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Background: Quantifying the professional ethical challenges that nurses encounter is crucial for both theoretical insights and practical outcomes. The objective of this research is to assess the psychometric properties of the Chinese adaptation of the Moral Distress Scale for Healthcare Professionals (MD-APPS). Methods: In 2024, a survey approach was utilized to engage with several tertiary-level healthcare institutions throughout China. A cohort of 448 nursing professionals who satisfied the specified selection benchmarks was consequently incorporated into the study. To evaluate the scale's reliability and validity, methods including the Content Validity Index (CVI), Factor Analysis—both Exploratory (EFA) and Confirmatory (CFA)—alongside assessments of internal consistency and test-retest reliability were employed. Results: Expert evaluations yielded an I-CVI of 0.90, suggesting good content validity for the MD-APPS's Chinese adaptation. Exploratory Factor Analysis (EFA) revealed a bi-dimensional framework with 7 components, explaining 56.34% of the cumulative variance. Confirmatory Factor Analysis (CFA) outcomes displayed a χ-square/df ratio of 1.542. The estimate for Robust RMSEA was 0.054, and the SRMR was ascertained to be 0.041. Indices for both Robust TLI and Robust CFI surpassed the 0.9 threshold, indicating an acceptable fit; this aspect was supported by a P-value (Chi-square) of 0.094. The internal consistency, measured by Cronbach's α, was found to be 0.74, while the test-retest reliability over a two-week period reached 0.964. These findings provide initial evidence for the psychometric properties of the Chinese MD-APPS. Conclusion: The Chinese adaptation of the MD-APPS demonstrates promising initial psychometric properties, suggesting its potential suitability for exploring nurses' professional ethical challenges within the Chinese cultural context. This scale may facilitate the identification of diverse elements influencing nurses' professional ethics and the assessment of the ethical climate in nursing practices. However, further validation studies are needed to fully establish its psychometric robustness across various healthcare settings in China. [ABSTRACT FROM AUTHOR]

Objective: Premenstrual Syndrome is also known as premenstrual tension syndrome because of the pronounced premenstrual mental and emotional anomalies. This study focuses on the association between occupational stress, sleep quality and premenstrual syndrome in clinical nurses and the mediating role of sleep quality. Methods: A cross-sectional study was conducted to measure occupational stress, sleep quality and premenstrual syndrome in 415 clinical nurses using the Chinese Nurses Stressor Scale, the Pittsburgh Sleep Quality Index Scale, and the Premenstrual Syndrome Scale. SPSS was used to explore the relationship between the variables, and AMOS was used to explore the mediating role between the variables. Results: Nurses' occupational stress positively predicted PMS (β = 0.176, p < 0.001), and the regression coefficients for sleep quality were significantly different for both paths of nurses' occupational stress (β = 0.665, p < 0.001) and PMS (β = 0.261, p < 0.001). The mediation effect accounts for 49.57% of the total effect. Conclusion: This study revealed a notably high incidence of PMS among clinical nurses in China, with occupational stress and sleep quality significantly correlated with PMS. Sleep quality played an intermediary role between occupational stress and PMS. Consequently, managers should prioritize addressing occupational stress, mitigating PMS symptoms, enhancing nurses' health and nursing quality, and preventing nursing risks through mental health support and improving sleep quality. [ABSTRACT FROM AUTHOR]

The carcinogenicity of benzene was reevaluated by the International Agency for Research on Cancer in 2017, with the Working Group reaffirming positive yet inconclusive associations with non‐Hodgkin lymphoma (NHL). To extend our previous observation of a significant exposure‐response for cumulative occupational benzene exposure and NHL risk among Chinese women in a population‐based cohort in Shanghai, we extended follow‐up of this cohort and pooled the data with a similarly designed population‐based cohort of men in Shanghai. Cumulative exposure estimates were derived for 134,449 participants in the pooled analysis by combining ordinal job‐exposure matrix intensity ratings with quantitative benzene measurements from an inspection database of Shanghai factories. Associations between benzene exposure metrics and NHL (n = 363 cases including multiple myeloma [MM]) were assessed using Cox proportional hazard models. Ever occupational exposure to benzene in the pooled population was associated with NHL risk (HR = 1.5, 95% CI = 1.2–2.0), and exposure‐response relationships were observed for increasing duration (ptrend =.003) and cumulative exposure (ptrend =.003). Associations with ever exposure, duration, and cumulative exposure were similar for NHL with and without MM in the case definition, including lifetime cumulative exposures in the highest quartile (HR = 1.6, 95% CI = 1.1–2.4 with MM included; HR = 1.7, 95% CI = 1.1–2.7 with MM excluded). An elevated risk of the chronic lymphocytic leukemia subtype was suggested in the pooled analyses (HR for ever vs. never exposure = 2.3, 95% CI = 0.9–5.6). These observations provide additional support for a plausible association between occupational benzene exposure and risk of NHL. [ABSTRACT FROM AUTHOR]

In the era of globalized geo-economics, international big channel are changing the way geo-economic elements flow across borders, expanding cooperation spaces such as ports and border-free trade zones to more distant inland areas and shaping new ways of cross-border geo-economic cooperation. As an international land and sea channel connecting China and Myanmar, the China-Myanmar Indian Ocean New Channel (hereinafter "the Channel") is of great importance for promoting geo-economic cooperation between the two countries and the construction of the Belt and Road Initiative. However, owing to various obstacles in geo-economic cooperation, the geo-economic effect of the Channel has not been effectively brought into play. In this study, the obstacles to geo-economic cooperation in the Channel and its collaborative mechanisms were analyzed to provide important scientific and technological support for enhancing its geo-economic effects and strengthening geo-economic cooperation between China and Myanmar. The natural geography of the region with its high mountains and deep valleys and the frequently occurring natural disasters are natural obstacles that limit the geo-economic effect of the Channel. Moreover, the difference in economic development between China and Myanmar is not conducive to the deepening of geo-economic cooperation in the Channel. Complex armed conflicts have disrupted the construction of the Channel and China's investment in its route, and the potential intervention of India and the United States will become an added constraint on its further development. Furthermore, the multiple stakeholders game in the construction of the Channel may bring geo-risks. Contrary to preconceived notions, geo-economic cooperation in the Channel is not a strategy for regional control, but rather to create an international trade corridor deeply related to transportation logistics, supply chains, industrial chains and value chains. To promote geo-economic cooperation in the Channel, its construction should be based on a multi-level collaborative mechanism for geo-economic cooperation. At the national level, the docking of development strategies between China and Myanmar should be strengthened by promoting integration of the Channel into the Belt and Road Initiative, strengthening the docking of China-Myanmar policy communication mechanisms, and formulating a long-term development strategy plan for the Channel. At the channel level, the geo-economic effect of the Channel should be upgraded by promoting the linkage of internal and external infrastructures, strengthening geo-economic element cross-border flow and industrial cooperation, and deepening economic and trade cooperation with Myanmar and the Indian Ocean region. At the stakeholder level, a consultation mechanism involving multi-stakeholder participation should be established by strengthening the docking of multi-stakeholder interests, coordinating the mechanism of China-Myanmar port docking, and creating a three-dimensional risk prevention mechanism for the Channel. [ABSTRACT FROM AUTHOR]

In order to explore effective ways to develop Chinese English learners' communicative competence, this study first briefly reviews the advantages of communicative language teaching (CLT) method which widely practiced in the Western countries and analyzes in details its obstacles in Chinese classroom context. Then it offers guidelines for compromising the communicative approach with the traditional Chinese approach. Finally, it puts forward some principles and techniques for English teaching practice in the Chinese environment.

Runoff prediction with a small number of observations is an important but challenging topic in hydrological research. In this study, a coupled nonlinear dynamical model based on randomly distributed embedding (RDE) is proposed, which fully extracts the spatial correlation between runoff series to achieve accurate prediction of small sample runoff. First, ensemble empirical mode decomposition (EEMD) is employed to make the data smooth. Second, phase space reconstruction (PSR) is performed, which not only expands the dimensionality of the data but also reconstructs the high-dimensional attractors of the nonlinear dynamical system. Finally, RDE is applied to generate enough non-delay attractors from the high-dimensional observations to map the delay attractors of the target variable. Each mapping converts the spatial information of the high-dimensional data into the future information of the target variable. An application for predicting the monthly runoff at the Xianyang, Zhangjiashan, and Zhuangtou stations in the Weihe River, China, is performed to evaluate the performance of RDE, convolutional neural network (CNN), long short-term memory (LSTM), and CNN-LSTM, and the sensitivity of RDE to the training sample size is analysed. The results show that RDE improves the root mean square error (RMSE) by approximately 16.74–45.61% over the other models. Moreover, RDE maintains high accuracy as the training sample size decreases. With only 12.31% of the training samples, a satisfactory result is still obtained. RDE is reliable and robust, and the prediction results remain almost unchanged as the sample size decreases. Therefore, RDE will be of great value for runoff prediction in situations when only small numbers of samples are available. [ABSTRACT FROM AUTHOR]

Background: Little is known about the long‐term trends of preterm birth rates in China and their geographic variation by province. Objectives: To estimate the annual spatial–temporal distribution of preterm birth rates in China by province from 1990 to 2020. Data Sources: We searched PubMed, EMBASE, Web of Science, CNKI, WANFANG and VIP from January 1990 to September 2023. Study Selection and Data Extraction: Studies that provided data on preterm births in China after 1990 were included. Data were extracted following the Guidelines for Accurate and Transparent Health Estimates Reporting. Synthesis: We assessed the quality of each survey using a 9‐point checklist. We estimated the annual preterm birth risk by province using Bayesian multilevel logistic regression models considering potential socioeconomic, environmental, and sanitary predictors. Results: Based on 634 survey data from 343 included studies, we found a gradual increase in the preterm birth risk in most provinces in China since 1990, with an average annual increase of 0.7% nationally. However, the preterm birth rates in Inner Mongolia, Hubei, and Fujian Province showed a decline, while those in Sichuan were quite stable since 1990. In 2020, the estimates of preterm birth rates ranged from 2.9% (95% Bayesian credible interval [BCI] 2.1, 3.8) in Inner Mongolia to 8.5% (95% BCI 6.6, 10.9) in Jiangxi, with the national estimate of 5.9% (95% BCI 4.3, 8.1). Specifically, some provinces were identified as high‐risk provinces for either consistently high preterm birth rates (e.g. Jiangxi) or relatively large increases (e.g. Shanxi) since 1990. Conclusions: This study provides annual information on the preterm birth risk in China since 1990 and identifies high‐risk provinces to assist in targeted control and intervention for this health issue. [ABSTRACT FROM AUTHOR]

Bioaerosols play significant roles in causing health and climate effects. Sugar compounds in air have been widely used to trace the source of bioaerosols. However, knowledge about the association of sugar molecules and the microbial community at taxonomic levels in atmospheric aerosols remains limited. Here, microbial community compositions and sugar molecules in total suspended particles collected from a typical rural site, Gucheng, in the North China Plain were investigated by gas chromatography–mass spectrometry and high-throughput gene sequencing, respectively. Results show that fungal community structure exhibited distinct diurnal variation with largely enhanced contribution of Basidiomycota at night, while bacterial community structure showed no obvious difference between daytime and night. SourceTracker analysis revealed that fungi and bacteria were mainly from plant leaves and unresolved sources (presumably human-related emissions and/or long-distance transport). All the detected anhydrosugars and sugar alcohols and trehalose showed diurnal variations with lower concentrations in the daytime and higher concentrations at night, which may be affected by enhanced fungal emissions at night, while primary sugars (except trehalose) showed an opposite trend. Mantel's test showed that more sugar compounds exhibited significant associations with fungal community structure than bacterial community structure. Co-occurrence analysis revealed the strong associations between sugar compounds and a few saprophytic fungal genera with low relative abundances, e.g., Hannaella, Lectera, Peniophora, Hydnophlebia, Sporobolomyces and Cyphellophora. This study suggests that the entire fungal community, rather than specific fungal taxa, likely greatly contributes to sugar compounds in rural aerosols, while the contribution of bacteria is limited. [ABSTRACT FROM AUTHOR]

Background: Oblique lumbar interbody fusion (OLIF) is an internationally popular minimally invasive technology for the treatment of various lumbar diseases. Since its introduction to China in 2014, OLIF technology has clearly shown its superiority in reconstructing intervertebral stability, restoring intervertebral space height, achieving indirect decompression, and restoring normal lumbar sequence. However, some patients still suffer from persistent symptoms after OLIF, including low back pain and soreness, which indirectly affect the overall surgical efficacy and patient satisfaction. Therefore, some clinicians recommend that patients routinely use spinal orthoses after OLIF to reduce the stress on the lower back muscles and ligaments, thereby relieving or avoiding postoperative residual symptoms or new symptoms. Accordingly, spinal orthosis use after OLIF has emerged as an essential option. However, the role of spinal orthoses in OLIF and their specific impact on postoperative patient clinical outcomes have remained unclear, and there is a lack of strong clinical evidence to indirectly or directly support the role of spinal orthoses in OLIF and demonstrate their impact on patient clinical outcomes. This study aims to investigate the role of spinal orthoses in OLIF by grouping patients based on the use or nonuse of spinal orthosis after OLIF, thus providing a better basis for the majority of patients and physicians. Methods/design: We plan to conduct a 1-year randomized controlled trial involving 60 subjects. The subjects will be randomized into two groups: group A (those wearing spinal orthoses after surgery) and group B (those not wearing spinal orthoses after surgery). The clinical outcomes of these patients will be evaluated using the Oswestry disability index, visual analog scale, and Brantigan, Steffee, Fraser 1 day before surgery and 2 weeks and 1, 6, and 12 months after surgery. Discussion: This randomized controlled trial aims to provide a reference for further comprehensive trial design. The findings of this study will provide a better and more scientific basis for the choice of postoperative rehabilitation and treatment for patients undergoing such a procedure. Trial registration: This study has been registered in the Chinese Clinical Trial Registry (Registration No.: ChiCTR2200059000). Registration date: April 22, 2022. Registration website: http://www.chictr.org.cn/showproj.aspx?proj=166310 [ABSTRACT FROM AUTHOR]

Background: There are limited data about the clinical benefits and harm of direct oral anticoagulants (DOACs) in stroke prevention in patients with atrial fibrillation (AF) complicated with anemia or thrombocytopenia. Methods: This is a multi-center retrospective cohort study involving 5469 AF patients from 15 hospitals in China. Patients were divided into three groups according to hemoglobin and platelet levels: Group 1 (hemoglobin male ≥ 130 g/L; female ≥ 120 g/L and platelet ≥ 100 × 109/L), Group 2 (hemoglobin male < 130 g/L; female < 120 g/L or platelet < 100 × 109/L), and Group 3 (hemoglobin male < 130 g/L; female < 120 g/L and platelet < 100 × 109/L). Patients in each category are further divided into two groups according to their stroke prevention strategies: rivaroxaban or dabigatran. Clinical results include major, minor, total bleeding, thrombosis, and the composite outcome of major bleeding and thrombosis. Results: Higher hemoglobin levels were associated with a reduced risk of total bleeding and major bleeding, while platelet counts were not associated with any event. Compared with Group 1, Group 2 had a higher risk of major bleeding (aOR 1.70, 95%CI 1.12–2.57, P = 0.012), and the composite endpoint of major bleeding and thrombosis (aOR 1.70, 95%CI 1.19–2.44, P = 0.004). Compared with Group 1, Group 3 had a higher total bleeding risk (aOR 2.15, 95%CI 1.14–4.05, P = 0.018). Compared with dabigatran, rivaroxaban was associated with higher composite risk in Group 1 (aOR 2.91, 95% CI 1.66–5.16, P < 0.001) and Group 2 (aOR 3.05, 95%CI 1.46–6.39, P = 0.003), but there was no significant difference in Group 3 (aOR 1.78, 95%CI 0.23—13.54, P = 0.577). Conclusions: Higher hemoglobin levels are associated with a reduced risk of total bleeding and major bleeding in patients with AF. Dabigatran was associated with better clinical outcomes than rivaroxaban in patients with anemia or thrombocytopenia but not in those with anemia and thrombocytopenia. [ABSTRACT FROM AUTHOR]

Blood donor retention is an effective way to improve blood safety and maintain a stable blood supply. According to the social cognition theory, outcome expectation is an important determinant of behavioral maintenance. However, no outcome expectation scale for blood donation is available in the literature. The aim of the present study was to develop and validate a positive outcome expectation scale (POES) and a negative outcome expectation scale (NOES) for re-donation among blood donors. In Study 1, a total of 12 items for POES and 7 items for NOES were developed. Exploratory factor analysis (EFA) was performed to examine the factor structure of the two scales among a convenience sample of 155 college student blood donors in China (100 females, 55 males; Mage = 20.23 ± 1.94). In Study 2, the factor structure was further validated with a second convenience sample of 164 blood donors recruited from blood collection sites (79 female, 85 males; Mage = 25.68 ± 7.87) using confirmatory factor analysis (CFA). The internal consistency, convergent validity, discrimination validity and criterion validity were also tested. In Study 1, one item from NOES with a communality value lower than.30 was deleted. A three-factor structure for POES and a two-factor structure for NOES were established through the EFA. These factor structures were further supported by the CFA in Study 2. Both POES and NOES showed satisfactory internal consistency, convergent validity, discrimination validity and criterion validity. The POES and NOES demonstrated good reliability and validity in measuring the positive and negative outcome expectations of re-donation among blood donors. The two scales can be utilized in research and practice in predicting and promoting blood re-donation. [ABSTRACT FROM AUTHOR]

Simple Summary: Digitaria sanguinalis is considered one of the most malignant grass weeds worldwide and is widely distributed in Chinese maize fields. In this study, we explored the mechanism of metabolic resistance via cytochrome P450s of the LJ-01 population of Digitaria sanguinalis, which evolved high-level resistance to the ALS inhibitor nicosulfuron and evolved cross- and multiple resistance to thifensulfuron-methyl and pyrazosulfuron-ethyl, as well as the PS II inhibitors bromoxynil octanoate and atrazine. This study provides scientific and theoretical guidance for the control of resistant populations in D. sanguinalis. Large crabgrass (Digitaria sanguinalis (L.) Scop.) is one of the major malignant grass weeds in Chinese maize (Zea mays L.) fields, and it has recently developed resistance to the acetolactate synthase (ALS)-inhibiting herbicide nicosulfuron. This study focused on a suspected nicosulfuron-resistant (R) population (LJ-01) of D. sanguinalis, collected from Lujiang County in Anhui Province, China, to explore the resistance level and potential resistance mechanism. Whole-plant dose–response testing confirmed that the LJ-01 population evolved a high level of resistance to nicosulfuron (11.5-fold) compared to the susceptible (S) population, DY-02. The ALS gene sequencing and relative expression assay of the R plants indicated that target gene mutation and overexpression were not responsible for the resistance phenotype. However, pretreatment with malathion, a known cytochrome P450 monooxygenase (P450) inhibitor, alleviated the resistance of the R population to nicosulfuron by approximately 36%. High-performance liquid chromatography (HPLC) analysis revealed that the R plants metabolized nicosulfuron faster than the S plants. Moreover, cross-resistance testing suggested that the R population exhibited low levels of resistance to thifensulfuron-methyl and pyrazosulfuron-ethyl, but it remained susceptible to rimsulfuron. Multiple resistance patterns showed that the R population evolved low resistance to the photosystem inhibitors bromoxynil octanoate and atrazine and sensitivity to the acetyl-CoA carboxylase (ACCase) inhibitor cyhalofop-butyl and the 4-hydroxyphenylpyruvate dioxygenase (HPPD) inhibitors tembotrione, mesotrione, and topramezone. This study reports, for the first time, the simultaneous resistance to ALS and different photosystem inhibitors in D. sanguinalis. The nicosulfuron resistance observed in the R population could primarily be attributed to an enhanced metabolism involving P450 enzymes. [ABSTRACT FROM AUTHOR]

The employment of biochar in crop production can not only improve soil quality, but also helps the field ecosystem to fix carbon and reduce emissions. Although the benefits of their application in crop production have been more and more confirmed, it is not clear when it comes to the acidic soil of tobacco and rice rotation. A tobacco–rice rotation experiment was conducted in southern China to probe the application value of biochar under these conditions. Three biochar application rates were employed in this experiment. BC0 (without biochar), BC25 (25 t ha−1), and BC50 (50 t ha−1). The findings show that biochar significantly boosted soil fertility and crop yields. Meanwhile, the soil organic carbon of tobacco rice rotation field with biochar increased by 31.76%. After a whole growth period of tobacco and rice, the cumulative emission reduction of CO2 and N2O from the soil by biochar were 15,944 kg ha−1 and 1810 g ha−1, respectively. The use of biochar not only significantly improved the bacterial diversity of tobacco and rice rotation soil, but also altered the original microbial community structure. The profusion of Proteobacteria and Acidobacteria was reduced and the abundance of Actinobacteria and Bacteroidetes was enhanced in the treatments with biochar. Among them, Sphingomonadales, Planctomycotes, and Ktedonobacteria, which are beneficial to plant growth and soil health, have become key phylotypes. The carbon balance analysis data show that the net carbon sequestration of the two treatments with biochar is positive, while that of the treatment without biochar is negative. In terms of economic benefit, the application of biochar increased the average of 2.055 CNY kg−1 consumed energy (CE) in the whole tobacco–rice rotation system. The ecological benefit was 0.51 kg C kg−1 CE. In conclusion, biochar can be effectively used in the practice of tobacco–rice rotation and acidic soil improvement in southern China. To explore the application value of biochar on acidic soil in south China, the effects of different application rates of biochar on crop production, carbon sequestration, and emission reduction were compared through a tobacco and rice rotation experiment. The results show that field application of biochar is not only economically feasible in agricultural production, but also has positive ecological benefits. [ABSTRACT FROM AUTHOR]

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Previous neuroimaging studies have suggested that developmental dyslexia has a different neural basis in Chinese and English populations because of known differences in the processing demands of the Chinese and English writing systems. Here, using functional magnetic resonance imaging, we provide the first direct statistically based investigation into how the effect of dyslexia on brain activation is influenced by the Chinese and English writing systems. Brain activation for semantic decisions on written words was compared in English dyslexics, Chinese dyslexics, English normal readers and Chinese normal readers, while controlling for all other experimental parameters. By investigating the effects of dyslexia and language in one study, we show common activation in Chinese and English dyslexics despite different activation in Chinese versus English normal readers. The effect of dyslexia in both languages was observed as less than normal activation in the left angular gyrus and in left middle frontal, posterior temporal and occipitotemporal regions. Differences in Chinese and English normal reading were observed as increased activation for Chinese relative to English in the left inferior frontal sulcus; and increased activation for English relative to Chinese in the left posterior superior temporal sulcus. These cultural differences were not observed in dyslexics who activated both left inferior frontal sulcus and left posterior superior temporal sulcus, consistent with the use of culturally independent strategies when reading is less efficient. By dissociating the effect of dyslexia from differences in Chinese and English normal reading, our results reconcile brain activation results with a substantial body of behavioural studies showing commonalities in the cognitive manifestation of dyslexia in Chinese and English populations. They also demonstrate the influence of cognitive ability and learning environment on a common neural system for reading. (Contains 4 tables and 4 figures.)

Previous research has examined the effects of client and bureaucrat attributes as well as contextual factors on clients' perception of aggregate-level public services. However, there is limited evidence on clients' evaluation of specific frontline services and the role of technology. This study takes advantage of a unique multi-year course evaluation dataset in higher education in China to elucidate the effect of teleworking on clients' perception of frontline services. Due to the COVID-19 outbreak in January 2020, Chinese universities were forced to turn the in-person courses into online courses, which provided an excellent opportunity to identify the exogenous effect of technological shock. A series of statistical analyses suggest that online teaching significantly improves students' perceptions of course quality. Moreover, this positive effect increases when class size, a typical indicator of task complexity in teaching processes, increases. This study has important theoretical and policy implications for introducing teleworking into public service delivery. [ABSTRACT FROM AUTHOR]

Household air pollution (HAP) from indoor combustion of solid fuel is a global health burden that has been linked to multiple diseases including lung cancer. In Xuanwei, China, lung cancer rate for non-smoking women is among the highest in the world and largely attributed to high levels of polycyclic aromatic hydrocarbons (PAHs) that are produced from combustion of smoky (bituminous) coal. Alu retroelements, repetitive mobile DNA sequences that can somatically multiply and promote genomic instability have been associated with risk of lung cancer and diesel engine exhaust exposure. We conducted analyses for 160 non-smoking women in an exposure assessment study in Xuanwei, China with a repeat sample from 49 subjects. Quantitative PCR was used to measure Alu repeat copy number relative to albumin gene copy number (Alu/ALB ratio). Associations between clusters derived from predicted levels of 43 HAP constituents, 5-methylchrysene (5-MC), a PAH previously associated with lung cancer in Xuanwei and was selected a priori for analysis, and Alu repeats were analyzed using generalized estimating equations. A cluster of 31 PAHs reflecting current exposure was associated with increased Alu copy number (β:0.03 per standard deviation change; 95% confidence interval (CI):0.01,0.04; P -value = 2E-04). One compound within this cluster, 5-MC, was also associated with increased Alu copy number (P -value = 0.02). Our findings suggest that exposure to PAHs due to indoor smoky coal combustion may contribute to genomic instability. Additionally, our study provides further support for 5-MC as a prominent carcinogenic component of smoky coal emissions. Further studies are needed to replicate our findings. [ABSTRACT FROM AUTHOR]

CU test and CD test were performed to capture the stress-strain characteristics of the clay in Dongting Lake area, China. Since the classical constitutive model cannot ideally describe the strain hardening behavior of the clay, an improved constitutive model that involved three damage factors was proposed. The damage first factor D 1 , which represents elemental volume strength F , was fitted by the Weibull function. The second and third damage factors D 2 and D 3 , which represent the porosity ratio e and the drainage rate P ε respectively, were fitted by Harris function. The CD test damage model is constructed by D 1 , D 2 , and D 3 . In the CU test, the porosity ratio e is a constant value, and the drainage volume is 0, so that D 2 is constant value and D 3 is 0. Therefore, the CU test damage model of the clay was constructed using the damage first factor D 1 . In the end, the accuracy of the proposed CU/CD damage constitutive models of the clay was validated with the experimental results. It is found that the results fitted by the proposed methodology are in good agreement with the experimental results. [ABSTRACT FROM AUTHOR]

Smallflower umbrella sedge (Cyperus difformis L.) is an invasive weed, and infestations of C. difformis are increasing in rice (Oryza sativa L.) fields in China. Bensulfuron-methyl is a widely used sulfonylurea herbicide that inhibits the acetolactate synthase (ALS) enzyme and has been used in recent years for effectively controlling annual weeds in the Cyperaceae family. In this study, a suspected resistant population of C. difformis (BBHY1) was collected from a rice field in Huaiyuan County, Anhui Province, China, that survived treatment with bensulfuron-methyl at the field-recommended rate (FRR). Single-dose tests and whole-plant bioassays confirmed that the BBHY1 population was resistant to bensulfuron-methyl and had evolved a high level of resistance, with a resistance index (RI) of 12.87. Sequencing of the ALS gene revealed a CCT to CAT point mutation at codon 197, which caused a P-to-H substitution in the resistant plants. Analysis of the relative expression of ALS revealed no significant differences between the resistant and susceptible populations. Inhibiting the activity of cytochrome P450s (P450s) or glutathione S-transferases (GSTs) had no significant effect on bensulfuron-methyl resistance. The BBHY1 population exhibited cross-resistance to pyrazosulfuron-ethyl, penoxsulam, and bispyribac-sodium, with RIs ranging from 5.48 to 20.63, but remained susceptible to MCPA sodium, florpyrauxifen-benzyl, and bentazon, with RIs of <1.00. These herbicides could be potentially used as alternatives for controlling resistant populations and managing herbicide resistance in other aggressive weeds in rice fields. [ABSTRACT FROM AUTHOR]

Background: Based on the few available studies on the prognostic benefit of using direct oral anticoagulants (DOACs) after atrial fibrillation (AF) ablation. Therefore, this study aimed to evaluate the prognostic differences between patients who underwent radiofrequency ablation (RFA) and those without RFA taking DOACs. Methods: This is a multicenter retrospective cohort study enrolling 6137 patients with non-valvular AF (NVAF) at 15 hospitals in China. Patient information was collected through a mean follow-up of 10 months and medical record queries. Clinical outcomes included major bleeding, total bleeding, thrombosis, all-cause death, and a composite endpoint of bleeding, thrombosis, and all-cause death. Results: After adjusting for confounders and propensity score matching (PSM), patients with RFA of NVAF had a significantly lower risk of major bleeding [OR 0.278 (95% CI, 0.150-0.515), P<0.001], thrombosis [OR 0.535 (95% CI, 0.316-0.908), P=0.020] and the composite endpoint [ OR 0.835 (95% CI, 0.710-0.982), P=0.029]. In the RFA PSM cohort, dabigatran was associated with reduced all-cause death in patients with RFA of NVAF [OR 0.420 (95% CI, 0.212-0.831), P=0.010]. In the no RFA PSM cohort, rivaroxaban was associated with a reduction in major bleeding [OR 0.521 (95% CI, 0.403-0.673), P<0.001], total bleeding [OR 0.114 (95% CI, 0.049-0.266), P<0.001], and the composite endpoint [OR 0.659 (95% CI, 0.535-0.811), P<0.001]. Conclusion: Among patients with NVAF treated with DOACs, RFA was a negative correlate of major bleeding, thrombosis, and composite endpoints but was not associated with total bleeding or all-cause mortality. [ABSTRACT FROM AUTHOR]

The prevalence and infectious intensity of schistosomiasis japonica has decreased significantly in China in the past few decades. However, more accurate and sensitive diagnostic methods are urgently required for the further control, surveillance, and final elimination of the disease. In this study, we assessed the diagnostic efficacy of a real-time fluorescence quantitative PCR (qPCR) method and recombinase polymerase amplification (RPA) combined with a lateral-flow dipstick (LFD) assay for detecting early infections of Schistosoma japonicum and different infection intensities. The sensitivity of the qPCR at 40 days post-infection (dpi) was 100% (8/8) in mice infected with 40 cercariae, which was higher than in mice infected with 10 cercariae (90%, 9/10) or five cercariae (77.8%, 7/9). The results of the RPA–LFD assays were similar, with sensitivities of 55.6% (5/9), 80% (8/10), and 100% (8/8) in mice infected with 5, 10, and 40 cercariae, respectively. In goats, both the qPCR and RPA–LFD assays showed 100% (8/8) sensitivity at 56 dpi. In the early detection of S. japonicum infection in mice and goats with qPCR, the first peak in positivity appeared at 3–4 dpi, when the positivity rate exceeded 40%, even in the low infection, intensity mice. In the RPA–LFD assays, positive results first peaked at 4–5 dpi in the mice, and the positivity rate was 37.5% in the goats at 1 dpi. In conclusion, neither of the molecular methods produced exceptional results for the early diagnosis of S. japonicum infection. However, they were useful methods for the regular diagnosis of schistosomiasis in mice and goats. [ABSTRACT FROM AUTHOR]

Temperature proxies for paleoclimate reconstruction have been made typically via ice cores, tree rings, stalagmites, and lake sediments. While extremely useful, these proxies can be limited spatially. Here we sampled a 98 m "soil core" from Loess Plateau of China and examined the relationship between pore water isotopic values and hydroclimate history. We extracted soil pore water for δ18O, δ2H, and 3H and measured chloride concentration. The 3H‐peak at 6 m and chloride mass balance were used to turn depth into calendar year. A 1000 year span was revealed. δ18O and δ2H values between 14–50 m were anomalously low—bracketing well the Little Ice Age period from 1420 to 1870. The identification was consistent with other standard proxies in the region and showed the same temporal dynamics of temperature anomalies. Our study shows the potential of stable isotopes of soil water for paleoclimate reconstruction in deep soils. Plain Language Summary: While paleoclimate reconstructions have been made with ice cores, tree rings, lake sediments and other proxies, few if any studies have explored the potential use of soil cores from the unsaturated zone to tease out paleoclimate information. Here, we report the soil water stable isotope data for an unusually deep, unsaturated zone soil core from the Loess Plateau of China. We found that waters extracted from the soil have relatively low δ2H and δ18O values in between the depths of 14–50 m. Waters at these depths likely derive from precipitation from the Little Ice Age period that occurred in that region of China from 1420 to 1870. Beyond simple time period identification, our isotope signal also captured the temperature dynamics during the Little Ice Age. We determined this by analyzing pore waters at 20 cm intervals. Tritium (3H, a radioactive tracer) and a salt mass balance method enabled us to covert core depth increments into calendar year. Our study shows the potential of soil water extractions from the deep critical zone for meaningful interpretation of paleoclimate conditions. Key Points: A 98 m "soil core" from the Loess Plateau of China recorded clear paleoclimate informationδ2H and δ18O values of extracted soil water between 14 and 50 m were anomalously low relative to the rest of the coreThe 14–50 m soil pore water bracketed the Little Ice Age period from the years 1420 to 1870 [ABSTRACT FROM AUTHOR]

Global warming has driven the expansion of cultivated land to high-altitude areas. Intensive vegetable production, which is generally considered to be a high economic value and high environmental risk system, has expanded greatly in high-altitude mountainous areas of China. However, the environmental cost of vegetable production in these areas is poorly understood. In this study, pepper production at low (traditional pepper production area) and high (newly expanded area) altitudes were investigated in Shizhu, a typical pepper crop area. The output and environmental cost at the two altitudes were identified. the influence of resource inputs, climate, and soil properties on pepper production was evaluated. There were obvious differences in output and environmental cost between the two altitudes. High-altitude pepper production achieved a 16.2% lower yield, and had a higher fertilizer input, resulting in a 22.3% lower net ecosystem economic benefit (NEEB), 23.0% higher nitrogen (N) footprint and 24.0% higher carbon (C) footprint compared to low-altitude farming. There is potential for environmental mitigation with both high- and low-altitude pepper production; Compared to average farmers, high-yield farmers groups reduced their N and C footprints by 16.9–24.8% and 18.3–25.2%, respectively, with 30.6–34.1% higher yield. A large increase in yield could also be achieved by increasing the top-dress fertilizer rate and decreasing the plant density. Importantly, high-altitude pepper production was achieved despite less advanced technology and inferior conditions (e.g., a poor road system and uneven fields). It provides a reference for the study of the environmental cost of other high-altitude regions or other crop systems at high-altitude areas. [ABSTRACT FROM AUTHOR]

Diesel engine exhaust (DEE) is an established lung carcinogen, but the biological mechanisms of diesel‐induced lung carcinogenesis are not well understood. MicroRNAs (miRNAs) are small noncoding RNAs that play a potentially important role in regulating gene expression related to lung cancer. We conducted a cross‐sectional molecular epidemiology study to evaluate whether serum levels of miRNAs are altered in healthy workers occupationally exposed to DEE compared to unexposed controls. We conducted a two‐stage study, first measuring 405 miRNAs in a pilot study of six DEE‐exposed workers exposed and six controls. In the second stage, 44 selected miRNAs were measured using the Fireplex circulating miRNA assay that profiles miRNAs directly from biofluids of 45 workers exposed to a range of DEE (Elemental Carbon (EC), median, range: 47.7, 6.1–79.7 μg/m3) and 46 controls. The relationship between exposure to DEE and EC with miRNA levels was analyzed using linear regression adjusted for potential confounders. Serum levels of four miRNAs were significantly lower (miR‐191‐5p, miR‐93‐5p, miR‐423‐3p, miR‐122‐5p) and one miRNA was significantly higher (miR‐92a‐3p) in DEE exposed workers compared to controls. Of these miRNAs, miR‐191‐5p (ptrend =.001, FDR = 0.04) and miR‐93‐5p (ptrend =.009, FDR = 0.18) showed evidence of an inverse exposure–response with increasing EC levels. Our findings suggest that occupational exposure to DEE may affect circulating miRNAs implicated in biological processes related to carcinogenesis, including immune function. [ABSTRACT FROM AUTHOR]

The extent and mechanisms by which precipitation extremes affect hydrological processes in the critical zone (CZ) of loess possessing a thick unsaturated zone remains poorly understood. To this end, we here employed a coupled liquid‒vapor‒heat‒airflow STEMMUS (simultaneous transfer of energy, mass, and momentum in unsaturated soil) model to investigate the impact of extreme precipitation, at both event and annual scales, on CZ hydrological processes within a semiarid loess site vegetated by apple trees on China's Loess Plateau. At the event scale, the vapor flux was two orders of magnitude lower than the liquid water flux. However, the thermal vapor flux penetrated to depths of 200 cm, whereas the isothermal liquid water flux only infiltrated to 100 cm during the study period, implying that thermal‐gradient‐driven vapor transfer is an important mechanism for deep‐layer recharge (DLR). At the annual scale, the DLR below 200 cm during extremely wet years was 6.5 times larger than that during extremely dry years. In contrast, extreme changes in climate had only limited impacts on evapotranspiration; the difference between extremely wet and extremely dry years averaged only 35 mm, much less than the difference in precipitation, which averaged 310 mm. However, the extremely dry years showed a higher ratio (0.58) between transpiration and evapotranspiration than did the extremely wet years (0.51). The findings reported here improve our understanding of CZ hydrological processes related to precipitation extremes in semiarid loess regions. Key Points: Thermal‐gradient‐driven vapor transfer is an important mechanism for deep‐layer recharge (DLR) in loessThe DLR below 200 cm during extremely wet years was 6.5 times larger than that during extremely dry yearsExtreme changes in precipitation had only limited impacts on evapotranspiration [ABSTRACT FROM AUTHOR]

School guidance and counseling services are important for adolescent development. This study focused on the predictive role of three main delivery strategies (guidance curriculum, group counseling, and individual counseling) on students' positive development (academic, personal-social, career) and psychopathology (anxiety, depression, problem behaviors) in the high school context. Cross-sectional data were obtained from 59 high schools and 8556 students from mainland China. The results showed that the relationships between the number of times students attended guidance and counseling services and the domains of positive development were significantly higher than the relationship of the services with psychopathology. Furthermore, non-recursive model analyses showed that the latent variable of positive development mediated the influence of the services on psychopathology. In addition, psychopathology mediated the influence of counseling on positive development. The present findings confirm that school guidance and counseling services are effective for student development in China and provide partial support for the classification of guidance and counseling delivery strategies in terms of actual service effects. While paying attention to the differences in delivery strategies, school administrators are advised to consider the indirect effects of guidance and counseling on student development, which benefits the development and integration of comprehensive guidance services. [ABSTRACT FROM AUTHOR]

Objectives Diesel exhaust is an established human carcinogen, however the mechanisms by which it leads to cancer development are not fully understood. Mitochondrial dysfunction is an established contributor to carcinogenesis. Recent studies have improved our understanding of the role played by epigenetic modifications in the mitochondrial genome on tumorigenesis. In this study, we aim to evaluate the association between diesel engine exhaust (DEE) exposure with mitochondrial DNA (mtDNA) methylation levels in workers exposed to DEE. Methods The study population consisted of 53 male workers employed at a diesel engine manufacturing facility in Northern China who were routinely exposed to diesel exhaust in their occupational setting, as well as 55 unexposed male control workers from other unrelated factories in the same geographic area. Exposure to DEE, elemental carbon, organic carbon, and particulate matter (PM2.5) were assessed. mtDNA methylation for CpG sites (CpGs) from seven mitochondrial genes (D-Loop , MT-RNR1 , MT-CO2 , MT-CO3 , MT-ATP6 , MT-ATP8 , MT-ND5) was measured in blood samples. Linear regression models were used to estimate the associations between DEE, elemental carbon, organic carbon and PM2.5 exposures with mtDNA methylation levels, adjusting for potential confounders. Results DEE exposure was associated with decreased MT-ATP6 (difference = −35.6%, P -value = 0.019) and MT-ATP8 methylation (difference = −30%, P -value = 0.029) compared to unexposed controls. Exposures to elemental carbon, organic carbon, and PM2.5 were also significantly and inversely associated with methylation in MT-ATP6 and MT-ATP8 genes (all P -values < 0.05). Conclusions Our findings suggest that DEE exposure perturbs mtDNA methylation, which may be of importance for tumorigenesis. [ABSTRACT FROM AUTHOR]

The housing price-to-income ratio (PIR) is an important indicator for measuring the health of the real estate market and detecting residents' housing affordability. Including data of 336 cities in China from 2009 to 2020 as the research unit, the PIR's spatial and temporal evolution characteristics are explored by using the urban rank-size rule and Markov chain, and its influencing factors are explored using the random forest model. The results show the following: (1) The PIR is in a normal distribution pattern, and there was a significant positive spatial correlation, which tended to increase. (2) Spatially, the PIR shows an overall distribution trend of "high in the east and low in the west", and a rising trend of fluctuation is shown in the average PIR. (3) The PIR's time evolution has high stability. China's urban PIR is primarily the stable type from 2009 to 2015 and mainly the upward transfer type from 2015 to 2020. (4) The influence of economic, demographic, social, and expected factors on the PIR decreases, among which real estate investment density, industrial structure level, residents' consumption level, and real estate activity are the dominant factors enhancing trends and showing a complex nonlinear relationship. [ABSTRACT FROM AUTHOR]

External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice. [ABSTRACT FROM AUTHOR]

The distribution of beddings varies greatly in shale reservoirs. The influence of beddings on hydraulic fracture propagation has often been studied using simplified geological models, i.e., uniformly distributed bedding models. However, the propagation processes of hydraulic fractures in shale reservoirs with complicated distributed beddings remains unclear. In this research, an outcrop-data-based bedding model of a continental shale formation in the Ordos Basin, China, is built. A mathematical model for fracture propagation is built using the discrete element method and is then verified by a hydraulic fracturing experiment. Reservoir-scale simulations are employed to investigate the influence of geological factors and engineering factors on fracture geometry. The study finds that beddings have significant inhibitory effects on fracture height growth; hydraulic fractures have difficulty in breaking through zones with densely distributed beddings. If a hydraulic fracture encounters a bedding plane with a larger aperture, it is more likely to be captured and expand along the weak interface. High vertical stress difference and a high fluid injection rate can promote the vertical penetration of hydraulic fractures through beddings and activate the bedding system to yield a complex fracture network. Increments in fluid viscosity can increase the resistance of fracture propagation, thereby reducing fracture complexity. [ABSTRACT FROM AUTHOR]

Soil organic nitrogen (SON) and its mineralization are among the most critical factors that affect soil N availability. However, it is unclear how crop residue return and chemical N fertilization affect soil N availability by altering SON and its mineralization. Therefore, we studied the SON pools, SON mineralization, and related soil properties and enzymes activities in the lower reaches of the Yangtze River Valley in China with stand ages of 7‐year N (0, 75, 150, and 300 kg N ha−1) fertilization and 4‐year barley‐cotton residue return. Regardless of residue retention or removal, the contents of total SON and its fractions (ammonium N, amino acid N, amino sugar N, and unidentified N) increased consistently with the increasing of N input, while SON mineralization, microbial biomass N content, urease and protease activities showed a curvilinear response that was highest at N rate of 150 kg N ha−1. Crop residue returning significantly increased SON content under 75 and 150 kg N ha−1, mostly due to the increase of amino acids N. Other variables, such as SON mineralization, microorganism, and enzymes, were also enhanced by residue returning, and the largest increases were observed at 150 kg N ha−1. In addition, our result also show that excessive N input (300 kg N ha−1) would reduce soil N availability by mainly suppressing microbial N processes. We concluded that crop residue combined with appropriate N has a great potential to improve soil N availability by mainly improving amino acid N content and SON mineralization. [ABSTRACT FROM AUTHOR]

Background. Infection with syphilis is still a major public health problem. The precise data for syphilis seroprevalence in the populations will help to develop a strategy for prevention and treatment of it. However, the data for syphilis prevalence in continuous years among volunteer blood donors in China is rare. Methods. A retrospective study for Treponema pallidum (TP) antibody in blood donors was conducted from January 2010 to December 2019 at the Blood Center of Zhejiang Province, China. TP antibody was detected with two different reagents using enzyme-linked immunosorbent assay and the only sample which was reactive in the two reagents was defined as seropositive. Results. A total of 992,646 volunteer blood donors were analyzed and the positive rate of TP antibody in the blood donors was 0.43%. From 2010 to 2019, the positive rates of TP antibody were 0.53%, 0.51%, 0.51%, 0.43%, 0.36%, 0.18%, 0.11%, 0.12%, 0.11%, and 0.10%, respectively. The positive rates of TP antibody were significantly different among blood donor age group (p < 0.001), with the highest positive rate in 45–54-years-old group (0.93%). The positive rates of TP antibody in male and female blood donors were 0.44% and 0.41%, respectively. The positive rate was 0.57% among the first-time blood donors, which was significantly higher than that of the repeat blood donors (0.17%). The positive rate of TP antibody in blood donors decreased gradually with the increase of educational level. Conclusion. The syphilis seroprevalence is low in the blood donors of the Hangzhou area, and the positive rate of blood donors is associated with age, educational level, and times of blood donation. Increasing the number of repeat blood donations is helpful to improve blood safety. [ABSTRACT FROM AUTHOR]

The impact of average wages on electricity consumption among urban residents in China has generated many fascinating debates for scholarly research, but only a few studies have considered the spatial spillover effect of average wages on residential electricity consumption. With the use of city-level panel data from 278 Chinese cities spanning 2005 to 2016, this preliminary study explores the impacts of the average wage on residential electricity consumption. Specifically, based on the spatial Durbin model with fixed effects, three different spatial weight matrices (the economic distance, the inverse distance, and the four nearest neighbours) are utilised to check the robustness of the results under different standards. The results show that the residential electricity consumption of each city increased during the observation period, presenting obvious spatial correlations. Secondly, the average wage of residents had a positive spatial spillover effect, which promoted the residential electricity consumption of both local and surrounding cities. Thirdly, the population density, electricity intensity, educational level of urban residents, and per capita household liquefied petroleum gas consumption in urban areas are key factors influencing residential electricity consumption. Therefore, improving the educational level of urban residents and reducing the electricity intensity can help reduce electricity consumption by residents in China. This paper also presents policy recommendations. [ABSTRACT FROM AUTHOR]

Although national health-related quality of life population norms had been published based on the EuroQol 5-Dimensions 5-levels scale, China is a vast country with diverse cultural and social development in various regions. Therefore, regional population norms may better reflect the health status of residents in a given area. The purpose of the study was to derive the HRQoL population norm for adult general population in southern Jiangsu Province using the EQ-5D-5L scale and explore potential influencing factors. The data were based on a cross-sectional survey conducted in Liyang City from March 2019 to July 2020. EQ-5D-5L utility scores based on Chinese value set and EQ-VAS scores were used to assess HRQoL. The Tobit regression model and generalized linear model were performed to identify the association among potential covariates and HRQoL. The means (95% confidence interval) of the EQ-5D-5L utility scores and EQ-VAS scores were 0.981(0.980–0.983) and 83.6(83.2–83.9), respectively. Younger people (≤ 40 years old) were more likely to experience problems with anxiety or depression. Additionally, women had lower HRQoL scores although multivariate analysis found no statistical difference between the sexes. Lower HRQoL was associated with advanced age, lower socioeconomic status, no spouse, lack of regular physical activities, smoking cessation, and chronic non-communicable diseases. Subjects who declared that they were afflicted by diseases presented significantly lower utility scores, ranging from 0.823 (0.766–0.880) for memory-related diseases to 0.978 (0.967–0.989) for hepatic diseases. Regional population norms of HRQoL are needed in the health economic study owing to the great socioeconomic differences across regions in China. The present study provides HRQoL population norms for adults in southern Jiangsu. These norm values could help policy makers better allocate limited health resources and prioritize service plans. [ABSTRACT FROM AUTHOR]

• Depression and making positive sense of adversity tend to decrease over the study period. • More childhood maltreatment relates to lower initial level and relatively slower decrease of Making positive sense of adversity. • Childhood maltreatment impact emerging adults' depression trajectory through making positive of adversity. Childhood maltreatment is known to be associated with depression in emerging adulthood, but the understanding of the underlying mechanisms is incomplete. In this 4-wave longitudinal study, we explored the developmental trajectory of depression and making positive sense of adversity (MPSA), and the longitudinal mediating role of MPSA on the effects of childhood maltreatment on emerging adulthood depression based on the Stress Process Model. Participants were 675 Chinese college students (63.9 % female, M age = 19.53 years) who were followed over one and a half years. Tests of unconditional and multivariate latent growth models indicated that MPSA and depression tend to decrease over the study period; childhood maltreatment indirectly influenced the trajectory of depression by mediating MPSA rather than directly affecting emerging adults' depression. The initial value of MPSA fully mediated the relationship between initial values of childhood maltreatment and depression, while the mediating effect of the rate of change of MPSA was also significant, so the longitudinal mediation effects of MPSA are verified. These findings provide certain theoretical implications and potential applied value in designing interventions to promote positive adaptation for maltreated emerging adults. [ABSTRACT FROM AUTHOR]

Brown carbon (BrC) aerosols exert vital impacts on climate change and atmospheric photochemistry due to their light absorption in the wavelength range from near-ultraviolet (UV) to visible light. However, the optical properties and formation mechanisms of ambient BrC remain poorly understood, limiting the estimation of their radiative forcing. In the present study, fine particles (PM 2.5) were collected during 2016–2017 on a day/night basis over urban Tianjin, a megacity in northern China. Light absorption and fluorescence properties of water extracts of PM 2.5 were investigated to obtain seasonal and diurnal patterns of atmospheric water-soluble BrC. There were obvious seasonal, but no evident diurnal, variations in the light absorption properties of BrC. In winter, BrC showed much stronger light-absorbing ability, with a mass absorption efficiency at 365 nm (MAE 365) in winter (1.54±0.33 m 2 gC -1) that was 1.8 times larger than MAE 365 in summer (0.84±0.22 m 2 gC -1). Direct radiative effects by BrC absorption relative to black carbon in the UV range were 54.3±16.9 % and 44.6±13.9 % in winter and summer, respectively. In addition, five fluorescent components in BrC, including three humic-like fluorophores and two protein-like fluorophores were identified with excitation–emission matrix fluorescence spectrometry and parallel factor (PARAFAC) analysis. The less oxygenated components contributed more to winter and nighttime samples, while more oxygenated components increased in summer and daytime samples. The higher humification index (HIX), together with lower biological index (BIX) and fluorescence index (FI), suggests that the chemical compositions of BrC were associated with a high aromaticity degree in summer and daytime due to photobleaching. Fluorescent properties indicate that wintertime BrC were predominantly affected by primary emissions and fresh secondary organic aerosol (SOA), while summer ones were more influenced by aging processes. Results of source apportionments using organic molecular compositions of the same set of aerosols reveal that fossil fuel combustion and aging processes, primary bioaerosol emission, biomass burning, and biogenic and anthropogenic SOA formation were the main sources of BrC. Biomass burning contributed much more to BrC in winter and at nighttime, while biogenic SOA contributed more in summer and during the daytime. In particular, our study highlights that primary bioaerosol emission is an important source of BrC in urban Tianjin in summer. [ABSTRACT FROM AUTHOR]

Background: Pertuzumab is a humanized monoclonal antibody for the treatment of breast cancer. HLX11 is a biosimilar of pertuzumab developed by Shanghai Henlius Biotech, Inc. We conducted a bioequivalence study for HLX11 and pertuzumab (United States [US]-, European Union [EU]-, and China [CN]-approved products). Objectives: This study compared the biosimilarity in pharmacokinetics (PK), safety, and immunogenicity between HLX11 and reference pertuzumab (approved in the US, the EU, and CN) in healthy Chinese male participants after a single infusion and further characterized the PK profile of HLX11. Methods: Eligible individuals were randomized 1:1:1:1 to receive a single dose of 420 mg HLX11, US-, EU-, or CN-pertuzumab via intravenous infusion over 60 min. The primary endpoints were maximum serum drug concentration (Cmax), area under the serum concentration–time curve (AUC) from time 0 to time of the last quantifiable concentration (AUC0–t), and AUC from time 0 to infinity (AUC0–∞). PK bioequivalence was established if the 90% confidence intervals (CIs) of the geometric mean ratios of the primary endpoints were between 80.0 and 125.0%. Secondary endpoints included other PK parameters, safety, and immunogenicity. Results: A total of 160 participants were enrolled and randomly assigned to each group (n = 40 per group). The 90% CIs of the geometric mean ratios of the primary endpoints were all within the prespecified equivalence margins (HLX11 vs. pertuzumab [US-, EU-, CN-approved products]: Cmax 97.03–115.06%, 91.39–109.80%, 94.53–110.65%; AUC0–t 87.65–99.68%, 87.07–100.79%, 86.29–101.09%; AUC0–∞ 87.66–99.90%, 87.54–101.05%, 89.23–103.20%). The incidence of adverse drug reactions was comparable across the four groups. The presence of anti-drug antibodies or neutralizing antibodies had no obvious effect on PK. Conclusion: The PK, safety, and immunogenicity of HLX11 were highly similar to those of reference pertuzumab (US-, EU-, CN-approved products). The established bioequivalence supports further clinical trials of HLX11 in cancer treatment. Trial Registration: This study was registered with ClinicalTrials.gov (NCT04411550) and Chinadrugtrials.org.cn (CTR20200618). [ABSTRACT FROM AUTHOR]

Calibration and validation (Cal/Val) of the sea surface height as measured by satellite radar altimeters is essential to understand altimeter biases, observation trends, and instrument aging. It also supports the long-term stability of the produced climate change records of sea level as determined by altimetry. In this article, we report the calibration of HY-2B and Jason-2/3 using the established research infrastructure and data sharing initiative introduced by the Altimetry Calibration Cooperation Plan (ACCP) of China. Currently, three ACCP calibration sites encompass the Wanshan Islands, and two national oceanic sites are located along the China coastline. For each Cal/Val site, the components of the facilities—the geodetic, sea level, and Global Navigation Satellite System (GNSS) infrastructure—and the followed monitoring procedures and calibration methods are described. The HY-2B performance was primarily evaluated using about two years data, which indicated a mean bias of −0.2 ± 4.2 cm. Confidence in the results is strong, because the HY-2B biases were cross compared and confirmed by all the three independent sites and the three satellite ground tracks. Compared with its predecessor HY-2A, HY-2B shows very stable observations with no linear drift at present. In addition, Jason-2 and Jason-3 were mainly assessed using Qianliyan site. Our results indicate that the Jason-3 sea-surface height bias is approximately 2–3 cm smaller than that of Jason-2 and that the long-term stability of Jason-2/3 shows no significant trend, which in good agreement with the international dedicated sites. The instrument noises of Jason-2/3 and HY-2B were estimated based on the ACCP sites. The results show that the instrument noise in the previous literature is underestimated. This was also consolidated by the result from wavenumber spectrum and global crossover point analysis. The code and Wanshan data used in these Cal/Val experiments are publicly available to facilitate further work in this domain (https://github.com/GenericAltimetryTools/CalAlti). [ABSTRACT FROM AUTHOR]

Background: Vaccination is the most effective method for the prevention of COVID-19. However, willingness to be vaccinated is not consistent. This study aimed to explore vaccine cognition, risk perception, and health behavior of COVID-19 in China. Methods: A cross-sectional survey was performed in Guangdong province, China, including demographic characteristics, health status and preventive behaviors, cognition of COVID-19 vaccination, and the health belief model (HBM). Results: A total of 1640 participants were recruited. The main access to information about COVID-19 and vaccination as through official news and broadcasts (67.3%), social network software (58.7%), and professional popularization (46.2%). The precautions taken were wearing a mask (67.0%) and avoiding gathering together (71.3%). COVID-19 vaccination acceptability was different among different age groups and educational levels (p < 0.001). The major reasons for accepting vaccination included that it was an effective way to prevent COVID-19 (61.8%) and that it was required by working units/schools (51.1%). The fitting effect indexes of the (HBM) Model 2 showed better fitting than those of Model 1. In Model 2, perceived benefits (OR = 3.13, 95% CI: 1.79–5.47), cues to action (OR = 2.23, 95% CI: 1.60–3.11), and different occupations (OR = 1.13, 95% CI: 1.04–1.23) were positively correlated with vaccine acceptance; while perceived susceptibility (OR = 0.47, 95% CI: 0.30–0.74) and perceived barriers (OR = 0.44, 95% CI: 0.29–0.69) were negative factors associated with vaccine acceptance. Conclusion: Different sociodemographic characteristics lead to differences in acceptance of vaccination, and the publicity and credibility of government play an indispensable role in epidemic control. The establishment of the HBM further predicted that perceived susceptibility to COVID-19, benefits of vaccination, barriers of cognition, and cue to action were the influencing factors of intention and health behaviors. [ABSTRACT FROM AUTHOR]

China has a marked continental monsoon climate characterized by dry and wet hazards that have destructive impacts on grape yields and quality. The purpose of this study was to analyze the spatiotemporal characteristics of dryness/wetness in the wine regions of China and explore the links between these variations and large-scale climatic factors. The crop-specific standardized precipitation evapotranspiration index (SPEI) was used to characterize the dryness/wetness using meteorological data collected at 168 meteorological stations located in or near the wine regions from 1981–2015. Results showed that most wine regions of China experienced a wetting trend. The drought and wet event characteristics were region- and site-specific. The main wine regions of China (e.g., Xinjiang, Helan Mountain and Hexi Corridor) were characterized by relatively high drought severity; the extreme drought frequencies of the three regions were higher as well (11.5%, 3.3%, and 3.6%, respectively). Xinjiang was also characterized by a high wetness severity and an extremely high wetness frequency of 16%, but the wetness severity decreased over time. A 4–6-year periodical oscillation was commonly detected over the wine regions. The dryness/wetness characteristics were highly associated with the Southern Oscillation Index, Niño 3.4 and the Indian Ocean Dipole, with highest correlation coefficients of −0.40, 0.36 and 0.43 at lag times of 11, 8, and 11 months, respectively. The serious dry and wet events that occurred in 2001 and 1998, respectively, were speculated to be associated with anomalous atmospheric circulation patterns. These results can be used to inform grapevine stakeholders at various levels (e.g., farmer and industry) for developing strategies to mitigate and adapt dryness/wetness events in the wine regions of China. It is expected that the approach proposed in this study can also be applicable to wine regions of other countries. [ABSTRACT FROM AUTHOR]

While previous studies have examined the negative effects of work-related smartphone use after hours, little is known about whether and how it influences employees' unhealthy sleep behavior (i.e., bedtime procrastination). Drawing on the ego depletion theory, this study explored the effects of work-related smartphone use after hours on bedtime procrastination. To further uncover potential cross-cultural differences, a sample of 210 public employees from the United States and 205 public employees from China were used. Results via path analysis revealed that off-time work-related smartphone use positively influenced bedtime procrastination via the mediating role of self-control depletion. These findings were consistent between the United States and Chinese sample; however, off-time work-related smartphone use after hours increased the likelihood of self-control depletion more strongly in the United States than in China. The implications of our findings for both theory and practice were discussed. [ABSTRACT FROM AUTHOR]

The effect of cyanobacterial blooms on aquatic ecosystems has received wide attention, yet little is known about their impacts on zooplankton genetic structure.For 26 months (April 2012–May 2014), we monitored zooplankton in a warm‐temperate ice‐free lake in Eastern China, with an emphasis on seasonal population dynamics of the cladoceran, Daphnia galeata. There was a seasonal succession in the zooplanktonic community (composed of Cladocera, Copepoda, and Rotifera).Genetic analysis (based on 14 microsatellite loci) of the 21 monthly samples in which D. galeata was present demonstrated that several clones could successfully overwinter and/or persist for many months. However, all clones, including these long‐lived clones, were completely replaced by new ones after October 2013, probably due to cyanobacteria blooms in that summer. A high clonal richness coupled with high turnover rate was observed in the D. galeata population overall, suggesting frequent sexual reproduction.Daphnia galeata experimentally fed with a diet of Microcystis aeruginosa (the most abundant toxic cyanobacterial species in the lake) had a substantially reduced survivorship, consistent with the field observations.Our findings highlight the changes of zooplanktonic population dynamics in terms of both community and clonal structure in a warm‐temperate ice‐free lake, and call for further investigation on ecological responses of zooplankton to cyanobacterial blooms. [ABSTRACT FROM AUTHOR]

Background: Pegylated recombinant human granulocyte colony-stimulating factors (PEG-rhG-CSFs) are more commonly and widely used than recombinant human granulocyte colony-stimulating factors (rhG-CSFs) in preventing chemotherapy-induced neutropenia in patients with stage II-IV breast cancer. To reduce the financial burden on these patients, the corresponding medical insurance directory needs to be revised. Objectives: To evaluate the cost-effectiveness of PEG-rhG-CSF versus rhG-CSF in patients with stage II-IV breast cancer in central China. Methods: Two Markov models, a chemotherapy model and a post-chemotherapy model, were developed to study the effects and costs, with a time horizon of 12 weeks and 35 years, respectively. Cost and probability input data were primarily obtained from a retrospective real-world study conducted in five tertiary hospitals. Propensity score matching was adopted to overcome retrospective bias. Other parameters were extracted from literature as well as advice from clinical experts. Univariate and probabilistic sensitivity analyses were conducted. Results: In the first chemotherapy model, PEG-rhG-CSF was associated with fewer episodes of febrile neutropenia (FN) (N = 19 per 1000 patients treated), infections (N = 24 per 1000 patients treated) and deaths (N = 2 per 1000 patients treated), but higher costs (¥36 more per patient treated). The post-chemotherapy model indicated that PEG-rhG-CSF led to higher gains in quality-adjusted life years (QALYs) (11.695 versus 11.516) in comparison to rhG-CSF. Sensitivity analysis showed that the cost of PEG-rhG-CSF had the greatest impact on the incremental costs, and incremental QALYs were very sensitive to the risk of RDI <85%. The probability of PEG-rhG-CSF being cost-effective compared to rhG-CSF was 66% at the willingness to pay (WTP) thresholds of ¥72,371 per QALY gained. Conclusion: According to this economic evaluation based on real-world data, PEG-rhG-CSF may be considered as a more cost-effective strategy relative to rhG-CSF for stage II-IV breast cancer patients in central China. However, to reflect a national perspective, further evidence is needed using data from larger-scale studies. [ABSTRACT FROM AUTHOR]

The chemical traits of litter are among the most critical factors that affect its decomposition. During vegetation restoration of planted forests, increasing age of the planted species and succession of the understory species may lead to significant changes in litter traits. However, it is unclear how these changes occur and how they affect litter decomposition. Therefore, we studied the decomposition of litter from four Robinia pseudoacacia plantations in the Loess Plateau in China with stand ages of 10–43 years using an indoor simulation test. We measured changes in litter substrate quality and chemical diversity, structural properties of the litter microbial community, activity of litter enzymes, and mixed decomposition effects during vegetation restoration. Their relationships to changes in litter decomposition rate were analyzed using structural equation modeling. Improvements in substrate quality of forest litter induced by vegetation restoration drove changes in fungal community composition during late decomposition (day 358), which in turn increased the activity of lignin‐decomposing enzymes and ultimately accelerated litter decomposition. At the same time, decreases in the chemical diversity of forest litter induced by vegetation restoration reduced the diversity of litter fungi during middle and late decomposition (days 182 and 358). This caused significant negative mixed decomposition effects, thereby inhibiting litter decomposition. However, improvements in litter substrate quality dominated the changes in litter decomposition rate, and the decomposition rate of R. pseudoacacia plantation litter thus increased over the course of vegetation restoration. [ABSTRACT FROM AUTHOR]

Background: Talaromyces Marneffei (Penicillium marneffei, T.marneffei) has been frequently reported in patients with adult acquired immunodeficiency syndrome. Still, cases of children with HIV combined with T.marneffei infection are very rare. This report describes the case of a HIV-child who is a girl from China. Her special clinical manifestations and laboratory diagnosis results can provide clinicians with the basis for diagnosis and treatment of T.marneffei related rare diseases.Case Presntation: We reported a single case of 7-year-old Chinese female patient who presented with fever, abdominal pain, multiple lymphadenopathy, hepatosplenomegaly, left lower extremity ecchymosis, and bloody stool. The patient received anti-inflammatory therapy; however, her symptoms did not improve. Consequently, she was diagnosed with T.marneffei and HIV infection; it was also confirmed that her mother did not undergo HIV blocking therapy during pregnancy. Yet, the child's family refused all treatment, after which the child was discharged from the hospital. The patient died a few days later.Conclusion: This case suggested that children with AIDS suffering from fever, lymphadenopathy and coagulation dysfunction, penicilliosis should be suspected. Clinicians should diagnose the disease early through laboratory and imaging results, which can help reduce the mortality, prolong the survival time and improve the quality of life of children. [ABSTRACT FROM AUTHOR]

Some previous studies have explored the impact of family function on school belonging. However, little is known about the parallel mediating relationship underlying them. This study aims to investigate the formation mechanism of school beginning in a sample of Chinese adolescents and examined the parallel mediating role of interpersonal self-support and individual self-support in the link between family function and school belonging. A cross-sectional study was conducted in four schools of the district of Hunan province in China, and 741 students were surveyed using cluster sampling. Family cohesion and adaptability scale (FACES), Adolescent students self-supporting personality scale (SSPS-AS), School belonging scale were applied. The results indicated that interpersonal self-support and individual self-support, together, and uniquely, parallel mediated the relationship between family function and school belonging. It can be concluded that family function not only has direct effects on school belonging but also has indirect effects through interpersonal self-support and individual self-support. [ABSTRACT FROM AUTHOR]

How can China fully use the limited carbon emission space to achieve the dual goal of stable economic growth and a gradual decline in carbon emissions under increasingly severe global climate change? To address this issue, this paper incorporates the carbon emission space as a production factor into the total factor analysis framework and discusses how environmental regulations affect the total factor carbon productivity. The conclusions reveal that the current environmental regulations have a direct effect on improvement in the total factor carbon productivity of industrial sectors. Environmental regulations also have an indirect effect on the total factor carbon productivity that is mainly achieved through the energy structure and technological advancement. The results of the additional analyses show that these direct and indirect effects have threshold characteristics. Increasing the total factor carbon productivity is beneficial only when the environmental regulation intensity, energy structure and technological level are within a reasonable threshold range. Therefore, the environmental regulation intensity, energy structure conditions and technological level need to be considered when environmental regulations are relied upon to improve the total factor carbon productivity. [ABSTRACT FROM AUTHOR]

Urinary mutagenicity reflects systemic exposure to complex mixtures of genotoxic/carcinogenic agents and is linked to tumor development. Coal combustion emissions (CCE) and diesel engine exhaust (DEE) are associated with cancers of the lung and other sites, but their influence on urinary mutagenicity is unclear. We investigated associations between exposure to CCE or DEE and urinary mutagenicity. In two separate cross‐sectional studies of nonsmokers, organic extracts of urine were evaluated for mutagenicity levels using strain YG1041 in the Salmonella (Ames) mutagenicity assay. First, we compared levels among 10 female bituminous (smoky) coal users from Laibin, Xuanwei, China, and 10 female anthracite (smokeless) coal users. We estimated exposure–response relationships using indoor air concentrations of two carcinogens in CCE relevant to lung cancer, 5‐methylchrysene (5MC), and benzo[a]pyrene (B[a]P). Second, we compared levels among 20 highly exposed male diesel factory workers and 15 unexposed male controls; we evaluated exposure‐response relationships using elemental carbon (EC) as a DEE‐surrogate. Age‐adjusted linear regression was used to estimate associations. Laibin smoky coal users had significantly higher average urinary mutagenicity levels compared to smokeless coal users (28.4 ± 14.0 SD vs. 0.9 ± 2.8 SD rev/ml‐eq, p = 2 × 10−5) and a significant exposure‐response relationship with 5MC (p = 7 × 10−4). DEE‐exposed workers had significantly higher urinary mutagenicity levels compared to unexposed controls (13.0 ± 10.1 SD vs. 5.6 ± 4.4 SD rev/ml‐eq, p =.02) and a significant exposure‐response relationship with EC (p‐trend = 2 × 10−3). Exposure to CCE and DEE is associated with urinary mutagenicity, suggesting systemic exposure to mutagens, potentially contributing to cancer risk and development at various sites. [ABSTRACT FROM AUTHOR]

Background: Lumbar spinal stenosis (LSS) is a common degenerative condition associated with old age. Its incidence continues to increase with the rapidly aging population in China. Treatment for LSS usually begins with conservative treatments, as some patients refuse surgical procedures or have surgery contraindications. Caudal epidural steroid injections (CESIs) and selective nerve root blocks (SNRBs) are two commonly used conservative treatments for LSS, which have proven to be effective at relieving LSS symptoms in many studies. However, there are no randomized controlled trials comparing these two procedures. We planned the first study to assess which one of these two procedures is more effective in treating LSS. We will compare the efficacy of these two treatment methods in terms of duration of symptom relief and recurrence rate. We hope our findings will help clinicians choose an optimal treatment for LSS patients.Methods/design: We plan to conduct a 1-year randomized controlled trial that will include a total of 76 subjects. They will be randomly divided into two groups: group A (patients will receive CESIs) and group B (patients will receive SNRBs). Two days before the procedure, we will assess these patients using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale, Oswestry Disability Index (ODI), and numeric rating scale (NRS) for pain. One day, 2 weeks, 3 months, 6 months, and 1 year after the procedure, we will assess the condition of these patients again with the NRS and ODI.Discussion: We hope our findings will lay the foundation for the design of further comprehensive studies and help clinicians make a choice between CESIs and SNRBs for LSS patients.Trial Registration: Chinese Clinical Trial Registry ChiCTR1900028038 . Registered on 8 December 2019. [ABSTRACT FROM AUTHOR]

The problems caused by the interaction between slopes and hydrologic environment in traffic civil engineering are very serious in the granite residual soil area of China, especially in Guangdong Province. Against the background of two heavy rainfall events occurring during a short period due to a typhoon making landfall twice or even two typhoons consecutively making landfall, laboratory model tests were carried out on the hydrological effects of the granite residual soil slope considering three vegetation types under artificial rainfall. The variation in slope surface runoff, soil moisture content and rain seepage over time was recorded during the tests. The results indicate that surface vegetation first effectively reduces the splash erosion impact of rainwater on slopes and then influences the slope hydrological effect through rainwater forms adjustment. (1) The exposed slope has weak resistance to two consecutive heavy rains, the degree of slope scouring and soil erosion damage will increase greatly during the second rainfall. (2) The multiple hindrances of the stem leaf of Zoysia japonica plays a leading role in regulating the hydrological effect of slope, the root system has little effect on the permeability and water storage capacity of slope soil, but improves the erosion resistance of it. (3) Both the stem leaf and root system of Nephrolepis cordifolia have important roles on the hydrological effect. The stem leaf can stabilize the infiltration of rainwater, and successfully inhibit the surface runoff under continuous secondary heavy rainfall. The root system significantly enhances the water storage capacity of the slope, and greatly increases the permeability of the slope soil in the second rainfall, which is totally different from that of the exposed and Zoysia japonica slopes. (4) Zoysia is a suitable vegetation species in terms of slope protection because of its comprehensive slope protection effect. Nephrolepis cordifolia should be cautiously planted as slope protection vegetation. Only on slopes with no stability issues should Nephrolepis cordifolia be considered to preserve soil and water. [ABSTRACT FROM AUTHOR]