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Simple Summary: This study presented an artificial intelligence-based classification emphasizing error identification and quantification of cellularity and nuclear morphological features in digital pathological images of common astrocytic tumors. The identification of incorrect predictions was essential for the subsequent development of better techniques. Quantifying cellularity and nuclear morphological features brought deeper insights into neoplastic morphology and paved the way for further development of a scoring system for objective classification and precision diagnosis to improve interobserver variations. Interobserver variations in the pathology of common astrocytic tumors impact diagnosis and subsequent treatment decisions. This study leveraged a residual neural network-50 (ResNet-50) in digital pathological images of diffuse astrocytoma, anaplastic astrocytoma, and glioblastoma to recognize characteristic pathological features and perform classification at the patch and case levels with identification of incorrect predictions. In addition, cellularity and nuclear morphological features, including axis ratio, circularity, entropy, area, irregularity, and perimeter, were quantified via a hybrid task cascade (HTC) framework and compared between different characteristic pathological features with importance weighting. A total of 95 cases, including 15 cases of diffuse astrocytoma, 11 cases of anaplastic astrocytoma, and 69 cases of glioblastoma, were collected in Taiwan Hualien Tzu Chi Hospital from January 2000 to December 2021. The results revealed that an optimized ResNet-50 model could recognize characteristic pathological features at the patch level and assist in diagnosis at the case level with accuracies of 0.916 and 0.846, respectively. Incorrect predictions were mainly due to indistinguishable morphologic overlap between anaplastic astrocytoma and glioblastoma tumor cell area, zones of scant vascular lumen with compact endothelial cells in the glioblastoma microvascular proliferation area mimicking the glioblastoma tumor cell area, and certain regions in diffuse astrocytoma with too low cellularity being misrecognized as the glioblastoma necrosis area. Significant differences were observed in cellularity and each nuclear morphological feature among different characteristic pathological features. Furthermore, using the extreme gradient boosting (XGBoost) algorithm, we found that entropy was the most important feature for classification, followed by cellularity, area, circularity, axis ratio, perimeter, and irregularity. Identifying incorrect predictions provided valuable feedback to machine learning design to further enhance accuracy and reduce errors in classification. Moreover, quantifying cellularity and nuclear morphological features with importance weighting provided the basis for developing an innovative scoring system to achieve objective classification and precision diagnosis among common astrocytic tumors. [ABSTRACT FROM AUTHOR]

The current study aimed to evaluate the effect of bilirubin on the outcomes of colorectal cancer (CRC) in patients who underwent radical CRC surgery. The levels of serum bilirubin, including total bilirubin (TBil), direct bilirubin (DBil) and indirect bilirubin (IBil), were divided into higher groups and lower groups according to the median. Multivariate logistic regression was performed to analyze the independent predictors for overall complications and major complications. For TBil, the hospitalization time of the higher TBil group was longer than that of the lower TBil group (p = 0.014 < 0.05). For DBil, the higher DBil group had longer operation times (p < 0.01), more intraoperative bleeding (p < 0.01), longer hospital stays (p < 0.01), and higher rates of overall complications (p < 0.01) and major complications (p = 0.021 < 0.05) than the lower DBil group. For the IBil group, blood loss during operation (p < 0.01) and hospital stays (p = 0.041 < 0.05) in the higher IBil group were lower than those in the lower IBil group. In terms of complications, we found that DBil was an independent predictor for overall complications (p < 0.01, OR = 1.036, 95% CI = 1.014-1.058) and major complications (p = 0.043, HR= 1.355, 95% CI= 1.009-1.820). Higher preoperative DBil increase the risk of complications after primary CRC surgery. [ABSTRACT FROM AUTHOR]

INTRODUCTION Quitting smoking, the critical path to reach the global targets of reducing tobacco use, can bring major and immediate health benefits to smokers. Exploring factors that help individuals to quit smoking is of great importance. The present study explored influencing factors on smoking cessation, in order to provide comprehensive reference for tobacco control policies. METHODS Ex-smokers and current smokers were recruited online in this crosssectional survey, from 1 October to 31 November 2022, in China. The observational data were collected using a questionnaire to collect information with respect to sociodemographic characteristics of smokers, attitudes towards smoking cessation, details of smoking cessation, and different potential factors related to smoking cessation through open-ended questions. RESULTS A total of 638 smokers from 30 provinces were recruited as eligible respondents, with a mean age of 37.3 ± 11.7 years and a mean smoking history of 15.9 ± 13.7 years. The percentage of males was 92.3%. Of the 638 respondents, only 3.9% had no intention to stop smoking. Among 155 subjects who had quitted smoking successfully, willpower (55.5%) was considered as the most important contributing factor. Among 365 subjects who tried to quit but failed, lack of willpower (28.2%), tobacco dependence (16.2%), influence of surrounding smokers or smoking environments (15.9%), bad moods (9.9%), stress from work or life (7.9%), habits (7.1%), socialization (4.1%), and easy availability of tobacco (2.7%) were considered as the adverse factors leading to failure in quitting smoking. CONCLUSIONS Willpower and support from family members were the vital factors that lead to successful smoking cessation. Future tobacco control policies should also focus on addressing withdrawal symptoms and creating smoke-free environments as well as other factors. [ABSTRACT FROM AUTHOR]

Purpose: Phytostabilization is known to be a promising technique to prevent the off-site movement of cadmium (Cd) from severely contaminated arable soils. Previous studies have recognized plants and amendments that could be potentially used for phytostabilization, such as non-edible fiber and energy crops and biochar. However, there is a paucity of information on the performance of these candidate crops and amendments for the application in the field. Methods: Twelve plant-amendment systems were established on the farmland severely contaminated with Cd in the South China karst area, which comprises cash crops kenaf (Hibiscus cannabinus), ramie (Boehmeria nivea), and sorghum (Sorghum bicolor) together with the application of lime, coconut shell biochar, and rice straw biochar at different rates. A comprehensive score was introduced to evaluate the performance of the studied plant-amendment systems, considering not only the indicators related to soil Cd mobility but also the costs. Results: After one crop cycle, a 40% median rate of reduction was achieved in soil available Cd. An intensive application of biochar lowered the comprehensive performance since a significantly increased cost gained only a slight improvement in the reduction of soil available Cd. Sorghum with 0.5% (w/w) rice straw biochar showed the best performance in the study site, which effectively sequestrated Cd in the roots and reduced soil available Cd at a relatively low cost. Conclusion: This work shows the performance and the comprehensive evaluation of candidate plant-amendment systems for the in situ phytostabilization. [ABSTRACT FROM AUTHOR]

Origins of early Paleozoic metabasites (granulites and amphibolites) and their host metasedimentary rocks in the Dunhuang block, NW China, are addressed by new geochronological and geochemical data. The metabasites show back-arc basalt-like geochemical features, marked by high Zr/ Nb ratios and Zr-Hf troughs, but they can be classified into two groups based on their dissimilar protolith ages and distinct Nd signatures. Most group I metabasaltic rocks were emplaced before 455 Ma and possess high Ba/Nb ratios (11.46-224), low (Nb/ La)PM (0.10-0.71), and negative whole-rock eNd(t) values (-12.7 to -2.7), whereas group II rocks have protolith ages around 445 Ma, low Ba/Nb ratios (0.70-22.93), low (Nb/La)PM (0.78-1.51), and less evolved whole-rock Nd isotopic features (eNd[t]: -2.0 to +2.7). It is proposed that group I metabasites originated from an enriched lithospheric mantle, while group II metabasites were derived from the depleted asthenospheric mantle. The metasedimentary rocks received detritus mainly from the neighboring Cambrian magmatic arc, and they are compositionally similar to active-margin sediments. Metamorphic zircon U-Pb ages ranging 462-422 Ma from the investigated rocks together with prominent magmatism further suggest high-grade metamorphism prevailing during the Late Ordovician-early Silurian. Based on these data, a Cascadia-type evolution is proposed involving an Ordovician-early Silurian suprasubduction stretching of the Cambrian active continental margin, which culminated with mantle upwelling. Recent paleogeographic reconstructions support the evolution and assembly of interior Proto-Tethys-Ran oceanic and continental plates, including the Dunhuang block, between 510 and 440 Ma, followed by Panthalassan subduction beneath the Tarim-North China continental assemblage at 440-430 Ma. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between chewing sugar-free gum (SFG) and dental caries status in China. Methods: A total of 860 teenagers (aged 12 to 15 years) and 490 adults (aged ≥ 18 years) were recruited using a multistage stratified cluster method from economically developed areas (Beijing, Guangdong) and less economically developed areas (Hubei, Xinjiang). Each participant completed a questionnaire including oral health-related knowledge of SFG and chewing habits of SFG and agreed to undertake a clinical assessment. Potential factors associated with chewing conditions were analysed through a chi-square statistical test. A negative binominal regression analysis was performed to quantify the relationship between dental caries and consumption of SFG. Results: The overall percentage of the survey population who consumed SFG was 43.4%, and SFG-related knowledge and awareness was only 19.4%. For decayed, missing and filled permanent teeth (DMFT), the mean value was 1.63 ± 2.41 and 2.29 ± 3.65 in the chewing group and non-chewing group, respectively. According to the negative binominal regression analysis, the caries status in the SFG chewing group was better than in the non-chewing group (adjusted prevalence rate ratio [PRR] 0.73; 95% confidence interval [CI] 0.62--0.87). Conclusion: The chewing condition and oral health-related knowledge and awareness of SFG is low. Chewing SFG is related to a better dental caries status, so regular consumption of SFG should be recommended when promoting oral health. [ABSTRACT FROM AUTHOR]

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Objectives: The 22q11.2 deletion syndrome is considered the most frequent chromosomal microdeletion syndrome in humans and the second leading chromosomal cause of congenital heart disease (CHD). We aimed to identify the prevalence and the detailed genetic characterisation of 22q11.2 region in children with CHD including simple defects and to explore the genotype-phenotype relationship between deletion/amplification type and clinical data.Methods: Patients with CHD for surgery were screened by multiplex ligation-dependent probe amplification and capillary electrophoresis methods. Universal Probe Library technology was applied for validation.Results: In 354 patients with CHD, 40 (11.3%) carried different levels of deletions/amplifications at the 22q11.2 region with various phenotypes. The affected genes at this region include CDC45 (15 patients), TBX1 (8), USP18 (8), RTDR1 (7), SNAP29 (6), TOP3B (6), ZNF74 (4) and other genes with less frequency. Among those, two patients carried 3 Mb typically deleted region from CLTCL1 to LZTR1 (low copy repeats A-D) or 1.5 Mb deletions from CLTCL1 to MED15 (low copy repeats A-C). Clinical facial manifestations were found in 12 patients.Conclusions: This study revealed an unexpected high prevalence of chromosome 22q11.2 variations in patients with CHD even in simple defects. The genotype-phenotype relationship analysis suggests that genetic detection of 22q11.2 may become necessary in all patients with CHD and that detection of unique deletions or amplifications may provide useful insight into personalised management in patients with CHD. [ABSTRACT FROM AUTHOR]

Objective: To investigate the current status and distribution of resources for oral health in China, by means of analysing national data from the National Investigation of Resources for Oral Health. Methods: The National Investigation of Resources for Oral Health in China was performed in 2015, in parallel with the 4th National Oral Health Survey of China (2015 to 2016). A structured questionnaire on resources for oral health was used to collect the data of professional institutions and stomatological/dental workforce in each province. For each province, the local Investigation Group was responsible to summarise the status and distribution of institutions with stomatological/dental departments and stomatological/dental workforce. Descriptive analysis of resources for oral health was performed to learn about the number and percentage of each category both for each province and nationally. The ratio of number of stomatological/dental workforce to population was also calculated and compared with the criteria of the World Health Organisation (WHO). Results: There were totally 75,399 stomatological/dental departments nationally in all professional institutions in the mainland of China, most of which were set in institutions of primary health care services. Institutions of private sectors accounted for a higher proportion (69.8%) which was over two-fold compared to that of public ones (30.2%). General hospitals were the major part of hospitals with stomatological/dental departments compared with stomatological/dental specialised hospitals. Stomatological/dental clinics were the majority of institutions of primary health care services, compared to community health care service centres/stations and township health care services. Amongst all professional institutions of public health with stomatological/dental departments, 35.0% were maternal and child health care services and 11.2% were institutions for prevention and control of oral diseases. The total number of stomatological/dental workforce in the country was 314,347, among whom 171,587 (54.6%) were stomatologists/dentists. The ratio of number of stomatologists/dentists to population was 1:7,768 nationally, which was lower than the WHO standard of 1:5,000. Conclusion: The National Investigation of Resources for Oral Health in China exhibited the current status and distribution of resources for oral health over the country, whereas insufficiencies of stomatological/dental workforce and institutions and inequalities of their distribution were found nationally. This could provide some policy suggestions for the health authorities in China to promote oral health in the Chinese population in the future. [ABSTRACT FROM AUTHOR]

Objective: To investigate the oral health status and related factors of 12-year-olds from regions with and without coverage of the National Oral Health Comprehensive Intervention Program in China by means of analysing national data from the 4th National Oral Health Survey. Methods: Data of 12-year-olds participating in the 4th National Oral Health Survey of China were used for statistical analysis. Children who were recruited in the survey completed a dental examination and filled in a questionnaire. Oral health status, pit-and-fissure sealant history, oral hygiene behaviours, sugar consumption habits, status of dental service utilisation, and oral health knowledge were compared between children from regions with and without coverage of the national programme. For the number of decayed, missing and filled permanent teeth (DMFT) and its components, as well as the number of teeth with pit-and-fissure sealants, mean values were statistically tested to see if significance existed between regions covered by the national programme and uncovered regions, whereas caries prevalence and percentage of pit-and-fissure sealants presented were also compared. Results: Data from 27,821 12-year-old children were analysed, among whom 7,726 were from regions covered by the national programme and 20,095 were from uncovered regions. Statistical significance was found in caries experience and activity, pit-and-fissure sealant history, sugar consumption habits, utilisation of dental services and oral health knowledge when compared between the covered and uncovered regions. Prevalence of dental caries and indices for caries experience and activity was lower in regions covered by the national programme than those not covered, while the percentage of pit-and-fissure sealants presented and the number of teeth with pit-and-fissure sealants exhibited higher in the covered regions. This remained the same even if we focused only on the first molars instead of the full dentition. Conclusion: The National Oral Health Comprehensive Intervention Program for Children in China potentially contributed to better oral health status, behaviour and knowledge in 12-year-old children. The expansion and extension of coverage of the national programme was expected to be beneficial for improving oral health status in children, as well as constructing teams of oral and dental workforce and working mechanisms in some underdeveloped regions. [ABSTRACT FROM AUTHOR]

There is evidence that access to green spaces have positive effects on health, possibly through beneficial effects on exercise, air quality, urban heat islands, and stress. Few previous studies have examined the associations between green space and mortality, and they have given inconsistent results. This ecological study relates green space to mortality in Hong Kong from 2006 to 2011. The Normalized Difference Vegetation Index (NDVI), a measure of green space coverage, was measured for 199 small geographic areas in Hong Kong. Negative Binomial Regression Models were fit for mortality outcomes with NDVI, age, gender, population density, and area-level socio-economic variables as predictors, with Generalized Estimating Equations used to control for within-cluster correlation. An interquartile range (0.44 units) higher NDVI was significantly associated with lower cardiovascular (relative risk (RR) = 0.88, 95% confidence interval (CI) = 0.80, 0.98) and diabetes (RR = 0.72, 95% CI = 0.60, 0.92) mortality, and non-significantly associated with lower chronic respiratory mortality (RR = 0.90, 95% CI = 0.79, 1.02). Associations were stronger for males and low-income area residents. Lung cancer mortality had no significant association with green space. Better provision of urban green space, particularly in low-income areas, appears to have potential to reduce mortality in densely-populated Asian cities. [ABSTRACT FROM AUTHOR]

Background: Regional differences in practices, ethnicity, and climate may influence the skin compatibility of sanitary pads. Although several clinical trials have been performed in North America, Mexico, Western Europe, Eastern Europe, and Africa, there is no clinical study reported for Asia. Objective: The purpose of this study was to examine the skin compatibility of two types of modern sanitary pads in Chinese women along with a dermatological assessment and their satisfaction and preference. Materials and methods: The self-feeling and safety of a new sanitary pad with a non-woven top specially-shaped surface sheet was tested and compared with a conventional sanitary pad with a perforated film top sheet. The subjects studied were 22 Chinese women (age: 20--50 years) with a history of mild and occasional sanitary pad dermatitis residing in Shanghai. One subject wished to discontinue the trial for personal reasons, thus 21 subjects completed the trial. These subjects were randomly assigned to two types of sanitary pads, and used one type during their next menstrual period, and another type during their following menstrual period. After each menstrual period, a dermatologist examined the objective and subjective skin symptoms and determined a score. The subjects were asked to rate their level of satisfaction with respect to overall usability, softness, stickiness, dryness, and absorbency, and to choose which pad they had preferred. Results: No adverse effect was observed for either type of pad. Edema, erythema, burning, and stinging were not obvious symptoms for either type of pad. For itching, 30--65% of the subjects scored slight or mild for both types of pads. A comprehensive evaluation showed that several symptoms were observed on both type of pads at slight and mild levels, but minimal and insignificant differences were found between them. The majority of subjects were highly satisfied with both types, but preferred the new sanitary pad with a non-woven specially-shaped surface top sheet for its softness and absorbency. Conclusion: Our results indicate that both types of sanitary pads were tolerated well by Chinese women, thereby providing an important extension of earlier studies. [ABSTRACT FROM AUTHOR]

The Yishak Volcanic Series (YVS) is part of the Late Cambrian Kudi ophiolite in the western Kunlun Mountains, NW China, which marks the oldest suture zone in the Tibetan Plateau. The YVS is a well-preserved sequence comprising five conformable units (A to E) of basalts to andesites, with mafic dykes in Units A to D. These rocks are sequentially characterized upward by geochemical features of N-MORB (Unit A), E-MORB (Unit B), island-arc basalt (Unit C), BABB (Unit D and mafic dykes) and boninite series rocks (Unit E), reflecting complex interactions among various source components. The evolution of magma compositions from MORB-dominated to boninite series rocks clearly indicates temporally increasing subduction signatures, which, in combination with the extensional tectonic background, suggests that the Kudi ophiolite most likely formed in a spontaneous nucleation of subduction zone. [ABSTRACT FROM AUTHOR]

Oceanic arc subduction systems are the loci of substantial recycling of oceanic crust and production of juvenile arc crust that differentiates to more evolved felsic crust. Inevitably, some juvenile sediments are subducted with the oceanic crust. However, distinguishing the incorporation of juvenile sediments in oceanic arcs is not always straightforward, because they may not measurably shift many geochemical signatures, such as Sr and Nd isotopes, of oceanic arcs. Nevertheless, combined zircon U-Pb, Hf, and O isotope data can provide a powerful tool to decipher sedimentary flux into oceanic arc magmas, and here we report a case study for the late Paleozoic A-type granites from the West Junggar oceanic arc in the southern Central Asian Orogenic Belt. These plutons contain hastingsite and iron biotite diagnostic minerals and have high alkali, FeOT/MgO, Zr, and Ga/Al, but possess low CaO contents, and strongly negative Eu, Sr, and Ba anomalies, demonstrating their close affinity with A-type granites. Zircon U-Pb analyses indicate that these A-type granites emplaced in the Late Carboniferous to Early Permian (ca. 307-298 Ma). Their high zircon εHf(t) values (+12.4 to +15.5), suggest that the magmas were derived from a mantle or juvenile crustal source. However, their δ18Ozrn (+7.2‰ to +11.9‰) values are significantly higher than that of the mantle, and modeling using Hf-O isotope and rare earth element data indicate the assimilation of sedimentary materials at a proportion of ~50%. Our data suggest that juvenile sediments (e.g., greywacke) played an important role in the formation of the studied A-type granites. The re-melting of sedimentary material induced by the late Carboniferous ridge subduction can promote the transition from an intra-oceanic arc to continental crust. Our results show that the subduction and re-melting of juvenile sediments in oceanic arc systems could be an important mechanism for the maturation of oceanic arc crust. [ABSTRACT FROM AUTHOR]

Background: Little is currently known about long-term health effects of ambient ultrafine particles (UFPs) due to the lack of exposure assessment metrics suitable for use in large population-based studies. Land use regression (LUR) models have been used increasingly for modeling small-scale spatial variation in UFPs concentrations in European and American, but have never been applied in developing countries with heavy air pollution., Objective: This study developed a land-use regression (LUR) model for UFP exposure assessment in Shanghai, a typic mega city of China, where dense population resides., Method: A 30-minute measurement of particle number concentrations of UFPs was collected at each visit at 144 fixed sites, and each was visited three times in each season of winter, spring, and summer. The annual adjusted average was calculated and regressed against pre-selected geographic information system-derived predictor variables using a stepwise variable selection method., Result: The final LUR model explained 69% of the spatial variability in UFP with a root mean square error of 6008 particles cm -3 . The 10-fold cross validation R 2 reached 0.68, revealing the robustness of the model. The final predictors included traffic-related NO x emissions, number of restaurants, building footprint area, and distance to the nearest national road. These predictors were within a relatively small buffer size, ranging from 50 m to 100 m, indicating great spatial variations of UFP particle number concentration and the need of high-resolution models for UFP exposure assessment in urban areas., Conclusion: We concluded that based on a purpose-designed short-term monitoring network, LUR model can be applied to predict UFPs spatial surface in a mega city of China. Majority of the spatial variability in the annual mean of ambient UFP was explained in the model comprised primarily of traffic-, building-, and restaurant-related predictors., 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 © 2021 Elsevier B.V. All rights reserved.)