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Background: In China, tuberculous pleural effusion is the most common cause for pleural effusion. Elevated ADH and positive tuberculin test usually are characteristic of tuberculous pleural effusion. We reported a 71-year-old male patient with elevated ADH and positive tuberculin test firstly misdiagnosed as tuberculous pleural effusion finally proven as pleural mesothelial sarcoma by thoracoscopic pathology. Methods: Appropriate laboratory tests and thoracentesis were carried out. Thoracoscopy and pathological biopsy were performed to differentiate tuberculous pleural effusion. Results: Chest CT showed right pleural effusion. ADH in pleural effusion was over 45 U/L and PPD test was positive. No abnormal cells were found in pleural effusion pathology. Pathology of thoracoscopic biopsy proved pleural mesothelioma. Conclusions: Elevated ADH and positive tuberculin test are not a specific index for tuberculosis and thoracoscopic biopsy pathology is crucial for differential diagnosis. [ABSTRACT FROM AUTHOR]

Background China has the world's highest diabetes prevalence, which along with hypertension and inflammation continues to grow particularly among children. Little is known about the strength of the association of these cardiometabolic risk factors between parents and their children; thus, the potential of household-based strategies to reduce risk is unknown. Objectives The objective of the study is to examine the parent-child association for haemoglobin A1c (HbA1c), blood pressure (BP) and C-reactive protein (CRP) in a large, geographically diverse Chinese sample. Methods In 940 parent-child pairs (children aged 7-17 years) who participated in the 2009 China Health and Nutrition Survey, we measured each individual's HbA1c and CRP using fasting blood and BP. We used sex-specific random-effects linear regression to examine the parent-child association for these risk factors, accounting for within-family clustering. Results Child's HbA1c was positively associated with parental HbA1c. Beta coefficients ranged from 0.06 (95% CI 0.03-0.12) for father-daughter to 0.43 (95% CI 0.28-0.58) for mother-son pairs. We also detected a positive mother-daughter association for BP and positive father-child associations for CRP. Conclusion The statistically significant parent-child association for HbA1c, BP and CRP in Chinese families suggests that household-based interventions could be useful for confronting the high rates of diabetes, hypertension and inflammation in China. [ABSTRACT FROM AUTHOR]

This paper introduces the TERT-IV prototype developed by Tianjin University. The application of the TERT-IV system to measurement parameters of two-phase flow has been studied. The methods of analyzing measured data of ERT system are presented and applied to identify flow regimes and estimate void fraction. For the several typical flow regimes, the methods of principal component analysis and artificial neural network to identify the two-phase flow regimes is presented, and that is proved to have higher recognition rate by experimental test. For the different phase distribution on a pipe cross-section, the methods of relative changes summation and polynomial regression are used to estimate void fraction, and are proved to be possible by comparing the results of simulation calculation to the analytic results of experimental measured data.The research results show that the method is feasible using feature extraction and analysis data to measure the parameters of two-phase flow under the different flow conditions, and prove that it is possible to monitor on-line the transportation process of air/water two-phase flow using ERT system. [Copyright &y& Elsevier]

Climate dictates wildfire activity around the world. But East and Southeast Asia are an apparent exception as fire-activity variation there is unrelated to climatic variables. In subtropical China, fire activity decreased by 80% between 2003 and 2020 amid increased fire risks globally. Here, we assessed the fire regime, vegetation structure, fuel flammability and their interactions across subtropical Hubei, China. We show that tree basal area (TBA) and fuel flammability explained 60% of fire-frequency variance. Fire frequency and fuel flammability, in turn, explained 90% of TBA variance. These results reveal a novel system of scrubland–forest stabilized by vegetation–fire feedbacks. Frequent fires promote the persistence of derelict scrubland through positive vegetation–fire feedbacks; in forest, vegetation–fire feedbacks are negative and suppress fire. Thus, we attribute the decrease in wildfire activity to reforestation programs that concurrently increase forest coverage and foster negative vegetation–fire feedbacks that suppress wildfire. Vegetation-fire feedbacks in Subtropical China. [Display omitted] • A novel system of scrubland–forest stabilized by vegetation–fire feedbacks. • The feedbacks are positive and promote frequent fire in scrubland. • The feedbacks are negative and suppress fire in forest. [ABSTRACT FROM AUTHOR]

Objective: To summarize the causes of death and clinical characteristics of systemic lupus erythematosus (SLE) hospitalized patients in the last 20 years to improve SLE survival rates by detecting critical SLE early., Methods: In this case-control study, 218 SLE death cases were retrospectively analyzed from January 2002 to December 2022, with 110 SLE inpatients chosen at random as controls. The clinical symptoms, causes of death, and risk factors in patients with SLE were investigated., Results: There were 218 deaths among 9538 patients with SLE, including 188 women and 30 men. The death rate fell steadily from 4.14% in 2002 to 1.96% in 2013 and remained at 1.84% from 2014 to 2022. The standardized mortality ratio (SMR) was 4.98 [95% CI (4.06-5.89)] from 2002 to 2012 and 3.39 [95% CI (2.74-4.04)] from 2013 to 2022. Infection, lupus-induced multiple organ failure syndrome (MODS), and neuropsychiatric lupus (NPLE) were the leading causes of death, accounting for 31.19%, 15.14%, and 11.47% of overall deaths. Age had a significant association with the major causes of death. Logistic regression analysis showed NPLE[OR = 10.772,95% CI (3.350,34.633), p < 0.001], lupus pulmonary involvement (LP)[OR = 3.844,95%CI (1.547,9.552), p = 0.004], pneumonia[OR = 3.439,95%CI(1.552,7.621), p = 0.002], thrombocytopenia[OR = 14.941,95%CI (4.088,54.604), p < 0.001], creatinine>177 μmol/L[OR = 8.644,95%CI (2.831,26.388), p < 0.001], glutamic transaminase(AST) > 60U/L[OR = 5.762,95%CI (2.200,15.088), p < 0.001], total bilirubin > 34 μmol/L[OR = 16.701,95%CI (3.349,83.294), p = 0.001], higher SLE Disease Activity Index (SLEDAI)[OR = 1.089,95%CI (1.032,1.149), p = 0.002] and SLE Damage Index (SDI)[OR = 3.690,95%CI (2.487,5.474), p < 0.001] correlated positively with death., Conclusion: From 2002 to 2013, the mortality rate among patients with SLE fell steadily but remained unchanged from 2014 to 2022. Patients with SLE had significantly higher SMR than the general population. Childhood-onset SLE had a poorer prognosis than adult-onset SLE. Infection, MODS, and NPLE were the three leading causes of death. Major organ involvement and high disease activity were risk factors for mortality., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The increasing incidence of diseases caused by Coxsackievirus A6 (CV-A6) and the presence of various mutants in the population present significant public health challenges. Given the concurrent development of multiple vaccines in China, it is challenging to objectively and accurately evaluate the level of neutralizing antibody response to different vaccines. The choice of the detection strain is a crucial factor that influences the detection of neutralizing antibodies. In this study, the National Institutes for Food and Drug Control collected a prototype strain (Gdula), one subgenotype D1, as well as 13 CV-A6 candidate vaccine strains and candidate detection strains (subgenotype D3) from various institutions and manufacturers involved in research and development. We evaluated cross-neutralization activity using plasma from naturally infected adults ( n  = 30) and serum from rats immunized with the aforementioned CV-A6 strains. Although there were differences between the geometric mean titer (GMT) ranges of human plasma and murine sera, the overall trends were similar. A significant effect of each strain on the neutralizing antibody test (MAX/MIN 48.0 ∼16410.3) was observed. Among all strains, neutralization of the S112 strain by 15 different sera resulted in higher neutralizing antibody titers (GMT S112  = 132.0) and more consistent responses across different genotypic immune sera (MAX/MIN = 48.0). Therefore, S112 may serve as a detection strain for NtAb testing in various vaccines, minimizing bias and making it suitable for evaluating the immunogenicity of the CV-A6 vaccine.

This study aimed to provide data for the clinical features of invasive pneumococcal disease (IPD) and the molecular characteristics of Streptococcus pneumoniae isolates from paediatric patients in China. We conducted a multi-centre prospective study for IPD in 19 hospitals across China from January 2019 to December 2021. Data of demographic characteristics, risk factors for IPD, death, and disability was collected and analysed. Serotypes, antibiotic susceptibility, and multi-locus sequence typing (MLST) of pneumococcal isolates were also detected. A total of 478 IPD cases and 355 pneumococcal isolates were enrolled. Among the patients, 260 were male, and the median age was 35 months (interquartile range, 12-46 months). Septicaemia (37.7%), meningitis (32.4%), and pneumonia (27.8%) were common disease types, and 46 (9.6%) patients died from IPD. Thirty-four serotypes were detected, 19F (24.2%), 14 (17.7%), 23F (14.9%), 6B (10.4%) and 19A (9.6%) were common serotypes. Pneumococcal isolates were highly resistant to macrolides (98.3%), tetracycline (94.1%), and trimethoprim/sulfamethoxazole (70.7%). Non-sensitive rates of penicillin were 6.2% and 83.3% in non-meningitis and meningitis isolates. 19F-ST271, 19A-ST320 and 14-ST876 showed high resistance to antibiotics. This multi-centre study reports the clinical features of IPD and demonstrates serotype distribution and antibiotic resistance of pneumococcal isolates in Chinese children. There exists the potential to reduce IPD by improved uptake of pneumococcal vaccination, and continued surveillance is warranted.

Objective: This study used whole-genome sequencing (WGS) to explore the genetic diversity, virulence factors, and antimicrobial resistance determinants of string test-positive Klebsiella pneumoniae (KP) over a 4-year surveillance period in Huzhou, China., Methods: In total, 632 clinical isolates were collected via hospital surveillance from 2020 to 2023; 100 were positive in the string test and these 100 strains were subjected to antimicrobial susceptibility testing using an agar dilution method followed by WGS., Results: The resistance rates to cefotaxime (77.0%), trimethoprim-sulfamethoxazole (67.0%), and nalidixic acid (64.0%) were high. Multilocus sequence typing revealed high genetic diversity; there were 33 sequence types (STs) and 15 capsular serotypes. The most common ST was ST23 (16.0%) and the most common capsular serotype was K1 (22.5%). Virulome analysis revealed among-strain differences in virulence factors that affected bacterial adherence, efflux pump action, iron uptake, nutritional factors, metabolic regulation, the secretion system, and toxin production. The Kleborate strain-specific virulence scores of all 100 string test-positive KPs were derived: 28 strains scored 5, 28 scored 4, 21 scored 3, 12 scored 1, and 11 scored 0. All 77 strains with scores of 3 to 5 contained the iucA gene. The phylogeny based on whole-genome single nucleotide polymorphisms (wgSNPs) indicated high clonality; the string test-positive KP strains were grouped into six clades. Closely related isolates in each genetic cluster usually shared STs., Conclusion: The present study highlights the significance of the KP iuc A gene in terms of hypervirulence and the diverse genotypes of string test-positive KP strains isolated in Huzhou hospitals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yan, Xu, Shen, Dong and Ji.)

This study evaluated the residue behavior and dissipation dynamics of a new imidacloprid FS 600 seed treatment in potato cultivation systems in Shandong and Jilin, China. Sensitive and accurate UPLC-MS/MS methods were established to quantify imidacloprid residues in potatoes, potato plants, and soil. Results showed that imidacloprid dissipation followed a first-order kinetic model, with half-lives ranging from 6.9 to 26.7 days in plants and 19.8 to 28.9 days in soil. At harvest, the highest average residues in potatoes and soil were 0.778 mg/kg and 0.149 mg/kg, respectively. The dietary risk assessment indicated a chronic risk quotient (CRQ) of 39.73% for adults, indicating minimal risk to human consumers, while the ecological risk quotient (ERQ) and ecotoxicity exposure ratio (TER) revealed low to moderate toxicity to earthworms, warranting caution in the use of this formulation. This research provides valuable data for assessing the safety of imidacloprid FS seed treatment in potato cultivation.

Listeria monocytogenes are considered to be the major foodborne pathogen worldwide. To understand the prevalence and potential risk of L. monocytogenes in retail foods, a total of 1243 retail foods in 12 food categories were sampled and screened for L. monocytogenes from 2020 to 2022 in Huzhou, China. A total of 46 out of 1234 samples were confirmed to be L. monocytogenes positive with a total rate of 3.7%. The contamination rate of seasoned raw meat (15.2%) was the highest, followed by raw poultry meat and raw livestock meat (9.9%) and salmon sashimi (9.5%). The L. monocytogenes isolates belonged to four serotypes, 1/2a,1/2b, 1/2c, and 4b, with the most prevalent serotype being 1/2a (47.9%). All isolates were grouped into 15 sequence types (STs) belonging to 14 clonal complexes (CCs) via multilocus sequence typing (MLST). The most prevalent ST was ST9/CC9 (23.9%), followed by ST3/CC3 (19.6%) and ST121/CC121 (17.4%). Notably, 11 STs were detected from ready-to-eat (RTE) foods, some of them have been verified to be strongly associated with clinical origin listeriosis cases, such as ST3, ST2, ST5, ST8, and ST87. Listeria pathogenicity islands 1 (LIPI-1) and LIPI-2 were detected in approximately all L. monocytogenes isolates, whereas the distribution of both LIPI-3 genes and LIPI-4 genes exhibited association with specific ST, with LIPI-3 in ST3 and ST288, and LIPI-4 in ST87. The strains carrying LIPI-3 and LIPI-4 virulence genes in this study were all isolated from RTE foods. Antimicrobial susceptibility tests showed that >90% of isolates were susceptible to PEN, AMP, ERY, CIP, SXT, VAN, CHL, and GEN, indicating the antibiotic treatment might be still efficient for most of the L. monocytogenes strains. However, for the three clinical first-line antibiotics (PEN, AMP, and GEN), we also observed three and four strains showing MIC values greater than the susceptibility standards for PEN and AMP, respectively, and one strain showing resistance to GEN., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Recruiting advanced cancer patients is crucial for nursing research in cancer care. However, nurse researchers often face various socio-cultural challenges, particularly in mainland China, where cultural taboos around death pose significant obstacles. An unexplored constraint in this context is the pivotal role Chinese family members play in patients' healthcare decision-making. This research gap underscores the need for a deeper understanding of Chinese family members' perspectives on the engagement of advanced cancer patients in nursing research., Objective: To explore the perceptions and concerns of family members regarding the recruitment and participation of advanced cancer patients in nursing research., Design: A qualitative descriptive study was conducted., Settings: Three cancer hospitals in mainland China., Participants: A purposive sample of 18 family members, consisting of children or spouses of advanced cancer patients, was recruited as participants., Methods: Semi-structured interviews were conducted to collect data between September 2022 and January 2023. The thematic analysis method was used to analyze the data., Results: Three themes were identified: The absence of prior participation, Family members' reluctance to facilitate patient involvement, and Strategies to encourage patients' future participation. Family members were hesitant to allow their relatives with advanced cancer to engage in nursing research, primarily due to concerns about distressing patients, the use of potential sensitive language, stigma, and the risks involved in participation. To address these concerns, they emphasized the importance of gaining family approval prior to patient enrolment. They highlighted the need of family involvement on behalf of sick relatives in research, advocating for the inclusion of a wide range of patients rather than targeting specific subgroups. They also reiterated the significance of choosing the right time for participation and avoiding using sensitive terms such as 'cancer', 'dying', and 'death' when engaging with patients. Moreover, they proposed the recruitment of patients by trusted professionals, shortening the duration of research activities and simplifying research procedures., Conclusions: This study provides fresh insights into the perspectives of family members concerning the recruitment and engagement of advanced cancer patients in nursing research. It emphasizes the importance of addressing their concerns and recommendations, aiding nurse researchers in developing culturally sensitive recruitment strategies and fostering the inclusive participation of advanced cancer patients in nursing research within the context of family-centered care and cultural taboos surrounding death., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Although suicide is a major public health problem, little research has addressed factors linked to suicide risk in U.S. Asian ethnic subgroups, including the U.S. Chinese population. In this study, we investigate the relationship between racial discrimination and suicidal ideation among Chinese immigrants in the U.S., as well as the mediating and moderating role of coping., Method: This is a secondary analysis of online survey data from 501 Chinese immigrants in the U.S. Perceived racial discrimination and problem-focused, emotion-focused, and avoidant coping were measured. Mediation and moderation analyses were conducted to determine whether the three types of coping served as mediators or moderators between racism and suicidal ideation., Results: Chinese immigrants who perceived racial discrimination were more likely to engage in suicidal ideation ( OR = 1.38, 95% CI [1.05, 1.81]). Greater use of problem-focused coping was associated with decreased risk of suicidal ideation ( OR = 0.38, 95% CI [0.26, 0.54]). The interaction of racial discrimination and problem-focused, emotion-focused, and avoidant coping did not significantly predict suicidal ideation ( p > .05), but the mediating effects of emotion-focused and avoidant coping were significant., Conclusions: Greater attention should be paid to the detrimental effects of racial discrimination on suicidal ideation among Chinese immigrants. A focus on strengthening problem-focused coping and reducing emotion-focused and avoidant coping among Chinese immigrants should lead to effective suicide prevention strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Given the established impact of exercise in reducing arterial stiffness and the potential for intermittent hypoxia to induce its elevation, this study aims to understand how oxygen desaturation during exercise affects arterial stiffness in individuals with COPD., Methods: We enrolled patients with stable COPD from China-Japan Friendship Hospital from November 2022 to June 2023. The 6-minute walk test (6-MWT) was performed with continuous blood oxygen saturation (SpO 2 ) monitoring in these patients. The patients were classified into three groups: non-exercise induced desaturation (EID), mild-EID and severe-EID, according to the changes in SpO 2 during the 6-MWT. The Cardio-Ankle Vascular Index (CAVI) and the change in CAVI (ΔCAVI, calculated as CAVI before 6MWT minus CAVI after the 6MWT) were measured before and immediately after the 6MWT to assess the acute effects of exercise on arterial stiffness. GOLD Stage, pulmonary function, and other functional outcomes were also measured in this study., Results: A total of 37 patients with stable COPD underwent evaluation for changes in CAVI (ΔCAVI) before and after the 6-MWT. Stratification based on revealed three subgroups: non-EID (n=12), mild-EID (n=15), and severe-EID (n=10). The ΔCAVI values was -0.53 (-0.95 to -0.31) in non-EID group, -0.20 (-1.45 to 0.50) in mild-EID group, 0.6 (0.08 to 0.73) in severe-EID group. Parametric tests indicated significant differences in ΔCAVI among EID groups (p = 0.005). Pairwise comparisons demonstrated significant distinctions between mild-EID and severe-EID groups, as well as between non-EID and severe-EID groups (p = 0.048 and p = 0.003, respectively). Multivariable analysis, adjusting for age, sex, GOLD stage, diffusion capacity, and blood pressure, identified severe-EID as an independent factor associated with ΔCAVI (B = 1.118, p = 0.038)., Conclusion: Patients with COPD and severe-EID may experience worsening arterial stiffness even during short periods of exercise., Competing Interests: The authors have no conflicts of interest to declare in this work., (© 2024 Wang et al.)

Background: Asthma exacerbation (AE) is a significant clinical problem during pregnancy. This study aimed to identify maternal and perinatal outcomes associated with AE during pregnancy., Methods: We conducted a retrospective cohort study using the Peking University Third Hospital database from January 1, 2013 to December 31, 2020. We compared the clinical characteristics and maternal, perinatal and offspring outcomes of asthma with and without exacerbations among women who delivered during this period. The primary outcome was hypertensive disorders of pregnancy (HDP). Univariable and multivariable logistic regression analyses were used to analyze the clinical characteristics of AE during pregnancy and the association between AE and adverse maternal and perinatal outcomes., Results: The prevalence of asthma during pregnancy increased from 0.52% in 2013 to 0.98% in 2020. Of the 220 patients with asthma during pregnancy included in the study, 105 experienced AE during pregnancy: 62.9% (n = 66) had mild-to-moderate AE and 37.1% (n = 39) had severe AE. Pregnant women with allergic rhinitis have a higher risk of AE during pregnancy. Women who experienced AE were more at risk for hypertensive disorders of pregnancy than women who did not experience any exacerbation (12.4%vs3.5%, p < 0.05)., Conclusions: The prevalence of asthma among pregnant women in China is on the rise. There is a notable correlation between pregnant women who suffer from allergic rhinitis and an elevated risk of AE during pregnancy. Studies have shown that AE during pregnancy are associated with an increased risk of hypertensive disorders of pregnancy., (© 2024. The Author(s).)

The rapid evolution of the digital economy has significantly accelerated progress towards achieving green and sustainable processes, particularly in the field of green production. While existing research has delved into the effects of the digital economy on Green Innovation (GI) and the consequences of digital transformation on Corporate Value (CV), there remains a notable gap in the literature regarding the potential for synergistic enhancements in firms' GI&CV through the ongoing digital revolution. This study utilizes an evolutionary game model and employs system dynamics methods to simulate the dynamic evolution trajectory of the influence of the digital economy on the synergy between GI&CV. Subsequently, it empirically assesses the interconnected synergies between GI&CV using a dataset comprising information from Chinese listed firms spanning from 2011 to 2020, examining the impact of the digital economy on these synergies. Moreover, the study delves into the analysis of the transmission mechanism and conducts an extended investigation to further explore this phenomenon. The findings of this paper including: (1) The digital economy acts as a driving force behind the synergistic enhancement of firm GI&CV. Moreover, this effect is further augmented by governmental environmental regulation and green subsidy policies. (2) Drawing upon the information asymmetry theory and the resource-based theory, the regional marketization level and firms' digital transformation play intermediary roles. (3) The heterogeneity test indicate that firms situated in eastern regions and those classified as non-heavily polluted benefitted to a greater extent. This study sheds light on the incentive implications of digital economy for the synergistic upgrading of GI&CV, thereby extending the breadth of study on the consequences of digital economy. Moreover, it offers actionable suggestions for enterprises to leverage digital economy development towards achieving a synergistic improvement of GI&CV., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Song 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.)

Hypertrophic cardiomyopathy (HCM) is associated with adverse outcomes, such as heart failure, arrhythmia, and mortality. Sudden cardiac death (SCD) is a common cause of death in HCM patients, and identification of patients at a high risk of SCD is crucial in clinical practice. The China Hypertrophic Cardiomyopathy Project is a hospital-based, multicenter, prospective, registry cohort study of HCM patients, covering a total of 3000 participants and with a 5-year follow-up plan. A large number of demographic characteristics and clinical data will be fully collected to identify prognostic factors in Chinese HCM patients. Furthermore, the main purpose of this study is to integrate demographic and clinical characteristics to establish new 5-year SCD risk predictive equations for Chinese HCM patients by the use of machine learning technologies. The project has crucial clinical significance for risk stratification and determination of HCM patients with high risk of adverse outcomes. CLINICAL TRIALS REGISTRATION: ChiCTR2300070909., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Clozapine was first manufactured in China in 1976. Clozapine is currently used not only for treatment-refractory schizophrenia (TRS), but also continues to be used in the treatment of patients with non-TRS and other mental disorders; moreover, low-dose clozapine is also used in sedative-hypnotic therapy and in combination with other drugs. There is need for studies in China using various titrations and assessing their risk for myocarditis and aspiration pneumonia. The Chinese clozapine package insert will also greatly benefit from these changes., Competing Interests: Declaration of competing interest In the last 3 years, the authors report no conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

T lymphoblastic leukemia /lymphoma (T-ALL/LBL) is a rare and highly aggressive neoplasm of lymphoblasts. We evaluated 195 T-ALL/LBL adolescent and adult patients who received ALL-type chemotherapy alone (chemo,n = 72) or in combination with autologous hematopoietic stem cell transplantation(auto-HSCT,n = 23) or allogeneic hematopoietic stem cell transplantation(allo-HSCT,n = 100) from January 2006 to September 2020 in three Chinese medical centers. 167 (85.6%) patients achieved overall response (ORR) with 138 complete response (CR) patients (70.8%) and 29 partial response (PR) patients (14.8%). Until October 1, 2023, no difference was found in 5-year overall survival (5-OS) and 5-year progression free survival(5-PFS) between allo-HSCT and auto-HSCT (5-OS 57.9% vs. 36.7%, P = 0.139, 5-year PFS 49.4% vs. 28.6%, P = 0.078) for patients who achieved CR, for patients who achieved PR, allo-HSCT recipients had higher 5-OS compared with chemo alone recipients (5-OS 23.8% vs. 0, P = 0.042). For patients undergoing allo-HSCT, minimal residual disease (MRD) negative population showed better 5-OS survival compared with MRD positive patients (67.8% vs. 19.6%, p = 0.000). There were no significant differences between early T-cell precursor (ETP), NON-ETP patients with or without expression of one or more myeloid-associated or stem cell-associated (M/S + ) markers (NON-ETP with M/S + , NON-ETP without M/S + ) groups in allo-HSCT population for 5-OS. (62.9% vs. 54.5% vs.48.4%, P > 0.05). Notch mutations were more common in patients with non-relapsed/refractory disease than relapsed/refractory disease (χ² =4.293, P = 0.038). In conclusion, Allo-HSCT could be an effective consolidation therapy not just for patients with CR, but also for those who achieved PR. The prognosis is significantly improved by obtaining MRD negative prior to allogeneic transplantation., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease (COPD). However, limited information is available on vaccination coverage among patients with acute exacerbations of COPD (AECOPD) in China. This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD., Methods: Baseline data from a national, multicenter, hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed. The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years. To ensure national representativeness, rates were weighted according to the distribution of hospital levels and types enrolled in this study. Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors. The independent variables included the region and hospital features where the participants were located, sociodemographic characteristics (age, sex, rural/urban residence, education, etc.), and clinical indicators (COPD disease history, lung function parameters, comorbidities, etc.). The treatment profiles of the vaccinated and unvaccinated participants were compared., Results: Of 6949 eligible participants, the weighted rates of influenza/pneumococcal, influenza, and pneumococcal vaccination were 2.72% (95% confidence interval [CI]: 2.34%-3.10%), 2.09% (95% CI: 1.76%-2.43%), and 1.25% (95% CI: 0.99%-1.51%), respectively. In multivariable models, age ≥60 years (60-69 years, odds ratio [OR]: 1.90, 95% CI: 1.11-3.25; ≥80 years, OR: 2.00, 95% CI: 1.06-3.78), geographical regions (Northern China relative to Eastern China, OR: 5.09, 95% CI: 1.96-13.21), urban residence (OR: 1.69, 95% CI: 1.07-2.66), a higher education level (junior high school, OR: 1.77, 95% CI: 1.21-2.58; senior high school or above, OR: 2.61, 95% CI: 1.69-4.03), former smoking (OR: 1.79, 95% CI: 1.15-2.79), and regular inhaled medication treatment (OR: 3.28, 95% CI: 2.29-4.70) were positively associated with vaccination. Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated (OR: 0.65, 95% CI: 0.45-0.96). Compared with unvaccinated participants, vaccinated participants adhered better to pharmacological and non-pharmacological treatment., Conclusions: Influenza and pneumococcal vaccination coverage are extremely low. Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China., (Copyright © 2024 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Background: There is a lack of individualised prediction models for patients hospitalised with chronic obstructive pulmonary disease (COPD) for clinical practice. We developed and validated prediction models of severe exacerbations and readmissions in patients hospitalised for COPD exacerbation (SERCO)., Methods: Data were obtained from the Acute Exacerbations of Chronic Obstructive Pulmonary Disease Inpatient Registry study (NCT02657525) in China. Cause-specific hazard models were used to estimate coefficients. C-statistic was used to evaluate the discrimination. Slope and intercept were used to evaluate the calibration and used for model adjustment. Models were validated internally by 10-fold cross-validation and externally using data from different regions. Risk-stratified scoring scales and nomograms were provided. The discrimination ability of the SERCO model was compared with the exacerbation history in the previous year., Results: Two sets with 2196 and 1869 patients from different geographical regions were used for model development and external validation. The 12-month severe exacerbations cumulative incidence rates were 11.55% (95% CI 10.06% to 13.16%) in development cohorts and 12.30% (95% CI 10.67% to 14.05%) in validation cohorts. The COPD-specific readmission incidence rates were 11.31% (95% CI 9.83% to 12.91%) and 12.26% (95% CI 10.63% to 14.02%), respectively. Demographic characteristics, medical history, comorbidities, drug usage, Global Initiative for Chronic Obstructive Lung Disease stage and interactions were included as predictors. C-indexes for severe exacerbations were 77.3 (95% CI 70.7 to 83.9), 76.5 (95% CI 72.6 to 80.4) and 74.7 (95% CI 71.2 to 78.2) at 1, 6 and 12 months. The corresponding values for readmissions were 77.1 (95% CI 70.1 to 84.0), 76.3 (95% CI 72.3 to 80.4) and 74.5 (95% CI 71.0 to 78.0). The SERCO model was consistently discriminative and accurate with C-indexes in the derivation and internal validation groups. In external validation, the C-indexes were relatively lower at 60-70 levels. The SERCO model discriminated outcomes better than prior severe exacerbation history. The slope and intercept after adjustment showed close agreement between predicted and observed risks. However, in external validation, the models may overestimate the risk in higher-risk groups. The model-driven risk groups showed significant disparities in prognosis., Conclusion: The SERCO model provides individual predictions for severe exacerbation and COPD-specific readmission risk, which enables identifying high-risk patients and implementing personalised preventive intervention for patients with COPD., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Long-term exposure to urban dust containing potentially toxic elements (PTEs) poses detrimental impacts on human health. However, studies estimating human health risks in urban dusts from a global perspective are scarce. We evaluated data for twelve PTEs in urban dusts across 59 countries from 463 published articles, including their concentrations, input sources, and probabilistic risks to human health. We found that 34.1 and 60.3% of those investigated urban dusts have been heavily contaminated with As and Cd, respectively. The input of PTEs was significantly correlated with economic structure due to emissions of industrial activities and traffic emissions being the major sources. Based on the Monte Carlo simulation, we found that the mean hazard index below the safe threshold (1.0) could still cause non-negligible risks to human health. Arsenic and Cr were the major PTEs threatening human health, and relatively high risk levels were observed in cities in China, Korea, Chile, Malaysia, and Australia. Importantly, our analysis suggested that PTEs threaten the health of approximately 92 million adults and 280 million children worldwide. Overall, our study provides important foundational understanding and guidance for policy decision-making to reduce the potential risks associated with PTE exposure and to promote sustainable development of urban economies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The prevalence of myopia among children and adolescents is currently rising to alarming levels (>80%) in China. This study used several routinely collected demographic factors to quantify myopia and glass-wearing rates for primary and secondary school students. We identified myopia risk factors and proposed new aspects for early intervention. This study was a cross-sectional survey of myopia and glass-wearing rates for students (6-18 years old) in Yantai, China. We collected both vision (vision acuity [VA] and spherical equivalence [SE]) and glass-wearing information to establish respective logistic models for quantifying myopia and glass-wearing rate. We further propose a joint decision region (VA, SE, age) to guide early intervention. Among 10,276 children, 63% had myopia (65% wore glasses). The prevalence of myopia increases with age and levels off during adulthood. Females had a higher overall prevalence rate than males (P < .001). The rural age mode (≈15.5) is about 2 years larger than the urban age (≈13.5) for myopia students. For the myopia rate, in the age ≤14.5, the linear age effect was significant (odds ratio [OR] = 1.73, P < .0001), males had a significant negative baseline effect at the start of schooling (vs. females) (OR = 0.68, P < .0001), and the urban group had a significant positive baseline effect (vs. rural) (OR = 1.39, P < .0001). The correlation between VA and SE increases with age and has a directional shift (from negative to positive) at ages 8 to 9. For the glass-wearing rate, age had a significant positive effect (OR = 1.25, P < .0001), VA had a significant negative effect (OR = 0.002, P < .0001), and body mass index had a slightly significant positive effect (OR = 1.02, P = .03). Urban female have a higher myopia rate than rural male at the start of schooling, and vocational high school has improved vision upon high school. Body mass index was not a significant factor for myopia. The myopia rate model is specific to age range (separated at 14.5 years old). Students of lower ages are less likely to wear glasses for correction, and this may require intervention. The temporal age-specific (VA, SE) correlations and joint distributions strengthen the speculation in the literature that age 8 to 9 is a critical intervention period and motivates us to propose a rigorous intervention decision region for (age, VA, and SE) which mainly applies for this tight age period., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

With the phase-out of perfluorooctanoic acid (PFOA) and its replacement by perfluoroalkyl ether carboxylic acids (PFECAs), there is a potential for increased exposure to various new PFECAs among the general population in China. While there are existing studies on dietary exposure to legacy perfluoroalkyl and polyfluoroalkyl substances (PFASs), research on dietary exposure to PFECAs, especially among the general Chinese populace, remains scarce. In the present study, we investigated the distribution of PFECAs in dietary sources from 33 cities across five major regions in China, along with the associated dietary intake. Analysis indicated that aquatic animal samples contained higher concentrations of legacy PFASs compared to those from terrestrial animals and plants. In contrast, PFECAs were found in higher concentrations in plant and terrestrial animal samples. Notably, hexafluoropropylene oxide dimer (HFPO-DA) was identified as the dominant compound in vegetables, cereals, pork, and mutton across the five regions, suggesting widespread dietary exposure. PFECAs constituted the majority of PFAS intake (57 %), with the estimated daily intake (EDI) of HFPO-DA ranging from 2.33 to 3.96 ng/kg bw/day, which corresponds to 0.78-1.32 times the reference dose (RfD) (3.0 ng/kg bw/day) set by the United States Environmental Protection Agency. Given the ubiquity of HFPO-DA and many other PFECAs in the nationwide diet of China, there is an urgent need for further research into these chemicals to establish relevant safety benchmarks or consumption advisory values for the diet., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Porous sandstone geothermal water is an important geothermal resource, which is a low-carbon and clean resource, but lacks systematic research on a regional scale. The northern part of Jinan City is rich in geothermal resources, specifically porous sandstone thermal reservoirs. However, there is still incomplete research on the mechanism of geothermal genesis and the hydrochemical characteristics of geothermal water in porous sandstone. This study aims to address this gap by collecting 21 groundwater samples from northern Jinan and comparing their conventional ion and isotope characteristics to investigate the hydrochemical characteristics during the formation of geothermal water and uncover the genesis mechanism of porous sandstone geothermal water. The results indicate that the geothermal water is classified as Na-Cl type and Na-SO 4 -Cl type. The hydrochemical characteristics of geothermal water are primarily influenced by water-rock interaction and groundwater mixing. The water source primarily comes from the atmospheric precipitation in the Taiyi mountains, with an altitude of 910.75-1542.2 m.s.a.l.. The estimated temperature of the thermal reservoir ranges from 51 to 78 °C, and the depth of geothermal water circulation is estimated to be between 1316 and 2216 m. Based on the characteristics of the geothermal field, including the "cap rock, water source, heat source, reservoir, and channel," a conceptual model of the porous sandstone geothermal water flow system is proposed. This model offers novel insights into the genesis mechanism of geothermal water under similar geological conditions., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Mountains are the world's most important centers of biodiversity. The Sino-Himalayan Mountains are global biodiversity hotspot due to their extremely high species richness and endemicity. Ample research investigated the impact of the Qinghai-Tibet Plateau uplift and Quaternary glaciations in driving species diversification in plants and animals across the Sino-Himalayan Mountains. However, little is known about the role of landscape heterogeneity and other environmental features in driving diversification in this region. We utilized whole genomes and phenotypic data in combination with landscape genetic approaches to investigate population structure, demography, and genetic diversity in a forest songbird species native to the Sino-Himalayan Mountains, the red-billed leiothrix (Leiothrix lutea). We identified 5 phylogeographic clades, including 1 in the East of China, 1 in Yunnan, and 3 in Tibet, roughly consistent with differences in song and plumage coloration but incongruent with traditional subspecies boundaries. Isolation-by-resistance model best explained population differentiation within L. lutea, with extensive secondary contact after allopatric isolation leading to admixture among clades. Ecological niche modeling indicated relative stability in the extent of suitable distribution areas of the species across Quaternary glacial cycles. Our results underscore the importance of mountains in the diversification of this species, given that most of the distinct genetic clades are concentrated in a relatively small area in the Sino-Himalayan Mountain region, while a single shallow clade populates vast lower-lying areas to the east. This study highlights the crucial role of landscape heterogeneity in promoting differentiation and provides a deep genomic perspective on the mechanisms through which diversity hotspots form., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Molecular Biology and Evolution.)

Purpose: Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women., Methods: The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases., Results: Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I., Conclusions: For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China., (© 2024. The Author(s).)

The pharmaceutical industry is an important industry for the national economy and the people's livelihood, which is not only beneficial to the people's livelihood, but also has huge commercial value. How to promote the development of Chinese pharmaceutical industry is an urgent problem to be solved. In this study, 47 listed pharmaceutical companies are taken as cases, and Qualitative Comparative Analysis of Fuzzy Sets (fsQCA) is used to analyze the influence of five antecedent conditions on the total factor productivity of pharmaceutical enterprises from the perspective of corporate governance, and to explore the composition to Total Factor Productivity (TFP) improvement. The results are as follows. First, single corporate governance factor does not constitute the necessary condition to improve the TFP of pharmaceutical enterprises. Second, there are three configurations of high TFP of pharmaceutical enterprises, among these, two configurations belong to regulatory constraints type and one configuration belongs to the active board type. There is only one configurations to low TFP of pharmaceutical enterprises: the passive board. Based on the perspective of configuration, this paper discusses how corporate governance drives TFP improvement in pharmaceutical enterprises, which can provide systematic thinking and practical guidance for each company to promote its TFP improvement according to its own corporate structure., (© 2024. The Author(s).)

Background: In the course of China's modernization, the sports industry's advancement plays a dual role in enhancing national health and driving economic transformation. The integration and coalescence of the sports and health sectors have emerged as pivotal avenues for the structural elevation of China's sports industry. Hence, empirically scrutinizing the influential mechanisms and outcomes of sports and health industry integration on the sports industry's structural enhancement holds substantial practical significance., Method: This study formulates theoretical hypotheses regarding the impact mechanism of sports and health industry integration on the sports industry's sophisticated industrial structure. Drawing insights from literature review and categorization, three dimensions-industrial integration, government role, and market mechanism-are delineated. Employing panel data spanning 2015 to 2020 from four primary Chinese cities, an econometric model is devised to empirically dissect the influence of sports and health industry integration on the sports industry's structural advancement., Findings: The three pivotal explanatory variables-integration of sports and health industries, government role, and market mechanism-exert a positive influence on the sports industry's sophisticated industrial structure. Notably, the impact of market mechanisms outweighs that of government roles, with government roles exhibiting comparatively weaker individual impact effects., Conclusion: The dynamic development process characterizing the structural advancement of China's sports industry in first-tier cities exhibits positive and sustained developmental traits, with discernible convergence in trends. While market mechanisms demonstrate a more immediate and pronounced direct promotional effect than government roles, the enduring influence of government roles over an extended timeframe is evident from a dynamic long-term development perspective. Building upon these findings, the study suggests relevant stakeholders foster advanced sports industry structures by: refining the integration system of sports and health industries; fortifying the fundamental role of market mechanisms; and fully leveraging the government's impact in promoting sports and health industry integration., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Liu 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.)

The Ultrasound Physician Branch of the Chinese Medical Doctor Association sought to develop evidence-based recommendations on the operational standards for 2-D shear wave elastography examination of musculoskeletal tissues. A consensus panel of 22 Chinese musculoskeletal ultrasound experts reviewed current scientific evidence and proposed a set of 12 recommendations for 13 key issues, including instruments, operating methods, influencing factors and image interpretation. A final consensus was reached through discussion and voting. On the basis of research evidence and expert opinions, the strength of recommendation for each proposition was assessed using a visual analog scale, while further emphasizing the best available evidence during the question-and-answer session. These expert consensus guidelines encourage facilitation of the standardization of clinical practices for collecting and reporting shear wave elastography data., Competing Interests: Conflict of interest The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Pesticides are frequently sprayed in greenhouses to ensure crop yields, where airborne particulate matter (PM) may serve as a carrier in depositing and transporting pesticides. However, little is known about the occurrence and fate of PM-borne pesticides in greenhouses. Herein, we examined the distribution, dissipation, and transformation of six commonly used pesticides (imidacloprid, acetamiprid, prochloraz, triadimefon, hexaconazole, and tebuconazole) in greenhouse PM (PM 1 , PM 2.5 , and PM 10 ) after application as well as the associated human exposure risks via inhalation. During 35 days of experiment, the six pesticides were detected in all PM samples, and exhibited size- and time-dependent distribution characteristics, with the majority of them (>64.6%) accumulated in PM 1 . About 1.0-16.4% of initially measured pesticides in PM remained after 35 days, and a total of 12 major transformation products were elucidated, with six of them newly identified. The inhalation of PM could be an important route of human exposure to pesticides in the greenhouse, where the estimated average daily human inhalation dose (ADD inh ) of the six individual pesticides was 2.1-1.2 × 10 4 pg/kg day -1 after application (1-35 days). Our findings highlight the occurrence of pesticides/transformation products in greenhouse PM, and their potential inhalation risks should be further concerned.

Carbon emission reduction is an essential means to achieve the "double carbon goal," and the scientific and reasonable allocation of carbon emission quotas (CEQ) is the basis for promoting carbon emission reduction. In this study, the first level was based on the entropy TOPSIS scores of provinces under the principles of fairness, efficiency, sustainability, and feasibility and used the K-mean clustering method to cluster the 30 provinces and allocate the CEQ to each zone group; the second level consolidated the impacts of the four principles and the marginal abatement costs of CO 2 to allocate CEQ to the provinces within the zone group. Finally, each province's initial spatial balance of CEQ (ISBQ) is classified and evaluated. The study shows that the most quotas are for Guangdong, Zhejiang, and Inner Mongolia, and the least for Ningxia, Shanxi, and Guizhou. This study compares the results of CEQ allocation with the current carbon emission scale and finds that 11 provinces, such as Shandong and Hebei, show a deficit in future carbon emission space, and 19 provinces, such as Hainan and Beijing, show a surplus in carbon emission space. Given each province's different emission reduction tasks and pressures, differentiated emission control policies are the key to achieving China's "2030 target"., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The calculation of trade-embodied air pollution (TEAP) and its economic losses can be reasonably used to assess the impact of transboundary air pollution. However, these air pollutants, which are associated with international trade, can be easily ignored due to their concealment. Based on this, the global multiregional input‒output model (MRIO) is used to quantify the volume of five air pollutants that are embodied in the trade of 20 countries from 2000 to 2016. Then, the shadow price of trade-embodied air pollution (SPTEAP) and the elasticity of factor substitution (EFS) are both calculated by applying the translog production function. Finally, impulse response analysis is used to study the dynamic impact of EFS on the SPTEAP. The main conclusions are as follows: (1) All countries experienced a mass transfer of TEAP, among which China and the USA are the developing and developed countries with the largest amount of TEAP transfers, respectively. (2) The SPTEAP and EFS vary greatly among countries, and these values are generally higher in developed countries than in developing countries. The relationship between the three EFSs can be expressed as [Formula: see text] in all countries, thus indicating that improving the technological level of a country is the best solution for reducing the TEAP in that country while incurring the lowest cost and the least difficulty. (3) Over the long run, the increase in [Formula: see text] and [Formula: see text] reduces the SPTEAP. Conversely, an increase in [Formula: see text] increases the SPTEAP. Therefore, policymakers should weigh these three factors according to the fluctuation of the SPTEAP and constantly adjust the allocation structure and ratio of these factors to maximize the benefits of transboundary air pollution governance., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The inundation pattern is an important ecohydrological indicator for studying floodplain lake wetlands, as it is the key factor affecting the wetland vegetation distribution patterns. Poyang Lake, the largest freshwater lake in China, is a typical floodplain lake wetland. This study presents a hydrodynamic model and vegetation survey of Poyang Lake, analyzed the spatiotemporal heterogeneity of the inundation pattern (inundation duration and depth), assessed the response patterns of wetland vegetation concerning the inundation pattern, and examined the impact of the proposed Poyang Lake Water Conservancy Hub (PLWCH) on the inundation pattern and wetland vegetation. The results revealed that the inundation pattern of Poyang Lake had significant spatial heterogeneity. Inundation pattern was found to have a significant impact on the vegetation succession. The response relationship between the distribution areas of different wetland vegetation types and inundation pattern was in accordance with the Gaussian curve, and the ecological threshold range of the Carex spp. community was the greatest. Owing to factors such as climate change and anthropogenic activities, the inundation pattern of Poyang Lake varied significantly since 2003, with the average inundation duration and average inundation depth decreasing by 15 d and 0.32 m, respectively. Consequently, the spatial distribution of wetland vegetation changed significantly, whereby the Carex spp., Polygonum criopolitanum, and Phalaris arundinacea communities extended down to the lower elevation zone. In the future, the PLWCH may result in increases in the inundation duration and depth, restrain the downward vegetation extension trend, and promote the vegetation to move to higher elevations similar to the status prior to 2003. These findings provide a detailed description of the spatiotemporal heterogeneity of the inundation pattern and the drivers of wetland vegetation distribution patterns in floodplain lake wetlands, serving as a scientific basis for conservation and restoration of these ecosystems., 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 © 2023 Elsevier B.V. All rights reserved.)

With the replacement of perfluorooctanoic acid (PFOA) with perfluorinated ether carboxylic acids (PFECAs), residents living near fluorochemical industrial parks (FIPs) are exposed to various novel PFECAs. Despite expectations of low accumulation, short-chain PFECAs, such as perfluoro-2-methoxyacetic acid (PFMOAA), previously displayed a considerably high body burden, although the main exposure routes and health risks remain uncertain. Here, we explored the distribution of perfluoroalkyl and polyfluoroalkyl substances (PFASs) in diverse environmental media surrounding a FIP in Shandong Province, China. PFECAs were found at elevated concentrations in all tested matrices, including vegetables, cereals, air, and dust. Among residents, 99.3% of the ∑ 36 PFAS exposure, with a 43.9% contribution from PFECAs, was due to gastrointestinal uptake. Dermal and respiratory exposures were negligible at 0.1 and 0.6%, respectively. The estimated daily intake (EDI) of PFMOAA reached 114.0 ng/kg body weight (bw)/day, ranking first among all detected PFECAs. Cereals emerged as the dominant contributor to PFMOAA body burden, representing over 80% of the overall EDI. The median EDI of hexafluoropropylene oxide dimer acid (HFPO-DA) was 17.9 ng/kg bw/day, markedly higher than the USEPA reference doses (3.0 ng/kg bw/day). The absence of established threshold values for other PFECAs constrains a comprehensive risk assessment.

Taking three major urban agglomerations in China as examples, this paper uses the Dagum Gini coefficient and its decomposition method, a Kernel density estimation method, and Markov chain and spatial Markov chain to study the regional differences, dynamic evolution characteristics, and spatial spillover effects of carbon emission intensity (CEI) of urban agglomerations, and accordingly, it proposes differentiated emission reduction and carbon reduction policies. The following results were obtained: (1) The overall CEI of the three major urban agglomerations and each individual urban agglomeration were found to have declined significantly over time, with an overall spatial pattern of "high in the north and low in the south," with inter-group differences being the main source of the overall differences. (2) The imbalance in CEI between cities was more obvious within the Beijing-Tianjin-Hebei (BTH) urban agglomeration, while the synergistic emission reduction effect of the Yangtze River Delta (YRD) and Pearl River Delta (PRD) urban agglomerations increased over the study period. (3) The probability of a city maintaining a stable level of CEI was much higher than the probability of a state shift, and there was a spatial spillover effect of carbon emissions between neighboring cities. This study can provide theoretical support for the global response to greenhouse gas emissions, promoting green development and carbon reduction in various countries and urban agglomerations and providing a quantitative basis for the formulation of relevant policies., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To compare the efficacy and safety between baricitinib (BARI) and tofacitinib (TOFA) for the treatment of the rheumatoid arthritis (RA) patients receiving methotrexate (MTX) in clinical practice., Methods: This retrospective study recruited 179 RA patients treated with BARI (2-4 mg/d) or TOFA (10 mg/d) at The First Affiliated Hospital of Guangxi Medical University from September 2019 to January 2022. The rate of low disease activity (LDA) was used as the primary end point. Secondary end points included the Disease Activity Scale-28 (DAS-28)-C-reactive protein (CRP); the rate of DAS28-CRP remission; visual analogue scale (VAS) for pain, swollen joint, and tender joint counts; and adverse events at the 6-month follow-up. Several factors affecting LDA achievement were also analyzed., Results: Seventy-four patients were treated with BARI and 105 were treated with TOFA, including 83.24% females, with a median (IQR) age of 56.0 (53.0-56.0) years old and disease duration of 12.0 (6.0-12.0) months. There was no difference of the rate of LDA between the BARI and TOFA treatment groups. All disease indices in the two groups were significantly improved, including a significantly lower VAS in the BARI group (P < 0.05), reflecting the drug efficacy after 1 and 6 months of treatment. The incidence of adverse reactions was similar in these two groups., Conclusion: The treatment efficacy and safety of BARI and TOFA in the RA patients were similar, but BARI was more effective in pain relief than TOFA. An older baseline age was more likely to achieve LDA in the BARI group, while a low baseline erythrocyte sedimentation rate (ESR) was more likely to achieve LDA in the TOFA group., (© 2023. Sociedade Brasileira de Reumatologia.)

With the introduction of economy carbon neutral target policies one after another worldwide, the carbon emission reduction actions of economies around the world have become a hot topic attracting international attention. Meanwhile, the role of the Internet in energy saving and emissions reduction in economies around the world is also becoming more prominent. However, for now, there is still a lack of in-depth research on the impact and role relationship between Internet development and global economy carbon emission efficiency. Therefore, based on the availability of data, this study used the Malmquist index based on game intersection to measure and analyze carbon emission efficiency based on 58 economies around the world that proposed carbon neutrality targets between 2000 and 2019. The study used a spatial econometric model to explore the impact of Internet development on carbon emission efficiency. The objective was to provide a policy reference for high-, medium-, and low-income economies worldwide to achieve their carbon neutrality targets as soon as possible. The results of the study showed that carbon emission efficiency was closely linked to economic development level in economies around the world, that the gap between the development levels of high- and low-Internet-connected economies is gradually widening, that Internet development significantly improved carbon emission efficiency, that levels of economic and financial development played a mediating role in the relationship between Internet development and carbon emissions efficiency, and that the level of urbanization played a moderating role in the relationship between Internet development and carbon emissions efficiency. Exploring the influence and the mechanism of action between Internet development and carbon emission efficiency will contribute to early achievement of global carbon neutrality targets in all economies., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

As an important part of regional coordinated development, the high-quality development of the Yellow River Basin has become a national strategy. It is imminent for resource-based cities to perform a high-quality transformation. The analysis of carbon emission efficiency in the Yellow River Basin includes the examination of spatiotemporal evolution characteristics and the main driving factors. This is done by utilizing the super-efficiency SBM-DEA and panel Tobit regression models, with the assistance of night light data. Our findings are as follows: (1) Carbon emissions continue to grow. The "Jiziwan" basin is an area where plenty of high-emitting cities agglomerate. The carbon emission of resource-based cities presents a W-shaped pattern in time. (2) In time, the carbon emission efficiency follows a U-shaped curve. Spatially, the carbon emission efficiency in the middle reaches is comparatively low, whereas it is relatively high in both the upper and lower reaches. And that in high carbon-emitting resource-based cities are in the low to medium range. (3) Carbon emission efficiency has a significant negative relationship with energy intensity, urbanization rate, and population density and a significant positive relationship with industrial proportion. Energy intensity is the most direct driving force. That is to say, we can increase carbon emission efficiency effectively by reducing energy intensity., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Campylobacter is a major foodborne pathogen that causes outbreaks and sporadic gastrointestinal disease, creating a serious disease burden. Campylobacter strains isolated from diarrhea cases (n = 11) and raw poultry meat products (n = 2) in Huzhou, including 11 Campylobacter jejuni and 2 Campylobacter coli strains, were subjected to virulence gene, drug resistance gene, genetic correlation, antibiotic resistance, and multilocus sequence typing (MLST) analyses. The 13 Campylobacter isolates were divided into 12 sequence types (STs), one of which was a new ST. The isolated strains contain multiple virulence-related genes. Drug sensitivity analysis showed that the resistance rate of the 13 isolates to nalidixic acid, ciprofloxacin, and tetracycline was 92.3%. Genome sequencing indicated that all 11 strains of C. jejuni carried the tet(O) and blaOXA resistance genes, and 2 strains of C. coli carried multiple drug resistance genes. Phylogenetic analysis based on core-genome single-nucleotide polymorphisms indicated that the 11 C. jejuni isolates from diarrhea patients and food sources are not closely phylogenetically related., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2023 Wu 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.)

Highland barley, also called "qingke" in Tibetan, is mainly cultivated in the Tibetan Plateau of China and has been used as a major staple food for Tibetans. Recently, Fusarium head blight (FHB) of qingke was frequently observed around the Brahmaputra River in Tibet. Considering the importance of qingke for Tibetans, the assessment of Fusarium mycotoxin contamination is essential for food safety. In this study, a total of 150 freshly harvested qingke grain samples were obtained from three regions around the Brahmaputra River in Tibet (China) in 2020. The samples were investigated for the occurrence of 20 Fusarium mycotoxins using high-performance liquid chromatography-tandem mass spectrometry (HPLC‒MS/MS). The most frequently occurring mycotoxin was enniatin B (ENB) (46%), followed by enniatin B 1 (ENB 1 ) (14.7%), zearalenone (ZEN) (6.0%), enniatin A 1 (ENA 1 ) (3.3%), enniatin A (ENA) (1.3%), beauvericin (BEA) (0.7%), and nivalenol (NIV) (0.7%). Due to the increase in altitude, the cumulative precipitation level and average temperature decreased from the downstream to the upstream of the Brahmaputra River; this directly correlated to the contamination level of ENB in qingke, which gradually decreased from downstream to upstream. In addition, the level of ENB in qingke obtained from qingke-rape rotation was significantly lower than that from qingke-wheat and qingke-qingke rotations (p < 0.05). These results disseminated the occurrence of Fusarium mycotoxins and provided further understanding of the effect of environmental factors and crop rotation on Fusarium mycotoxins., (© 2023. The Author(s) under exclusive licence to Society for Mycotoxin (Research Gesellschaft für Mykotoxinforschung e.V.) and Springer-Verlag GmbH Germany, part of Springer Nature.)

Inorganic mineral particles play an important role in the formation of atmospheric aerosols in the Sichuan Basin. Atmospheric haze formation is accompanied by the phase transition of mineral particles under high humidity and stable climatic conditions. Backward trajectory analysis was used in this study to determine the migration trajectory of atmospheric mineral particles. Furthermore, Positive matrix factorization (PMF) was used to analyze the sources of atmospheric mineral particles. The phase transition mechanisms of atmospheric mineral particles were studied using ion chromatography, inductively coupled plasma emission spectrometry, total organic carbon analysis, X-ray diffraction, Fourier-transform infrared spectroscopy, scanning electron microscopy coupled with energy dispersive spectrometry, and grand canonical Monte Carlo methods. Three migration and phase transition paths were identified for the mineral particles. Sources of atmospheric mineral particles included combustion, vehicle emissions, industrial emissions, agricultural sources, and mineral dust. The main mineral phases in atmospheric particles, calcite and dolomite, were transformed into gypsum, and muscovite may be transformed into kaolinite. The phase transition of mineral particles seriously affects the formation of aerosols and worsens haze. Typically, along the Nanchong-Suining-Neijiang-Zigong-Yibin path, calcite is converted into gypsum under the influence of man-made inorganic pollution gases, which worsen the haze conditions and cause slight air pollution for 3-5 days. However, along the Guangyuan-Mianyang-Deyang-Chengdu-Meishan-Ya'an path, anthropogenic volatile organic compounds (VOCs) hindered gypsum formation from dolomite. Furthermore, dolomite and VOCs formed stable adsorption systems (system energies from -0.41 to -4.76 eV, long bonds from 0.20 to 0.24 nm). The adsorption system of dolomite and m/p-xylene, with low system energy (-1.46 eV/-1.33 eV) and significant correlation (r 2  = 0.991, p < 0.01), was the main cause of haze formation. Consequently, calcite gypsification and dolomite--VOC synergism exacerbated regional haze conditions. This study provides a theoretical reference for the mechanism of aerosol formation in basin climates., 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 © 2023 Elsevier Ltd. All rights reserved.)

Although previous studies have suggested that meteorological factors are associated with Bell's palsy, articles on this topic are rare and the results are inconsistent. We aim to reveal the relationship between exposure to different meteorological factors and the onset of severe Bell's palsy (SBP) with daily data. A case-crossover study based on time-series data was applied, and the minimum risk value of each climatic factor was set as the reference value. We fitted a distributed lag non-linear model (DLNM) which applied quasi-Poisson regression to evaluate the exposure-response association and the lag-response association of meteorological factors on the occurrence of SBP. The mode value and per-decile interval value of each meteorological factor were all included in the analysis. Sensitivity analyses were conducted to test the robustness of results. A total of 863 SBP patients (474 males and 389 females) from 7 hospitals in the Shenzhen Futian District were selected from January 2009 to February 2020. The highest relations effect was tested in the cumulative exposure-response result shown as follows; mean temperature at the minimum value 15.3°C with RR of 10.370 (1.557-69.077) over lag 0 to 13; relative humidity at the 30th value 71% with RR of 8.041 (1.016-63.616) over lag 0 to 14; wind speed at the 90th value 31 (0.1 m/s) with RR of 1.286 (1.038-1.593) over lag 0; mean air pressure at the 30th value 1001.4 (pa) with RR of 9.052 (1.039-78.858) over lag 0 to 5; visibility at the 80th value 26.5 (km) with RR of 1.961 (1.005-1.423) over lag 0 to 2; average total cloud cover at the max value 100 (%) with RR 1.787 (1.014-3.148) over lag 0 to 2; sunshine duration at the 10th value 0.1 (h) with RR of 4.772 (1.018-22.361); daily evaporation shows no relationship in the cumulative result; daily average solar radiation at the minimum value 0 (W/m2) with RR of 5.588 (1.184-26.382). There is a relationship between wind speed and the onset of SBP, while mean air pressure, visibility, and average total cloud cover, especially sunshine duration and solar radiation which showed a strong effect, may be associated with severe clinical symptoms of SBP. Mean temperature and relative humidity may affect the course of SBP., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Stroke represents the second most prevalent contributor to global mortality. The Chinese Visceral Adiposity Index (CVAI) serves as an established metric for assessing visceral adiposity in the Chinese population, exhibiting prognostic capabilities. This investigation aimed to explore the association of CVAI and new-onset stroke among middle-aged and older Chinese populations., Methods: The study employed data from the 2011 and 2018 China Health and Retirement Longitudinal Study (CHARLS) to assess the association of CVAI and the incidence of new-onset stroke. Utilizing a directed acyclic graph (DAG), 10 potential confounders were identified. Moreover, to explore the association between CVAI and new-onset stroke, three multifactor logistic regression models were constructed, accounting for the identified confounders and mitigating their influence on the findings., Results: The study comprised 7070 participants, among whom 417 (5.9%) experienced new-onset strokes. After controlling for confounding variables, regression analysis suggested that the new-onset stroke's highest risk was linked to the fourth quartile (Q4) of the CVAI, with an odds ratio (OR) of 2.33 and a 95% confidence interval (CI) of 1.67-3.28. The decision tree analysis demonstrated a heightened probability of new-onset stroke among hypertensive individuals with a CVAI equal to or greater than 83, coupled with a C-reactive protein level no less than 1.1 mg/l. Age seemed to have a moderating influence on the CVAI and new-onset stroke association, exhibiting a more prominent interaction effect in participants under 60 years., Conclusions: In middle-aged and older Chinese populations, a linear relationship was discerned between CVAI and the probability of new-onset stroke. CVAI provides a predictive framework for stroke incidence in this demographic, laying the groundwork for more sophisticated risk prediction models that improve the precision and specificity of stroke risk evaluations., (© 2023. The Author(s).)

The apparel industry, one of the largest manufacturing industries in the world, generates a large amount of solid waste. It is necessary to reduce excessive apparel consumption in order to reduce waste of the apparel industry. This study takes China as an example to explore the residents' second-hand apparel recycling intention (SARI). Purchasing second-hand, renting and swapping apparel are comprehensively defined as second-hand apparel (SA) recycling. Then, the influence of six environmental psychological factors on SARI is explored, including environmental concern (EC), trust in social media (TSM), consumer innovativeness (CI), face consciousness (FC), perceived consumer effectiveness (PCE) and subjective norm (SN). In this study, 348 valid questionnaires are collected, and structural equation model is used to process the data. The results show that EC, CI and PCE have no significant effect on SARI. SN and TSM positively promote SARI, while FC has a negative effect. The results are expected to provide in-depth insights to further understand and improve the SARI of residents in emerging economies from the environmentally psychological level.

In 2019, China proposed the weight of consumption responsibility (WCR) policy for renewable energy. This study first analyzes the interaction between the electricity market and the green certificate market and establishes a two-market equilibrium model with multiple subjects. Secondly, a system dynamics model of the development decision of the new energy manufacturers (NEMs) under the interaction of the two markets is established. Finally, taking Henan province as an example, the development trend of NEMs is simulated, and sensitivity analysis is conducted to explore the key influencing factors for the development of NEMs. The results show that the electricity market and the green certificate market interact with each other mainly through the price of electricity and the price of green certificates, thus evolving the trading behavior of trading subjects. By 2035, for every 0.25% increase in non-hydropower WCR in Henan province, the annual added new energy installation will be around 1200 MW. In the current scenario, the policy of certificate multiplier will be detrimental to the overall development of NEMs, and a conservative investment strategy and accelerated technology improvements are more beneficial to NEMs. Carbon emission peaking and carbon neutrality policies can also accelerate the growth of new energy installations., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The present study was performed to evaluate the effect of crop rotation on Fusarium mycotoxins and species in cereals in Sichuan Province. A total of 311 cereal samples were randomly collected and analyzed from 2018 to 2019 in Sichuan Province. The results of mycotoxin analysis showed that the major trichothecene mycotoxins in Sichuan Province were nivalenol (NIV) and deoxynivalenol (DON), and the mean concentration of total trichothecenes (including NIV, fusarenone X [4ANIV], DON, 3-acetyldeoxynivalenol [3ADON], and 15-acetyldeoxynivalenol [15ADON]) in wheat was significantly higher than that in maize and rice. The concentration of total trichothecenes in the succeeding crops was significantly higher than that in the previous crops. In addition, wheat grown after maize had reduced incidence and concentration of trichothecene mycotoxins compared with that grown after rice, and ratooning rice grown after rice had increased incidence and concentration of trichothecene mycotoxins. Our data indicated that Fusarium asiaticum with the NIV chemotype was predominant in wheat and rice samples, while the number of the NIV chemotypes of F. asiaticum and Fusarium meridionale and the 15ADON chemotype of Fusarium graminearum in maize were almost the same. Although the composition of Fusarium species was affected by crop rotations, there were no differences when comparing the same crop rotation except for the maize-wheat rotation. Moreover, the same species and chemotype of Fusarium strains originated from different crops in various rotations, but there were no significant differences in pathogenicity in wheat and rice. These results contribute to the knowledge of the effect of crop rotation on Fusarium mycotoxins and species affecting cereals in Sichuan Province, which may lead to improved strategies for control of Fusarium mycotoxins and fungal disease in China.

Background: In recent years, the issue of suicide caused by the stress of a contradictory relationship between graduate students and academic supervisors has aroused heated discussion in society. Based on the interpersonal psychological theory of suicide, this study aims to examine the influence of the perceived abusive supervision on graduate students' suicidal ideation and the parallel mediating roles of thwarted belongingness and perceived burdensomeness., Methods: We conducted a cross-sectional online survey measuring perceived abusive supervision, interpersonal psychological needs and suicidal ideation among 232 Chinese graduate students. A structural equation model was constructed to test the hypothesis., Results: The results showed that abusive supervision directly exacerbated suicidal ideation (β = 0.160, 95% CI = [0.038, 0.281], p = 0.009) and indirectly influenced suicidal ideation through thwarted belongingness (β = 0.059, 95% CI = [0.008, 0.110], p = 0.019) and perceived burdensomeness (β = 0.102, 95% CI = [0.013, 0.191], p = 0.018). The indirect effect accounted for 50.15% of the overall effect., Conclusions: These findings enrich our understanding of the influence of supervisor-student relationship by integrating the literatures on educational and organizational behaviour, and provide practical insights for psychosocial interventions from the perspective of the interpersonal psychological theory of suicide., (© 2023. The Author(s).)