTI in multivariate logistic regression analysis. Conclusions: The incidence of LRTI caused by TFBA is high. LRTI is association with longer postoperative hospitalization time. The TFB retention time is an independent risk factor for LRTI. If a patient presents with significant LRTI symptoms, a course of steroids and antibiotics maybe a safer approach rather than proceeding immediately with bronchoscopic removal. [ABSTRACT FROM AUTHOR]

Background: There were limited studies on the quantification of the modifiable and nonmodifiable lung cancer burden over time in China. Furthermore, the potential effect of risk factor reduction for lung cancer on gains in life expectancy (LE) remains unknown. Methods: This study explored temporal trends in lung cancer deaths and disability‐adjusted life years (DALY) attributable to modifiable risk factors from 1990 to 2019, based on the 2019 Global Burden of Disease Study. The abridged period life table method was used to quantify the effect of risk factors on LE. The authors used the decomposition approach to estimate contributions of aging metrics to change in the lung cancer burden. Results: Nationally, the majority of lung cancer deaths and DALYs were attributable to behavioral and environmental risk clusters. Potential gains in life expectancy (PGLE) at birth would be 0.78 years for males and 0.35 years for females if the exposure to risk factors was mitigated to the theoretical minimum level. Tobacco use had the most robust impact on LE for both sexes (PGLE: 0.71 years for males and 0.19 years for females). From 1990 to 2019, risk‐attributable age‐standardized death and DALY rates of lung cancer showed an increasing trend in both sexes; adult population growth imposed 245.9 thousand deaths and 6.2 million DALYs for lung cancer. Conclusions: The modifiable risk‐attributable lung cancer burden remains high in China. Effective tobacco control is the critical step toward addressing the lung cancer burden. Adult population growth was the foremost driver of transition in the age‐related lung cancer burden. Plain Language Summary: We estimate the lung cancer burden attributable to modifiable and nonmodifiable contributors and the effect of risk factor reduction for lung cancer on the life expectancy in China.The findings suggest that the majority of lung cancer deaths and disability‐adjusted life years were attributable to behavioral risk clusters, and the risk‐attributable lung cancer burden increased nationally from 1990 to 2019.The average gains in life expectancy would be 0.78 years for males and 0.35 years for females if the exposure to risk factors for lung cancer was reduced to the theoretical minimum risk exposure level.Adult population growth was identified as the foremost driver of variation in the aging lung cancer burden. This study emphasizes the crucial role of context‐specific interventions and policies targeted to reducing modifiable risk exposure and tackling population aging to effectively mitigate the lung cancer burden and ultimately improve the life expectancy. [ABSTRACT FROM AUTHOR]

Since the 1970s, certain areas within the Three-Rivers Headwater Region (TRHR) of China have faced severe land degradation due to the combined effects of climate change and human activities, leading to restricted ecological service functions and hindering the achievement of sustainable development goals (SDGs). Land degradation in the TRHR has received widespread attention. However, the current research mainly focuses on single-dimensional degradation and lacks a comprehensive evaluation of patterns and structures, as well as above-ground and underground assessments. To address this gap, this study employed the SDG indicator 15.3.1 framework, comprehensively considering fragmentation and habitat quality index based on land cover changes, grassland degradation index, and soil water erosion index. These indexes represent the three land degradation pathways of landscape degradation, vegetation degradation, and soil erosion. This study assessed land degradation patterns in the TRHR from 2000 to 2020. Results show that approximately 44.67% of the TRHR experienced land degradation during this period, mainly in meadow-dominated regions. Additionally, 5.64% of the regions experienced the superimposition of two or more land degradation pathways, with the frequent coexistence of soil erosion and grassland degradation, accounting for 4.1% of the affected areas. Landscape degradation affected approximately 2.39% of the regions, characterized by increased grassland fragmentation or habitat quality degradation. In terms of grassland degradation, 22.26% of the regions showed medium degradation, while 7.21% and 5.63% experienced moderate and severe degradation, respectively. Moreover, approximately 13.36% of the region faced a worsening situation of soil erosion. Approximately 55.34% of the study area underwent land improvement, with significant enhancements mainly concentrated in the western and eastern regions. The regrowth of grassland in the western region and the enhancement and homogenization of grassland productivity in the eastern region played pivotal roles in promoting land improvement. This study provides critical insights into the land degradation pattern in the TRHR over the past 20 years, offering valuable references for formulating and implementing measures to protect and construct the ecological security barrier of the plateau. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral therapy (ART) improved the prognosis of people living with human immunodeficiency virus (HIV) (PLWH). Life-long treatment is required in PLWH and is accompanied by various metabolic abnormalities in the disease course. Data about the epidemiology and the dynamic changes of dyslipidemia in PLWH receiving antiretroviral therapy were scarce in Asian countries. This study aimed to explore the risk factors of dyslipidemia and analyze the longitudinal changes of dyslipidemia among Chinese PLWH receiving HAART. Methods: We conducted a longitudinal analysis of PLWH enrolled in two large multicenter clinical trials across China, and outpatients followed at the clinic of Peking Union Medical College Hospital. Demographic data and clinical parameters were collected. The risk factors and longitudinal changes in lipid profiles associated with HIV-1 infection were analyzed. The definition of dyslipidemia was made based on the National Cholesterol Education Program, Adult Treatment Panel (NCEP-ATP) III guidelines. Results: A total of 1542 PLWH were included. The median follow-up was 6 years. At baseline, the concentrations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were 4.1 ± 0.91 mmol/L, 1.2 (interquartile ranges [IQR] 0.85–1.75) mmol/L, 1.1 ± 0.37 and 2.4 ± 0.76 mmol/L, respectively. The rate of hypercholesterolemia, hyperglyceridemia, high LDL-C, and low HDL-C were 10.18%, 26.39%, 9.08%, and 44.94%, respectively. The overall prevalence of dyslipidemia was 69.3%, which raised to 84.3% after antiretroviral therapy, substantially higher. CD4/CD8 ratio < 0.3 and viral load > 105 copies/mL were risk factors associated with any subtype of dyslipidemia. A negative correlation between CD8+CD38+ percentage and HDL-C concentration was found. The regimens including efavirenz (EFV) and tenofovir (TDF) showed better lipid profiles. Longitudinal analysis revealed that both the level and the percentage of abnormal TG and HDL-C occurred drastic change in the first 6 months after ART initiation (from 4.07 to 4.41, from 1.11 to 1.28mmol/L, from 26.39 to 31.1% and from 44.94 to 29.5%, respectively). Conclusions: The prevalence of dyslipidemia is high in PLWH and increases after ART, mainly represented as high TG and low HDL-C and associated with advanced stage of HIV-1 infection. The greatest changes in lipids occurred in the early stage after initiating ART therapy. The results suggest that dyslipidemia should be monitored and managed when starting ART. [ABSTRACT FROM AUTHOR]

Background: Although there is a robust relationship among social trauma, optimism, and depression, the inner mechanism of this correlation remains unclear and need to be further explored. The mainly purpose of the current study was to investigate the relationship between social trauma, optimism, and depression among college students in China. More specifically, examined the moderating role of the optimism between social trauma and depression in Chinese college students. Methods: A sample of 464 Chinese college students (54.7% female, Mage=19.29) from three universities were selected by the convenient sampling, and the Social Trauma Questionnaire (STQ), the Optimism Questionnaire (OPQ), and the Self-Rating Depression (SDS) were completed by these Chinese undergraduates. The descriptive statistics, Pearson correlations, and hierarchical regression analysis were used to examine the results. Results: (1) The social trauma was positively associated with depression, whereas the optimism was negatively associated with social trauma, and depression; (2) The social trauma had a significant correlation with depression, and the optimism could moderate the relationship between social trauma and depression. More specifically, the further study showed that there was a significant positive relation between social trauma and depression under the low optimism level, however, there was a non-significant relation between social trauma and depression under the high optimism level. Conclusion: The optimism is the protective mechanism of college students' mental health (e.g., depression), it could weaken the trauma that associated with social trauma among college students. [ABSTRACT FROM AUTHOR]

Seasonal freezing depth change is important in many environmental science and engineering applications. However, such changes are rare at region scales, especially over China, in the long time series. In this study, we evaluated the annual changes in seasonal maximum freezing depth (MFD) over China from 1971 to 2020 using an ensemble-modeling method based on support vector machine regression (SVMR) with 600 repetitions. Remote sensing data and climate data were input variables used as predictors. The models were trained using a large amount of annual measurement data from 600 meteorological stations. The main reason for using SVMR here was because it has been shown to perform better than random forests (RF), k-nearest neighbors (KNN), and generalized linear regression (GLR) in these cases. The prediction results were generally consistent with the observed MFD values. Cross validation showed that the model performed well on training data and had a better spatial generalization ability. The results show that the freezing depth of seasonally frozen ground in China decreased year by year. The average MFD was reduced by 3.64 cm, 7.59 cm, 5.54 cm, and 5.58 cm, in the 1980s, 1990s, 2000s, and 2010s, respectively, compared with the decade before. In the last 50 years, the area occupied by the freezing depth ranges of 0–40 cm, 40–60 cm, 60–80 cm, 80–100 cm, and 120–140 cm increased by 99,300 square kilometers, 146,200 square kilometers, 130,300 square kilometers, 115,600 square kilometers, and 83,800 square kilometers, respectively. In addition to the slight decrease in freezing depth range of 100–120 cm, the reduced area was 29,500 square kilometers. Freezing depth ranges greater than 140 cm showed a decreasing trend. The freezing depth range of 140–160 cm, which was the lowest range, decreased by 89,700 square kilometers. The 160–180 cm range decreased by 120,500 square kilometers, and the 180–200 cm range decreased by 161,500 square kilometers. The freezing depth range greater than 200 cm, which was the highest reduction range, decreased by 174,000 square kilometers. Considering the lack of data on the change in MFD of seasonally frozen ground in China in recent decades, machine learning provides an effective method for studying meteorological data and reanalysis data in order to predict the changes in MFD. [ABSTRACT FROM AUTHOR]

Background: Information seeking, as an important part of the prevention and control of infectious diseases, can lead to positive outcomes by reducing uncertainty and alleviating panic. However, most previous studies have limited their analysis to individual-level psychosocial factors, and little is known about how social-level factors influence individuals' information-seeking intentions. Methods: The cross-sectional survey was conducted from July 30, 2020 to August 15, 2020 in China. We used a convenience sampling strategy to recruit participants from among the Internet users. The structural equation model was used to identify the incentives associated with coronavirus disease 2019 (COVID-19) risk information-seeking intention. Results: In this study, the responses of 871 Internet users who reflected a response rate of 85% were analyzed. Information-seeking intention was found to be directed by informational subjective norms (ISNs), perceived information need, risk knowledge, the sense of community (SOC), and negative affective responses, and ISNs were found to be the strongest driving factor. Individuals with a stronger SOC, which was associated with greater pressure and expectations, show negative affective responses. COVID-19 risk knowledge can affect the information-seeking intention of Internet users not only directly but also indirectly through their perceived information need. In addition, more risk knowledge was associated with a lower perceived risk likelihood. Conclusion: When formulating risk communication strategies, governments and health institutions should take targeted measures to improve the public's SOC and knowledge. This will provide an opportunity to explore the role of individual cognition and environmental risk information in public health. [ABSTRACT FROM AUTHOR]

Simple Summary: Salinity can affect the physiological, reproductive, and developmental characteristics of marine molluscs. The Chinese razor clam (Sinonovacula constricta) is a marine bivalve that inhabits estuarine and intertidal habitats where salinity is usually lower when compared to open sea waters. The species is also an economically important subject of aquaculture in China. Here, RNA sequencing was used to study the internal mechanism of salt stress response in the Chinese razor clam. Differentially expressed RNAs were identified and lncRNA/circRNA-miRNA-mRNA regulatory networks were successfully constructed. Furthermore, the expression of four candidate genes in the Chinese razor clam subjected to different salinity stress were examined by qRT-PCR. The results of this study will improve our understanding of genetic-level responses to salinity changes in the Chinese razor clam. Moreover, the acquired information may be useful for optimization of the artificial breeding of the species under aquaculture conditions. The Chinese razor clam (Sinonovacula constricta) is an important for Chinese aquaculture marine bivalve that naturally occurs across intertidal and estuarine areas subjected to significant changes in salinity level. However, the information on the molecular mechanisms related to high salinity stress in the species remain limited. In this study, nine gill samples of S. constricta treated with 20, 30, and 40 ppt salinity for 24 h were used for whole-transcriptome RNA sequencing, and a regulatory network of competing endogenous RNAs (ceRNAs) was constructed to better understand the mechanisms responsible for adaptation of the species to high salinity. A total of 83,262 lncRNAs, 52,422 mRNAs, 2890 circRNAs, and 498 miRNAs were identified, and 4175 of them displayed differential expression pattern among the three groups examined. The KEGG analyses of differentially expressed RNAs evidenced that amino acid synthesis and membrane transport were the dominant factors involved in the adaptation of the Chinese razor clam to acute salinity increase, while lipid metabolism and signaling played only a supporting role. In addition, lncRNA/circRNA-miRNA-mRNA regulatory networks (ceRNA network) showed clearly regulatory relationships among different RNAs. Moreover, the expression of four candidate genes, including tyrosine aminotransferase (TAT), hyaluronidase 4 (HYAL4), cysteine sulfinic acid decarboxylase (CSAD), and ∆1-pyrroline-5-carboxylate synthase (P5CS) at different challenge time were detected by qRT-PCR. The expression trend of TAT and HYAL4 was consistent with that of the ceRNA network, supporting the reliability of established network. The expression of TAT, CSAD, and P5CS were upregulated in response to increased salinity. This might be associated with increased amino acid synthesis rate, which seems to play an essential role in adaptation of the species to high salinity stress. In contrast, the expression level of HYAL4 gene decreased in response to elevated salinity level, which is associated with reduction Hyaluronan hydrolysis to help maintain water in the cell. Our findings provide a very rich reference for understanding the important role of ncRNAs in the salinity adaptation of shellfish. Moreover, the acquired information may be useful for optimization of the artificial breeding of the Chinese razor clam under aquaculture conditions. [ABSTRACT FROM AUTHOR]

Background: The current neck management for early oral squamous cell carcinoma (OSCC) has always been a controversial issue. A comprehensive model is necessary for predicting an individual's metastasis risk and appropriate patient counseling. Methods: A nomogram for predicting 2‐year LNM in patients with cT1‐2N0 OSCC was developed and validated using clinicopathological data from 642 patients from 2000 to 2018 in four hospitals, China. Results: Three variables (pathology grade, depth of invasion, tumor‐infiltrating lymphocytes) were included in nomogram. C‐indices were 0.826 (95% CI: 0.786–0.866) and 0.726 (95% CI: 0.653–0.780) in the internal and external validation. Kaplan–Meier method found the 2‐year LNM rate of high‐risk group (35.8%) was much higher than that of the low‐risk group (14.5%). The nomogram model has an advantage over the 8th AJCC TNM stage in predicting the individual 2‐year LNM probability for early OSCC. Conclusion: Patients with low‐risk nomogram score may receive neck observation; those with high‐risk score should receive END. [ABSTRACT FROM AUTHOR]

Soil water erosion is considered to be a major threat to ecosystems and an important environmental problem. Aggravation of soil and water loss in the Three-River Headwaters Region (TRHR) is a prominent problem in China. In this research, the Revised Universal Soil Loss Equation (RUSLE) was applied to evaluate annual soil loss caused by water erosion in the TRHR from 2000 to 2020. Spatiotemporal patterns of soil water erosion were analyzed and the main driving factors of rainfall erodibility and vegetation coverage were investigated using ArcGIS spatial analysis. The results revealed that during the study period, soil erosion in the TRHR averaged 10.84 t/hm2/a, and values less than 25 t/hm2/a were characterized as micro and mild erosion. The soil erosion modulus observed a slightly increasing trend over the past decade. The changing trends in the Yangtze, Huanghe, and Lancang river source regions (YRSR, HRSR, and LRSR) were 0.03, 0.07, and 0.03 t/hm2/a, respectively. Both rainfall erodibility and vegetation coverage observed a growing trend, with slopes of 6.78 MJ·mm/(t·hm2·a) and 0.12%/a, respectively. In general, variation of rainfall erodibility showed a relatively higher contribution to soil erosion than vegetation coverage. Findings of this study could provide information for sustainable vegetation restoration, soil conservation, and water management at a regional scale. [ABSTRACT FROM AUTHOR]

Taraxacum germplasm resources in northeastern China are not current and do not accurately reflect the actual distribution of the species. The objective of this study was to investigate the morphological traits of Taraxacum species distributed in northeastern China and identify those that will facilitate their classification in this region. Leaf, flower, and achene characteristics of 18 species were used for morphological classification. Scanning electron microscopy (SEM) was used to examine pollen morphology. Internal transcribed spacer (ITS) sequences were analyzed to determine sequence differences among the species and their utility in delimitation. Taxa were classified into groups based on their morphology. The ITS sequence analysis supported the taxon classification, but the genetic distances among the taxa did not reflect morphological differences. Phylogenetic analysis was used to divide the 18 species into three groups. Group I: T. coreanum (which has white flowers). Group Ⅱ: T. heterolepis, T. sinomongolicum, T. variegatum, T. asiaticum var. lonchophyllum, T. falcilobum, T. brassicaefolium, and T. erythropodium (outer involucre bracts, narrow membranous or nonmembranous). Group Ⅲ: T. formosanum, T. liaotungense, T. mongolicum, T. borealisinense, T. ohwianum, T. platypecidum, T. urbanum, T. antungense, T. asiaticum, and T. junpeianum (outer involucre bracts, broad membranous). The main taxonomic characteristics of Taraxacum floral organs and achene morphology. [ABSTRACT FROM AUTHOR]

Data on hepatitis B virus (HBV) pregenomic (pgRNA) levels in HIV/HBV coinfected patients pre‐ and post‐combined antiretroviral therapy (cART) are limited. This study aimed to evaluate the distribution of HBV pgRNA levels in treatment‐naive coinfected patients and explore the changes that occur after the initiation of cART by examining patients from multicentre cohort studies performed in China. We included HIV/HBV coinfected subjects from the China AIDS Clinical Trial cohorts established from 2008 to 2014. Clinical and serological markers of HIV and HBV infection and biochemical data were acquired at baseline and after 96 and 240–480 weeks of cART. The correlations between HBV pgRNA and HBV DNA levels as well as HBsAg levels were calculated using Spearman's bivariate correlation analysis, and multivariate regression analysis was performed to determine factors associated with undetectable HBV pgRNA levels before cART and HBeAg loss after cART. A total of 132 HIV/HBV coinfected patients were enrolled, and 100 individuals were HBeAg‐negative. A total of 34.4% (32/93) of patients were positive for HBV pgRNA, and the median HBV pgRNA level was 4.92 (IQR: 4.21–6.12) log10 copies/mL before cART. The median HBV pgRNA level was significantly lower in HBeAg‐negative individuals than in HBeAg‐positive individuals (4.22 (IQR: 2.70–4.84) log10 copies/mL vs. 5.77 (IQR: 4.63–6.55) log10 copies/mL, p = 0.002). HBV pgRNA was moderately correlated with HBsAg (r = 0.594, p = 0.001), and positively associated with HBV DNA (r = 0.445, p = 0.011). The factors independently associated with undetectable HBV pgRNA level before cART were HBV DNA (OR: 5.61, 95% CI: 1.50–20.96, p = 0.01) and HBeAg status (OR: 5.95, 95% CI: 1.52–23.25, p = 0.01). A total of 87.5% (28/32) of patients were followed for a median duration of 138 (IQR: 54–240) weeks, and the HBV pgRNA levels became undetectable in seven patients. The 132 patients were observed for 695.5 person‐years, and no HBsAg loss occurred. Thirteen individuals achieved HBeAg loss, four patients had undetectable levels of HBV pgRNA pre‐cART, and the level of six individuals became undetectable during the 48‐week (IQR: 48–264) follow‐up period. HBeAg status was significantly associated with HBV pgRNA level in HIV/HBV coinfected patients pre‐ and post‐cART. Additionally, undetectable HBV pgRNA level may be associated with HBeAg loss after cART. [ABSTRACT FROM AUTHOR]

Background. In recent years, with a large number of rural people going out to work, the mental problems of left-behind children have been widely concerned by people from all walks of life. Objective. The purpose is to improve the teaching quality of music education of left-behind children and solve their unique mental problems. Methods. Based on the questionnaire survey, the mental state of left-behind children is studied, and the mental problems of left-behind children are intervened based on musical practice classes. First, the left-behind children's mental status is studied. Second, through the questionnaire, the left-behind children's music classroom status is studied and analyzed. Then, the musical classroom intervention experiment is designed to prevent and adjust the left-behind children's mental problems. Results. The results show that more than 90% of left-behind children spend less than one month with their parents every year. Most of the left-behind children are supervised by their grandparents, and 68% of them have been accompanied by their grandparents for more than nine months. Due to the lack of parents' company, most of the left-behind children are lack of self-confidence and timid and tend to care about others' opinions. Musical practice classes have a good effect on the regulation and prevention of left-behind children's mental problems. Conclusions. This study uses a questionnaire survey method to explore the new form of left-behind children's music classroom, preventing and regulating left-behind children's mental problems, which provides a reference for the research in related fields. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer death worldwide. Data on the effectiveness of one-off low-dose CT (LDCT) in reducing lung cancer mortality and all-cause mortality are needed to inform screening programmes in countries with limited medical resources. We aimed to evaluate the effectiveness of one-off LDCT screening in the early detection of lung cancer in China. A multicentre, population-based, prospective cohort study was done in 12 cities of eight provinces across China, recruiting individuals aged 40–74 years who were asymptomatic for lung cancer with no lung cancer history. Participants were classified as at high risk or low risk of lung cancer using a sex-specific risk score that incorporated cigarette smoking, level of physical activity, occupational exposures, history of chronic respiratory diseases, family history of lung cancer, diet, and passive smoking (women only). Participants at high risk were invited for a one-off LDCT scan and were classified into screened and non-screened groups on the basis of whether or not they had the scan. Lung cancer incidence density, lung cancer mortality, and all-cause mortality were calculated for the screened and non-screened groups. The effectiveness of a one-off LDCT scan was evaluated by a comparison of the screened and non-screened groups in terms of lung cancer mortality and all-cause mortality in the period from cohort entry until administrative censoring (June 20, 2020). Inverse probability weighting was adopted to account for potential imbalanced factors between the two groups and Cox proportional hazards model was used to estimate the weighted associations between mortality and one-off LDCT scans. Between Feb 19, 2013, and Oct 31, 2018, 1 032 639 individuals were assessed for eligibility. 1 016 740 participants were enrolled in the study, of whom 3581 had a lung cancer diagnosis after a median follow-up of 3·6 years (IQR 2·8–5·1). Among the 223 302 participants at high risk, 79 581 (35·6%) had an LDCT scan (screened group) and 143 721 (64·4%) did not (non-screened group). After inverse probability weighting, lung cancer incidence density was 47·0% higher (hazard ratio 1·47 [95% CI 1·27–1·70]; p<0·0001), lung cancer mortality was 31·0% lower (0·69 [95% CI 0·53–0·92]; p=0·010) and all-cause mortality was 32·0% lower (0·68 [0·57–0·82]; p<0·0001) for participants in the screened group compared with those in the non-screened group. One-off LDCT screening was associated with significantly lower lung cancer mortality and all-cause mortality in a large population in China. Our results point to the promise of one-off LDCT screening in countries with limited medical resources. Further studies are needed to explore interactions by subgroup—including sex, age, smoking status, and economic status—to develop population-specific screening strategies. Ministry of Finance and National Health Commission of the People's Republic of China. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Objective. The objective is to assess the benefit of cochlear implants in health-related quality of life among postlingually deaf adults in China. Methods. Seventy-one postlingually deaf adult cochlear implant users in one cochlear implant center in China participated in this study. The HUI3 questionnaire as a measurement evaluated their quality of life. A cross-sectional analysis was conducted. Results. Cochlear implant had made statistically significant improvements in quality of life among postlingually deaf adults. The HUI3 scores were significantly better in four attributes (hearing, speech, emotion, and pain) after a cochlear implant. A positive correlation between change in hearing and improvement in emotion was significant. The change in pain and improvement in emotion also had a positive correlation. The duration of HA and CI use had no impact on the gain in HUI3 scores, and the baseline of hearing and emotion state had an influence on HUI3 gain. Conclusion. This study found cochlear implant users had a greatly improved hearing, speech, emotion, and pain, which made statistically significant improvement in quality of life among postlingually deaf adults. There was a statistically significant association between the change of emotion state and improvement in hearing level. We also found a statistically significant correlation between the reduction of feeling in pain and improvement in emotion. The change of quality of life seemed to be influenced by the primary state of emotion and hearing. We believe the measurement HUI3 is suitable for these patients in China. [ABSTRACT FROM AUTHOR]

Using the Chinese listed firms from 2007 to 2015 as a sample, we examine how industrial policy affects the financialization of non-financial corporations (NFCs). We find that industrial policy reduces the level of the financialization of NFCs. Further evidence shows that industrial policy lowers firms' motivation to ease financial constraints and mitigates operating risks. This effect becomes more substantial in the regions with a higher level of marketization and stronger government financial capacity. Our findings have important policy implications for the emerging countries to promote real economic growth and curb the 'shifting from the real economy to the virtual economy'. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a promising HIV prevention method. However, the rollout of PrEP among men who have sex with men (MSM) is facing challenges. This study sought to understand PrEP acceptability and service use challenges among MSM in China. The study was conducted in 2018 in Guangdong Province using a mixed-methods approach. Among 489 HIV-negative MSM who completed an online survey, 374 (76.5%) had heard of PrEP before. The most common PrEP information sources were internet/social media (32.1%) and community-based organizations (30.4%). Two-thirds (n=328) of the MSM would accept PrEP even the protective efficacy is less than 100%, 60.1% (n=294) expressed willingness to use PrEP once it is approved in China, and 59.3% (n=290) were willing to pay out of pocket. Employment, disclosure of MSM status, and mental health issues were associated with PrEP acceptability. In-depth interviews with 30 MSM revealed that high cost, low accessibility, and stigma in clinic settings were barriers to PrEP using. Primary care-based PrEP services were acceptable, but patients' confidentiality was a concern. PrEP promotion efforts should address social and mental health challenges among MSM and mobilize primary care systems and community-based organizations to achieve the best result. [ABSTRACT FROM AUTHOR]

Accurate prediction of the rate of penetration (ROP) is a difficult issue in the drilling process, especially under complex formation conditions. Many methods, such as mechanism and machine learning, were introduced to investigate it. However, most of them are offline prediction methods which may not be capable of capturing the online trend of ROP. In this paper, a novel dynamic model for ROP prediction is proposed considering the process characteristics, which consists of three stages. In the first stage, the correlations between ROP and eight drilling parameters are analyzed, and the rotational speed, weight on bit, depth are selected as the model inputs. In the second stage, the drilling data are pre-processed by using the filtering and re-sampling techniques. In the last stage, the moving window strategy, extreme learning machine, and 10-fold cross validation are used to establish the ROP model. Our main idea of online prediction of ROP lies in this last stage. Specifically, two steps (modeling and prediction) are executed alternately in the moving drilling depth windows so as to predict the ROP more accurately. Finally, the proposed ROP prediction model is applied to the drilling well ZK3 in Xiangyang area, Central China. The prediction accuracy is improved by at least 7% compared with seven well-known ROP prediction methods, two online and five offline, which validates the effectiveness of the proposed method. It is believed that the proposed model provides a basis for intelligent optimization control in drilling process. • A novel intelligent dynamic model is proposed for the online prediction of drilling ROP. • The influence of the length of moving window and distance between two windows are investigated thoroughly. • The proposed model can learn autonomously in the drilling process and has a fast computation speed. • The proposed method has a higher prediction accuracy than two online and five offline well-known conventional methods. [ABSTRACT FROM AUTHOR]

This article examines the impact of cross-shareholding on corporate environmental investment (Env) using Chinese listed firms from 2014 to 2019 as the research setting. The results show that there is a positive impact of cross-shareholding on corporate environmental investment. The finding remains robust to a battery of robustness checks. In addition, the heterogeneity analysis illustrates that the positive impact of cross-shareholding on corporate environmental investment is more pronounced in state-owned firms and high-polluting industries when compared to non-state-owned firms and low-polluting industries, respectively. This study extends the research on cross-shareholding and provides practical implications for corporate sustainable development. [ABSTRACT FROM AUTHOR]

Study of constraints of stock emplacement and geometry on associated skarn orebodies is significant for the understanding of the epithermal deposit system. We have chosen the typical Tongguanshan skarn ore deposit (eastern China) as our target area. The Tongguanshan stock was emplaced at the NE–SW-striking Tongguanshan anticline and is characterized by macroscopically homogeneous quartz–monzodiorite. The magnetic parameters show that the stock is dominated by oblate magnetic ellipsoids and a high degree of anisotropy (> 1.1), and this value is higher at the stock margin. The strike of magnetic foliation at the stock margin is parallel to the stock boundary with sub-horizontal magnetic lineations. A vertical NE–SW-striking magnetic foliation, which is parallel to the regional structures, is revealed inside the stock. The three-dimensional geometric modelling shows that the stock has a tongue-like geometry and the contact surface in both eastern and western sides dips to the NW, but the western side is steeper. Nevertheless, the orebodies are almost developed at the eastern side. Accordingly, we propose that the Tongguanshan stock was constructed by multiple magma pulses, initiated at the SW part of the stock, and ascended along inherited NE–SW extended fractures in the Tongguanshan anticline. The successive magma pulses either accreted by a unilateral E-wards trend or by bilateral magma accretion, which resulted in a deformation difference in the contact zone and caused uneven orebody development. Our study also shows that the strike, dip angle and curvature situation of contact surface, which affects the water–rock reaction process and distribution of the dilation zone, are important ore-controlling factors. [ABSTRACT FROM AUTHOR]

China accounts for 25% of the global greening. There are temporal and spatial differences of China's greening and intrinsic driving forces. Thus, it is crucial to determinize the contributions of human activities and climate change on greening at region scale. The Beijing–Tianjin–Hebei Region (BTHR) is one of the most active areas with human activities in China. It is necessary to explore negative or positive impacts of human activities on the regional greening or browning under climate change. A time series of annual vegetation coverage from satellite data was selected to quantify regional greening in the BTHR from 2000 to 2019 and their responses to climate change and human activities. Results showed generally widespread greening over the last 20 years at an average increased rate of 0.036 decade−1 in vegetation coverage (P < 0.01). Overall warmer and wetter climate across the BTHR were positively correlated with regional greening. The positive effects of human activities on greening accounted for 48.4% of the BTHR, especially the benefits of ecological restoration projects and the agricultural activities. Increases in vegetation coverage had resulted from the combined effects of climate change and human activities. Climate change had a stronger influence on vegetation coverage than human activities. Contributions of climate change to greening and browning was about 74.1% and < 20%, respectively. The decrease in vegetation coverage was mainly the results of the inhibition of human activities. More detailed socioeconomic and anthropogenic datasets are required for further analysis. Further research consideration would focus on the nonlinear responses of vegetation to climate change. [ABSTRACT FROM AUTHOR]

This study examines local residents' place attachment (PA) to the city or town they live and investigates how this attachment influences their perceptions and support for tourism development (ST), as well as comparing the differences of these relationships among the city and town residents in a linear World Heritage Site (WHS) setting. Structural equation model was used to analyze samples of 226 city residents and 235 town residents along the Grand Canal Yangzhou Section, China. The findings suggested that residents' PA is positively correlated their ST. Results also suggested that the PA-ST effect is partially mediated by residents' positive perceptions in the city area while fully mediated by residents' positive and negative perceptions in the town areas. This study could help local governments make heritage development and management policies accordingly for cities and towns along the Grand Canal area. [ABSTRACT FROM AUTHOR]

Objective: To observe the clinical effect of high suspension and low incision (HSLI) surgery on mixed haemorrhoids, compared with Milligan-Morgan haemorrhoidectomy. Methods: A multi-centre, randomized, single-blind, non-inferiority clinical trial was performed. Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing Rectum Hospital, Air Force Medical Center of People's Liberation Army of China, and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018. By using a blocked randomization scheme, participants were assigned to two groups. The experimental group was treated with HSLI, while the control group was treated with Milligan-Morgan haemorrhoidectomy. The primary outcome was the clinical effect evaluated at 12 weeks after operation. The secondary outcomes included the number of haemorrhoids treated during the operation, pain scores, use of analgesics, postoperative oedema, wound healing, incidence of anal stenosis, anorectal manometry after operation, as well as surgical duration, length of stay and total hospitalization expenses. A safety evaluation was also conducted. Results: In total, 246 eligible participants were enrolled, with 123 cases in each group. There was no significant difference in the clinical effect between the two groups (100.00% vs. 99.19%, P>0.05). Compared with the control group, the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group (P<0.05 or P<0.01); the patient number with wound healing at 2 weeks after operation and the functional length of anal canal at 12 weeks after operation were significantly increased in the experimental group (P<0.05). There was no significant difference in the incidence of anal stenosis, the numbers of patients using analgesics and patients with postoperative oedema between the two groups after operation (P>0.05). The surgical duration and length of stay in the experimental group were significantly longer than those in the control group, and the total hospitalization expense was significantly higher than that in the control group (all P<0.05). No adverse events were reported in either group during the whole trial or follow-up period. Conclusion: HSLI had the advantages of preserving the skin of anal canal completely, alleviating postsurgical pain and promoting rapid recovery after operation. (Registration No. ChiCTR1900022883) [ABSTRACT FROM AUTHOR]

Background: Factors predicting peripheral blood total HIV-1 DNA size in chronically infected patients with successfully suppressed viremia remain unclear. Prognostic power of such factors are of clinical significance for making clinical decisions.Methods: Two sets of study populations were included: 490 China AIDS Clinical Trial (CACT) participants (Training cohort, followed up for 144 to 288 weeks) and 117 outpatients from Peking Union Medical College Hospital (PUMCH) (Validation cohort, followed up for more than 96 weeks). All patients were chronically HIV-1-infected and achieved successful HIV-1 plasma RNA suppression within week 48. Total HIV-1 DNA in blood at baseline, 12, 24, 48, 96, 144 and 288 weeks after combined antiretroviral therapy (cART) initiation were quantified. Generalized estimating equations and logistic regression methods were used to derive and validate a predictive model of total HIV-1 DNA after 96 weeks of cART.Results: The total HIV-1 DNA rapidly decreased from baseline [median = 3.00 log10 copies/106 peripheral blood mononuclear cells (PBMCs)] to week 24 (median = 2.55 log10 copies/106 PBMCs), and leveled off afterwards. Of the 490 patients who had successful HIV-1 plasma RNA suppression by 96 w post-cART, 92 (18.8%) had a low total HIV-1 DNA count (< 100 copies/106 PBMCs) at week 96. In the predictive model, lower baseline total HIV-1 DNA [risk ratio (RR) = 0.08, per 1 log10 copies/106 PBMCs, P < 0.001] and higher baseline CD4+ T cell count (RR = 1.72, per 100 cells/μL, P < 0.001) were significantly associated with a low total HIV-1 DNA count at week 96. In an independent cohort of 117 patients, this model achieved a sensitivity of 75.00% and specificity of 69.52%.Conclusions: Baseline total HIV-1 DNA and CD4+ T cell count are two independent predictors of total HIV-1 DNA after treatment. The derived model based on these two baseline factors provides a useful prognostic tool in predicting HIV-1 DNA reservoir control during cART. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has given rise to stigma, discrimination, and even hate crimes against various populations in the Chinese language–speaking world. Using interview data with victims, online observation, and the data mining of media reports, this paper investigated the changing targets of stigma from the outbreak of Covid-19 to early April 2020 when China had largely contained the first wave of Covid-19 within its border. We found that at the early stage of the pandemic, stigma was inflicted by some non-Hubei Chinese population onto Wuhan and Hubei residents, by some Hong Kong and Taiwan residents onto mainland Chinese, and by some Westerners towards overseas Chinese. With the number of cases outside China surpassing that in China, stigmatization was imposed by some Chinese onto Africans in China. We further explore how various factors, such as the fear of infection, food and mask culture, political ideology, and racism, affected the stigmatization of different victim groups. This study not only improved our understanding of how stigmatization happened in the Chinese-speaking world amid Covid-19 but also contributes to the literature of how sociopolitical factors may affect the production of hate crimes. [ABSTRACT FROM AUTHOR]

Background: The effective treatment of coronavirus disease 2019 (COVID-19) remains unclear. We reported successful use of high-dose intravenous immunoglobulin (IVIg) in cases of severe COVID-19, but evidence from larger case series is still lacking. Methods: A multi-center retrospective study was conducted to evaluate the effectiveness of IVIg administered within two weeks of disease onset at a total dose of 2 g/kg body weight, in addition to standard care. The primary endpoint was 28-day mortality. Efficacy of high-dose IVIg was assessed by using the Cox proportional hazards regression model and the Kaplan-Meier curve adjusted by inverse probability of treatment weighting (IPTW) analysis, and IPTW after multiple imputation (MI) analysis. Results: Overall, 26 patients who received high-dose IVIg with standard therapy and 89 patients who received standard therapy only were enrolled in this study. The IVIg group was associated with a lower 28-day mortality rate and less time to normalization of inflammatory markers including IL-6, IL-10, and ferritin compared with the control. The adjusted HR of 28-day mortality in high-dose IVIg group was 0.24 (95% CI 0.06–0.99, p<0.001) in IPTW model, and 0.27 (95% CI 0.10–0.57, p=0.031) in IPTW-MI model. In subgroup analysis, patients with no comorbidities or treated in the first week of disease were associated with more benefit from high-dose IVIg. Conclusions: High-dose IVIg administered in severe COVID-19 patients within 14 days of onset was linked to reduced 28-day mortality, more prominent with those having no comorbidities or treated at earlier stage. [ABSTRACT FROM AUTHOR]

Background: The plasma concentration of patients treated with efavirenz (EFV) 600 mg was found to exceed the upper limit of the proposed therapeutic window in most Chinese HIV-infected individuals; thus, dosage reduction of EFV to 400 mg daily warranted consideration. This study aimed to assess the pharmacodynamics of EFV 400 mg for HIV-1-infected patients in China. Method: Twenty cART-naïve individuals were enrolled in this study. EFV 400 mg combined with tenofovir (TDF) and lamivudine (3TC) as an initial antiretroviral regimen was administered for 48 weeks. EFV concentration and T cell subsets as well as HIV RNA load were evaluated at baseline and at 4, 12, 24, and 48 weeks. Moreover, neuropsychiatric adverse effects were also assessed by the Hamilton depression (HAMD) scale and Pittsburgh sleep quality index (PSQI). Results: Eighteen males and two females whose median age was 26 (interquartile range [IQR]: 23–32) years completed 48 weeks of follow-up. The median EFV concentrations were 1.88 (IQR: 1.54–2.42), 1.74 (IQR: 1.36–1.93), 1.93 (IQR: 1.66–2.22), and 1.85 (IQR: 1.54–2.14) mg/L at weeks 4, 12, 24, and 48, respectively. The viral load was 4.59 (IQR: 4.10–5.19) log10 copies/mL at baseline, and it decreased by 4.6 (IQR: 3.98–5.18) log10 copies/mL from baseline to week 48. Three of 20 (15%), 10 of 20 (50.0%), 17 of 20 (85%), and 18 of 19 (95%) participants had a plasma viral load less than 50 copies/mL at weeks 4, 12, 24, and 48, respectively. The median CD4 cell count was 330 (IQR: 237–410) cells/μL at baseline, and it increased to 473 (IQR: 344–574) cells/μL at 48 weeks. The HAMD score was 5 (IQR: 3–9.8) and 3 (IQR: 2.25–4) at baseline and 48 weeks, respectively. The PSQI score was 4 (IQR: 2–5.8) and 3 (IQR: 2–4) at baseline and 48 weeks, respectively. Dizziness was the most common event, occurring in 70% of patients within the first 2 weeks of treatment. Conclusion: Patients prescribed with EFV 400 mg-containing agents demonstrated favourable virological and immunological responses. And the plasma EFV concentration was within the recommended therapeutic range, with fewer adverse reactions than with EFV 600 mg. EFV 400 mg was effective and safe in Chinese HIV-infected patients. Trial registration: NCT04596488; Registered 21 October, 2020; Retrospectively registered. [ABSTRACT FROM AUTHOR]

This paper constructs an international trade network model to investigate the spillover effects of import decline in China and the US. Our results show that, first, research target countries can be divided into spillover blockers, absorbers, and amplifiers based on whether they transmit economic shocks. Second, for the same degree of decline in import in China and the US, export changes in the major world economies are affected more by the US than by China. In addition, the impact of import decline in the US on China is greater than that in China on the US. Meanwhile, China's original economic shock could be amplified much more than that of the US. Third, in terms of the transmission of economic impact, Asian and European countries are largely affected, whereas countries in South America are least likely to be affected by economic shocks from China and the US. [ABSTRACT FROM AUTHOR]

Schnitzler syndrome (SchS) is a rare acquired systemic autoinflammatory disease. The major clinical features of SchS are urticarial rash and monoclonal gammopathy, accompanied by fever, joint pain, and lymphadenopathy. There were few reports about SchS in Chinese population. Herein, we describe two patients with SchS in China and conducted a systematic literature review about SchS. Two Chinese Han patients were diagnosed as SchS in our department from 2017 to 2019. Their phenotype and genotype were carefully documented and studied. We also conducted a systematic literature review about SchS. There was one man (66 years old) and one woman (49 years old). Recurrent fever and urticarial rash occurred in both of them during the febrile attacks and normalized in asymptomatic intervals. Other manifestations included arthralgia, lymphadenopathy, and hearing loss. Hepatic cirrhosis and epilepsy were seen in the male patient. None of them had bone pain or family histories. Serum monoclonal IgM gammopathy was found in both patients. MyD88 gene mutation L258P was identified in the female patient. They were treated with tocilizumab and tripterygium wilfordii Hook F (TwHF) respectively, and both showed good response. The rarity and diversity of SchS make it difficult to be recognized. Anti-IL-6 agents may be alternative therapies when anti-IL-1 therapy is unresponsive or unavailable. Due to the case report, the effect of TwHF in the treatment of SchS should be further studied. [ABSTRACT FROM AUTHOR]

The purpose of this study was to observe and compare the clinical efficacy of active acupuncture and placebo acupuncture in the treatment of insomnia and mood disorders. 96 patients with insomnia in Chengdu were randomly divided into two groups (1:1). The active acupuncture group (AA group n = 48) received the tube of Park sham device with deep needle insertion. The placebo acupuncture group (PA group n = 48) received the tube of Park sham device with a retractable needle shaft and a blunt tip. The same acupuncture points and treatment cycles were used in both groups. The overall score for the Pittsburgh Sleep Quality Index (PSQI) is the primary outcome. Secondary outcomes recorded sleep rate, self-reported depression scale (SDS), self-assessment anxiety scale (SAS), the 'six component' scores of PSQI, and 'Deqi' scale scores. Eventually, 90 patients completed the study. After 2 weeks of treatment, the total score of PSQI in the AA group was 4.6 ± 2.4 and in the PA group was 12.9 ± 1.8 (ES = 3.91, p <.1). The SAS, SDS score in the AA group were 39.9 ± 5.6/39.9 ± 5.9 and in the PA group were 59.7 ± 6.1/61.2 ± 4.4 (ES = 3.38/4.9, p <.1). The sleep rate were 93.8% and 25.0% (p <.1). During the 1 month follow-up period, the PSQI total score in the AA group (5.2 ± 1.9) was superior to the PA group (13.1 ± 1.8) (ES = 4.27, p <.1). The SAS, SDS score in the AA group were 40.4 ± 5.1/42.7 ± 6.6 and in the PA group were 63.7 ± 6.6/63.5 ± 4.8 (ES = 3.95/3.60, p <.1). Throughout the study period, the 'six component' scores of PSQI in the AA group was superior to the PA group (each p <.1). Except for tingling and cooling, other acupuncture sensations were significant differences (each p <.1). Compared to the placebo acupuncture, active acupuncture can significantly improve insomnia, and clinical efficacy is maintained for at least 6 weeks. [ABSTRACT FROM AUTHOR]

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spread mainly through respiratory droplets or direct contact. However, the infection condition of the genital system is unknown. Our aim in this study was to determine if SARS-CoV-2 is present in the vaginal fluid of women with coronavirus disease 2019 (COVID-19). Methods Ten women with confirmed severe COVID-19 pneumonia admitted to the Tongji Zhongfa Hospital intensive care unit from 4 February 2020 through 24 February 2020 were included. Clinical records, laboratory results, and computed tomography examinations were retrospectively reviewed. The potential for genital infection was accessed by testing for the presence of SARS-CoV-2 in vaginal fluids obtained from vaginal swab samples. Reverse transcriptase polymerase chain reaction was used to confirm the SARS-CoV-2 infection in vaginal fluids. Results The clinical characteristics of the 10 women were similar to those reported in other severe COVID-19 patients. All 10 patients were tested for SARS-CoV-2 in vaginal fluid, and all samples tested negative for the virus. Conclusions Findings from this small group of cases suggest that SARS-CoV-2 virus does not exist in the vaginal fluids of severe COVID-19 patients. [ABSTRACT FROM AUTHOR]

A Gram-stain-negative, facultative aerobic, non-spore-forming, non-motile, non-flagellated, rod-shaped bacterium, designated strain NAU-18T was isolated from an oil-contaminated soil in China. Strain NAU-18T could grow at 10–42 °C (optimum, 30 °C), at pH 5.0–8.0 (optimum, 7.0) and in the presence of 0–2.0% (w/v) NaCl (optimum, 0.5% NaCl in R2A). The predominant fatty acids were C18:1ω7c (71.2%) and Summed feature 2 (5.1%), representing 76.3% of the total fatty acids. The major respiratory quinones were Q9 and Q10. The DNA G + C content of strain NAU-18T was 61.4 mol% based on its draft genome sequence. Genome annotation of strain NAU-18T predicted the presence of 6668 genes, of which 6588 are coding proteins and 80 are RNA genes. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain NAU-18T was a member of the genus Rhizobium and showed 96.93% (with 93.2% coverage) and 96.81% (with 100% coverage) identities with those of Neorhizobium alkalisoli CCBAU 01393T and Rhizobium oryzicola ZYY136T, respectively. In the phylogenetic analysis, strain NAU-18T and R. oryzicola ZYY136T are consistently placed in the same branch. Strain NAU-18T represents a novel species within the genus Rhizobium, for which the name Rhizobium terrae sp. nov. is proposed, with the type strain NAU-18T (=KCTC 62418T = CCTCC AB 2018075T). [ABSTRACT FROM AUTHOR]

Uranium enrichment measurement is an essential quality inspection for fuel rods before delivery to users. Generally, compared with active neutron assay (ANA) equipment, passive gamma-ray assay (PGA) equipment is more economical and safer. However, the current PGA equipment based on photomultipliers is too slow (1 m/min) to meet the growing needs in China. Recently, we have developed a set of compact high-speed PGA equipment including four detection modules (128 units in total), a 128-channel data acquisition system (DAS), a power supply, special software, and an automatic loading and unloading mechanism. The detection unit is based on silicon photomultipliers in virtue of its compact size and good performance. The DAS processes signals of all units in parallel into a sequence of data packets carrying the energy information and the corresponding unit ID. The software integrates the data packets into a fluctuating count curve in a time-delay superposition method and identifies possible abnormal pellets. After calibrations, our equipment can locate abnormal pellets accurately at a speed of 6 m/min. In addition, it can directly measure the enrichment of fresh pellets not in secular equilibrium without waiting for two months. So far, the equipment has been successfully run for one year on the assembly line of China North Nuclear Fuel Co. and shows good potential to replace the traditional ANA equipment. [ABSTRACT FROM AUTHOR]

The pollen of T. angustifolia, also known as Pu huang in Chinese, has been used for treatment of stranguria, hematuria, dysmenorrhea, metrorrhagia and injuries in China for a long time. Extensive efforts have been directed toward its phytochemical and biological aspects. However, little is known about its anti-nociceptive implication and material basis. This work presented the investigation of the anti-nociceptive effect of Typhae Pollen using an effect-directed fractionation strategy, thereby leading to identification of isorhamnetin-3-O-neohesperidin (1) and typhaneoside (2), together with other minor flavonoid glycoside congeners, as the main anti-nociceptive constituents. This work not only unveils the anti-nociceptive potential of Typhae Pollen, but also establishes a method to enrich and identify the anti-nociceptive constitutes of Typhae Pollen. Moreover, this work is a successful example of effect-directed fractionation strategy, which represents a powerful tool in TCM-based drug discovery and development. [ABSTRACT FROM AUTHOR]

Background: The impact of HIV-1 subtype (CRF01_AE and non-CRF01_AE) on HIV-1 DNA levels in HIV-1 chronically infected patients with suppressive antiretroviral therapy (ART) remains poorly understood. To evaluate the correlation of HIV-1 subtype with DNA level, and identify baseline predictors of HIV-1 DNA decay.Methods: ART-naïve HIV-1-infected patients from two large multi-center studies in China were classified into CRF01_AE and non-CRF01_AE subtype groups. Peripheral blood samples were collected at baseline and week 12, 24, 48 and 96 after ART initiation and total HIV-1 DNA levels were quantified by real-time PCR. HIV-1 DNA levels at week 96 were categorized into high, moderate, and low levels, reflecting HIV-1 DNA ≥ 3, 2-3, ≤ 2 log10 copies/106 PBMCs, respectively, and the corresponding proportion of CRF01_AE and non-CRF01_AE subtype were compared. The baseline predictors of low HIV-1 total DNA levels (≤ 2 log10 copies/106 PBMCs) at week 96 were evaluated using a logistic regression model.Results: Compared to the non-CRF01_AE subtypes (n = 185), patients with CRF01_AE subtype (n = 188) harboured a higher level of HIV-1 DNA (median: 3.19 vs. 2.95 log10 copies/106 PBMCs, P < 0.001) prior to treatment. After 96 weeks of ART, HIV-1 DNA levels remained higher in the CRF01_AE subtype group (median: 2.63 vs. 2.39 log10 copies/106 PBMCs, P = 0.002). There was no significant difference in the proportion of patients achieving high (22.3% vs. 14.6%, P = 0.054), moderate (59.6% vs. 60.5%, P = 0.849) and low levels (18.1% vs 24.9%, P = 0.111) between CRF01_AE and non-CRF01_AE groups. In the multivariable analysis, baseline HIV-1 DNA level and CD4+ T cell count but not the subtype were independent risk factors for achieving HIV-1 DNA level ≤ 2 log10 copies/106 PBMCs.Conclusion: HIV-1 CRF01_AE subtype is neither correlated with HIV-1 DNA reservoir decline nor a prognostic factor for achieving lower HIV-1 DNA levels (≤ 2 log10 copies/106 PBMCs) after ART. However, higher HIV-1 DNA level in HIV-1 CRF01_AE patients should be aroused much attention and strengthen surveillance during ART. [ABSTRACT FROM AUTHOR]

In karst rocky desertification areas, bryophytes coexist with algae, bacteria, and fungi on exposed calcareous rocks to form a bryophyte crust, which plays an irreplaceable role in the restoration of karst degraded ecosystems. We investigated the biodiversity of crust bryophytes in karst rocky desertification areas from Guizhou Province, China. A total of 145 species in 22 families and 56 genera were identified. According to frequency and coverage, seven candidate dominant mosses were screened out, and five drought-resistant indexes of them were measured. Hypnum leptothallum, Racopilum cuspidigerum, and Hyophila involuta have high drought adaptability. We explored the interactions between two dominant mosses (H. leptothallum, H. involuta) and the structure of microbial communities in three karst rocky desertification types. Microbial diversity and function analysis showed that both moss species and karst rocky desertification types affect microbial communities. Moss species much more strongly affected the diversity and changed the community composition of these microbial groups. Bacteria were more sensitive in the microbiome as their communities changed strongly between mosses and drought resistance factors. Moreover, several species of fungi and bacteria could be significantly associated with three drought-resistant indexes: Pro (free proline content), SOD (superoxide dismutase activity), and POD (peroxidase activity), which were closely related to the drought adaptability of mosses. Our results enforced the potential role of moss-associated microbes that are important components involved in the related biological processes when bryophytes adapted to arid habitats, or as one kind of promoters in the distribution pattern of early mosses succession in karst rocky desertification areas. [ABSTRACT FROM AUTHOR]

The dependence of county industry on high CO 2 emission industries makes it difficult to balance the development of county economy and CO 2 emission reduction. Therefore, this article attempts to study on the spatial-temporal evolution and influencing factor on land use-related CO 2 emissions at region-county level to promote county economy from CO 2 source to CO 2 sink. 9 regions and 38 counties in Chongqing of China were thus selected as study objects. Based on land use data, land use-related CO 2 emissions were estimated using direct and indirect CO 2 emission models for the period 1997–2015. On this basis, the space-time patterns were revealed from two scales of region and county. And the main factors influencing CO 2 emissions according to land use were revealed based on Logarithmic Mean Divisia Index (LMDI) and geographic detector analysis (GDA), respectively. The results show that: 1) at regional scale, CO 2 emissions of different regions all greatly improve in which southeastern ecological protection and development area showed the largest increase. Increases in per capita CO 2 emissions in two-wing (suburban) areas are higher than those in downtown and surrounding-downtown areas. 2) at regional scale, the influences of various decomposed factors on the change of CO 2 emissions fluctuate. The effect of population shows an insignificant influence on CO 2 emissions. Economic development greatly influences CO 2 emissions. Additionally, energy consumption shows a significant inhibitory effect on CO 2 emissions while energy mix exhibits significant hysteresis. 3) at county scale, heavy CO 2 emissions are concentrated in core urban areas; moderate and mild emissions occur mainly in the main urban expansion area, the region around the main urban areas, and in regional hub cities; low emissions are mainly concentrated in the Wuling mountainous area in southeast Chongqing and the Three Gorges Reservoir area in northeast Chongqing. 4) at county scale, the main influences on land use-related CO 2 emissions are total energy consumption, per capita GDP, and urbanization rate. Minor influences include population size, proportion of secondary and tertiary industries, and proportion of land used for construction. [ABSTRACT FROM AUTHOR]

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. A number of targeted therapies have been approved for clinical use or are in clinical trials. Next generation sequencing (NGS) is widely applied in the identification of actionable genomic alterations and enables personalized cancer therapy for patients. Several multiple-gene panels are available in China for the practice of precision medicine-based cancer therapy. However, the efficiency of these panels requires evaluation. The current study investigated 23 NSCLC samples using a custom designed panel of complete coding regions of ~180 cancer driver genes (FD-180) and whole exome sequencing for control samples, obtained from white blood cell samples. The results obtained suggested that actionable mutations with available targeted therapeutic options were identified in 69.6% of cases, including 60.9% of therapeutic targets recommended by the National Comprehensive Cancer Network guidelines. Furthermore, 8.7% of patients had a gene mutation that potentially qualified them for clinical trials or associated off-label therapies. As such, the results obtained in the current study demonstrated the reliability of the targeted NGS panel and its potential use for identifying actionable gene alterations and designing personalized therapies for patients with NSCLC. [ABSTRACT FROM AUTHOR]