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Objective: This study aimed to analyze the factors influencing glycemic control in patients with type 2 diabetes mellitus (T2DM). Methods: Baseline data, encompassing basic information, lifestyle habits, and treatment of 305 T2DM patients from March 2021 to January 2023, were collected and analyzed using SPSS 26.0 software. Results: Univariate and multivariate logistic regression analyses identified insulin therapy (OR = 2.233; 95%Cl = 1.013–4.520; P = 0.026) and regular clinic visits (OR = 0.567; 95%Cl = 0.330–0.973; P = 0.040) as independent factors influencing glycemic control. No observed interactions between the two variables were noted. Conclusion: History of insulin therapy and regular clinic visits were significantly and independently associated with glycated hemoglobin control in T2DM patients. Tailored interventions based on individual circumstances are recommended to optimize glycemic control. [ABSTRACT FROM AUTHOR]

Depressive symptoms and aggression often co-occur, and previous studies have found different bidirectional links between depressive symptoms and aggression, suggesting inconsistent developmental cascades. Moreover, it is unclear whether different functions of aggression are differentially associated with depressive symptoms over time. The present study examined the longitudinal associations of reactive and proactive aggression with depressive symptoms in early adolescence. Adolescents (n = 942, 50.7% girls; mean age = 12.54 years, SD = 0.42) were surveyed annually over three years (2019–2021). Random-intercept cross-lagged panel models were used to disentangle between- and within-person effects. The results showed moderate between-person associations of depressive symptoms with the two aggressive functions. And depressive symptoms were more highly associated with reactive aggression than with proactive aggression. However, the state-level bidirectional cross-lagged associations between reactive and proactive aggression and depressive symptoms were not significant. This study highlights the stable trait-like association between depressive symptoms and reactive aggression, and the absence of state-level bidirectional cross-lagged associations challenges previous developmental cascades in adolescents. [ABSTRACT FROM AUTHOR]

The main aim of this study was to determine whether the use of contrast-enhanced ultrasound (CEUS) could improve the categorization of suspicious breast lesions based on the Breast Imaging Reporting and Data System (BI-RADS), thereby reducing the number of benign breast lesions referred for biopsy. This prospective study, conducted between January 2017 and December 2018, enrolled consenting patients from eight teaching hospitals in China, who had been diagnosed with solid breast lesions classified as BI-RADS 4 using conventional ultrasound. CEUS was performed within 1 wk of diagnosis for reclassification of breast lesions. Histopathological results obtained from core needle biopsies or surgical excision samples served as the reference standard. The simulated biopsy rate and cancer-to-biopsy yield were used to compare the accuracy of CEUS and conventional ultrasound (US). Among the 1490 lesions diagnosed as BI-RADS 4 with conventional ultrasound, 486 malignant and 1004 benign lesions were confirmed based on histology. Following CEUS, 2, 395, and 211 lesions were reclassified as CEUS-based BI-RADS 2, 3, and 5, respectively, while 882 (59%) remained as BI-RADS 4. The actual cancer-to-biopsy yield based on US was 32.6%, which increased to 43.4% when CEUS-based BI-RADS 4A was used as the cut-off point to recommend biopsy. The simulated biopsy rate decreased to 73.4%. Overall, in this preselected BI-RADS 4 population, only 2.5% (12/486) of malignant lesions would have been miscategorized as BI-RADS 3 using CEUS-based reclassification. The diagnostic accuracy, sensitivity, and specificity of contrast-enhanced ultrasound reclassification were 57.65%, 97.53%, and 38.35%, respectively. Our collective findings indicate that CEUS is a valuable tool in further triage of BI-RADS category 4 lesions and facilitates a reduction in the number of biopsies while increasing the cancer-to-biopsy yield. [ABSTRACT FROM AUTHOR]

Background: There may be unexplored interactions between family health, personality, and smoking that could help provide new perspectives on tobacco control. Objective: To examine the relationship between the health of one's family and their smoking habits, as well as investigate the potential influence of personality on this relationship. Methods: For this cross-sectional investigation, a national survey conducted in China in 2022 recruited a total of 21,916 individuals. The Family Health Scale was utilized to assess the health of the family. The 10-item Big Five Inventory scale was utilized to assess the Big five personality traits. The relationship between big five personality, family health, and smoking were investigated using binary and linear logistic regression. The indirect effects mediated by Big five personality were analyzed using mediation analysis with Sobel tests, and the indirect effects were composited using the Karlson-Holm-Breen method. Results: The overall prevalence of smoking in the study population was 14.87%, 26.19% for males and 3.54% for females. Urban and rural smoking prevalence was 13.81% and 16.10% respectively. Binary logistic regression analysis revealed a significant negative relationship between smoking and family health (odds ratio 0.964, 95% CI 0.959, 0.970, P < 0.001) with covariates controlled. The Karlson-Holm-Breen composition facilitated the connection between extraversion (47.81%) and nervousness (52.19%). Conclusions: Preventive interventions for smoking behavior should prioritize family health and the Big five personality as significant areas to focus on. According to this study, in addition to implementing various interventions for different personalities, family health should be strengthened to reduce smoking behavior. [ABSTRACT FROM AUTHOR]

The co-allocation of photovoltaic arrays with crops presents a promising strategy to mitigate the conflict between photovoltaics and agricultural land. However, there is a notable lack of quantitative research on the impact of agrivoltaic system on land quality in fragile areas. In this study, peanuts (Arachis hypogaea) and ryegrass (Lolium perenne) were cultivated in photovoltaic array in the dry–hot valley of southwest China, with an off-site native land serving as the control. Sixteen soil physicochemical and biochemical parameters were measured in the gap and under-panel and control area. Results demonstrated that the agrivoltaic system significantly enhanced soil moisture, organic carbon, nitrogen–phosphorus–potassium nutrients, microbial biomass, and urease activity. It also led to varying degrees of increase in soil pH and electrical conductivity, along with reduced soil sucrase and phosphatase activity. In comparison to the control, the agrivoltaic system notably improved soil quality and multifunctionality. Specially, gap cultivation had a more pronounced positive impact on soil quality than under-panel cultivation, and the cultivation of peanuts had a greater effect on soil quality and multifunctionality improvement than ryegrass. This study provides fundamental data to support the improvement of land quality in photovoltaic developed regions, and to alleviate the conflict between photovoltaics and agricultural land. [ABSTRACT FROM AUTHOR]

A new loach species, Oreonectes andongensis sp. nov. is described from the Guangxi Zhuang Autonomous Region, China. The new species can be differentiated from other members of the genus by combinations of characters: a developed posterior chamber of the swim bladder, 13–14 branched caudal-fin rays, 8–16 lateral-line pores, body width 12–15% of standard length (SL), interorbital width 42–47% of head length (HL), and caudal peduncle length 11–16% of SL. Bayesian inference phylogenetic analysis based on mitochondrial Cyt b provided strong support for validity of O. andongensis sp. nov. (uncorrected p-distance 6.0–7.5%). [ABSTRACT FROM AUTHOR]

Our aim in this study was to translate and psychometrically evaluate a Chinese version of the Behavioral Regulation in Sport Questionnaire (BRSQ). Participants were Chinese collegiate athletes (N = 361) who were competitive in their respective sports. We examined the construct validity of the Chinese BRSQ using alternative structural equation models and evaluated convergent validity, factor score reliability, and measurement invariance of the optimal model. Due to insufficient score reliability for some subscales, our initial Chinese BRSQ was deemed problematic. A modified version of the questionnaire with a four-factor structure (amotivation, external regulation, introjected regulation, and autonomous motivation) demonstrated excellent construct validity, convergent validity, and score reliability. There was measurement invariance across athlete level and sex. This tool provides a valuable resource for practitioners and sport psychology researchers for assessing sport motivation among competitive university athletes in China. [ABSTRACT FROM AUTHOR]

Amid the increasing global internet penetration, understanding the impact of internet use on residents' health is crucial. This aids in formulating more effective health policies and provides empirical evidence for promoting health equity and improving overall public health. Drawing on the China Health and Retirement Longitudinal Study (CHARLS), this paper employs the Propensity Score Matching-Difference in Differences (PSM-DID) method to examine the impact of the internet on individual health and further explores the pathways through which the internet affects health. We introduce the research background and significance in the introduction. Then, in the theoretical analysis, it incorporates internet variables into the Becker health demand model to analyze changes in health demand and impact pathways. The empirical analysis tests the theoretical findings, leading to empirical results. Finally, the study discusses the results and provides relevant recommendations. The findings indicate significant positive effects of the internet on both physical and psychological health. These effects are realized through reducing health information asymmetry, lowering health costs, and increasing exposure to health-promoting environments. In the heterogeneity analysis, economic-related internet content shows a significant positive impact on resident health. Intensive internet use adversely affects psychological health. The beneficial effects of the internet on health are more pronounced among older individuals, those covered by medical insurance, and regions with higher levels of digital economy. Based on these findings, the study offers policy recommendations concerning individuals' internet use patterns, the digital evolution of the healthcare industry, and government infrastructure development. [ABSTRACT FROM AUTHOR]

The relationship between bone mineral density and type 2 diabetes is still controversial. The aim of this study is to investigate the relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) in elderly men and postmenopausal women. The participants in this study included 692 postmenopausal women and older men aged ≥ 50 years, who were divided into the T2DM group and non-T2DM control group according to whether or not they had T2DM. The data of participants in the two groups were collected from the inpatient medical record system and physical examination center systems, respectively, of the Tertiary Class A Hospital. All data analysis is performed in SPSS Software. Compared with all T2DM group, the BMD and T scores of lumbar spines 1–4 (L1–L4), left femoral neck (LFN) and all left hip joints (LHJ) in the non-T2DM group were significantly lower than those in the T2DM group (P < 0.05), and the probability of major osteoporotic fracture in the next 10 years (PMOF) was significantly higher than that in T2DM group (P < 0.001). However, with the prolongation of the course of T2DM, the BMD significantly decreased, while fracture risk and the prevalence of osteoporosis significantly increased (P < 0.05). We also found that the BMD of L1-4, LFN and LHJ were negatively correlated with homeostatic model assessment-insulin resistance (HOMA-IR) (P = 0.028, P = 0.01 and P = 0.047, respectively). The results also showed that the BMD of LHJ was positively correlated with indirect bilirubin (IBIL) (P = 0.018). Although the BMD was lower in the non-T2DM group than in the T2DM group, the prolongation of the course of T2DM associated with the lower BMD. And the higher prevalence of osteoporosis and fracture risk significantly associated with the prolongation of the course of T2DM. In addition, BMD was significantly associated with insulin resistance (IR) and bilirubin levels in T2DM patients. Registration number: China Clinical Trials Registry: MR-51-23-051741; https://www.medicalresearch.org.cn/search/research/researchView?id=c0e5f868-eca9-4c68-af58-d73460c34028. [ABSTRACT FROM AUTHOR]

Objective: Adverse childhood experiences (ACEs) have been associated with a range of adverse health outcomes, with pain being potentially one of them. This population-based cross-sectional study aimed to investigate the associations between Adverse Childhood Experiences (ACEs) and pain in Chinese adults and evaluate whether physical activity and demographic and socioeconomic characteristics modify this associations. Methods: Cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), were utilized in this study. A total of 9923 respondents with information on 12 ACE indicators and 15 self-reported body pains were included. Logistic regression models were used to assess associations of the ACEs and pain. Modification of the associations by physical activity, demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. Results: Among the 9923 individuals included in the primary analyses, 5098 (51.4%) males and the mean (SD) age was 61.18 (10·.44) years. Compared with individuals with 0 ACEs, those who with ≥ 5 ACEs had increased risk of single pains and multiple pain. A dose–response association was found between the number of ACEs and the risk of pain (e.g. neck pain for ≥ 5 ACEs vs. none: OR, 1.107; 95% CI, 0.903–1.356; p < 0.001 for trend). In the associations of each body pain with each ACE indicator, most ACE indicators were associated with an increased risk of pain. In addition, physical activity, sociodemographic and socioeconomic characteristics, such as age, sex, educational level, area of residence, childhood economic hardship, did not demonstrate a significant modify on the associations between ACEs and pain. Conclusions: These findings indicate that cumulative ACE exposure is associated with increased odds of self-reported pain in Chinese adults, regardless of adult physical activity, sociodemographic and socioeconomic characteristics. [ABSTRACT FROM AUTHOR]

Based on survey data covering 309 family grain farms in China, a structural equation model was used to conduct an empirical study on the relationship between ecological cognition, digital agricultural technology adoption, and the sustainable development of family grain farms in China. The results are in the following: Ecological cognition has a significant positive effect on the sustainable development of family grain farms. And digital agricultural technology adoption has a partial mediating effect on the influence of ecological cognition on the sustainable development of family grain farms. The ecological cognition level of farmers should be continuously improved, and more support should be given to adopt digital agricultural technology to effectively promote the sustainable development of family grain farms in China. [ABSTRACT FROM AUTHOR]

As they represent an important form of agricultural operation, the sustainable development of family farms is not only an objective necessity for promoting comprehensive rural revitalization in China, but also an imperative strategy for accelerating the construction of agricultural power in China. Based on the survey data of 357 family grain farms in China, this paper uses a structural equation model to empirically analyze the relationship between market-oriented perceptions, organizational resilience, and the sustainable development of family grain farms. The results show that market-oriented perceptions have a significant positive impact on the sustainable development of family grain farms; additionally, organizational resilience plays a mediating role in the impact of market-orientation perceptions on the sustainable development of family grain farms. Based on this, the paper proposes a two-fold approach to the sustainable development of family farms: improving the level of market-orientation perceptions of family farmers and enhancing the organizational resilience of family grain farms. [ABSTRACT FROM AUTHOR]

Following a burgeoning literature on private actors under digital authoritarianism, this study aims to understand the role played by social media users in sustaining authoritarian rule. It examines a subcultural community—the queer-fantasy community—on Chinese social media to expound how members of this community interpreted China's censorship policy, interacted based on the interpretation, and participated in censorship. Integrating structural topic modeling and emergent coding, this study finds that a political environment of uncertainty fostered divergent imaginaries about censorship. These imaginaries encouraged participatory censorship within the online community, which strengthened the political control of the Internet in the absence of the state. This study illuminates how participatory censorship works, especially in non-professional and non-politically mobilized online communities. With a focus on social media users, it also offers a lens for future research to compare peer-based surveillance and content moderation in authoritarian and democratic contexts. [ABSTRACT FROM AUTHOR]

Persistent organic pollutants pose a great threat to amphibian populations, but information on the bioaccumulation of contaminants in amphibians remains scarce. To examine the tissue distribution and maternal transfer of organic halogenated pollutants (OHPs) in frogs, seven types of tissues from black‐spotted frog (muscle, liver, kidney, stomach, intestine, heart, and egg) were collected from an e‐waste–polluted area in South China. Among the seven frog tissues, median total OHP concentrations of 2.3 to 9.7 μg/g lipid weight were found (in 31 polychlorinated biphenyl [PCB] individuals and 15 polybrominated diphenyl ether [PBDE], dechlorane plus [syn‐DP and anti‐DP], bexabromobenzene [HBB], polybrominated biphenyl] PBB153 and ‐209], and decabromodiphenyl ethane [DBDPE] individuals). Sex‐specific differences in contaminant concentration and compound compositions were observed among the frog tissues, and eggs had a significantly higher contaminant burden on the whole body of female frogs. In addition, a significant sex difference in the concentration ratios of other tissues to the liver was observed in most tissues except for muscle. These results suggest that egg production may involve the mobilization of other maternal tissues besides muscle, which resulted in the sex‐specific distribution. Different parental tissues had similar maternal transfer mechanisms; factors other than lipophilicity (e.g., molecular size and proteinophilic characteristics) could influence the maternal transfer of OHPs in frogs. Environ Toxicol Chem 2024;43:1557–1568. © 2024 SETAC [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors. Materials and methods: An online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023. Results: In this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work–family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout. Conclusions: Fatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China. [ABSTRACT FROM AUTHOR]

The conversion of coal-fired power plants to nuclear power stations is a potential method for decarbonizing coal power and offers a pathway for low-carbon development in China's power industry. This paper focuses on retrofitting China's coastal coal-fired power stations and compares the potential nuclear reactor technologies for the retrofit: China's mainstream pressurized water reactor and the commercially operated fourth-generation high-temperature gas-cooled reactor (HTGR). The analysis compares the degree of matching between the two technologies and coal-fired power stations in terms of unit capacity, thermal system parameters, unit speed, structural dimensions, and weight, which significantly impact the retrofit scheme. The results indicate that HTGR is more compatible with coal-fired power plants and is recommended as the type of nuclear reactor technology to be retrofitted. The study selected the 210 MWe High-Temperature Gas-Cooled Reactor Pebble-Bed Module (HTR-PM) as the reactor technology for retrofitting a typical 300 MW class subcritical coal-fired unit. Based on the concept of subcritical parameters upgrading, the potential analysis and strategy study of retrofit is carried out in terms of the turbine, the main heat exchange equipment, the main pumps, and the main thermal system pipelines in the conventional island. The results indicate that the conventional island of the HTR-PM nuclear power plant has significant potential for retrofitting, which can be a crucial research direction for nuclear retrofitting of coal-fired power plants. [ABSTRACT FROM AUTHOR]

Background: The incidence of rabies exposure is high and increasing in China, leading to an urgent demand of rabies post-exposure prophylaxis (PEP) clinics for the injured. However, the spatial accessibility and inequality of rabies-exposed patients to rabies PEP clinics is less known in China. Methods: Based on rabies exposure data, PEP clinic data, and resident travel origin-destination (OD) matrix data in Guangzhou City, China, we first described the incidence of rabies exposure in Guangzhou from 2020 to 2022. Then, the Gaussian two-step floating catchment area method (2SFCA) was used to analyze the spatial accessibility of rabies-exposed patients to rabies PEP clinics in Guangzhou, and the Gini coefficient and Moran's I statistics were utilized to evaluate the inequality and clustering of accessibility scores. Results: From 2020 to 2022, a total of 524,160 cases of rabies exposure were reported in Guangzhou, and the incidence showed a significant increasing trend, with an average annual incidence of 932.0/100,000. Spatial accessibility analysis revealed that the overall spatial accessibility scores for three scenarios (threshold of driving duration [d0] = 30 min, 45 min, and 60 min) were 0.30 (95% CI: 0.07, 0.87), 0.28 (95% CI: 0.11, 0.53) and 0.28 (95% CI: 0.14, 0.44), respectively. Conghua, Huangpu, Zengcheng and Nansha districts had the higher accessibility scores, while Haizhu, Liwan, and Yuexiu districts exhibited lower spatial accessibility scores. The Gini coefficient and Moran's I statistics showed that there were certain inequality and clustering in the accessibility to rabies PEP clinics in Guangzhou. Conclusions: This study clarifies the heterogeneity of spatial accessibility to rabies PEP clinics, and provide valuable insights for resource allocation to achieve the WHO target of zero human dog-mediated rabies deaths by 2030. [ABSTRACT FROM AUTHOR]

This study examined the mediating role of intergroup orientation in the relationship between ethnic and national identification. Our participants were 1320 Yi minority youths from a secondary school located in the Yi ethnic autonomous prefecture of southwest China. The participants completed three self-report questionnaires measuring ethnic and national identification, and intergroup orientation, respectively. Structural equation modeling was employed to determine the relationships between ethnic and national identification and intergroup orientation, and to explore the mechanism underlying the association between ethnic and national identification. The results showed that Yi minority youths with a stronger sense of ethnic identity had a stronger sense of national identity. The results further indicated that stronger ethnic identity led to a more positive intergroup orientation, which in turn predicted a stronger national identity. Our findings may facilitate the cultivation of positive attitudes between national subgroups in multiethnic countries and help ethnic minority youth develop a stronger awareness of national identity while retaining their ethnic identity. [ABSTRACT FROM AUTHOR]

Background: Although China has a long history of using insects as food and medicine and has developed numerous associated knowledge and practices, especially in its rural and mountainous areas, systematic surveys concerning this subject are limited. In-depth ethnobiological research is needed to compile a comprehensive database of edible and medicinal insects and record the associated knowledge of these food and medicinal resources. Methods: Data on edible and medicinal insects and associated knowledge about them were collected by interviewing 216 local villagers in a mountainous territory in southeast Guangxi Zhuang Autonomous Region, China. Results: Local villagers used at least 16 edible and 9 medicinal insects, of which 4 wasp species were used in both entomophagy and medicinal practices. Parapolybia varia, Polistes olivaceus, and Anomala chamaeleon were newly recorded edible insects in China. The wasps, Euconocephalus sp., Gryllotalpa orientalis, and Cyrtotrachelus longimanus, were preferred and culturally important edible insects. Populations of Euconocephalus sp. and G. orientalis were reported to have substantially decreased in recent years. Wasps and a bamboo bee were used to treat rheumatism, while cockroaches and antlions were used to treat common cold symptoms in infants. Insect-related knowledge was positively correlated with the interviewees' age. Conclusions: Villagers have accumulated considerable local and traditional knowledge of entomophagy and entomo-therapeutic practices. However, this knowledge is in danger of being lost, which highlights the urgent need to document this information. Edible insects enrich local diets, and a more sustainable supply (such as through insect farming) could maintain local entomophagy practices. Medicinal insects are a part of local folk medicine, and pharmacological and chemical techniques could be applied to identify various biologically active substances in these insects. [ABSTRACT FROM AUTHOR]

Information and communication technologies (ICTs) in basic education, i.e. K12 education, have often been constrained by sociocultural context and limited to pedagogical aspects, and these innovations have not yet catalyzed curriculum reform as expected. To address this research gap, this study adopted a key-competence-based subject knowledge learning tool, i.e. Smart Learning Partner (SLP), and conducted a quasi-experimental study to evaluate its effects among middle school students. A total of 400 participants in Grade 7 from four schools were followed for a period of two and a half years. The results on online learning engagement indicated that the manipulation generally succeeded in promoting students' use of SLP in the experimental schools. Furthermore, the results on academic performance showed that SLP could not only directly benefit students' learning in the first academic year but also continued to have an effect within the following one and a half years. This study contributes to the existing knowledge in two aspects: first, it extends the use of an adaptive learning cognitive map and shows positive effects in supporting the implementation of the whole curriculum; second, it presents a long-term and large-scale example of successfully integrating ICTs into the key-competence-based curriculum reform in the Chinese context. [ABSTRACT FROM AUTHOR]

Background: Accurately stratifying patients with pulmonary arterial hypertension (PAH) is very important, and traditional risk scores still have internal heterogeneity. This study aimed to construct a risk stratification model that can accurately identify clinical worsening (CW) events in conventional low‐intermediate risk patients with pulmonary hypertension under targeted drug treatment by using echocardiographic parameters. Methods: This study is a single‐center, prospective study, including 105 PAH patients who underwent regular follow‐up at Guangdong Provincial People's Hospital from October 2021 to April 2023. The primary endpoint was the occurrence of CW, including death, hospitalization due to pulmonary hypertension, escalation of targeted drug therapy, and worsening of PAH. The predictive value of the echocardiography‐based three‐strata risk model was assessed using Kaplan‐Meier curves and COX regression analysis. Results: A total of 98 PAH patients were ultimately included in this study. The median follow‐up duration was 26 months (range 7–28 months). The echocardiography‐based three‐strata model included the ratio of tricuspid annular plane systolic excursion and pulmonary artery systolic pressure (TAPSE/PASP) and inferior vena cava (IVC). The echocardiography‐based three‐strata model had higher diagnostic value (C‐index =.76) compared to the 2022 ESC/ERS three‐strata model and four‐strata model (C‐index =.66 and C‐index =.61, respectively). PAH patients with lower TAPSE/PASP and wider IVC showed a higher CW rate compared to patients with higher TAPSE/PASP and normal IVC (HR = 15.1, 95%CI:4.4‐51.9, p <.001). Conclusion: The echocardiography‐based three‐strata model based on TAPSE/PASP and IVC can effectively improve the stratification of low‐intermediate risk PAH patients under targeted treatment. [ABSTRACT FROM AUTHOR]

This paper complicates the classic security dilemma by considering the notions of ontological security and relational deterrence. It studies how the ontological security dilemma has emerged between the US, China, and Taiwan from the relational perspective and how these spiral chains will further develop in the future. The paper incurs the literature on relational analysis to expound on how different ontological security concerns allude to relational deterrence between the three actors. Taiwan's separatism is more of a threat to China's relational self than to physical security because the separatist does not belong to any already agreed relationship. A geometric model and a few simulations yield three unconventional findings. 1) The less advantaged the US military is over China, the less likely armed unification will occur. 2) The US anti-Chinese tendency is irrelevant in determining the probability of armed unification. 3) What may escalate the spiral are China's anti-Taiwan independence and Taiwan's anti-unification. Case sensitivity indicates the ontological sensibilities of a security dilemma. [ABSTRACT FROM AUTHOR]

Objectives Nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3-associated autoinflammatory disease (NLRP3 -AID) is a rare autosomal dominant systemic autoinflammatory disease. We aimed to summarize the phenotypic and genotypic features of Chinese adult NLRP3 -AID patients with hearing loss. Methods A retrospective cohort study of twenty-one adult patients with NLRP3 -AID was conducted in Peking Union Medical College Hospital between July 2015 and March 2023. All patients underwent whole exome sequencing and otorhinolaryngologic assessments. Clinical features and therapeutic data were collected and analysed. Results We found that 13/21 (61.90%) of patients had hearing loss with high-frequency impairment in the majority, and most patients presented with vestibular dysfunction as a new finding. The NLRP3 -AID patients with early-onset, cold or stress triggered episodes, red eyes, fatigue, hypopsia and mutations located in the NACHT domain of the NLRP3 protein were more likely to suffer from hearing loss, especially sensorineural hearing loss, perhaps as a result of pathogenic variants of high penetrance. By a series of audiological evaluations, TNF-α inhibitors were confirmed to improve or reverse hearing loss. Conclusions We reported the first cohort of Chinese adult NLRP3 -AID patients with hearing loss and characterized vestibular dysfunction, highlighted the necessity for attention to high-frequency hearing and provided potential alternative treatment. [ABSTRACT FROM AUTHOR]

Objective: The volume based procurement (VBP) program in China was initiated in 2022. The cost‐effectiveness of robotic arm assisted total knee arthroplasty is yet uncertain after the initiation of the program. The objective of the study was to investigate the cost‐effectiveness of robotic arm‐assisted total knee arthroplasty and the influence of the VBP program to its cost‐effectiveness in China. Methods: The study was a Markov model‐based cost‐effectiveness study. Cases of primary total knee arthroplasty from January 2019 to December 2021 were included retrospectively. A Markov model was developed to simulate patients with advanced knee osteoarthritis. Manual and robotic arm‐assisted total knee arthroplasties were compared for cost‐effectiveness before and after the engagement of the VBP program in China. Probability and sensitivity analysis were conducted. Results: Robotic arm‐assisted total knee arthroplasty showed better recovery and lower revision rates before and after initiation of the VBP program. Robotic arm‐based TKA was superior to manual total knee arthroplasty, with an increased effectiveness of 0.26 (16.87 vs 16.61) before and 0.52 (16.96 vs 16.43) after the application of Volume‐based procurement, respectively. The procedure is more cost‐effective in the new procurement system (17.13 vs 16.89). Costs of manual or robotic arm‐assisted TKA were the most sensitive parameters in our model. Conclusion: Based on previous and current medical charging systems in China, robotic arm‐assisted total knee arthroplasty is a more cost‐effective procedure compared to traditional manual total knee arthroplasty. As the volume‐based procurement VBP program shows, the procedure can be more cost‐effective. [ABSTRACT FROM AUTHOR]

T lymphoblastic leukemia /lymphoma (T-ALL/LBL) is a rare and highly aggressive neoplasm of lymphoblasts. We evaluated 195 T-ALL/LBL adolescent and adult patients who received ALL-type chemotherapy alone (chemo,n = 72) or in combination with autologous hematopoietic stem cell transplantation(auto-HSCT,n = 23) or allogeneic hematopoietic stem cell transplantation(allo-HSCT,n = 100) from January 2006 to September 2020 in three Chinese medical centers. 167 (85.6%) patients achieved overall response (ORR) with 138 complete response (CR) patients (70.8%) and 29 partial response (PR) patients (14.8%). Until October 1, 2023, no difference was found in 5-year overall survival (5-OS) and 5-year progression free survival(5-PFS) between allo-HSCT and auto-HSCT (5-OS 57.9% vs. 36.7%, P = 0.139, 5-year PFS 49.4% vs. 28.6%, P = 0.078) for patients who achieved CR, for patients who achieved PR, allo-HSCT recipients had higher 5-OS compared with chemo alone recipients (5-OS 23.8% vs. 0, P = 0.042). For patients undergoing allo-HSCT, minimal residual disease (MRD) negative population showed better 5-OS survival compared with MRD positive patients (67.8% vs. 19.6%, p = 0.000). There were no significant differences between early T-cell precursor (ETP), NON-ETP patients with or without expression of one or more myeloid-associated or stem cell-associated (M/S+) markers (NON-ETP with M/S+, NON-ETP without M/S+) groups in allo-HSCT population for 5-OS. (62.9% vs. 54.5% vs.48.4%, P > 0.05). Notch mutations were more common in patients with non-relapsed/refractory disease than relapsed/refractory disease (χ² =4.293, P = 0.038). In conclusion, Allo-HSCT could be an effective consolidation therapy not just for patients with CR, but also for those who achieved PR. The prognosis is significantly improved by obtaining MRD negative prior to allogeneic transplantation. [ABSTRACT FROM AUTHOR]

In contrast to Western platforms, which are dominated by crowdsourced labour, China's food-delivery platforms rely heavily on outsourced couriers to provide high-quality services. The conflicts emerging from outsourced labour relations have been inadequately examined. Based on extensive fieldwork in south China, this study reveals an intriguing fact: the outsourcing model frequently triggers yet largely conceals couriers' strikes. This study uses the work regime approach and labour bargaining power theory to analyse the complex dynamics created by the platforms. By scrutinizing state institutions, relationships among various organizations and workplace interactions, this study finds that the platform firms have dominant power but that inherent tensions exist between outsourcing platform firms, outsourced agencies, human supervisors and workers, forming a regime that this study calls "contentious despotism." Importantly, labour conflict is alive and potentially enduring in China's gigantic platform economy. [ABSTRACT FROM AUTHOR]

Bay areas have experienced a rapid development in their city integration and tourism industry over the past decade. However, city integration has rarely been studied in the tourism literature along with its dimensions and impact on tourism development. Therefore, this study examines city integration and its effects on tourism development from the perspective of residents in the Greater Bay Area, China. Through a qualitative research method with 73 semi-structured interviews, this study identified five dimensions of the effects of city integration on tourism development were also determined, including resource, community, product, marketing and economic dimensions. The theoretical contributions and practical implications of the findings were also discussed. [ABSTRACT FROM AUTHOR]

Improving corporate carbon performance is imperative for sustainable economic and social development. Using a sample of Chinese A-share-listed manufacturing firms from 2012 to 2019, this study explores how government environmental subsidies affect corporate carbon performance. The baseline results show that government environmental subsidies are positively associated with corporate carbon performance, suggesting an improving effect of government environmental subsidies on corporate carbon performance. These results are robust to a set of sensitivity tests. Further, the channel analyses show that government environmental subsidies improve corporate carbon performance by alleviating financial constraints and enhancing environmental information disclosure. Moreover, cross-sectional analyses show that the improving effect of government environmental subsidies on corporate carbon performance is stronger in state-owned enterprises, in firms with higher executive environmental awareness, and in firms with higher media attention. This study provides meaningful insights for the government seeking to promote low-carbon development through environmental subsidies. [ABSTRACT FROM AUTHOR]

Objective: To understand the epidemiological distribution characteristics of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in Yangquan City, Shanxi Province, China, from 2006 to 2021, to explore the influencing factors leading to the re-emergence of the epidemic, and to provide a basis for the formulation of targeted control strategies. Methods: Case information spanning from 2006 to 2021 in Yangquan City was collected for a retrospective case-control study conducted from June to September 2022. A 1:3 matched ratio was employed. A questionnaire was utilized to gather data on basic information, demographic characteristics, awareness of MT-ZVL knowledge, residence, and dog breeding and living habits. The study employed a multifactorial conditional stepwise logistic regression model to analyze the influencing factors. Results: A total of 508 subjects was analyzed. Risk factors for MT-ZVL included the use of soil/stone/concrete as building materials (OR = 3.932), presence of nearby empty/stone stack houses (OR = 2.515), dog breeding (OR = 4.215), presence of stray dogs (OR = 2.767), and neighbor's dog breeding (OR = 1.953). Protective factors comprised knowledge of MT-ZVL (OR = 0.113) and using mosquito repellents (OR = 0.388). The findings indicate significant associations between environmental and behavioral factors and MT-ZVL incidence in Yangquan City, Shanxi Province, China, from 2006 to 2021. These results underscore the importance of public awareness campaigns and targeted interventions aimed at reducing exposure to risk factors and promoting protective measures to mitigate the re-emergence of MT-ZVL outbreaks. Conclusion: House building materials, presence of neighboring empty houses, breeding domestic dogs and distribution of stray dogs surrounding the home are risk factors for MT-ZVL. Awareness of MT-ZVL and implementation of preventive measures during outdoor activities in summer and autumn are protective and may reduce the risk of MT-ZVL. Author summary: In recent years, a rapid reemergence of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) has been seen in the extension region of the Loess Plateau that had previously achieved elimination in China. In this study, we investigate the epidemiological characteristics of MT-ZVL and identify the factors associated with the rapid rise in MT-ZVL epidemics using a case-control design. A questionnaire was used to collect basic information, demographic characteristics, awareness of MT-ZVL knowledge, residence, and dog breeding and living habits. A multifactorial conditional stepwise logistic regression model was used to analyze the influencing factors. The study revealed that there has been a rising trend in the MT-ZVL endemic areas. House building materials, presence of neighboring empty houses, breeding domestic dogs and distribution of stray dogs surrounding the home are risk factors for MT-ZVL. Awareness of MT-ZVL and implementation of preventive measures during outdoor activities in summer and autumn are protective and may reduce the risk of MT-ZVL. We believe that our study makes a significant contribution to the literature to develop strategy for control the ongoing local transmission of MT-ZVL in hill districts. By analyzing the epidemiological characteristics and influencing factors of MT-ZVL, this research provides a basis for further optimizing the targeted control strategies. [ABSTRACT FROM AUTHOR]

Background: Propofol is effective and used as a kind of routine anesthetics in procedure sedative anesthesia (PSA) for ureteroscopy. However, respiratory depression and unconscious physical activity always occur during propofol-based PSA, especially in elderly patients. Esketamine has sedative and analgesic effects but without risk of cardiorespiratory depression. The purpose of this study is to investigate whether esketamine can reduce the propofol median effective dose (ED50) for successful ureteroscope insertion in elderly male patients. Materials and methods: 49 elderly male patients undergoing elective rigid ureteroscopy were randomly divided into two groups: SK Group (0.25 mg/kg esketamine+propofol) and SF Group (0.1 µg/kg sufentanil+propofol). Patients in both two groups received propofol with initial bolus dose of 1.5 mg/kg after sufentanil or esketamine was administered intravenously. The effective dose of propofol was assessed by a modified Dixon's up-and-down method and then was adjusted with 0.1 mg/kg according to the previous patient response. Patients' response to ureteroscope insertion was classified as "movement" or "no movement". The primary outcome was the ED50 of propofol for successful ureteroscope insertion with esketamine or sufentanil. The secondary outcomes were the induction time, adverse events such as hemodynamic changes, hypoxemia and body movement were also measured. Result: 49 patients were enrolled and completed this study. The ED50 of propofol for successful ureteroscope insertion in SK Group was 1.356 ± 0.11 mg/kg, which was decreased compared with that in SF Group, 1.442 ± 0.08 mg/kg (P = 0.003). The induction time in SK Group was significantly shorter than in SF Group (P = 0.001). In SK Group, more stable hemodynamic variables were observed than in SF Group. The incidence of AEs between the two groups was not significantly different. Conclusion: The ED50 of propofol with esketamine administration for ureteroscope insertion in elderly male patients is 1.356 ± 0.11 mg/kg, significantly decreased in comparsion with sufentanil. Trial registration: Chinese Clinical Trial Registry, No: ChiCTR2300077170. Registered on 1 November 2023. Prospective registration. http://www.chictr.org.cn. [ABSTRACT FROM AUTHOR]

Potash, also known as potassium (K), is a crucial component of the agricultural sector and serve as "the food of food". Historically, the formation of potash deposits has been attributed to the "tectonic-climatic" theory, in which the role of prolonged arid climate is still debating. Consider the minerogenetic time scale, paleoclimatic events may have played an undeniable role in the formation of potash. However, few studies have been conducted on this topic, which may impede theoretical development. The Lop Nur playa of the Tarim Basin, Northwest China, is a typical hinterland salt lake that formed during the combined effect of the collision between the Eurasian Plate and the Indian Plate and the Quaternary climatic background. As a potash metallogenetic area, Lop Nur is the best place to study how paleoclimatic events affect salt mineralization. In this study, we summarize the development of paleoclimate records and multiple ages from Quaternary sediments and analyze the mineralization theory of the Lop Nur salt lake. The comprehensive chronicle framework employed in paleoenvironmental reconstruction has unveiled the fluctuating aridity and the subsequent process of playa formation. By integrating mineralization mechanisms, ranging from the "mountain-basin transfer" theory to the "tectonic-climatic-source coupled" theory, we systematically reviewed the potential impacts of paleoclimatic events as both impetuses and limitations in the formation of potash deposits in Lop Nur. From a more prospective aspect of this review, the paleoclimatic events for potash mineralization are examined in relation to the worldwide distribution of salt lakes. This examination takes into account the lacustrine paleo-proxies and potash types, which indicate similar paleoclimatic influences on the mineralization process, albeit with varying origins. In the future, a more comprehensive understanding of potassium salt resources can be achieved through a thorough comparison of reconstructed paleoenvironments and high-resolution regional mineralization modeling results. [ABSTRACT FROM AUTHOR]

To alleviate the contradiction in healthcare resources, the Chinese government formally established the framework of a hierarchical medical system in 2015, which contains the following brief generalities: " separate treatment of emergencies and slows, first-contact care at the primary, two-way referral, and upper and lower linkage, ". This study systematically summarizes and models the connotations of China's hierarchical medical system and a sample of 11,200 chronic disease patients in Tianjin, the largest port city in northern China, was selected for the empirical study to investigate the relationship between chronic disease patients' policy perceptions of the hierarchical medical system and their preference for healthcare. We found that under the strategy of separate treatment, improving the healthcare accessibility, drug supply, and lowering the cost of medical care would have a positive impact on increasing the preference of patients with chronic diseases to go to the primary hospitals. Under the two-way triage strategy, improving the level of physician services, referral convenience and treatment Standards have a positive impact on chronic disease patients' preference for primary care; The impact of the hierarchical medical system on the preference for healthcare differed between groups, focusing on differences in health literacy level, age and household type; The role of " upper and lower linkage " is crucial in the hierarchical medical system and it plays a part in mediating the influence of the " separate treatment of emergencies and slows" design and the "two-way referral " order on the treatment preferences of chronic disease patients. The results of the study provide a reference for the further development of a scientific and rational hierarchical medical system in the future. [ABSTRACT FROM AUTHOR]

Background: The Baiku Yao, primarily residing in Guangxi and Guizhou provinces of China, is a distinctive branch of the Yao ethnic group, known for their profound cultural preservation and unique ethnobotanical knowledge. This study investigates the Baiku Yao community's utilization of traditional food plants, focusing on the relationship between their dietary practices and the local biodiversity within their mountainous living environment. It aims to illuminate the cultural significance and survival strategies embedded in their ethnobotanical knowledge, highlighting the potential for sustainable living and biodiversity conservation. Methods: Through ethnobotanical surveys, key informant interviews, and quantitative analysis techniques such as the cultural food significance index (CFSI) and relative frequency of citations (RFC), this research systematically documents the diversity and cultural importance of edible plants in the Baiku Yao community. The study assesses how these plants contribute to the community's diet, traditional medicine, and overall cultural practices. Results: A total of 195 traditional edible plants were documented, belonging to 142 genera and 68 families, with a significant concentration in certain families such as Asteraceae, Rosaceae, and Fabaceae. The Baiku Yao diet prominently features herbaceous plants, with wild (103 species) and cultivated (89 species) varieties as diverse food sources. They utilize various plant parts, particularly fruits and leaves, for multiple purposes, including nutrition, medicine, and fodder. Their processing techniques, from raw to fermented, showcase a rich culinary tradition and emphasize a holistic use of plants for enhancing diet and health in a concise overview. The RFC and CFSI analyses reveal a deep cultural reliance on a variety of plant species, with a notable emphasis on vegetables, fruits, spices, and medicinal herbs. Specific plants like Zingiber officinale, Zea mays, and Oryza sativa were highlighted for their high cultural significance. The study also uncovers the multifunctional use of these plants, not only as food but also for medicinal purposes, fodder, and other cultural applications, reflecting the Baiku Yao's profound ecological wisdom and their harmonious coexistence with nature. Conclusion: The findings emphasize the rich ethnobotanical knowledge possessed by the Baiku Yao, underscoring the importance of documenting, safeguarding, and transmitting this invaluable traditional knowledge. This study contributes to a deeper understanding of cultural heritage and biodiversity conservation, advocating for concerted efforts to protect such traditional practices against the threats of modernization and cultural erosion. [ABSTRACT FROM AUTHOR]

Background: As the number of elderly migrants in China continues to grow, it is necessary to pay closer attention to their health and health services. Some studies have confirmed that social capital plays a significant role in the utilization of health services. Therefore, an in-depth exploration of the relationship between social capital and the utilization of essential public health services (EPHS) by elderly migrants will not only contribute to improving their overall health but also facilitate a more balanced development of public health service system in China. Methods: Based on the cross-sectional data from the 2017 China Migrants Dynamic Survey (CMDS), this study examined the impact of social capital on the utilization of EPHS among elderly migrants. We evaluated social capital at two distinct levels: the individual and the community, and considered two dimensions of social capital: structural social capital (SSC) and cognitive social capital (CSC). The study aimed to delve into the impact of these forms of social capital on the utilization of EPHS among elderly migrants, and whether the migration range moderates this impact by multilevel logistic regression analysis. Results: A total of 5,728 migrant elderly individuals were selected. The health records establishment rate and health education acceptance rate were approximately 33.0% and 58.6%, respectively. Social capital influenceed the utilization of EPHS among elderly migrants. Specifically, individual-level SSC and CSC have impacts on both the establishment of health records (OR = 1.598, 95%CI 1.366–1.869; OR = 1.705, 95%CI 1.433–2.028) and the acceptance of health education (OR = 1.345, 95%CI 1.154–1.567; OR = 2.297, 95%CI 1.906–2.768) among elderly migrants, while community-level SSC only affected the acceptance of health education (OR = 3.838, 95%CI 1.328–11.097). There were significant differences in individual-level SSC, health records, and health education among different migration range subgroups among elderly migrants. Migration range moderated the effect of social capital on the utilization of EPHS, crossing provinces could weaken the relationship between SSC and health education. Conclusions: Social capital is associated with a higher utilization rate of EPHS among elderly migrants. It is necessary to encourage them to actively participate in social activities, strengthen public services and infrastructure construction in the area, and improve their sense of belonging and identity. [ABSTRACT FROM AUTHOR]

Objectives: With the world's population increasing in age, there has been a significant rise in the prevalence of cognitive impairment and dementia among individuals. This study aims to investigate the association between grandparenting and cognitive function among middle-aged and older Chinese using data from 2011 to 2018 China Health and Retirement Longitudinal Study (CHARLS). Additionally, the study seeks to explore the potential mediating effect of intergenerational support from children on this relationship, using data from the CHARLS 2011 database. Methods: 5254 participants were recruited at the baseline survey in CHARLS 2011. Subsequently, a follow-up survey was conducted over 8 years, from CHARLS 2011 to 2018, with 1472 individuals completing the follow-up survey. The CHARLS included surveys on grandparenting and cognitive assessments. Grandparenting was categorized as yes and no. The assessment of cognitive function involved the evaluation of episodic memory and mental intactness. The present study used cross-sectional and longitudinal analyses to examine the relationship between grandparenting and cognitive function. The bootstrap method assessed the mediating effect of children's intergenerational support. Results: The results of both cross-sectional and longitudinal studies indicated a positive association between grandparenting and cognitive function in middle-aged and older Chinese (B = 0.138, p < 0.05; B = 0.218, p < 0.05). Children's emotional and economic support played intermediary roles between grandparenting and cognitive function. Conclusion: The results emphasized the significance of policymakers considering the consequences of intergenerational care and family support when formulating and executing social service policies targeted at the middle-aged and older population in China. [ABSTRACT FROM AUTHOR]

Promoting the widespread access and integration of new energy generation into existing power markets is a key strategy for China to achieve peak carbon and carbon neutrality. A joint regulatory mechanism composed of government regulators, power generation enterprises, and third-party testing organizations has become an effective way to ensure the stable operation of the power market and safeguard the economic interest of all parties. In order to analyze the key factors affecting the mechanism and improve the regulatory efficiency, this paper constructs a three-party evolutionary game model, explores the motivations of the participants under different strategy choices, and establishes a set of indicator systems for evaluating producers. The evolutionary game model is numerically simulated using the unified dynamics method, and the evolutionary stable strategy analysis is used to reveal how the key parameters affect the outcome of the game and its dynamic process, so as to find out the potential driving factors affecting the strategy choices. The results of the study show that in the early stage of market development, it is crucial to improve the profitability of firms, and the government needs to impose strict penalties and high incentives. As the market gradually matures and becomes more transparent, the government can gradually reduce the level of penalties. At the same time, ensuring accountability mechanisms from higher authorities to the government is key to ensure the effectiveness of regulation. This study provides an important theoretical basis and policy recommendations for constructing a new regulatory structure for the electricity market. [ABSTRACT FROM AUTHOR]

Introduction and objective: Constipation is a common complication following spinal surgery that can result in distension, abdominal pain, infection, and even intestinal perforation. This study reports on an evidence-based implementation project to reduce the incidence of constipation in spinal surgery wards. Methods: The project was conducted in the spinal surgery ward of a general tertiary hospital in Changsha City, China, from March to August 2022. We used the JBI Implementation Framework and the JBI Model of Evidence-Based Healthcare for audits and feedback. Data were collected and analyzed using JBI's Practical Application of Clinical Evidence System (PACES) software. Seven audit criteria were developed based on the best practice recommendations summarized by JBI. A baseline audit was conducted with 20 nurses and 50 patients in the spinal surgery ward, and a follow-up audit was conducted using the same sample size and setting. Results: The baseline audit revealed compliance below 46% for five of the seven criteria. Strategies developed to address poor compliance included educating nurses and patients, developing a post-operative constipation risk assessment sheet, organizing stakeholder focus group meetings, establishing a constipation management routine, and effective empowerment of nurses. The follow-up audit showed positive compliance results, with the highest rate for Criterion 7 (100%) and the greatest increase for Criterion 2 (from 0% to 78%). Furthermore, the incidence of post-operative constipation decreased from 48% to 16%. Conclusion: The project improved compliance with audit criteria, reduced the incidence of constipation, and enhanced the efficiency of quality management in the spinal surgery ward. http://links.lww.com/IJEBH/A186 [ABSTRACT FROM AUTHOR]

Camellia oleifera is a woody, edible-oil plant native to China. Anthracnose is the major disease of Ca. oleifera, and Colletotrichum fructicola is the main epidemic pathogen. Our previous research indicated that CfHac1 (homologous to ATF/CREB1) and CfGcn5 (general control nonderepressible 5, Gcn5) are integral to key cellular processes that govern fungal development and pathogenesis. Further transcriptomic analyses of the CfHac1 and CfGcn5 mutants, particularly under conditions of endoplasmic reticulum (ER) stress, hold the potential to unveil additional genes implicated in this critical cellular response. We identified all OST/PMT (oligosaccharyltransferase/Protein O-Mannosyltransferases) genes in C. fructicola and analyzed their expression levels. To elucidate novel glycosylation-related genes that may be important for the virulence of C. fructicola, we took an unbiased transcriptomic approach comparing wild-type and the ∆Cfhac1 mutant. Notably, all OST/PMT genes were induced by dithiothreitol and down-regulated in the ΔCfhac1 mutant, yet only the CfPMT4 (Protein O-Mannosyltransferases 4) gene (A04626) was unaffected in the ΔCfgcn5. The results of targeted gene deletion experiments indicate that CfPMT4 plays a crucial role in both vegetative growth and conidiation. Additionally, our investigation revealed that the ΔCfpmt4 exhibits deficiencies in appressorium formation, as well as in its response to cell wall integrity and endoplasmic reticulum stresses. Furthermore, the mutant displayed impaired glycogen metabolism, which may contribute to reduced penetration ability. Overall, CfPmt4, an O-mannosyltransferase, controls the growth, development, and pathogenicity of Colletotrichum fructicola. Understanding the function of the CfPMT4 homolog could provide a potential molecular target for controlling Ca. oleifera anthracnose. [ABSTRACT FROM AUTHOR]

The rice–crayfish co-culture system, a representative of Agri-aqua food systems, has emerged worldwide as an effective strategy for enhancing agricultural land use efficiency and boosting sustainability, particularly in China and Southeast Asia. Despite its widespread adoption in China's Jianghan Plain, the exact spatiotemporal dynamics and factors influencing this practice in this region are yet to be clarified. Therefore, understanding the spatiotemporal dynamics and influencing factors of the rice–crayfish fields (RCFs) is crucial for promoting the rice–crayfish co-culture system, and optimizing land use policies. In this study, we identified the spatial distribution of RCF using Sentinel-2 images and land use spatiotemporal data to analyze its spatiotemporal dynamics during the period of 2016–2020. Additionally, we used the Multiscale Geographically Weighted Regression model to explore the key factors influencing RCF's spatiotemporal changes. Our findings reveal that (1). the RCF area in Jianghan Plain expanded from 1216.04 km2 to 2429.76 km2 between 2016 and 2020, marking a 99.81% increase. (2). RCF in Jianghan Plain evolved toward a more contiguous and clustered spatial pattern, suggesting a clear industrial agglomeration in this area. (3). The expansion of the RCFs was majorly influenced by its landscape and local agricultural conditions. Significantly, the Aggregation and Landscape Shape Indexes positively impacted this expansion, whereas proximity to rural areas and towns had a negative impact. This study provides a solid foundation for promoting the rice–crayfish co-culture system and sustainably developing related industries. To ensure the sustainable development of rice–crayfish co-culture industries in Jianghan Plain, we recommend that local governments optimize the spatial layout of rural settlements, improve transportation infrastructure, and enhance regional agricultural water sources and irrigation system construction, all in line with the national strategy of rural revitalization and village planning. Additionally, promoting the concentration and contiguity of RCF through land consolidation can achieve efficient development of these industries. [ABSTRACT FROM AUTHOR]

Introduction: Public stigma towards people who use drugs is widespread and places obstacles in way of their recovery. Previous studies have used different approaches to measure public stigma, resulting in a notable gap in the understanding of the relationship between it and its associated factors. Some studies measure public stigma by assessing stigma perceived by those who use drugs, while others investigate attitudes towards them among the general public. This study aimed to compare perceived and public stigma, and factors related to these two variables. Methods: The study comprised a cross‐sectional survey in China of two samples: males who used drugs (N = 257) and the general public (N = 376). The survey assessed demographic variables, social distance, public stigma and perceived stigma of those who use drugs. The data were analysed using t‐tests and linear regression. Results: Public stigma was significantly higher than perceived stigma. The findings indicated that gender, knowledge of drugs, family relationships with people who use drugs, attributions of drug use and social distance were significantly related to levels of public stigma. Among those who use drugs, perceived stigma was significantly correlated with age, marital status, duration of drug abstinence and social distance. Discussion and Conclusions: Findings indicate that public stigma undermines the recovery of people who use drugs and highlight the importance of interaction between them and the social environment. The study also underscores the necessity of developing policies to enhance their integration into mainstream culture and provide access to social support and life activities. [ABSTRACT FROM AUTHOR]

SM4 cryptographic algorithm is a block cipher algorithm issued by China's state cryptographic administration and has become an international standard. We implement the quantum circuits of SM4 block cipher by optimizing the number of qubits and the value of depth-times-width. The quantum circuits of the S-box are first studied. According to the algebraic structure of the S-box, four kinds of improved quantum circuits of S-box are presented for different phases in SM4 based on composite field arithmetic. In order to optimize the number of qubits, we implement the quantum circuit of SM4 by connecting the quantum subcircuits in series. The implemented quantum circuit of SM4 only uses 260 qubits, which is the least number of qubits used not only in implementing the SM4 quantum circuit, but also in implementing the block cipher algorithms with 8-bit S-box, 128-bit plaintext and 128-bit secret key. When optimizing the value of depth-times-width, we achieve it through parallel implementation. The trade-off quantum circuit uses a total of 288 quantum bits, and the Toffoli depth is 1716. The depth-times-width is 49,4208, which is less than the existing best value 82,5792. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the correlation between socioeconomic status (SES) and the incidence of hypertension among adults aged 18 or above in southwest China. Methods: A multistage proportional stratified cluster sampling method was employed to recruited 9280 adult residents from 12 counties in southwest China, with all participants in the cohort tracked from 2016 to 2020. The questionnaire survey gathered information on demographics, lifestyle habits, and household income. The physical exam recorded height, weight, and blood pressure. Biochemical tests measured cholesterol levels. The chi-square test was employed to assess the statistical differences among categorical variables, while the Cox proportional hazards regression model was applied to evaluate the association between socioeconomic status (SES) and the incidence of hypertension. Results: The finally effective sample size for the cohort study was 3546 participants, after excluding 5734 people who met the exclusion criteria. Adults in the highest household income group had a significantly lower risk of hypertension compared to those in the lowest income group (HR = 0.636, 95% CI: 0.478–0.845). Besides, when compared to individuals in the illiterate population, the risk of hypertension among adults with elementary school, junior high school, senior high school and associate degree educational level decreased respectively by 34.4% (HR = 0.656, 95%CI: 0.533–0.807), 44.9% (HR = 0.551, 95%CI: 0.436–0.697), 44.9% (HR = 0.551, 95%CI: 0.405–0.750), 46.1% (HR = 0.539, 95%CI: 0. 340–0.854). After conducting a thorough analysis of socioeconomic status, compared with individuals with a score of 6 or less, the risk of hypertension in participants with scores of 8, 10, 11, 12, and greater than 12 decreased respectively by 23.9% (HR = 0.761, 95%CI: 0.598–0.969), 29.7% (HR = 0.703, 95%CI: 0.538–0.919), 34.0% (HR = 0.660, 95%CI: 0.492–0.885), 34.3% (HR = 0.657, 95%CI: 0.447–0.967), 43.9% (HR = 0.561, 95%CI: 0.409–0.769). Conclusion: The findings indicate a negative correlation between socioeconomic status and hypertension incidence among adults in southwest China, suggesting that individuals with higher socioeconomic status are less likely to develop hypertension. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents and young adults are the main target population for human papillomavirus (HPV). The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio‐ecological perspective. Design: A questionnaire survey was conducted in three secondary schools and three colleges in China. Sample: A total of 1756 students aged 14–22 years participated in this study. Among the 1756 participants, 182 students have received the HPV vaccine. For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors. Measurements: Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self‐efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured. Results: Only 182 (10.4%) had received the HPV vaccine among the 1756 participants. Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine. Binary logistic regression analysis showed that students who were female, had lower self‐efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine. Conclusions: Students had high HPV vaccination intentions while had low vaccination rate. Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention. Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake. [ABSTRACT FROM AUTHOR]

Objective: To examine the development and challenges of public health nursing education in China during the period of the Republic of China (1912‐1949). Methods: This study utilized a historical research design that combined a social framework and a policy framework to explore the early history of public health nursing education in China. Historical data were collected from periodicals, newspapers, archives, books and other sources. Results: Public health was integrated into the nursing school curriculum for the first time during the period of the Republic of China, and health facilities and nursing schools conducted early explorations of public health nurse training. However, public health nursing education faced difficulties in terms of the curriculum, personnel training, and the localization of education. Conclusions: The achievements and difficulties associated with public health nursing education in China during the period of the Republic of China provide a historical reference for the integration of public health into current basic nursing education and the compatibility between the training of public health nurses and practical needs. Comparative studies of early public health nursing education across countries are expected to offer a better understanding of current public health nursing education. [ABSTRACT FROM AUTHOR]

Background IgG4-associated kidney disease (IgG4-RKD) encompasses a spectrum of disorders, predominantly featuring tubulointerstitial nephritis (TIN) and membranous glomerulonephropathy (MGN). The limited understanding of the co-occurrence of IgG4-RD-TIN with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) poses a diagnostic and therapeutic challenge. Methods We examined 49 cases, comprising 21 cases of IgG4-RD-TIN (group A), 10 cases of IgG4-RD-TIN accompanied with MGN (group B), and 18 cases of IgG4-RD-TIN concurrent with AAV (group C), at the First Affiliated Hospital of Zhejiang University, China, from June 2015 to December 2022. Results The mean age and gender of the three IgG4-RKD subtypes were not statistically significant. IgG4-RD-TIN exhibited higher serum creatinine and a higher incidence of hypocomplementemia (group A 47.6%, group B 30%, group C 16.7%). IgG4-RD-TIN-MGN was characterized by proteinuria (group A 0.3 g/d, group B 4.0 g/d, group C 0.8 g/d, P  < 0.001) and hypoalbuminemia. IgG4-RD-TIN-AAV exhibited hypohemoglobinemia (group A 103.45 g/l, group B 119.60 g/l, group C 87.94 g/l, P  < 0.001) and a high level of urine erythrocytes. The primary treatment for IgG4-RD-TIN was steroids alone, whereas IgG4-RD-TIN-MGN and IgG4-RD-TIN-AAV necessitated combination therapy. Group A experienced two relapses, whereas groups B and C had no relapses. There was no significant difference in patient survival among the three groups, and only two cases in group C suffered sudden death. Conclusions This study provides valuable insights into clinical manifestations, auxiliary examination features, pathological characteristics, and prognosis of IgG4-RD-TIN, IgG4-RD-TIN-MGN, and IgG4-RD-TIN concurrent AAV. Large-scale studies are required to validate these findings. [ABSTRACT FROM AUTHOR]

Four new wood-inhabiting fungi, Trechispora albofarinosa, T. bisterigmata, T. pileata and T. wenshanensis spp. nov., are proposed based on a combination of morphological features and molecular evidence. Trechispora albofarinosa is characterized by the farinose basidiomata with flocculence hymenial surface, a monomitic hyphal system with clamped generative hyphae, and ellipsoid, warted basidiospores. Trechispora bisterigmata is characterized by the membranous basidiomata with odontioid hymenial surface, rhizomorphic sterile margin, barrelled basidia and subglobose to broad ellipsoid, smooth basidiospores. Trechispora pileata is characterized by the laterally contracted base, solitary or imbricate basidiomata, fan shaped pileus, radially striate-covered surface with appressed scales, odontioid hymenophore surface, and subglobose to broad ellipsoid, thin-walled, smooth basidiospores. Trechispora wenshanensis is characterized by a cottony basidiomata with a smooth hymenial surface, and ellipsoid, thin-walled, warted basidiospores. Sequences of ITS and LSU marker of the studied samples were generated, and phylogenetic analyses were performed with the maximum likelihood, maximum parsimony, and Bayesian inference methods. The phylogenetic tree inferred from the ITS+nLSU sequences highlighted that four new species were grouped into the genus Trechispora. [ABSTRACT FROM AUTHOR]

Due to the increasing development of highway reconstruction and expansion projects in China, many large-span highway tunnels are being constructed near existing highway tunnels. Tunneling underneath will inevitably cause variation in the surrounding rock displacement and may even lead to collapse. In this study, based on an analysis of extensive field monitoring data from the Gucheng tunnel, the variation law for the surrounding rock full-displacement and the influence of the tunnel-face spatial effect in a large-span mudstone tunnel are analyzed. The change in the full displacement experienced the following sequence: slow pre-displacement growth → rapid increase → slow increase → gradual stability. The displacement released by the excavation of the tunnel construction accounts for 40~60% of the total displacement, and the closer to the excavation contour, the more obvious the displacement release. The final convergence value of vertical displacement is obtained by hyperbolic function regression prediction analysis. Based on this value, Lee and Hoek equations are used for parameter analysis and field-data fitting. It is concluded that the larger the proportion of the early displacement of the surrounding rock before construction to the total displacement, the smaller the influence of the tunnel-face spatial effect on the surrounding rock. The numerical simulation results are compared with actual monitoring results, and good agreement is observed. The larger the burial depth of the tunnel, the smaller the influence range in the tunnel-face spatial effect, and the more concentrated the displacement release. The variation law and the influential range for the surrounding rock full-displacement described in this paper can provide a reference for predicting and controlling the deformation during the construction of future large-span mudstone tunnels. [ABSTRACT FROM AUTHOR]

Background: Positive development plays an important role in youth when dealing with stressful circumstances. According to the resource dilution theory, adolescents with or without siblings may receive different levels of emotional and material resources from their parents. The purpose of this study is to examine the association between the positive development of adolescents in China today with their family characteristics such as the number of siblings. Methods: A total of 2072 junior high and senior high school students (13 to 18 years old) in Chengdu, Sichuan, China, were investigated by cluster sampling. The Chinese Positive Youth Development scales (CPYDs) were used to measure positive youth development. The generalized linear model was used to explore the relationships among the number of siblings, parent–child relationships and positive youth development. Results: Adolescents from only‐child families had better performance on positive development (H = 21.87, P < 0.001) and better relationships with parents (H = 15.1, P < 0.05). The positive development of male and female adolescents does not significantly differ in families with different numbers of siblings. The generalized linear model showed that a positive parent–child relationship is positively correlated with adolescent positive development (P < 0.05). Conclusion: Positive youth development is not only associated with the number of siblings but also other modifiable familial factors. The positive relationship between parents and adolescents is of great practical value in daily life to improve youth development, and this might be the real lesson the resource dilution theory tells. [ABSTRACT FROM AUTHOR]

Due to policy changes in the context of COVID-19 pandemic, online teaching has become the main form of class in many Chinese universities. Flipped classroom has been widely used in other disciplines, but there is a dearth of evidence available about the use in online teaching of emergency medicine. This study aimed to develop a flipped classroom for online emergency medicine teaching and evaluate its effectiveness by comparing it with traditional lecture-based online teaching. A total of 62 clinical medical undergraduates from Jinan University participated in this study from September to December in 2022. An online flipped classroom approach was developed (FC group, n = 31). Traditional lecture-based online teaching was applied as a contrast (LBT group, n = 31). The undergraduates completed examinations and questionnaires at the end of the course. A course experience questionnaire and course examination score were used to evaluate the effectiveness of the flipped classroom approach. Regarding the five dimensions of the course experience questionnaire, the scores for good teaching (3.47 ± 0.50 vs. 2.34 ± 0.48, p <.001), appropriate assessment (3.31 ± 0.68 vs. 2.95 ± 0.71, p =.043) and generic skills (3.16 ± 0.60 vs. 2.72 ± 0.39, p <.001) were higher for the FC group than for the LBT group. There was no significant difference between the two groups in clear goals and standards, and appropriate workload. The undergraduates in the FC group showed significantly higher overall satisfaction than those in the LBT group (3.52 ± 0.1.03 vs. 2.87 ± 0.92, p =.012). The examination scores (77.936 ± 11.573 vs. 70.484 ± 7.434, p <.001), especially the scores for questions related to case analysis (33.032 ± 5.363 vs. 26.968 ± 7.657, p <.001), were significantly higher in the FC group than in the LBT group. The flipped classroom for online teaching was efficient in improving undergraduates' emergency medical academic performance and promoting the development of clinical case analysis ability. These findings provide an alternative flipped classroom approach for online teaching of emergency medicine. [ABSTRACT FROM AUTHOR]