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The plethora of pathways leading to health problems of later life has made the causal assessment of widowhood on the health of older adults difficult. This research aimed to assess the short‐term impact of widowhood on the objective health of older adults and to the moderating role of community‐based care (CBC) in improving the health outcomes of older adults. In this study, the activities of daily living (ADLs) and number of hospitalisations of older adults were measured, and PSM‐DID models were conducted. Widowhood had a significant negative impact on the objective health of older adults. Widowed adults had higher ADL scores (B = 0.569, 95 percent CI: 0.295 to 0.844) and more hospitalisations (B = 2.551, 95 percent CI: 1.189 to 3.914) than nonwidowed adults. Meanwhile, CBC in urban areas can significantly reduce ADL scores (B = −0.154, SE = 0.082) and the number of hospitalisations (B = −1.402, SE = 0.348) in older adults, whereas CBC in rural areas can only significantly reduce ADL scores (B = −0.197, SE = 0.087). Taken together, there is an urgent need to focus on the health of widowed and older adults and to provide CBC in both urban and rural areas equally. [ABSTRACT FROM AUTHOR]

Introduction: Implementing integrated care for the aged population has been regarded as a mechanism to achieve healthy ageing. However, evidence from undeveloped nations has been scant. This study aims to explore the integrated care experience in Anhui and Fujian Province of China based on the Rainbow Model of Integrated Care (RMIC). Methods: The qualitative study was conducted in Anhui (in the middle area) and Fujian Province (in the eastern area) between May and September in 2018. The interviewees included twenty-eight policy makers working at departments of health and civil affairs at different levels and seventeen heads of medical and elderly care institutions. Results: The preliminary progress of integrated care in the sample cities of two provinces are mainly shown at solid policy basis by multiple key government agencies and political commitment achieved (system integration); preliminary coordination mechanism established between medical and elderly care institutions (organizational integration); consolidation of multi-disciplinary collaboration (professional integration); and reinforced role of family doctor teams for community-home dwelling elderly (service integration). Main challenges are also identified at insufficient inter-agency coordination, weak service capacity, lack of sustainable funding schemes, low level of information integration, and shortage of professional supply. Conclusion: Our findings provide a feasible path for other countries to strengthen integrated care for the aged population, particularly for those confronting rapid population ageing but with fragmented health care and elderly care systems. [ABSTRACT FROM AUTHOR]

Background: One of the most noticeable integrated care-related policies in China is the growth and proliferation of County-level Integrated Health Organizations (CIHOs), which take over a set of primary healthcare institutions to form an integrated delivery network in order to achieve an ordered hierarchical delivery system by strengthening primary care. Objectives: This paper presents emerging findings from an ongoing evaluation of the early impacts of the demonstrator site, Deqing CIHO, in Zhejiang Province, in order to examine the extent to which the implementation has achieved its core objectives: (1) establishing the hierarchical referral system, (2) capacity building of primary healthcare providers, and (3) reducing the costs. Design: This case study was conducted to determine institutional and managerial processes. Settings: Data were collected and analyzed at the CIHO and county level. A structured questionnaire was used for data collection. Primary and secondary outcome measures: Indicators were selected from the existing database of the county health system and arranged into three segments to assess (1) service utilization among each level of care; (2) capacity-building progress for primary care centers, (3) cost-related indicators for both levels of care. Results: Service utilization data show that one year after CIHO implementation, the proportion of patients who chose to get inpatient care outside of the county decreased from 27.3% to 24.5%. Hospital admissions were retrieved from outside the county, while service volume slightly shifted from hospitals to primary care sites. Capacitybuilding indicators for township health centers show that 6 out of 12 items showed better performance compared to the national average growth rate, and a moderated growth rate appeared in terms of per capita cost. Conclusion: Progress evaluation results from Deqing CIHO indicated some positive effects on three main outcomes, which reveal the potential of CIHOs in not only strengthening primary care but also controlling cost as a result of early implementation. Further emphases of evaluation are required to determine the impacts on the quality and experience of care that are estimated using claim-based data at the individual level. [ABSTRACT FROM AUTHOR]

Background: Paeonia lactiflora 'Hangshao' is widely cultivated in China as a traditional Chinese medicine 'Radix Paeoniae Alba'. Due to the abundant unsaturated fatty acids in its seed, it can also be regarded as a new oilseed plant. However, the process of the biosynthesis of unsaturated fatty acids in it has remained unknown. Therefore, transcriptome analysis is helpful to better understand the underlying molecular mechanisms. Results: Five main fatty acids were detected, including stearic acid, palmitic acid, oleic acid, linoleic acid and α-linolenic acid, and their absolute contents first increased and then decreased during seed development. A total of 150,156 unigenes were obtained by transcriptome sequencing. There were 15,005 unigenes annotated in the seven functional databases, including NR, NT, GO, KOG, KEGG, Swiss-Prot and InterPro. Based on the KEGG database, 1766 unigenes were annotated in the lipid metabolism. There were 4635, 12,304, and 18,291 DEGs in Group I (60 vs 30 DAF), Group II (90 vs 60 DAF) and Group III (90 vs 30 DAF), respectively. A total of 1480 DEGs were detected in the intersection of the three groups. In 14 KEGG pathways of lipid metabolism, 503 DEGs were found, belonging to 111 enzymes. We screened out 123 DEGs involved in fatty acid biosynthesis (39 DEGs), fatty acid elongation (33 DEGs), biosynthesis of unsaturated fatty acid (24 DEGs), TAG assembly (17 DEGs) and lipid storage (10 DEGs). Furthermore, qRT-PCR was used to analyze the expression patterns of 16 genes, including BBCP, BC, MCAT, KASIII, KASII, FATA, FATB, KCR, SAD, FAD2, FAD3, FAD7, GPAT, DGAT, OLE and CLO, most of which showed the highest expression at 45 DAF, except for DGAT, OLE and CLO, which showed the highest expression at 75 DAF. Conclusions: We predicted that MCAT, KASIII, FATA, SAD, FAD2, FAD3, DGAT and OLE were the key genes in the unsaturated fatty acid biosynthesis and oil accumulation in herbaceous peony seed. This study provides the first comprehensive genomic resources characterizing herbaceous peony seed gene expression at the transcriptional level. These data lay the foundation for elucidating the molecular mechanisms of fatty acid biosynthesis and oil accumulation for herbaceous peony. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationships between cognitive emotion regulation (CER) strategies, resilience, and insomnia and the underlying mechanism that explains the relationships. Six hundred and fifty-three middle-aged and old people recruited from community service centers in Henan province completed questionnaires related to CER strategies, resilience, and insomnia. Results showed refocus on planning and positive reappraisal negatively predicted insomnia, and catastrophising, rumination and self-blame positively predicted insomnia. Moreover, maladaptive emotion regulation strategies (especially catastrophising) mediated the relationship between resilience and insomnia. The findings suggest the middle-aged and elderly with insomnia tended to employ maladaptive emotion regulation strategies and had lower resilience. Maladaptive emotion regulation strategies buffered the positive effect of resilience on sleep. [ABSTRACT FROM AUTHOR]

In this study, sediment grain size (MGS), specific surface area (SSA), total organic carbon (TOC) contents, C/N molar ratios, stable carbon isotope, and P species in a sediment core, collected from the East China Sea (ECS) inner-shelf were measured to explore the applicability of detrital phosphorus (De-P) as a potential indicator of past flooding events in the Changjiang River Basin (CRB). In particular, we examined the linkages between the evolution of floods with regional climate changes and anthropogenic activities in the CRB. Peaks of De-P concentrations in sediments corresponded well with the worst flooding events of the CRB over the past two centuries (e.g., 1850s, 1860s, 1900s, 1920s, 1950s, 1980s, and 2000s). Moreover, De-P also corresponded well with the extreme hypoxic events in 1981 and 1998 in the Changjiang Estuary as indicated by Mo/Al ratios, indicating potential linkages between De-P as a flooding proxy to flood-induced hypoxia events in this region. In addition, a robust relationship was found among De-P, the floods in 1950s, 1980s, and 2000s of the CRB, the intensive El Niño-Southern Oscillation (ENSO), the abnormally weak East Asian Summer Monsoon (EASM) and the warm phase of Pacific Decadal Oscillation (PDO), suggesting that De-P also provided insights to linkages between regional climate change and flooding events in this region. [ABSTRACT FROM AUTHOR]

• Parent material and cropping system had higher explanation to stratification. • Clay loam soils had a weaker stratification compared to sandy loam soils. • Rice–upland crop rotation commonly increased organic carbon stratification. • Terrain, climate, soil depth and inherent content also affected stratification. The stratification ratio (SR) is a good indicator of the quantitative evaluation of the soil nutrient variation with depth, which is inter-related with nutrient cycles and agricultural productivity. However, the effects of the parent material and cropping system on the SR of soil organic carbon (SOC) and total nitrogen (TN) have received little attention. The current study collected 444, 437, and 363 soil samples at the depths of 0–20, 20–40, and 40–60 cm, respectively, in subtropical southwest China, where the predominant parent materials are alluvial deposits, purple shales, and limestone and the cropping systems are rice–upland crop rotation, upland crop rotation, and rice monoculture. A two-way analysis of variance (two-way ANOVA) and a redundancy analysis (RDA) were applied to investigate the effects of the parent material, cropping system, topography, and climate on SOC and TN contents, and the corresponding SR (SR1, 0–20 cm:20–40 cm; SR2, 0–20 cm:40–60 cm). Results indicated that the parent material and cropping system were the main factors linked to the SR of the SOC and TN, whereas topography and climate seemed to have weaker effects on the SR in the agricultural landscape. Generally, alluvial deposit- and purple shale-derived soils presented higher SR than limestone-derived soils. Rice–upland crop rotation systems increased the SR compared to rice monoculture and upland crop rotation systems. Exceptions were observed in rice–upland crop rotation and rice monoculture systems under limestone. The study highlighted the efficient SR indicator in examining the SOC and TN depth distribution corresponding to the parent material and cropping system and is expected to provide valuable information regarding the optimization of the cropping pattern in different lithological regions, thereby enhancing agricultural productivity. [ABSTRACT FROM AUTHOR]

Abstract: The speciation, potential bioavailability and preservation of phosphorus (P) in surface sediments of the Changjiang (Yangtze River) Estuary and adjacent East China Sea (ECS) inner shelf were investigated through the analyses of P fractions and sediment bulk properties. A sequential extraction method (SEDEX) was used to separate and quantify the following six sedimentary P reservoirs: exchangeable P (Ex–P), authigenic P (Au–P), detrital P (De–P), organic P (Or–P), refractory P (Re–P) and Fe-bound P (Fe–P). Total P (TP) in surface sediments ranged from 15.0 to 21.4 μmol g−1 and was highest near the Changjiang river mouth. The average contribution of each form of P to TP was 55.6% (De–P), 17.8% (Re–P), 16.1% (Or–P), 5.5% (Au–P), 2.5% (Ex–P) and 2.5% (Fe–P), respectively. De–P showed relatively higher concentrations in the river mouth and the ECS shelf region, off the Changjiang Estuary. High concentrations of Or–P were found mainly in mud areas showing a similar distribution pattern with silt, sediment surface area (SSA), and total organic carbon (TOC). Re–P was mainly distributed near the estuarine area and the Zhe–Min coast. Bioavailable P (BAP), accounted for 9.5–32.0% of TP (with a mean of 21.2%) and showed a similar distribution pattern to that of Or–P. De–P/SSA and TOC/SSA loadings both decreased with increasing of SSA, while Or–P/SSA loadings varied little with SSA, indicating that Or–P may have reached an adsorption–desorption equilibrium on mineral surfaces. TOC to total organic P (TOP; sum of Re–P and Or–P) ratios less than the Redfield ratio (84 in average) may have indicated efficient remineralization of organic matter in mobile muds of the Changjiang Estuary and adjacent ECS inner shelf. Furthermore, the relatively high TOC/Or–P ratios (72–422 with a mean of 188) likely suggest a higher degree of preferential regeneration of labile Or–P over TOC in sediments. [Copyright &y& Elsevier]

Background: Excessive consumption of sugar-sweetened beverages (SSBs) may increase the risk of obesity. Data in regards to the consumption of SSBs is insufficient in the Chinese population, especially in middle school students experiencing rapid nutritional transition. We aimed to describe the consumption of SSBs among junior high school students and explore the relationship between SSB intake and adolescents' overweight/obesity in Beijing. Methods: This was a cross-sectional study under which 322 (46%) male and 380 (54%) female (age 11-15 y, median 13 y) were recruited from two middle schools of Xicheng District in Beijing. All subjects completed a questionnaire and 24-hour dietary recall for 3 consecutive days. Results: Prevalence of overweight was 21.1% in males and 11.6% in females. Prevalence of obesity was 22.7% in males and 10.3% in females. Of the students, 7.7% consumed SSBs at least once per day. Students whose storage of SSBs at home is more than 1 type are more likely to consume higher quantities of SSBs everyday (p<0.001). After adjusting for confounding factors, OR of high SSBs intake group versus low SSBs intake group was 2.6. Students whose parents had a higher BMI had a higher risk of overweight/obesity (OR=1.13, p=0.007). Conclusions: Among middle school students in Beijing, prevalence of obesity is more severe than that of overweight. Sugar-sweetened beverages have been the most popular drinks, and consumption of SSBs has a positive association with levels of overweight/obesity among male students. [ABSTRACT FROM AUTHOR]

Background: When Angiostrongylus cantonensis develops from the third and fourth stage, it needs to change its host from the middle host, snail to the final host, rat. However, the mechanism involved in this change remains unclear. Methods: The transcriptome differences of the third and fourth stages of A. cantonensis were explored by next-generation Illumina Hiseq/Miseq sequencing in China, in 2018. Results: Overall, 137 956 488 clean reads and 20 406 213 373 clean bases of the two stages larvae were produced. Based on the queries against the Gene Ontology (GO), NCBI non-redundant protein sequences (Nr), Swissprot, and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, 14 204 differentially expressed genes (DEGs) were predicted. GO enrichment analysis revealed 5660 DEGs with the top s categories as followings: biological process (GO:0008150, related to 5345 DEGs), cellular component (GO:0005575, related to 5297 DEGs), molecular function (GO:0003674, related to 5290 DEGs). In KEGG enrichment analysis, 116 genes were related to oxidative phosphorylation and 49 genes involved in the glycolytic process. Conclusion: Metabolism changes, especially oxidative phosphorylation and glycolysis, might play a key role in A. cantonensis infection of its final rat host. Many other pathways might also contribute to the transcriptome changes between these two life stages. Overall, additional studies are needed for further details. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although Dietary Guidelines for Chinese Residents offers advice for breakfast in China, current breakfast consumption habits are unclear. The aim of this study was to describe the frequency of breakfast consumption among adults and explore its associations with daily food consumption and daily nutrient intake.Methods and Study Design: A stratified cluster sampling technique was employed in this cross-sectional study. Demographic characteristics, breakfast consumption, and daily food and nutrient intake were investigated.Results: Dietary data were collected for 3251 adult residents through interviews. We determined that residents with an annual income of Conclusions: Breakfast skipping may influence the daily intake of nutrients. A simple and important public health message should be delivered to target populations. [ABSTRACT FROM AUTHOR]

The chronobiology of cercarial emergence appeared to be a genetically controlled behavior, adapted to definitive host species, for schistosome. However, a few physiological and ecological factors, for example the change of photoperiod, were reported to affect the rhythmic emergence of cercariae. Therefore, the effect of photoperiod change on cercarial emergence of two Schistosoma japonicum isolates, the hilly and the marshland, was investigated. Four shedding experiments each under a different photoperiod were conducted. Under a natural photoperiod, two distinct shedding modes, one from the hilly region and one from the marshland, were observed. Under a reversed photoperiod, the regular pattern (i.e. under a natural photoperiod) of S. japonicum cercarial emergence was reversed for the marshland isolate and disappeared for the hilly isolate. With an input of a 2 h darkness from 7am to 9am, the cercarial emergence peak were delayed for the two isolates; whereas with an input of a 2 h darkness from 5pm to 7pm, neither effect on the cercarial emergence rhythm was observed. The total cercariae emerged for both parasite isolates varied with a different photoperiod. The results indicate that the change of photoperiod could affect the chronobiology of S japonicum cercarial emergence. [ABSTRACT FROM AUTHOR]

With the development of new sequencing technology, the entire N6-methyl-adenosine (m(6)A) RNA methylome can now be unbiased profiled with methylated RNA immune-precipitation sequencing technique (MeRIP-Seq), making it possible to detect differential methylation states of RNA between two conditions, for example, between normal and cancerous tissue. However, as an affinity-based method, MeRIP-Seq has yet provided base-pair resolution; that is, a single methylation site determined from MeRIP-Seq data can in practice contain multiple RNA methylation residuals, some of which can be regulated by different enzymes and thus differentially methylated between two conditions. Since existing peak-based methods could not effectively differentiate multiple methylation residuals located within a single methylation site, we propose a hidden Markov model (HMM) based approach to address this issue. Specifically, the detected RNA methylation site is further divided into multiple adjacent small bins and then scanned with higher resolution using a hidden Markov model to model the dependency between spatially adjacent bins for improved accuracy. We tested the proposed algorithm on both simulated data and real data. Result suggests that the proposed algorithm clearly outperforms existing peak-based approach on simulated systems and detects differential methylation regions with higher statistical significance on real dataset. [ABSTRACT FROM AUTHOR]

The application potential and environmental benefits of ground source heat pump (GSHP) systems have become the focal points of decarbonization in the building sector. Synchronized and scientific analysis of GSHP systems' environmental and economic performance, however, remains lacking. This study analyzes the application prospects of GSHP systems via a life cycle assessment-based life cycle costing method, and considers China's actual status quo. The internal and external annual costs of a GSHP system per square meter are $ 4.05 and $ 1.37, respectively. Electricity generation and steel production are key processes to improve the environmental performance of a GSHP system further. Compared with coal-based heating, a GSHP system can mitigate 65%–95% of the environmental impact and 85% of external costs, except for the metal depletion impact which is 1.5 times higher than that of coal-based heating. In Shandong Province, promoting GSHP systems can substitute up to 69.4% of the district heating area, which implies reductions in fossil depletion, greenhouse gas emissions, human health impact, ecosystem quality impact, and external costs by up to 2.37 × 1010 kg oil eq, 1.08 × 1011 kg CO 2 eq, 3.87 × 105 DALY, 1.18 × 103 Species. year, and $ 2.51 × 1010, respectively. In consideration of environmental and economic aspects, a GSHP system can exhibit benefits compared with coal-based heating after 2.34 years of operation. To improve the economic and environmental performance of GSHP systems, a series of recommendations on financial subsidies, renewable energy development, inter-regional power transmission, steel scrap utilization, and hydrogen reduction steelmaking is provided. • Environmental and economic feasibilities of a ground source heat pump were examined. • Electricity generation and steel production are the main contributors. • More than 65% of environmental impact and 85% of external costs can be mitigated. • A ground source heat pump shows its life cycle benefits after 2.34-years operation. • The application potential in the cities of Dongying, Yantai, and Qingdao is high. [ABSTRACT FROM AUTHOR]

[Display omitted] • A novel SBR-UMSR process was constructed to treat manure-free piggery wastewater. • The front-end SBR functioned as a COD remover to get an effluent with a COD/TN ≤ 1. • Partial nitrification – anammox process was well performed in the back-end UMSR. • Effective synchronous removal of COD and TN was achieved in the combined process. • COD, NH 4 +-N and TN in effluent all well met the strict discharge standard of China. A novel combined sequencing batch reactor (SBR) – up-flow microaerobic sludge reactor (UMSR) process was developed to treat manure-free piggery wastewater characterized by low COD/TN ratio and high NH 4 +-N. The front-end SBR was designed to get an effluent with COD/TN ≤ 1 by removing COD, allowing the back-end UMSR to practice anammox for the simultaneous removal of TN and NH 4 +-N. Fed with the raw piggery wastewater, the combined SBR-UMSR process was started up at 27℃ with a reflux ratio of 15:1 in the UMSR. After 230-days running, the removal of COD, TN, and NH 4 +-N in the combined SBR-UMSR process reached 78.41%,85.05%, and 92.21%, respectively. 50.22% of COD in the wastewater was removed in the SBR, while 87.11% of NH 4 +-N and 79.69% of TN were removed in the UMSR. Stoichiometry and bacterial function analysis revealed that the partial nitrification – anammox process was the dominant nitrogen removal approach in the UMSR. [ABSTRACT FROM AUTHOR]

Abstract: Tinfoil manufacturing and electronic waste (e-waste) recycling remain rudimentary processes in Zhejing Province, China, which could account for elevated blood lead levels (BLLs) and health impacts on children. We assessed the potential health risks of lead in tinfoil manufacturing and e-waste recycling areas. 329 children in total aged 11–12 who lived in a tinfoil manufacturing area (Lanxi), an e-waste recycling area (Luqiao) and a reference area (Chun''an) were studied. Lead levels in children''s blood were determined by inductively coupled plasma mass spectrometer (ICP-MS). Blood urea nitrogen (BUN), serum creatinine, serum calcium, δ-Aminolaevulinic acid (δ-ALA) and intelligence quotient (IQ) were also measured. Geometric mean of BLLs in Lanxi, Luqiao and Chun''an were 8.11μg/dL, 6.97μg/dL, and 2.78μg/dL respectively, with 35.1%, 38.9% and 0% of children who had BLLs above 10μg/dL. The BLLs in exposed areas were much higher than those in the control area. Lanxi children had higher creatinine and calcium than Chun''an children, and Luqiao children had higher δ-ALA and lower calcium than Chun''an children. No significant differences of IQ were observed between Lanxi, Luqiao and Chun''an, however a negative relationship between BLLs and IQ was shown for the study children. The results indicated that lead pollution from e-waste recycling and tinfoil processing appears to be a potential serious threat to children''s health. [Copyright &y& Elsevier]