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Talaromyces marneffei (T. marneffei) can cause talaromycosis, a fatal systemic mycosis, in patients with AIDS. With the increasing number of talaromycosis cases in Guangdong, China, we aimed to investigate the susceptibility of 189 T. marneffei clinical strains to eight antifungal agents, including three echinocandins (anidulafungin, micafungin, and caspofungin), four azoles (posaconazole, itraconazole, voriconazole, and fluconazole), and amphotericin B, with determining minimal inhibition concentrations (MIC) by Sensititre YeastOne™ YO10 assay in the yeast phase. The MICs of anidulafungin, micafungin, caspofungin, posaconazole, itraconazole, voriconazole, fluconazole, and amphotericin B were 2 to > 8 μg/ml, >8 μg/ml, 2 to > 8 μg/ml, ≤ 0.008 to 0.06 μg/ml, ≤ 0.015 to 0.03 μg/ml, ≤ 0.008 to 0.06 μg/ml, 1 to 32 μg/ml, and ≤ 0.12 to 1 μg/ml, respectively. The MICs of all echinocandins were very high, while the MICs of posaconazole, itraconazole, and voriconazole, as well as amphotericin B were comparatively low. Notably, fluconazole was found to have a higher MIC than other azoles, and exhibited particularly weak activity against some isolates with MICs over 8 μg/ml. Our data in vitro support the use of amphotericin B, itraconazole, voriconazole, and posaconazole in management of talaromycosis and suggest potential resistance to fluconazole. [ABSTRACT FROM AUTHOR]

Objective: We sought to construct an ultrasonography-based growth curve in a Chinese population.Study Design: Routine ultrasonographic examination was performed in 5496 normal pregnancies (>95% first births) in five obstetric ultrasonography laboratories in Central-South China from January 1, 1992, to December 31, 1993.Results: All the fetal growth measures increased with gestational age, whereas the ratios either decreased or remained constant across gestation. Biparietal diameter and cerebral hemispheric width were higher at early gestational ages, whereas femur length, thoracic circumference, and abdominal circumference were lower at later gestational ages in our study than in previous studies. The ratio of lateral ventricular width/cerebral hemispheric width was lower at an early gestational age but higher in later gestational ages in our study.Conclusions: A different standard of ultrasonography-based fetal growth is needed for different populations. The ultrasonography-based growth curve constructed in this large Chinese population provides an additional tool for the evaluation of fetal growth and development. [ABSTRACT FROM AUTHOR]

Purpose: Urbanization is causing an increasingly negative effect on public health in China. This study was established to examine the associations between socio-economic and environmental exposures and the potential impact of gene-environment interactions and cancer risk of urban population in Chongqing, China. Participants: The cohort was established in Beibei District of Chongqing in southwest China. Between March 2016 and December 2016, we enrolled 57,332 adults who were 40-69 years of age, and collected baseline data on demographic information, socio-economic status, lifestyle, family and personal disease histories through face-to-face interviews using a standardized questionnaire. Regular follow-up including face-to-face interviews will take place every 5 years. Findings to date: Ninety-nine percent (56658/57332) of the participants completed the baseline assessment. The eligible participants had a mean age of 54.8 years, and 51.42% were females. Nearly three-fifths of participants having a normal BMI (18.5 to 23.9 kg/m2) and one-third being overweight (24.0 to 27.9 kg/m2). Among males, 29.58% were smokers and 21.08% were alcohol users. Among females, 1.49% were smokers and 1.66% were alcohol users. Among all participants, 7.03% of males and 9.08% of females reported their family history of cancer. Future plans: The relationships of modifiable risk factors with the cancer risk will be analyzed. Meanwhile, participants will be closely tracked to minimize loss to follow-up. We plan to construct a risk prediction model on cancer and verify the prediction model by genome-wide association studies (GWAS). The successful completion of this cohort study will allow for better targeting of cancer screening to those at highest risk in urban population of China and provide clinicians and policymakers with a practical predication rule. [ABSTRACT FROM AUTHOR]

The Pseudogastromyzon genus, consisting of species predominantly distributed throughout southeastern China, has garnered increasing market attention in recent years due to its ornamental appeal. However, the overlapping diagnostic attributes render the commonly accepted criteria for interspecific identification unreliable, leaving the phylogenetic relationships among Pseudogastromyzon species unexplored. In the present study, we undertake molecular phylogenetic and morphological examinations of the Pseudogastromyzon genus. Our phylogenetic analysis of mitochondrial genes distinctly segregated Pseudogastromyzon species into two clades: the Pseudogastromyzon clade and the Labigastromyzon clade. A subsequent morphological assessment revealed that the primary dermal ridge (specifically, the second ridge) within the labial adhesive apparatus serves as an effective and precise interspecific diagnostic characteristic. Moreover, the distributional ranges of Pseudogastromyzon and Labigastromyzon are markedly distinct, exhibiting only a narrow area of overlap. Considering the morphological heterogeneity of the labial adhesive apparatus and the substantial division within the molecular phylogeny, we advocate for the elevation of the Labigastromyzon subgenus to the status of a separate genus. Consequently, we have ascertained the validity of the Pseudogastromyzon and Labigastromyzon species, yielding a total of six valid species. To facilitate future research, we present comprehensive descriptions of the redefined species and introduce novel identification keys., (© 2023 The Authors. Integrative Zoology published by International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

In the digital era, digital economy has a far-reaching impact on the collaborative agglomeration of manufacturing and service industries. This research aims to examine the economic relationship between digital economy and industrial collaborative agglomeration. Based on a panel data set of 286 Chinese cities, this research employs Tobit model, moderating effect model, and mediating effect model to conduct data analysis. It is found that digital economy has a nonlinear relationship with industrial collaborative agglomeration, and this relationship is a U-shape. Moderating effect analysis reveals that government intervention significantly regulates the role of digital economy in industrial collaborative agglomeration. Mediating effect analysis indicates that digital economy promotes industrial collaborative agglomeration through entrepreneurial activity. Heterogeneity analysis shows that the facilitating effect of digital economy on collaborative agglomeration in high-end industries comes earlier than in middle- and low-end industries. Moreover, this research finds that digital economy plays a significant role in industrial collaborative agglomeration in central and western regions of China but not in the eastern region. To enhance the impact of digital economy on industrial collaborative agglomeration, it is crucial to strengthen the engagement of the government and ensure the availability of digital technology., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Mycotoxins and heavy metals extensively contaminate grains and grain products, posing severe health risks. This work implements validated ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and inductively coupled plasma mass spectrometry (ICP-MS) methods to quantify the concentration of 12 mycotoxins and five heavy metals in rice, maize, soybeans, and wheat flour samples marketed in Shanghai. The mixed contamination characteristics were analyzed using correlation cluster analysis and co-contamination index, and the probabilities of all cross combinations of contaminations were analyzed using a self-designed JAVA language program. The results showed that grains and grain products were frequently contaminated with both mycotoxins and heavy metals, mostly with deoxynivalenol (DON), 3-acetyl-deoxynivalenol (3-ADON), 15-acetyl-deoxynivalenol (15-ADON), ochratoxin A (OTA), aflatoxins, fumonisin B1 (FB1), fumonisin B2 (FB2), fumonisin B3 (FB3), arsenic (As), chromium (Cr) and cadmium (Cd). All the samples (100 %) were contaminated with two or more contaminants, and 77.3 % of the samples were co-contaminated with more than four contaminants. In cereals and cereal products, the following combinations were closely associated: (FB3 +3-ADON), (FB1 +As), (FB1 +FB2), (DON+FB1), (DON+Cd), (As+Cd), (DON+Cd+As), (FB1 +FB2 +As), and (DON+3-ADON+15-ADON). The results indicated that mycotoxins and heavy metals frequently co-occurred in Shanghai grains and grain products, and they provided primary data for safety assessments, early warnings, and regulatory measures on these contaminants to protect public health., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this study., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The study aimed to assess the efficacy and safety of 125 I seed implantation in the treatment of pelvic recurrent cervical cancer following radiotherapy. This meta-analysis was registered in PROSPERO. We looked up relevant studies in the databases of CNKI, Wanfang, CBM, PubMed, Embase, Cochrane Library, and Web of Science. The endpoint measures include the objective response rate, disease control rate, progression-free survival, overall survival, and adverse events., Recent Fidings: The meta-analysis included six studies and a total of 246 patients. The pooled ORR of tumor response was 63%, and the DCR was 87%. The median PFS was 9.09 months, and the median OS was 13.46 months. The incidence of adverse events of Grade ≥III was 6%., Conclusion: In conclusion, this meta-analysis confirmed that 125 I seed implantation has a good local control rate and high safety in the treatment of pelvic recurrent cervical cancer following radiotherapy, and can be used as a remedial treatment for pelvic recurrent cervical cancer following radiotherapy to prolong the survival time of patients., Trial Registration: PROSPERO: CRD42023423857., (© 2024 The Author(s). Cancer Reports published by Wiley Periodicals LLC.)

Objective: Venous thromboembolism (VTE) poses a significant threat to lung cancer patients, particularly those receiving treatment with immune checkpoint inhibitors (ICIs). We aimed to develop and validate a nomogram model for predicting the occurrence of VTE in lung cancer patients undergoing ICI therapy., Methods: The data for this retrospective cohort study was collected from cancer patients admitted to Chongqing University Cancer Hospital for ICI treatment between 2019 and 2022. The research data is divided into training and validation sets using a 7:3 ratio. Univariate and multivariate analyses were employed to identify risk factors for VTE. Based on these analyses, along with clinical expertise, a nomogram model was crafted. The model's predictive accuracy was assessed through receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis, clinical impact curve, and other relevant metrics., Results: The initial univariate analysis pinpointed 13 potential risk factors for VTE. The subsequent stepwise multivariate regression analysis identified age, Karnofsky performance status, chemotherapy, targeted, platelet count, lactate dehydrogenase, monoamine oxidase, D-dimer, fibrinogen, and white blood cell count as significant predictors of VTE. These 10 variables were the foundation for a predictive model, illustrated by a clear and intuitive nomogram. The model's discriminative ability was demonstrated by the ROC curve, which showed an area under the curve of 0.815 (95% CI 0.772-0.858) for the training set, and 0.753 (95% CI 0.672-0.835) for the validation set. The model's accuracy was further supported by Brier scores of 0.068 and 0.080 for the training and validation sets, respectively, indicating a strong correlation with actual outcomes., Conclusion: We have successfully established and validated a nomogram model for predicting VTE risk in lung cancer patients treated with ICIs., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

In the post-COVID-19 pandemic era, influenza virus infections continuously lead to a global disease burden. Evaluating vaccine effectiveness against influenza infection is crucial to inform vaccine design and vaccination strategy. In this study, we recruited 1120 patients with influenza-like illness (ILI) who attended fever clinics of 4 sentinel hospitals in the Ili Kazakh Autonomous Prefecture, Xinjiang Uygur Autonomous Region, China, from January 1 to April 7, 2024. Using a test-negative design, we estimated influenza vaccine effectiveness (VE) of 54.7% (95% CrI: 23.7, 73.1) against medical-attended influenza infection, with 62.3% (95% CrI: 29.3, 79.8) against influenza A, and 51.2% (95% CrI: 28.7, 83.0) against influenza B. Despite the moderate VE estimated in this study, influenza vaccination remains the most important approach to prevent influenza at the community level.

Objective: Gastric cancer (GC), one of the highest venous thromboembolism (VTE) incidence rates in cancer, contributes to considerable morbidity, mortality, and, prominently, extra cost. However, up to now, there is not a high-quality VTE model to steadily predict the risk for VTE in China. Consequently, setting up a prediction model to predict the VTE risk is imperative., Methods: Data from 3,092 patients from December 15, 2017, to December 31, 2022, were retrospectively analyzed. Multiple logistic regression analysis was performed to assess risk factors for GC, and a nomogram was constructed based on screened risk factors. A receiver operating curve (ROC) and calibration plot was created to evaluate the accuracy of the nomogram., Results: The risk factors of suffering from VTE were older age (OR = 1.02, 95% CI [1.00-1.04]), Karnofsky Performance Status (KPS) ≥ 70 (OR = 0.45, 95% CI [0.25-0.83]), Blood transfusion (OR = 2.37, 95% CI [1.47-3.84]), advanced clinical stage (OR = 3.98, 95% CI [1.59-9.99]), central venous catheterization (CVC) (OR = 4.27, 95% CI [2.03-8.99]), operation (OR = 2.72, 95% CI [1.55-4.77]), fibrinogen degradation product (FDP) >5 µg/mL (OR = 1.92, 95% CI [1.13-3.25]), and D-dimer > 0.5 mg/L (OR = 2.50, 95% CI [1.19-5.28]). The area under the ROC curve (AUC) was 0.82 in the training set and 0.85 in the validation set., Conclusion: Our prediction model can accurately predict the risk of the appearance of VTE in gastric cancer patients and can be used as a robust and efficient tool for evaluating the possibility of VTE., Competing Interests: The authors declare that they have no competing interests., (© 2024 Zhou et al.)

Objective: To understand the prevalence rate of obstructive pulmonary dysfunction in workers exposed to silica dust and analyze its risk factors, so as to provide reference for the formulation of diagnostic criteria for chronic obstructive pulmonary disease caused by occupational dust., Methods: Data collection and structured questionnaire were used to collect the data of 2064 workers exposed to silica dust who underwent health examination in Hunan Occupational Disease Prevention and Control Hospital and Yuanling Second People's Hospital from January 1, 2021 to June 30, 2022. The prevalence rate of obstructive pulmonary ventilation dysfunction was analyzed and the risk factors were analyzed., Results: The prevalence rate of obstructive pulmonary ventilation dysfunction (FEV1/FVC < 70%) was 2.3% in 2064 silica dust exposed workers. The prevalence of restrictive pulmonary ventilation dysfunction (FVC/Pre < 80%) was 8.1%. The prevalence of obstructive pulmonary ventilation dysfunction in the high level exposure group was higher than that in the low level exposure group, 8.2 vs0.9% (P < 0.05). The rate of obstructive pulmonary ventilation dysfunction in female group was higher than that in male group (5.3% vs. 1.7%, p = 0.00). Workers with obstructive pulmonary dysfunction were older and worked longer than workers without obstructive pulmonary dysfunction, but there was no statistical difference. Multivariate regression analysis showed that high exposure level was a risk factor for obstructive pulmonary ventilation dysfunction in silica dust exposed workers (P < 0.05). Females were the risk factors for obstructive pulmonary ventilation dysfunction (P < 0.05)., Conclusion: Silica dust exposure can cause obstructive pulmonary ventilation dysfunction and lead to chronic obstructive pulmonary disease. High level of exposure is a risk factor for obstructive pulmonary ventilation dysfunction. Women exposed to dust are more prone to obstructive pulmonary ventilation dysfunction than men. Early diagnosis of chronic obstructive pulmonary disease caused by silica dust and timely intervention measures are very important to delay the decline of lung function and protect the health of workers., (© 2024. The Author(s).)

Objective: To create a nomogram for predicting the likelihood of venous thromboembolism (VTE) in colon cancer patients from China., Methods: The data of colon cancer patients from Chongqing University Cancer Hospital between 2019 and 2022 were analyzed. Patients were divided into training set and internal validation set by random split-sample method in a split ratio of 7:3. The univariable and multivariable logistic analysis gradually identified the independent risk factors for VTE. A nomogram was created using all the variables that had a significance level of p < 0.05 in the multivariable logistic analysis and those with clinical significance. Calibration curves and clinical decision curve analysis (DCA) were used to assess model's fitting performance and clinical value. Harrell's C-index (concordance statistic) and the area under the receiver operating characteristic curves (AUC) were used to evaluate the predictive effectiveness of models., Results: A total of 1996 patients were ultimately included. There were 1398 patients in the training set and 598 patients in the internal validation set. The nomogram included age, chemotherapy, targeted therapy, hypertension, activated partial thromboplastin time, prothrombin time, platelet, absolute lymphocyte count, and D-dimer. The C-index of nomogram and Khorana score were 0.754 (95% CI 0.711-0.798), 0.520 (95% CI 0.477-0.563) in the training cohort and 0.713 (95% CI 0.643-0.784), 0.542 (95% CI 0.473-0.612) in the internal validation cohort., Conclusions: We have established and validated a nomogram to predict the VTE risk of colon cancer patients in China, which encompasses a diverse age range, a significant population size, and various clinical factors. It facilitates the identification of high-risk groups and may enable the implementation of targeted preventive measures., (© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Psychological issues are of significant concern in present-day society, as poor mental well-being results in depression and suicidal behavior. Understanding the current situation of psychological stress among secondary school students will help policy makers to formulate targeted measures to help them cope with stress, and at the same time evaluate the effectiveness of the existing policies to address the shortcomings and enhance the diversification of interventions. The main purpose of this review was to map the existing evidence on the prevalence and levels of psychological stress among adolescents in China, and to identify the associated risk factors. This review strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was performed spanning Web of Science, PubMed, and Scopus databases. Studies involving only humans and full text in English were selected. Selection was limited to samples from mainland China, Hong Kong, Macau, and Taiwan. Variables were extracted, exploring the factors that affected the mental wellness of Chinese middle school students. A final 15 articles and 1 report were included. The findings revealed psychological stress is prevalent among Chinese middle school population, with the degree of prevalence from low to severe stress levels. Three dimensions of psychological stress affecting Chinese secondary school students: school, family and lifestyle. Within the school, the factors included academic stress, peer relationships etc. Family-related factors were comprised of parent-child relationship, parents' mental health status etc. Lastly, lifestyle-related factors included poor diet, sedentary and inactivity etc. Our findings suggest that policy makers should reduce the excessive emphasis on examination results and focus on the all-round development of students, and that schools should organize a variety of extra-curricular activities to reduce students' stress. Parents should create a harmonious family atmosphere to minimize conflicts and maintain close communication with teachers., Systematic Review Registration: OSF; https://doi.org/10.17605/OSF.IO/HEFCP., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hao, Mat Ludin, Ahmad, Meng and Zhong Lei.)

Exploring the relative role of different indoor environments in respiratory infections transmission remains unclear, which is crucial for developing targeted nonpharmaceutical interventions. In this study, a total of 2,583,441 influenza-like illness cases tested from 2010 to 2017 in China were identified. An agent-based model was built and calibrated with the surveillance data, to assess the roles of 3 age groups (children <19 years, younger adults 19-60 years, older adults >60 years) and 4 types of indoor environments (home, schools, workplaces, and community areas) in influenza transmission by province with varying urbanization rates. When the urbanization rates increased from 35% to 90%, the proportion of children aged <19 years among influenza cases decreased from 76% to 45%. Additionally, we estimated that infections originating from children decreased from 95.1% (95% confidence interval (CI): 92.7, 97.5) to 59.3% (95% CI: 49.8, 68.7). Influenza transmission in schools decreased from 80.4% (95% CI: 76.5, 84.3) to 36.6% (95% CI: 20.6, 52.5), while transmission in the community increased from 2.4% (95% CI: 1.9, 2.8) to 45.4% (95% CI: 35.9, 54.8). With increasing urbanization rates, community areas and younger adults contributed more to infection transmission. These findings could help the development of targeted public health policies. This article is part of a Special Collection on Environmental Epidemiology. This article is part of a Special Collection on Environmental Epidemiology., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

HLA-B*46:01:42 differs from HLA-B*46:01:01:01 by one nucleotide in exon 5., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study investigated the change in the microbiome of tomato rhizosphere soils after the invasion of Ralstonia solanacearum and analyzed the correlation between microbes and soil physicochemical properties. Diversity analyses of the bacteria in healthy and diseased rhizosphere soil samples (HRS and DRS) revealed that HRS had a higher species diversity and were compositionally different from DRS ( P ≤ 0.05). Substantial differences in the relative abundance of Actinobacteria (37.52% vs 28.96%, P ≤ 0.05) and Proteobacteria (29.20% vs 35.59%, P ≤ 0.05) were identified in HRS and DRS, respectively. Taxonomic composition analysis showed ten differentially abundant genera, and seven of them ( Gaiella , Roseisolibacter , Solirubrobacter , Kribbella , Acidibacter , Actinomarinicola , and Marmoricola ) are more abundant in HRS. Soil pH and enzyme activities were negatively correlated with the abundance of R. solanacearum . The contents of total nitrogen (TN), total phosphorus (TP), total potassium (TK), alkaline nitrogen (alkaline N), available phosphorus (AP), available potassium (AK), NO3-N(NN), NH4 + -N (AN), and organic matter (OM) were all significantly increased in DRS. The composition and richness of protozoa in the samples show significant differences. Cephalobus , Acrobeles , Heteromita , norank&#95;Tylenchida, and Rotylenchulus were enriched in DRS. Microbial interaction networks revealed that the HRS networks were more complex than the DRS networks. Overall, the results of this study demonstrate that healthy soil has a more complex microbial community structure and higher enzyme activity, and the invasion of R. solanacearum damages the soil microbial system.IMPORTANCEHow does the invasion of Ralstonia solanacearum affect tomato rhizosphere bacteria and protozoa? Which microbial changes can affect the growth of R. solanacearum ? To date, most research studies focus on bacteria, with little research on protozoa, and even less on the synergistic effects between protozoa and bacteria. Here, we analyzed the correlation between tomato rhizosphere bacterial and protozoan communities and soil physicochemical properties during the invasion of R. solanacearum . We found that the diversity and abundance of rhizosphere microorganisms in healthy rhizosphere soil samples (HRS) were significantly higher than those in diseased rhizosphere soil samples (DRS), and there were significant changes in soil pH and enzyme activity. Overall, in this study, the analysis of microbial changes during the invasion of R. solanacearum provides a theoretical basis for the prevention and control of bacterial wilt., Competing Interests: The authors declare no conflict of interest.

While earthquakes are considered one of the most prevalent natural disasters in China, there is limited empirical evidence regarding the long-term effects of earthquakes on energy poverty. Using data from China Family Panel Studies and China's historical earthquake catalog, this study investigates the long-term effects of earthquake intensity on energy poverty among households in China, and analyzes the long-term effects over different time spans. Our findings indicate that, higher earthquake intensities have an overall worsening long-term impact on energy poverty. When segmented into different time spans, households in regions with higher earthquake intensities are less likely to fall into energy poverty over the past 20 years and the past 20 to 50 years, whereas more likely to be energy poor over the longer time span. Moreover, we uncover that public infrastructure, government assistance, and mental well-being serve as channels through which earthquakes affect household energy poverty, with divergent effects over different time spans. In addition, we observe nonlinear evidence of earthquake intensity's long-term impact on energy poverty, and the long-term impacts are heterogeneous across different regions, as well as households with different registration statuses and household fuel types. These insights can inform policy interventions aimed at alleviating long-term energy poverty in areas affected by natural disasters., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study comprehensively incorporates pathological parameters and novel clinical prognostic factors from the international prognostic index (IPI) to develop a nomogram prognostic model for overall survival in patients with diffuse large B-cell lymphoma (DLBCL). The aim is to facilitate personalized treatment and management strategies. This study enrolled a total of 783 cases for analysis. LASSO regression and stepwise multivariate COX regression were employed to identify significant variables and build a nomogram model. The calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) curve were utilized to assess the model's performance and effectiveness. Additionally, the time-dependent concordance index (C-index) and time-dependent area under the ROC curve (AUC) were computed to validate the model's stability across different time points. The study utilized 8 selected clinical features as predictors to develop a nomogram model for predicting the overall survival of DLBCL patients. The model exhibited robust generalization ability with an AUC exceeding 0.7 at 1, 3, and 5 years. The calibration curve displayed evenly distributed points on both sides of the diagonal, and the slopes of the three calibration curves were close to 1 and statistically significant, indicating high prediction accuracy of the model. Furthermore, the model demonstrated valuable clinical significance and holds the potential for widespread adoption in clinical practice. The novel prognostic model developed for DLBCL patients incorporates readily accessible clinical parameters, resulting in significantly enhanced prediction accuracy and performance. Moreover, the study's use of a continuous general cohort, as opposed to clinical trials, makes it more representative of the broader lymphoma patient population, thus increasing its applicability in routine clinical care., (© 2023. The Author(s).)

The energy structure transformation is of significant practical importance as it ensures energy security, accomplishes the "dual carbon" goal and realizes high-quality economic growth. In order to explore the impact exerted by energy structure transformation on the coordinated development of economic and environmental systems, this paper employs the coupled coordination degree model to measure the coupling degree of economic and environmental systems across 30 provinces in China from 2000 to 2021. Additionally, on the basis of theoretical analysis, it adopts the fixed effect model and the mediated effect model to provide a systematic explanation of the impact energy structure transformation exerts on the coordinated development of the economic and environmental systems, as well as the underlying mechanisms. The results reveal that China's structural transformation of energy consumption significantly promotes the coordinated development of the economic and environmental systems, a conclusion that remains robust even after consideration of the explanatory variable substitutions, municipality exclusion, and tail reduction. From the perspective of heterogeneity, regions with better economic development show a more obvious dividend effect of energy structural transformation on the coordinated development of the economy and the environmental system; energy structural transformation imposes a positive impact on the coordinated development of the economy and the environmental system only in regions characterized by high levels of human capital and urbanization. In terms of the mechanism of action, energy structural transformation can facilitate of industrial structure upgrading and then drive the coordinated development of economic and environmental systems. The study proposes several policy recommendations: transform the traditional fossil energy consumption mode, reduce the proportion of traditional fossil energy, introduce corresponding subsidy policies, encourage enterprises to invest in clean energy, boost investor confidence, and enhance employment quality and income level., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Per- and polyfluoroalkyl substances (PFASs) are a class of synthetic organic fluorides that have been widely used in various industrial and consumer applications. However, their potential ecological risks have raised concerns. In this study, PFASs were investigated in different environmental media in the Jiulong River and Xiamen Bay regions of China, revealing widespread contamination of PFASs in the watershed. PFBA, PFPeA, PFOA, and PFOS were detected in all 56 sites, with short-chain PFASs dominating (72 % of the total). Novel PFAS alternatives, including F53B, HFPO-DA, and NaDONA, were detected in >90 % of the water samples. Seasonal and spatial variations in PFAS concentrations were observed in the Jiulong River estuary, while Xiamen Bay was not significantly affected by seasonal changes. In sediment, PFSAs were dominant with long-chains while PFCAs with short-chains, and the occurrence was influenced by water depth and salinity. PFSAs were more inclined to be adsorbed in sediments than PFCAs, and log K d of PFCAs increased with the numbers of -CF 2 -. Paper packaging, machinery manufacturing, WWTP discharge, airport and dock activities were the dominant sources of PFASs. Risk quotient showed that PFOS or PFOA may pose high toxicity to Danio rerio and Chironomus riparius. Although the overall ecological risk in the catchment is still low, the hazard of bio-concentration under long-term exposure and multi-pollutant synergistic toxicity cannot be ignored., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Much less is known about the importance of blood pressure (BP) trajectories concerning the incidence of coronary heart disease (CHD) in people with disabilities. Our aim was to evaluate this association., Methods: This cohort study surveyed 5711 adults from the Shanghai Disability Health Survey from June 2012 to June 2019. The latent class growth mixture model was used to examine distinct BP trajectories. We evaluated the association of BP trajectories with the risk of CHD by Cox proportional hazard models. The model for CHD risk fitted to BP trajectories was compared with models fitted to other BP-related indicators by goodness-of-fit, discrimination, and calibration., Results: During a median follow-up of 71.74 months, 686 cases (median age was 49.03 (54.49, 58.55) years, 51.90% female) with CHD were identified, with a cumulative incidence of 12.01%. Systolic BP (SBP) and diastolic BP (DBP) were categorized into three classes, respectively. A statistically significant association was only observed between SBP trajectories and CHD. Compared with the normotensive stable SBP group (n = 1956), the prehypertension-stable group (n = 3268) had a higher risk (adjust hazards ratio (aHR) = 1.266, 95% confidence interval (CI) 1.014-1.581), and the stage 1 hypertension-decreasing group (n = 487) had the highest risk (aHR = 1.609, 95%CI 1.157-2.238). Among the BP-related indicators, the SBP trajectory was the strongest predictor of new-onset CHD. Findings were similar when sensitivity analyses were conducted., Conclusions: SBP trajectory was a more important risk factor for CHD than other BP-related indicators and stringent BP control strategies may be effective for primary CHD prevention in the disabled population., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: The survival of patients with lymphoma varies greatly among individuals and were affected by various factors. The aim of this study was to develop and validate a prognostic model for predicting overall survival (OS) in patients with lymphoma., Methods: We conducted a prospective longitudinal cohort study in China between January 2014 and December 2018 (n = 1,594). After obtaining the follow-up data, we randomly split the cohort into the training cohort (n = 1,116) and the validation cohort (n = 478). The least absolute shrinkage and selection operator (LASSO) regression analysis was used to select the predictors of the model. Cox stepwise regression analysis was used to identify independent prognostic factors, which were finally displayed as static nomogram and web-based dynamic nomogram. We calculated the concordance index(C-index) to describe how the predicted survival of objectively confirmed prognosis. The calibration plot is used to evaluate the prediction accuracy and discrimination ability of the model. Net reclassification index (NRI) and decision curve analysis (DCA) curves were also used to evaluate the prediction ability and net benefit of the model., Results: Nine variables in the training cohort were considered to be independent risk factors for patients with lymphoma in the final model: age, Ann Arbor Stage, pathologic type, B symptoms, chemotherapy, targeted therapy, lactate dehydrogenase (LDH), β2-microglobulin and C-reactive protein (CRP). The C-indices of OS were 0.749 (95% CI, 0.729-0.769) in the training cohort and 0.731 (95% CI, 0.762-0.700) in the validation cohort. A good agreement between prediction by nomogram and actual observation was shown in the calibration curve for the probability of survival in both the training cohort and validation cohorts. The areas under curve (AUC) of the area under the receiver operating characteristic (ROC) curves for 1-year, 3-year, and 5-year OS were 0.813, 0.800, and 0.762, respectively, in the training cohort, and 0.802, 0.768, and 0.721, respectively, in the validation cohort. Compared with the Ann Arbor Stage system, NRI and DCA showed that the model had a higher predictive capacity and net benefit., Conclusion: The prediction models reliably estimate the outcome of patients with lymphoma. The model had high discrimination and calibration, which provided a simple and reliable tool for the survival prediction of the patients, and it might help patients benefit from personalized intervention., (© 2023. The Author(s).)

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., (© 2023. The Author(s).)

Background: The world is undergoing an unprecedented wave of urbanization. However, the effect of rapid urbanization during the early or middle stages of urbanization on seasonal influenza transmission remains unknown. Since about 70% of the world population live in low-income countries, exploring the impact of urbanization on influenza transmission in urbanized countries is significant for global infection prediction and prevention., Objective: The aim of this study was to explore the effect of rapid urbanization on influenza transmission in China., Methods: We performed spatiotemporal analyses of province-level influenza surveillance data collected in Mainland China from April 1, 2010, to March 31, 2017. An agent-based model based on hourly human contact-related behaviors was built to simulate the influenza transmission dynamics and to explore the potential mechanism of the impact of urbanization on influenza transmission., Results: We observed persistent differences in the influenza epidemic attack rates among the provinces of Mainland China across the 7-year study period, and the attack rate in the winter waves exhibited a U-shaped relationship with the urbanization rates, with a turning point at 50%-60% urbanization across Mainland China. Rapid Chinese urbanization has led to increases in the urban population density and percentage of the workforce but decreases in household size and the percentage of student population. The net effect of increased influenza transmission in the community and workplaces but decreased transmission in households and schools yielded the observed U-shaped relationship., Conclusions: Our results highlight the complicated effects of urbanization on the seasonal influenza epidemic in China. As the current urbanization rate in China is approximately 59%, further urbanization with no relevant interventions suggests a worrisome increasing future trend in the influenza epidemic attack rate., (©Hao Lei, Nan Zhang, Beidi Niu, Xiao Wang, Shenglan Xiao, Xiangjun Du, Tao Chen, Lei Yang, Dayan Wang, Benjamin Cowling, Yuguo Li, Yuelong Shu. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 07.07.2023.)

Per- and polyfluoroalkyl substances (PFASs) are a large and complex class of synthetic chemicals widely used in industrial and domestic products. This study compiled and analyzed the distribution and composition of PFASs in marine organisms sampled along the coast of China from 2002 to 2020. Perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) were dominant in bivalves, cephalopods, crustaceans, bony fish and mammals. PFOA in bivalves, crustaceans, bony fish and mammals gradually decreased from north to south along the coast of China, and the PFOA contents of bivalves and gastropods in the Bohai Sea (BS) and the Yellow Sea (YS) were higher than those of PFOS. The increased production and use of PFOA have been detected by biomonitoring temporal treads in mammals. For the organisms in the East China Sea (ECS) and the South China Sea (SCS), which were less polluted by PFOA compared to BS and YS, PFOS was universally higher than PFOA. The PFOS of mammals with high trophic levels was significantly higher than that of other taxa. This study is conducive to better understanding the monitoring information of PFASs of marine organisms in China and is of great significance for PFAS pollution control and management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

China has diversified resources of indigenous cattle, which are classified into Northern, Central, and Southern groups according to their geographical distribution. Chaling cattle belong to Southern group. This breed is famous for the production of good quality meat with elite meat grades. To analyze the genetic diversity of Chaling cattle, 20 samples were sequenced using whole-genome resequencing technology, along with 138 published whole-genome sequencing data of Indian indicine cattle, Chinese indicine cattle, East Asian taurine cattle, Eurasian taurine cattle, and European taurine cattle as control. It was found that Chaling cattle originated from Chinese indicine cattle. The genetic diversity of Chaling cattle is higher than that of Indian indicine cattle, East Asian taurine cattle, Eurasian taurine cattle, and European taurine cattle, but lower than that of Chinese indicine cattle and Xiangxi cattle. Annotating the selection signals obtained by composite likelihood ratio, θπ, F ST , π-ratio, and XP-EHH methods, several genes associated with immunity, heat tolerance, reproduction, growth, and meat quality showed strong selection signals. In general, this study provides a theoretical basis for analyzing the genetic mechanism of Chaling cattle with excellent adaptability, rough feeding tolerance, good immune performance, and good meat quality. This work lays a foundation for genetic breeding of Chaling cattle in future., (© 2023 Stichting International Foundation for Animal Genetics.)

Objectives: As the genetic variants of SARS-CoV-2 continuously pose threats to global health, evaluating superspreading potentials of emerging genetic variants is of importance for region-wide control of COVID-19 outbreaks., Methods: By using detailed epidemiological contact tracing data of test-positive COVID-19 cases collected between July and August 2021 in Nanjing and Yangzhou, China, we assessed the superspreading potential of outbreaks seeded by SARS-CoV-2 Delta variants. The transmission chains and case-clusters were constructed according to the individual-based surveillance data. We modelled the disease transmission as a classic branching process with transmission heterogeneity governed by negative binomial models. Subgroup analysis was conducted by different contact settings and age groups., Results: We reported a considerable heterogeneity in the contact patterns and transmissibility of Delta variants in eastern China. We estimated an expected 14% (95% CI: 11-16%) of the most infectious cases generated 80% of the total transmission., Conclusions: Delta variants demonstrated a significant potential of superspreading under strict control measures and active COVID-19 detecting efforts. Enhancing the surveillance on disease transmissibility especially in high-risk settings, along with rapid contact tracing and case isolations would be one of the key factors to mitigate the epidemic caused by the emerging genetic variants of SARS-CoV-2., Competing Interests: Conflict of Interests All authors declare that they have no conflict of interest or financial conflicts to disclose. The funding agencies have no role in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant health issue closely associated with multiple extrahepatic cancers. The association between MAFLD and clinical outcomes of endometrial cancer (EC) remains unknown., Methods: We retrospectively included 725 EC patients between January 2012 and December 2020. The odds ratios (ORs) were calculated using logistic regression analyses. Kaplan-Meier survival curves were used for survival analysis., Results: Among EC patients, the prevalence of MAFLD was 27.7% (201/725, 95% confidence interval (Cl) = 0.245-0.311). MAFLD was significantly associated with cervical stromal involvement (CSI) (OR = 1.974, 95% confidence interval (Cl) = 1.065-3.659, p = 0.031). There was a significant correlation between overall survival (OS) and CSI (HR = 0.31; 95%CI: 0.12-0.83; p = 0.020), while patients with MAFLD had a similar OS to those without MAFLD ( p = 0.952). Moreover, MAFLD was significantly associated with CSI in the type I EC subgroup (OR = 2.092, 95% confidence interval (Cl) = 1.060-4.129, p = 0.033), but not in the type II EC subgroup ( p = 0.838). Further logistic regression analysis suggested that the hepatic steatosis index (HSI) was significantly associated with CSI among type I EC patients without type 2 diabetes mellitus (T2DM) (OR = 1.079, 95% confidence interval (Cl) = 1.020-1.139, p = 0.012)., Conclusions: About one-quarter of our cohort had MAFLD. MAFLD was associated with the risk of CSI in EC patients, and this association existed in type I EC patients but not in type II EC patients. Furthermore, the HSI can help predict CSI in type I EC patients without T2DM.

Background: Although inactivated COVID-19 vaccines are proven to be safe and effective in the general population, the dynamic response and duration of antibodies after vaccination in the real world should be further assessed., Methods: We enrolled 1067 volunteers who had been vaccinated with one or two doses of CoronaVac in Zhejiang Province, China. Another 90 healthy adults without previous vaccinations were recruited and vaccinated with three doses of CoronaVac, 28 days and 6 months apart. Serum samples were collected from multiple timepoints and analyzed for specific IgM/IgG and neutralizing antibodies (NAbs) for immunogenicity evaluation. Antibody responses to the Delta and Omicron variants were measured by pseudovirus-based neutralization tests., Results: Our results revealed that binding antibody IgM peaked 14-28 days after one dose of CoronaVac, while IgG and NAbs peaked approximately 1 month after the second dose then declined slightly over time. Antibody responses had waned by month 6 after vaccination and became undetectable in the majority of individuals at 12 months. Levels of NAbs to live SARS-CoV-2 were correlated with anti-SARS-CoV-2 IgG and NAbs to pseudovirus, but not IgM. Homologous booster around 6 months after primary vaccination activated anamnestic immunity and raised NAbs 25.5-fold. The neutralized fraction subsequently rose to 36.0% for Delta (p=0.03) and 4.3% for Omicron (p=0.004), and the response rate for Omicron rose from 7.9% (7/89)-17.8% (16/90)., Conclusions: Two doses of CoronaVac vaccine resulted in limited protection over a short duration. The inactivated vaccine booster can reverse the decrease of antibody levels to prime strain, but it does not elicit potent neutralization against Omicron; therefore, the optimization of booster procedures is vital., Funding: Key Research and Development Program of Zhejiang Province; Key Program of Health Commission of Zhejiang Province/ Science Foundation of National Health Commission; Major Program of Zhejiang Municipal Natural Science Foundation; Explorer Program of Zhejiang Municipal Natural Science Foundation., Competing Interests: HZ, QH, NN, XZ, BC, XM, JH, ZC, PY, HL, SW, LD, JF, YL, JY, JJ, HL No competing interests declared, (© 2023, Zhang, Hua et al.)

Influenza causes a significant disease burden as an acute respiratory infection. Evidence suggests that meteorological factors can influence the spread of influenza; however, the association between these factors and influenza activity remains controversial. In this study, we investigated the impact of temperature on influenza across different regions of China based on the meteorological data and influenza data from 554 sentinel hospitals in 30 provinces and municipalities in China from 2010 to 2017. A distributed lag nonlinear model (DLNM) was used to analyze the exposure lag response of daily mean temperatures to the risk of influenza-like illness (ILI), influenza A (Flu A), and influenza B (Flu B). We found that in northern China, low temperatures increased the risk of ILI, Flu A, and Flu B, while in central and southern China, both low and high temperatures increased the risk of ILI and Flu A, and only low temperatures increased the risk of Flu B. This study suggests that temperature is closely associated with the influenza activity in China. Temperature should be integrated into the current public health surveillance system for highly accurate influenza warnings and the timely implementation of disease prevention and control measures., Competing Interests: The authors declare no conflict of interest.

The forest-landscape image is the bridge for communication between human beings and the forest. The aim of this paper is to construct the landscape-image conceptual model from the personal perception of the forest, with what people are looking at and how they are viewing themselves as a part of the forest. This research constructed a forest-landscape image by young adults by utilizing the landscape-image-sketching technique and selecting 140 young adults who had lived in Changsha, Central China for ten years, using convenience sampling, during April and May 2018. The results demonstrated that the forest was considered as the people's life world, as rural scenery around the respondents' homes, instead of the perception of the objective forest, an important habitat for animals and a limited resource supplier for human living. In fact, the natural values of the forest, such as the ecological and aesthetic values, received more attention than the social ones of the forest, including the life, production, and cultural values. Finally, it is important to raise the public's awareness of the objective entity of the forest and to guide the variety of experiences for the respondents in the forest.

Sauropterygia is the largest, most successful group of Mesozoic marine diapsids, spanning from the late Early Triassic to the Late Cretaceous. Plesiomorphic for sauropterygians, pachypleurosauroids are important for our understanding on the early evolution of this group. Here, we present a new pachypleurosaurid, Luopingosaurus imparilis gen. et sp. nov., based on an exceptionally preserved skeleton from the early Middle Triassic Luoping Lagerstätte in Yunnan, China. The discovery documents the first long-snouted pachypleurosaurid with an unexpected hyperphalangy in the manus, providing new insights into the morphological diversification, ecological adaption and biogeographic evolution of this clade. The discovery further indicates that there is a morphological divergence between short-snouted (brevirostrine) keichousaurids and relatively long-snouted (longirostrine) pachypleurosaurids, which was probably driven by ecological specializations related to feeding and foraging. Additionally, an evolutionary trend towards the reduction of the ratio of the hyoid length to mandibular length (HM ratio) is recognized in pachypleurosauroids. This reduction of HM ratio, associated with the increase of the snout length, might implicate a gradual recession of suction feeding in pachypleurosauroid evolution. Phylogenetic studies incorporating Luopingosaurus recover European pachypleurosaurids as successive sister groups to Chinese derived pachypleurosaurids, supporting a western Tethyan origin for this family., (© 2022. The Author(s).)

Objectives: The aim of this study was to explore whether indoor or outdoor relative humidity (RH) modulates the influenza epidemic transmission in temperate and subtropical climates., Methods: In this study, the daily temperature and RH in 1558 households from March 2017 to January 2019 in five cities across both temperate and subtropical regions in China were collected. City-level outdoor temperature and RH from 2013 to 2019 were collected from the weather stations. We first estimated the effective reproduction number (R t ) of influenza and then used time-series analyses to explore the relationship between indoor/outdoor RH/absolute humidity and the R t of influenza. Furthermore, we expanded the measured 1-year indoor temperature and the RH data into 5 years and used the same method to examine the relationship between indoor/outdoor RH and the R t of influenza., Results: Indoor RH displayed a seasonal pattern, with highs during the summer months and lows during the winter months, whereas outdoor RH fluctuated with no consistent pattern in subtropical regions. The R t of influenza followed a U-shaped relationship with indoor RH in both temperate and subtropical regions, whereas a U-shaped relationship was not observed between outdoor RH and R t . In addition, indoor RH may be a better indicator for R t of influenza than indoor absolute humidity., Conclusion: The findings indicated that indoor RH may be the driver of influenza seasonality in both temperate and subtropical locations in China., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The mechanism of Venous thromboembolism (VTE) is complicated and difficult to prevent due to factors such as bone marrow invasion, therapy, and immune-mediated effects. This study aims to establish a nomogram model for predicting the risk of thrombosis in lymphoma patients undergoing chemotherapy, which has been increasing over the past 30 years., Methods: The data of lymphoma patients from the Affiliated Cancer Hospital of Chongqing University in China between 2018 and 2020 were analyzed. This included age, sex, body mass index, ECOG score, histological type, Ann Arbour Stage, white blood cells count, haemoglobin level, platelet count, D-dimer level, and chemotherapy cycle. Univariate and multivariate cox analysis was used to determine the risk factors for VTE. Characteristic variables were selected to construct a nomogram model which was then evaluated using ROC curve and calibration., Results: Age, sex, PLT, D-dimer and chemotherapy cycle were considered as independent influencing factors of VTE. The mean (standard deviation) of the C index, AUC and Royston D statistics of 1000 cross-validations of the Nomogram model were 0.78 (0.01), 0.81 (0.01) and 1.61(0.07), respectively. It indicates a good calibration degree and applicability value as shown by the calibration curve. The DCA curve showed a rough threshold range of 0.05-0.60 with a good model., Conclusions: We have established and validated a nomogram model for predicting the risk of thrombosis in lymphoma patients. This model can assess the risk of thrombosis in each individual patient, enabling the identification of high-risk groups and targeted preventive treatment.

Background Understanding the transmission source, pattern, and mechanism of infectious diseases is essential for targeted prevention and control. Though it has been studied for many years, the detailed transmission patterns and drivers for the seasonal influenza epidemics in China remain elusive. Methods In this study, utilizing a suite of epidemiological and genetic approaches, we analyzed the updated province-level weekly influenza surveillance, sequence, climate, and demographic data between 1 April 2010 and 31 March 2018 from continental China, to characterize detailed transmission patterns and explore the potential initiating region and drivers of the seasonal influenza epidemics in China. Results An annual cycle for influenza A(H1N1)pdm09 and B and a semi-annual cycle for influenza A(H3N2) were confirmed. Overall, the seasonal influenza A(H3N2) virus caused more infection in China and dominated the summer season in the south. The summer season epidemics in southern China were likely initiated in the "Lingnan" region, which includes the three most southern provinces of Hainan, Guangxi, and Guangdong. Additionally, the regions in the south play more important seeding roles in maintaining the circulation of seasonal influenza in China. Though intense human mobility plays a role in the province-level transmission of influenza epidemics on a temporal scale, climate factors drive the spread of influenza epidemics on both the spatial and temporal scales. Conclusion The surveillance of seasonal influenza in the south, especially the "Lingnan" region in the summer, should be strengthened. More broadly, both the socioeconomic and climate factors contribute to the transmission of seasonal influenza in China. The patterns and mechanisms revealed in this study shed light on the precise forecasting, prevention, and control of seasonal influenza in China and worldwide.

Meteorological factors and the increase in extreme weather events are closely related to the incidence rate of infectious diarrhea. However, few studies have explored whether the impact of the same meteorological factors on the incidence rate of infectious diarrhea in different climate regions has changed and quantified these changes. In this study, the time series fixed-effect Poisson regression model guided by climate was used to quantify the relationships between the incidence rate of various types of infectious diarrhea and meteorological factors in different climate regions of China from 2004 to 2018, with a lag of 0-2 months. In addition, six social factors, including per capita Gross Domestic Product (GDP), population density, number of doctors per 1000 people, proportion of urbanized population, proportion of children aged 0-14 years old, and proportion of elderly over 65 years old, were included in the model for confounding control. Additionally, the intercept of each province in each model was analyzed by a meta-analysis. Four climate regions were considered in this study: tropical monsoon areas, subtropical monsoon areas, temperate areas and alpine plateau areas. The results indicate that the influence of meteorological factors and extreme weather in different climate regions on diverse infectious diarrhea types is distinct. In general, temperature was positively correlated with all infectious diarrhea cases (0.2 ≤ r ≤ 0.6, p < 0.05). After extreme rainfall, the incidence rate of dysentery in alpine plateau area in one month would be reduced by 18.7% (95% confidence interval (CI): -27.8--9.6%). Two months after the period of extreme sunshine duration happened, the incidence of dysentery in the alpine plateau area would increase by 21.9% (95% CI: 15.4-28.4%) in that month, and the incidence rate of typhoid and paratyphoid in the temperate region would increase by 17.2% (95% CI: 15.5-18.9%) in that month. The meta-analysis showed that there is no consistency between different provinces in the same climate region. Our study indicated that meteorological factors and extreme weather in different climate areas had different effects on various types of infectious diarrhea, particularly extreme rainfall and extreme sunshine duration, which will help the government develop disease-specific and location-specific interventions, especially after the occurrence of extreme weather.

Solar radiation is the external driving force of the Earth's climate system. In different spatial and temporal scales, meteorological elements have different responses and lag periods to solar activity (SA), climatic oscillation (CO), geographic factors (GF) and other influencing factors. However, such studies are not abundant and in-depth in the world. To further understand the "solar-climate-water resource" system, this study considers China as the study area and investigates the monthly data of temperature (T) and precipitation (P) during 1900-2020 that were obtained from 3836 grid stations. The strong interaction and lag distribution between T or P with SA and CO were studied and influence weights of SA, CO, and geographical factors (GF) of each grid station were calculated. A multivariate hysteretic decomposition model was established to simulate and quantitatively decompose the periodic lag considering the factors of the earth's revolution. It is found that the strong interaction/lag periods obtained in a long-time scale can be decomposed into several periods shorter than the SA period. The distribution of strong interaction/lag periods is nested with topography and echoes with cities. The underlying surface conditions and urbanization are also important factors affecting the T and P lag. There are two distinct dividing lines in the lag period and influencing factor pattern of T and P. The T dividing line moves through valleys where water or mountain ranges meet, where the gap facilitates monsoon movement across regions, while the P dividing line is a zone of dramatic terrain, where tall mountains block water vapor transport. In the lag trend of T, the northern region of China has the longest lag period, and the lag period of surrounding regions tends to converge to the northern region. The lag period caused by SN in southwest China is larger than that in northwest China, while the lag effect of CO is opposite in the above two regions. The lag trend of P also has the above characteristics, but the difference is that the lag period in central China is the longest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

With the rapid development of China's economy, people are eager for an effective way to relieve work pressure and strengthen their health at the same time. Outdoor sport is one of the best choices for people. However, the amount of recommended data on the network is very large. As a result, when people understand outdoor sports through the network, they cannot effectively obtain the information they want. This is the problem of "information overload," and personalized recommendation system can effectively alleviate this problem. In order to effectively recommend outdoor sports to users, a useful attempt was made in the personalized recommendation system for outdoor sports in this paper. The specific work of this paper is as follows: firstly, the current situation of outdoor sports in China was summarized, and the related technologies of the recommendation system were studied, including user modeling technology, recommendation target modeling technology, and recommendation algorithm. In order to obtain better recommendation effect, this paper proposes to mix user-based collaborative filtering recommendation algorithm, project-based collaborative filtering recommendation algorithm, and content-based recommendation algorithm. The hybrid algorithm adopts the way of feature expansion and weighted combination. Firstly, the hybrid model (model 1) of user-based collaborative filtering recommendation and content-based recommendation is obtained. Secondly, the hybrid model (model 2) based on project collaborative filtering recommendation and content-based recommendation was obtained. Finally, model 1 and model 2 were combined together to get a hybrid model with better final recommendation effect. For the common cold start problem in the recommendation system, the system adopts content-based recommendation algorithm to solve it., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Hao Lei et al.)

Objective: With the widespread use of social media, excessive use of social media may lead to problematic behaviors such as social media disorder, which has a negative impact on teenagers' mental health. Thus, it is an urgent need to provide a measurement tool to assess social media addiction in different cultures. The aim of this study was to assess the psychometric properties of the Chinese version of 27-item Social Media Disorder (SMD) Scale (developed using the diagnostic criteria of DSM-V Internet Gaming Disorder) in college students, and to verify its impact on mental health., Methods: Two online surveys were conducted among a total of 1,539 Chinese college students, including 1,316 subjects in sample 1 and 223 subjects in sample 2. The discrimination, criterion validity, construct validity and reliability of the Chinese version of SMD-27 scale were examined., Results: The Chinese version of SMD-27 scale showed excellent psychometric properties. The item-total correlation coefficients of the scale ranged from 0.31 to 0.56, and the item-dimension correlations of the scale ranged from 0.459 to 0.834. Findings from confirmatory factor analysis indicated a great fit of the model of the Chinese version of SMD-27, with CFI = 0.956, TLI = 0.951, RMSEA = 0.036 in sample one and CFI = 0.970, TLI = 0.967, RMSEA = 0.040 in sample two, thus confirming the second-order factor structure of the scale. The SMD-27 scale showed good internal consistency between two different samples with their respective Cronbach's alpha of 0.87 and 0.92, and good test-retest reliability over a period of 1 month. In addition, multiple regression results generally supported the impact of social media addiction on mental health., Conclusion: This study provides evidence that the Chinese version of SMD-27 scale is applicable to Chinese college populations, and it is a promising tool for the study of social media addiction in China., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lei, Huang, Chai and Zhang.)

Although microplastic pollution in the soil environment is currently an important research topic, few studies have focused on farmland soil in arid regions. This study investigated the abundances, sizes, polymer compositions, and forms of microplastics across nine agricultural plots cultivated with maize, sunflower, and potato (three of each crop) plants to determine the influences of different cropping characteristics and agricultural practices. The study area was within the arid region of the Ulungur River basin in Qinghe County, Altay, Xinjiang, China. The main forms of microplastics were fragments and fibers, and polyethylene was the dominant polymer (91.6%). The microplastic abundance ranged from 11 347 items/kg dw to 78 061 items/kg dw (mean of 52 081.7 items/kg dw ). The abundance and proportion of microplastics with a diameter of <0.2 mm were significantly higher in the sunflower and maize plots (i.e., tall crops) than in the potato plots (i.e., short crops) (p < 0.05). This is due to straw residues affecting the migration and recovery of the mulch. The abundance and fragmentation of microplastics were significantly higher in the sunflower and maize plots where plastic mulch was extensively used because these tall crops anchored the mulch near their stem-root systems. The mulch was then slowly aged (e.g., via wind erosion) before being fragmented due to agricultural practices (e.g., mechanical plowing and residue retention). Although microplastics sourced from mulch are probably immobilized by straw residues in the short term, fragile and easily broken pieces of mulch are eventually released into the soil due to agricultural practices. The findings suggest that different cropping characteristics can affect the abundance and fragmentation of microplastics in agricultural soils, even within the same region, and thus the level and type of microplastic pollution. Traditional plastic mulch should be replaced with biodegradable mulch to reduce microplastic pollution in agricultural fields., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: The incidence and mortality of lung cancer rank first among malignant tumors, and its long treatment cycle will bring serious economic burdens to lung cancer patients and their families. There are few studies on the prognosis of lung cancer and insurance policies. This article explores the relationship between the lung cancer-specific death and public health insurance, self-paying rate, and the joint effect of public health insurance and self-paying rate., Materials and Methods: A prospective longitudinal cohort study was conducted in Chongqing, China from 2013 to 2019. The selected subjects were patients with C33-C34 coded according to the tenth edition of the International Classification of Diseases (ICD-10), aged 20 years or older. We conduct a subgroup analysis based on public health insurance types and self-paying rates. After following the inclusion and exclusion criteria, the chi-square test was used to describe the demographic and clinical characteristics of patients with different insurance types and different self-paying rates. Multivariate logistic regression was used to analyze the relationship between patients with different insurance types, self-paying rates, and lung cancer treatment methods. Finally, the Cox proportional hazard model and the competitive risk model are used to calculate the cumulative hazard ratio of all-cause death and lung cancer-specific death for different insurance types and different self-paying rate groups., Results: A total of 12,464 patients with lung cancer were included in this study. During the follow-up period (median 13 months, interquartile range 5.6-25.2 months), 5,803 deaths were observed, of which 3,781 died of lung cancer. Compared with patients who received urban resident-based basic medical insurance (URBMI), patients who received urban employee-based basic medical insurance (UEBMI) had a 38.1% higher risk of lung cancer-specific death (Hazard Ratios (HRs) = 1.381, 95% confidence interval (CI): 1.293-1.476, P < 0.005), Compared with patients with insufficient self-paying rate, patients with a higher self-paying rate had a 40.2% lower risk of lung cancer-specific death (HRs = 0.598, 95% CI: 0.557-0.643, P < 0.005). Every 10% increase in self-paying rate of URBMI reduces the risk of lung cancer-specific death by 17.6%, while every 10% increase in self-paying rate of UEBMI reduces the risk of lung cancer-specific death by 18.0%., Conclusions: The National Medical Security Administration should, under the condition of limited medical insurance funds, try to include the original self-paid anti-tumor drugs into the national medical insurance coverage. This can not only reduce the mortality rate of lung cancer patients, but also reduce the family burden of lung cancer patients. On the other hand, high-risk groups should increase their awareness of lung cancer screening and actively participate in the national cancer screening project led by the state., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Lei, Li, Zhou, Wang, Sun, Wang, Wu and Peng.)

Objective: To analyze the epidemiological characteristics of pneumoconiosis in Qinghai Province from 2011 to 2020, and to provide a basis for the formulation of prevention and control strategy. Methods: In April 2021 , the cases of pneumoconiosis were monitored by the Occupational Disease and Health Hazard Factors Monitoring Information System in Qinghai Province from 2011 to 2020. The distribution of pneumoconiosis, the composition of diseases and the working years exposed to dust were analyzed. Results: All 1026 cases of pneumoconiosis were newly diagnosed in Qinghai Province from 2011 to 2020, silicosis and coal worker pneumoconiosis were the main diseases (78.36% ,804/1026). Stage Ⅰ pneumoconiosis were 484 (47.17%,484/1026) cases. 359 (34.99%,359/1026) cases, 315 (30.70%,315/1026) cases and 252 (24.56%, 252/1026) cases had been diagnosed respectively in Xining City, Haidong City and Haixi Prefecture; 628 (61.21%,628/1026) cases and 418 (40.74%, 418/1026) cases engaged in mining industry and large-sized enterprise, respectively. The working years exposed to dust in silicosis cases were shorter than that in coal worker pneumoconiosis and other pneumoconiosis ( P <0.05). Conclusion: The pneumoconiosis area and industry focus in Qinghai Province is obvious. The supervision and adninistration of small and micro scale employers should be strengthened to protect the health rights and interests of workers, especially for the key area and industry.

Reconstruction of natural streamflow is fundamental to the sustainable management of water resources. In China, previous reconstructions from sparse and poor-quality gauge measurements have led to large biases in simulation of the interannual and seasonal variability of natural flows. Here we use a well-trained and tested land surface model coupled to a routing model with flow direction correction to reconstruct the first high-quality gauge-based natural streamflow dataset for China, covering all its 330 catchments during the period from 1961 to 2018. A stronger positive linear relationship holds between upstream routing cells and drainage areas, after flow direction correction to 330 catchments. We also introduce a parameter-uncertainty analysis framework including sensitivity analysis, optimization, and regionalization, which further minimizes biases between modeled and inferred natural streamflow from natural or near-natural gauges. The resulting behavior of the natural hydrological system is represented properly by the model which achieves high skill metric values of the monthly streamflow, with about 83% of the 330 catchments having Nash-Sutcliffe efficiency coefficient (NSE) > 0.7, and about 56% of the 330 catchments having Kling-Gupta efficiency coefficient (KGE) > 0.7. The proposed construction scheme has important implications for similar simulation studies in other regions, and the developed low bias long-term national datasets by statistical postprocessing should be useful in supporting river management activities in China., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2021 Science China Press. Published by Elsevier B.V. All rights reserved.)

Abstract: Among the diverse medical education systems in China, the 8-year program is dedicated to cultivating physician scientists. Although the research ability of senior students in 8-year medical programs is a pivotal quality, it remains unclear. This study aimed to clarify the current status and challenges of students' research experience, abilities, and outputs.A multicenter cross-sectional study was conducted in 5 medical schools in northern China. Electronic questionnaires were sent to 235 randomly chosen fifth-grade or sixth-grade 8-year-program medical students. A total of 211 responses were collected and analyzed using SPSS 22.0.Only 13.3% of participants chose research as their future career goal. Students generally felt that conducting research was stressful and difficult. The greatest obstacle was a lack of time due to heavy workloads. The 2 major motivations for research were graduation and/or future employment (75.8%) and research interest (24.2%). More than half of the students (142, 67.3%) had research experience by the time of the survey, among whom 84 students already had research outputs. A higher proportion of students with outputs was motivated by the requirements for graduation or employment compared to students without outputs (71.4% vs 55.2%, P  =  .046).Senior 8-year-program medical students in China generally had high pressure to conduct research and devoted their efforts to overcome these challenges. More guidance and novel encouragement to enhance students' initiative and interest in research could be provided by medical schools and educators in the future., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Nonpharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19) are vital to reducing transmission risks. However, the relative efficiency of social distancing against COVID-19 remains controversial, since social distancing and isolation/quarantine were implemented almost at the same time in China., Methods: In this study, surveillance data of COVID-19 and seasonal influenza in 2018-2020 were used to quantify the relative efficiency of NPIs against COVID-19 in China, since isolation/quarantine was not used for the influenza epidemics. Given that the relative age-dependent susceptibility to influenza and COVID-19 may vary, an age-structured susceptible/infected/recovered model was built to explore the efficiency of social distancing against COVID-19 under different population susceptibility scenarios., Results: The mean effective reproductive number, Rt, of COVID-19 before NPIs was 2.12 (95% confidence interval [CI], 2.02-2.21). By 11 March 2020, the overall reduction in Rt of COVID-19 was 66.1% (95% CI, 60.1-71.2%). In the epidemiological year 2019-20, influenza transmissibility was reduced by 34.6% (95% CI, 31.3-38.2%) compared with transmissibility in epidemiological year 2018-19. Under the observed contact pattern changes in China, social distancing had similar efficiency against COVID-19 in 3 different scenarios. By assuming the same efficiency of social distancing against seasonal influenza and COVID-19 transmission, isolation/quarantine and social distancing could lead to 48.1% (95% CI, 35.4-58.1%) and 34.6% (95% CI, 31.3-38.2%) reductions of the transmissibility of COVID-19, respectively., Conclusions: Though isolation/quarantine is more effective than social distancing, given that the typical basic reproductive number of COVID-19 is 2-3, isolation/quarantine alone could not contain the COVID-19 pandemic effectively in China., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

As Coronavirus Disease-2019 (COVID-19) vaccines became available in December 2020, increasingly more surveys were organized to examine the acceptance of vaccination, while most of them were conducted online. This study aimed to explore the difference between online and traditional on-site surveys in terms of COVID-19 vaccine acceptance. From November to December 2020, an online survey ( n = 2013) and an on-site survey ( n = 4,316) were conducted simultaneously in China. Multivariate logistic regression was used to identify influencing factors of acceptance, and propensity score matching (PSM) was adopted to balance the outcomes. As a result, 90.0% of the online respondents accepted COVID-19 vaccination, while it was only 82.1% in the on-site survey. After applying PSM, the acceptance rate of the on-site survey was declined to 78.6%. The age structure, residence location, education, and health status were observed as important factors in addressing vaccination acceptance, which needed to be specifically considered when designing online surveys., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Lyu, Lai, Ma, Cao, Lei, Wang, Zhang, Jing, Feng, Guo, Li and Fang.)

Soil respiration (R S ) is affected by many factors and shows significant diurnal and seasonal changes at different spatial and temporal scales. However, in a semi-arid steppe, the mechanism of the dynamic influence of environmental factors on R S is not clear, and the effect of subtle changes of soil water on R S under drought stress is yet to be explored. Therefore, Xilin River Basin, was the study area and a hydrological gradient on the four ecosystems for R S and hydrometeorological monitoring was selected. We proposed the use of dynamic sunrise and sunset time to distinguish day from night and determine related statistics. Additionally, we analyzed the temporal variation of R S and its response process and mechanism for hydrometeorological factors during the growing season and at daily scales. Further, we quantitatively simulated the R S of 594 scenarios in different growing season stages, ecosystems, and precipitation patterns. Results showed that: (1) in the hydrological gradient belt, different ecosystems exhibited the same trend but different characteristics of R S regulation. From May to November 2020, R S was 2.34-3.89, 1.89-5.97, 1.90-5.27 and 2.29-3.45 gC m -2 day -1 for the four ecosystems. (2) The use of dynamic sunrise and sunset time to distinguish day and night can more accurately describe the statistical value of each variable, which exhibits remarkable feasibility in daily scale research. (3) The changes in R S were adequately explained by temperature at various time scales, and the photosynthetically active radiation was positively correlated with R S at the daily scale. The special soil water content (M S ) condition in the study area was not sufficient to explain R S . (4) Precipitation can affect R S by changing soil and air; however, only when precipitation exceeds the effective precipitation threshold of 0.6 ± 0.3 mm, it significantly affects R S ., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021. Published by Elsevier B.V.)

Purpose: Psychological distress greatly impaired the psychological and physical well-being of lung cancer patients. Identification of protective and risk factors is a prerequisite of developing effective psychological treatment protocol. The study aims to determine the relationship of mindfulness and psychological distress and further clarify the mechanism of mindfulness against psychological distress through perceived stigma and social support among Chinese lung cancer patients., Method: A cross-sectional survey study involving 441 valid Chinese lung cancer patients was conducted from September 2018 to August 2019. After all validated questionnaires that measured psychological distress, level of mindfulness, social support, and perceived stigma were returned by patients, we firstly performed correlation analysis to assess the associations between mindfulness, social support, perceived stigma, and psychological distress. Then structural equation modelling analysis was conducted to further clarify the mediating effects of perceived stigma and social support on the relationship between mindfulness and psychological distress., Results: According to our hypothesis and further modification, our revised model adequately fits to data. Mindfulness (β =  - 0.107, p = 0.008) and social support (β =  - 0.513, p < 0.001) had a direct effect on psychological distress. Meanwhile, mindfulness had a direct effect on perceived stigma (β =  - 0.185, p < 0.001), and perceived stigma had a direct effect on social support (β =  - 0.373, p < 0.001). Furthermore, mindfulness had also the indirect effect on psychological distress through the chain mediating role of stigma and social support among lung cancer patients., Conclusions: Mindfulness has direct negative effect on psychological distress and has also indirectly negative psychological distress through impacting social support and perceived stigma., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: School closure is a common mitigation strategy during severe influenza epidemics and pandemics. However, the effectiveness of this strategy remains controversial. In this study, we aimed to explore the effectiveness of school closure on seasonal influenza epidemics in provincial-level administrative divisions (PLADs) with varying urbanization rates in China., Methods: This study analyzed influenza surveillance data between 2010 and 2019 provided by the Chinese National Influenza Center. Taking into consideration the climate, this study included a region with 3 adjacent PLADs in Northern China and another region with 4 adjacent PLADs in Southern China. The effect of school closure on influenza transmission was evaluated by the reduction of the effective reproductive number of seasonal influenza during school winter breaks compared with that before school winter breaks. An age-structured Susceptible-Infected-Recovered-Susceptible (SIRS) model was built to model influenza transmission in different levels of urbanization. Parameters were determined using the surveillance data via robust Bayesian method., Results: Between 2010 and 2019, in the less urbanized provinces: Hebei, Zhejiang, Jiangsu and Anhui, during school winter breaks, the effective reproductive number of seasonal influenza epidemics reduced 14.6% [95% confidential interval (CI): 6.2-22.9%], 9.6% (95% CI: 2.5-16.6%), 7.3% (95% CI: 0.1-14.4%) and 8.2% (95% CI: 1.1-15.3%) respectively. However, in the highly urbanized cities: Beijing, Tianjin and Shanghai, it reduced only 5.2% (95% CI: -0.7-11.2%), 4.1% (95% CI: -0.9-9.1%) and 3.9% (95% CI: -1.6-9.4%) respectively. In China, urbanization is associated with decreased proportion of children and increased social contact. According to the SIRS model, both factors could reduce the impact of school closure on seasonal influenza epidemics, and the proportion of children in the population is thought to be the dominant influencing factor., Conclusions: Effectiveness of school closure on the epidemics varies with the age structure in the population and social contact patterns. School closure should be recommended in the low urbanized regions in China in the influenza seasons., (© 2021. The Author(s).)