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The impact of development on the ecological environment is a matter of concern, especially in the ecologically fragile agro-pastoral ecotone. The agro-pastoral ecotone of northern Shaanxi (ANS) is a representative region of the agro-pastoral ecotone in northern China. The agricultural use of sand land (AUSL) is an effective way to respond to the development needs of this region. The AUSL will certainly have an impact on water yield services in the ANS, where water resources are already scarce. In this study, the Integration Valuation of Ecosystem Services and Tradeoffs Tool (InVEST) model was used to simulate the water yield of the ANS under different intensity scenarios of AUSL. The results showed that AUSL reduces the regional water yield, but the impact is limited. At the maximum scale of development, the total regional water yield decreased by 1.35% compared to the base year of 2020. In terms of distribution pattern, water yield decreased the most in Yuyang District and the least in Fugu County due to the uneven distribution of sand land. At the land use and land cover (LULC) scale, the AUSL has a diminishing effect on the water yield of both cultivated land and sand land due to the more intense evapotranspiration from cropland. This study can provide data and decision support for the ANS region for building the resource-economical and environment-friendly society. [ABSTRACT FROM AUTHOR]

[Display omitted] • SOC prediction in the agro-pastoral transitional zone of northwest China was realised using VIS-NIRS and chemometrics. • Ten spectral transforms coupled with correlation analysis and the Boruta algorithm for feature wavelength selection. • SOC content prediction model based on Boruta-FD-RF was developed. • Integrating spectral preprocessing, feature selection and chemometrics strategies has good prediction accuracy and stability. Rapidly and accurately grasp the change of soil organic carbon content in farmland, which is of great significance in guiding the timely and effective mastery of farmland soil fertility and improvement of soil physical properties. In this study, an ASD FieldSpec 4 spectrometer was used to collect spectral reflectance data on 128 agricultural soil samples taken from Jingbian County, Yulin City, Shaanxi Province, China. Firstly, descriptive statistics of the SOC in the study area were performed, and secondly, after 10 spectral transformations were performed, the correlation analysis and the Boruta algorithm were used to extract the characteristic wavebands of soil organic carbon, respectively, in order to reduce the redundancy of the data. Finally, by comparing the accuracies of different strategies, we constructed a spectral prediction model of soil organic carbon in farmland of the Northwest Agricultural and Animal Husbandry Intertwined Zone that integrates the optimal preprocessing, feature selection strategy and modelling method. The results indicate that: 1) The mean SOC content of the farmland in the study area was low and at the nutrient deficient level, with the standard errors and coefficients of variation for the modelling and validation sets were 1.596 g kg−1, 1.457 g kg−1, 54 % and 52 %, respectively; 2) The shape and trend of spectral special curves with different SOC contents show consistency, and the SOC content is negatively correlated with spectral reflectance; 3) CA selects more feature bands, but the feature bands are more homogeneous, while the Boruta algorithm can effectively remove irrelevant variables and improve the SOC feature selection effect; 4) The SOC prediction model based on Boruta-FD-RF can be better for soil organic carbon estimation, with R2 of 0.899 and 0.748 for the training set and validation set, respectively, RMSE of 1.432 g kg−1 and 1.967 g kg−1, and RPD of 2.557 and 1.647, respectively. The results show that the SOC model established by integrating optimal spectral pre-processing, feature selection strategy and chemometrics strategy has obvious improvement in prediction accuracy and stability, and this study provides an important reference for the fast and accurate estimation of SOC content in farmland of Agro-pastoral Transitional zone in northwest China. [ABSTRACT FROM AUTHOR]

Background: The Chinese government implemented the first round of National Centralized Drug Procurement (NCDP) pilot (so-called "4 + 7" policy) in mainland China in 2019. This study aims to examine the impact of "4 + 7" policy on the price of policy-related drugs.Methods: This study used drug purchasing order data from the Centralized Drug Procurement Survey in Shenzhen 2019, covering 24 months from January 2018 to December 2019. "4 + 7" policy-related drugs were selected as study samples, including 25 drugs in the "4 + 7" procurement list and 57 alternative drugs that have an alternative relationship with "4 + 7" List drugs in clinical use. "4 + 7" List drugs were then divided into bid-winning and bid-non-winning products according to the bidding results. Single-group Interruption Time Series (ITS) analysis was adopted to examine the change of Drug Price Index (DPI) for policy-related drugs.Results: The ITS analysis showed that the DPI of winning (- 0.183 per month, p < 0.0001) and non-winning (- 0.034 per month, p = 0.046) products significantly decreased after the implementation of "4 + 7" policy. No significant difference was found for the immediate change of DPI for alternative drugs (p = 0.537), while a significant decrease in change trend was detected in the post-"4 + 7" policy period (- 0.003 per month, p = 0.014). The DPI of the overall policy-related drugs significantly decreased (- 0.261 per month, p < 0.0001) after "4 + 7" policy.Conclusions: These findings indicate that the price behavior of pharmaceutical enterprises changed under NCDP policy, while the price linkage effect is still limited. It is necessary to further expand the scope of centralized purchased drugs and strengthen the monitoring of related drugs regarding price change and consumption structure. [ABSTRACT FROM AUTHOR]

Background: In China, an indigenously developed electronic medication monitor (EMM) was designed and used in 138 counties from three provinces. Previous studies showed positive results on accuracy, effectiveness, acceptability, and feasibility, but also found some ineffective implementations. In this paper, we assessed the effect of implementation of EMMs on treatment outcomes. Methods: The longitudinal ecological method was used at the county level with aggregate secondary programmatic data. All the notified TB cases in 138 counties were involved in this study from April 2017 to June 2019, and rifampicin-resistant cases were excluded. We fitted a multilevel model to assess the relative change in the quarterly treatment success rate with increasing quarterly EMM coverage rate, in which a mixed effects maximum likelihood regression using random intercept model was applied, by adjusting for seasonal trends, population size, sociodemographic and clinical characteristics, and clustering within counties. Results: Among all 69 678 notified TB cases, the treatment success rate was slightly increased from 93.5% [95% confidence interval (CI): 93.0–94.0] in second quarter of 2018 to 94.9% (95% CI: 94.4–95.4) in second quarter of 2019 after implementing EMMs. There was a statistically significant effect between quarterly EMM coverage and treatment success rate after adjusting for potential confounders (P = 0.0036), increasing 10% of EMM coverage rate will lead to 0.2% treatment success rate augment. Besides, an increase of 10% of elderly or bacteriologically confirmed TB will lead to a decrease of 0.4% and 0.9% of the treatment success rate. Conclusions: Under programmatic settings, we found a statistically significant effect between increasing coverage of EMM and treatment success rate at the county level. More prospective studies are needed to confirm the effect of using EMM on TB treatment outcomes. We suggest performing operational research on EMMs that provides real-time data under programmatic conditions in the future. [ABSTRACT FROM AUTHOR]

Background: In China, an indigenously developed electronic medication monitor (EMM) was used. EMM recorded each time the device was opened (no real time data), offering an indirect measure of tuberculosis treatment adherence. Previous study in China showed that the EMM uptake was satisfactory, missing adherence data were common in the information management system (25%) and shift to directly observed therapy (DOT) based on poor adherence documented by EMMs were seldom. Objectives: Among people with tuberculosis notified in 30 counties (July-December 2018) where EMM supported self-administered therapy (SAT) was suggested to all eligible (no communication impairment, ambulatory), we assessed the relative differences in unfavourable outcomes and deaths among those started on EMM at baseline (within first month of diagnosis) when compared to SAT alone. Methods: This was a cohort study using secondary data. We employed an intention to treat analysis, and used modified Poisson regression with robust variance estimates to assess the association. Results: Of 1810 eligible people, 1047 used EMM at baseline and of them, 216 (20.1%) stopped using EMM midway. Of 763 people who did not use EMM at baseline, 267 (35.0%) started using EMM later during the treatment. Among those who started using EMM at baseline, 6.3% [95% CI: 4.9, 8.0] had unfavourable outcomes compared to 6.7% [95% CI: 5.1, 8.8] among those who did not (p = 0.746). Lesser deaths were observed in people who started EMM at baseline when compared to those who did not: 2.5% [95% CI: 1.7, 3.7] versus 3.5% [95% CI: 2.4, 5.2], p = 0.191. The lack of association remained after adjusting for potential confounders (occupation, TB classification and TB category). Conclusion: Under programmatic settings, we did not find significant differences in the outcomes. Optimization of EMMs by shifting to DOT when indicated, addressing the issue of missing data and ensuring continuous use is required. [ABSTRACT FROM AUTHOR]

Background: China piloted a digital adherence technology called electronic medication monitor (EMM) to support self-administered treatment for tuberculosis. EMM is a portable plastic box that records each time the device is opened, offering an indirect measure of treatment adherence. During the monthly patient visits to tuberculosis designated hospitals, the doctors access the data from the EMM. Objectives: Among people with tuberculosis notified in 30 counties in China (July-December 2018) where EMM supported self-administered treatment was suggested to all those eligible (no communication impairment, ambulatory care), we assessed the i) proportion eligible for using EMM ii) uptake of EMM and factors associated and iii) treatment adherence, including the proportion shifted to DOT. Methods: This was an observational study using secondary programme data. Single instance of ≥50% or continued instance of 20–49% monthly missed doses was the eligibility criteria to shift to DOT. We used log binomial regression to identify factors associated with not using EMM within first month. Results: Of 2227 with EMM eligibility data, 1810 (81%) were eligible for EMM. Of 1810 people, 1314 (73%) ever used EMM anytime during treatment, among them, 134 (10%) were eligible for shift to DOT (based on EMM data), and 29 (22%) were shifted. In addition, 70 were shifted while the EMM data was missing. Of 1047 people who started using EMM within first month, we observed 6381 person-months of follow up and there were 1526(25%) instances of missing EMM data. Children (<15 years), elderly (≥65 years), semi-skilled or unemployed people, people with tuberculosis pleurisy and previous tuberculosis treatment were less likely to use EMM within first month. Conclusion: The EMM uptake was satisfactory but shift to DOT has to be ensured based on adherence data from EMM. The subsequent follow-up action when EMM data is missing has to be clarified in the guidelines. [ABSTRACT FROM AUTHOR]

Extracting a channel network based on the Digital Elevation Model (DEM) is one of the key research topics in digital terrain analysis. However, when the channel area is wide and flat, it is easy to form parallel channels, which seriously affect the accuracy of channel network extraction. To solve this problem, this study proposes a method to identify and eliminate parallel channels extracted by classical methods. First, the channel level in the study area is marked based on the flow accumulation data, and the parallel channels are then identified using the positional relationship between the different channel levels. Finally, the modification point of the identified parallel channels is determined to eliminate the parallel channels, with the help of the change relationship between the parallel channel and its upper-level channel. In this study, two watersheds in southeast China are selected as examples for method verification and analysis. Experimental results show that the parallel channel identification method proposed in this paper can accurately identify all parallel channels and eliminate the identified parallel channels one by one. The location relationship of the modified channels is consistent with the actual situation, indicating that the proposed method has good application potential in DEM-based channel extraction networks. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD), pneumonia, asthma, and lung cancer are four common respiratory diseases that impose a substantial economic burden on both patients and government in China. The objective of our study is to analyze the temporal trends of several clinical tracking metrics for hospitalization regarding these diseases. Hospital discharge data of 54 hospitals for the period 2005–2015 were derived from the Health and Family Planning Commission in Northeast China. The age-adjusted rate of discharge for the four respiratory diseases increased significantly (COPD, pneumonia, asthma: P trend <  .001; lung cancer: P trend =  .046). The mean LOS for the four diseases all showed a significant decline (P trend <  .001), whereas the mean charge per stay and aggregate charge followed an upward trend over time (P trend <  .001). There was a clear upward trend for the readmission rate for asthma patients (P trend =  .001), while the trend for COPD patients was unclear (P trend =  .224). Age-adjusted discharge rates, LOS, and charges for hospitalization regarding several common respiratory diseases in China showed different patterns of change over the past decade. Our results should aid government and administrators in making informed decisions about the management and treatment of respiratory diseases. [ABSTRACT FROM AUTHOR]

Serious desertification caused by human activity and climate change, in addition to water loss and soil erosion related to arsenic sandstone in the Mu Us Sandy Land, lead to severe scarcity of soil and water resources, which causes worse local agricultural conditions accordingly. Many physical properties of arsenic sandstone is complementary with that of sand, arsenic sandstone is therefore supposed to be blended to enhance water productivity and arability of sandy land. Container experiments are carried out to study the enhancement of water holding capacity of the mixture, the blending ratio of arsenic sandstone and sand, and the proper size of the arsenic sandstone particles, respectively. The results of the experiments show that particle size of 4 cm with a ratio of 1:2 between arsenic sandstone and sand are the proper parameters on blending. Both water content and fertility increase after blending. Water use efficiency in the mixture is 2.7 times higher than that in sand by the water release curves from experiments. Therefore, a new sand control and development model, including arsenic sandstone blending with sand, efficient water irrigation management and reasonable farming system, is put forward to control and develop sandy land so that water-saving agriculture could be developed. Demonstration of potato planting about 153.1 ha in area in the Mu Us Sandy Land in China indicates that water consumption is 3018 m 3/ha in the whole growth period. It means that about 61% of irrigation water can be saved compared with water use in coarse sand without treatment. Recycle economic mode and positive feedback of sand resource-crop planting-soil resource are constructed, which changes sand into arable soil and make it possible to develop water-saving agriculture on it. The proposed model will be helpful for soil-water resources utilization and management in the Mu Us Sandy Land. [ABSTRACT FROM AUTHOR]

Background: In settings such as China, where universal implementation of directly observed therapy (DOT) is not feasible, innovative approaches are needed to support patient adherence to TB treatment. The electronic medication monitor (EMM) is one of the digital technologies recommended by the World Health Organization (WHO), but evidence from implementation studies remains sparse. In this study, we evaluated acceptance of the EMM among health care workers and patients while implementing the device for differential TB patient management at the community level.Methods: Zhenjiang City in Jiangsu Province was purposively selected for the study. All participating patients were allowed to select their preferred management approach. If patients declined to use the EMM, DOT was offered. The EMM was designed to hold 1 month of anti-TB drugs for once-daily dosing of fixed-dose combination (FDC) tablets. Patient EMM records were monitored monthly by a physician; if 20 to 50% of doses were missed twice, or more than 50% of doses were missed once, the patient was switched to DOT. The four physicians and five nurses involved in the study at four designated hospitals were surveyed using a structured questionnaire to assess their acceptance of the EMM.Results: From October 2017 through January 2018, 316 pulmonary TB patients were notified in the TB information management system, and 231 (73.1%) met the study enrollment criteria. Although 186 patients (80.5%) initially consented to use the EMM, 17 later refused to use it. Among the 169 patients who used the EMM, 15 (8.9%) were switched to DOT due to poor adherence, and the other 154 completed the treatment course. The median adherence rate was 99.3%. Surveyed health care workers from designated hospitals found the EMM acceptable, although eight of nine felt use of the device moderately increased their workload. However, the EMM program significantly reduced the workload of community physicians by reducing patient visits by 87.9%.Conclusions: This study demonstrated the acceptability of using an indigenously developed EMM for differential management of TB patients at the community level. However, more operational research should be conducted before introducing and scaling the technology throughout China. [ABSTRACT FROM AUTHOR]

Background: Although global longitudinal strain (GLS) is proven to be reduced and associated with adverse outcomes in septic patients, it has not been elucidated whether or not layer-specific strains are reduced. We aimed to explore the layer-specific strains of left ventricular (LV) for assessing myocardial dysfunction in septic patients. Methods: A prospective observational study of patients with sepsis was conducted in a tertiary hospital in China. Routine two-dimensional speckle tracking echocardiography was performed within 24 h of enrollment. Demographic data, laboratory values, and clinical outcomes were collected. Results: We recruited 79 septic patients finally. The mean age of septic patients was 59.4 years old and 45 (57.0%) were male. The median Acute Physiology Age and Chronic Health Evaluation (APACHE II) score, and mean sequential organ failure assessment (SOFA) score of all patients were 19.0 and 7.7, respectively. According to the left ventricular ejection fraction (LVEF) value of 50%, the patients were categorized into two groups: SICM (sepsis-induced cardiomyopathy, LVEF < 50%, n = 22) and non-SICM group (LVEF ≥ 50%, n = 57). The median LVEF of SICM and non-SICM patients were 41.9% and 58.7%, and SICM patients had less negative layer-specific strain and global strain than that of non-SICM patients. The echocardiographic comparison of non-SICM and healthy controls was conducted to explore the myocardial injuries of non-SICM patients and the non-SICM had worse LS-epi than that of controls (-18.5% vs. -21.4%, p = 0.024). Conclusion: There were 72.2% (57) septic patients presented with non-SICM (LVEF ≥ 50%), and the strain value of epicardium of them was less negative than healthy controls. [ABSTRACT FROM AUTHOR]

Socioeconomic drought is one of the most frequent natural disasters in the world and is closely related to human life. The main cause of socioeconomic drought is the contradiction between water supply and demand; hence, as local reservoirs play a major role in improving water supply and coping with extreme climate, it is reasonable to estimate socioeconomic drought based on reservoir operations. The multivariate standardized reliability and resilience index (MSRRI) is utilized to evaluate socioeconomic drought, considering the characteristics of reservoir management and storage water resources. Therefore, with the MSRRI, this study takes the Heihe River Basin in northwestern China, which is controlled by two reservoirs dominating the upstream and downstream regions, as a case study to reveal the evolution characteristics of socioeconomic drought in the basin and the external impacts of climate variability. The results showed that (1) the drought intensity in the up-midstream region is stronger than that in the downstream region; in view of the hysteresis in the downstream region, the occurrence of drought in the up-midstream region could be regarded as an early warning to implement preventive measures in the downstream region; (2) an increasing trend in socioeconomic drought throughout the basin exists on both monthly and annual scales, which indicates that the increasing possibility of drought should be effectively addressed; (3) cross wavelet analysis indicated that the large-scale climate indices contribute to the variations in the socioeconomic droughts throughout the basin, indicating that climate variability may provide a reference for managers to deal with socioeconomic drought in the HRB. [ABSTRACT FROM AUTHOR]

• The extrapulmonary tuberculosis (EPTB) epidemic situation in China was systematically revealed. • One-fourth of tuberculosis patients had EPTB, and the proportion of EPTB solo was 21.3%. • The proportion of EPTB in children was significantly higher, reaching 50.5%. • EPTB occurs mostly in respiratory, musculoskeletal, and peripheral lymphatic systems. • EPTB should be added to the National Tuberculosis Program as a notifiable disease. Extrapulmonary tuberculosis (EPTB) is not a notifiable infectious disease in China but is a heavy burden on public health. However, the epidemic situation of EPTB nationwide is unclear. This study aimed to investigate the magnitude and main subtypes of EPTB in China. We conducted a national cross-sectional study with multistage, stratified cluster random sampling during 2020-2021. We calculated proportions of EPTB in all patients with TB by organs. Logistic regression models were used to estimate odds ratios by characteristics. A total of 6843 patients with TB were included. Of them, 24.6% were patients with EPTB, and the proportion of EPTB solo was 21.3%. Higher EPTB burden was observed in children, female patients, clinically diagnosed patients, provincial-level and prefectural-level health facilities, and Central and West China. EPTB occurred most frequently in respiratory (35.5%), musculoskeletal (15.8%), and peripheral lymphatic (15.8%) systems with top three subtypes, including tuberculous pleurisy (35.0%), spinal TB (9.8%) and cervical tuberculous lymphadenopathy (7.9%). With the increase of age, proportion of peripheral lymphatic TB decreased, and proportion rank of genitourinary TB rose. It is essential to strengthen the diagnosis and treatment capacity for EPTB in primary medical facilities. EPTB should be added to the National Tuberculosis Program as a notifiable disease. [ABSTRACT FROM AUTHOR]

Congenital scoliosis (CS) is a spinal deformity present at birth due to underlying congenital vertebral malformation (CVM) that occurs during embryonic development. Hemivertebrae is the most common anomaly that causes CS. Recently, compound heterozygosity in TBX6 has been identified in Northern Chinese, Japanese, and European CS patient cohorts, which explains about 7%‐10% of the affected population. In this report, we recruited 67 CS patients characterized with hemivertebrae in the Southern Chinese population and investigated the TBX6 variant and risk haplotype. We found that two patients with hemivertebrae in the thoracic spine and one patient with hemivertebrae in the lumbar spine carry the previously defined pathogenic TBX6 compound heterozygous variants. In addition, whole exome sequencing of patients with CS and their family members identified a de novo missense mutation (c.G47T: p.R16L) in another member of the T‐box family, TBXT. This rare mutation compromised the binding of TBXT to its target sequence, leading to reduced transcriptional activity, and exhibited dominant‐negative effect on wild‐type TBXT. Our findings further highlight the importance of T‐box family genes in the development of congenital scoliosis. [ABSTRACT FROM AUTHOR]

Background: China is still faced with the public health challenge of tuberculosis (TB), and a robust surveillance system is critical for developing evidence-based TB control policies. The Tuberculosis Information Management System (TBIMS), an independent system launched in 2005, has encountered several challenges in meeting the current needs of TB control. The Chinese government also planned to establish the National Health Information System (NHIS) aggregating data in different areas. The China National Health Commission-Gates TB Project Phase III launched a new TB surveillance system to address these challenges and also as a pilot for the countrywide implementation of the NHIS. This commentary highlights the improvements and challenges in implementing the new TB system and also discusses the implications for the roll-out of the NHIS. Main text: The new TB surveillance system piloted in each prefecture of the project provinces was designed based on the local information system under the unified principle of organizing patient information under a unique ID and realizing the function of data exchange. Upon mid-2019, the data exchange successful rate reached almost 100%, and the system showed good performance in data completeness. Major improvements of the new system included achieving automatic data extraction instead of manual entry, assisting clinical service provision, and the augmented statistical functions. The major challenges in the implementation and scale-up of the new system were the licensing issue and the diversities of infrastructures that hinder the promotion of the new system at a low cost. This pilot also accumulated experiences for the roll-out of the NHIS regarding the technical solutions of reforming current information systems as well as effective training approaches for the developers and users of the new system. Conclusions: The successful implementation of the new TB surveillance system in the three TB designated medical institutions demonstrated how the diverse infrastructures of the information system could be reformed to achieve the functions of automatic data extraction and data exchange and better cater to the needs of healthcare workers. This pilot also accumulated rich experiences and lessons learnt for developing technical solutions and personnel training for the scale-up of the NHIS. [ABSTRACT FROM AUTHOR]

• A practical, robust and reliable decomposition ensemble model for streamflow forecasting. • A data preprocessing technique robust to mode mixing and noise was used to extract features. • A deep learning model skilled to remember previous streamflow was used to dig prior information. Reliable and accurate streamflow forecasting is vital for water resource management. Many streamflow prediction studies have demonstrated the excellent prediction ability of decomposition ensemble models. Several studies first extracted subsignals from a streamflow series and then split subsignals into training and validation sets to build prediction models, capturing some future information not available in practical streamflow forecasting. Alternatively, dividing a time series into training and validation sets first and later decomposing them into subsignals can expose the subsignals to the boundary effect, making predicting streamflow difficult. Furthermore, building one model for each subsignal is laborious and can cause error accumulation. Therefore, establishing a robust and efficient decomposition ensemble model without future information to predict highly nonstationary and nonlinear streamflow is challenging. Hence, a single-model forecasting (SF) scheme that assesses the validation distribution during the training stage to adapt to the boundary effect was designed. A SF scheme based on variational mode decomposition (VMD) and long short-term memory (LSTM), namely, SF-VMD-LSTM, was proposed to predict daily streamflow 1–7 days ahead. Non-decomposition-based and decomposition-ensemble-based LSTM models established using SF, multi-model ensemble forecasting (MEF) and SF with the most influential subsignals (SFMIS) and the ensemble empirical mode decomposition (EEMD) and discrete wavelet transform (DWT) were compared. Additionally, multi-model ensemble hindcasting (MEH), single-model hindcasting (SH) and SH with the most influential subsignals (SHMIS) were used as benchmarks to evaluate the forecasting schemes' adaptability to the boundary effect. Two daily streamflow series from Han River and Jing River, China, were investigated. The results indicate that (1) SF is more robust and efficient than MEF and SFMIS; (2) VMD performs better than EEMD and DWT; (3) SF-VMD-LSTM, with NSE values larger than 0.8 for almost all the prediction scenarios, outperformed other comparative models. Therefore, SF-VMD-LSTM is robust and efficient for forecasting highly nonstationary and nonlinear streamflow. [ABSTRACT FROM AUTHOR]

Background: Alongshan virus (ALSV) is a novel discovered segmented flavivirus associated with human febrile illness in northeastern China. Ixodes persulcatus is considered as a candidate vector of ALSV in the endemic regions. However, the role of domesticated animals in the circulation and transmission of ALSV have not been investigated. To evaluate the prevalence of ALSV infections in domesticated animals, viral RNA and viral specific antibodies were detected in sheep and cattle in Hulunbuir of northeastern Inner Mongolia. The findings contribute to the understanding of the ecology and transmission of ALSV among different natural hosts. Methods: A total of 480 animal serum samples were collected in Hulunbuir of northeastern China in May, 2017. Viral specific antibodies were tested by indirect enzyme-linked immunosorbent assay (ELISA) with a purified E. coli recombinant capsid protein (VP2) of ALSV (strain H3) and further detected by viral neutralization test (VNT). RNA in serum samples were extracted and detected for ALSV sequence by quantitative real-time RT-PCR. ALSV RNA positive samples were used for virus isolation. Results: ALSV-specific antibodies were detected in 9.2% (22/240) of examined sheep and 4.6% (11/240) of examined cattle by ELISA, while lower serological positivity with 4.2% (10/240) for sheep and 1.7% (4/240) for cattle was confirmed by VNT. In contrast, the prevalence of ALSV RNA was much higher, ranging from 26.3% (63/240) in sheep to 27.5% (66/240) in cattle. The partial S1 (NS5-like) and S3 (NS3-like) segments of ALSVs in sheep and cattle shared high identities of more than 98% to the human and tick isolates in the studied regions. Conclusions: These results suggest that the natural infection of ALSV can be found in sheep and cattle in the endemic regions. [ABSTRACT FROM AUTHOR]

Background: Wilson's disease with osseomuscular type is a rare condition, which often lacks typical hepatic and neurological symptoms and causes misdiagnoses easily. During the past 10 years, eight Chinese patients of osseomuscular type of Wilson's disease were identified in our clinic.Methods: Clinical information was gathered from medical records and follow-ups. The genetic testing was performed in each patient. Serum ceruloplasmin, Kayser-Fleischer rings, liver function, brain magnetic resonance imaging and abdominal ultrasonography were also evaluated.Results: The median age of onset is 12 years of age. The patients had their initial musculoskeletal conditions with arthralgia or joint deformity, while the hepatic or neurologic signs were minimal. Most patients (6/8) eventually developed clinical neurological symptoms afterwards with a median interval of 36 months. All of them had normal liver function and low serum ceruloplasmin (<0.1 g/L). Most patients (6/8) present with Kayser-Fleischer rings and abnormal hepatic ultrasonography. The arthralgia was resolved with copper chelation therapy.Conclusions: Wilson's disease with osseomuscular type occurs without typical hepatic or neurological symptoms, which makes the clinical diagnosis challenging. Serum ceruloplasmin, abdominal ultrasonography, ophthalmic examination and genetic testing help to establish the diagnosis. Early diagnosis can initiate an effective treatment and prevent the further damage. [ABSTRACT FROM AUTHOR]

Background and Purpose: Thrombolytic therapy rate for acute ischemic stroke remains low, and improving public awareness of thrombolytic therapy may be helpful to reduce delay and increase chances of thrombolytic therapy. Our purpose was to survey the level of knowledge about thrombolytic therapy for acute ischemic stroke among community residents in Yuzhong district, Chongqing, China. Methods: In 2011, a population-based face-to-face interview survey was conducted in Yuzhong district, Chongqing. A total of 1500 potential participants aged ≥18 years old were selected using a multi-stage sampling method. Results: A total of 1101 participants completed the survey. Only 23.3% (95% CI = 20.8 to 25.8) were aware of thrombolytic therapy for acute ischemic stroke, of whom 59.9% (95% CI = 53.9 to 65.9) knew the time window. Awareness of thrombolytic therapy was higher among young people, those with higher levels of education and household income, those with health insurance, and those who knew all 5 stroke warning signs, while awareness of the time window was higher among those aged 75 years or older. Multivariate logistic regression analysis showed that awareness of thrombolytic therapy was independently associated with age, education level, health insurance and knowledge of stroke warning signs (P<0.05). Conclusions: In this population-based survey the community residents have poor awareness of thrombolytic therapy for acute ischemic stroke. [ABSTRACT FROM AUTHOR]

Background and Purpose: Persons who perceive their risk for stroke can promote the intervention of stroke risk factors and reduce the risk of stroke occurrence. Our purpose was to assess the knowledge of stroke risk factors and the level of perceived risk for stroke. Methods: In 2011, a population-based face-to-face interview survey was conducted in Yuzhong district, Chongqing. A total of 1500 potential participants aged ≥18 years old were selected using a multi-stage sampling method. The knowledge of stroke risk factors and perceived risk for stroke was surveyed. Results: A total of 941 participants completed the questionnaire survey. The respondents’ awareness rate of stroke risk factors ranged between 53.3% and 87.2%. The community residents’ perceived risk for stroke was only 17.7%. Multiple logistic regression analysis showed that 45–64 years age group, a history of hypertension, hyperlipidemia, heart disease, and stroke were independent predictors of perceived risk for stroke. Perceived risk for stroke increased as the number of risk factors increased (P<0.001). However, even for respondents with three or more risk factors, only 41% perceived themselves to be at risk for stroke. Conclusions: In this population-based survey, few community residents perceived risk for stroke, even among those with multiple stroke risk factors, most did not perceive themselves to be at risk for stroke. Persons with 45–64 years old, a history of hypertension, hyperlipidemia, heart disease or stroke were more likely to perceive risk for stroke. The awareness of the risk for stroke has yet to be enhanced among community residents. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the most common form of senile dementia, and the overall prevalence increases exponentially with age. It is well known that genetic variants may play an important role in the pathogenesis of this disorder. Recently, two independent large-scale genome-wide association studies (GWAS) identified 3 novel single nucleotide polymorphisms (SNPs) (rs11136000 within CLU, rs3851179 within PICALM and rs6656401 within CR1) that are associated with late-onset AD (LOAD), and these results have been replicated by other studies performed in the Caucasian population. Recently, an independent study failed to verify the association for the SNP within CLU in a Han Chinese population, indicating that there may be genetic heterogeneity in this association. In the present study, we studied the SNPs within PICALM and CR1 in 474 sporadic AD patients (SAD) and 591 unrelated age- and sex-matched healthy controls of Han Chinese descent. Our data revealed that the frequencies of both of these SNPs were not significantly difference between the SAD and control groups. Thus, the association between SNPs within PICALM, CR1, and SAD should be studied further in different ethnic groups. [ABSTRACT FROM AUTHOR]