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The research aimed to make a quasi-experimental study of College English in a Chinese blended learning community environment. A mixed method was adopted to collect data about students' academic achievement and learning satisfaction. Academic achievement consisted of obtrusive data from the final exam, and learning satisfaction data came from a unified standard questionnaire organized by the university. Utilizing quasi-experimental design, results showed that the experimental class (C1) adopting the framework of blended learning community (BLC) earned a higher level of academic achievement and satisfaction. It is concluded in this research that the BLC framework was shown to have a positive effect on students' academic achievement and learning satisfaction than face-to-face (FTF) learning in the context of English learning in higher education. Pedagogical implications and future research recommendations were also included.

Using an integrated school leadership framework, this research intended to investigate 1.whether and to what extent transformational leadership could leverage teacher leadership; 2 the integrated effects of principal transformational leadership and teacher leadership on teacher self-efficacy and student academic performance. This study used a two-stage stratified sampling approach and collected the complex survey data in one Chinese province. Researchers employed a rigorous three-level Structural Equation Model to investigate multi-dimensional relationships among the aforementioned variables. The results suggest that principal transformational leadership is significantly and positively related to teacher leadership. Meanwhile, principal transformational leadership and teacher leadership are both positively related to teacher self-efficacy, but only teacher leadership is positively related to student learning. This study adds nuanced and international evidence and provides a practical framework to improve schools by involving teacher leaders through principal transformational leadership.

Even though the concept has been introduced more than 2 decades ago, available evidence conventionally operationalises shared instructional leadership as a composite, which has missed the opportunity to reveal to what extent principal and teacher instructional leadership helps improve instructional outcomes. Using the complex survey data collected in China, this research employed a three-level structural equation model to investigate the multidimensional relationships among principal and teacher instructional leadership, teacher self-efficacy, and student learning outcomes. The results suggest principal instructional leadership is significantly related to teacher instructional leadership. Both are positively related to teacher self-efficacy and student performance, though the effect sizes vary noticeably. Using a survey design, this study has added international and nuanced evidence to the shared instructional leadership research, through an integrated model emphasising both principals' and teachers' leading roles.

Although the teaching methods of the blended learning and BOPPPS (bridge-in, objective, preassessment, participatory learning, postassessment, and summary) model are proven to be successful and highly effective at improving the academic knowledge of the students, respectively, it is unclear whether blended learning combined with the BOPPPS model (BL-BOPPPS) could work well in an introduction course of health services management (HSM) for the health management students in China. The study investigated the perceptions and effects of implementing the BL-BOPPPS model on student learning outcomes in an introduction course of HSM. The intervention group consisted of 55 students introduced to the BL-BOPPPS model, while the control group consisted of 54 students who received a conventional lecture. After the end of course, the effectiveness of teaching was self-assessed with questionnaires by all students, and examination scores for the two groups were compared. The students' satisfaction levels of BL-BOPPPS teaching strategy were up to 81.8% in the intervention group. Compared with the control group, the intervention group showed significant elevation of perception scores of skills (P = 0.001), initiative (P = 0.002), self-control (P = 0.008), self-efficacy (P = 0.001), motivation (P = 0.004), and the academic performance (P = 0.001). The BL-BOPPPS model could stimulate the enthusiasm and interest of health students; boost students' skills, initiative, and motivation in learning; and improve the self-directed learning ability, academic performance, and teaching quality. The findings provide a basis of evidence for the promotion of the BL-BOPPPS model in various disciplines in Chinese colleges and universities.

Current interdisciplinary medical training calls for reforms and innovations in the assessment of pathophysiology education. Formative assessment is used to monitor student learning to provide ongoing feedback that can improve both learning and teaching. Beginning in 2016, we implemented a formative assessment composed of case-based multiple-choice questions (MCQs) for all students in all majors. In 2017, case study questions began to be employed in the formative assessment, and student-set, case-based questions were further introduced. Aiming to gather the students' suggestions and feedback on the mixed-method assessment, we conducted a survey on aspects such as the effectiveness of the assessment, assessment content and completion, opinions on student-set questions, and the impact on pathophysiology learning for students from 2017 to 2019. In addition, we compared students' semesterly final scores with those of previous students and evaluated the relationship between formative and summative assessment scores. The results for 1,277 students clearly showed that the reformed formative assessment system was well received by the students. The students thought that the formative assessment not only allowed for the provision of real-time feedback on the effectiveness of teaching and learning but also nurtured self-motivation, the development of analytical and problem-solving skills, and collaborative efforts. Both the semesterly final scores and the proportions of students scoring in higher score ranges increased after the implementation of the formative assessment, and the summative assessment scores were positively related to the formative assessment scores. Consequently, the reformed formative assessment system significantly improved the quality of pathophysiology education.

Background: Autism spectrum disorder (ASD) is a multifactorial, pervasive, neurodevelopmental disorder, of which intestinal symptoms collectively represent one of the most common comorbidities. Methods: In this study, 1,222 children with ASD and 1,206 typically developing (TD) children aged 2-7 years were enrolled from 13 cities in China. Physical measurement and basic information questionnaires were conducted in ASD and TD children. The Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Behavior Checklist (ABC) were used to evaluate the clinical symptoms of children with ASD. The six-item Gastrointestinal Severity Index (6-GSI) was used to evaluate the prevalence of intestinal symptoms in two groups. Results: The detection rates of constipation, stool odor, and total intestinal symptoms in ASD children were significantly higher than those in TD children (40.098% vs. 25.622%, 17.021% vs. 9.287%, and 53.601% vs. 41.294%, respectively). Autistic children presenting with intestinal comorbidity had significantly higher scores on the ABC, SRS, CARS, and multiple subscales than autistic children without intestinal symptoms, suggesting that intestinal comorbidity may exacerbates the core symptoms of ASD children. Conclusion: Intestinal dysfunction was significantly more common in autistic than in TD children. This dysfunction may aggravate the core symptoms of children with ASD. [ABSTRACT FROM AUTHOR]

The objective of this paper was to analyze the difference of composition between hybrid sorghum and conventional sorghum in southwest China, and to establish the method of variety identification. The basic physical and chemical components of 29 sorghum samples were determined, and the metabolite composition of 29 sorghum samples was determined by ultra high performance liquid chromatography coupled with Q Exactive HF-X mass spectrometry. The marker component screening and construction of variety identification model were carried out using stoichiometry, which included principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), cluster analysis and receiver operating characteristic (ROC) curve analysis. The model was based on the basic physicochemical composition and all metabolites. The results showed that the contents of amylopectin and tannin of the conventional varieties form southwest China were higher than that of hybrid varieties, while the contents of amylose and 1000-grain weight were lower. By analyzing the physicochemical properties, it was possible to identify certain samples. The OPLS-DA model was constructed with all 1048 compounds variables, and 46 of the differential metabolites that had a significant impact on the model identification were screened out. A novel OPLS-DA identification model was developed for sorghum varieties, achieving a 100% accuracy in identification. The conventional varieties from southwest China exhibited a relatively high concentration of phenolic compounds. Furthermore, after conducting receiver operating characteristic (ROC) curve analysis and assessing the relative standard deviation (RSD) of quality control sample (QC), 20 feature components that exhibited both high diagnostic accuracy and good reproducibility were identified. Among them, syringetin 3-glucoside and 6"-o-acetyldaidzein had higher expression abundance in conventional sorghum varieties, while D-glucarate, putsutrine, N-acetylputsutrine and L-glutamine had higher content in hybrid sorghum varieties. This study unveiled the disparity in metabolites between hybrid sorghum and conventional sorghum. The study successfully developed a scientifically rigorous and precise untargeted metabolomics approach using UHPLC-Q Exactive HF-X-MS. This method can be effectively utilized for the identification of sorghum varieties, offering a novel strategy for sorghum variety identification. [ABSTRACT FROM AUTHOR]

Background: Lacunes, a characteristic feature of cerebral small vessel disease (CSVD), are critical public health concerns, especially in the aging population. Traditional neuroimaging techniques often fall short in early lacune detection, prompting the need for more precise predictive models. Methods: In this retrospective study, 587 patients from the Neurology Department of the Affiliated Hospital of Hebei University who underwent cranial MRI were assessed. A nomogram for predicting lacune incidence was developed using LASSO regression and binary logistic regression analysis for variable selection. The nomogram's performance was quantitatively assessed using AUC-ROC, calibration plots, and decision curve analysis (DCA) in both training (n = 412) and testing (n = 175) cohorts. Results: Independent predictors identified included age, gender, history of stroke, carotid atherosclerosis, hypertension, creatinine, and homocysteine levels. The nomogram showed an AUC-ROC of 0.814 (95% CI: 0.791-0.870) for the training set and 0.805 (95% CI: 0.782-0.843) for the testing set. Calibration and DCA corroborated the model's clinical value. Conclusion: This study introduces a clinically useful nomogram, derived from binary logistic regression, that significantly enhances the prediction of lacunes in patients undergoing brain MRI for various indications, potentially advancing early diagnosis and intervention. While promising, its retrospective design and single-center context are limitations that warrant further research, including multi-center validation. [ABSTRACT FROM AUTHOR]

Aim: To explore the effects of demographic characteristics, mental workload, and Adversity quotient (AQ) on the job engagement of nurses in East China. Design: A quantitative and cross‐sectional study. Method: The survey collected questionnaire data on mental workload, adversity quotient, and job engagement from 473 nurses selected working in 12 Grade‐A tertiary hospitals based on informed consent in East China between July 2020 and March 2021. Results: The total score of mental workload was 78.24 ± 11.65, the adversity quotient score was 128.26 ± 15.84, job engagement score was 42.32 ± 7.79. Job engagement has a remarkable positive correlation with adversity quotient (r = 0.613, p<0.001), and a negative correlation with mental workload (r = −0.499, p<0.001). Mental workload has an apparent negative correlation with adversity quotient (r = −0.291, p<0.001). Labor‐management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self‐assessment, control, and endurance could predict 70.9% of job engagement of nurses. Conclusions: The mental workload of nurses was higher, the AQ was at a medium level, and the job engagement of nurses was also slightly higher. Labor‐management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self‐assessment, control, and endurance had predictive effects on nurses' job engagement. It is necessary to take a variety of measures according to the social‐demographic characteristics, improve the adversity quotient, and evaluate the mental workload correctly, to improve the job engagement of nurses. Impact: The epidemic situation and other emergencies make the work pressure of nurses in Grade‐A tertiary hospitals increase suddenly. It should pay attention to the influence of different demographic factors, and pay attention to the correct guidance of work demand‐mental workload, as well as the cultivation, and improvement of job resource‐AQ, which can improve the job engagement of nurses to some extent. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The purpose of this article is to understand the relationship between transformational leadership and collective teacher efficacy in the Chinese primary school context using quantitative research methods. This article also examines the transferability of transformational leadership and its effects in a high power distance culture. The main research question is, 'To what extent can transformational leadership explain the variance in collective teacher efficacy in Chinese primary schools?' The results of path analysis show that managing the instructional program has a significant effect on group competence (a dimension of collective efficacy) and that setting direction affects another dimension of collective efficacy, task analysis. When collective teacher efficacy is treated as a single variable, setting direction and managing the instructional program have relatively significant effects on collective teacher efficacy. This study adds to the literature on the relationship between transformational leadership and collective teacher efficacy in the Chinese primary school context. It advances knowledge of educational management and facilitates the understanding of cross-cultural leadership phenomena.

The longitudinal associations between popularity, overt aggression, and relational aggression were assessed in middle school and high school cohorts drawn from a large urban Northwest Chinese city. The middle school (n = 880; 13.33 years.) and high school samples (n = 841; 16.66 years.) were each followed for 2 years. In the concurrent regression analyses, overt aggression was more strongly and consistently associated with popularity than relational aggression after controlling for likability. Cross-lagged analyses revealed that popularity predicted subsequent increases in overt and relational aggression throughout middle and high school whereas overt aggression at 7th and 10th grade predicted increases in popularity 1 year later. These findings provide further evidence that popularity is associated with aggression and suggest that overt and relational aggression may be a consequence rather than a contributor to popularity in Chinese adolescents.

This study develops a model to assess building vulnerability across Xinxing County by integrating quantitative derivation with machine learning techniques. Building vulnerability is characterized as a function of landslide hazard risk and building resistance, wherein landslide hazard risk is derived using CNN (1D) for nine hazard-causing factors (elevation, slope, slope shape, geotechnical body type, geological structure, vegetation cover, watershed, and land-use type) and landslide sites; building resistance is determined through quantitative derivation. After evaluating the building susceptibility of all the structures, the susceptibility of each village is then calculated through subvillage statistics, which are aimed at identifying the specific needs of each area. Simultaneously, different landslide hazard classes are categorized, and an analysis of the correlation between building resistance and susceptibility reveals that building susceptibility exhibits a positive correlation with landslide hazard and a negative correlation with building resistance. Following a comprehensive assessment of building susceptibility in Xinxing County, a sample encompassing different landslide intensity areas and susceptibility classes of buildings was chosen for on-site validation, thus yielding an accuracy rate of the results as high as 94.5%. [ABSTRACT FROM AUTHOR]

The concurrent and longitudinal associations between popularity, likeability, and prosocial behavior were evaluated in this three-year study of middle school and high school Chinese adolescents. The initial sample included 766 middle school (mean age = 13.3 years) and 668 high school participants (mean age = 16.6 years); there were 880 (399 girls) middle school and 841 (450 girls) adolescents who participated in at least one year of data collection. Significant positive associations between popularity, prosociality, and academic achievement were found. Both popularity and likeability concurrently predicted significant unique variance in prosocial behavior after controlling for academic achievement; longitudinal cross-lagged analyses revealed bi-directional associations between popularity and prosocial behavior such that popularity positively predicted subsequent prosocial behavior and prosocial behavior predicted subsequent popularity. Cross-cultural research on popularity may profitably focus on variation in prosocial behavior as the relative salience of coercive and prosocial control strategies may vary across cultures.

Objective: Most studies investigated the relationship between COVID-19 and Guillain-Barré syndrome (GBS) by comparing the incidence of GBS before and during the pandemic of COVID-19. However, the findings were inconsistent, probably owing to varying degrees of the lockdown policy. The quarantine requirements and travel restrictions in China were lifted around December 7, 2022. This study aimed to explore whether the relative frequency of GBS increased during the major outbreak in the absence of COVID-19-mandated social restrictions in China. Methods: GBS patients admitted to the First Hospital, Shanxi Medical University, from December 7, 2022 to February 20, 2023, and from June, 2017 to August, 2019 were included. The relative frequencies of GBS in hospitalized patients during different periods were compared. The patients with and without SARS-CoV-2 infection within six weeks prior to GBS onset formed the COVID-GBS group and non-COVID-GBS group, respectively. Results: The relative frequency of GBS among hospitalized patients during the major outbreak of COVID-19 (13/14,408) was significantly higher than that before the COVID-19 epidemic (29/160,669, P < 0.001). More COVID-GBS patients (11/13) presented AIDP subtype than non-COVID-GBS cases (10/27, P = 0.003). The mean interval between onset of infective symptoms and GBS was longer in COVID-GBS (21.54 ± 11.56 days) than in non-COVID-GBS (5.76 ± 3.18 days, P < 0.001). Conclusions: COVID-19 significantly increased the incidence of GBS. Most COVID-GBS patients fell into the category of AIDP, responded well to IVIg, and had a favorable prognosis. [ABSTRACT FROM AUTHOR]

Background: The real-world tuberculosis (TB) surveillance data was generally incomplete due to underreporting and underdiagnosis. The inventory study aimed to assess and quantify the incompletion of surveillance systems in southwestern China. Methods: The inventory study was conducted at randomly selected health facilities (HF) by multi-stage stratified cluster sampling. The participants were included in the period between August of 2020 in province-level and prefecture-level HF, and in the period between June to December of 2020 in other categories of HF respectively. The clinical committee confirmed medical records were matched to the National Notifiable Disease Reporting System (NNDRS) and the Tuberculosis Information Management System (TBIMS) to define the report and register status. The underreporting and under-register rates were evaluated based on the matched data, and factors associated with underreport and under-register were assessed by the 2-level logistic multilevel model (MLM). Results: We enrolled 7,749 confirmed TB cases in the analysis. The province representative overall underreport rate to NNDRS was 1.6% (95% confidence interval, 95% CI, 1.3 − 1.9), and the overall under-register rate to TBIMS was 9.6% (95% CI, 8.9–10.3). The various underreport and under-register rates were displayed in different stratifications of background TB disease burden, HF level, HF category, and data source of the medical record in HF among prefectures of the province. The intraclass correlation coefficient (ICC) was 0.57 for the underreporting null MLM, indicating the facility-level cluster effect contributes a great share of variation in total variance. The two-level logistic MLM showed the data source of medical records in HF, diagnostic category of TB, and type of TB were associated with underreporting by adjusting other factors (p < 0.05). The ICC for under-register was 0.42, and the HF level, HF category, data source of medical records in HF, diagnostic category of TB and type of TB were associated with under-register by adjusting other factors (p < 0.05). Conclusion: The inventory study depicted incomplete TB reporting and registering to NNDRS and TBIMS in southwestern China. It implied that surveillance quality improvement would help advance the TB prevention and control strategy. [ABSTRACT FROM AUTHOR]

Improving access to HIV/AIDS healthcare services is of great concern to government and policymakers striving to strengthen overall public health. How to reasonably allocate HIV/AIDS healthcare resources and maximize the equality of access to healthcare services across subdistrict areas has become an urgent problem to be solved. However, there is limited research on this topic in China. It is necessary to evaluate spatial accessibility to improve the accessibility and equity of HIV/AIDS healthcare services. In this study, the improved multi-modal two-step floating catchment area (2SFCA) and inverted 2SFCA (i2SFCA) methods are used to measure the spatial accessibility of HIV/AIDS healthcare services and the crowdedness of the healthcare sites in Shandong Province, China. Then, the theoretical supply and the optimal spatial distribution of resources are calculated and visualized by minimizing the accessibility gaps between demand locations. This study showed that the spatial accessibility of HIV/AIDS service resources in Shandong Province was concentrated and unevenly distributed, and the accessibility scores in the marginal areas of prefecture-level cities were significantly lower than those in other areas. Regions with a large number of doctors had significantly higher levels of spatial accessibility. The ART accessibility scores in the southwest of Shandong Province were higher than those in other regions. As the travel friction coefficient increased, the accessibility scores formed an approximately circular cluster distribution centered on the healthcare sites in geographical distribution. More ART drugs needed to be supplied in marginal areas and more doctors were needed to work on HIV/AIDS in urban areas to address the spatial distribution imbalance of HIV/AIDS healthcare services. This study profoundly analyzed the spatial accessibility of HIV/AIDS healthcare services and provided essential references for decision-makers. In addition, it gives a significant exploration for achieving the goal of equal access to HIV/AIDS healthcare services in the future. [ABSTRACT FROM AUTHOR]

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Time perspective is a predictor of addiction, and relapse is an important feature of addiction. Owing to the high relapse rate among drug addicts, it is particularly essential to explore the mechanism of relapse tendency from a time perspective. In this study, we explored the relationship between heroin abstainers' time perspective and relapse tendency, and the mediating role of motivation for abstinence. Heroin abstainers (n = 300) from a compulsory isolated detoxification center in China were investigated by using the Zimbardo Time Perspective Inventory, Motivation for Abstention Questionnaire, and Questionnaire on Relapse Tendency of Compulsory Drug Addicts. The results showed that past negative time perspective was positively associated with relapse tendency, while future and balanced time perspectives were negatively associated with relapse tendency. Past negative time perspective was negatively associated with motivation for abstinence, whereas future and balanced time perspectives were positively associated with motivation for abstinence. Moreover, motivation for abstinence partially mediated the relationship between heroin addicts' time perspective and relapse tendency. Based on these results, we suggest that attention should be paid to the role of time perspectives in relapse interventions for drug addicts. Highlights: Time perspective is significantly correlated with relapse tendency. Past negative time perspective is positively associated with heroin addicts' relapse tendency, while future and balanced time perspectives are negatively associated with relapse tendency. Motivation for abstinence plays a partial mediating role in the relationship between heroin addicts' time perspective and relapse tendency. [ABSTRACT FROM AUTHOR]

Background Study: As flipped learning is a flexible pedagogical methodology to tailor students' needs and maximize the learning effects, this study integrated peer learning with MosoTeach‐supported flipped mode in an undergraduate blended EFL course. MosoTeach is a popular online learning platform in China with a variety of learning resources. Objectives: The study aimed to test the impact of MosoTeach flipped learning (MTFL) mode on undergraduate EFL students' perceived motivation, participation, feedback, and test performance. Methods: A quasi‐experimental design was carried out in Z university during the spring semester of 2020, with the experimental group (n = 34) adopting the MTFL model and a control group (n = 33) the non‐flipped mode. Results and Conclusions: The independent t‐test results showed that the experimental MTFL group outperformed the control group in post‐test scores, and a positive correlation was found in the relationship between the experimental MTFL group's post‐test scores and MosoTeach learning experience points (LEPs). Moreover, the course perception questionnaire survey indicated a higher level of students' perceived motivation, participation, and feedback in the experimental MTFL group, which corresponded to the results of the content analysis of students' responses to open‐ended questions and reflective reports. But students in both groups experienced challenges such as isolation, procrastination and technological anxiety. Lay Description: What is currently known about this topicFlipped language learning is mostly reported to be effective in improving EFL learning.Peer learning is mostly reported to be effective in improving EFL learning.MosoTeach was investigated in English learning contexts before, but without experimental design. What this paper addsMosoTeach proved as a valid online learning platform in flipped language learning, and the learning experience points (LEPs) on MosoTeach could predict students' exam performance.Students in the experimental group (MosoTeach‐supported flipped) had better exam performance and a higher level of motivation, participation and feedback.Students in both groups experienced isolation, procrastination and technological anxiety. Implications for practice:Peer discussion boards in MosoTeach provide learning support effectively for students in pre‐class learning.Group projects and peer assessment in MosoTeach integrate pre‐class peer discussion into in‐class interaction successfully.MosoTeach provides equal opportunity for every student in the large‐size Chinese English classes, thus contributing to the equity of in‐class peer interactions. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) reactivity in individual immunologic and nucleic acid tests (NAT) tests does not represent the true infectious status of the blood donor. This study discusses the use of confirmatory tests to determine when deferral of blood donors is appropriate. Methods: HBsAg or HBV NAT reactive samples were confirmed via a neutralisation test. All the HBsAg reactive but neutralisation test negative samples were subjected to further anti‐HBc testing. The receiver operating characteristic curve was used to obtain the best threshold value using signal‐to‐cut‐off ratios of two HBsAg enzyme‐linked immunosorbent assay reagents. Results: Of the 780 HBV reactive samples collected, there were 467 HBsAg reactive but HBV DNA negative samples, of which 65 (13.92%) and 402 (86.08%) were neutralisation test positive and negative, respectively. Of the 402, 91 samples (30% of tested samples) were anti‐HBc reactive. HBV DNA positive specimens negative by virus neutralisation were >80% HBcAg positive. A screening strategy was proposed for Chinese blood collection agencies. Conclusion: These findings suggest that adopting a screening algorithm for deferring HBV reactive blood donors based on HBsAg and NAT testing followed with HBsAg S/CO consideration and HBcAg testing can be both safe and feasible in China. [ABSTRACT FROM AUTHOR]

Introduction: Insulin degludec (degludec), an ultra-long-acting basal insulin analogue, provides equivalent glycemic control to other basal insulin analogues, with lower risk of hypoglycemia and flexible dosing. Chinese TREsiba AudiT (CN-TREAT) investigated outcomes with degludec in people with type 2 diabetes (T2D) in routine clinical practice in China. Methods: This was a retrospective chart review study in adults with T2D initiating or switching to degludec at 50 sites in China between January 2020 and July 2021. The primary endpoint was change in glycated hemoglobin (HbA1c) from baseline to end of study (EOS; week 20). Secondary endpoints included change from baseline to EOS in fasting plasma glucose (FPG), self-measured plasma glucose (SMPG), daily insulin dose, and rate of hypoglycemia. Results: Data from 936 participants were included (499 insulin-naïve; 437 insulin-experienced). Mean (95% confidence interval [CI]) HbA1c change from baseline to EOS was − 1.48%-points (− 1.57; − 1.38; P < 0.0001) overall: − 1.95%-points (− 2.08; − 1.81; P < 0.0001) in insulin-naïve participants and − 0.95%-points (− 1.08; − 0.82; P < 0.0001) in insulin-experienced participants. Mean (95% CI) changes in FPG and SMPG were − 2.27 mmol/L (− 2.69; − 1.85; P < 0.0001) and − 2.89 mmol/L (− 3.52; − 2.25; P < 0.0001), respectively, with similar reductions in insulin-naïve and insulin-experienced subgroups. Rate of hypoglycemia did not change statistically significantly from baseline to EOS overall, or in insulin-experienced participants, except when adjusted for baseline hypoglycemia. Basal insulin dose did not change statistically significantly in insulin-experienced participants. Conclusion: In routine clinical practice in China, initiation or switching to degludec was associated with improvements in glycemic control in people with T2D, with no increased risk of hypoglycemia. Trial Registration: ClinialTrials.gov, NCT04227431. [ABSTRACT FROM AUTHOR]

Background: There is great heterogeneity in the quality of care among hospitals in China, but studies on the performance measures and prognosis of patients with heart failure (HF) are still deficient. Hypothesis: Performance measures have been used as a guideline to clinicans, however, the association between them and outcomes among HF patients in China remains unclear. Methods: We analyzed 4497 patients with HF from the Heart Failure Registry of Patient Outcomes study. Performance measures were determined according to the guidelines, and the patients were divided into four groups based on a composite performance score. Multiple imputation and Cox proportional‐hazard regression models were used to assess the association between the performance measures and clinical outcomes. Results: Overall, only 12.5% of patients met the top 25% of the performance measures, whereas 33.5% of patients met the bottom 25% of the measures. A total of 992 (22.2%) patients died within 1 year, involving a larger proportion of patients who had met only the bottom 25% of the performance measures than had met the top 25% (27.0% vs. 16.3%, respectively). The patients who met the top 25% of the measures had a lower 1‐year mortality rate (adjusted hazard ratio: 0.78, 95% confidence interval: 0.61–0.98). Conclusions: The association between performance measures and mortality appeared to follow a dose–response pattern with a larger degree of compliance with performance measures being associated with a lower mortality rate in patients with HF. Accordingly, the quality of care for patients with HF in China needs to be further improved. [ABSTRACT FROM AUTHOR]

Salt marshes can export considerable nutrients and carbon to the ocean through submarine groundwater discharge (SGD). However, the complicated SGD processes in salt marshes remain poorly understood. Here, we first report the phenomenon of numerous highly saline artesian springs found in a salt marsh system of East China. Multiple methods including time‐series thermal monitoring, isotope signatures, and high‐resolution electrical resistivity tomography were combined to determine their origin and trajectory. Strong evidence suggests that these springs keep discharging even during high tide and represent a long‐term re‐distribution process of the ancient marine water trapped in the unconfined aquifer. This new pattern of spring‐derived groundwater flow indicates a hidden SGD pathway and has significant implications for studies concerning SGD‐derived fluxes in similar multi‐aquifer‐aquitard coastal systems. [ABSTRACT FROM AUTHOR]

Background: Studies on antiretroviral therapy (ART) in children living with HIV (CLHIV) are limited due to the small population and low accession rate of ART. Methods: All 0-14-year-old CLHIV admitted to the Ganzhou Center for Disease Control and Prevention from January 2006 to June 2023 were included retrospectively. The information of treatment regimens, disease progression, and laboratory tests of the patients under ART were used to explore the outcomes and impacts of long-term ART. The normality of all the data was tested by the Shapiro-Wilk test. Results: From 2006 to 2023, 18 CLHIV were reported in Ganzhou. Among them, 11 received ART and were followed up for 60.0 ± 48.4 months. After receiving ART, the median viral load of them decreased from 89,600 copies/ml to 22 copies/ml (P = 0.007), the median CD4+ T cell count increased from 380.7 cells/µL to 661.9 cells/µL (P = 0.028), and the median CD8+ T cell count decreased from 1065.8 cells/µL to 983.3 cells/µL (P = 0.584). The laboratory test results regarding liver function, renal function, blood cell count, and glucolipid metabolism tended to be within normal reference ranges, and the mean height-for-age z-score and weight-for-age z-score increased. However, all the three CLHIV who received cotrimoxazole developed pneumocystis carinii pneumonia, upper respiratory infection, skin lesions, bacterial pneumonia and/or thrush; the mean body-mass-index-for-age z-score decreased from 0.52 to -0.63. Conclusion: For CLHIV, ART could effectively inhibit the replication of HIV and improve the immune function of patients. More studies that focus on ART in CLHIV are urgently needed. [ABSTRACT FROM AUTHOR]

This study takes the tuff reservoir of the Huoshiling Formation in the Dehui Fault Depression, Songliao Basin, as an example to clarify the characteristics and primary controlling factors of tuff reservoirs. 3D seismic, core, image log, thin section, production dynamic and other data were used. Mineral x‐ray diffraction, core computerized tomography scanning, high‐pressure mercury injection, porosity, permeability, scanning electron microscopy, cathodoluminescence thin section, element testing and other experiments were conducted. The volcanic rocks in the study area are divided into andesite, volcanic breccia, lithic tuff and crystal tuff. The experiment results show that the mineral composition of tuff is primarily quartz, feldspar and clay minerals. The reservoir space comprises secondary pores and fractures, whereas primary pores are not developed. Average pore‐throat radius of most samples ranges from 0.017 to 0.131 μm, and the pore‐throat is primarily fine. The average porosity is 12.21% (a typical medium‐high porosity reservoir), and the average permeability is 0.072 mD (an extra‐low permeability reservoir). Tectonic fractures generated by tectonic movement are one of the reservoir spaces of tuff. Faults and tectonic fractures constitute a crucial migration channel of the fluid in the deep stratum. The tuff formed in the underwater environment, and the reservoir is affected by alteration. Devitrification is a crucial cause of medium‐high porosity and ultra‐low permeability in reservoirs. The alteration caused by hydrothermal fluid in deep fluids creates a considerable number of pores and fractures filled with clay minerals. Furthermore, acid fluid dissolves tuff along faults and fractures. In terms of time, the filling action is earlier than the dissolution action. The weathering indexes of CIA, CIW, PIA and WIP indicate that the tuff has suffered intense weathering, and the reservoir's physical properties have been improved to some extent. [ABSTRACT FROM AUTHOR]

The purpose of the paper was to analyze the influence of corn 'price-subsidy separation' policy on the stability of pork supply chain, so as to maintain the stability of pork supply market. Based on the panel data of 19 major corn producing provinces in China from 2012 to 2021, the impact of corn 'price-subsidy separation' policy on the stability of pork supply chain in China was tested by double difference method. The results show that, on the basis of controlling a series of other factors, with the increase of corn price, the implementation of corn 'price-subsidy separation' policy could positively improve the stability of pork supply chain in China, and the improvement effect was about 0.042. Further study showed that the policy of 'price-subsidy separation' of corn has obvious influence on the upstream stability of pork supply chain, and the upstream stability of pork supply chain had increased by 0.106 7% after the implementation of the policy. The study indicates that 'price-subsidy separation' policy of corn can promote the stability of pork supply chain in China, and the effect is stronger in the upstream of pork supply chain. [ABSTRACT FROM AUTHOR]

This study described the care status of People Living with HIV (PLWH) including antiretroviral therapy (ART) and viral suppression from 2018 to 2020. We recognized that immediate ART was associated with improved viral suppression. Therefore, we also aimed to explore the factors affecting the early initiation of ART. We initiated a retrospective cohort study to evaluate the care status of people living with HIV in Shandong Province. From 2018 to 2020, patients infected by homosexual transmission in particular had a higher ART rate (78.82%, 79.69%, and 87.72%, respectively). Of PLWH who received ART, 79.57%, 77.63%, and 67.71% achieved viral suppression, respectively. However, COVID-19 may affect the rate of ART and viral suppression, which we need to explore in our research. From 2018 to 2020, the proportion of immediate antiretroviral therapy within 30 days of diagnosis increased from 48.12% to 65.42%. Multivariate logistic regression demonstrated that patients with junior college degree or above (OR, 1.39 [95%CI, 1.12–1.73]) and key population or medical institutions (OR, 3.62 [95%CI, 2.18–6.16]; OR, 3.88 [95%CI, 2.33–6.59]) were substantially likely to receive ART immediately, while patients outside the province (OR, 0.60 [95%CI, 0.50–0.73]) were less likely to receive ART immediately. [ABSTRACT FROM AUTHOR]

Background: Recurrent dropout often occurs among participants receiving methadone maintenance treatment (MMT), which negatively affects treatment effectiveness. However, few researchers focused on this phenomenon including those in China. This study examined systematically factors associated with dropout based on recurrent events analysis among Chinese MMT participants. Methods: This retrospective study involved participants who firstly enrolled in MMT program between 2006 and 2017 of nine clinics in the Guangdong Province. The factors influencing recurrent dropout were identified using Prentice-Williams-Peterson model with total time (PWP-TT), then a comparison with Cox proportional hazards model was conducted. Results: Among a total of 1,319 participants, 1,922 treatment episodes were identified. There were 366 (27.7%) participants remained in MMT at one year follow-up. There was a progressive shortening of the treatment episode duration among participants with multiple treatment episodes. Protective factors included higher average age (50 years) before attending MMT, the higher last methadone dosage before each dropout (50ml) and higher average dosage (-60ml) in each episode, while being divorced, arrested in the past 3months, having contact with drug-using friends more than once per day, and being positive for the first morphine urine test were risk factors. Additionally, higher average dosage (60ml) had constant protective effects on subsequential treatment episodes. Conclusions: The risk of dropout increased as participants experienced multiple treatment episodes in MMT. The influencing factors for recurrent dropout were variable across all treatment episodes. Greater efforts are needed to provide sufficient methadone dosage for the participants to decrease dropout rate. [ABSTRACT FROM AUTHOR]

Background: There is a dearth of research or inconsistency in findings of behaviours among children with autism spectrum disorder (ASD) and children with intellectual disability (ID) as well as children who are typically developing (TD). This study compared 7 behavioural domains of 96 behaviours among Chinese children. Method: There were 803 children, including 426 children with low-functioning ASD (LFASD), 193 children with high-functioning ASD (HFASD), 128 children with ID, and 56 TD children. Ages ranged from 36 to 84 months. Each individual was administered the Chinese Autism Diagnostic Scale by a group of Chinese professionals. Results: All 7 domains were found to be more impaired for the children with ASD than the other groups. Three domains contained the most distinctive behaviours: Play behaviours, Social-Interactive behaviours, and Receptive Language behaviours. The Expressive Language domain was different for the LFASD group versus the group with ID. Conclusion: Children with ASD differed from children without ASD by several specific behaviours. These behaviours also differentiated performances by the children with HFASD and LFASD.

Two experiments investigated Chinese deaf and hard of hearing (DHH) adolescents' recognition of category names in an innovative task of semantic categorization. In each trial, the category-name target appeared briefly at the screen center followed by two words or two pictures for two basic-level exemplars of high or middle typicality, which appeared briefly approximately where the target had appeared. Participants' reaction times when they were deciding whether the target referred to living or nonliving things consistently revealed the typicality effect for the word, but a reversed-typicality effect for picture-presented exemplars. It was found that in automatically processing a category name, DHH adolescents with natural sign language as their first language evidently activate two sets of exemplar representations: those for middle-typicality exemplars, which they develop in interactions with the physical world and in sign language uses; and those in written-language learning

As industrialisation and urbanisation aggressively take hold in China, all possible labour pools are being tapped to meet the market demands. Liushou women, or women who stay behind in rural areas as their spouses join the massive migrant workforce, are one such labour pool. Vocational training has been adopted by the Chinese state as a development strategy for Liushou women. Against this background, this paper explores how the current vocational training policies and programmes have promoted gender equity for Liushou women. Specifically, it conducts an extensive literature and policy review using a mix of analytical tools: women's empowerment framework and the social relations approach. Not only does it map the changing social relations within which vocational training for the women is embedded, it also addresses women's equity in the areas of welfare, access, conscientisation, participation and control.

Background: Nursing work is a work with high-stress load, and nurses with different personality may have different subjective feelings about their workload. Therefore, it is particularly necessary to comprehend the perceived professional benefits of nurses engaged in nursing work under high-pressure background, especially during the epidemic period. This study explored the relationship between mental workload, personality, and perceived professional benefits of nurses, and offer advices for the intervention of nurses with different personality to improve their perceived professional benefits. Materials and methods: In this study, we used a cross-sectional study with a convenient sampling. 473 in-service nurses in Class A tertiary hospitals of Zhejiang Province were recruited by using the NASA Mission Load Index scale of nurses, the brief version of China's Big Five Personality Questionnaire, and the Nurses' perceived professional benefits questionnaire from July 2020 to March 2021. Sample size is 54.91%, and the response rate is 100%. Cronbach's alpha method was used to evaluate the reliability of the instruments. Descriptive statistical analysis was used to describe the socio-demographic data of the subject, and scores for research variables. The Mann-Whitney U-test, and Kruskal-Wallis H rank-sum test were used to compare the scores of perceived professional benefits with different demographic characteristics. Correlation analysis results were presented as the Spearman correlation coefficient. The plug-in v2.16.3 provided by SPSS software was used for linear regression analysis, and the deviation-corrected percentile Bootstrap method was used to examine the mediating role of personality (neuroticism, conscientiousness, agreeableness, openness and extroversion). Results: Age, length of service in nursing, and record of formal schooling can affect nurses' perceived professional benefits. Mental workload, and perceived professional benefits were all above the median value. The mental workload was negatively correlated with perceived professional benefits (r= -0.129, P < 0.01), positively correlated with neuroticism (r = 0.242, P < 0.01), negatively correlated with agreeableness, openness, extroversion (r=-0.229~-0.221, P < 0.01), and negatively correlated with conscientiousness, but the differences were not significant. Nurses' perceived professional benefits were negatively correlated neuroticism (r=-0.109, P < 0.05), but positively associated with conscientiousness, agreeableness, openness, and extroversion (r = 0.098 ~ 0.326, P < 0.05). The mental workload can directly affect the perceived professional benefits in the direct effects, and can also affect the it through the mediating effect of agreeableness, extroversion, neuroticism, and openness. Conclusions: Age, length of service in nursing, and record of formal schooling could affect nurses' perceived professional benefits, and personality played a partial mediating role in the influence of mental workload on the perceived professional benefits. The results of this study can provide strategies for nurses' human resource management. According to different demographic factors, and personality, various measures should be taken to guide nurses to evaluate the mental workload correctly, reduce their emotional pressure, increase job resources, and improve their perceived professional benefits. [ABSTRACT FROM AUTHOR]

Background: Dietary management has been recommended as the cornerstone of type 2 diabetes mellitus (T2DM) management. However, low adherence to dietary recommendations has been identified in both developed and developing countries. Previous research suggests that inhibitory control influences eating behavior, but few studies have been conducted in patients with T2DM. Thus, we aimed to explore the relationship between inhibitory control and dietary adherence among patients with T2DM. Methods: A total of 393 patients with T2DM from the endocrinology departments of three tertiary hospitals in China were enrolled by the convenience sampling method. Dietary adherence was measured by the Dietary Behavior Adherence Scale for Patients with Type 2 Diabetes Mellitus. Additionally, inhibitory control was subjectively measured by the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) and objectively assessed by the stop signal task (SST) and the Stroop task. The relationship between inhibitory control and dietary adherence was analyzed using Pearson correlation analysis and hierarchical regression analysis. Results: Subjectively measured inhibitory control had a significant predictive effect for dietary adherence after controlling for demographic and clinical variables. Adding the inhibitory control variable to the regression equation resulted in the following values: overall model F (19, 373) = 7.096, p < 0.001, increase in R2 value by 0.069, change in F (1, 373) = 35.219, p < 0.001. Similarly, the performance of the Stroop task had a significant predictive effect for dietary adherence to some foods, i.e., carbohydrate and fat. Adding the Stroop effect variable to the regression equation resulted in the following values: overall model F (19, 81) = 2.848, p = 0.005, increase in R2 value by 0.060, change in F (1, 81) = 8.137, p = 0.006. Conclusions: Inhibitory control was a predictor of dietary adherence in patients with T2DM. Future interventions should investigate whether inhibitory control training results in the improvement of dietary adherence in patients with T2DM. [ABSTRACT FROM AUTHOR]

Background: There were no data about prevention and control status of RR-TB in a poor area with high burden of TB in China. In order to develop evidence-based RR-TB response strategies and improve enrollment of RR-TB patients in Yunnan province, China, this study was aimed at analyzing the changing trends in the detection and enrollment of RR-TB patients and examining the factors that may have implication on enrollment in treatment. Methods: Data, which includes demographics, screening and testing, and treatment enrollment, was collected from the TB Management Information System. Retrospective data analysis and factors analysis were applied. Descriptive statistics, Chi-square test, Rank sum test and logistic regression analysis were used. Results: From 2016 and 2018, the province had been challenged by low levels of screening, detection and enrollment of RR-TB. During the period between 2019 and 2020, a comprehensive model of RR-TB prevention and control was established in Yunnan, characterized by a robust patient-centered approach for RR-TB care and multiple, targeted interventions through the cascade of care from detection to treatment. In 2020, 93.8% of the bacteriologically positive TB patients were screened for RR-TB, which had been significantly increased by 146.9% from 38.0% in 2016. The interval from initial consultation at RR-TB facility to diagnosis (inter-quartile range) was reduced from 29.5 (1–118) days in 2016 to 0 (0–7) days in 2020. Despite the increasing rates of enrollment of RR-TB patients over the years, non-enrollment of those detected was still high (32.3%) in 2020. The main reasons for non-enrollment identified were refusal of treatment due to financial difficulties, loss to follow-up or death before starting treatment. Multivariate analysis showed that the elderly patients aged 65 or above (OR = 2.7, CI: 1.997–3.614), new patients (OR = 0.7, CI: 0.607–0.867), conventional DST used for confirmatory diagnosis of RR-TB (OR = 1.9, CI: 1.620–2.344) and diagnosis of RR-TB being conducted by the RR-TB care facilities at the prefecture and municipal level (OR = 4.4, CI: 3.608–5.250) have implications on RR-TB non-enrollment. Conclusions: As a comprehensive RR-TB model was implemented in Yunnan with scaled up use of molecular test for rapid detection of RR-TB, initial screening of RR-TB were decentralized to the county- and district-level to strengthen rapid, early detection of RR-TB, achieving a higher coverage of screening in the end. However, there remains a major gap in enrollment of RR-TB. The main barriers include: limited knowledge and awareness of RR-TB and financial burdens among patients, delayed diagnosis, loss to follow-up, difficulties in self care and travel for elderly patients, and limited capacity of clinical management at the lower-level RR-TB care facilities. The situation of the RR-TB epidemic in Yunnan could be improved and contained as soon as possible by continuous strengthening of the comprehensive, patient-centered model with targeted interventions coordinated through multi-sectoral engagement to improve enrollment of RR-TB patients. [ABSTRACT FROM AUTHOR]

Healthcare as a kind of service is closely related to human health, but its uneven distribution among regions could affect the equity of residents' access to the service and lead to the unbalanced development of healthcare levels. Therefore, this article establishes an integrated model by means of the stochastic frontier analysis method to evaluate regional healthcare efficiency and analyse its influencing factors. Specifically, the distribution and change trend of healthcare technical output (TO) efficiency and health output (HO) efficiency are investigated from the temporal and spatial perspectives, and then the influencing factors of the two types of healthcare efficiency are explored, respectively. Taking China as a case study, the results show that there are obvious regional differences in TO efficiency as a whole, where the values of the eastern and central regions are significantly higher, while the western and northeast regions have lower TO efficiency. Economic, social, and regional factors have a significant influence on both TO efficiency and HO efficiency, among which the impacts of population density on the two types of efficiency are opposite. Accordingly, some policy recommendations have been put forward for improving regional healthcare efficiency. [ABSTRACT FROM AUTHOR]

Two new compounds, aphegiractin A1/A2 (1a/1b), and seven known compounds were isolated by phytochemical work on EtOAc-soluble ingredients extracted from stem and root barks of Daphne giraldii. Their structures were established based on extensive spectroscopic methods, including HRESIMS, CD experiments, 1D and 2D NMR. All compounds were evaluated for their antioxidant activity to DPPH, ABTS radical scavenging activity and inhibitory activity on tyrosinase. Of these compounds, compound 3 exhibited significant antioxidant activities. [ABSTRACT FROM AUTHOR]

As global industrialization and its associated anthropogenic activities rapidly increase, so too does the areal extent of human-altered soils. The soil classification framework must incorporate the classification schemes of these disturbed soils in order to remediate land. Soil Taxonomy (ST) and the World Reference Base for Soil Resources (WRB) are the most widely used soil classification systems in the world. In this study, 15 typical anthropogenic soil profiles with engineering and technical characteristics from China were selected for a classification study. The aim of this study was to clarify the classifications of these soil profiles in the ST, WRB, Chinese Soil Taxonomy (CST), and Geogenetic Soil Classification of China (GSCC), and make references accordingly. The results showed that the WRB can classify these soils as Technosols in the first level. ST can classify most of these soils as subgroups within the different great groups under Entisols, as well as the Human-Altered and Human-Transported Material classes within the soil family differentiae. For Chinese soil classification schemes, there is a large loophole in the CST regarding the classification of anthropogenic soils. Many anthropogenic soils cannot reflect these soils' artificial and technical naming characteristics. For the CST, revised proposals based on the WRB and ST were proposed. Based on the artificial disturbance of soil layers, a manufactured layer was added to the diagnostic basis. The Artificalic Anthrosols suborder was added, and it can be divided into the Transporti-Artificalic Anthrosols and Alteri-Artificalic Anthrosols groups. The subgroups were defined by their levels of contamination, imperviousness, and artifact content. The "T" layer symbol was added to soil profile descriptions to reflect a specific layer about technology, such as A, E, B, and C, to reflect the main genetic horizons. This revised classification system is proposed for inclusion in the revised CST to account for the very large and expanding extent of disturbed soils in China and to remain current with other global soil taxonomy systems. [ABSTRACT FROM AUTHOR]

While air quality in China has improved significantly in recent years, the population is becoming increasingly vulnerable to air pollution due to the aging population. In this study, we assessed premature deaths attributable to long- and short-term exposures to PM2.5 and O3, as well as their driving forces in Shandong from 2014 to 2060 based on county-level near-real-time air pollutant concentration datasets and projected concentrations of PM2.5 and O3. We found that the concentrations of PM2.5 and O3 in most districts and counties from Shandong are still higher than the corresponding concentration limit of Grade II. Premature mortality caused by long- and short-term exposures to PM2.5 decreased by 13,045 and 8092 in 2020 compared with those in 2014, respectively. Furthermore, premature mortality attributable to short-term exposure to O3 was 36.08% higher than that due to short-term exposure to PM2.5 in 2020. The results of the driving force analysis indicate that the health benefits brought about by the improvement in air quality have been offset by the changes in population age structure. In the future, the increase in O3 concentration and population aging are the top two driving forces having adverse effects on the health burden. This study provides support for controlling the health risks of PM2.5 and O3 pollution, especially for the development of dual-pollutant concentration targets and synergistic control strategies. [ABSTRACT FROM AUTHOR]

Both public administration researchers and practitioners have realized that citizens' satisfaction with and acceptance of urban renewal compensation policy are critical for the local authorities to initiate urban renewal projects. However, little is known about the possible effects of social influence from citizens' peers and referents on their satisfaction and acceptance. This research proposes a theoretical model that hypothesizes the relationships among citizens' expectation confirmation, satisfaction and acceptance and introduces perceived distributive justice and subjective norms as representations of social influence. Two rounds of questionnaire surveys with a one-month time lag were conducted to collect data for testing the proposed model. Survey data from 314 citizens involved in different urban renewal compensation modes in China show that citizens' expectation confirmation positively influences citizen satisfaction, which in turn determines the final public acceptance of the policy. The results also highlight the critical roles that perceived distributive justice and subjective norms play in different compensation modes. These findings provide researchers and administrators with theoretical and practical implications. [ABSTRACT FROM AUTHOR]

This article presents a theory of the order of power to explain the dynamics and interaction between the political and legal orders in China's courts. This theory posits that the political order is embodied in the extensive administrative ranking system (ARS) of the People's Republic of China and has a systematic impact on the legal order regardless of the subject matter. The ARS is a system that regulates power relations between various institutional and personal actors in all key power fields, including courts. According to this theory, power, as stratified by the ARS, relativizes law during the processes of legal implementation, application, and enforcement. This theory provides a coherent explanation of judicial behavioural patterns in different subject matters, such as the centralization of criminal investigations in some crimes but not others, the distribution of corruption in China's courts, and the outcome patterns of administrative litigation. Whilst the conventional wisdom sees that the political and the legal orders in China's courts are partitioned based on the subject matter, this theory asserts the opposite: the impact of the political order is systemic, comprehensive, and applicable to the entire legal field. This article fills a knowledge gap in Chinese law and politics, where the ARS has received little attention except for recent studies on administrative litigation. The article also identifies two overlooked but distinctive features of the ARS—its multidimensionality and interconnectivity—our understanding of which is disproportionately poor in relation to their significance. [ABSTRACT FROM AUTHOR]

Background: In recognizing the need for a reliable and valid instrument to assess psychological distress among children and adolescents, the present study translated the newly developed Depression Anxiety Stress Scale for Youth (DASS-Y) into Chinese, while also comparing its psychometric properties with those of the well-established DASS-21 within a primary and middle school demographic. Methods: Utilizing a combination of convenience sampling and purposive sampling, a cohort comprising 1,507 primary and 1,131 middle school students was recruited. Rasch analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used in the data analysis. Results: Significant differences were observed between the DASS-Y and the DASS-21, notably within the anxiety subscale. The proportions of individuals with clinical mood disorders identified by the two scales demonstrated a significant disparity. Both scales, following an adjustment of responses, exhibited satisfactory internal consistency and convergent validity, with the acceptance of a three-factor structure. Furthermore, the DASS-Y showed superior discriminant validity relative to the DASS-21, providing more compelling evidence regarding concurrent validity. Conclusion: Overall, the Chinese version of the DASS-Y demonstrated superior robustness to the DASS-21 in terms of psychometric properties. The findings provide initial evidence for the psychometric properties of the DASS-Y from another culture. [ABSTRACT FROM AUTHOR]

Background: Previous studies have examined symptom clusters in children with acute leukemia, yet a knowledge gap persists regarding central symptom clusters and their influencing factors. By identifying these central clusters and associated factors, healthcare providers can enhance their understanding and effective management of symptoms. Our study seeks to address this gap by identifying symptom clusters, exploring central clusters, and investigating the demographic and health-related factors associated with these clusters in children with acute leukemia undergoing chemotherapy. Methods: A total of 586 children with acute leukemia from January 2021 to April 2023 were recruited from China. They were investigated using Memorial Symptom Assessment Scale 10-18 during chemotherapy. The principal component analysis was used to identify the symptom clusters. An association network was conducted to describe the relationships among symptoms and clusters. A multiple linear model was used to investigate the associated factors for the severity of overall symptoms and each symptom cluster. Results: Five clusters were identified, including oral and skin cluster, somatic cluster, self-image disorder cluster, gastrointestinal cluster and psychological cluster. Gastrointestinal cluster was the most central symptom cluster. Age, sex, clinical classification, number of having chemotherapy and education degree and marital status of the primary caregiver are associated with the severity of these five symptom clusters. Conclusion: Our study highlights the importance of evaluating symptom clusters in children with acute leukemia during chemotherapy. Specifically, addressing gastrointestinal symptoms is crucial for effective symptom management and overall care. [ABSTRACT FROM AUTHOR]

Because of the presence of shallow water tables and consequent secondary salinization in irrigated areas of Xinjiang China, there is an urgent need for installation of drainage systems to control the salinity levels in the crop rootzone. The goal of this study was to compare the midterm effects of the open ditch (depth of 2.2 m) and subsurface pipe (depth of 2.2 m) drainages on soil salinity, drainage, groundwater, cotton biomass, yield, and economic benefits while using drip irrigation under mulch (plastic film). We conducted a field experiment for eight consecutive years (2012–2019) in Shawan County of Xinjiang, China. Our experimental results indicated that open ditch and subsurface pipe drainages each reduced total soil salinity, improved saline–sodic soils, and controlled groundwater level, which caused a significant increase in the cotton biomass and yield. The open ditch drainage treatment (ODDA) represented a better desalination effect than the subsurface pipe drainage treatment (SPDA) at 73% and 81%, respectively. The electrical conductivity and pH of ODDA and SPDA water samples decreased as the soil salinities decreased over time. We used the farmland conditions from 2012 as the baseline for our experiment and evaluated how these baseline conditions changed over time in response to these treatments. Compared to this baseline, the cotton yield of ODDA and SPDA treated farmland increased by 18.30 times and 19.96 times in 2019, respectively. The investment payback periods for ODDA and SPDA treatments were 7.59 and 6.34 years, respectively, and their returns on investment were 12% and 30%, respectively. The midterm economic benefits of subsurface pipe drainage were more prominent than those of open ditch drainage. These results provide a reference for improving, developing, and utilizing soil saline–sodic land, and the sustainable development of agriculture in arid areas. [ABSTRACT FROM AUTHOR]

Background: With the expansion of professional degree graduate students' enrollment in China education, the mental health of these professional degree graduate students in medical-related majors who are under pressure of study, scientific research, clinical practice, and employment should not be ignored. What is the mental health level of these graduate students under the effect of learning career adaptation (internal resources) in the face of daily stress (external factors)? The purpose of this study is to discuss the relationship between these variables, and the mediating role of learning career adaptation of professional degree graduate students in traditional Chinese medicine colleges, and universities, to provide a theoretical basis for improving the learning career adaptation of students, and improving the level of mental health. Methods: A cross-sectional survey was conducted among 1593 professional degree graduate students majoring in clinical medicine, traditional Chinese medicine, and nursing in five traditional Chinese medicine universities. Finally, 660 questionnaires were returned, with a recovery rate of 41.43%. The scores of daily stress, learning career adaptation, and mental health were measured by Daily Stressors Scale for graduate students, graduate-students learning career adaptation scale, and General Mental Health Questionnaire (GHQ-20). Descriptive statistics were used to analyze the status quo of daily stress, learning career adaptation, and mental health. Pearson correlation analysis were used to analyze the relationship between them. we undertake analyses using structural equation modeling to construct the latent variable path model of daily stress, learning career adaptation on mental health. The significance level of the mediating effect was tested by the non-parametric percentile bootstrap method. Results: The scores of mental health, daily stress, and learning career adaptation were 50.56 ± 10.80, 35.12 ± 19.55, and 67.13 ± 7.48 respectively. Daily stress was negatively correlated with the three dimensions of learning career adaptation: career confidence, focus on his career, and career control (P < 0.01). Daily stress was positively correlated with depression and anxiety (P < 0.01). Self-affirmation, depression, and anxiety were negatively correlated with career confidence, focus on his career, and career control (P < 0.05). Learning career adaptation plays a partial mediating role between daily stress, and mental health (p < 0.001), with an intermediate effect value of 0.127, representing 28.54% of the total effect. Conclusions: Mental health, learning career adaption of medical-related professional degree graduate students in traditional Chinese medical universities were at a moderate degree, and an upper-middle level respectively, while daily stress is to a lesser extent. Learning career adaptation mediates the relationship between daily stress, and mental health partially. To some extent, it can buffer the impact of daily stress on mental health, especially anxiety. The educational administrator could take various measures to improve the mental health of professional degree graduate students. It can also enhance their learning career adaptation from the perspective of individuals, and organizations to improve their mental health. [ABSTRACT FROM AUTHOR]

Introduction: The current study aims to investigate the etiology spectrum and the clinical characteristics of bronchiectasis in Chinese children. Methods: The study is designed as a multicenter retrospective study. 193 cases were enrolled in 13 centers in China between 2008 and 2017. The inclusive cases must meet the clinical as well as the HRCT criteria. Only if both two radiologists confirmed the diagnosis, the case could be enrolled. The cases that could not provide clinical and imageology data were excluded. The data were entered into the specialized system and then analyzed. Results: One hundred sixty‐nine cases (87%) were found to have the underlying etiology. Post‐infective (46%), primary immunodeficiency (14%), and PCD (13%) were the common causes. All cases came from 28 provinces in Mainland China. The median age of symptom onset was 5.8 (2.0, 8.9) years. The median age of diagnosis was 8.4 (4.5, 11.6) years. The main symptoms were cough, sputum expectoration, and fever during the exacerbation. Nineteen percent of patients suffered from limited exercise tolerance. Clubbing was found in 17% of cases. Nearly 30% of patients presented growth limitations. On the HRCT findings, 126 cases had diffused bronchiectasis, and bilateral involvement was found in 94 cases. The lower lobes and right middle lobes were most commonly involved. Approximately 30% of cultures of sputum and bronchoalveolar lavage were positive. Conclusion: A majority of cases could be found the underlying etiology. Post‐infective, primary immunodeficiency, and PCD were the most common causes. Some clinical figures might indicate a specific etiology. [ABSTRACT FROM AUTHOR]