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This study investigated how peer-mediated Dynamic Assessment (DA) unfolded in translation revision competence (TRC) of students of Master's degree of Translation and Interpreting (MTI) in China. Thirty subjects first completed three revision tasks and were then rated as high- or low-level performers according to their average scores across the first two tasks. Students were subsequently assigned to either the role of learner or peer mediator. Peer mediators received training in a graduated prompts approach to DA to learn how to provide their peers with mediation. Peer mediation sessions were conducted with the mediators and the learners paired at random and directed to jointly review their third revision. After that, all participants re-revised their last texts with their justifications and were interviewed about their attitudes towards peer interaction and their progress in TRC. Diagnosis of TRC comprised scores of the first two revisions as well as the third revision following peer mediation, with this latter score indicating responsiveness to mediation and interpreted as the Zone of Proximal Development. The findings indicated that peer mediation may help improve both mediators' and learners' TRC, yet other potential factors at work should not be ignored. The peer engagement process allowed participants to improve their TRC in terms of justification and interpersonal skills. This research explored the application of DA in translation training and provided a process-oriented evaluation for translation studies.

Forest fire risk prediction is essential for building a forest fire defense system. Ensemble learning methods can avoid the problem of difficult model selection for disaster susceptibility prediction and can significantly improve modeling accuracy. This study introduces a stacking ensemble learning model for predicting forest fire risks in Yunnan Province by integrating various data types, such as meteorological, topographic, vegetation, and human activity factors. A total of 70,274 fire points and an equal number of randomly selected nonfire points were used to develop the model, with 70% of the data allocated for training and the remaining 30% for testing. The stacking model combined four diverse machine learning methods: random forest (RF), extreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM), and multilayer perceptron (MLP). We evaluated the model's predictive performance using metrics like accuracy, area under the characteristic curve (AUC), and fire density (FD). The results demonstrated that the stacking fusion model exhibited remarkable accuracy with an AUC of 0.970 on the test set, significantly surpassing the performance of individual machine learning models, which had AUC values ranging from 0.935 to 0.953. Furthermore, the stacking fusion model effectively captured the maximum fire density in extremely high susceptibility areas, demonstrating enhanced generalization capabilities. [ABSTRACT FROM AUTHOR]

Background: The development trajectories of children's SER remain unknown. This study aimed to characterize spherical equivalent refraction (SER) trajectories during grades 1–4 in Chinese children. Methods: This prospective cohort study included 1226 first-grade non-myopic children from 12 public primary schools, randomly selected in two districts in Guangzhou, China. From November 2018 to March 2022, four-wave ocular examinations and questionnaire surveys have been completed. The group-based trajectory modeling was used to explore SER trajectories in grades 1–4. Results: All five trajectories showed an upward trend and rose faster after grade 2. Children in the sharp-developing (n = 44), high-developing (n = 136), and rapid-developing (n = 237) myopia groups developed myopia before grades 2, 3, and 4, respectively. Their SER development speed remained at a relatively high level after myopia, almost consistent with that before myopia. Children in the moderate-developing (n = 418) and low-developing (n = 391) non-myopia groups did not develop myopia before grade 4. Some characteristics in grade 1 were independently associated with SER trajectories, including sex, axial length, number of parents with myopia, residence, academic achievement, and the duration of outdoor activity. Based on the baseline characteristics, we established the model predicting the probability of children belonging to each group. Conclusions: Myopia interventions are best started in grade 1 or preschool age. If interventions are not taken in time, the latest intervention window might be in grades 1, 2, and 3 for children with a high probability of belonging to the sharp-developing, high-developing, and rapid-developing myopia groups, respectively. The above probabilities might be predicted using the model we established. Moreover, the interventions for myopic children shouldn't be ignored. [ABSTRACT FROM AUTHOR]

This study investigated how peer-mediated Dynamic Assessment (DA) unfolded in translation revision competence (TRC) of students of Master's degree of Translation and Interpreting (MTI) in China. Thirty subjects first completed three revision tasks and were then rated as high- or low-level performers according to their average scores across the first two tasks. Students were subsequently assigned to either the role of learner or peer mediator. Peer mediators received training in a graduated prompts approach to DA to learn how to provide their peers with mediation. Peer mediation sessions were conducted with the mediators and the learners paired at random and directed to jointly review their third revision. After that, all participants re-revised their last texts with their justifications and were interviewed about their attitudes towards peer interaction and their progress in TRC. Diagnosis of TRC comprised scores of the first two revisions as well as the third revision following peer mediation, with this latter score indicating responsiveness to mediation and interpreted as the Zone of Proximal Development. The findings indicated that peer mediation may help improve both mediators' and learners' TRC, yet other potential factors at work should not be ignored. The peer engagement process allowed participants to improve their TRC in terms of justification and interpersonal skills. This research explored the application of DA in translation training and provided a process-oriented evaluation for translation studies. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of robotic‐assisted lobectomy (RAL) for patients with non–small‐cell lung cancer (NSCLC) has not been fully evaluated. Methods: This retrospective study compared the perioperative outcomes of NSCLC patients who underwent RAL and video‐assisted lobectomy (VAL) using propensity score matching (PSM) analysis. Subgroup analyses were then performed. Results: A total of 822 NSCLC patients (359 RAL cases and 463 VAL cases) were included, and there were 292 patients in each group after PSM. Compared with the VAL group, the RAL group had a significantly higher number of lymph nodes (LNs) harvested (10 vs. 8, p < 0.001) and more LN stations examined (6 vs. 5, p < 0.001). The operative duration (95 minutes vs. 115 minutes, p < 0.001) and intraoperative estimated blood loss (65 mL vs. 80 mL, p < 0.001) were significantly reduced, and the drainage volume on postoperative day (POD) 1 (240 mL vs. 200 mL, p < 0.001) and hospitalization costs (¥81084.96 vs. ¥66142.55, p < 0.001) were significantly higher in the RAL group. Subgroup analysis indicated that the incidence of postoperative complications (17.9% vs. 26.7%, p = 0.042) was significantly reduced in the RAL group for overweight and obese patients (body mass index [BMI] ≥24 kg/m2), which became insignificant in the BMI < 24 kg/m2 subgroup (31.0% vs. 24.8%, p = 0.307). Conclusion: RAL might have potential advantages in terms of lymph node assessment, reducing intraoperative blood loss, and shortening operation duration. Overweight and obese patients could benefit more from RAL because of reduced risk of postoperative complications. [ABSTRACT FROM AUTHOR]

Previous studies have documented negative associations between somatic symptoms and remission of major depressive disorder (MDD). However, the correlations of specific somatic symptoms with remission remain uncertain. We aimed to explore the associations between specific somatic symptoms and remission focusing on sex differences among patients with MDD. We used data from patients with MDD in the Depression Cohort in China. At baseline, total somatic symptoms were evaluated using the 28-item Somatic Symptoms Inventory and were categorized into pain, autonomic, energy, and central nervous system (CNS) symptoms. To measure remission of MDD, depressive symptoms were evaluated using the Patient Health Questionnaire-9 after 3 months of treatment. We ultimately included 634 patients. Compared with quartile 1 of total somatic symptom scores, the full-adjusted ORs (95% CIs) for remission from quartile 2 to quartile 4 were 0.52 (0.30, 0.90), 0.44 (0.23, 0.83), and 0.36 (0.17, 0.75), respectively (P -value for trend = 0.005). The restricted cubic spline showed no non-linear associations between total somatic symptoms with remission (P -value for non-linear = 0.238). Pain, autonomic, and CNS symptoms showed similar results. Sex-stratified analysis showed that total somatic symptoms, pain symptoms, and autonomic symptoms were negatively correlated with remission in females, whereas CNS symptoms were negatively associated with remission in males. Our findings indicate that specific somatic symptoms exert differential effects on remission of MDD. Therapeutic interventions that target pain, autonomic, and CNS symptoms may increase the probability of remission. Furthermore, interventions for somatic symptoms should be tailored by sex, and females deserve more attention. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that sexual minorities are at a higher risk of experiencing depressive symptoms. However, few prior investigations have examined the potential mechanisms involved. This study aimed to employ the four-way decomposition approach that integrates the analysis of mediation and interaction to investigate the potential role of problematic internet use between sexual orientation and depressive symptoms. The participants were recruited through a multi-stage, stratified cluster, and random sampling method in China. Students who identified as "gay or lesbian" and "bisexual" were defined as "sexual minorities". The Young's Internet Addiction Test (IAT) was used to evaluate problematic internet use. The Center for Epidemiologic Studies Depression Scale (CESD-20) was used to evaluate depressive symptoms. A total of 59,859 adolescents were included in this study, with 30,180 (53.25 %) boys and 29,679 (46.75 %) girls. Of these, 7263 (12.13 %) were identified as sexual minorities. Gender differences were observed in the association between sexual orientation, problematic internet use, and depressive symptoms. The mediating effect of problematic internet use was 28.80 % for boys and 36.84 % for girls, respectively. The interaction effect between problematic internet use and sexual minority status on depressive symptoms was 21.19 % and 9.65 % for boys and girls, respectively. The current study was limited by the cross-sectional design. These findings suggest that prevention and intervention programs aimed at improving mental health outcomes among sexual minority adolescents should prioritize considering the impact of problematic internet use and potential gender differences. • Sexual minorities have a higher risk of depressive symptoms. • Sexual minorities are more likely to develop problematic internet use. • Problematic internet use plays both mediating and interactive roles. • There are gender differences in these relationships. [ABSTRACT FROM AUTHOR]

• It is the first of its kind in China to explore the factors influencing the stigma of depression in persons living with MDD from the multidimensional perspective of individuals, their families, and society. • The study investigated the association of IS and PS with medication adherence based on a longitudinal cohort. • This study introduces a testable hypothesis from our data, proposing that strategies targeting IS in individuals with major MDD could significantly increase adherence to antidepressant treatment. This study sought to evaluate internalized stigma (IS) and perceived stigma (PS), in persons (n = 522) living with major depressive disorder (MDD), with a view to analyzing the association of IS and PS with medication adherence in a cohort of participants with MDD in China. Perceived stigma is the awareness of societal negative views and attitudes towards depression, and IS is applying others' attitudes to oneself, both measured by the Depression Stigma Scale (DSS). Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). We observed that 76.0 % of participants reported IS and 84.5 % reported PS. Factors associated with increased IS included older age, marital status, disease history, and a higher baseline Patient Health Questionnaire-9 (PHQ-9). Higher education level, family income, and scores on the Connor-Davidson Resilience Scale (CD-RISC) were associated with lower levels of IS. Higher education levels, Childhood Trauma Questionnaire (CTQ) scores, and living with others were also associated with higher PS, while engagement in exercise and higher number of prior episodes were associated with lower PS. IS had a negative association with medication adherence, whereas PS did not significantly associate with adherence. In conclusion, a testable hypothesis is derived from our data that strategies targeting IS amongst persons with MDD may improve overall rates of adherence to antidepressant treatment, a necessary prelude to improving recovery. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD)., Methods: Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations., Results: Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01-1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96-1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02-1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82-1.01)., Conclusion: Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small., Competing Interests: Declaration of competing interest Dr. Roger S. McIntyre has received research grant support from CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute; speaker/consultation fees from Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals,Viatris, Abbvie, Atai Life Sciences. Dr. Roger McIntyre is a CEO of Braxia Scientific Corp. Other authors declare that they have no competing interests., (Copyright © 2023. Published by Elsevier Inc.)

Background: This study aimed to explore the association of emotional and behavioral problems with sleep disturbance among Chinese adolescents, and to test whether these associations vary with adolescents' academic performance., Methods: Data were from the 2021 School-based Chinese Adolescents Health Survey using a multistage, stratified-cluster, and random-sampling method to collect information from 22,684 middle school students in Guangdong Province, China., Results: Emotional problems (aOR = 1.34, 95 % CI = 1.32-1.36), conduct problems (aOR = 1.19, 95 % CI = 1.16-1.21), hyperactivity (aOR = 1.35, 95 % CI = 1.33-1.37), and peer problems (aOR = 1.06, 95 % CI = 1.04-1.09) were significantly associated with the increased risk of sleep disturbance among middle school students in Guangdong Province. The prevalence of sleep disturbance among adolescents was 29.4 %. There were significant interactions of emotional problems/conduct problems/peer problems/prosocial behavior with academic performance on sleep disturbance. Further stratification analyses by academic performance showed that adolescents with self-reported good academic performance had a higher risk of sleep disturbance than those students with self-reported average or poor academic performance., Limitations: This study only included school students and used the cross-sectional design to preclude causality determination., Conclusions: Our findings suggest that emotional and behavioral problems elevate the risk of sleep disturbance in adolescents. Adolescent academic performance plays a modulating role in these above-mentioned significant associations for sleep disturbance., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Single measurements of waist circumference (WC) can predict the incident hypertension, while dynamic change patterns of WC during young adulthood and their association with the incidence of hypertension are poorly demonstrated. This study aimed to identify the longitudinal WC trajectories during young adulthood and explore their association with the risk of incident hypertension. We utilized the data from the China Health and Nutrition Survey (1993-2015) and included 6604 participants aged 18-50 years with repeated WC measurements of 3-8 times and information on incident hypertension. The group-based trajectory model was used to identify WC trajectories. Cox proportional hazard model was conducted to evaluate the association of WC trajectories with the risk of incident hypertension. We identified four distinct WC trajectories during young adulthood. Participants with the low-increasing and the moderate-increasing trajectories had increasing but normal WC, while those with the high-increasing and the sharp-increasing trajectories developed from non-abdominal obesity to abdominal obesity. Compared with the low-increasing trajectory, the adjusted hazard ratios (95% confidence intervals) were 1.48 (1.16-1.89), 2.50 (1.84-3.40), and 3.86 (2.40-6.21) for the moderate-increasing, the high-increasing, and the sharp-increasing trajectories, respectively. After further excluding participants with obesity at baseline, this association did not alter substantially. The gender-specific trajectory analyses yielded similar results. WC trajectories during young adulthood were significantly associated with the risk of incident hypertension in Chinese. Moreover, even the increasing WC trajectory within the normal range during young adulthood might increase the risk of hypertension., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Objective: This study assessed temporal relationships of serum uric acid (SUA) with blood glucose and determine the mediating effects of body mass index (BMI) and dyslipidemia on the relation of SUA and risk of type 2 diabetes., Methods: Participants aged ≥ 45 years were participated in 2011 and followed up until 2015. Cox proportional hazards regression with a robust variance estimator was performed to explore the association of SUA with the risk of diabetes, and crosslagged path analysis was introduced to examine the temporal relationships between SUA and blood glucose. A mediation analysis was finally used to identify the mediating effect of BMI and dyslipidemia on the relation of SUA and the future risk of diabetes., Results: A total of 9,020 participants were included with an average age of 58.59 years at baseline in 2011, and 53.6% of them were women. Linear dose-response relationship was identified by restricted spline cubic analysis between baseline SUA and follow-up blood glucose (the non-linear trend for fasting plasma glucose (FPG): β 2 = -0.71, p = 0.52; for HbA1c: β 2 = 0.05, p = 0.07; for risk of diabetes: β 2 = 0.12, p = 0.39). Additionally, compared with the lowest quartiles of SUA, the adjusted risk ratios of diabetes were 1.00 (95% CI : 0.82-1.23), 1.08 (95% CI : 0.89-1.31), and 1.37 (95% CI : 1.11-1.96) for quartile 2-4 ( p -trend < 0.01), respectively. Further additional adjustments for BMI or dyslipidemia, these ratios were not statistically significant. In addition, a unidirectional relationship from baseline SUA to follow-up FPG (ρ 1 = 0.24, p = 0.03) was further confirmed using crosslagged path analysis. After stratifying by genders, the above results were only significant in the women subgroup, and we thus conducted a mediation analysis in women and found that the BMI and dyslipidemia partially mediated the effect of SUA on diabetes with a 23.05 and 18.82% mediating effect, respectively., Conclusions: These findings provide strong evidence that hyperuricemia preceded diabetes, and the effect of baseline SUA on follow-up type 2 diabetes was more pronounced among middle-aged and elderly Chinese women, especially in postmenopausal women, and this effect is partly mediated by BMI and dyslipidemia at baseline., 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 Cheng, Li, Zheng, Tian and Jia.)

Objective: This study aimed to assess the relationship between waist-to-height (WHtR) and estimated glomerular filtration rate (eGFR) in men, non-menopausal, and postmenopausal women among middle-aged and elderly Chinese., Methods: This study analyzed the data of 7,807 participants in a cross-sectional survey, ie, the third wave of the China Health and Retirement Longitudinal Study. Restrictive cubic-spline regression with three knots was used to assess the dose-response association of WHtR with eGFR. Piecewise linear regression models were further established to calculate the slope of each segment and their 95% confidence interval (CI)., Results: After adjusting for potential confounders, an inverse L-shaped dose-response relationship was found between WHtR and eGFR among men (Pnonlinear = 0.024, threshold = 0.513) and postmenopausal women (Pnonlinear = 0.009, threshold = 0.503). The slopes on the right sides of the threshold were statistically significant among men (β2 = -33.77, 95% CI: -53.23 to -14.31) and postmenopausal women (β2 = -36.53, 95% CI: -49.71 to -23.35), respectively. A weak negative linear relationship existed between WHtR and eGFR in non-menopausal women., Conclusions: The relationship between WHtR and eGFR tended to be inverse-L-shaped in men and postmenopausal women, but may vary with postmenopausal status in women., Competing Interests: Financial disclosure/conflicts of interest: None reported., (Copyright © 2020 by The North American Menopause Society.)

Purpose: The aim was to investigate whether serum uric acid (SUA) was associated with incident hypercholesterolaemia and hypertriglyceridaemia in middle-aged and older Chinese., Methods: This prospective cohort study used data from the China Health and Retirement Longitudinal Study. A total of 6,063 participants were included, who were free of hypercholesterolaemia and hypertriglyceridaemia at baseline (2011) and were followed until 2015. Natural cubic spline models were conducted to investigate the dose-response association of SUA with incident hypercholesterolaemia and hypertriglyceridaemia. Moreover, SUA was categorized into four groups according to gender-specific quartiles. Log-binomial regression was performed to explore the association of SUA with hypercholesterolaemia and hypertriglyceridaemia, with the quartile 1 as a reference., Results: After full adjustment, we observed a positive linear dose-response relationship between SUA and hypercholesterolaemia and hypertriglyceridaemia. Compared with the quartile 1 of SUA, the adjusted risk ratios (95% confidence interval) of hypertriglyceridaemia were 1.15 (0.95-1.39), 1.23 (1.02-1.49) and 1.31 (1.08-1.59) for quartile 2-4 ( p -value for trend = .004), respectively. Whereas, we failed to find SUA significantly associated with hypercholesterolaemia. Sex-stratified analyses indicated that the association of SUA with hypertriglyceridaemia was more evident in the female., Conclusions: These findings suggest that SUA may be positively associated with incident hypertriglyceridaemia. KEY MESSAGES The natural cubic spline model showed a positive linear dose-response relationship between serum uric acid levels and hypertriglyceridaemia. Compared with the quartile 1 of SUA, the adjusted risk ratios (95% confidence interval) of hypertriglyceridaemia were 1.15 (0.95-1.39), 1.23 (1.02-1.49) and 1.31 (1.08-1.59) for quartile 2-4 ( p -value for trend = .004), respectively. Sex-stratified analyses indicated that the association of serum uric acid with hypertriglyceridaemia was more evident in the female.

Objective: The aim of this study was to assess the association of early menopause with diabetes and the mediating effect of abdominal obesity., Methods: This cross-sectional study was conducted among 5,693 participants. The data from the second follow-up (2015) of the China Health and Retirement Longitudinal Study were used. Participants self-reported their age at menopause and were divided into three age groups (<45, 45-54, and >54 years) according to the 10th, 10th to 90th, and 90th percentiles, with a menopausal age of 45 to 54 years serving as reference. The total effect was decomposed into direct and indirect (mediating) effects using logistic regression based on the Karlson-Holm-Breen method., Results: Compared to the menopausal age of 45 to 54 years, early menopause (<45 years) was associated with diabetes (odds ratio  = 2.19, 95% CI: 1.29-3.69) among Chinese women. The mediating effect of early menopause (<45 years) on diabetes was 4.98% (P = 0.321) for abdominal obesity., Conclusions: Early menopause may be associated with diabetes among Chinese women. Moreover, the mediating effect of abdominal obesity makes up a small percentage and has no statistical significance. Further studies are needed to examine other mechanisms behind the association of early menopause with diabetes.

A Gram-reaction-positive, endospore-forming, aerobic bacterium, designated strain CY1(T), was isolated from iron mineral soil of Hunan Province, China. The isolate was rod-shaped and motile by means of peritrichous flagella. The major cellular fatty acids were anteiso-C15:0 and iso-C16:0 and the major quinone was menaquinone 7. The major polar lipids were phosphatidylglycerol and diphosphatidylglycerol phosphatidylethanolamine. The genomic DNA G+C content was 50.5 mol% and the major diagnostic diamino acid in cell-wall peptidoglycan was meso-diaminopimelic acid. Phylogenetic analyses based on the 16S rRNA gene sequence indicated that strain CY1(T) is most closely related to Paenibacillus chondroitinus DSM 5051(T) (97.7% 16S rRNA gene sequence similarity), Paenibacillus pocheonensis Gsoil 1138(T) (97.4%) and Paenibacillus frigoriresistens YIM 016(T) (97.0%). DNA-DNA hybridization dissociation values were lower than 49% with the most closely related species. On the basis of phenotypic, chemotaxonomic and phylogenetic evidence, strain CY1(T) is affiliated to the genus Paenibacillus, but could be distinguished from the species of this genus. A novel species with the name Paenibacillus ferrarius sp. nov. is proposed. The type strain is CY1(T) ( =KCTC 33419(T) =CCTCC AB 2013369(T))., (© 2015 IUMS.)

Dramatic progress has occurred in neonatal intensive care in tertiary centers in mid-eastern China. We investigated the characteristics of neonatal respiratory failure (NRF) including the incidence, management, outcomes and costs in 14 neonatal intensive care units (NICUs) of Hebei, a province at an intermediate economic level in China. Over a period of 12 consecutive months in 2007-2008, perinatal data were collected prospectively from all NICU admissions (n = 11,100). NRF was defined as severe hypoxemia requiring respiratory support for more than 24 h, and was diagnosed in 1,875 newborns (16.9%). The average birth weight of newborns with NRF was 2,200 g (range 600-5,500 g), with 60.9% <2,500 g, and 2% <1,000 g. The male:female ratio was 2.6:1. The leading diagnosis was respiratory distress syndrome; 58.3% of newborns with respiratory distress syndrome received surfactant. Continuous positive airway pressure was used more than ventilation (73.3 vs. 49.1%,p < 0.001). Overall, the mortality rate until discharge was 31.4% (583/1,859). Most deaths (432, 74.1%) followed a parental decision to withdraw care. NRF mortality varied in association with different gross domestic product levels, family annual income and nurse-to-bed ratios. The median cost of a hospital stay was 10,169 CNY (interquartile range: 6,745-16,386) for NRF survivors. We conclude that, despite the available respiratory support in these emerging NICUs, the mortality of NRF remains. This was associated with prematurity, standard of care but also with socioeconomic factors affecting treatment decisions. Assessment of efficacy of respiratory support for NRF in such emerging neonatal services should account for both standard of care and socioeconomic conditions., (Copyright © 2010 S. Karger AG, Basel.)