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Purpose: Private supplementary tutoring has been increasingly used by parents as part of wider strategies to assist their children's education careers in China. With a theoretical lens of parentocracy, this article aimed to investigate the influential parental factors underlying the demand for private tutoring, focusing on parents' socioeconomic resources and attitudes toward education. Design/Approach/Methods: This article drew upon data from the 2014 iteration of the China Family Panel Studies. Structural equation modeling (SEM) analysis was employed to explore the influences of parental factors. Findings: The SEM analysis confirmed that parental income, education, and aspirations on children's education had both direct and indirect positive effects through the mediating factor of role construction on demand for tutoring. A multiple-group analysis was further conducted, and the difference in the patterns for urban and rural parents was explored. Parental occupation had no impact on demand for tutoring for rural parents but had both direct and indirect effects for urban parents. Both direct and indirect effects of household income on demand for tutoring were greater for urban parents than for rural parents. Originality/Value: This article examined the direct and indirect influences of parental factors on demand for private tutoring and explored the differences in patterns for urban and rural parents in a quantitative way. Findings have implications for education inequality.

Growing literatures highlight global shifts in education brought by spreading neoliberal values and marketisation. Parallel literatures address parenting styles. Parents, these literatures observe, are increasingly made responsible and/or voluntarily take responsibility for educational inputs alongside mainstream schooling. Much parental investment is in the so-called shadow education sector of private supplementary tutoring. Examining Chinese patterns, this paper notes longstanding high enrolment rates in both academic and non-academic supplementary education prior to government restrictions that brought a sharp marketplace jolt. The paper then employs parental interview data to show the rationales for such investment despite efforts by the Chinese authorities to retain schooling as a fully-sufficient form of education. The strengthened government policy altered the picture, but it seems likely that in the competitive society many parents will still secure supplementary support to manage what they feel to be a precarious environment.

The present paper focuses on the regulations on private supplementary tutoring, which in China is widely called "Xiaowai Peixun." Although much previous international literature has mostly focused on tutoring in academic subjects, tutoring in non-academic ones such as piano and painting has become popular in China and is also seen as educational investment by families. To fit this context, the present paper adopts a definition of private tutoring covering tutoring in both academic and non-academic subjects. The present paper first elaborates on the development of private tutoring in China and why it should be regulated. And then it depicts a general picture about how governments have regulated private tutoring institutions and identifies the elements in regulatory framework. At last, it discusses the possible negative results and proposes two suggestions to complement regulations.

There are limited studies investigating the association between short-term exposure to PM2.5 and incident cardiovascular disease (CVD) cases in China. This study aims to examine the short-term effects of PM2.5 on the incidence of cardiovascular diseases. A combination of Poisson-distribution generalized linear model and distributed lag non-linear model was used to examine the association between short-term exposure to PM2.5 and incident cases of CVD. The results revealed that per 10 µg/m3 increment of PM2.5 would increase the incident CVD cases by 0.147% (Relative Risk: 1.00147, 95% Confidence Interval: 1.00008–1.00286) at a lag of 2 days. The stratified analyses showed higher effects risk in females, older residents (aged 60–75 years), and acute myocardial infarction group (p-value for difference <0.05). This study indicates that short-term exposure to PM2.5 may increase the risk of CVD and highlights the necessity for a higher air quality standard in Yantai, China. [ABSTRACT FROM AUTHOR]

Few studies have investigated the association between PM2.5 and hypertension among floating populations. We therefore examined the relationship using binary logistic regression. Each grade of increment in the annual average PM2.5 (grade one: ≤15 µg/m3; grade two: 15–25 µg/m3; grade three: 25–35 µg/m3 [Excluding 25]; grade four: ≥35 µg/m3) was associated with an increased risk of hypertension (odds ratio [OR] = 1.081, 95% confidence interval (CI): 1.034–1.129). Among the female floating population (OR = 1.114, 95% CI: 1.030–1.204), those with education level of primary school and below (OR = 1.140, 95% CI: 1.058–1.229), construction workers (OR = 1.228, 95% CI: 1.058–1.426), and those living in the eastern region of China (OR = 1.241, 95% CI: 1.145–1.346) were more vulnerable to PM2.5. These results indicate that PM2.5 is positively associated with hypertension in floating populations. Floating populations who are female, less educated, construction workers, and living in the eastern region of China are more vulnerable to the adverse impacts of PM2.5. [ABSTRACT FROM AUTHOR]

Background: Ischemic stroke is a major cause of disability and death worldwide. A narrow therapeutic window profoundly constrained the utilization of alteplase. Objectives: To investigate therapeutic effects and safety of intravenous recombinant human prourokinase (rhPro-UK) in patients with acute ischemic stroke (AIS) in the 4.5–6 h therapeutic time windows. Methods: We conducted a phase IIa, randomized, and open-label multicenter clinical trial. Between 4.5 and 6 h after the onset of AIS, patients were randomly administrated to receive intravenous rhPro-UK at a 50 mg or 35 mg dose. The primary endpoint was excellent functional outcome defined as modified Rankin scale (mRS) score of 1 or less at 90 days. The secondary outcome was the treatment response, which was based on an at least 4-point improvement from baseline National Institutes of Health stroke scale (NIHSS) score at 24 h after drug administration. Safety endpoints included death, symptomatic intracerebral hemorrhage (sICH), and other serious adverse events. Results: We enrolled 80 patients in the 4.5–6 h therapeutic time windows at 17 medical centers in China from December 2016 to November 2017. A total of 39 patients were treated with 50 mg rhPro-UK, and 39 were treated with 35 mg rhPro-UK. Compared with the baseline, the NIHSS score at 24 h and days 7, 14, 30, and 90 was decreased significantly among patients treated with either rhPro-UK 50 mg or 35 mg. The mean reduction in the NIHSS from baseline to 90 days after the onset was 3.56 and 5.79 in the rhPro-UK 50 mg group and the rhPro-UK 35 mg group, respectively. The rates of functional independence at 90 days of rhPro-UK 50 mg and 35 mg were 61.54% and 69.23%, respectively (P = 0.475), and the proportion of patients with functional response to treatment at 24 h were 28.21% and 33.33% (P = 0.624). No sICH occurred in the two groups, and death occurred in only one patient in the rhPro-UK 50 mg group. There was no significant difference in mortality at 90 days and the rate of other serious adverse events between two groups. Conclusion: In the 4.5–6 h time window, more than 60% of patients at either dose of rhPro-UK (50 mg or 35 mg) achieved functional independence at 90 days without increased mortality and sICH risk. Thus, intravenous rhPro-UK was effective and safe for patients with AIS within 4.5–6 h after stroke onset. While no significant differences were identified between different dosages of rhPro-UK regarding clinical outcomes, it is a logical step to further test the safety and efficacy of the low dose of rhPro-UK in a well-powered phase III study. Trial Registration: http://www.chictr.org.cn. Identifier: ChiCTR1800016519. Date of registration: 6 June 2018. [ABSTRACT FROM AUTHOR]

Private tutoring has expanded and intensified in China. However, no government statistical data or other empirical studies fully capture its extent and characteristics. This paper analyses private tutoring received by students in Grades 1-12 as indicated by a nationwide representative survey entitled China Family Panel Studies. The paper employs a Hurdle model to examine determinants of demand for tutoring, focusing on factors related to students and their parents. The first step is concerned with the decision to receive tutoring or not; and the second step explores factors influencing expenditures on tutoring among those who decide to receive it.

Purple soil is a type of global soil that is referred to by various names in different countries, which makes it difficult to understand, utilize, and ameliorate purple soil internationally. Soil Taxonomy (ST) and the World Reference Base for Soil Resources (WRB) are the most widely used soil classification systems in the world. The aim of this study was to clarify the classification of purple soil in ST and the WRB and to establish a reference between different classification systems of purple soil. Therefore, based on the current principles and methods of the ST and WRB systems, 18 typical purple soil profiles in the eastern Sichuan Basin were identified, retrieved, and classified. Then, the soil units of the WRB were compared with those of ST and the Chinese Soil Taxonomy (CST). The results revealed that the 18 typical purple soil profiles could be classified into three soil orders, four soil group orders, and seven soil subgroups in ST and four reference soil groups (RSGs) in the WRB; each profile had its own unique principal and supplementary qualifier combinations within the soil units. It was found that when compared with the ST system, the WRB and CST systems had stronger abilities to distinguish purple soil. In addition, the WRB system was able to more comprehensively consider soil characteristics such as soil layer thickness, ferric horizon, soil color, texture mutations, and carbonate through qualifiers. However, the CST system added diagnostic characteristics, such as the lithologic characteristics of purplish sandstones and shales and the ferric properties and alic properties at the soil group and subgroup levels, which enhanced the differentiation ability of the purple soil at the subgroup level. [ABSTRACT FROM AUTHOR]

'Deleveraging' is an important objective of China's economic macro-control. Tax cuts are an important measure to promote enterprises' deleveraging and reduce operating costs and financial risks. This study employs the 2018 value-added tax (VAT) rate reduction by the Chinese government in a quasi-natural experiment with financial data from listed companies from 2016 to 2019 as research samples, applying the difference-in-differences (DID) model to analyse the policy's deleveraging effect. The results show that the VAT rate reduction significantly reduced the leverage and current debt ratios of enterprises in the treatment group but had no significant effect on long-term debt ratio. Further investigation shows that the VAT rate reduction's deleveraging effect was more significant for state-owned, highly leveraged companies, small and medium-sized enterprises and companies in eastern China. In western China, the total leverage ratio of enterprises experienced no significant change, current debt ratio increased, long-term debt ratio decreased and financial risks and financing constraints further intensified. This study's conclusions have significance as a reference for China and other developing countries to improve tax reduction policies, stimulate enterprise vitality, reduce enterprise financial risks and effectively navigate the economic recession. [ABSTRACT FROM AUTHOR]

Limited studies examined the interaction effects between exposure to ambient PM2.5 and economic development on the settlement intention of floating population. We used binary logistic model to examine the association of PM2.5, per capita GDP (PGDP), PM2.5 × PGDP on the settlement intention. Additive interaction term of PM2.5 and PGDP level was used to investigate their interactive effects. Overall, each one grade increment in annual average PM2.5 was associated with decreased probability of settlement intention (OR = 0.847, 95%CI: 0.811–0.885). The interaction effect between PM2.5 and PGDP on settlement intention was significant (OR = 1.168, 95%CI: 1.142–1.194). The stratified analysis showed PM2.5 exhibits lower settlement intention in the aged 55 years or above, engaged in low-skilled works, and living in the western China. This study indicates that PM2.5-exposed will decrease the settlement intention of floating population. High economic development level can weaken the relationship between PM2.5 and settlement intention. Policymakers should balance the socio-economic development and environmental health and focus on vulnerable population. [ABSTRACT FROM AUTHOR]

There are limited studies investigating the relationship between exposure to PM2.5 and the health status among the mobile population. A cross-sectional analysis was performed in a nationally representative sample (2017 China Migrants Dynamic Survey data) consisting of 169,469 mobile population. The ordered logistic regression model was used to examine the association between PM2.5 and the health status in mobile population. Stratified analyses were performed to identify whether the association varied across gender, age group, and regions in China. Overall, every 10 μg/m3 increment in annual average PM2.5 was associated with increased risk of poor self-reported health (OR = 1.021, 95% CI: 1.012–1.030). Mobile population aged 31–49 years and living in the central region suffers the highest PM2.5-associated health risk (OR = 1.030, 95% CI: 1.019–1.042; OR = 1.095, 95% CI: 1.075–1.116). Our study suggests that PM2.5 exposure was associated with an increased risk of poor self-reported health in mobile population, particularly among the population aged 31–49 years and people living in the central region of China. Policymakers should pay more attention to the vulnerable mobile population to tackle the health burden of ambient air pollution. [ABSTRACT FROM AUTHOR]

There are limited studies examining the association between PM2.5 exposure and incident cerebrovascular disease (CD) cases in China. In this study, daily counts of incident CD cases and daily PM2.5 concentrations were obtained in Yantai, Shandong Province, China from 2014 to 2019. We used a combination of the Poisson-distribution generalized linear model (GLM) and a distributed lag nonlinear model (DLNM) to examine the association of short-term exposure to ambient PM2.5 and incident cases of CD. The results revealed that for every 10 μg/m3 increment of PM2.5 would increase the incident CD cases by 0.216% (RR:1.00216, 95%CI:1.0016–1.0028) at lag4. The stratified analysis demonstrated that the females and residents aged 65 years or above presented higher short-term PM2.5-associated CD risks than the males and aged below 65 years. Targeted prevention strategies should be adopted to reduce the PM2.5-related CD burden, especially for the susceptible population in China. [ABSTRACT FROM AUTHOR]

As the prevalence of Staphylococcus aureus infections is of worldwide concern, phenotype and genotype in prevalent MRSA strains require longitudinal investigation. In this study, the antibiotic resistance, virulence gene acquisition, and molecular type were determined on a large scale of nosocomial S. aureus strains in Southern China during 2009–2015. Bacterial identification and antimicrobial susceptibility to 10 antibiotics were tested by Vitek-2. Virulence genes encoding staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE), exfoliative toxins (ETA and ETB), Panton–Valentine leukocidin (PVL), and toxic shock syndrome toxin (TSST) were detected by PCR, with SCCmec typing also conducted by multiplex PCR strategy. Genotypes were discriminated by MLST and spaA typing. MLST was performed by amplification of the internal region of seven housekeeping genes. PCR amplification targeting the spa gene was performed for spa typing. No resistance to vancomycin, linezolid, or quinupristin and increase in the resistance to trimethoprim/sulfamethoxazole (55.5%) were identified. A total of nine SCCmec types and subtypes, thirteen STs clustered into thirteen spa types were identified, with ST239-SCCmec III-t037 presenting the predominant methicillin-resistant S. aureus (MRSA) clone. Typically, SCCmec type IX and ST546 were emergent types in China. Isolates positive for both pvl and tsst genes and for both eta and etb genes were also identified. Important findings in this study include: firstly, we have provided comprehensive knowledge on the molecular epidemiology of MRSA in Southern China which fills the gap since 2006 or 2010 from previous studies. Secondly, we have presented the correlation between virulence factors (four major groups) and genotypes (SCCmec, ST and spa types). Thirdly, we have shown evidence for earliest emergence of type I SCCmec from 2012, type VI from 2009 and type XI from 2012 in MRSA from Southern China. [ABSTRACT FROM AUTHOR]

China's economy is developing rapidly, and enterprises are paying more and more attention to environmental protection in the process of economic development. However, relatively speaking, the environmental awareness of enterprises and employees needs to be further improved. This paper investigates the impact of green human resource management on environmental performance by questionnaire survey. A total of 372 questionnaires were distributed to front-line employees and human resource supervisors, 357 of which were valid. Using descriptive statistics, correlation analysis, regression analysis, and mediating effect test, this paper studies the relationship between green human resource management and environmental performance, and tests the mediating role of employees' work values between green human resource management and enterprise environmental performance. The conclusion of the empirical study has some inspiration for the green human resource management of enterprises, provides some references for the development of relevant theories, and provides practical significance for the green development of enterprises. [ABSTRACT FROM AUTHOR]

Subalpine vegetation across the Tibetan Plateau is globally one of the most sensitive to climate change. However, the potential landscape‐scale effects of climate change on subalpine forest dynamics remain largely unexplored. Here, we used a forest landscape model (LANDIS‐II) coupled with a forest ecosystem process model (PnET‐II) to simulate forest dynamics under future climate change in Jiuzhaigou National Nature Reserve in the eastern subalpine region of the Tibetan Plateau. We examined changes in the composition, distribution and aboveground biomass of cold temperate coniferous forests, temperate coniferous forests, deciduous broad‐leaved forests and redwood forest under four climate change scenarios (RCP2.6, RCP4.5, RCP8.5 and the current climate) from 2016 to 2096. Our model predicts that by 2096, (i) cold temperate coniferous forests will expand and increase by 7.92%, 8.18%, 8.65% and 7.02% under current climate, RCP2.6, RCP4.5 and RCP8.5 scenarios, respectively; (ii) distribution of forests as a whole shows upward elevational range shift, especially under RCP8.5 scenario and (iii) total aboveground biomass slowly increases at first and then decreases to 12%–16% of current distribution under RCPs. These results show that climate change can be expected to significantly influence forest composition, distribution and aboveground biomass in the subalpine forests of eastern Tibetan Plateau. This study is the first to simulate forest dynamics at the landscape scale in subalpine areas of the Tibetan Plateau, which provides an important step in developing more effective strategies of forest management for expected climate change, not only in China but also around the world. [ABSTRACT FROM AUTHOR]

Clostridioides difficile ST37 is an emerging and prevalent multilocus sequence type and represents a lineage of clinical significance. This study aimed to characterize two epidemic C. difficile ST37 strains, CD161 and CDT4. CD161 acquires a chromosome and two distinct plasmids, pCD161-L, sharing high similarity with Clostridium phage, and pCD161-S, while CDT4 has a chromosome and a plasmid pCDT4 identical to pCD161-S. In the chromosome of both strains, three CdISt1-like elements and a skinCd element, which might influence sporulation, were identified. The multidrug resistance of the strains was due to the mutation in 23S rDNA, gyrA, and gyrB genes and the acquisition of ermB, ant6-Ia, aac6'-aph2", and tetM genes. In addition, a distinct pathogenicity locus (PaLoc) with truncated tcdA gene represents the genetic feature of ST37 strains. To our knowledge, this is the first complete genome, both chromosomes and plasmids, of epidemic C. difficile ST37 strains in China. [ABSTRACT FROM AUTHOR]

This paper endeavours to shed light on the effect of private tutoring for Mathematics, Chinese and English in various kinds of class-size on students’ performances in the National College Entrance Exam (NCEE) in China. To achieve this, it draws upon a dataset collected by a specifically designed questionnaire on private tutoring of grade 12 students in Jinan, China. With the consideration of nested alternative structure of choices among private tutoring in different class-size and self-selection problem, the study employed a nested logit model to investigate the factors underlying students’ choice of private tutoring and has fitted OLS model to examine the effects of different class-size tutoring. [ABSTRACT FROM AUTHOR]

Cites several events related to the transition of education in China. Restoration of the college entrance examination in 1979; Demand for 'compensation policies'; Implementation of family planning as a national policy in 1980.

A retrospective study was conducted on 1,739 Staphylococcus isolates from the First Affiliated Hospital of Jinan University (FAHJU) in Guangzhou during 2001-2010. With the exception of teicoplanin and vancomycin, antimicrobial resistance was commonly observed among the isolates examined, with high resistance rates for β-lactamases (94.0% and 73.7% for penicillin and oxacillin) and resistance percentages for cefoxitin, chloramphenicol, ciprofloxacin, clindamycin, erythromycin, gentamicin, trimethoprim-sulfamethoxazole, and tetracycline ranging from 83.9% to 19.4%. Two hundred sixty-three of the 1,739 isolates were subjected to SCC mec typing and 42 to MLST, spaA, and coa typing. ST239-MRSA-III was prevalently identified along with one distinct coa type HIJKL and 2 spaA types (WGKAOMQ-t037 and WGKAQQ-t030). Class 1 integrons were commonly detected (31.6%), although none of the integron-positive MRSA strains had been isolated since 2009. The widespread detection of integron-based antimicrobial resistance determinants may further contribute to the emergence of superbugs. [ABSTRACT FROM AUTHOR]

A large amount of waste activated sludge (WAS) and food waste (FW) are produced every year in China. Anaerobic co-digestion is considered to be an effective way to solve this problem. This study applied FW/WAS mixture as co-substrate to create different digestive environment, aiming to understand the mechanism of Fe 3 O 4 particles in promoting AD performance. The results showed that the addition of Fe 3 O 4 presented various performances when facing different digestive acidification stress brought by different mixing ratios of WAS and FW. Methanogenic pathways and microbial communities varied with substrates' properties. For group A (WAS mono-digestion), the acetoclastic methanogens dominated, 20 mg/g VS (according to the iron element) Fe 3 O 4 could promote methane production, while 200 mg/g VS Fe 3 O 4 would inhibit microbial activity. The promoted methane production by Fe 3 O 4 was attributable to the promotion of sludge hydrolysis. For group B (WAS: FW = 1:0.5, based on VS addition, similarly hereinafter), Fe 3 O 4 triggered direct interspecific electron transfer (DIET) between bacteria and methanogens. For group C (WAS: FW = 1:1), the hydrogenotrophic methanogens dominated, bacteria excreted more non-conductive polysaccharides in EPS to resist unfavorable environment, thereby it prevented their contact with Fe 3 O 4 particles. So, it was difficult for Fe 3 O 4 to trigger DIET and promote the digestive performance of batch experiments in such condition. [Display omitted] • Microbial communities determine the performance of Fe 3 O 4 in the digestive system. • Methanogenic pathways and microbial communities vary with substrates' properties. • Fe 3 O 4 triggers DIET in a stable state when hydrogenotrophic methanogenesis domains. • Excessive EPS prevented Fe 3 O 4 from triggering DIET between microorganisms. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is a medically important pathogen showing intrinsic low permeability to various antimicrobial agents and its potential to acquire multiple resistance mechanism. A longitudinal surveillance aimed to investigate the antimicrobial resistance and its determinants of Pseudomonas aeruginosa in Southern China. A total of 2163 P. aeruginosa isolates were obtained from patients in Southern China during 2004–2016. The antimicrobial susceptibility of the isolates was performed by disk diffusion and Vitek 2 automated system and interpreted according to the Clinical and Laboratory Standard Institute (CLSI) 2015. A significant downtrend of resistant rate (>10.0%) was observed for tested antibiotic agents including ciprofloxacin (>30.0%), gentamicin (29.0%), tobramycin (24.2%) and ceftazidime (24.0%) except for aztreonam and amikacin. A total of 269 randomly selected isolates were further studied on the carriage of β-lactam resistance genes by using 7 groups of multiplex PCRs targeting on 20 genes. β-lactam resistance genes were rarely detected with a rate lower than 8%. Among all β-lactam resistance genes, bla SHV acquired the highest identification rate (18/269, 6.7%), followed by bla OXA-1 -like (6/269, 2.2%) and bla PER (6/269, 2.2%). In addition, 8 different plasmid replicons were amplified using 8 groups of multiplex PCRs including 18 sets of primers. Only five plasmid replicons were identified in 5 different P. aeruginosa isolates. Insignificant clonal relatedness among the positive strains identified by regular PCR were further verified by randomly amplified polymorphic DNA (RAPD)-PCR. This study has provided comprehensive knowledge on current antimicrobial resistance, β-lactam resistance genes and plasmid replicons carriage in a large scale of clinical P. aeruginosa isolates. • The resistant rate of the 13 tested antibiotic agents showed a downtrend. • The most predominant specimen source of P. aeruginosa was sputum. • P. aeruginosa isolates rarely carried β-lactam resistance genes. • The carriage rate of plasmid replicons in P. aeruginosa isolates was low. [ABSTRACT FROM AUTHOR]

Streptococcus agalactiae is considered as a leading case of bacterial infection among neonates. Although relative protection strategies have been performed in many high-income countries, resulting in a massive reduction in the occurrences of early-onset GBS disease, the late-onset disease has not affected. Here, the whole genome of S. agalactiae Guangzhou-SAG036 was sequenced by the Pacific Biosciences Sequel using the P4–C2 chemistry and the continuous long reads were used for de novo assembly using HGAP. Besides, genes prediction and multiply annotation were performed by comparing it with diverse databases. The whole genome has a length of 2,206,504 bp and contains 2162 predicted genes with an average G + C content of 35.85%. Based on the whole genome sequence, 2 large prophages, 20 virulence factors genes, and 8 antibiotic resistant genes were identified. MLST analysis revealed S. agalactiae Guangzhou-SAG036 was identified as ST-17. The virulence factors genes were identified with different functions including adherence, antiphagocytosis, spreading factor, immune evasion, invasion, toxin. Besides, the antibiotic-resistant genes may provide S. agalactiae with resistance to multi-drugs including erythromycin, streptomycin, azithromycin, spiramycin, ampicillin, kanamycin, cationic peptides, and tetracycline. Therefore, the infection of S. agalactiae Guangzhou-SAG036 ST-17 strain maybe caused by the complex virulence factors and multi-drugs resistance. These results contribute to further understand GBS epidemiology and surveillance targets. • The whole genome of S. agalactiae Guangzhou-SAG036 has a length of 2,206,504 bp with an average G + C content of 35.85%. • The genome shows high similarity (99% identity) with two sequenced S. agalactiae strains isolated from China in 2016 and one isolated from Canada in 2010. • 2162 predicted genes had been identified containing two prophages. • MLST type was identified as ST-17. • 19 virulence factors genes and 8 antibiotic resistant genes were identified. [ABSTRACT FROM AUTHOR]

Background and Objective: Our study aimed to evaluate the associations between platelet count (PC) and in-hospital outcomes for patients with stroke after rt-PA intravenous thrombolysis., Methods: We identified patients who had been hospitalized with a primary diagnosis of stroke and had received rt-PA intravenous thrombolysis from June 2015 to July 2019 at participating hospitals in the Chinese Stroke Center Alliance. PC measured before intravenous thrombolysis was categorized into the following four groups: severe thrombocytopenia (PC < 100 × 10 9 /L), mild thrombocytopenia (100 ≤ PC < 150 × 10 9 /L), normal PC (150 ≤ PC ≤ 450 × 10 9 /L), and thrombocythemia (PC > 450 × 10 9 /L). Outcomes were determined from clinical data collected during hospitalization. The primary clinical outcome was symptomatic intracranial hemorrhage (sICH). Secondary outcomes were mortality, bleeding events, gastrointestinal (GI) hemorrhage, and in-hospital stroke recurrence. We used multivariate logistic regression models to evaluate the associations between PC and outcomes., Results: We included 44,882 individuals with a median age of 66 years, of whom 34.7 % were female, 951 (2.1 %) had severe thrombocytopenia, 7218 (16.1 %) had mild thrombocytopenia, 36,522 (81.4 %) had a normal PC, and 191 (0.4 %) had thrombocythemia. Both severe and mild thrombocytopenia groups had higher risks of bleeding events (adjusted OR 1.30; 95 % CI,1.01-1.67; p = 0.045; adjusted OR 1.32; 95 % CI,1.19-1.46; p < 0.001) and sICH (adjusted OR 1.48;95 % CI,1.13-1.94; p = 0.005; adjusted OR 1.43;95 % CI,1.27-1.60; p < 0.001) than the normal PC group. Patients with 100 ≤ PC < 150 × 10 9 /L also had a higher risk of in-hospital stroke recurrence (adjusted OR 1.12; 95 % CI,1.02-1.22; p = 0.02)., Conclusions: Intravenous thrombolysis brings a high risk of sICH given PC < 150 × 10 9 /L, especially PC < 100 × 10 9 /L. It indicated that PC < 100 × 10 9 /L is a reasonable contraindication to thrombolysis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Few studies have investigated the association between PM 2.5 and hypertension among floating populations. We therefore examined the relationship using binary logistic regression. Each grade of increment in the annual average PM 2.5 (grade one: ≤15 µg/m 3 ; grade two: 15-25 µg/m 3 ; grade three: 25-35 µg/m 3 [Excluding 25]; grade four: ≥35 µg/m 3 ) was associated with an increased risk of hypertension (odds ratio [OR] = 1.081, 95% confidence interval (CI): 1.034-1.129). Among the female floating population (OR = 1.114, 95% CI: 1.030-1.204), those with education level of primary school and below (OR = 1.140, 95% CI: 1.058-1.229), construction workers (OR = 1.228, 95% CI: 1.058-1.426), and those living in the eastern region of China (OR = 1.241, 95% CI: 1.145-1.346) were more vulnerable to PM 2.5 . These results indicate that PM 2.5 is positively associated with hypertension in floating populations. Floating populations who are female, less educated, construction workers, and living in the eastern region of China are more vulnerable to the adverse impacts of PM 2.5 .

There are limited studies investigating the association between short-term exposure to PM 2.5 and incident cardiovascular disease (CVD) cases in China. This study aims to examine the short-term effects of PM 2.5 on the incidence of cardiovascular diseases. A combination of Poisson-distribution generalized linear model and distributed lag non-linear model was used to examine the association between short-term exposure to PM 2.5 and incident cases of CVD. The results revealed that per 10 µg/m 3 increment of PM 2.5 would increase the incident CVD cases by 0.147% (Relative Risk: 1.00147, 95% Confidence Interval: 1.00008-1.00286) at a lag of 2 days. The stratified analyses showed higher effects risk in females, older residents (aged 60-75 years), and acute myocardial infarction group (p-value for difference <0.05). This study indicates that short-term exposure to PM 2.5 may increase the risk of CVD and highlights the necessity for a higher air quality standard in Yantai, China.

Background: Hepatitis C threatens human health and brings a heavy economic burden. Shandong Province is the second most populous province in China and has uneven regional economic development. Therefore, we analyzed the incidence rate trend and regional differences of hepatitis C in Shandong Province from 2004 to 2021., Methods: The monthly and annual incidence rates of hepatitis C in Shandong Province from 2022 to 2030 were predicted by fitting Autoregressive Integrated Moving Average model (ARIMA), Long Short-Term Memory (LSTM) and ARIMA-LSTM combined model., Results: From 2004 to 2021, annual new cases of hepatitis C in Shandong Province increased from 635 to 5834, with a total of 61,707 cases. The incidence rate increased from 0.69/100 thousand in 2004 to 6.40/100 thousand in 2019, with a slight decrease in 2020 and 2021. The average annual incidence rate was 3.47/100 thousand. In terms of regional distribution, the hepatitis C incidence rate in Shandong Province was generally high in the west and low in the east. It is estimated that the hepatitis C incidence rate in Shandong Province will be 9.21 per 100 thousand in 2030., Conclusion: The hepatitis C incidence rate in Shandong Province showed an increasing trend from 2004 to 2019 and a decreasing trend in 2020 and 2021. Significant regional variations in incidence rate existed. An upward trend in incidence rate is predicted from 2022 to 2030. It is necessary to strengthen the prevention and control of hepatitis C to achieve the goal of eliminating viral hepatitis by 2030., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Limited studies examined the interaction effects between exposure to ambient PM 2.5 and economic development on the settlement intention of floating population. We used binary logistic model to examine the association of PM 2.5 , per capita GDP (PGDP), PM 2.5 [Formula: see text] PGDP on the settlement intention. Additive interaction term of PM 2.5 and PGDP level was used to investigate their interactive effects. Overall, each one grade increment in annual average PM 2.5 was associated with decreased probability of settlement intention (OR = 0.847, 95%CI: 0.811-0.885). The interaction effect between PM 2.5 and PGDP on settlement intention was significant (OR = 1.168, 95%CI: 1.142-1.194). The stratified analysis showed PM 2.5 exhibits lower settlement intention in the aged 55 years or above, engaged in low-skilled works, and living in the western China. This study indicates that PM 2.5 -exposed will decrease the settlement intention of floating population. High economic development level can weaken the relationship between PM 2.5 and settlement intention. Policymakers should balance the socio-economic development and environmental health and focus on vulnerable population., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

There are limited studies investigating the relationship between exposure to PM 2.5 and the health status among the mobile population. A cross-sectional analysis was performed in a nationally representative sample (2017 China Migrants Dynamic Survey data) consisting of 169,469 mobile population. The ordered logistic regression model was used to examine the association between PM 2.5 and the health status in mobile population. Stratified analyses were performed to identify whether the association varied across gender, age group, and regions in China. Overall, every 10 μg/m 3 increment in annual average PM 2.5 was associated with increased risk of poor self-reported health (OR = 1.021, 95% CI: 1.012-1.030). Mobile population aged 31-49 years and living in the central region suffers the highest PM 2.5 -associated health risk (OR = 1.030, 95% CI: 1.019-1.042; OR = 1.095, 95% CI: 1.075-1.116). Our study suggests that PM 2.5 exposure was associated with an increased risk of poor self-reported health in mobile population, particularly among the population aged 31-49 years and people living in the central region of China. Policymakers should pay more attention to the vulnerable mobile population to tackle the health burden of ambient air pollution., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

There are limited studies examining the association between PM 2.5 exposure and incident cerebrovascular disease (CD) cases in China. In this study, daily counts of incident CD cases and daily PM 2.5 concentrations were obtained in Yantai, Shandong Province, China from 2014 to 2019. We used a combination of the Poisson-distribution generalized linear model (GLM) and a distributed lag nonlinear model (DLNM) to examine the association of short-term exposure to ambient PM 2.5 and incident cases of CD. The results revealed that for every 10 μg/m 3 increment of PM 2.5 would increase the incident CD cases by 0.216% (RR:1.00216, 95%CI:1.0016-1.0028) at lag4. The stratified analysis demonstrated that the females and residents aged 65 years or above presented higher short-term PM 2.5 -associated CD risks than the males and aged below 65 years. Targeted prevention strategies should be adopted to reduce the PM 2.5 -related CD burden, especially for the susceptible population in China., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The pandemic of coronavirus disease 2019 (COVID-19) caused by the SARS-coronavirus 2(SARS-CoV-2) virus has become the greatest global public health crisis in recent years,and the COVID-19 epidemic is still continuing. However, due to the lack of effectivetherapeutic drugs, the treatment of corona viruses is facing huge challenges. In thiscontext, countries with a tradition of using herbal medicine such as China have beenwidely using herbal medicine for prevention and nonspecific treatment of corona virusesand achieved good responses. In this review, we will introduce the application of herbalmedicine in the treatment of corona virus patients in China and other countries, andreview the progress of related molecular mechanisms and antiviral activity ingredients ofherbal medicine, in order to provide a reference for herbal medicine in the treatment ofcorona viruses. We found that herbal medicines are used in the prevention and fightagainst COVID-19 in countries on all continents. In China, herbal medicine has beenreported to relieve some of the clinical symptoms of mild patients and shorten the length of hospital stay. However, as most herbal medicines for the clinical treatment of COVID-19still lack rigorous clinical trials, the clinical and economic value of herbal medicines in theprevention and treatment of COVID-19 has not been fully evaluated. Future work basedon large-scale randomized, double-blind clinical trials to evaluate herbal medicines andtheir active ingredients in the treatment of new COVID-19 will be very meaningful.

Antipsychotic-induced weight gain (AIWG) is a common adverse effect of this treatment, particularly with second-generation antipsychotics, and it is a major health problem around the world. We aimed to review the progress of pharmacogenetic studies on AIWG in the Chinese population to compare the results for Chinese with other ethnic populations, identify the limitations and problems of current studies, and provide future research directions in China. Both English and Chinese electronic databases were searched to identify eligible studies. We determined that > 25 single-nucleotide polymorphisms in 19 genes have been investigated in association with AIWG in Chinese patients over the past few decades. HTR2C rs3813929 is the most frequently studied single-nucleotide polymorphism, and it seems to be the most strongly associated with AIWG in the Chinese population. However, many genes that have been reported to be associated with AIWG in other ethnic populations have not been included in Chinese studies. To explain the pharmacogenetic reasons for AIWG in the Chinese population, genome-wide association studies and multiple-center, standard, unified, and large samples are needed.

This study aimed at identification and characterization of a novel multidrug-resistant Pseudomonas putida strain Guangzhou-Ppu420 carrying two copies of qnrVC6 isolated from a hospital in Guangzhou, China, in 2012. Antimicrobial susceptibility was tested by Vitek2™ Automated Susceptibility System and Etest™ strips, and whole-genome sequencing facilitated analysis of its multidrug resistance. The genome has a length of 6,031,212 bp and an average G + C content of 62.01%. A total of 5,421 open reading frames were identified, including eight 5S rRNA, seven 16S rRNA, and seven 23S rRNA, and 76 tRNA genes. Importantly, two copies of qnrVC6 gene with three ISCR1 around, a bla VIM-2 carrying integron In528, a novel gcu173 carrying integron In1348, and six antibiotic resistance genes were identified. This is the first identification of two copies of the qnrVC6 gene in a single P. putida isolate and a class 1 integron In1348.

Background: Fluoroquinolone-resistant Haemophilus influenzae (FRHI) has been reported worldwide but remain unclear in China., Methods: A total of 402 H. influenzae isolates collected from 2016 to 2017 were included. Antimicrobial susceptibility on 10 antibiotics was performed, and minimum inhibitory concentration of ciprofloxacin- and nalidixic acid-resistant strains were further determined by E-test strips, with risk factors also evaluated. Strains with resistance or reduced susceptibility to ciprofloxacin were subjected to sequencing of the quinolone resistance-determining regions (QRDR) and plasmid-mediated quinolone resistance genes by sequencing, with multi-locus sequence typing., Results: 2.2% of H. influenzae strains were non-susceptible (7/402, 1.7%) or susceptible (2/402, 0.5%) to ciprofloxacin but NAL-resistant by E-test, and multidrug resistance was more common in fluoroquinolones non-susceptible H. influenzae group (p = 0.000). Infection risk factors included invasive procedure (p = 0.011), catching cold/previous contact with someone who had a cold (p = 0.019), fluoroquinolones use during previous 3 months (p = 0.003). With none of mutations obtained in gyrB, parE and other plasmid-mediated quinolone resistance genes, 7 and 4 strains were found for Ser-84-Leu substitutions in gyrA and one amino acid substitution in the QRDR of gyrA linked with one amino acid substitution in the QRDR of parC, respectively. In addition, five sequence types (ST) were identified, with ST1719 firstly found., Conclusions: For the first time, this study has reported the incidence, risk factors, molecular determinants on fluoroquinolones resistance and ST of FRHI strains in mainland China, representing the first evidence of mutation of gyrA and parC in China and the new ST1719 worldwide.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the authors. There is significant discrepancy in the genomic characteristics between the currently and previously dominant GBS (2018) and previously dominant GBS (2013-2014). The dramatically rapid and unexpected evolution of GBS strains has led to the significant discrepancy from recent findings which makes all the authors strongly concerned that this will influence the accuracy and validity of GBS treatment and therapy if based on the current manuscript. For example, the genomic difference between the currently prevalent type (II and III) and previously prevalent type (III) is considerably diverse, for which the pathogenic and virulent characteristics of the strains are very different. As all authors have a strong sense of responsibility and expertise in clinical microbiology, agreed by all authors, on behalf of all authors of this manuscript, the authors consequently request for article withdrawal for this manuscript., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: We previously described the novel qnrVC6 and bla IMP-45 carrying megaplasmid pBM413. This study aimed to investigate the complete genome of multidrug-resistance P. aeruginosa Guangzhou-Pae617, a clinical isolate from the sputum of a patient who was suffering from respiratory disease in Guangzhou, China., Methods: The genome was sequenced using Illumina Hiseq 2500 and PacBio RS II sequencers and assembled de novo using HGAP. The genome was automatically and manually annotated., Results: The genome of P. aeruginosa Guangzhou-Pae617 is 6,430,493 bp containing 5881 predicted genes with an average G + C content of 66.43%. The genome showed high similarity to two new sequenced P. aeruginosa strains isolated from New York, USA. From the whole genome sequence, we identified a type IV pilin, two large prophages, 15 antibiotic resistant genes, 5 genes involved in the "Infectious diseases" pathways, and 335 virulence factors., Conclusions: The antibiotic resistance and virulence factors in the genome of P. aeruginosa strain Guangzhou-Pae617 were identified by complete genomic analysis. It contributes to further study on antibiotic resistance mechanism and clinical control of P. aeruginosa., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: To investigate the incidence of workplace violence involving nurses and to identify related risk factors in a high-quality Chinese teaching hospital., Methods: A cross-sectional study design was used. The final sample comprised responses from 1831 registered nurses collected with a whole-hospital survey from June 1 to June 15, 2016. The demographic characteristics of the nurses who had experienced any form of violence were collected, and logistic regression analysis was applied to evaluate the risk factors for nurses related to workplace violence., Results: Out of the total number of nurses surveyed, 904 (49.4%) nurses reported having experienced any type of violence in the past year. The frequencies of exposure to physical and non-physical violence were 6.3% (116) and 49.0% (897), respectively. All the incidence rates of violence were lower than those of other studies based on regional hospitals in China and were at the same level found in developed countries and districts. Binary logistic regression analysis revealed that nurses at levels 2 to 4 and female nurses in clinical departments were the most vulnerable to non-physical violence. For physical violence, the two independent risk factors were working in an emergency department and having 6-10 years of work experience., Conclusions: Workplace violence directly threatens nurses from high-quality Chinese teaching hospitals. However, the incidence of WPV against nurses in this teaching hospital was better than that in regional hospitals. This study also provides reference material to identify areas where nurses encounter relatively high levels of workplace violence in high-quality Chinese teaching hospitals., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Carbapenem-resistant Gram-negative bacilli (GNB) have become an important cause of nosocomial infections of hospitalized patients., Methods: To investigate the microbial infection patterns and molecular epidemiology characteristics of the carbapenem-resistant GNB isolates from a long-term hospitalized patient, antimicrobial susceptibility testing, phenotypic screening test for carbapenemase production, PCR screening and DNA sequencing of carbapenemase genes, repetitive extragenic palindromic sequence-based PCR (REP-PCR), multilocus sequencing typing (MLST) and genetic environment analysis were performed., Results: Twelve strains with carbapenemase genes were detected from 63 carbapenem-resistant isolates, including two bla IMP-25 -carrying Pseudomonas aeruginosa, one bla NDM-1 -carrying Citrobacter freundii, three bla NDM-1 -carrying Klebsiella pneumoniae and six bla KPC-2 -carrying K. pneumoniae. Only the bla NDM-1 genes were successfully transferred from three K. pneumoniae strains to Escherichia coli C600 by conjugation. Genetic environment of bla IMP-25 , bla NDM-1 and bla KPC-2 genes in our study were consistent with previous reports. Molecular typing of K. pneumoniae performed by MLST revealed that most of the isolates belonged to ST11. bla NDM-1 -carrying K. pneumoniae sequencing type 1416 was first reported in our study., Conclusions: Carbapenem-resistant GNB are common pathogens during long-term hospitalization, and ST11 bla KPC-2 -carrying K. pneumoniae is the dominant bacterium in our study. Colonization and horizontal transmission of resistance by plasmids of carbapenem-resistant GNB have increased the risks of persistent infection and mortality of long-term hospitalized patients., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Duck Tembusu virus (DTMUV) causes substantial egg drop disease. DTMUV was first identified in China and rapidly spread to Malaysia and Thailand. The antigenicity of the DTMUV E protein has not yet been characterized. Here, we investigated antigenic sites on the E protein using the non-neutralizing monoclonal antibodies (mAbs) 1F3 and 1A5. Two minimal epitopes were mapped to 221 LD/NLPW 225 and 87 YAEYI 91 by using phage display and mutagenesis. DTMUV-positive duck sera reacted with the epitopes, thus indicating the importance of the minimal amino acids of the epitopes for antibody-epitope binding. The performance of the dot blotting assay with the corresponding positive sera indicated that YAEYI was DTMUV type-specific, whereas 221 LD/NLPW 225 was a cross-reactive epitope for West Nile virus (WNV), dengue virus (DENV), and Japanese encephalitis virus (JEV) and corresponded to conserved and variable amino acid sequences among these strains. The structure model of the E protein revealed that YAEYI and LD/NLPW were located on domain (D) II, which confirmed that DII might contain a type-specific non-neutralizing epitope. The YAEYI epitope-based antigen demonstrated its diagnostic potential by reacting with high specificity to serum samples obtained from DTMUV-infected ducks. Based on these observations, a YAEYI-based serological test could be used for DTMUV surveillance and could differentiate DTMUV infections from JEV or WNV infections. These findings provide new insights into the organization of epitopes on flavivirus E proteins that might be valuable for the development of epitope-based serological diagnostic tests for DTMUV., Competing Interests: The authors declare no competing financial interests.

Carbapenem, imipenem and meropenem have been broadly prescribed contributing to the global occurrence and prevalence of carbapenem resistance in Psuedomonas aeruginosa, and the associated resistance genotypes remains clinically significant. A retrospective surveillance had been conducted on 499 P. aeruginosa isolates in South China during 2003-2007, including antimicrobial resistance and characterization of MBLs on carbapenem-resistant strains. One hundred and sixty-four out of 499 strains were carbapenem-resistant, with 11, 4 and 5 strains positive for blaIMP-9, blaIMP-25 and blaVIM-2, respectively. Sixteen out of 20 isolates were positive for intI1 and contained identical flanking regions (as indicated in KM384735), and all tested isolates containing the qacE△1-sul1 of the typical 3'-conserved region. A novel blaIMP-25 metallo-β-lactamase and a genetic array of aacA4-blaIMP-25-oxa30-catB3 have been discovered from this retrospective surveillance on antimicrobial resistance of P. aeruginosa., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

As recently indiscriminate abuse of existing antibiotics in both clinical and veterinary treatment leads to proliferation of antibiotic resistance in microbes and poses a dilemma for the future treatment of such bacterial infection, antimicrobial resistance has been considered to be one of the currently leading concerns in global public health, and reported to widely spread and extended to a large variety of microorganisms. In China, as one of the currently worst areas for antibiotics abuse, the annual prescription of antibiotics, including both clinical and veterinary treatment, has approaching 140 gram per person and been roughly estimated to be 10 times higher than that in the United Kingdom, which is considered to be a potential area for the emergence of "Super Bugs". Based on the integrons surveillance in Guangzhou, China in the past decade, this review thus aimed at summarizing the role of integrons in the perspective of both clinical setting and environment, with the focus on the occurrence and prevalence of class 1, 2 and 3 integrons.

Objective: To evaluate the incidence and prognostic value of hyponatremia in patients with Guillain-Barré syndrome (GBS) in northern China., Methods: Four hundred fifty-five GBS patients were divided into mild, moderate, and severe groups according to Medical Research Council sum score (MRC sum score) at nadir. The incidences of hyponatremia in these three groups were analyzed by x(2) tests. Logistic regression models were performed to determine risk factors of hyponatremia and poor outcome., Results: Hyponatremia was detected in 21·5% GBS patients. And 36·2% severe GBS cases were found to have hyponatremia, which was significantly higher than mild and moderate groups (11·8, 13·0%; all P value <0·001). However, no significant difference was found between mild and moderate groups (P  =  0·769). Multivariable logistic regression analysis identified three conditions closely associated with hyponatremia: age > 50 years (odds ratio: 2·013, P  =  0·014), facial weakness (odds ratio: 2·493, P  =  0·001), and mechanical ventilation (odds ratio: 12·871, P < 0·001). Both hyponatremia (odds ratio: 12·770, P < 0·001) and bulbar weakness (odds ratio: 3·391, P  =  0·023) predicted death of GBS patients., Conclusions: Hyponatremia is an important predictor of poor outcome in GBS patients.