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Introduction: COVID-19 has demonstrated the importance of competent staff with expertise in public health emergency preparedness and response in the civil aviation system. The civil aviation system is a critical sentinel and checkpoint to prevent imported cases and slow the spread of communicable diseases. Understanding the current competencies of staff to deal with public health emergencies will help government agencies develop targeted training and evidence-based policies to improve their public health preparedness and response capabilities. Methods: This cross-sectional pilot study was conducted from November 2022 to October 2023, involving 118 staff members from various positions within China's civil aviation system. A 59-item questionnaire was translated and developed according to a competency profile. Data were collected using the self-report questionnaire to measure the workforce's self-perceptions of knowledge and skills associated with public health emergency proficiency, categorized into (1) general competency, (2) preparedness competency, (3) response competency, and (4) recovery competency. KMO & Bartlett test and Cronbach's α reliability analysis were used to test the reliability and validity of the questionnaire. Descriptive statistics, independent sample T-test, ANOVA, and linear regression models were performed to analyze the competencies. Results: A total of 107 staff members from the aviation system were surveyed in this study. The KMO & Bartlett test, (KMO = 0.919, P < 0.001) and Cronbach's α coefficients (α = 0.985) for this questionnaire were acceptable. The results suggested that respondents scored a mean of 6.48 out of 9 for the single question. However, the staff needed to acquire more knowledge in investigating epidemic information (5.92) and case managing (5.91) in the response stage. Overall, males scored higher (409.05 ± 81.39) than females (367.99 ± 84.97), with scores in the medical department (445.67 ± 72.01) higher than management (387.00 ± 70.87) and general department (362.32 ± 86.93). Additionally, those with completely subjective evaluation (425.79 ± 88.10) scored higher than the general group (374.39 ± 79.91). To predict the total score, female medical workers were more likely to have lower scores (β = -34.5, P = 0.041). Compared with those in the medical department, the management workers (β = -65.54, P = 0.008) and general workers (β = -78.06, P < 0.001) were associated with a lower total score. Conclusions: There was still a gap between the public health emergency competencies of the civil aviation system and the demand. Staff in China's civil aviation systems demonstrated overall competence in public health emergency preparedness and response. However, there was a need to enhance the accumulation of practical experience. Implementing effective training programs for public health emergencies was recommended to mitigate knowledge gaps. Meanwhile, regular training evaluations were also recommended to give comprehensive feedback on the value of the training programs. [ABSTRACT FROM AUTHOR]

Since 2019n-CoV has swept the whole world, people's daily life is affected seriously and the public space system is facing to major challenges. Community public space should be re-evaluated and optimized as people change the way they use it. This research conducted a nationwide questionnaire survey in China, which collected the opinions of residents on community public space from the perspective of epidemic prevention and social needs to select research indicators. The questionnaire data were processed through the frequency analysis method, precedence chart and TOPSIS. We found: (1) under the background of the epidemic, people pay more attention to the satisfaction of leisure activities in community public space and the control of social spacing during activities; (2) the current assessment result of community public space risk of 2019-nCoV exposure is 0.386, which is relatively high; and (3) the exposure risk of the community can be effectively reduced by controlling for the two indicators of social distance and social facility sterilization. When the social distance is 1.8–3 m and the facility sterilization is once a day, the community public space minimizes exposure risk. In view of the above results, this paper selects the Wuhan start-up area of Wuhan, China, as an example for carrying out the optimization design of community public space based on the epidemic and the design the space optimization model for the two indicators of social distance and facility disinfection from both software and hardware aspects. [ABSTRACT FROM AUTHOR]

The overapplication of nitrogen to wheat reduces profits and has adverse environmental consequences. Machine learning techniques are employed to identify the factors that hold the most potential in improving nitrogen recommendations. The database used in our analysis consisted of a formula fertilization project, the second soil census of China, and cultivated land fertility evaluation. The results showed that the wheat nitrogen yield response was mainly concentrated around 1300–2400 kg/ha in Henan Province, with the highest values observed in the southern and eastern regions and the lowest in the northern region. The soil nitrogen content, nitrogen fertilizer, wet nitrogen deposition, dry nitrogen deposition, and soil nitrogen supply capacity were mainly concentrated around 0.65–1.30 g/kg, 173–203 kg N/ha, 15–39 kg N/(ha yr), 7–49 kg N/(ha yr), and 105–150 kg N/ha, respectively. When comparing the spatial distribution of the soil nitrogen content, nitrogen fertilizer, and nitrogen deposition, we found that the soil nitrogen supply capacity emerged as the predominant factor controlling wheat grain production. Soil types, precipitation, and temperature demonstrated a notable positive correlation with the soil nitrogen supply capacity. Given this background, it would be unreasonable to rely solely on the soil nitrogen content as the standard for fertilizer management. Particularly in high-yield fields, our focus should be on preserving optimal soil fertility by placing greater emphasis on the soil nitrogen supply capacity rather than simply reducing fertilizer application during wheat growth. [ABSTRACT FROM AUTHOR]

The Baiyinnuo'er deposit in northern China is located in the south section of the Great Xing'an Range, and it is the largest skarn Zn–Pb deposit in the region. Skarn and Zn–Pb orebodies mainly occur between the different units of the Permian Huanggangliang Formation, or within the contact zone between the intrusive rocks and the marble. Although Baiyinnuo'er has been well investigated previously, the timing of the Zn–Pb mineralization is still controversial, largely due to the lack of appropriate ore or alteration minerals that could be directly used for isotopic dating. In this study, we report the results of Rb–Sr isotopic analysis for sphalerite and pyrite samples from the Baiyinnuo'er orebodies, which yielded two isochron ages of 137.4 ± 3.4 and 140.0 ± 7.8 Ma, respectively, constraining the Zn–Pb mineralization time of the deposit as the Early Cretaceous. The data are also consistent with the age of the granitoids in the mining area, indicating a potential genetic relationship between the Early Cretaceous magmatism and mineralization. Many other intrusion-related hydrothermal deposits (including the two typical skarns, Huanggang and Haobugao) in the southern Great Xing'an Range also share similar mineralization ages (i.e., 140–130 Ma). Together, these data suggest an Early Cretaceous mineralization event in this region, and this large-scale mineralization could be related to the regional tectonic regime transition from compression to extension as a result of the rollback of the subducted Paleo-Pacific plate. The initial 87Sr/86Sr ratios of the sphalerite and pyrite samples are 0.70569 and 0.70616, respectively, implying that the ore-forming material could have a significant contribution from the mantle components. The current study shows that sulfide Rb–Sr dating could be used in deciphering the timing of skarn deposit formation. [ABSTRACT FROM AUTHOR]

purpose of this study is to evaluate the factors involved in the early stage of exertional heat stroke (EHS) that are associated with mortality. Methods: In this retrospective, case-control study, patients from 11 tertiary medical centers in China were enrolled from January 1, 2012, to December 31, 2019. Demographic information, underlying diseases, ambient temperature, and relative humidity, clinical manifestations, initial body temperature, time from onset to diagnosis of EHS (including suspected), and the duration of body temperature > 38°C of all enrolled patients were recorded. The occurrence of organ dysfunction within 72 h was evaluated, and in-hospital deaths were recorded. The patients were subsequently divided into a survival group and a non-survival group. The "case" refers to patients in the non-survival group, while the "control" refers to patients without death. Results: Of the 214 hospitalized patients with EHS, 183 survived and 31 died, and the overall mortality was 14.49% (31/214). A binary logistic regression showed that only the duration of body temperature > 38°C (OR 1.80, 95% CI 1.34– 2.42) and the number of organs damaged within 72 h of onset (OR 6.54, 95% CI 2.31– 18.56) were statistically significant in terms of risk of death in hospital (p < 0.05). A goodness of fit test produced a p-value of 0.76. According to receiver operating characteristic curve (ROC) analysis, the areas under the curve (AUC) were 0.989 (95% CI 0.978– 1.000; p < 0.05) and 0.936 (95% CI 0.896– 0.976; p < 0.05). Conclusion: Of the various factors involved in the early stage of the disease, the duration of high body temperature and the number of organs damaged within 72 h of onset were independent risk factors and predictors associated with death. [ABSTRACT FROM AUTHOR]

Against the backdrop of the uncertainty and irreversibility of shale gas development investment, we use the real option analysis framework to study how the government can optimally arrange an investment incentive policy for shale gas development and promote the immediate investment of enterprises under shale gas price uncertainty. In this article, we present two types of investment incentive policies for shale gas development, namely tax reductions and production subsidies. The output characteristics of shale gas development are included in the real option model. From this study, the government incentive level required to trigger the immediate investment of enterprises will rise with an increase in shale gas price volatility and the output decline rate and decrease with an increase in the initial gas recovery rate. When shale gas price volatility and the output decline rate are less than a certain level or the initial recovery rate is greater than a certain level, enterprises' investment will be spontaneous, even without government incentives. The study reveals that shale gas development incentives for the immediate investment of enterprises need to focus not only on the uncertainty of the external environment, but also on the shale gas resource endowment characteristics in Chinese regions. [ABSTRACT FROM AUTHOR]

An isotopic study was systemically carried out on the granitic complex, diorite-porphyrite, ores and ore minerals of the 103 Ma Xiaoxinancha gold-rich copper deposit in Jilin province to determine the geodynamic model of diagenesis and metallogenesis. Results show that the initial Nd and Sr isotopic compositions of the granitic complex are in the range of 0.70425-0.70505 for (87Sr/86Sr)i, 0.51243-0.51264 for INd, and -1.31 to + 2.64 for εNd( t); those of the diorite-porphyrite are in the range from 0.70438-0.70448 for (87Sr/86Sr)i, 0.51259-0.51261 for INd, and + 1.56 to + 2.09 for εNd( t). For ores and sulfides, the (87Sr/86Sr)i, INd, and εNd( t) values are in the range from 0.70440-0.70805, 0.51259-0.51279 and +1.72 to +5.56, respectively. The Pb isotopic ratios of the granitic complex range from 18.2992-18.6636 for 206Pb/204Pb, from 15.5343-15.5660 for 207Pb/204Pb, and from 38.1640-38.5657 for 208Pb/204pb For diorite-porphyrite, the isotopic ratios of 206Pb/204Pb, 207Pb/204Pb and 208Pb/204b are 18.3919, 15.5794 and 38.3566, respectively, whereas those of the ores and ore sulfides vary from 18.2275-18.3770 for 206Pb/204Pb, from 15.5555-15.5934 for 207Pb/204Pb and from 38.1318-38.3131 for 208Pb/204Pb. The results indicate that the mineralization was correlated to the formation and evolution of the granitic complex and the diorite-porphyrite. Combining with the reported data in petrologic characteristics, elemental geochemistry and chronology, conclusions can be drawn that the geodynamic settings of diagenesis and metallogenesis of this deposit were consistent with the subduction of the Izanagi oceanic plate during the Early Cretaceous. The diorite-porphyrite was formed by the emplacement of the adakitic magma triggered by partial melting of the enriched mantle, which originated from the derivative continental lithospheric mantle metasomatized by dehydration fluids from the subducting oceanic crust. The granitic complex was produced by fractional crystallization of the mixture between the adakitic magma and the high-K calc-alkaline acidic magma, which were generated by the remelting of the lower crust in the course of intraplate upwelling of the adakitic magma. The ore-bearing fluid reservoir convened in a late stage of the evolution of the mixed magma chamber. [ABSTRACT FROM AUTHOR]

The North China Craton is one of China's major gold-producing areas. Breakthroughs have been continually made in deep prospecting at depths of 500–2000 m in the Jiaodong Peninsula, and geophysical methods have played an important role. Given that the geophysical signals of deep-seated gold deposits are difficult to detect, due to their thick overburden layers, conventional geophysical methods are not suitable for deep prospecting. Therefore, this study upgrades the geological-geophysical prospecting model, which is based on the deep metallogenic model and geophysical method of large exploration depths. Based on the analysis of the metallogenic geological factors of the altered-rock-type gold deposits in the fracture zones of the Jiaodong Peninsula, this study proposes that the gold deposits are controlled by large-scale faults, generally occur near the contact interfaces between the Early Precambrian metamorphic rock series and Mesozoic granitoids, and exhibit a stepped metallogenic model. This model then becomes the prerequisite and basic condition for deep prospecting by geophysical methods. For this reason, the traditional geophysical model, which focuses on the exploration of shallow mineralization anomalies, is transformed into a comprehensive multi-parameter geological-geophysical qualitative prospecting model highlighting the exploration of ore-controlling structural planes. The model adopts various frequency domain methods (e.g., CSAMT, AMT, WFEM), reflection seismology, and other methods to detect the deep geological structure. The characteristics of parameters such as gravity and magnetism, resistivity, polarizability, and the seismic reflection spectrum are applied to identify the ore-controlling fault location and dip angle change, and to estimate the ore-bearing location according to the stepped metallogenic model. The prospecting demonstration of deep-seated gold deposits in the Shuiwangzhuang mining area indicates the effectiveness of the comprehensive model. The comprehensive deep prospecting model effectively solves the problem of deep prospecting of gold deposits controlled by faults, promotes the great breakthrough of deep prospecting in the Jiaodong Peninsula, and provides an important technology demonstration for deep prospecting throughout China. [ABSTRACT FROM AUTHOR]

Background: Skin and subcutaneous disease is the fourth-leading cause of the nonfatal disease burden worldwide and constitutes one of the most common burdens in primary care. However, there is a severe lack of dermatologists, particularly in rural Chinese areas. Furthermore, although artificial intelligence (AI) tools can assist in diagnosing skin disorders from images, the database for the Chinese population is limited.Objective: This study aims to establish a database for AI based on the Chinese population and presents an initial study on six common skin diseases.Methods: Each image was captured with either a digital camera or a smartphone, verified by at least three experienced dermatologists and corresponding pathology information, and finally added to the Xiangya-Derm database. Based on this database, we conducted AI-assisted classification research on six common skin diseases and then proposed a network called Xy-SkinNet. Xy-SkinNet applies a two-step strategy to identify skin diseases. First, given an input image, we segmented the regions of the skin lesion. Second, we introduced an information fusion block to combine the output of all segmented regions. We compared the performance with 31 dermatologists of varied experiences.Results: Xiangya-Derm, as a new database that consists of over 150,000 clinical images of 571 different skin diseases in the Chinese population, is the largest and most diverse dermatological data set of the Chinese population. The AI-based six-category classification achieved a top 3 accuracy of 84.77%, which exceeded the average accuracy of dermatologists (78.15%).Conclusions: Xiangya-Derm, the largest database for the Chinese population, was created. The classification of six common skin conditions was conducted based on Xiangya-Derm to lay a foundation for product research. [ABSTRACT FROM AUTHOR]

• The bimodal volcanic rocks in the western Jiangnan Orogenic Belt were formed at 820–806 Ma in a back-arc extension environment. • The final formation of the Jiangnan Orogenic Belt along the southeastern margin of the Yangtze Block occurred later than ca. 806 Ma. • Preliminary scenario for the tectonic evolution of the Jiangnan Orogenic Belt and the southeastern margin of the Yangtze Block is constructed. This study presents zircon SIMS U-Pb ages, whole-rock geochemistry and Nd-Hf-O isotope data of Neoproterozoic meta-volcanic rocks discovered from the Longsheng area of the western Jiangnan Orogenic Belt. Zircon SIMS U-Pb dating reveals that these rocks were emplaced during 820–806 Ma. The basaltic rocks are enriched in light rare earth element (LREE; [La/Yb] N = 3.38–8.40), slight negative Nb and Ta anomalies, and positive ε Nd (t) (+4.39 to +4.75) values. In addition, they possess relatively high zircon δ18O values of 7.24–10.78‰. These features, together with the SiO 2 contents (41.26–51.76 wt%), and high Mg# of 54–68, Ti/V and Ti/Y ratios of 49–68 and 415–570, suggest that they could derived from a depleted mantle source metasomatized by subduction-related melts. The dacitic rocks are high-K calc-alkaline and exhibit the characteristics of A1-type granite: typical enrichment in alkaline element, LREE ([La/Yb] N = 5.74–15.16) and large ion lithophile element (LILE), and depletion in Nb, Ta, Sr and Ti. Coupled with their different and negative ε Nd (t) (−8.75 to −9.16) compared with the basaltic rocks. This indicates that the dacitic rocks were probably generated by partial melting of crust as a result of magma underplating. The geochemical and Nd-Hf-O isotopic characteristics, together with regional geology, imply that the formation of the Longsheng bimodal volcanic rocks involves an extensional regime associated with a subduction-related environment. These new data, combined with previous results, indicate a preliminary scenario for the tectonic evolution of the Jiangnan Orogenic Belt and the southeastern margin of the Yangtze Block, which can provide significant insight into the understanding the evolution of South China. [ABSTRACT FROM AUTHOR]

• We apply behavioral economics to explain non-market prices in the rural land market. • In developed economies and mature markets, farmers tend to adopt the efficiency principle. • Experienced farmers are more likely to adopt the efficiency principle than inexperienced farmers. • Land title registration, to some extent, could reduce decision biases and enable rational decision-making. • The improvement of land market policy is conducive to reduce the decision biases of farmers. Transaction prices often deviate from the market price in rural land markets. This has been attributed to the decision process being driven by satisficing behaviors. Owing to bounded rationality, individuals tend to adopt the satisfaction principle (searching for a satisfactory solution) rather than the efficiency principle (striving to maximization) when making decisions. Accordingly, we have developed a conceptual framework to explore how decision principles cause decision biases in China's rural land market and their driving factors. Drawing on unique survey data from 31 Chinese provinces in 2018, we employ regression models to test the theoretical hypotheses. Empirical verifications reveal the following: i) The cause of decision bias, such as non-market prices, is farmers' adopting the satisfaction principle to make decisions. ii) Economic development, market maturity, and land registration can help reduce transaction costs, thereby reducing decision bias. iii) Given that experienced farmers are more likely to adopt the efficiency principle, their experience can help partly reduce decision biases in the rural land market. Thus, for the purpose of avoiding these anomalies in the market, policies to promote market participation and conduct land certifications should be implemented according to local economic conditions. Additionally, farmers need more opportunities to learn about the market and transactions. [ABSTRACT FROM AUTHOR]

Naked carp (Gymnocypris przewalskii) is a migratory fish endemic to the Qinghai Lake, the largest inland saline-alkaline lake in China. Based on our previous results of comparative transcriptome sequencing, we found that pathways related to regulation of actin cytoskeleton, plasma membrane damage, and inflammation-related signaling were significantly enriched during saline-alkaline stress, suggesting involvement of annexin (ANN) family proteins in stress adaption in naked carp. Herein, to explore the role of annexin family in naked carp under saline-alkaline stress, twenty GpANNs family members were identified at the genome-wide scale, and bioinformatics and expression analysis under saline-alkaline stress were performed. The predicted subcellular localization showed that most members of GpANNs were distributed in the cytoplasm, and the rest were localized in the cytoskeleton, nucleus, or mitochondria, respectively. GpANNs family proteins contained specific type II Ca2+-binding motifs, actin-binding motifs, GTP-binding motifs, etc. Phylogenetic tree analysis showed that the annexin homologues from naked carp, carp (Cyprinus carpio), zebrafish (Danio rerio), and chinese cavefish (Sinocyclocheilus rhinocerous) were divided into eight groups, i.e. ANN1 ∼ 6, ANN11 and ANN13. But homologues of ANN7 ∼ 10 groups were not found in these three fish species. Twenty-eight, nineteen and twenty-nine orthologous gene pairs were identified between naked carp and carp, zebrafish and chinese cavefish, respectively. Six paralogous gene pairs were identified in naked carp, all of which had a Ka/Ks ratio less than one, suggesting that the GpANNs family may have undergone purifying selection pressure during evolution. Expression of GpANN3 was significantly up-regulated in the kidney tissue under saline-alkaline stress, while GpANN2 was significantly down-regulated. Similar trends of protein expression were also observed by Western blot, suggesting involvement of GpANN3 and GpANN2 in stress response. Confocal microscopy revealed that GpANN2 was localized in both cytoplasm and nucleus, but GpANN3 was preferentially localized in the cytoplasm. Our study demonstrated the role of annexins in stress adaption, and provided the basic information required for further function analyses in naked carp. • The annexin family were comprehensively analyzed in G. przewalskii for the first time, but ANN7 ∼ 10 memebers were lacked. • GpANNs contain a variety of motifs which may be important sites for protein function under saline-alkaline conditions. • GpANNs exhibited differential expression patterns in 12 different tissues under saline-alkaline stress. • In kidney, GpANN2 and GpANN3 significantly responded to saline-alkaline stress at both mRNA and protein levels. [ABSTRACT FROM AUTHOR]

Background: Fetal growth monitoring is important for twin pregnancies. However, there has been no clinically validated tool for monitoring fetal growth of twin pregnancies in China. This study aims to develop and validate a chorionicity-specific growth chart of ultrasound estimated fetal weight (EFW) for Chinese twin pregnancies., Methods: This retrospective cohort study included all twin pregnancies who delivered two live fetuses with gestational age ≥ 34 weeks without severe obstetric complications at a tertiary hospital from January 2007 to March 2021. The participants were divided into a development set (delivered in or before December 2017) and a validation set (delivered in or after January 2018). Chorionicity-specific growth charts were created using the generalized additive models for location, scale, and shape (GAMLSS) based on the development set. The fetuses from the validation set were classified into three groups based on the last EFW: small-for-gestational-age (SGA) indicated by both the newly established twin charts and the Hadlock singleton chart currently used for twin pregnancies in China, suspected SGA indicated by only the singleton chart, and no SGA indicated by either chart. The incidence of neonatal outcomes among the three groups was then compared accordingly, including intensive care unit (NICU) stay length, respiratory diseases, and neurological disorders., Results: The development set included 883 twin pregnancies and a total of 6374 EFW measurements between 16 and 38 weeks of gestation, and the validation set included 801 twin pregnancies and 7630 EFW measurements. In the development set, monochorionic diamniotic (MCDA) twins had a significantly lower EFW compared to dichorionic diamniotic (DCDA) twins beginning at 26 weeks, with the difference gradually increasing thereafter, supporting the establishment of chorionicity-specific growth charts. Of the 1,602 twin neonates in the validation set, 103 (6.4%) were classified into the SGA group, 164 (10.2%) into the suspected SGA group, and 1335 (83.3%) into the no SGA group. The incidence of respiratory diseases and neurological disorders was comparable between the suspected SGA group and the no SGA group, but apparently higher in the SGA group. Meanwhile, NICU stay lengths were consistently longer for twins in the SGA group compared to the no SGA group (difference: 0.57, 95% CI: 0.31-0.83), with no significant differences observed between the suspected SGA and no SGA groups., Conclusions: The fetal growth trajectories differed by chorionicity, with a lower EFW for MCDA twins beginning at 26 weeks. The establishment of chorionicity-specific growth chart could reduce overdiagnosis of SGA and improve fetal growth monitoring of twin pregnancies., (© 2024. The Author(s).)

Limited research has reported the association between MTNR1B gene polymorphisms and ischemic stroke (IS), and there is insufficient evidence on whether adopting a healthy lifestyle can mitigate genetic risks in this context. This study aimed to investigate the associations between MTNR1B gene variants (rs10830963 and rs1387153) and IS, examining the potential effect of gene-lifestyle interactions on IS risk. Conducted in northern China, this family-based cohort study involved 5116 initially IS-free subjects. Genotype data for rs10830963 and rs1387153 in MTNR1B were collected. Eight modifiable lifestyle factors, including body mass index (BMI), smoking, alcohol consumption, dietary habits, physical activity, sedentary time, sleep duration, and chronotype, were considered in calculating healthy lifestyle scores. Multilevel Cox models were used to examine the associations between MTNR1B variants and IS. Participants carrying the rs10830963-G and rs1387153-T alleles exhibited an elevated IS risk. Each additional rs10830963-G allele and rs1387153-T allele increased the IS risk by 36% (HR = 1.36, 95% CI, 1.12-1.65) and 32% (HR = 1.32, 95% CI, 1.09-1.60), respectively. Participants were stratified into low, medium, and high healthy lifestyle score groups (1537, 2188, and 1391 participants, respectively). Genetic-lifestyle interactions were observed for rs10830963 and rs1387153 (p for interaction < 0.001). Notably, as the healthy lifestyle score increased, the effect of MTNR1B gene variants on IS risk diminished (p for trend < 0.001). This study underscores the association between the MTNR1B gene and IS, emphasizing that adherence to a healthy lifestyle can mitigate the genetic predisposition to IS., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To explore the effects of short-term particulate matter (PM) exposure and the melatonin receptor 1B ( MTNR1B ) gene on triglyceride-glucose (TyG) index utilizing data from Fang-shan Family-based Ischemic Stroke Study in China (FISSIC)., Methods: Probands and their relatives from 9 rural areas in Fangshan District, Beijing, were included in the study. PM data were obtained from fixed monitoring stations of the National Air Pollution Monitoring System. TyG index was calculated by fasting triglyceride and glucose concentrations. The associations of short-term PM exposure and rs10830963 polymorphism of the MTNR1B gene with the TyG index were assessed using mixed linear models, in which covariates such as age, sex, and lifestyles were adjusted for. Gene-environment inter-action analysis was furtherly performed using the maximum likelihood methods to explore the potential effect modifier role of rs10830963 polymorphism in the association of PM with TyG index., Results: A total of 4 395 participants from 2 084 families were included in the study, and the mean age of the study participants was (58.98±8.68) years, with 53. 90% females. The results of association analyses showed that for every 10 μg/m 3 increase in PM 2.5 concentration, TyG index increased by 0.017 (95% CI : 0.007-0.027), while for per 10 μg/m 3 increment in PM 10 , TyG index increased by 0.010 (95% CI : 0.003-0.017). And the associations all had lagged effects. In addition, there was a positive association between the rs10830963 polymorphism and the TyG index. For per increase in risk allele G, TyG index was elevated by 0.040 (95% CI : 0.004-0.076). The TyG index was 0.079 (95% CI : 0.005-0.152) higher in carriers of the GG genotype compared with carriers of the CC genotype. The interaction of rs10830963 polymorphism with PM exposure had not been found to be statistically significant in the present study., Conclusion: Short-term exposure to PM 2.5 and PM 10 were associated with higher TyG index. The G allele of rs10830963 polymorphism in the MTNR1B gene was associated with the elevated TyG index.

Background: Over 10 million robotic surgeries have been performed. However, the cost and benefit of robotic surgery need to be evaluated to help hospitals, surgeons, patients, and payers make proper choices, making a health economic analysis necessary. The authors revealed the bibliometric profile in the field of health economics of robotic surgery to prompt research development and guide future studies., Materials and Methods: The Web of Science Core Collection scientific database was searched for documents indexed from 2003 to 31 December 2022. Document types, years, authors, countries, institutions, journal sources, references, and keywords were analyzed and visualized using the Bibliometrix package, WPS Office software, Microsoft PowerPoint 2019, VOSviewer software (version 1.6.18), ggplot2, and Scimago Graphica., Results: The development of the health economics of robotic surgery can be divided into three phases: slow-growing (2003-2009), developing (2010-2018), and fast-developing (2019-2022). J.C.H. and S.L.C. were the most active and influential authors, respectively. The USA produced the most documents, followed by China, and Italy. Korea had the highest number of citations per document. Surgical Endoscopy and Other Interventional Techniques accepted most documents, whereas Annals of Surgery, European Urology, and Journal of Minimally Invasive Gynecology had the highest number of citations per document. The Journal of Robotic Surgery is promising. The most-cited document in this field is New Technology and Health Care Costs - The Case of Robot-Assisted Surgery in 2010. The proportion of documents on urology is decreasing, while documents in the field of arthrology are emerging and flourishing., Conclusion: Research on the health economics of robotic surgery has been unbalanced. Areas awaiting exploration have been identified. Collaboration between scholars and coverage with provisions for evidence development by the government is needed to learn more comprehensively about the health economics of robotic surgery., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: China has been increasing the investment in Primary Health Care Institutions (PHCIs) since the launch of the New Health Care System Reform in 2009. It is a crucial concern whether the PHCIs can meet residents' need both in urban and rural with the limited government finance, especially encountering the challenge of the COVID-19. This study aimed to reveal the trend of the primary health service efficiency in the past decade, compare the urban-rural differences, and explore relevant factors., Methods: DEA and Malmquist models were applied to calculate the health service efficiency of PHCIs among 28 provinces in China, with the input variables including the number of institutions, number of beds, number of health technicians, and the outputs variables including the number of outpatients and emergency visits, number of discharged patients. And the Tobit model was used to analyze the factors on the efficiency in urban and rural. A sensitivity analysis for model validations was also carried out., Results: The average technical efficiency (TE) of urban PHCIs fluctuated from 63.3% to 67.1%, which was lower than that in rural (75.8-82.2%) from 2009 to 2019. In terms of dynamic efficiency, the urban PHCIs performed better than the rural, and the trends in the total factor productivity change were associated with favorable technology advancement. The population density and dependency ratio were the key factors on TE in both of the urban and rural PHCIs, and these two factors were positively correlated to TE. In terms of TE, it was negatively correlated with the proportion of total health expenditure as a percentage of GDP in urban PHCIs, while in rural it was positively correlated with the urbanization rate and negatively correlated with GDP per capita. Besides, the tests of Mann-Whitney U, and Kruskal-Wallis H indicated the internal validity and robustness of the chosen DEA and Malmquist models., Conclusions: It needs to reduce the health resource wastes and increase service provision in urban PHCIs. Meanwhile, it is necessary to strengthen medical technology and gaining greater efficiency in rural PHCIs by technology renovation., 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 © 2023 Zhou, Peng, Chang, Liu, Gao, Zhao, Li, Feng and Qin.)

Objectives: To assess the feasibility of preoperative ultrasound (US)-guided incisional biopsy through a prospective controlled clinical trial., Methods: This was a prospective, double-arm, single-center study of Chinese patients. Thirty patients were enrolled in the study. Fourteen patients received incisional biopsies for which the choice of biopsy area relied on a clinical evaluation, and 16 patients received incisional biopsies for which the choice of biopsy area relied on a US-guided evaluation. The following procedure was used in the US-guided incisional biopsy group: 1) clinical and dermoscopic evaluation of skin lesions; 2) US examination; 3) incisional biopsy; 4) surgical excision; and 5) histopathological examination. The same procedure was used in the non-US-guided group except without US examination., Results: In the non-US-guided group, the mean tumor thicknesses obtained from incisional biopsy and postoperative histopathological examination were 2.1 and 4.1 mm, respectively. Seven melanomas were underestimated by incisional biopsy, resulting in margins narrower than currently recommended. In the US-guided group, the mean tumor thicknesses obtained from US, incisional biopsy, and postoperative histopathological examination were 3.4, 2.9, and 2.7 mm, respectively. In only 3 melanomas was the tumor thickness of the incisional biopsy less than that of the postoperative histopathological examination, demonstrating that US-guided biopsy obtains the maximum thickness area., Conclusions: Preoperative US-guided incisional biopsy can enhance the pathological accuracy of incisional biopsy, which may allow us to better perform surgical excision with safe peripheral surgical margins., (© 2022 American Institute of Ultrasound in Medicine.)

Severe dysplasia of vocal cord leukoplakia (VCL) is more likely to occur in laryngeal carcinoma. Alcohol dehydrogenase and acetaldehyde dehydrogenase are both important enzymes in alcohol metabolism. This study aimed to investigate the incidence rate of malignant transformation in patients with VCL and the role of drinking habits and ALDH2 and ADH1B genetic polymorphisms in the malignant transformation of VCL. From January 2007 to January 2017, 136 cases of VCL were included in this retrospective analysis. Information on medical history, alcohol and tobacco consumption habits, ALDH2 and ADH1B genotypes, gastroesophageal reflux, and clinical pathological characteristics of VCL was collected. As a result, patients had a median follow-up of 9.6 years (interquartile range: 7.5-12.5 years). Twenty-three of 136 VCL patients finally developed laryngeal carcinoma, resulting in a cumulative malignant transformation rate of 16.9%. Cox regression analysis demonstrated that the independent risk factors for the malignant transformation of VCL included age over 60 years (hazard ratio [HR]: 13.872, p < 0.001), ALDH2 *2 allele status (HR: 9.694, p < 0.001), alcohol (HR: 10.011, p < 0.001) and tobacco (HR: 8.869, p < 0.001) exposure after operation, and drinking frequency (HR: 2.178, p = 0.016). Therefore, among patients over 60 years old, an ALDH2-inactivating mutation and excessive ethanol and tobacco consumption are potential contributors to the malignant transformation of VCL., (© 2022 Wiley Periodicals LLC.)

The quantitative assessment of ecosystem health is important for interpreting the ecological effects of land use changes and formulating effective measures of sustainable ecological development by policymakers. This study investigated the response of ecosystem health to land use changes and landscape patterns in the karst mountainous regions of southwest China by taking Guiyang City as a case study area and assessing the spatial and temporal changes in ecosystem health from 2008 to 2017 using the vigor-organization-resilience model; it analyzed the influence of land use changes and landscape patterns on ecosystem health using spatial overlay analysis, the Dunnett's T3 test, and the Spearman correlation analysis. The results show that the land use structure dramatically changed, with a trend of a sharp decrement of farmland and rapid increment of forestland and construction land due to rapid urbanization and ecologization. The overall ecosystem health was at a relatively strong level, with the average value greater than 0.6. The deterioration of ecosystem health was attributed to the expansion of construction land and farmland and the degradation of forestland, while the increment of forestland was the major contributor to the improvement of ecosystem health. The ecosystem health of the forestland + farmland landscape was significantly superior to that of forestland + construction land and construction land + farmland landscapes. Moreover, each landscape configurations had a significant positive or negative correlation with the ecosystem health. This study provides a valuable reference for formulating sustainable environmental management strategies in karst mountainous regions in China.

The coronavirus disease 2019 (COVID-2019) that emerged in Wuhan, China, has rapidly spread to many countries across all six WHO regions. However, its pathobiology remains incompletely understood and many efforts are underway to study it worldwide. To clarify its pathogenesis to some extent, it will inevitably require lots of COVID-2019-associated pathological autopsies. Pathologists from all over the world have raised concerns with pathological autopsy relating to COVID-2019. The issue of whether a person died from COVID-2019 infection or not is always an ambiguous problem in some cases, and ongoing epidemiology from China may shed light on it. This review retrospectively summarizes the research status of pathological autopsy for COVID-2019 deaths in China, which will be important for the cause of death, prevention, control and clinical strategies of COVID-2019. Moreover, it points out several challenges at autopsy. We believe pathological studies from China enable to correlate clinical symptoms and pathological features of COVID-2019 for doctors and provide an insight into COVID-2019 disease., (© FEMS 2020.)

Acetylacetone (AcAc) is a common atmospheric oxygenated volatile organic compound due to broad industrial applications, but its atmospheric oxidation mechanism is not fully understood. We investigate the mechanism, kinetics, and atmospheric fate of the OH-initiated oxidation for the enolic and ketonic isomers of AcAc using quantum chemical and kinetic rate calculations. OH addition to enol-AcAc is more favorable than addition to keto-AcAc, with the total rate constant of 1.69 × 10 -13 exp(1935/T) cm 3 molecule -1 s -1 over the temperature range of 200-310 K. For the reaction of the enol-AcAc with OH, the activation energies of H-abstraction are at least 4 kcal mol -1 higher than those of OH-addition, and the rate constants for OH-addition are by 2-3 orders of magnitude higher than those for H-abstraction. Oxidation of AcAc is predicted to yield significant amounts of acetic acid and methylglyoxal, larger than those are currently recognized. A lifetime of less than a few hours for AcAc is estimated throughout the tropospheric conditions. In addition, we present field measurements in Beijing and Nanjing, China, showing significant concentrations of AcAc in the two urban locations. Our results reveal that the OH-initiated oxidation of AcAc contributes importantly to ozone and SOA formation under polluted environments.

Antibiotic susceptibility of Neisseria gonorrhoeae in Guangzhou during 2002-2011 showed that resistance to penicillin and ciprofloxacin was high, while ceftriaxone remained effective although there was a trend towards reduced sensitivity.