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Development in science, technology, engineering, and mathematics (STEM) is widely emphasized worldwide. In the past decades, China has become the largest rising economy with a strong forward momentum in STEM advancement and education, which has profoundly impacted the global economy. This study investigates the current trends in STEM career aspirations among Chinese adolescents, who will soon become the future workforce. The results indicate a significant increase of students' STEM aspirations in comparison to the 2015 PISA outcomes. Further investigation suggests that the rapid change can be attributed to the recent transitions in world politics which have shifted from collaboration to exclusive competition. Insights gained from this study call for a change of mindset to recognize that in the STEM economy, collaboration is the most powerful form of competition.

Diverse chancelloriids from two sections of the Kaili Biota (Cambrian Wuliuan Stage) in Guizhou Province, China, are systematically described. A total of 25 complete individuals were collected from calcareous silty mudstones of the Cambrian Kaili Formation and are assigned to 3 genera and 6 species, including Archiasterella anchoriformis sp. nov., Chancelloria zhaoi sp. nov., C. eros, Allonnia erjiensis, Al. phrixothrix, and Al. sp. The new species Ar. anchoriformis with sclerites characterised by a large angle between two marginal-lateral rays and an obvious apical tuft represents the first unambiguous Archiasterella scleritome in South China. The C. zhaoi is dominated by a series of bilaterally symmetrical, rosette-like sclerites that composed of five or six lateral rays and a central ray. Moreover, based on a careful survey of the spatial-temporal distribution of chancelloriids (including both scleritome and isolated sclerite fossils) in South China, two flourishing ages, though may be related to preservational bias, of this metazoan group are recognised: 1) a significant diversification in the upper Stage 2 to Stage 3 and 2) a thriving in the Wuliuan Stage. [ABSTRACT FROM AUTHOR]

Cordyceps sinensis is a rare and endangered medicinal herb in China and a typical medicinal and food plant. Most of the research related to Cordyceps sinensis focuses on its pharmacological effects, artificial cultivation and clinical applications. However, there are few comprehensive evaluations on the quality of Cordyceps sinensis under different drying methods. In this study, the effects of vacuum freeze-drying (DG), oven-drying (HG) and air-drying (YG) on the morphological characteristics, microstructure, antioxidant activity and metabolites of Cordyceps sinensis were investigated using wild Cordyceps sinensis as the research object. The results showed that in their appearance and morphology, the YG- and HG-method Cordyceps sinensis samples were darker in color and wilted, while the DG- method Cordyceps sinensis samples were golden yellow in color and had better fullness. In terms of microstructure, the stomata of the YG and HG method Cordyceps sinensis samples were relatively small and irregularly shaped, whereas those of the DG method Cordyceps sinensis samples were larger and neat. In terms of antioxidant capacity, the HG-method samples were the lowest, followed by the YG group, and the DG group had the highest total antioxidant capacity. A correlation analysis revealed a significant relationship between antioxidant capacity and lipids, lipid molecules, nucleosides, nucleotides, and analogs. A metabolomics analysis identified 1937 metabolites from 18 superclasses, with lipids, lipid-like molecules, organic acids and derivatives, organoheterocyclic compounds, and organic oxygen compounds being the predominant metabolites in Cordyceps sinensis. Differentially accumulated metabolites (DAMs) in DG samples showed higher levels of lipids and lipid molecules, organic oxygen compounds, organic acids and derivatives, and organoheterocyclic compounds compared to the other drying methods, suggesting DG as the optimal preservation method for Cordyceps sinensis. These findings offer insights for selecting appropriate drying methods and maintaining the post-drying quality of Cordyceps sinensis. [ABSTRACT FROM AUTHOR]

Cordyceps sinensis is a precious medicinal and edible fungus, which is widely used in body health care and disease prevention. The current research focuses on the comparison of metabolite characteristics between a small number of samples and lacks a comprehensive evaluation of the quality of C. sinensis in a large-scale space. In this study, LC-MS/MS, principal component analysis (PCA), hierarchical cluster analysis (HCA), and the membership function method were used to comprehensively evaluate the characteristics and quality of metabolites in 15 main producing areas of C. sinensis in China. The results showed that a total of 130 categories, 14 supercategories, and 1718 metabolites were identified. Carboxylic acids and derivatives, fatty acyls, organo-oxygen compounds, benzene and substituted derivatives, prenol lipids, and glycerophospholipids were the main components of C. sinensis. The HCA analysis and KEGG pathway enrichment analysis of 559 differentially accumulated metabolites (DAMs) showed that the accumulation models of fatty acids and conjugates and carbohydrates and carbohydrate conjugates in glycerophospholipid metabolism and arginine and proline metabolism may be one of the reasons for the quality differences in C. sinensis in different producing areas. In addition, a total of 18 biomarkers were identified and validated, which had a significant discrimination effect on the samples (p < 0.05). Overall, YS, BR, and ZD, with the highest membership function values, are rich and balanced in nutrients. They are excellent raw materials for the development of functional foods and provide scientific guidance for consumers to nourish health care. [ABSTRACT FROM AUTHOR]

This article tentatively has a research on the history of the relationship between the government and the higher educational institutes and its legal foundation since China's Reform and Opening. It also puts forward the best principles of the relationship between the government and the higher educational institutes at the present stage.

Summary: Background: The relationship between sugar‐free beverage (SFB) intake and childhood obesity among Chinese children is unknown. Objectives: To describe the status of SFB consumption among children and adolescents in China and assess the association between SFB intake and different types of obesity. Methods: The study was based on the baseline data of an ongoing cohort project named Evaluation and Monitoring on School‐based Nutrition and Growth in Shenzhen (EMSNGS). Food frequency questionnaires were used to collect information on SFB consumption in 3227 students aged 9–17. Physical and clinical examinations were conducted by trained investigators and clinicians. Multivariable binary logistic regression models were performed to assess the association between SFB intake and general obesity, overweight/obesity, abdominal obesity, metabolically unhealthy overweight (MUOW)/metabolically unhealthy obesity (MUO). Results: The median age of the participants was 13.28 years. Among the participants, 55.2% were boys, and 66.1% were adolescents. The median SFB consumption was 16.67 mL/d. After adjusting for potential confounding factors, each 100 mL increase in daily SFB intake was associated with an increased risk of overweight/obesity (OR = 1.14; 95%CI: 1.06–1.23), abdominal obesity (OR = 1.12; 95%CI: 1.03–1.23), and MUOW/MUO (OR = 1.12; 95%CI: 1.02–1.21), respectively. Stratified analyses showed that family income may have an impact on the association between SFB intake and overweight/obesity (P for interaction = 0.021) and abdominal obesity (P for interaction = 0.031). Conclusion: SFB intake was positively associated with childhood obesity in Chinese children, particularly among individuals with high‐income families. [ABSTRACT FROM AUTHOR]

The initial release of near real-time (NRT) atmospheric and oceanic science products from Japanese Himawari-8/9 (H8/9) geostationary (GEO) satellites over the South China Sea (SCS) was unveiled in 2024. The primary objective behind crafting these NRT H8/9 satellite products is to facilitate weather and marine environment monitoring, enhance maritime security, and aid ocean navigation, among other purposes. As part of this investigation, a novel NRT data processing system was devised to generate a variety of regional H8/9 GEO satellite science products within a temporal resolution of 10 minutes and a gridded resolution of 0.05° × 0.05° from November 3, 2022 to the present. This algorithm system was built upon the preceding FengYun (FY) geostationary satellite algorithm testbed (FYGAT), which was the prototype of FY-4 GEO meteorological satellite science product operational processing system. These regional H8/9 GEO satellite science products encompass a range of crucial data such as cloud mask, fraction, height, phase, optical and microphysical properties, layered precipitable water, sea surface temperature, etc. We subjected these products to rigorous evaluations against high-quality analogous satellite products and reanalysis data spanning four months in 2023. The validations underscore a strong consistency between the H8/9 GEO satellite atmospheric and oceanic science products over the SCS and the referenced products. Nevertheless, slight discrepancies in these satellite science products were identified, primarily stemming from variations in sensor/dataset characteristics, retrieval algorithms, and geometric conditions. These outcomes demonstrate the suitability of the first edition of NRT atmospheric and oceanic science products of H8/9 satellites over the SCS in supporting the intended quantitative applications. This NRT GEO satellite data record is publicly accessible through the File Transfer Protocol (FTP) provided by the Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai) in China. Free access to the dataset can be found at https://doi.org/10.6084/m9.figshare.25015853 (Liu, 2024). [ABSTRACT FROM AUTHOR]

Phellodendron chinense is an extraordinary medicinal plant, and its stem bark is a famous traditional Chinese medicine in China, containing a number of phytochemicals with biological and pharmacological functions. Studies have shown that the medicinal ingredients in P. chinense from various regions are different, as soil types might be important factors affecting the growth and quality of P. chinense. In this study, the effects of acidic purple soil, alkaline purple soil, yellow soil and red soil on the growth, nutrient element accumulation and partitioning in P. chinense seedlings were studied. Our results showed that the biomass of leaves and stems in acidic purple soil was significantly higher than in other soils, and the root biomass was significantly lower than that in yellow soil. C, N, P and Ca contents cultured in acidic purple soil were the highest compared to other soils, and K and Mg content were the highest in yellow soil and red soil, respectively. The distribution of carbon between different organs can reflect environmental stress. N has become a limiting factor for the growth and development of P. chinense seedlings. C:N and C:P ratios in the leaves were significantly lower than those in the stem and roots. Among four soil types, the highest N:P ratio was 1.65 in P. chinense seedlings. These results suggest that four soil types may significantly affect the accumulation and distribution of biomass and nutrient elements in P. chinense seedlings. The characteristic patterns in different organs have different responses. Acidic purple soil is more suitable for the growth of P. chinense. These findings will help to understand the distribution characteristics and requirements of nutrient elements in P. chinense seedlings, and further provide a theoretical basis and reference for site selection and cultivation strategy. [ABSTRACT FROM AUTHOR]

This comparative study examines the way in which preschool teachers support children's science learning in a Chinese and a Norwegian kindergarten. The study takes an ethnographic approach. Preschool teachers from one kindergarten in Shanghai and one in Bergen were asked to videotape educational activities that focused on science in their kindergartens. These videos, as well as videos taken by the researchers, were used as a starting point for semi-structured group interviews with the preschool teachers. Our aim was to explore the science-oriented activities, strategies and objectives; and some of the sociocultural factors that might influence the preschool teachers' practices. Closer analysis, which took into consideration cultural values and traditions, revealed clear links between culture and practice.

Development in science, technology, engineering, and mathematics (STEM) is widely emphasized worldwide. In the past decades, China has become the largest rising economy with a strong forward momentum in STEM advancement and education, which has profoundly impacted the global economy. This study investigates the current trends in STEM career aspirations among Chinese adolescents, who will soon become the future workforce. The results indicate a significant increase of students' STEM aspirations in comparison to the 2015 PISA outcomes. Further investigation suggests that the rapid change can be attributed to the recent transitions in world politics which have shifted from collaboration to exclusive competition. Insights gained from this study call for a change of mindset to recognize that in the STEM economy, collaboration is the most powerful form of competition. [ABSTRACT FROM AUTHOR]

Assessing long-term tumor survival rates is crucial for evaluating the effectiveness of tumor treatment and burden. However, timely assessment of long-term survival in patients with pancreatic cancer is lagging in China. In this study, we applied period analysis to estimate the long-term survival of pancreatic cancer patients using data from four population-based cancer registries in Taizhou city, eastern China. A total of 1121 patients diagnosed with pancreatic cancer between 2004 and 2018 were included. We assessed the 5-year relative survival (RS) using period analysis and further stratified by sex, age at diagnosis, and region. The 5-year RS during 2014–2018 overall reached 18.9% (14.7% for men and 23.3% for women, respectively). A decrease of the 5-year RS from 30.3% to 11.2% was observed in four diagnostic age gradients (< 55, 55–64, 65–74, and > 74 years age groups). The 5-year RS was higher in urban (24.2%) than in rural (17.4%) areas. Moreover, the 5-year RS of pancreatic cancer patients showed an overall increasing trend for the three periods (2004–2008, 2009–2013, and 2014–2018). Our study, using period analysis for the first time in China, provides the latest estimates of the survival of patients with pancreatic cancer, which provides essential evidence for the prevention and intervention of pancreatic cancer. The results also indicate the importance of further applications of the period analysis for more up-to-date and accurate survival estimates. [ABSTRACT FROM AUTHOR]

In times of such public health crisis as the COVID-19, staying well-informed can not only help people get prepared and make wise decisions, but also relieve anxiety. Students with disabilities, however, face great difficulty in keeping up-to-date on the pandemic. Using a qualitative research method, this study explored the experiences and perceived difficulties of special education teachers in trying to keep their students informed amid the COVID-19 pandemic. Semistructured focus group interviews were conducted with a total of 24 teachers from seven special education schools in China. The results showed that teachers adopted various measures to improve students' information access, such as holding weekly class meetings, making use of posters and LED displays, working with families and collaborating with local health institutions. Despite these efforts, teachers reported facing multiple challenges and much remains to be desired. This research highlights the need for a holistic approach to providing information for students with disabilities, one that is tailored to their special needs and that involves other players in addition to teachers. [ABSTRACT FROM AUTHOR]

Purpose. Few related factors of low bone mass in Cushing's disease (CD) have been identified so far, and relevant sufficient powered studies in CD patients are rare. On account of the scarcity of data, we performed a well-powered study to identify related factors associated with low bone mass in young CD patients. Methods. This retrospective study included 153 CD patients (33 males and 120 females, under the age of 50 for men and premenopausal women). Bone mineral density (BMD) of the left hip and lumbar spine was measured by dual energy X-ray absorptiometry (DEXA). In this study, low bone mass was defined when the Z score was −2.0 or lower. Results. Among those CD patients, low bone mass occurred in 74 patients (48.37%). Compared to patients with normal BMD, those patients with low bone mass had a higher level of serum cortisol at midnight (22.31 (17.95-29.62) vs. 17.80 (13.75-22.77), p = 0.0006), testosterone in women (2.10 (1.33–2.89) vs. 1.54 (0.97–2.05), p = 0.0012), higher portion of male (32.43% vs. 11.54%, p = 0.0016) as well as hypertension (76.12% vs. 51.67%, p = 0.0075), and lower IGF-1 index (0.59 (0.43–0.76) vs. 0.79 (0.60–1.02), p = 0.0001). The Z score was positively associated with the IGF-1 index in both the lumbar spine (r = 0.35153, p < 0.0001) and the femoral neck (r = 0.24418, p = 0.0057). The Z score in the femoral neck was negatively associated with osteocalcin (r = −0.22744, p = 0.0229). Compared to the lowest tertile of the IGF-1 index (<0.5563), the patients with the highest tertile of the IGF-1 index (≥0.7993) had a lower prevalence of low bone mass (95% CI 0.02 (0.001–0.50), p = 0.0002), even after adjusting for confounders such as age, gender, duration, BMI, hypertension, serum cortisol at midnight, PTH, and osteocalcin. Conclusions. The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass. [ABSTRACT FROM AUTHOR]

Interleukin 21 (IL-21) is a receptor participating in innate immunity and correlates with the activation of innate immune cells. We sought to investigate the role of plasma IL-21 in patients with idiopathic membranous nephropathy (IMN). This was a cross-sectional and case-control study. We analyzed plasma IL-21 in patients with IMN, with other kidney diseases as the diseased controls (DCs), and the healthy controls (HCs), regarding their associations with the risk of having IMN and IMN severity. We enrolled 132, 22, and 38 patients with IMN, DC, and HC, respectively. Plasma IL-21 was significantly higher in those with IMN [9.42 (6.93, 12.60)] and DC [7.84 (2.90, 7.95)] compared with HC [5.60 (2.90, 7.10)] (p<0.05). Plasma IL-21 was significantly higher in those with IMN stage III [10.36 (6.94, 20.88)] and II [9.75 (7.60, 14.27)] than those with IMN stage I [6.99 (3.91, 9.08)] (p<0.05). Plasma IL-21 was significantly higher in those with a positive anti-phospholipase A2 receptor antibody (PLA2R) [9.60 (8.27, 12.93)] than those with a negative anti-PLA2R antibody [4.84 (2.90, 11.28)] (p<0.05). Receiver operator characteristic curve analysis showed that a cutoff value of 7.665 pg/mL distinguished patients with IMN from HC and DC with a sensitivity and specificity of 68.94 and 89.47 %, respectively, and the area under the curve was 0.8184. A cutoff value of 7.830 pg/mL identified those with IMN stage II with a sensitivity and specificity of 74.03 and 89.47 %, respectively, with an area under the curve of 0.8718 (p<0.001). Multivariate regression showed that plasma IL-21 was positively correlated with anti-PLA2R and 24 h urine protein, and negatively correlated with total protein and serum albumin. Plasma IL-21 levels increased significantly in patients with IMN. IL-21 may therefore serve as a biomarker for IMN. [ABSTRACT FROM AUTHOR]

The relationship between serum creatinine and type 2 diabetes is limited. We aimed to investigate the association of baseline serum creatinine and new-onset type 2 diabetes in Chinese population. This retrospective cohort study was conducted using data from the health screening program in China. The population were divided into four groups based on serum creatinine levels, and the outcome of interest was the occurrence of a diabetic event. Cox proportional risk model was used to assess the independent effect of baseline serum creatinine level on future diabetes risk. Sensitivity and subgroup analysis were used to verify the reliability of the results. After an average follow-up of 3.12 years, among 201,298 individuals aged ≥ 20 years, 3389 patients developed diabetes. Compared with participants in quartile 2–4 (> 51.6umol/L for female, > 71.8umol/L for male,), a significantly higher risk of new-onset Type 2 Diabetes (OR, 1.15; 95%CI: 1.07–1.23) was found in those in quartile 1 (< 51.6umol/L for female, < 71.8umol/L for male). Moreover, Similar results were found in various subgroups stratified by age, BMI, TG, TC, FPG and family history group. Low serum creatinine is independently associated with increased risk of type 2 diabetes in Chinese adults. It was also stable in various subgroups stratified. [ABSTRACT FROM AUTHOR]

Background: Patients suffered aneurysmal subarachnoid hemorrhage (aSAH) usually develop poor survival and functional outcome. Evaluating aSAH patients at high risk of poor outcome is necessary for clinicians to make suitable therapeutical strategy. This study is conducted to develop prognostic model using XGBoost (extreme gradient boosting) algorithm in aSAH. Methods: A total of 351 aSAH patients admitted to West China hospital were identified. Patients were divided into training set and test set with ratio of 7:3 to testify the predictive value of XGBoost based prognostic model. Additionally, logistic regression model was also constructed and compared with XGBoost based model. Area under the receiver operating characteristic curve (AUC), sensitivity and specificity were calculated to evaluate the value of XGBoost and logistic regression. Results: There were 74 (21.1%) non-survivors and 148 (42.1%) patients with unfavorable functional outcome. Non-survivors had older age (p=0.025), lower Glasgow coma scale (GCS) (p< 0.001), higher World Federation of Neurosurgical Societies WFNS score (p< 0.001), mFisher score (p< 0.001). The incidence of intraventricular hemorrhage (IVH) (p=0.025) and delayed cerebral ischemia (DCI) (p< 0.001) was higher in non-survivors than survivors. The AUC of XGBoost model for predicting mortality and unfavorable functional outcome were 0.950 and 0.958, which were higher than 0.767 and 0.829 of logistic regression model. Conclusion: XGBoost based model is more precise than logistic regression model in predicting outcome of aSAH patients. Using XGBoost prognostic model is helpful for clinicians to identify high-risk aSAH patients and therefore strengthen medical care. [ABSTRACT FROM AUTHOR]

People living with HIV (PLWH) bear higher prevalence of HCV coinfection. An accessible directly acting antivirals regimen with less drug–drug interaction with antiretroviral therapy (ART) is urgently needed in source limited regions. We aimed to assess the efficacy and safety of SOF + RBV for 24 weeks regimen in HIV–HCV coinfected patients in Liangshan Prefecture, China. PLWH under ART from China's national free antiretroviral treatment project (CNFATP) and diagnosed with treatment-naïve HCV infection were enrolled. SOF + RBV was administrated for 24 weeks and patients were followed for ≥ 12 weeks. The efficacy and safety were analyzed and related factors were explored. 58 patients completed 24 weeks of SOF + RBV and had all tests done. Genotype prevalence in this population was G3 44.8% (n = 26), G6 31.0% (n = 18) and G1 17.2% (n = 10) respectively. 52/58 (89.7%) patients achieved SVR12 while 10.3% experienced therapeutic failure. However, SVR12 was neither significantly different between groups of different gender, age, transmission routines, CD4+ cell count, HIV infection duration, ART duration and HBsAg prevalence nor influenced by HCV viral load, genotypes and hepatic stiffness. The regimen was well-tolerated without any serious AEs or AEs leading to treatment adjustment or discontinuation reported. PLWH in Liangshan showed a high prevalence of HCV coinfection with GT3 and GT6 as the most frequent genotypes. SOF + RBV for 24 weeks could achieve good SVR12 in this population and was well-tolerated. It has great potential to be generalized in coinfected population in source-limited regions. [ABSTRACT FROM AUTHOR]

The killer cell immunoglobulin-like receptor (KIR), which mediates the killing function of NK cells, is an attractive candidate for adoptive cellular therapy. The ethnic distribution for China provides a unique opportunity to investigate KIR gene distribution. The aim of this study was to explore the relationship between population history and the rapidly evolving KIR genetic diversity. 8050 Chinese donors from 184 hospitals were included to analyse frequency, haplotype, and B-content data of 16 KIR genes, by PCR-SSP for KIR genotyping. KIR gene carrier frequencies were found similar to those observed in other studies on Han, but different from Thais, Japanese, Africans, and populations of West Eurasian ancestry. High-frequency KIR genotype profiles found in the present population were consistent with other studies on Han populations but different from those conducted on other cohorts. The majority of our cohort carried group A KIR gene motifs. Additionally, populations with similar geographic locations in China were shown clustered together, while Hainan and Xinjiang provinces were slightly separated from these. The distribution of KIR genes varies by geographic region, and different ethnic groups may be a confounding factor of KIR diversity. [ABSTRACT FROM AUTHOR]

Streptococcus agalactiae colonization in pregnant women can cause postpartum intrauterine infections and life-threatening neonatal infections. To formulate strategies for the prevention and treatment of S. agalactiae infections, we performed a comprehensive analysis of antibiotic resistance and a molecular-based epidemiological investigation of S. agalactiae in this study. Seventy-two S. agalactiae strains, collected from pregnant women, were subjected to antibiotic susceptibility tests; then, the screened erythromycin and clindamycin nonsusceptible isolates were used for macrolides and clindamycin resistance genes detection, respectively. Detection of resistance genes, serotyping, and determination of virulence genes were performed by polymerase chain reaction. The clonal relationships among the colonized strains were evaluated by multilocus sequence typing. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) mass peak analysis was performed to discriminate the specific sequence types (STs). In our study, 69.4% and 47.2% of the strains were nonsusceptible to erythromycin and clindamycin, respectively; the multidrug resistance rate was 66.7%. All erythromycin nonsusceptible strains harbored resistance genes, whereas only 52.9% of the clindamycin nonsusceptible strains possessed the linB gene. Erythromycin resistance was mainly mediated by the ermB or mefA/E genes. Four serotypes were identified, and the most common serotype was serotype III (52.8%), followed by Ib (22.2%), Ia (18.0%), and II (4.2%). All the strains were divided into 18 STs that were assigned to nine clonal complexes. Most of the major STs were distributed into specific serotypes, including ST19/serotype III, ST17/serotype III, ST485/serotype Ia, ST862/serotype III, and ST651/serotype III. Analysis of virulence genes yielded seven clusters, of which bca-cfb-scpB-lmb (61.6%) was the predominant virulence gene cluster. Among all ST strains distributed in this region, only the ST17 strains had a mass peak at 7620 Da. The outcomes of this study are beneficial for the epidemiological comparison of colonized S. agalactiae in different regions and may be helpful for developing the strategies for the prevention of S. agalactiae infection in Guangzhou. Furthermore, our results show that MALDI-TOF MS can be used for the rapid identification of the ST17 strains. [ABSTRACT FROM AUTHOR]

Background: Whether a relationship exists between various metabolic factors and thyroid-stimulating hormone (TSH) levels in euthyroid persons remains unknown. This study aims to explore the relationship between TSH levels and metabolic factors in euthyroid individuals. Methods: A total of 2,663 subjects were enrolled from a nationwide population-based cross-sectional survey of iodine nutrition, thyroid disease and diabetes in China (2014–2017). Euthyroid individuals were divided into four groups according to quartiles of TSH levels: group A (n=305, 0.3–1.3 mIU/L), group B (n=829, 1.3–2.2 mIU/L), group C (n=673, 2.2–3.2 mIU/L) and group D (n=349, 3.2–4.2 mIU/L). Anthropometric parameters, biochemical indicators and TSH levels were determined. Results: A total of 2,156 euthyroid subjects with serum TSH levels within the normal range accounted for 86.8% of the sample. The systolic blood pressure (SBP) in group D was significantly higher than that in the other three groups. Group C displayed significantly lower thyroid peroxidase antibody (TPOAb) levels than the other three groups. Group C also had lower anti-thyroglobulin antibody (TgAb) levels than groups A and D, whereas the TgAb levels in group B were only lower than those in group A. Spearman's or Pearson's linear regression analysis showed that SBP (r=0.054; P=0.013) was positively correlated with TSH, but cholesterol (TC) (r=−0.043, P=0.047) was negatively correlated with TSH. Multiple stepwise regression analysis revealed that SBP, the urinary iodine concentration (UIC), waist circumference (WC), body mass index (BMI), TC, triglycerides (TGs) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of serum TSH levels. Conclusion: This large population-based study demonstrates a significant interaction between metabolic factors and TSH levels. An adverse weight status, high blood pressure levels, blood lipid metabolism disorder and excessive iodine intake may be early manifestations of thyroid disease in euthyroid subjects. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate an interactive nomogram to predict healthcare-associated infections (HCAIs) in the intensive care unit (ICU). Methods: A multicenter retrospective study was conducted to review 2017 data from six hospitals in Guizhou Province, China. A total of 1,782 ICU inpatients were divided into either a training set (n = 1,189) or a validation set (n = 593). The patients’ demographic characteristics, basic clinical features from the previous admission, and their need for bacterial culture during the current admission were extracted from electronic medical records of the hospitals to predict HCAI. Univariate and multivariable analyses were used to identify independent risk factors of HCAI in the training set. The multivariable model’s performance was evaluated in both the training set and the validation set, and an interactive nomogram was constructed according to multivariable regression model. Moreover, the interactive nomogram was used to predict the possibility of a patient developing an HCAI based on their prior admission data. Finally, the clinical usefulness of the interactive nomogram was estimated by decision analysis using the entire dataset. Results: The nomogram model included factor development (local economic development levels), length of stay (LOS; days of hospital stay), fever (days of persistent fever), diabetes (history of diabetes), cancer (history of cancer) and culture (the need for bacterial culture). The model showed good calibration and discrimination in the training set [area under the curve (AUC), 0.871; 95% confidence interval (CI), 0.848–0.894] and in the validation set (AUC, 0.862; 95% CI, 0.829–0.895). The decision curve demonstrated the clinical usefulness of our interactive nomogram. Conclusions: The developed interactive nomogram is a simple and practical instrument for quantifying the individual risk of HCAI and promptly identifying high-risk patients. [ABSTRACT FROM AUTHOR]

Objective: To retrospectively analyze the adverse effects of high-intensity focused ultrasound (HIFU) in management of benign uterine diseases. Materials and methods: From 2011 to 2017, 27,053 patients with benign uterine diseases were treated with HIFU in 19 centers in China. Among them, 17,402 patients had uterine fibroids, 8434 had adenomyosis, 876 had caesarean scar pregnancies, and 341 had placenta accreta. Results: The median age, height, weight, BMI of the patients was 42 years, 158 mm, 56 kg, 22.5 kg/cm2, respectively. After HIFU treatment, 13,170 adverse events were observed. Based on society of interventional radiology classification system, these adverse events were classified as Class A (47.5030%), Class B (0.7947%), Class C (0.3327%), and Class D (0.0518%). The rate of major adverse effects (Class C&D) was 0.3844%. Major adverse effects include skin burn, leg pain, vaginal discharge or bleeding, urinary retention, acute cystitis, intrauterine infection, bowel injury, acute renal failure, deep vein thrombosis, pubic symphysis injury, post-HIFU thrombocytopenia, sciatic nerve injury, and hydronephrosis. In 2011, the annual rate of major adverse effects was 0.9565%; the incidence decreased to 0.2852% in 2017. No significant difference was observed in the rates of major adverse effects between patients with uterine fibroids, adenomyosis and placenta accreta. Conclusions: Based on the results with low rate of major adverse effects from multiple centers, we concluded that HIFU is safe in treating patients with benign uterine diseases. With development of this technique and more experience on the part of the physicians, the rates of the major adverse effects will be further lowered. [ABSTRACT FROM AUTHOR]

For centuries, Flos Trollii has been consumed as functional tea and a folk medicine in China's north and northwest zones. The quality of Flos Trollii highly depends on the producing zones. Unfortunately, few studies have been reported on the geographical discrimination of Flos Trollii. This work comprehensively investigated Flos Trollii compounds with an integration strategy combining gas chromatography-mass spectrometry (GC-MS) and ultrahigh-performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) with chemometrics to explore the differences between Flos Trollii obtained from various origins of China. About 71 volatile and 22 involatile markers were identified with GC-MS and UHPLC-HRMS, respectively. Geographical discrimination models were synthetically investigated based on the identified markers. The results indicated that the UHPLC-HRMS coupled with the fisher discrimination model provided the best prediction capability (>97%). This study provides a new solution for Flos Trollii discrimination. • Developed a strategy combining GC-MS and UHPLC-HRMS with chemometrics to investigate compound variations in Flos Trollii. • The UHPLC-HRMS coupled with the FDA provided the best prediction capability (>97%). • The developed strategy should be an effective tool for determining the geographic origin of Flos Trollii. [ABSTRACT FROM AUTHOR]

Maize yield is limited by water deficit in the arid and semiarid regions of China. Conserving water and enhancing crop water productivity are inevitable requirements for the sustainable development of water efficient agriculture. Plant growth regulators (PGRs) play important roles in maize water stress tolerance. In this study, we investigated the effect of plant growth regulator-brazide, a functional analog of brassinolide (BR), on maize water stress resistance through a two-year (2020–2021) field experiment. The experiment included four water treatments (I100: 4012 m3 ha−1; I80: 3210 m3 ha−1; I60: 2407 m3 ha−1; I40: 1605 m3 ha−1), four PGR concentrations (CK: water; Bra: 0.1 μmol L−1 14-hydroxylated brassinosteroid; B1: 0.1 μmol L−1 brazide; B2: 1 μmol L−1 brazide; B3: 10 μmol L−1 brazide). The results showed that deficit irrigation (I60 and I40) decreased soil water content (SWC), photosynthetic rate (Pn), leaf area index (LAI), aboveground biomass (AB) and yield, but improved crop water productivity (WP c). Under deficit irrigation conditions, 1 μmol L−1 brazide application also increased dry matter accumulation and grain yield, a result attributed to improvement of the photosynthetic rate and increases in the root bleeding saps, water productivity. 1 μmol L−1 Brazide application reduced bare tip length, increasing kernel number per ear, thereby increased the yield of I60 and I40 by 15.1% and 11.4% (p ≤ 0.05; 2020), 16.4% and 20.4% (p ≤ 0.001; 2021), respectively. Path analysis showed brazide improved final yields by increasing thousand grain weight (TGW), photosynthetic rate (Pn) and WP c under deficit irrigation. The increase in TGW with brazide treatment was primarily attributed to the increase of Pn. Overall, Brazide increased maize drought resistance mainly by increasing Pn and WP c , with 1 μmol L−1 brazide as an optimal concentration. • A new plant growth regulator, Brazide, was evaluated in maize. • Brazide increased photosynthetic rate and WUE under deficit irrigation. • Application of brazide improved maize growth and grain yield under deficit irrigation. • 1 μmol L−1 brazide as an optimal concentration for maize in arid region of Northwest China. [ABSTRACT FROM AUTHOR]

Schools’ busy situation is far away from its Greek root “Scholé” that means leisure time compared with political duty and war at that era which is also similar in ancient China. From the leisure point of view, school should be relax and free for young children in kindergarten. This means that play should take the most time on the schedule. Unfortunately, Political class skillfully disseminating serious competition among nations to deliver anxiety on young generations’ education to the public,which makes parents and school system highly valued formal learning much more than play. Chinese kindergarten may be have the longest formal learning time due to its history emphasis on learning from the model. Endure hardship as the basic habit from the younger children for the nature of life is full of hardship in Chinese philosophy. These underpinned ideas encounter great challenges from the Western early childhood education which puts more emphasis on play. Play is conceived as children’s life itself, in which integrated learning can happen and is much more suitable and abundant for young children than formal learning. Although Chinese Educational Ministry promulgated kindergarten work regulation and educational guideline to make play as the basic activity in 1996 and 2001,there are still lots of factors that impede kindergartens implement play in practice. Lack of free time in kindergarten both on schedule and in fact is the obvious sign. This paper wants to reflect those factors in cultural perspective and try to use variety meanings of time especially subjective time to analysis the practice on reconstructing kindergartens’ play atmosphere and time, and the findings on creating different inter-subjective time for young children. [ABSTRACT FROM AUTHOR]

Data from 26 drill wells and 27 regional seismic profiles were integrated to investigate the timing, phase and origin of the post-rift subsidence in the middle to eastern Pearl River Mouth Basin (PRMB) of the northern South China Sea using the traditional 1-D backstripping technique. Different from previous research of backstripped tectonic subsidence in the basin, we calculated the tectonic subsidence using the newly built local porosity-depth relationships for decompaction and updated sedimentological and paleontological data for paleobathymetry reconstruction. Well-data based subsidence curves reveal a roughly decaying pattern in both the magnitude and rate of the post-rift subsidence in the PRMB, which is in accordance with the general decreasing trend of the thermal subsidence typical of a passive margin. Two events of rapid post-rift tectonic subsidence were identified, which occurred in the Early to early Middle Miocene and the Pliocene. The timing of the first rapid post-rift subsidence event varies and is earlier in the southern rather than northern part of the basin. Additionally, the amplitude of contemporaneous tectonic subsidence is greater in the southern part of the basin. The second rapid tectonic subsidence event occurred simultaneously in both the southern and northern parts of the basin, with the amplitude of subsidence being much greater in the southern part. We associate the first rapid subsidence event with the southward jump of the South China Sea spreading ridge, which occurred between the Oligocene and Early Miocene, while the second event with the arc-continent collision at Taiwan since the latest Late Miocene. The southern PRMB in the deep-water slope area shows a much higher magnitude of tectonic subsidence in both events than its northern counterpart in the shelf area, which could be associated with its much thinner lithosphere. The latter could cause upswelling of denser lower crust and upper mantle material, resulting in more rapid tectonic subsidence in the southern PRMB. [ABSTRACT FROM AUTHOR]

Enterocytozoon bieneusi is an obligate eukaryotic intracellular parasite that infects a wide variety of vertebrate and invertebrate hosts. Although considerable research has been conducted on this organism, relatively little information is available on the occurrence of E. bieneusi in captive Asiatic black bears. The present study was performed to determine the prevalence, genetic diversity, and zoonotic potential of E. bieneusi in captive Asiatic black bears in zoos in southwestern China. Fecal specimens from Asiatic black bears in four zoos, located in four different cities, were collected and analyzed for the prevalence of E. bieneusi. The average prevalence of E. bieneusi was 27.4% (29/106), with the highest prevalence in Guiyang Zoo (36.4%, 16/44). Altogether, five genotypes of E. bieneusi were identified among the 29 E. bieneusi-positive samples, including three known genotypes (CHB1, SC02, and horse2) and two novel genotypes named ABB1 and ABB2. Multi-locus sequence typing using three microsatellites (MS1, MS3, and MS7) and one minisatellite (MS4) revealed V, III, V, and IV genotypes at these four loci, respectively. Phylogenetic analysis showed that the genotypes SC02 and ABB2 were clustered into group 1 of zoonotic potential, the genotypes CHB1 and ABB1 were clustered into a new group, and the genotype horse2 was clustered into group 6 of unclear zoonotic potential. In conclusion, this study identified two novel E. bieneusi genotypes in captive Asiatic black bears, and used microsatellite and minisatellite markers to reveal E. bieneusi genetic diversity. Moreover, our findings show that genotypes SC02 (identified in humans) and ABB2 belong to group 1 with zoonotic potential, suggesting the risk of transmission of E. bieneusi from Asiatic black bears to humans and other animals. [ABSTRACT FROM AUTHOR]

Bradysia odoriphaga Yang and Zhang (the chive gnat) is the major insect pest affecting Chinese chives ( Allium tuberosum Rottl. ex Spreng.) in Northern China. Only three insecticide products are registered for its control. In the present study, we compared the persistence and distribution of thiamethoxam and phoxim in soil and determined their long-acting control effects against B. odoriphaga and two other secondary pests, Thrips alliorum Priesner and the Asiatic onion leaf miner Acrolepia alliella Semenov and Kuznetsov (Lepidoptera: Acrolepiidae), after a single soil application using the directional spray-washing method during the early Chinese chive root-rearing period. Under the same applied dosage, the rhizosphere soil at a depth of 4.0–10.0 cm had concentrations of thiamethoxam and phoxim ranging from 2.21 to 7.44 mg/kg and 0.09–0.44 mg/kg, respectively, at the 7th day after application. The half-lives of thiamethoxam and phoxim in the soil were 27.5 and 6.7 days, respectively. Thiamethoxam persisted for 210 days, whereas phoxim only persisted for 45 days in the soil and plants. In addition, thiamethoxam applied at 6.0 kg a.i./ha maintained a low population density of B. odoriphaga, T. alliorum and A. alliella for nine months longer than phoxim. In conclusion, thiamethoxam may help farmers more effectively manage B. odoriphaga and other secondary pests on Chinese chive and reduce the costs of insecticide use while sustaining protection. [ABSTRACT FROM AUTHOR]

To study the dissipation rates and final residual levels of chlorantraniliprole and thiamethoxam in maize straw, maize, and soil, two independent field trials were conducted during the 2014 cropping season in Beijing and Anhui Provinces of China. A 40% wettable powder (20% chlorantraniliprole + 20% thiamethoxam) was sprayed onto maize straw and soil at an application rate of 118 g of active ingredient per hectare (g a.i.ha−1). The residual concentrations were determined by ultra-high-performance liquid chromatography–tandem mass spectrometry. The chlorantraniliprole half-lives in maize straw and soil were 9.0–10.8 and 9.5–21.7 days, respectively. The thiamethoxam half-lives in maize straw and soil were 8.4–9.8 and 4.3–11.7 days, respectively. The final residues of chlorantraniliprole and thiamethoxam in maize straw, maize, and soil were measured after the pesticides had been sprayed two and three times with an interval of 7 days using 1 and 1.5 times the recommended rate (72 g a.i. ha−1and 108 g a.i. ha−1, respectively). Representative maize straw, maize, and soil samples were collected after the last treatment at pre-harvest intervals of 7, 14, and 28 days. The chlorantraniliprole residue was below 0.01 mg kg−1in maize, between 0.01 and 0.31 mg kg−1in maize straw, and between 0.03 and 1.91 mg kg−1in soil. The thiamethoxam residue concentrations in maize, maize straw, and soil were <0.01, <0.01, and 0.01–0.03 mg kg−1, respectively. The final pesticide residues on maize were lower than the maximum residue limit (MRL) of 0.02 mg kg−1after a 14-day pre-harvest interval. Therefore, a dosage of 72 g a.i. ha−1was recommended, as it can be considered safe to human beings and animals. [ABSTRACT FROM PUBLISHER]

The chemical composition of the essential oils and fatty acids among nine groups of Platycodi Radix in China was analyzed by gas chromatography–mass spectrometry. Complicated components were resolved using chemometric methods. Simultaneously, the various features among heuristic evolving latent projections, selective ion analysis and alternative moving window factor analysis were compared by using some experimental data. Temperature-programmed retention indices were applied in further identification of the chemical composition of the essential oils. The equivalent chain length, fraction chain length, and an established special retention indices library integrated with mass spectrometry were also applied to further identify the composition of fatty acids, including total fatty acids, esterified fatty acids and free fatty acids. A total of 121 different compounds accounting for 95.12–98.74% were identified among the essential oils. Chemical polymorphisms and variation existed in the essential oils of Platycodi Radix. Sixteen components were identified in fatty acids, and linoleic acid (18:2n-6c) and other unsaturated acid possess a characteristic majority. [ABSTRACT FROM AUTHOR]

Objective: To assess the health-related quality of life (QOL) of doctors and nurses using the recent free-access data. Methods: The health-related QOL data of doctors and nurses came from a sub-survey of the Fourth National Health Services Survey (NHSS) of China in 2008, which used the European Quality of Life-5 Dimensions 3 level version (EQ-5D-3L) to measure the QOL. We used logistic regression to compare the percentage of respondents reporting any problems for each dimension of the EQ-5D-3L descriptive system between inhabitants aged 15-64 years and doctors and nurses. Results: Fewer doctors and nurses reported problems in mobility (1.9%) than inhabitants aged 15-64 years (2.9%) (odds ratio = 0.65). No difference was detected in self-care problem. Compared with inhabitants aged 15-64 years, a relatively large proportion of doctors and nurses reported problems in usual activities (3.4% vs. 2.7%; odds ratio = 1.27), pain/discomfort (18.1% vs. 6.7%; odds ratio = 3.08), and anxiety/depression (24.6% vs. 5.1%; odds ratio = 6.07). The EQ-VAS score mean of doctors and nurses approached that of inhabitants aged 15-64 years (82 vs. 79). Conclusion: Compared with inhabitants aged 15-64 years, doctors and nurses have relatively poor health in usual activities, self-reporting pain/discomfort, and anxiety/depression. [ABSTRACT FROM AUTHOR]

Abstract: A high-resolution regional black carbon (BC) and organic carbon (OC) emission inventory for the year 2009 was developed for the Pearl River Delta (PRD) region, China, based on the collected activity data and the latest emission factors. PM2.5, BC and OC emissions were estimated to be 303kt, 39kt and 31kt, respectively. Industrial processes were major contributing sources to PM2.5 emissions. BC emissions were mainly from mobile sources, accounting for 65.0%, while 34.1% of OC emissions were from residential combustion. The primary OC/BC ratios for individual cities in the PRD region were dependent on the levels of economic development due to differences in source characteristics, with high ratios in the less developed cities and low ratios in the central and southern developed areas. The preliminary temporal profiles were established, showing the highest OC emissions in winter and relatively constant BC emissions throughout the year. The emissions were spatially allocated into grid cells with a resolution of 3km×3km. Large amounts of BC emissions were distributed over the central–southern PRD city clusters, while OC emissions exhibited a relatively even spatial distribution due to the significant biomass burning emissions from the outlying area of the PRD region. Uncertainties in carbonaceous aerosol emissions were usually higher than in other primary pollutants like SO2, NOx, and PM10. One of the key uncertainty sources was the emission factor, due to the absence of direct measurements of BC and OC emission rates. [Copyright &y& Elsevier]

To investigate the effects of anthropogenic activity, namely, land use change and reservoir construction, on particulate organic carbon (POC) transport, we collected monthly water samples during September 2007 to August 2009 from the Longchuanjiang River to understand seasonal variations in the concentrations of organic carbon species and their sources and the yield of organic and inorganic carbon from the catchment in the Upper Yangtze basin. The contents of riverine POC, total organic carbon and total suspended sediment (TSS) changed synchronously with water discharge, whereas the contents of dissolved organic carbon had a small variation. The POC concentration in the suspended sediment decreased non-linearly with increasing TSS concentration. Higher molar C/N ratio of particulate organic matter (average 77) revealed that POC was dominated by terrestrially derived organic matter in the high flows and urban wastewaters in the low flows. The TSS transported by this river was 2.7 × 105 t/yr in 2008. The specific fluxes of total organic carbon and dissolved inorganic carbon (DIC) were 5.6 and 6 t/km2/yr, respectively, with more than 90% in the high flow period. A high carbon yield in the catchment of the upper Yangtze was due to human-induced land use alterations and urban wastes. Consistent with most rivers in the monsoon climate regions, the dissolved organic carbon-POC ratio of the export flux was low (0.41). Twenty-two percent (0.9 t/km2/yr) of POC out of 4 t/km2/yr was from autochthonous production and 78% (3.1 t/km2/yr) from allochthonous production. The annual sediment load and hence the organic carbon flux have been affected by environmental alterations of physical, chemical and hydrological conditions in the past 50 years, demonstrating the impacts of human disturbances on the global and local carbon cycling. Finally, we addressed that organic carbon flux should be reassessed using adequate samples (i.e. at least two times in low-flow month, four times in high-flow month and one time per day during the flood period), daily water discharge and sediment loads and appropriate estimate method. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: Multi-year inventories of biomass burning emissions were established in the Pearl River Delta (PRD) region for the period 2003–2007 based on the collected activity data and emission factors. The results indicated that emissions of sulfur dioxide (SO2), nitrogen oxide (NOx), ammonia (NH3), methane (CH4), organic carbon (OC), non-methane volatile organic compounds (NMVOC), carbon monoxide (CO), and fine particulate matter (PM2.5) presented clear declining trends. Domestic biofuel burning was the major contributor, accounting for more than 60% of the total emissions. The preliminary temporal profiles were established with MODIS fire count information, showing that higher emissions were observed in winter (from November to March) than other seasons. The emissions were spatially allocated into grid cells with a resolution of 3 km × 3  km, using GIS-based land use data as spatial surrogates. Large amount of emissions were observed mostly in the less developed areas in the PRD region. The uncertainties in biomass burning emission estimates were quantified using Monte Carlo simulation; the results showed that there were higher uncertainties in organic carbon (OC) and elemental carbon (EC) emission estimates, ranging from −71% to 133% and −70% to 128%, and relatively lower uncertainties in SO2, NOx and CO emission estimates. The key uncertainty sources of the developed inventory included emission factors and parameters used for estimating biomass burning amounts. [Copyright &y& Elsevier]

Sixteen novel microsatellite DNA loci were developed from the giant panda (Ailuropoda melanoleuca) using a magnetic-bead capture method. A total of 115 alleles were obtained for these markers, ranging from 4 to 12 alleles per locus (average 7.188). These loci exhibited high levels of polymorphic information content and expected heterozygosity, 0.558-0.855 (average 0.729) and 0.628-0.885 (average 0.778), respectively. Therefore, the allelic polymorphism and heterozygosity show that the giant pandas raised in China Research and Conservation Center possess abundant genetic variation. In addition, if the three markers showing null alleles were excluded, the remaining 13 microsatellite loci still presented extremely low non-exclusion probabilities of parentage (0.002), paternity (0.000) and identity (0.000). As a result, this new suit of microsatellite markers would be a very informative tool for the genetic and conservation studies of giant pandas. [ABSTRACT FROM AUTHOR]

Spontaneous intracerebral hemorrhage (SICH) has been common in China with high morbidity and mortality rates. This study aims to develop a machine learning (ML)-based predictive model for the 90-day evaluation after SICH. We retrospectively reviewed 751 patients with SICH diagnosis and analyzed clinical, radiographic, and laboratory data. A modified Rankin scale (mRS) of 0–2 was defined as a favorable functional outcome, while an mRS of 3–6 was defined as an unfavorable functional outcome. We evaluated 90-day functional outcome and mortality to develop six ML-based predictive models and compared their efficacy with a traditional risk stratification scale, the intracerebral hemorrhage (ICH) score. The predictive performance was evaluated by the areas under the receiver operating characteristic curves (AUC). A total of 553 patients (73.6%) reached the functional outcome at the 3rd month, with the 90-day mortality rate of 10.2%. Logistic regression (LR) and logistic regression CV (LRCV) showed the best predictive performance for functional outcome (AUC = 0.890 and 0.887, respectively), and category boosting presented the best predictive performance for the mortality (AUC = 0.841). Therefore, ML might be of potential assistance in the prediction of the prognosis of SICH. [ABSTRACT FROM AUTHOR]

Objective Despite the recent surge of eating disorders among women in large Asian cities, male eating disorder cases remain rare. The current article described 5 male eating disorder cases that presented within a period of 2 years in Wuhan, a city in central China. Methods The authors described 4 cases of anorexia nervosa (2 restrictive, 2 bulimic) and 1 case of normal weight bulimia nervosa. Results Fear of fat was reported for all 5 cases, and none of the cases reported homosexuality. Discussion Sociocultural changes and westernization most probably accounted for the increasing incidence of eating disorders among male and female youngsters in China today. © 2004 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Air pollution is becoming increasingly serious along with social and economic development in the southwest of China. The distribution characteristics of particle matter (PM) were studied in Chengdu from 2016 to 2017, and the changes of PM bearing water-soluble ions and heavy metals and the distribution of secondary ions were analyzed during the haze episode. The results showed that at different pollution levels, heavy metals were more likely to be enriched in fine particles and may be used as a tracer of primary pollution sources. The water-soluble ions in PM2.5 were mainly Sulfate-Nitrate-Ammonium (SNA) accounting for 43.02%, 24.23%, 23.50%, respectively. SO42−, NO3−, NH4+ in PM10 accounted for 34.56%, 27.43%, 19.18%, respectively. It was mainly SO42− in PM at Clean levels (PM2.5 = 0~75 μg/m3, PM10 = 0~150 μg/m3), and mainly NH4+ and NO3− at Light-Medium levels (PM2.5 = 75~150 μg/m3, PM10 = 150~350 μg/m3). At Heavy levels (PM2.5 = 150~250 μg/m3, PM10 = 350~420 μg/m3), it is mainly SO42− in PM2.5, and mainly NH4+ and NO3− in PM10. The contribution of mobile sources to the formation of haze in the study area was significant. SNA had significant contributions to the PM during the haze episode, and more attention should be paid to them in order to improve air quality. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has been a pandemic worldwide. Old age and underlying illnesses are associated with poor prognosis among COVID-19 patients. However, whether frailty, a common geriatric syndrome of reduced reserve to stressors, is associated with poor prognosis among older COVID-19 patients is unknown. The aim of our study is to investigate the association between frailty and severe disease among COVID-19 patients aged ≥ 60 years. Methods: A prospective cohort study of 114 hospitalized older patients (≥ 60 years) with confirmed COVID-19 pneumonia was conducted between 7 February 2020 and 6 April 2020. Epidemiological, demographic, clinical, laboratory, and outcome data on admission were extracted from electronic medical records. All patients were assessed for frailty on admission using the FRAIL scale, in which five components are included: fatigue, resistance, ambulation, illnesses, and loss of weight. The outcome was the development of the severe disease within 60 days. We used the Cox proportional hazards models to identify the unadjusted and adjusted associations between frailty and severe illness. The significant variables in univariable analysis were included in the adjusted model. Results: Of 114 patients, (median age, 67 years; interquartile range = 64–75 years; 57 [50%] men), 39 (34.2%), 39 (34.2%), and 36 (31.6%) were non-frail, pre-frail, and frail, respectively. During the 60 days of follow-up, 43 severe diseases occurred including eight deaths. Four of 39 (10.3%) non-frail patients, 15 of 39 (38.5%) pre-frail patients, and 24 of 36 (66.7%) frail patients progressed to severe disease. After adjustment of age, sex, body mass index, haemoglobin, white blood count, lymphocyte count, albumin, CD8+ count, D-dimer, and C-reactive protein, frailty (HR = 7.47, 95% CI 1.73–32.34, P = 0.007) and pre-frailty (HR = 5.01, 95% CI 1.16–21.61, P = 0.03) were associated with a higher hazard of severe disease than the non-frail. Conclusions: Frailty, assessed by the FRAIL scale, was associated with a higher risk of developing severe disease among older COVID-19 patients. Our findings suggested that the use of a clinician friendly assessment of frailty could help in early warning of older patients at high-risk with severe COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

Background: Subarachnoid hemorrhage (SAH) accounts for 4.4% of cerebral vascular disease, which is one of the leading causes of death in China. Rupture of intracranial aneurysms (IAs) is the most common cause of SAH. The natural history of unruptured IAs (UIAs) and the risk factors for rupture are among the key issues regarding the pathogenesis of IA and SAH that remain unclear in the Chinese population.Methods: The China Intracranial Aneurysm Project (CIAP) is a prospective, observational, multicenter registry study of the natural courses, risk factors for the onset and rupture, treatment methods, comorbidity management and other aspects of intracranial aneurysms. To date, there are five studies in the CIAP. CIAP-1 is a prospective observational cohort study of UIAs. More than 5000 patients who will be followed for at least 1 year are expected to be enrolled in this cohort. These participants come from more than 20 centers that represent different regions in China. Enrollment began on May 1, 2017, and will take approximately 5 years. A nationwide online database of UIAs will be built. Participants' basic, lifestyle, clinical and follow-up information will be collected. The blood samples will be stored in the Central Biological Specimen Bank. Strict standards have been established and will be followed in this study to ensure efficient implementation.Discussion: The natural course of UIAs in the Chinese population will be explored in this registry study. In addition, the risk factors for the rupture of the UIAs and the joint effect of those factors will be analyzed. The present study aims to create a nationwide database of UIAs and investigate the natural course of UIAs in China. Trial registration The Natural Course of Unruptured Intracranial Aneurysms in a Chinese Cohort (ClinicalTrials.gov Identifier: NCT03117803). Registered: July 5, 2017. [ABSTRACT FROM AUTHOR]

Background: The prognostic benefits and safety of extended lymphadenectomy for hilar cholangiocarcinoma remain uncertain. The available evidence is still insufficient concerning its retrospective aspect. The aim of this study is to explore the clinical effect and safety of extended lymphadenectomy compared to regional lymphadenectomy in patients with hilar cholangiocarcinoma.Methods: The Relay-HC trial is a prospective, multicenter, and randomized controlled trial. Seven hundred and thirty-four eligible patients with resectable perihilar cholangiocarcinoma across 15 tertiary hospitals in China will be randomly assigned (1:1) to receive either regional lymphadenectomy or extended lymphadenectomy. The primary objective is to determine the overall survival after the two approaches. Secondary objectives of the study include the evaluation of perioperative mortality, postoperative complication, and disease-free survival. This study has been approved by the ethics committee of each participating hospital.Discussion: The Relay-HC trial is designed to investigate the prognostic benefits and safety of expanded lymphadenectomy for hilar cholangiocarcinoma. Currently, it has never been investigated in a prospective randomized controlled clinical trial.Trial Registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR1800015688 . Registered on 15 April 2018. [ABSTRACT FROM AUTHOR]

This paper attempts to present a complete picture of the status quo and future trends of the development of rural household energy in China based on a literature review and a systems analysis. First, a comprehensive literature review was conducted from the perspectives of energy consumption, carbon emissions and pollutants, energy resources, energy technologies, and energy policies. The review revealed the complexities and dynamics of the current system of rural household energy in China, and several key issues were identified for further attention. These issues are further explored by a systems analysis based on the “Integrated strategy of Sustainable development objectives, Decision-making systems, Operation systems, and Physical systems” (I-SDOP) concept. Following this method, a complete picture of the market status and policy targets is presented, by mapping an energy Sankey diagram and by reviewing the behavior of the main players. The results indicate that synergy of various energies, technologies, and players, and a combination of flexible engineering schemes and policy designs, with adequate consideration of temporal variation and regional disparity, are key strategies to promote the sustainable development of rural household energy, especially the distributed utilization of renewable energy, in China. [ABSTRACT FROM AUTHOR]

The perceptions and attitudes of commuters toward the behavioral thresholds for commuting time are of great significance for understanding their commuting patterns and possible changes in those patterns. This study focuses on the tolerance threshold of commuting time and presents the empirical evidences using the data from Kunming, China. The descriptive statistics of the tolerance thresholds of commuting time are presented. The statistical results demonstrate that the tolerance threshold of commuting time peaks at the interval of [30,40) min and the actual commuting time of 44.3% commuters is approximately equal to or exceeds the tolerance threshold. Furthermore, the determinants of the tolerance threshold of commuting time are identified using an ordered logistic model. The results demonstrate that age, gender, education level, household income, the presence of children, travel mode and residential location have a significant impact on the tolerance threshold of commuting time. [ABSTRACT FROM AUTHOR]

High-quality three dimensional seismic data integrated with well data are used to identify, interpret and assess the significance of mass transport deposits (MTDs) to the evolution of the Kaiping Sag, Zhu-II depression, Pearl River Mouth Basin (northern South China Sea). Diagnostic features observed in 3D and 2D reflection seismic profiles document a multifarious mass movement history spanning from the Middle Miocene to the Quaternary period. MTDs in the Kaiping Sag were composite and multi-event units involving the entire spectra of mass transport processes. The diagnostic fingerprints of MTDs includes chaotic to transparent acoustic facies, and significant amounts of basal erosion grooves in the middle part of basal shear surfaces. We decipher for the first time that tectonic events, sea level fluctuations slope instability and/or volcanism may control the southwest decreasing distribution of MTDs in the Kaiping Sag. Knowledge regarding the seismic identification characteristics, the spatial and temporal distribution of MTDs, along with a better understanding of their underlying geological processes is valuable for providing new insights on the tectono-stratigraphic evolution of the Kaiping Sag. [ABSTRACT FROM AUTHOR]

• aSAH patients developed hospital acquired pneumonia with the incidence of 27.4%. • aSAH patients developed pneumonia had higher mortality and longer length of stay. • WFNS, neutrophil, RBC transfusion, tracheostomy were factors of pneumonia in aSAH. • The model based on four factors predicted pneumonia after aSAH with an AUC of 0.808. Pneumonia is a common complication in aneurysmal subarachnoid hemorrhage (aSAH) patients and has been confirmed associated with unfavorable outcome of aSAH patients. This study is designed to explore risk factors and develop predictive model of hospital acquired pneumonia in aSAH patients. 351 aSAH patients received treatments in the neuro-intensive care unit (NICU) of West China hospital were included. Univariate and multivariate logistic regression were performed to explore risk factors of hospital acquired pneumonia. And predictive model for pneumonia was also constructed using logistic regression. Area under the receiver operating characteristics curve (AUC) were calculated to evaluate the accuracy of the constructed model and single markers. 96 aSAH patients developed hospital acquired pneumonia with incidence of 27.4%. Logistic regression analysis showed World Federation of Neurosurgical Societies (WFNS) score (0R = 1.677, p = 0.006), neutrophil count (0R = 1.300, p = 0.042), red blood cell transfusion (0R = 3.035, p = 0.030) and tracheostomy (0R = 7.645, p < 0.001) were independent risk factors of pneumonia in aSAH patients. Consisted of these four factors, the constructed model was valuable in predicting pneumonia with AUC of 0.808. The AUC of neutrophil to lymphocyte ratio and lactate dehydrogenase for predicting pneumonia was 0.671 and 0.613, respectively. WFNS, high neutrophil at admission, need of RBC transfusion and tracheostomy were independent risk factors of hospital acquired pneumonia in aSAH patients. The novel predictive model we constructed is efficient in evaluating possibility of pneumonia in aSAH patients during hospitalizations. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) brings severe mortality and morbidity risk to patients. Predicting the outcome of these patients is necessary for physicians to make suitable treatments to improve prognosis. The aim of this study is to develop a mortality prediction approach using XGBoost (extreme gradient boosting) in moderate-to-severe TBI. A total of 368 patients hospitalized in West China hospital for TBI with Glasgow Coma Scale (GCS) below 13 were identified. To construct the XGBoost prediction approach, patients were divided into training set and test set with a ratio of 7:3. A logistic regression prediction model was also constructed and compared with the XGBoost model. Area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity were calculated to compare the prognostic value between XGBoost and logistic regression. A total of 205 patients suffered a poor outcome with a mortality of 55.7%. Nonsurvivors had a lower GCS (5 vs. 7, P < 0.001) and a higher Injury Severit Score (ISS) than survivors (25 vs. 16, P < 0.001). Platelet (P < 0.001), albumin (P < 0.001), and hemoglobin (P < 0.001) were significantly lower in nonsurvivors, whereas glucose (P < 0.001) and prothrombin time (P < 0.001) were significantly higher in nonsurvivors. Among the XGBoost approach, GCS, prothrombin time, and glucose had the most significant feature importance. The area under the receiver operating characteristic curve (0.955 vs. 0.805) and accuracy (0.955 vs. 0.70) of XGBoost were both higher than logistic regression. Predicting mortality of patients with moderate-to-severe TBI using the XGBoost algorism is more effective and precise than logistic regression. The XGBoost prediction approach is beneficial for physicians to evaluate patients with TBI at high risk of poor outcome. [ABSTRACT FROM AUTHOR]

The conventional Ensemble Kalman filter (EnKF), which is now widely used to calibrate emission inventories and to improve air quality simulations, is susceptible to simulation errors of meteorological inputs, making accurate updates of high temporal-resolution emission inventories challenging. In this study, we developed a novel meteorologically adjusted inversion method (MAEInv) based on the EnKF to improve daily emission estimations. The new method combines sensitivity analysis and bias correction to alleviate the inversion biases caused by errors of meteorological inputs. For demonstration, we used the MAEInv to inverse daily carbon monoxide (CO) emissions in the Pearl River Delta (PRD) region, China. In the case study, 60% of the total CO simulation biases were associated with sensitive meteorological inputs, which would lead to the overestimation of daily variations of posterior emissions. Using the new inversion method, daily variations of emissions shrank dramatically, with the percentage change decreased by 30%. Also, the total amount of posterior CO emissions estimated by the MAEInv decreased by 14%, indicating that posterior CO emissions might be overestimated using the conventional EnKF. Model evaluations using independent observations revealed that daily CO emissions estimated by MAEInv better reproduce the magnitude and temporal patterns of ambient CO concentration, with a higher correlation coefficient (R , +37.0%) and lower normalized mean bias (NMB, -17.9%). Since errors of meteorological inputs are major sources of simulation biases for both low-reactive and reactive pollutants, the MAEInv is also applicable to improve the daily emission inversions of reactive pollutants. [Display omitted] [ABSTRACT FROM AUTHOR]

Summary: Rivers have been under sampled to investigate carbon degassing, especially in the tropical and sub-tropical regions. An unprecedented high-temporal-resolution (daily) sampling during July 2008–August 2009 was conducted in the Longchuan River of the upper Yangtze basin, a subtropical monsoon river in China, to reveal the daily-to-seasonal dynamics of the partial pressure of CO2 (pCO2) and CO2 degassing flux from the river using Henry’s constant and CO2SYS. The pCO2 levels ranged from 230 to 8300μatm with an average of 1230μatm and obvious daily and seasonal variations. More than 92% samples were supersaturated with CO2 in contrast to the atmospheric equilibrium (380μatm). pCO2 values in the river water in the wet season were relatively low, except in the flooding event in November, due to a dilution effect by heavy rainfall. In contrast, the pCO2 levels in the dry season were much higher, due to lower pH resulted from anthropogenic activities. Net CO2 degassing and pCO2 were strongly correlated with dissolved nitrogen, but weakly with water temperature, dissolved inorganic carbon and water discharge, and uncorrelated with particulate nutrients and biogenic elements. The estimated water-to-air CO2 degassing flux in the Longchuan River was about 27mol/m2/yr, with the upper limit of 50mol/m2/yr. Our study also indicated that among the carbon remobilized from land to water, around 7% (2800tC/yr) of the total carbon was emitted to the atmosphere, 42% (17,000tC/yr) deposited in the river-reservoirs system and 51% (21,000tC/yr) exported further downstream. High spatial and temporal resolution of estimates of CO2 emission from the world large rivers is required due to extremely heterogeneous catchment characteristics and anthropogenic activities in space and time. [Copyright &y& Elsevier]

Summary: Fluxes of dissolved and particulate nitrogen (N) and phosphorus (P) variables were measured monthly from September 2007 to March 2009 in the upper Longchuanjiang River (Yunnan Province, China) to determine annual loads and seasonal variability. Dissolved N (DN) and particle associated P (PAP) contributed 56% and 99% of the total nitrogen (TN) and total phosphorus (TP) yields of 549 and 608kg/km2/yr. Fluxes of particulate N (PN), dissolved P (DP), PAP and TP exhibited great seasonality because they were highly correlated with water discharge. Areal export rates of –N, PN, PAP and TP were higher than in the main channel and most tributaries of the Changjiang River. High particulate loads were contributed to erosion of phosphorus-rich soils during heavily rains in the wet season. Median measured concentrations of TN, –N and TP exceeded the maximum permissible limit for domestic and recreational use in China. High nitrogen and phosphorus concentrations draw attention to the potential for additional nutrient loading to foster the formation of algal blooms in locations where free-flowing river sections are changing into cascades of reservoirs. Importantly, the great seasonality in the data shows necessity of sufficient sampling for determining annual fluxes. [Copyright &y& Elsevier]

Abstract: Water samples were collected twice per month over a two-year period from the Longchuanjiang River (Yunnan Province, China) to understand monthly variations in major elements and solute fluxes as related to rock weathering and associated CO2 consumption rates. Solute concentrations were 5 times the median of 65mg/l for global average. Total cationic exchange capacity (Tz+) ranged from 2.4 to 6.1meq/l; and the mean (4.4meq/l) was significantly higher than that of the global river waters. Calcium and bicarbonate dominated the annual ionic composition, accounting for more than 70% of the solute flux that exceeded 71×106 kg/yr. Lower concentrations of most measured elements during the monsoon high flow period could be explained by dilution effects from precipitation. Three major reservoirs contributed to the dissolved load: carbonates, silicates and anthropogenic inputs, i.e., some 83% of the riverine cations from carbonates and 17% from silicates. The chemical weathering rate of 26.1t/km2/yr, with respective carbonate and silicate weathering rates of 20.3t/km2/yr (8.46mm/kyr) and 5.75t/km2/yr (2.13mm/kyr), was comparable to the average for global rivers, but higher than that for the Changjiang River in China. The CO2 consumption rate was estimated to be 173.7×103 mol/km2/yr and 202.9×103 mol/km2/yr by silicate and carbonate weathering, respectively. The CO2 consumed by rock chemical weathering in the upper Changjiang River reduced the atmospheric CO2 level and constituted a significant part of the global carbon budget. Consequently the carbon sink potential of rock chemical weathering in the Qinghai-Plateau deserves extra attention. Population density and anthropogenic activities, particularly agricultural practices, contributed remarkably to dissolved solutes and associated CO2 consumption worldwide, and anthropogenic inputs probably contributed some 10.4% to the dissolved solutes in the Longchuanjiang River. [Copyright &y& Elsevier]