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Using students' assessments of teaching at a top university in China from 2016 to 2021, this study examines whether evaluation of teaching improves teaching quality. Given the many doubts about the validity of students' evaluation of teaching, this study adopts a methodology to distinguish teaching quality improvement from the reversal effect. It shows that instructors with a poor (good) ranking in the previous evaluation are more likely to receive an improved (decreased) ranking in the current evaluation. This reversal effect is more pronounced among the instructors who are associate/assistant professors, younger and female. This study provides evidence that supports the reversal effect rather than the improvement.

This study was conducted in the purpose of investigating the effect of Tai Chi on drug craving for women with drug disorders. One hundred and twelve women were recruited from a drug rehabilitation center in China, and 47 and 48 were finally analyzed in the control group and exercise group, respectively. The exercise group underwent a 3-month Tai Chi training, whereas the control group experienced no exercise intervention during the same time period. The drug craving was measured by the visual analog scale. In data analysis, repeated-measures were utilized to test the differences between the control and exercise group over the course of the experiment time. The mean of the craving score significantly dropped from pre-test (control: mean = 5.38, SD = 3.04; exercise: mean = 4.68, SD = 2.93) to post-test (control: mean = 4.03, SD = 2.73; exercise: mean = 1.91, SD = 1.90) in both groups (control group: t = 3.84, df = 46, p < 0.001; exercise group: t = 5.941, df = 47, p < 0.001), with more decrease witnessed in the exercise group. Repeated-measures analysis with a Huynh–Feldt correction showed the significant effect of time (F = 27.383, p < 0.001) as well as the study group by time interaction (F = 3.52, p = 0.024). Tai Chi can ameliorate the drug craving in women and it could be a supportive treatment for drug addiction. [ABSTRACT FROM AUTHOR]

Rational allocation of healthcare facilities is a key component of planning strategies in promoting public health and wellbeing worldwide. Many Chinese cities have been experiencing population loss, making it challenging to match the supply and demand of healthcare facilities accurately. How to plan healthcare facilities to improve spatial accessibility in shrinking cities is still an underresearched topic. Taking Lufeng in China as the case, we used residential electricity consumption rate as proxy data to rectify the actual population distribution and used Gaussian two-step floating catchment area (G2SFCA) to evaluate the spatial accessibility of hierarchical healthcare facilities for making recommendations to improve the planning of healthcare facilities in shrinking cities to achieve better spatial accessibility. Our findings indicated that: (1) the supply and demand of healthcare facilities were generally not well matched, especially in the fringe area; (2) the sudden influx population during festival periods placed additional burden on medical resources in the fringe area and its spatial accessibility, especially on township hospitals and community healthcare services; and (3) to promote the spatial accessibility of healthcare facilities in shrinking cities, we proposed related planning strategies regarding the targeted allocation of three-level healthcare facilities to match the hierarchical diagnosis and treatment, and flexible setting of mobile healthcare facilities and telemedicine to echo the temporal population changes. These findings can provide references for improving livelihood health in cities experiencing population loss. [ABSTRACT FROM AUTHOR]

Background: Feedback is critical to improving practitioners' clinical practice and professional growth. Although they are still considered junior practitioners, their feedback-seeking experiences have yet to be investigated. This study aimed to understand the fundamental thoughts and experiences of new graduate nurses regarding feedback-seeking and to identify the main factors that influence their feedback-seeking behaviors. Methods: Conducting a descriptive phenomenological study, semi-structured in-depth interviews with newly graduated nurses from four hospitals in Zhejiang Province, China, face-to-face or via video call in the hospital conference room through purposive and snowball sampling. Interview data were evaluated using Colaizzi's 7-step phenomenological data analysis. The COREQ checklist was followed. Results: A total of 15 new graduate nurses were interviewed as a sample, and 13 categories emerged from our data. They were categorized into four central elements: (1) perceptions and attitudes, (2) drivers, (3) dilemmas and needs, and (4) transformation and growth. Conclusions: This study found that new graduate nurses have various needs but face dilemmas in the feedback-seeking process. Nursing managers should be proficient at providing positive leadership, collaborating with clinical mentors to foster an atmosphere where new graduate nurses may obtain honest, transparent, and fair feedback, and exercising caution when providing negative feedback. [ABSTRACT FROM AUTHOR]

Despite increasing awareness of mental health problems among older adults, limited mental health services are available to meet their needs. The proposed study aimed to evaluate the need for mental health services among older adults in Shanghai, China, and identify gaps in the existing service system to inform policy making. Based on 80 face-to-face interviews amongst several groups of older adults and community officers, doctors and government stakeholders, the study found that (a) the mental health needs of older adults living with family members mainly present as needs for social interaction, sense of belonging, and self-realization; (b) special groups, such as older adults living alone, mainly desire support to address loneliness, older adults with physical disabilities desire social respect, and those with mental disabilities seek social acceptance; and (c) community cadres and other stakeholders have paid little attention to demands related to mental well-being among older people. It is necessary to deliver mental health education to community stakeholders and the public, popularize mental health knowledge, and publicize professional psychological counseling and treatment services. Meanwhile, policy makers should allocate resources to train professional mental health services personnel to meet these growing mental health needs and increase financial support for mental health services for older adults. [ABSTRACT FROM AUTHOR]

Background: Self-management plays an important role in the disease management of glaucoma patients. The effectiveness of the program can be improved by assessing the patient's perspective and needs to tailor self-management support. Most studies have focused on assessing one of these self-management behaviours, such as medication adherence, and there is a lack of systematic assessment of the support needs and challenges of self-management for patients with glaucoma. Therefore, in this study, we conducted an in-depth investigation into the self-management challenges and support needs of patients with primary glaucoma, providing a basis for nursing staff to implement self-management support. Method: The phenomenological method and semistructured interviews were used in this study. A total of 20 patients with primary glaucoma were recruited between June and December 2022. Colaizzi's analysis method was used to analyse the interview data. Results: Challenges for patients include becoming an expert in glaucoma, managing negative emotions, adapting to daily life changes and resuming social activities. To address these challenges, four themes of patient self-management support needs were identified: (1) health information support, (2) social support, (3) psychological support, and (4) daily living support. Conclusion: Patients with primary glaucoma experience varying degrees of challenge in dealing with medical, emotional, and social aspects. Comprehending the support needs of patients, healthcare professionals should deliver targeted, personalized and comprehensive self-management interventions to enhance their capacity of patients to perform self-management and improve their quality of life. [ABSTRACT FROM AUTHOR]

Purpose: To explore the level of participation in shared decision-making by patients with glaucoma and identify influencing factors, to subsequently provide references to promote shared decision-making in ophthalmology, and achieve patient-centered care. Patients and Methods: A questionnaire was completed by 148 patients with glaucoma who had been admitted to a specialized ophthalmic hospital in China, between October 2021 and January 2022. The participants' responses to the nine-item Shared Decision-Making Questionnaire (SDM-Q-9) and a general information survey were analyzed to determine their level of participation in shared decision-making and influencing factors. Multiple linear regression was used to identify factors that influence shared decision-making at the time of clinical practice. Results: The mean score of SDM-Q-9 was 71.73± 21.27 (n=140). Multiple linear regression analysis showed that patients with negative attitudes towards participation in decision-making (P=0.023) and those who had rural insurance (P=0.017) had significantly lower SDM-Q-9 scores than those with positive attitudes and those with medical insurance. Patients who were more satisfied with their medical service had higher SDM-Q-9 scores (P< 0.05). Conclusion: Patients with glaucoma presented a high level of shared decision-making. Patients' attitudes towards participating in decision-making, the payment method of medical expenses, and the level of satisfaction with medical services are factors that influence their level of participation in shared decision-making. [ABSTRACT FROM AUTHOR]

Aims: To explore the effects of training programs for ophthalmic specialist nurses in Zhejiang Province of China. Methods: The training program included one month of theoretical training and three months of practical clinical training. The Two-Tutor system was used in training. The training contents were mainly set up around four modules: specialty knowledge and clinical skills, management, clinical teaching, and nursing research. We used theoretical examination, clinical practice assessment and trainee evaluation to assess the effectiveness of the training program. Before and after the training, the trainees' core competence was assessed by a homemade questionnaire. Results: In total, 48 trainees from 7 provinces (municipalities) in China participated in the training program. All trainees passed theoretical and clinical practice examinations and trainee evaluations. Their core competencies were significantly improved after training (p < 0.05). Conclusion: This training program for ophthalmic specialist nurses is scientific and effective in improving nurses' ability to provide ophthalmic specialist nursing care. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy (DR) is one of the major blinding eye diseases worldwide. Psychological, emotional and social problems of DR patients are prominent. The aim of this study is to explore the experiences of patients with different phases of DR from hospital to home based on the "Timing It Right" framework, and to provide a reference for formulating corresponding intervention strategies. Methods: The phenomenological method and semi-structured interviews were used in this study. A total of 40 patients with DR in different phases were recruited from a tertiary eye hospital between April and August 2022. Colaizzi's analysis method was used to analyse the interview data. Results: Based on the "Timing It Right" framework, different experiences in five phases of DR before and after Pars Plana Vitrectomy (PPV) were extracted. The patients experienced complicated emotional reactions and inadequate coping skills during the pre-surgery phase, increased uncertainty during the post-surgery phase, insufficient confidence and the decision to change during the discharge preparation phase, eagerness for professional support and moving forward in exploration during the discharge adjustment phase, and courageous acceptance and positive integration during the discharge adaptation phase. Conclusion: The experiences of DR patients with vitrectomy in different phases of disease are ever-changing, and medical staff should provide personalized support and guidance to help DR patients get through the hard times smoothly and enhance the quality of hospital-family holistic care. [ABSTRACT FROM AUTHOR]

Increasingly stringent regulations regarding vehicle emissions have contributed to the diversification of vehicle technologies, resulting in the increasing complexity of typical vehicles that make up a fleet. In order to investigate the real gas emissions of different typical vehicles, tests were conducted using a portable emission measurement system (PEMS) in Beijing and emission studies were conducted on eight light-duty passenger vehicles (LDPVs, including light-duty gasoline passenger vehicles and hybrid electric vehicles), eight heavy-duty passenger vehicles (HDPVs), and four light-duty trucks (LDTs). The results show that the emissions of relevant pollutants from LDPV meet the emission standard limits. The emission factors of CO2, CO, NOX, and HC of China IV and China V hybrid electric vehicles (HEVs) are much smaller than the emission standard limits and the emission factors of other vehicles, which have better emission reduction effects. Among LDPV, heavy-duty passenger vehicles (HDPVs), and LDT, the emissions of HDPV and LDT are extremely high. Emission characteristics vary on different types of roads, with the highest emission factors generally occurring on secondary roads. The micro-trip method was used to explore the influence of speed on emission factors. HEV are less sensitive to speed changes and can still maintain a low emission level at low speeds. The average speed and emission factors of HDPV in micro-trip has a strong correlation. [ABSTRACT FROM AUTHOR]

Purpose: To investigate mental health and self-management in glaucoma patients during the COVID-19 pandemic in China and to describe the correlation between anxiety, depression, glaucoma, and self-management. Methods: This cross-sectional study included glaucoma patients who enrolled in the case management platform and completed an online survey. The survey included the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Glaucoma Self-Management Questionnaire (GSMQ). Results: Among 109 glaucoma patients enrolled in this study, the proportions of patients suffering from depression and anxiety during the COVID-19 pandemic were 26.6% and 20.2%, respectively. A statistical association was found between depression and self-management behaviour in these glaucoma patients (r = -0.247, P = 0.010). The self-management scores in patients less than 35 years were lower than those in patients aged 35–60 years (P = 0.046). The scores of body function promotion in men were lower than those in women (P = 0.048). Patients with primary school education and below had lower scores in the medical management of disease than those with either middle school education (P = 0.032) or community college education or higher (P = 0.022). Conclusion: A high proportion of anxiety and depression was found in glaucoma patients during the COVID-19 pandemic. Better self-management behaviour was associated with stronger mental health regulation. It is important to help glaucoma patients improve their self-management behaviours, especially for young men with low educational levels. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association of potential cardiovascular disease (CVD) biomarkers in patients with type 2 diabetes.Research Design and Methods: We enrolled 120 participants (aged 61.5-69.5 years) with type 2 diabetes and 60 (aged 62.5-73.5 years) with normal glucose tolerance in the discovery group from the original Da Qing Diabetes Study. Their diabetes status was confirmed in 1986; then, the participants were followed over 23 years to collect CVD outcome data. Untargeted and targeted metabolomics analyses based on ultra-high-performance liquid chromatography-tandem mass spectrometry were used to identify potential markers. Multivariable regression analysis was used to evaluate the association between metabolites and CVD outcomes. An independent group of 335 patients (aged 67.0-77.0 years) with diabetes was used for biomarker validation.Results: In the discovery group, untargeted metabolomics analysis found 16 lipids and fatty acids metabolites associated with CVD risk in patients with diabetes, with palmitoyl sphingomyelin (PSM) having the strongest association. Plasma PSM concentrations were significantly higher in cases of diabetes with CVD than without (41.68 ± 10.47 vs. 9.69 ± 1.47 μg/mL; P < 0.0001). The odds ratio (OR) of CVD for 1 µg/mL PSM change was 1.19 (95% CI 1.13-1.25) after adjustment of clinical confounders. The validation study confirmed that PSM was significantly associated with increased CVD risk in diabetes (OR 1.22 [95% CI 1.16-1.30]).Conclusions: Changes in lipid and fatty acid content were significantly associated with CVD risk in the Chinese population with diabetes. PSM is a potential biomarker of increased CVD risk in diabetes. [ABSTRACT FROM AUTHOR]

Objective: The study was conducted to summarize the treatment outcomes of newly diagnosed epilepsy (NDE) and analyse the risk factors for refractory epilepsy (RE) in Northeast China. Methods: A total of 466 adult patients with NDE were consecutively enrolled in this programme. Clinical data were collected at baseline and each follow-up. Several scales concerning recognition and mood were also completed at the first visit. Results: Seizure-free status was achieved by 52% (n = 244) of the patients; however, 15% (n = 68) manifested RE. A total of 286 (61%) patients continued with the first ASM as monotherapy, among which 186 (40%) patients became seizure-free. Fifteen (22%) patients with RE became seizure-free following ASM adjustment and 34 patients (14%) had breakthrough seizures after being classified as seizure-free. One patient developed RE after attaining seizure-free status. Breakthrough seizures during the first expected interictal interval [Odds ratio (OR) = 5.81, 95% CI: 2.70–12.50], high seizure frequency at baseline (OR = 1.24, 95% CI: 1.04–1.49), younger age of onset (OR = 1.42, 95% CI: 1.12–1.79), and male sex (OR = 2.64, 95% CI: 1.26–5.53) were risk factors for RE. Significance: Treatment outcomes of the majority of NDE cases are good. New risk factors could help physicians more promptly and accurately identify patients who are likely to develop RE. Seizure-free state is not long enough to commence the withdrawal of ASMs. RE is not permanent and seizure-free may be achieved subsequently by appropriate drug adjustment. [ABSTRACT FROM AUTHOR]

Vehicles' lane-changing behavior can potentially result in traffic conflicts and crash risks, particularly in scenarios with interactions among multiple vehicles. To assess the crash risk of multi-vehicle interaction lane-changing (MILC) scenarios, this study presents a dynamic traffic graph-based risk assessment method. First, a method for constructing dynamic scene graphs is proposed, along with graph-based indicators for assessing scene and scenario risks. Second, the Gaussian mixture model-latent Dirichlet allocation (GMM-LDA) algorithm is utilized to cluster risk sequences of MILC scenarios, enabling the classification of scenario risks into different levels. The method considers both dynamic and static elements in these scenarios, as well as the spatial relationships among these elements. A case study was conducted to illustrate this approach at a weaving area in China. The findings reveal that diverging segments have the highest probability of high-risk MILC scenarios. Furthermore, the likelihood of high-risk scenarios involving consecutive lane-changing maneuvers is higher compared to single lane changes. Left lane-changing behavior exhibits a higher probability of high-risk scenarios compared to right lane-changing. The proposed risk assessment method facilitates the identification and construction of high-risk MILC scenarios. It also enables the exploration of the risk evolution process. • A semantic representation method is proposed to represents multi-vehicle interaction lane changing (MILC) scenarios. • A graph-based risk assessment method for MILC scenarios (MIRA) portrays the dynamic interactive feedback relationship between vehicles. • The GMM-LDA clustering method is used to identify the risk patterns of the MILC scenarios considering the dynamic spatial distribution of vehicles. • The research facilitates the identification of high-risk MILC scenarios, as well as enabling the exploration of the process of risk evolution. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to investigate whether a modified implantation method facilitating a fully open umbrella can reduce the pericardial effusion/pericardial tamponade (PE/PT) rate after left atrial appendage closure (LAAC) with the LAmbre device compared with the conventional method (CM) in patients with non‐valvular atrial fibrillation (NVAF). Methods and Results: Patients with NVAF who received either isolated LAAC or combined catheter ablation and LAAC using the LAmbre device at the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were enrolled. CM was used for device implantation in the initial 59 patients, while a modified method (MM) was used in the remaining 165 patients. Successful implantation was achieved in 98.3% of patients in the CM group and 98.8% in the MM group. A higher rate of a fully open umbrella (98.8% vs. 69%, p <.001), less requirement for recapture (46% vs. 62.1%, p =.036), and a lower incidence of delayed PE/PT (1.2% vs. 8.6%, p =.005) were found in the MM group compared with the CM group. All of the five delayed PT events occurred in patients with combined treatment. An umbrella that was not fully open was the only factor associated with delayed PE/PT events in a multivariable Cox model. Conclusions: LAAC with the LAmbre device using an MM significantly increases the rate of a fully open umbrella and decreases the requirement for recapture and the incidence of delayed PE/PT. This method is more effective in patients with combined treatment. [ABSTRACT FROM AUTHOR]

Objective. To investigate the association between myopia progression and school entrance age among Chinese schoolchildren and to suggest a more appropriate school age. Methods. 1,463 children aged six to nine years from Wenzhou, China, were examined and followed up for two and a half consecutive years. Their noncycloplegic refraction was measured twice each year by using an automatic refractometer; axial length (AL) and corneal radius of curvature (CRC) were tested annually by using the IOLMaster for 2.5 years. The questionnaires were completed by the children to collect detailed information regarding risk factors. Here, myopia is defined as a spherical equivalent less than −1.0D. Results. The changes in spherical equivalent (SE) of 7-year-old children in grade 1 and grade 2 were −0.45D and -0.56D, while changes in AL were 0.59 mm and 0.62 mm, respectively. The SE changes of 8-year-old children in grade 2 and grade 3 were −0.54D and −0.75D; meanwhile, the AL changes were 0.57 mm and 0.61 mm, respectively. Significant statistical differences were observed in ocular biological structure parameters, except for corneal radius of curvature (CRC) or anterior chamber depth (ACD), among children with the same age in different grades during this study. The prevalence of myopia was also significantly higher in higher grades for children with same age. Conclusions. Myopia is related to children's school entrance age. Children who start school in an earlier age are more likely to suffer from myopia, and the progression of myopia can be considerably faster. Therefore, it is recommended to enter school after the age of 7. [ABSTRACT FROM AUTHOR]

In the bus network, key bus station failure can interrupt transfer lines, which leads to the low effectiveness of the whole network, especially during peak hours. Thus, identifying key stations in the bus network before the emergency occurs has a great significance to improve the response speed. In this paper, we proposed a new method considering station hybrid influence and passenger flow to identify key stations in the whole bus network. This method aims to measure the influence of bus stations while combining the topological structure of the bus network and dynamic bus stations passenger flow. The influence of bus stations was calculated based on the local structure of the network, which refines from finding the shortest paths with high computational complexity. To evaluate the performance of the method, we used the efficiency of the network and vehicle average speed at the station to examine the accuracy. The results show that the new method can rank the influence of bus stations more accurately and more efficiently than other complex network methods such as degree, H-index, and betweenness. On this basis, the key stations of the bus network of Beijing in China are identified out and the distribution characteristics of the key bus stations are analyzed. [ABSTRACT FROM AUTHOR]

Schistosomiasis caused by Schistosoma japonicum is a public health concern in China, and Hubei is one of the most affected provinces. Although the routine surveillance since the mid 1950s has generated substantial data pertaining to the habitats of the intermediate snail host, Oncomelania hupensis, its spatiotemporal distribution is not known. A review of local chronicles on the annual records of schistosomiasis control program was conducted to retrospectively collect information about O. hupensis habitats. The habitats were mapped by a field survey in 2016. We categorized the habitats into five evolutionary types, namely, Type I, current habitat; Types II-IV, historical habitat; and Type V, suspected habitat according to habitat development. The shape of habitats was determined using geographical information systems. A visual database was established and managed on the ArcGIS platform. A total of 43 472 O. hupensis habitats, covering an area of approximately 430 000 hectares, were identified through the study. Over 60% of these habitats have been eliminated. The highest number of O. hupensis habitats was recorded in 1975; however, most of them were preserved until 1995. Our study, for the first time, sheds light on the spatiotemporal distribution of O. hupensis in the most affected province in China. The data will be valuable for policy making and for formulating strategies to eliminate schistosomiasis in Hubei Province. Author summary: Schistosomiasis is a major infectious disease of humans and animals, and is a global concern. In China, it is endemically found across 12 provinces along the Yangtze River and in the area south of the river. According to the "13th Five-Year Plan for National Schistosomiasis Control", by the end of 2020, schistosomiasis epidemic will continue to decline towards eradication throughout China. However, the control and elimination of its intermediate snail host, Oncomelania hupensis, is crucial for blocking schistosomiasis transmissions in China. Therefore, further understanding, surveillance, and control of O. hupensis distribution is critical to protect the health of individuals in endemic areas and to formulate relevant prevention and control strategies in order to reduce the burden of schistosomiasis, and ultimately overcome this epidemic. In this study, we reviewed local chronicles and annual records and extensively surveyed Hubei Province to collect information on the historical, current, and suspected habitats of O. hupensis. Subsequently, we used various geospatial tools (ArcGIS and Google Earth) to visualize the spatial distributions of habitats. Our study provides valuable data that will facilitate more effective habitat management of this intermediate host species and contribute to more precise management of schistosomiasis in China. [ABSTRACT FROM AUTHOR]

• More infected mice were detected in June samples than in September samples. • The sentinel mice infection pattern showed aggregation when the distance was less than or equal to 34.52 km. • Hotspots were detected especially in areas along the Yangtze River, such as the Fu-Lun, Dongjing-Tongshun, and Juzhang River basins. Progress in national schistosomiasis control in China has successfully reduced disease transmission in many districts. However, a low transmission rate hinders conventional snail surveys in identifying areas at risk. In this study, Schistosoma japonicum- infected sentinel mice surveillance was conducted to identify high-risk areas of schistosomiasis transmission in Hubei province, China. The risk of schistosomiasis transmission was assessed using sentinel mice monitoring in Hubei province from 2010 to 2018. Field detections were undertaken in June and September, and the sentinel mice were kept for approximately 35 days in a laboratory. They were then dissected to determine whether schistosome infection was present. Ripley's K -function and kernel density estimation were applied to analyze the spatial distribution and positive point pattern of schistosomiasis transmission. In total, 190 sentinel mice surveillance sites were selected to detect areas of schistosomiasis infection from 2010 to 2018, with 29 (15.26%) sites showing infected mice. Of 4723 dissected mice, 256 adult worms were detected in 112 infected mice. The infection rate was 2.37%, with an average of 2.28 worms detected per infected mouse. Significantly more infected mice were detected in the June samples than in the September samples (χ 2 = 12.11, p < 0.01). Ripley's L (d) index analysis showed that, when the distance was ≤34.52 km, the sentinel mice infection pattern showed aggregation, with the strongest aggregation occurring at 7.86 km. Three hotspots were detected using kernel density estimation: at the junction of Jingzhou District, Gong'an County, and Shashi District in Jingzhou City; in Wuhan City at the border of the Huangpi and Dongxihu Districts, and in the Hannan and Caidian Districts. The results showed that sentinel mice surveillance is useful in identifying high-risk areas, and could provide valuable information for schistosomiasis prevention and control, especially concerning areas along the Yangtze River, such as the Fu-Lun, Dongjing-Tongshun, and Juzhang River basins. [ABSTRACT FROM AUTHOR]

• Spatial empirical analysis is used to estimate the spatial effect between alcohol availability and alcohol-related crashes. • The SDM is found to be the optimal spatial model to characterize the relationship between alcohol outlets and crashes. • Population density and retail density are associated with an increase in alcohol-related crashes. • Dense population and hotels have spillover effects in adjacent zones and the space spillover effects should not be neglected. Introduction: Numerous studies have demonstrated the close relationship between alcohol availability and alcohol-related crashes. However, there is still a lack of spatial empirical analysis regarding this relationship, particularly in large cities of developing countries. Differences in alcohol outlets and drinking patterns in these cities may lead to quite different patterns of crash outcomes. Method: 3356 alcohol-related crashes were collected from the blood-alcohol test report of a forensic institution in Tianjin, China. Density of alcohol outlets such as retail locations, entertainment venues, restaurants, hotels, and companies were extracted based on 2114 Traffic Analysis Zones (TAZ) together with the residential and demographic characteristics. After applying the exploratory spatial data analysis, this research developed and compared the traditional Ordinary Least Square model (OLS), Spatial Lag Model (SLM), Spatial Error Model (SEM) and Spatial Durbin Model (SDM) to explore spatial effects of all the variables. Results: The results of incremental spatial autocorrelation show that the most significant distance threshold of alcohol-related roadway traffic crashes is 3 km. The SDM is found to be the optimal spatial model to characterize the relationship between alcohol outlets and crashes. The number of alcohol-involved traffic crashes is positively related to population density and retail density, but negatively related to the company density, hotel density, and residential density within the same TAZ. Meanwhile, dense population and hotels have reverse spillover effects in adjacent zones. Conclusions: The significant spatial direct effect and spillover effect of alcohol outlet densities on drunk driving crashes should not be neglected. These findings could help improve transportation planning, traffic law enforcement and traffic management for large cities in developing countries. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the prevalence of myopia in key (university-oriented) and non-key elementary schools in China using a traditional and a new criterion for myopia diagnosis in an epidemiological study.Methods: This school-based, cross-sectional study examined students from four key schools and seven non-key schools. Non-cycloplegic autorefraction and visual acuity (VA) were performed on each student. Myopia was defined as a spherical equivalent (SE) refractive error not better than -1.00 D. A questionnaire was also administered.Results: Of the 13,220 students examined, 6,546 (49.5 per cent) had myopia using the criterion of SE not better than -1.00 D. However, 2,246 (34.3 per cent) of these myopes had VA ≥ 0 logMAR in both eyes, indicating they were not functioning as myopes. Thus, a second myopia criterion was adopted: SE refractive error not better than -1.00 D + uncorrected VA ≥ 0 logMAR in at least one eye. By this definition, only 32.5 per cent of the overall sample had myopia. Students in key schools had a higher prevalence of myopia than those in non-key schools (53.8 per cent versus 44.7 per cent) by the initial criterion. By the new criterion, the prevalence of myopia was 41.2 per cent versus 22.7 per cent. Myopia was equal in grade 1 of both school types, but accelerated faster in key schools, where there was a much higher prevalence of myopia by fourth grade, and continued up to 79.2 per cent prevalence by sixth grade based on SE refractive error not better than -1.00 D.Conclusion: Students in more competitive university-oriented elementary schools developed myopia much faster than those in regular schools, although they started with the same level of myopia. Since one-third of the 'myopes' had VA ≥ 0 logMAR in both eyes, they would not be prescribed a correction, or be clinically treated as myopes. A new criterion of SE refractive error not better than -1.00 D + uncorrected VA ≥ 0 logMAR in at least one eye was tested. This criterion is more clinically appropriate and could be used in future epidemiological studies. [ABSTRACT FROM AUTHOR]

Purpose. To assess the changing profile of astigmatism in Chinese schoolchildren and the association between astigmatism changes and ocular biometry. Methods. We examined and followed up 1,463 children aged 6–9 years from Wenzhou, China. We measured noncycloplegic refraction twice each year and tested axial length (AL) and corneal radius of curvature (CRC) annually for two years. We defined clinically significant astigmatism (CSA) as ≤−0.75 diopter (D) and non-CSA astigmatism as ≤0 to >−0.75 D. Results. Prevalence of CSA at baseline was 22.4% (n = 327) and decreased to 20.3% (n = 297) at the two-year follow-up (P=0.046). Ninety-two (8.1%) non-CSA children developed CSA. In multiple regression, after adjusting for age, gender, baseline cylinder refraction, and axis, children who had longer baseline ALs (>23.58 mm; odds ratio (OR) = 5.19, 95% confidence interval (CI): 2.72–9.90) and longer baseline AL/CRC ratio (>2.99, OR = 4.99, 95% CI: 2.37–10.51) were more likely to develop CSA after two years. Four-hundred and two (27.5%) children had increased astigmatism, 783 (53.5%) had decreased, and 278 (19.0%) had no change during the two-year follow-up. Children with increased astigmatism had longer baseline ALs (23.33 mm, P<0.001), higher AL/CRC ratios (2.99 mm, P<0.001), and more negative spherical equivalent refraction (SER) (−0.63 D, P<0.001) compared with the decreased and no astigmatism change subgroups. Also, children in the increased astigmatism subgroup had more AL growth (0.68 mm, P<0.001), higher increases in AL/CRC ratio (0.08, P<0.001), and more negative SER change (−0.86 D, P<0.001) compared with the decreased and no astigmatism change subgroups. Conclusions. The prevalence of astigmatism decreased slightly over the two-year study period. Longer ALs and higher AL/CRC ratios were independent risk factors for developing CSA. Increased astigmatism was associated with AL growth, AL/CRC ratio increases, and the development of myopia. This trial is registered with ChiCTR1800019915. [ABSTRACT FROM AUTHOR]

This study evaluates the impact of health information technology in accessing medical resources and identifies its role in improving health equity. We used 262, 771 records from the electronic medical records and outpatient appointment systems of three clinics for logistic regression to analyze the impact of information technology on patients' access to medical care. We interviewed a few health professionals to gauge their reactions and to validate and understand our quantitative results. The proportion of inpatients affected by information technology is low, accounting for only 16.7% (N = 43, 870). The difference between rural and urban groups is statistically significant, and rural households are more susceptible to information technology. In addition, distance has a significant positive effect. We demonstrate an inverted U-shaped relationship between severity of disease and the impact of information technology. Moreover, our interview results are consistent with our quantitative results. Quantitative and interview results suggest that health information technology plays a positive role in accessing medical care for patients with rural household and those in remote areas. Meanwhile, this effect is complex for patients with different severities of illnesses. Governments and managers should vigorously promote health information technology for healthcare delivery in the future and focus their attention on patients with serious diseases. [ABSTRACT FROM AUTHOR]

This study presents a spatial approach for the macrolevel traffic crashes analysis based on point-of-interest (POI) data and other related data from an open source. The spatial autoregression is explored by Moran's I Index with three spatial weight features (i.e., (a) Rook, (b) Queen, and (c) Euclidean distance). The traditional Ordinary Least Square (OLS) model, the Spatial Lag Model (SLM), the Spatial Error Model (SEM), and the Spatial Durbin Model (SDM) were developed to describe the spatial correlations among 2,114 Traffic Analysis Zones (TAZs) of Tianjin, one of the four municipalities in China. Results of the models indicated that the SDM with the Rook spatial weight feature is found to be the optimal spatial model to characterize the relationship of various variables and crashes. The results show that population density, consumption density, intersection density, and road density have significantly positive influence on traffic crashes, whereas company density, hotel density, and residential density have significant but negative effects in the local TAZ. The spillover effects coefficient of population density and road density are positive, indicating that the increase of these variables in the surrounding TAZs will lead to the increase of crashes in the target zone. The impacts of company density and hotel density are just the opposite. In general, the research findings can help transportation planners and managers better understand the general characteristics of traffic crashes and improve the situation of traffic security. [ABSTRACT FROM AUTHOR]

Type 2 diabetes [T2D] and thyroid dysfunction [TD] often co-occur, have overlapping pathologies, and their risk increases with age. Since 1995, universal salt iodization has been implemented in China to prevent disorders caused by iodine deficiency. However, after two decades of implementation of universal salt iodization, the prevalence of TD in elderly Chinese patients with T2D is not well described and may have been underestimated. We conducted a questionnaire-based survey across 24 endocrinology centers in China between December 2015 and July 2016. Demographic and clinical data from 1677 patients with T2D were obtained and analyzed to examine the prevalence of TD along with T2D in these patients. We assessed TD prevalence according to the four TD subtypes [subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism], TD history, gender, and age. The diagnosis rates were calculated for TD and also for the TD subtype. The number of patients reaching treatment goals for T2D [hemoglobin A1c <7%] and TD [normal free thyroxine and thyroid-stimulating hormone [TSH]] and the incidences of complications and comorbidities were recorded. Among the enrolled patients with T2D [N = 1677], TD was diagnosed in 23.79% [399/1677] out of which 61% (245/399) were previously diagnosed and 38.59% (154/399) were newly diagnosed cases. Subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism were reported in 4.89%, 9.3%, 1.13%, and 3.16% of the total population, respectively. Among patients previously diagnosed with TD, the incidence in women [166/795; 20.88%] was higher than in men [79/882; 8.96%]. The treatment goals for TD and T2D were attained in 39.6% [97/245] and 34.41% [577/1677] of the cases, respectively. Diabetic complications and comorbidities were reported in 99.7% of patients, with peripheral neuropathy being the most common [43.46%] followed by cataract [24.73%]. We had found that the incidences of dyslipidemia, elevated LDL levels, and osteoporosis were significantly higher in patients with TD than those without TD. TD is underdiagnosed in elderly Chinese patients with T2D. [ABSTRACT FROM AUTHOR]

Arsenian pyrite in the Shuiyindong Carlin-type gold deposit in Guizhou, China, is the major host for gold with 300 to 4,000 ppm Au and 0.65 to 14.1 wt.% As. Electron miroprobe data show a negative correlation of As and S in arsenian pyrite, which is consistent with the substitution of As for S in the pyrite structure. The relatively homogeneous distribution of gold in arsenian pyrite and a positive correlation of As and Au, with Au/As ratios below the solubility limit of gold in arsenian pyrite, suggest that invisible gold is likely present as Au in a structurally bound Au complex in arsenian pyrite. Geochemical modeling using the laser ablation-inductively coupled plasma mass spectrometry (LA-ICP-MS) analysis of fluid inclusions for the major ore forming stage shows that the dominant Au species were Au(HS) (77%) and AuHS (23%). Gold-hydroxyl and Gold-chloride complexes were negligible. The ore fluid was undersaturated with respect to native Au, with a saturation index of −3.8. The predominant As species was HAsO. Pyrite in the Shuiyindong deposit shows chemical zonation with rims richer in As and Au than cores, reflecting the chemical evolution of the ore-bearing fluids. The early ore fluids had relatively high activities of As and Au, to deposit unzoned and zoned arsenian pyrite that host most gold in the deposit. The ore fluids then became depleted in Au and As and formed As-poor pyrite overgrowth rims on gold-bearing arsenian pyrite. Arsenopyrite overgrowth aggregates on arsenian pyrite indicate a late fluid with relatively high activity of As. The lack of evidence of boiling and the low iron content of fluid inclusions in quartz, suggest that iron in arsenian pyrite was most likely derived from dissolution of ferroan minerals in the host rocks, with sulfidation of the dissolved iron by HS-rich ore fluids being the most important mechanism of gold deposition in the Shuiyindong Carlin-type deposit. [ABSTRACT FROM AUTHOR]

The effects of petroleum retention within and expulsion from five intervals within the Triassic Chang 7 Member in the Ordos Basin in China have been demonstrated by deciphering a large suite of petrologic, organic petrographic, and organic geochemical analyses on 106 core samples. Organic properties and lithological heterogeneities control the amount and chemical composition of retained petroleum. Enrichment of aliphatic hydrocarbons in the silty, organic-lean intervals versus enrichment of aromatic fluids in the clayey, organic-rich units are probably caused by compositional fractionation occurred during primary and short-distance secondary migration. Migration of excess petroleum from organic-rich units to those organic-lean counterparts was further corroborated by the negative expulsion efficiencies calculated using a mass-balance model in the organic-lean intervals. Capillary pressure difference induced by the contrast in pore throat size of the clayey, organic-rich versus the silty, organic-lean intervals is postulated to be the major driver for the migration. A significant implication of this study is that the hydrocarbons in the first and fourth intervals constitute potential petroleum exploitation targets, given (i) improved oil quality caused by enriched aliphatic compounds versus viscous aromatic and polar compounds, (ii) lower organic matter sorption affinities, (iii) relatively high contents of brittle minerals in these two intervals. Despite its high content of retained hydrocarbons, the organic-rich fifth interval is not the best target, which is mainly due to the high sorption affinity of the organic matter structure, thereby causing low oil mobility and producibility. • The organic richness and lithological compositions control the amount and chemical composition of retained petroleum. • Primary migration leads to the fractionation of hydrocarbon compositions in organic-lean and organic-rich intervals. • Intervals with high oil saturation and negative expulsion efficiencies are potential petroleum exploitation targets. [ABSTRACT FROM AUTHOR]

• Some toll-like receptor genes initiate immune responses after pathogen detection. • Genetic diversity of these genes among Yunnan native cattle breeds was studied. • Genetic diversity of TLR3 and TLR8 varied among the five cattle breeds studied. • We provide genetic insight for the development of disease-resistant cattle breeds. Members of the Toll-like receptor (TLR) gene family have central roles in initiating innate immune responses after the detection of invading pathogens. In this study, we evaluated the genetic diversity of TLR3 and TLR8 genes among five Chinese native cattle breeds - Yunnan humped (DHMS), Wenshan (WSGN), Dianzhong (CXSB), Zhaotong (ZTGN), and Dengchuan (DLEY) cattle in Yunnan, southwest China. Our results showed that both genes had lower genetic diversity and haplotype diversity in DHMS cattle compared to those of other breeds. Additionally, population genetic analyses of TLR8 suggested that WSGN, DLEY, and ZTLD cattle had experienced a historic population contraction. Analyses of both TLR3 and TLR8 indicated significant negative Fay and Wu's H values (-4.19, p = 0.043 and -6.81, p = 0.004) for Yunnan humped cattle, suggesting recent adaptive evolution. In particular, the distribution of non-synonymous mutations differed among the five Chinese native cattle breeds in Yunnan, implying substantial genetic differences. Furthermore, the predicted functional effects of amino acid substitutions showed that the frequency of damage was lower in DHMS compared to the other four breeds. Thus, our findings suggest that the genetic diversity of TLR3 and TLR8 varied among the five cattle breeds studied, providing important genetic insights into disease resistance in these breeds. [ABSTRACT FROM AUTHOR]

Background: Limited information is available on the long-term risk of cardiovascular disease (CVD) associated with hypertriglyceridaemia (HTG) in the Chinese population. We estimated this risk over a 23-year period in participants recruited from among those included in the Da Qing Diabetes Study.Methods: A total of 833 Chinese adults including 379 with normal glucose levels and 454 with hyperglycaemia were identified by their oral glucose tolerance in 1986 in Da Qing, China. CVD outcomes were monitored until 2009. Thirty-four percent (280/833) of the participants had HTG, which was defined as a fasting plasma triglyceride (TG) level ≥ 1.7 mmol/L, at the baseline time point.Results: Over the 23-yearfollow-up period, 149 subjects in the HTG group and 190 subjects in the non-HTG group (NTG group) experienced their first CVD event, including fatal or nonfatal myocardial infarction (MI) and stroke. The age and sex-adjusted annual incidence of the first CVD event per 1000 person-years was 30.23 for the HTG group vs 18.68 for the NTG group. The corresponding rates for MI and stroke were 7.71 vs 3.89 and 19.55 vs 13.98, respectively. After adjusting for confounders, the HTG group had a 28% higher risk of the first CVD event than the NTG group. This association was significant among only the subjects with a serum cholesterol level > 5.7 mmol/L and those with diabetes or impaired glucose tolerance (IGT).Conclusion: HGT predicted a substantially higher subsequent long-term risk of the first CVD event in Chinese adults, especially in those with hypercholesterolaemia and hyperglycaemia. [ABSTRACT FROM AUTHOR]

Background: The last decade has witnessed many achievements in China's health care industry, but the industry still faces major challenges among which the uneven distribution of medical resources and the imbalance between supply and demand are the most pressing problems. Although mobile health (mHealth) services play a significant role in mitigating problems associated with health care delivery, their adoption rates have been low. Objective: The objective of this study was to explore the impact of resource scarcity and resource accessibility on the adoption of mHealth from the perspective of resource competition, to examine the concerning factors, and to provide a theoretical basis for promoting mHealth in China. Methods: We used 229,516 original registration records of outpatients to conduct an empirical analysis to examine the adoption of mHealth services from the perspective of resource competition. Results: The adoption rate of mobile services for outpatients was low, accounting for only 31.5% (N=71,707). The empirical results indicated that resource scarcity (beta=.435, P =.01) and accessibility (beta=−.134, P =.02) have a significant impact on the adoption of mHealth. In addition, gender (beta=.073, P =.01) and age (beta=−.009, P <.001) are significantly related to adoption of mHealth. Experience with mHealth has a moderating role in the relationship between resource scarcity (beta=−.129, P =.02), accessibility (beta=.138, P =.04), and adoption of mHealth. Conclusions: In this study we demonstrate that the external environment (resource scarcity and resource accessibility) has a significant impact on the adoption of mHealth. This study also demonstrates that experience with mHealth has a moderating role in the relationship between the elements of the external environment. Finally, we confirm that mHealth is a key factor in the delivery and allocation of medical resources and provide a theoretical basis for government agencies to develop policies on mHealth. [ABSTRACT FROM AUTHOR]

In this study, a sampling rate-corrected in vivo solid-phase microextraction-gas chromatography-mass spectrometry method (SR- in vivo SPME-GC-MS) was constructed to simultaneously detect fipronil and three of its metabolites in garlic, and their environmental behavior was long-term monitored in in vivo mode. All of three fipronil metabolites were more difficult to degrade than the parent pesticide. The final degradation rates of the metabolites in garlic were in the range of 4.4%-25.1%, much lower than that of the parent (78.6%-85.8%). While their total residues amount was about 3 times as high as fipronil, exceeding the maximum residue limits regulated by China and the European Union. The steady-state concentrations of fipronil and its metabolites in garlic were positively correlated with the pesticide stress dose. In short, the established in vivo tracking method is efficient and convenient. The features of simple operation, fast analysis, acceptable sensitivity, non-harmful or non-lethal to plants, available repeated and long-term monitoring of the same organism make it attractive for in vivo tracking assay, it is of great significance for the guidance of rational use of fipronil and protection of food safety. [Display omitted] • An innovative SR-in vivo SPME-GC-MS method was constructed. • The environmental behavior of fipronil and its metabolites in garlic was long-term monitored in in vivo mode. • The absorption, accumulation, metabolism, and elimination of fipronil and its metabolites in garlic were explored. • The method is simple, fast, efficient, non-destructive or non-lethal. [ABSTRACT FROM AUTHOR]

The development of electric vehicles (EVs) is expected to play an important role in achieving the emission reduction targets in the transportation sector by many countries and regions, including China's dual carbon goals. A bottleneck to the mass roll-out of EVs is the limited charging facilities. This paper considers the planning of charging facilities for a new developing area in a metropolis, and an optimization model for charging station planning based on the dynamic transportation system is proposed. The proposed model is developed using an objective framework that considers the spatio-temporal characteristics of EV charging demand in order to minimize the overall cost while the constraints from suppliers and drivers are met. The Voronoi diagram is used to determine the final service boundary of each charging station, and the effect is verified in the planning of charge stations for the Yizhuang new town in Beijing. The case study confirms that the proposed method can optimize the charging facilities that fit well with the traffic network conditions. Furthermore, it is shown that the charging demand varies in accordance with the population density and regional functionality in different areas. [ABSTRACT FROM AUTHOR]

Aims: To examine the long-term influence of metabolic syndrome (MetS) on death and vascular complications.Methods: Altogether, 1419 individuals with different levels of glycemia and MetS were recruited for this study. The participants were followed up for 30 years to assess outcomes.Results: Compared with the non_MetS, individuals with impaired glucose tolerance (IGT) plus MetS had a higher incidence (per 1000 person-years) of all-cause death (20.98 vs 11.70, hazard ratio [HR] = 1.84), macrovascular events (29.25 vs 15.94, HR = 1.36), and microvascular complications (10.66 vs 3.57, HR = 1.96). The incidence of these outcomes was even higher in participants with type 2 diabetes mellitus (T2DM) plus MetS. The T2DM without MetS shared a comparable risk profile of the outcomes with the T2DM plus MetS group (HRs were 3.45 vs 3.15, 2.21 vs 2.65, and 6.91 vs 7.41, respectively).Conclusions: The degree of hyperglycemia in MetS is associated with the severity of death and both micro- and macrovascular complications. T2DM was associated with a comparable risk for all outcomes as T2DM plus MetS. The findings highlight the need of early prevention of diabetes in individuals with IGT plus MetS, while the justification to redefine a subgroup of patients with T2DM as having MetS remains to be clarified. [ABSTRACT FROM AUTHOR]

Hexachlorobutadiene, pentachloroanisole, and chlorobenzenes are regulated to control their release into the environment. There is little information regarding the distribution and risks of these pollutants in Chinese rivers. Therefore, we selected a prosperous agricultural and industrial region in South China as our study area and investigated the contamination profiles and risks of these pollutants in sediment and fish tissue samples. The results showed that, when compared with their levels in sediment, these lipophilic pollutants tended to accumulate in fish tissues in the following order: liver > brain > muscle. Some trichlorobenzene was found to be the result of reductive dechlorination of higher chlorinated benzenes. Hexachlorobutadiene and hexachlorobenzene could pose medium risks at certain sampling sites, but in general, almost no risk was found to the ecosystem. When the estimated daily human intakes of analytes through fish consumption were calculated for different age groups, the results suggested the analytes were unlikely to be a serious health concern for human. Our results could be used to update the existing data on the occurrence of these pollutants in the aquatic environment and to provide information for further pollution control by the local government. [Display omitted] • HCBD, PCA, and CB residues in an aquatic environment of South China were studied. • Target pollutant levels followed the order of liver > brain > muscle ≈ sediment. • Microbial reductive dechlorination could affect the TCB content of sediment. • Target pollutant residues did not pose serious risks to ecosystems or humans. [ABSTRACT FROM AUTHOR]

Aims: To examine whether high-sensitivity C-reactive protein (hs-CRP) can predict all-cause death in Chinese adults with hyperglycemia.Methods: All the 237 diabetes and 49 prediabetes recruited in the study were evolved from the participants with impaired glucose tolerance in the original Da Qing Diabetes Study. Blood hs-CRP level was measured at 2006. Ten-year outcome of death was traced from 2006 to 2016. Cox model was used to analyse the association between hs-CRP level and the risk of all-cause death occurred over the subsequent 10 years.Results: During the follow-up, death occurred in 36 (37.9%) subjects in the highest hs-CRP tertile group (hs-CRP > 2.16 mg/L) and 19 (20.0%) in the lowest hs-CRP tertile group (hs-CRP < 0.82 mg/L, p < 0.05). The corresponding incidence of all-cause death (per 1,000 person-years) was 44.7 (95% CI 30.1-59.3) and 21.6 (95% CI 11.9-31.3) in the two groups respectively (p < 0.0001). The highest hs-CRP tertile was associated with the increased risk of all-cause death significantly (hazard ratio 1.88, 95% CI 1.07-3.32) after controlling for traditional risk factors.Conclusions: Serum hs-CRP was predictive of 10-year all-cause death in Chinese adults with hyperglycemia, suggesting the impact of low-grade inflammation on mortality deserves more attention. [ABSTRACT FROM AUTHOR]

Chang 7 Shale, characterized by lacustrine black organic-rich shales and interbedded siltstones, has become a target for shale oil exploration and development in the Upper Triassic Ordos Basin, China. However, the heterogeneous enrichment of organic matter (OM) has led to controversy regarding source rock evaluation and difficulty in accurate prediction of favorable zones. Sequence stratigraphy, as a tool for prediction of sedimentary deposits has encountered challenges in lacustrine deep-water environments because of rapid facies changes and limited lateral continuity of key beds. In this study, a novel method is proposed to predict OM enrichment based on parasequences division and calibration of well logging and core lithology through analyses of thin sections and geochemical data from 238 core samples, as well as available well-logging data from a selected well. Chang 7 shales were simplified into three facies in terms of sedimentary structure and mineral composition, combining geological genesis with lateral correlation. Argillaceous laminated shale (Facies 2), with the highest average total organic carbon and S 1 + S 2 values, is the most favorable facies for shale oil exploration. The Chang 7 Member was divided into 15 parasequences and six parasequence sets, within one transgressive-regressive sequence. Depositional sequences have a significant effect on the enrichment of OM, given 1) the influence of lake-level fluctuations on OM accumulation, 2) the OM enrichment determined by shale facies, and 3) the distribution of shale facies controlled by p arasequences. In particular, the most favorable locations are the bases of parasequences (generally the lower third to half from the bottom) in the TST and early RST. The application of this method to a test well showed excellent performance based on verification from the organic geochemical data of 86 samples. Five favorable targets of Facies 2 were marked within fifteen favorable locations. By linking meter-level depositional sequences with centimeter-level OM enrichment, this study provides an alternative approach to determine the target area in a single well profile and realize isochronous inter-well prediction for deep-water shales. • Shale facies and organic matter enrichment has high degree correlation. • The favorable shale facies in the TST and early RST is controlled by parasequences. • The favorable locations are the lower third to half from the bottom of parasequences. • The favorable facies was distinguished by well-logging lithology identification. • An isochronous prediction method of organic matter enrichment was proposed. [ABSTRACT FROM AUTHOR]

Background: This study explored the influence of type 2 diabetes and impaired glucose tolerance (IGT) on the risk of the multimorbidity cluster of cardiovascular disease (CVD) and cancer., Methods: A total of 1629 participants in the Da Qing Diabetes Prevention Outcome Study were recruited in the present analysis, including normal glucose tolerance (NGT, N = 492), IGT (N = 540), and newly diagnosed type 2 diabetes (N = 597) groups. Cox proportional hazards analyses were performed to assess the relationship between NGT, IGT, and newly diagnosed type 2 diabetes and the risk of the multimorbidity cluster of CVD and cancer., Results: The incidence rates for multimorbidity cluster CVD and cancer were 1.25, 3.17, and 3.23 per 1000 person-years in people with NGT, IGT, and the newly diagnosed type 2 diabetes groups, respectively, over 34-year follow-up. Cox analysis revealed that diabetes status (as time-dependent variable) was significantly associated with the subsequent increased risk of multimorbidity cluster of CVD and cancer compared with non-diabetes (hazard ratios [HR] = 2.55, 95% confidence interval [CI] 1.51-4.31) after adjustment of potential confounders. Similar analysis showed that this risk was significantly higher in the IGT and newly diagnosed type 2 diabetes groups compared with NGT, with HR of 3.28 (95% CI 1.83-5.87) and HR of 3.90 (95% CI 2.14-7.09), respectively. Whereas compared diabetes with IGT group, this risk was not significantly different., Conclusions: Similar to newly diagnosed type 2 diabetes, IGT is significantly associated with an increased risk of the multimorbidity cluster of CVD and cancer compared with NGT. This finding highlights the urgent need for an active detection of IGT and effective prevention and management of diabetes., Competing Interests: Declarations Ethics approval and consent to participate This study was approved by the institutional review boards of the Fuwai Hospital, Chinese Academy of Medical Science (number of the ethics approval, 2015 − 733). All surviving participants and proxies for the deceased participants provided written informed consent. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: The association between years of non-diabetes status after diagnosis of impaired glucose tolerance (IGT) and the risk of long-term death and cardiovascular outcomes needed to be clarified., Methods and Findings: In this post hoc analysis, we included 540 individuals with IGT who participated in the original Da Qing Diabetes Prevention Study (DQDPS). In the DQDPS, all participants were diagnosed with IGT by a 75 g oral glucose tolerance test and randomized to intervention or control groups with a 6-year lifestyle intervention trial. After the completion of the trial, death, cardiovascular events, and microvascular complications were monitored over a 30-year follow-up. In this post hoc analysis, the Cox analysis assessed the extended risk of these outcomes in individuals who either remained non-diabetes status or progressed to diabetes at the end of 2, 4, and 6 years after diagnosis of IGT. In all participants, the difference in the cumulative incidence rate of the outcomes between the diabetes and non-diabetes group gradually increased over 30 years. Compared with the diabetes group, a significantly lower risk of all-cause death (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.57 to 0.97, p = 0.026), cardiovascular events (HR: 0.63; 95% CI: 0.49 to 0.82, p < 0.001), and microvascular complications (HR: 0.62; 95% CI: 0.45 to 0.86, p = 0.004) first emerged in individuals who remained non-diabetes at the 4 years visit, whereas the significant risk reduction in cardiovascular death was first observed at the end of 6 years (HR: 0.56; 95% CI: 0.39 to 0.81, p = 0.002) after adjustment for age, sex, smoking status, BMI, systolic blood pressure, blood glucose, total cholesterol, intervention, and medications (including insulin plus oral hypoglycaemics, antihypertensives, and lipid-lowering agents). The results in the original intervention group alone were similar to the whole group. The main limitations of our study are the limited number of participants and the sole ethnicity of the Chinese population., Conclusions: In this study, we observed that maintaining several years of non-diabetes status after IGT diagnosis was associated with a significant reduction in long-term risk of death and vascular complications, and for most of these outcomes, maintaining at least 4 years of non-diabetes status may be needed to achieve a significant risk reduction., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Qian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Traffic violation is one of the leading causes of traffic crashes. In the context of global aging, it is important to study traffic violations by elderly drivers for improving traffic safety in preparation for a worldwide aging population. In this study, a hybrid approach of Latent Class Analysis (LCA) and XGBoost based SHAP is proposed to identify hidden clusters and to understand the key contributing factors on the severity of traffic violations by elderly drivers, based on the police-reported traffic violation dataset of Beijing (China). First, LCA is applied to segment the dataset into several latent homogeneous clusters, then XGBoost based SHAP is established on each cluster to identify feature contributions and the interaction effects of the key contributing factors on the severity of traffic violations by elderly drivers. Two comparison groups were set up to analyze factors, which are responsible for the different severities of traffic violations. The results show that elderly drivers can be classified into four groups by age, urban or not, license, and season; factors such as less annual number of traffic violations, national & provincial highway, night and winter are key contributing factors for higher severity of traffic violations, which are consistent with common cognition; key contributing factors for all clusters are similar but not identical, for example, more annual number of traffic violations contribute to more severe violation for all clusters except for Cluster 2; some factors which are not key contributing factors may affect the severity of traffic violations when they are combined with other factors, for example, the combination of lower annual number of traffic violations and county & township highway contributes to more severe violation for Cluster 1. These findings can help government to formulate targeted countermeasures to decrease the severity of traffic violations by specific elderly groups and improve road service for the driving population.

Background: Helicobacter pylori (Hp) is a global public health concern, particularly among children. While the "detection and treatment" approach gains ground in adult patients, paediatricians have divergent opinions regarding the current clinical protocols for diagnosing and treating Hp infection. Some argue for its potential impact on children's growth, emphasizing the need for adequate attention. Additionally, there are uncertainties regarding the appropriate screening tests for children who require Hp testing or have functional dyspepsia., Objective: This study aims to investigate pediatricians' current perspectives and understanding of Hp infection to provide valuable insights for Hp treatment., Methods: This study employs a cross-sectional research design. A questionnaire was designed using the "Questionnaire Star" platform and distributed online to physicians participating in the 12th Shanghai Pediatric Gastroenterology Forum in September 2020. The questionnaire covered topics such as physician professional information, the status of Hp diagnosis in hospitals, Hp knowledge, and knowledge of Hp treatment. Categorical data from each group were analyzed using chi-square tests to understand the diagnostic and treatment practices of pediatricians regarding Hp infection., Results: Among the 218 participating physicians who completed the questionnaire, 49.5% specialized in gastroenterology and practiced in hospitals equipped with Hp testing capabilities. Additionally, 85.8% practiced in hospitals with electronic gastroscopes. Notably, 94% considered Hp an infectious disease. Pediatric gastroenterology specialists, in particular, favored endoscopy for Hp detection compared to non-pediatric gastroenterologists. The investigation revealed variations in Hp detection understanding and consensus among the enrolled physicians. Challenges included determining the age for initiating Hp treatment in children and implementing family-based strategies., Conclusions: Further research is essential to inform the development of comprehensive detection and treatment strategies for Hp infection in children. Currently, the primary approach may involve individualized and standardized diagnosis and treatment.

Background: Higher levels of palmitoyl sphingomyelin (PSM, synonymous with sphingomyelin 16:0) are associated with an increased risk of cardiovascular disease (CVD) in people with diabetes. Whether circulating PSM levels can practically predict the long-term risk of CVD and all-cause death remains unclear. This study aimed to investigate whether circulating PSM is a real predictor of CVD death in Chinese adults with or without diabetes., Methods: A total of 286 and 219 individuals with and without diabetes, respectively, from the original Da Qing Diabetes Study were enrolled. Blood samples collected in 2009 were used as a baseline to assess circulating PSM levels. The outcomes of CVD and all-cause death were followed up from 2009 to 2020, and 178 participants died, including 87 deaths due to CVD. Cox proportional hazards regression was used to estimate HRs and their 95% CIs for the outcomes., Results: Fractional polynomial regression analysis showed a linear association between baseline circulating PSM concentration (log-2 transformed) and the risk of all-cause and CVD death (p < 0.001), but not non-CVD death (p > 0.05), in all participants after adjustment for confounders. When the participants were stratified by PSM-tertile, the highest tertile, regardless of diabetes, had a higher incidence of CVD death (41.5 vs. 14.7 and 22.2 vs. 2.9 per 1000 person-years in patients with and without diabetes, respectively, all log-rank p < 0.01). Individuals with diabetes in the highest tertile group had a higher risk of CVD death than those in the lowest tertile (HR = 2.73; 95%CI, 1.20-6.22)., Conclusions: Elevated PSM levels are significantly associated with a higher 10-year risk of CVD death, but not non-CVD death, in Chinese adults with diabetes. These findings suggest that PSM is a potentially useful long-term predictor of CVD death in individuals with diabetes., (© 2024. The Author(s).)

Fine particulate matter (PM 2.5 ) samples collected in 2018 in Taiyuan, a typical industrial and mining city in North China Plain (NCP), were characterized based on ultrahigh-performance liquid chromatography (UHPLC) coupled with orbitrap mass spectrometry. Potential molecular identifications based on precise molecular weight were conducted to obtain the compositional and source information of organic aerosols (OAs) in this city. Evident variation trends were observed during the sampling period in the composition, degree of oxidation and saturation of the obtained molecules. The proportion of CHOS- and CHO+ were increased from winter to summer and then decreased, conversely the proportion of CHN+ was decreased from winter to summer and then increased. By reclassifying the molecules, OA molecules were observed to be more saturated and oxidized in summer. It was caused by the high abundance of organosulfates (OSs) in summer, and aromatic amines/N-heterocycle aromatic hydrocarbons (PANHs) in winter. Molecular identification indicated that the OSs were basically originated from biogenic source isoprene or monoterpene, while the aromatic amines and PANHs were related to anthropogenic emissions of fossil fuel combustion, like other cities in the NCP area. The prevailing northwesterlies in winter may bring coal-burning pollutants from other cities, while the high abundance of organosulfates in summer may be related to the PM 2.5 transportation from Shijiazhuang. This study firstly demonstrates the molecular composition characteristics, potential sources, and geographical origins of PM 2.5 in Taiyuan, which gives a comprehensive understanding of PM 2.5 in a typical industrial and mining city., 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.)

Background: Gastric cancer (GC) is one of the leading causes of cancer deaths with high heterogeneity. There is currently a paucity of clinically applicable molecular classification system to guide precise medicine., Methods: A total of 70 Chinese patients with GC were included in this study and whole-exome sequencing was performed. Unsupervised clustering was undertaken to identify genomic subgroups, based on mutational signature, copy number variation, neoantigen, clonality, and essential genomic alterations. Subgroups were characterized by clinicopathological factors, molecular features, and prognosis., Results: We identified 32 significantly mutated genes (SMGs), including TP53, ARID1A, PIK3CA, CDH1, and RHOA. Of these, PREX2, PIEZO1, and FSIP2 have not been previously reported in GC. Using a novel genome-based classification method that integrated multidimensional genomic features, we categorized GC into four subtypes with distinct clinical phenotypes and prognosis. Subtype 1, which was predominantly Lauren intestinal type, harbored recurrent TP53 mutation and ERBB2 amplification, high tumor mutation burden (TMB)/tumor neoantigen burden (TNB), and intratumoral heterogeneity, with a liver metastasis tendency. Subtype 2 tended to occur at an elder age, accompanying with frequent TP53 and SYNE1 mutations, high TMB/TNB, and was associated with poor prognosis. Subtype 3 and subtype 4 included patients with mainly diffuse/mixed type tumors, high frequency of peritoneal metastasis, and genomical stability, whereas subtype 4 was associated with a favorable prognosis., Conclusions: By integrating multidimensional genomic characteristics, we proposed a novel genomic classification system of GC associated with clinical phenotypes and provided a new insight to facilitate genome-guided risk stratification and disease management., (© 2021. The Author(s).)

We reported the discovery and identification of emerging sulfur-containing polycyclic aromatic hydrocarbons, namely polycyclic aromatic sulfur heterocycles (PASHs), in PM 2.5 collected from two typical regions of China, Taiyuan and Guangzhou. Until now, there is no research on contamination status, sources and potential health risks of this unexpected group of organic contaminants in PM 2.5 . High atmospheric concentrations (ngm -3 ) and significant time-dependent variations were determined in PM 2.5 of Taiyuan from 2017 to 2018. Coal combustion/secondary formation and traffic emission/secondary formation were apportioned as possible pollution sources for the PM 2.5 -bound PASHs in Taiyuan and Guangzhou, respectively. Dithiothreitol and cell viability assays were applied for evaluations of PASH-induced reactive oxygen species (ROS) production and cell toxicity based on the determined real exposure levels for adults. The results illustrated that PASHs in PM 2.5 possibly caused oxidative stress and inhibition of human bronchial epithelial cells in seriously polluted regions such as Taiyuan, suggesting that the pollutant-induced health concerns may need more investigations. This study provides new insights into PM 2.5 pollution, and is beneficial for the development of effective contamination control strategies and reduction of risks on public health., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Aim: To examine the clinical characteristics, laboratory tests, imaging and electroencephalography presentation, treatment, and prognosis of anti-leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis and improve the awareness of this disease., Method: We performed a retrospective analysis of the clinical data of 41 patients who were diagnosed with anti-LGI1 encephalitis. Their clinical characteristics, laboratory tests, and imaging and electroencephalography data were collected, and the treatment results and prognosis were evaluated. The modified Rankin Scale (mRS) was used to evaluate neurological function., Results: A total of 41 patients were included in the study, the average follow-up time is 33.0 months.The initial symptoms included cognitive impairment (n = 16, 39.0%),faciobrachial dystonic seizures (FBDS) (n = 12, 29.3%), grand mal seizures (n = 5, 12.2%) hallucinations (n = 4, 9.8%), loss of consciousness (n = 2, 4.9%), nausea and vomiting (n = 1, 2.4%),and head discharge-like sensation and radiate one limb (n = 1, 2.4%). There were 20 and 21 patients in the good (mRS ≤ 2) and poor (mRS > 2) prognosis groups, respectively. In the good prognosis group, the initial symptoms included faciobrachial dystonic seizures (FBDS) (n = 6, 30.0%), cognitive impairment (n = 6, 30.0%), hallucinations (n = 4, 20.0%), grand mal seizures (n = 3, 15.0%), loss of consciousness (n = 2, 10.0%), and nausea and vomiting (n = 1, 5.0%). There were 10 patients with hyponatremia. Magnetic resonance imaging (MRI) showed limbic system involvement in 12 patients (60.0%).17 patients (85.0%) recovered, 2 (10.0%) showed significant improvement, and 1 (5.0%) died after a mean follow-up period of 36.9 months. In the poor prognosis group, the initial symptoms included FBDS (n = 6, 28.5%), cognitive impairment (n = 10, 47.6%), grand mal seizures (n = 2, 9.5%), and electric shock-like sensation in the left limbs (n = 1, 4.7%). There were 20 patients with hyponatremia. MRI showed limbic system involvement in 11 patients (52.4%). 11 patients (52.4%) recovered, 8 (38.1%) showed significant improvement, and 2 (9.5%) died after a mean follow-up period of 29.0 months., Conclusions: The clinical characteristics of anti-LGI1 encephalitis include hyponatremia, FBDS, epileptic seizures, hallucinations, cognitive impairment, and loss of consciousness, while the rarely seen characteristics are nausea, vomiting, and other autonomic dysfunctions and electric shock-like sensation. The appearance of hallucinations often indicates a good prognosis.Hyponatremia and elevated cerebrospinal fluid protein levels can be used as indicators that affect the prognosis of patients.Limbic system involvement has nothing to do with prognosis.Attention should be paid to early diagnosis and timely first-line immunotherapy., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Precis: Aerosols generated by a noncontact tonometer (NCT) were quantified. There was a positive correlation between aerosols and intraocular pressure (IOP), and the concentration of aerosols beside the air jet port was the highest., Purpose: To investigate the effects of IOP on the aerosol density generated during the use of an NCT and provide references and suggestions for daily protection of ophthalmic medical staff during the coronavirus disease-19 (COVID-19) outbreak., Objective and Methods: This cross-sectional clinical trial included 214 eyes of 140 patients from a hospital in Wenzhou city, Zhejiang Province. All subjects' IOPs were measured by an NCT (39 eyes with low IOP, 90 eyes with normal IOP, 37 eyes with moderately high IOP, and 48 eyes with very high IOP) between March 7 and June 17, 2020. The density of particulate matter (PM) 2.5 and PM10 generated during the process of IOP measurement with an NCT was analyzed. IOP values were recorded simultaneously. The aerosols generated during different IOP measurements were plotted in scatter plots., Results: PM2.5 was generated more at the air jet port of the tonometer during the process of IOP measurement (H=2.731, P=0.019). Larger quantities of PM2.5 and PM10 were generated when the IOP was higher, and these differences were statistically significant (PM2.5: H=119.476, P<0.001; PM10: H=160.801, P<0.001). Linear correlation analysis with one variable demonstrated that IOP had significantly positive correlations with PM2.5 (r=0.756, P<0.001) and PM10 (r=0.864, P<0.001)., Conclusions: Aerosols can be generated while using an NCT to measure IOP, and aerosols and IOP are positively correlated. Patients with moderately high IOP or very high IOP tend to generate more aerosols during the IOP measurement. The concentration of aerosols beside the air jet port was the highest.

Objective: In December 2019, coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. Online fever clinics were developed by hospitals, largely relieving the hospital's burden. Online fever clinics could help people stay out of crowded hospitals and prevent the risk of cross infections. The objective of our study was to describe the patient characteristics of an online fever clinic and explore the most important concerns and question of online patients., Materials and Methods: Our study extracted data from fever clinic records in medical information systems from January 24 to February 18, 2020 in a tertiary hospital in Wuhan. We described the characteristics of patients in fever clinic, then we extracted and classified questions of patient consultations through the online fever clinic dataset., Results: For the 64 487 patients who attended the online fever clinic, the average age was 30.4 years, and 37 665 (58.4%) were female patients. The current state of patients from online were home without isolation (52 360 [81.2%]), home isolated (11 152 [17.29%]), and outpatient observation (975 [1.51%]). From the 594 patient questions analyzed, confirming diagnosis and seeking medical treatment account for 60.61% and 38.05%, respectively, followed by treating (25.59%), preventing (4.38%), and relieving anxiety (1.68%)., Discussion: Online fever clinics can effectively relieve patients' mood of panic, and doctors can guide patients with suspected of COVID-19 to isolate and protect themselves through online fever clinic. Online fever clinics can also help to reduce the pressure of hospital fever clinics and prevent cross infection., Conclusions: This study indicated the importance of online fever clinics during the COVID-19 outbreak for prevention and control., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)