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In China, porcine reproductive and respiratory syndrome virus (PRRSV) vaccines are widely used. These vaccines, which contain inactivated and live attenuated vaccines (LAVs), are produced by MARC-145 cells derived from the monkey kidney cell line. However, some PRRSV strains in MARC-145 cells have a low yield. Here, we used two type 2 PRRSV strains (CH-1R and HuN4) to identify the genes responsible for virus yield in MARC-145 cells. Our findings indicate that the two viruses have different spread patterns, which ultimately determine their yield. By replacing the viral envelope genes with a reverse genetics system, we discovered that the minor envelope proteins, from GP2a to GP4, play a crucial role in determining the spread pattern and yield of type 2 PRRSV in MARC-145 cells. The cell-free transmission pattern of type 2 PRRSV appears to be more efficient than the cell-to-cell transmission pattern. Overall, these findings suggest that GP2a to GP4 contributes to the spread pattern and yield of type 2 PRRSV. [ABSTRACT FROM AUTHOR]

Personal data have become a key input in internet commerce, facilitating the matching between millions of customers and merchants. Recent data regulations in China, Europe, and the United States restrict internet platforms' ability to collect and use personal data for personalized recommendation and may fundamentally impact internet commerce. In collaboration with the largest e-commerce platform in China, we conduct a large-scale field experiment to measure the potential impact of data regulation policy and to understand the value of personal data in internet commerce. For a random subset of 555,800 customers on the Alibaba platform, we simulate the regulation by banning the use of personal data in the home page recommendation algorithm and record the matching process and outcomes between these customers and merchants. Compared with the control group with personal data, we observe a significantly higher concentration in the algorithmic recommendation of products in the treatment group and a very sharp decrease in the matching outcomes as measured by both customer engagement (click-through rate and product browsing) and market transaction (sales volume and amount). The negative effect is disproportionate and more pronounced for niche merchants and customers who would benefit more from e-commerce. We discuss the potential economic impact of data regulation on internet commerce as well as the role of personal data in generating value and fostering long-tail innovations. This paper was accepted by Chris Forman, information system. Funding: Z. Yuan wants to acknowledge financial support from NSFC [Grants 72203202, 72192803 and 72141305]. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4828. [ABSTRACT FROM AUTHOR]

The Hanjiang River, as a water donor basin, plays a fundamental role in supporting water supply security in northern China while maintaining the health and stability of ecosystems within the basin. However, the combined influence of climate change and anthropogenic interference has resulted in a significant change in the flow regime of the basin, challenging the sustainability of the river system. In order to understand the impact of the above factors on the river runoff, we analyzed the temporal and spatial pattern of runoff and climate factors in the basin and quantitatively assessed the contribution of climate change and human activities to the change in runoff using the elasticity coefficient method. Our results indicate that annual runoff has experienced a significant downward trend over the past 60 years, which is projected to continue into the future. It is also found that the temporal pattern of the runoff regime differed upstream and downstream of the Danjiangkou Reservoir due to the joint operation of the reservoir and China's Middle Route Project of South-to-North Water Diversion (MRP-SNWD). A significant decrease in runoff was primarily attributed to human activities, followed by precipitation. In contrast, evapotranspiration had the least effect. In particular, the MRP-SNWD was a significant anthropogenic factor, contributing to about 20.3% of the total change in runoff. Our results highlighted the unfavorable effects of human activity on the hydrological system in the Hanjiang River and provided some constructive suggestions to turn vulnerability into resilience. [ABSTRACT FROM AUTHOR]

The increasing impact of drought stress on ecosystems with regard to climate change has received considerable attention, which has been demonstrated to have a time‐lag effect on ecosystems. However, the time‐lag effect on different types of droughts and gross primary production (GPP) at large regional scales remains unclear. Thus, using the GOSIF GPP product data of solar‐induced chlorophyll fluorescence, the meteorological drought index (standardized precipitation evapotranspiration index [SPEI]), and the agricultural drought index (soil moisture deficit index [SMDI]) based on the soil moisture data obtained from the Global Land Data Assimilation System, the time‐lag effect of regional drought and GPP and the contribution of drought to GPP variation were analysed in China from 2000 to 2018. Results showed that (1) China's annual GPP increased at an average rate of 9.26 g C m−2 y−1. With regard to the average rate for each climate zone, the largest increase of 30.44 g C m−2 y−1 was observed in the southern subtropical region, and the smallest increase (4.01 g C m−2 y−1) was observed in the Qinghai–Tibetan plateau, with about 53.11% of the regions showing a significant upward trend. In addition, the significantly declining regions were primarily concentrated in urban areas, accounting for about 2.26% of China. (2) SPEI and GPP had an average lag time of 6.28 months, whereas SMDI and GPP had an average lag time of 7.17 months. The comparison demonstrated that SMDI had a greater influence on GPP than SPEI. (3) The average contribution rate of meteorological drought and agricultural drought to the decrease of GPP was 79.37% and 87.06%, and their average contribution rate to the increase of GPP was 39.11% and 50.57%, respectively. This study will provide comprehensive understanding of the effects of drought on carbon and water cycles in terrestrial ecosystems with regard to climate change. [ABSTRACT FROM AUTHOR]

The established literature demonstrates the critical role of the policy mix in the formulation and implementation of government policies for industrial upgrading. However, existing studies mainly examine the policy mix from either a horizontal or a vertical coordination perspective; very few examine both dimensions. To gain further insights, the current study involves an analysis of how China's central government manages horizontal and vertical coordination to pursue upgrading in manufacturing industries on the basis of an ambidextrous policy mix perspective and a thorough examination of both the external attributes (i.e., policy level) and content (i.e., policy instruments and themes) of policy documents. This analysis reveals several viable policy implications in relation to China's manufacturing transformation. In particular, it finds that China's policy mix for achieving manufacturing upgrading is highly coordinated on both horizontal and vertical dimensions. Governments at all levels apply the same set of policy instruments; environmental instruments are the most frequently used, followed by supply- and demand-side instruments. The core policy topics within the manufacturing upgrading structure include innovation, industrial transformation, industrial agglomeration, demonstration projects and service-oriented manufacturing. Therefore, this study establishes recommendations for future policies, which should focus on reinforcing guidance regarding national policies, encouraging local governments to apply innovative policy tools and increasing the use of demand-side policy instruments. [ABSTRACT FROM AUTHOR]

Background: Secondary bacterial pneumonia is an important complication of seasonal influenza, but little data is available about impact on death and risk factors. This study identified risk factors for all-cause in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza. Methods: A retrospective cohort study was performed at a tertiary teaching hospital in southwest China. The study cohort included all adult hospitalized patients with a laboratory-confirmed, community-acquired influenza virus infection during three consecutive influenza seasons from 2017 to 2020. Cause-specific Cox regression was used to analyze risk factors for mortality and secondary bacterial pneumonia, respectively, accounting for competing events (discharge alive and discharge alive or death without secondary bacterial pneumonia, respectively). Results: Among 174 patients enrolled in this study, 14.4% developed secondary bacterial pneumonia and 11.5% died during hospitalization. For all-cause in-hospital mortality, time-varying secondary bacterial pneumonia was a direct risk factor of death (cause-specific hazard ratio [csHR] 3.38, 95% confidence interval [CI] 1.25–9.17); underlying disease indirectly increased death risk through decreasing the hazard of being discharged alive (csHR 0.55, 95% CI 0.39–0.77). For secondary bacterial pneumonia, the final model only confirmed direct risk factors: age ≥ 65 years (csHR 2.90, 95% CI 1.27–6.62), male gender (csHR 3.78, 95% CI 1.12–12.84) and mechanical ventilation on admission (csHR 2.96, 95% CI 1.32–6.64). Conclusions: Secondary bacterial pneumonia was a major risk factor for in-hospital mortality among adult hospitalized patients with community-acquired influenza. Prevention strategies for secondary bacterial pneumonia should target elderly male patients and critically ill patients under mechanical ventilation. [ABSTRACT FROM AUTHOR]

In the context of global warming, snow cover changes have an extremely important impact on the hydrological cycle and the redistribution of water resources in arid and semi-arid regions. In this paper, based on the daily cloud-free snow area remote sensing product data in the source region of Yangtze River (SRYR) from 2000 to 2019, the snow phenology variables such as the snow cover day (SCD), snow onset date (SOD), snow end date (SED), and snow duration day (SDD) were extracted separately for each hydrological year, and the vertical distribution of snow cover area (SCA) in the SRYR was analyzed by combining with the digital elevation model (DEM). In addition, we also combined climate factors and land cover types to further explore the spatiotemporal variation characteristics of snow phenology in response to different influencing factors, in order to reveal the spatiotemporal variation patterns of snow cover in the SRYR. The results showed that: (1) The SCA in the SRYR has a more obvious vertical distribution, with the maximum SCA reaching 61.58% at high elevation, while at low elevation, the SCA is mostly below 20%. The distribution of SCD in the study area showed a significant exponential correlation with DEM (R2 = 0.87). (2) The area of SOD in the SRYR showed an advanced trend of about 63.37%, while the area of SED showed a delayed trend of about 69.59%, and the area which showed significant trends is 4.29% and 4.36%, respectively. Therefore, the trends of both SOD and SED showed insignificant changes. (3) Temperature change is the main factor affecting the change of snow cover in the SRYR. Among them, 90.9% of the regions showed a significant positive correlation between temperature and SCD, while precipitation showed a significant negative correlation with SCD in about 75.3% of the total area of SRYR. Under the stable snow area (SCD > 60), the land cover type is glacial or permanent snow about 1.5 × 103 km2, which covers almost the entire glacial or permanent snow of the SRYR. [ABSTRACT FROM AUTHOR]

The Poyang Lake Region (PLR) is well known for its ecological and economic importance. This paper first analyzed the changes in land use/land cover (LULC), followed by changes in landscape patterns and ecosystem services by landscape metrics and equivalent coefficients table method. Then, the influence of LULC change on landscape pattern and ecosystem services in both historical period (from 1990 to 2015) and future period (2030) was explored. The results showed that the area of construction land was 607.9 km2 in 1990 and 972.5 km2 in 2015. The increased construction land mainly converted from cultivated land. For the entire PLR, a higher use degree of LULC and a trend of fragmentation existed in recent years. The total ecosystem service values (ESVs) decreased by ¥2.44 × 109 from 1990 to 2015, mainly because of shrinkage of cultivated land and sharp increase in construction land. It was predicted that the areas of construction land and waterbody would increase by 34.6% and 2.2% compared with those in 2015. These changes would lead to more regular in patch shape, longer in patch edge, less connectivity of patches, and an increase of ¥6.2 × 108 ESVs in 2030. [ABSTRACT FROM AUTHOR]

The vertical alignment design method of road in scenic spots does not evolve enough along the vehicle's rapid variation. Values of the maximum longitudinal slope (MLS) and longest slope length (LSL) applicable to scenic roads used by the environmental-friendly vehicle (EFV) are not provided. To compensate for this shortage, a multibody vehicle dynamic model in uphill traving is built, providing the static equilibrium state and dynamic balancing process of a typical vehicle. MLS and LSL values in scenic roads are obtained based on this model through numerical simulation, considering typical EFV, maximum velocity loss (MVL), and ideal velocity loss (IVL). Field experiments for verifying the results are also carried out in Huashan Mountain, Cuihua Mountain National Park, and Taiping Forest Park, using two EFV types. MLS and LSL values in scenic roads applicable to EFV obtained in this research vary from 7.8% to 10.2% and 200 to 955 m, respectively, and both are larger than the corresponding values in current criteria. According to verification results, relative errors of climbing velocity vary from 0.0104 to 0.0205, showing the dynamic model's accuracy and further proving the practicality of MLS and LSL values obtained. The results obtained in this research lay a foundation for establishing the scenic-road vertical alignment design method. [ABSTRACT FROM AUTHOR]

The change of water resources resulting from climate warming in the Yangtze River Source Region (YRSR) has aroused wide concern in recent years. This research used the soil and water assessment tool (SWAT) to estimate the blue water (BW), green water flow (GWF), and green water storage (GWS). Then, the spatial and temporal change of BW, GWF, and GWS over the recent decades and next several decades was investigated. Results show that (1) the BW and GWF have increased by 2.3 mm/10a and 34.2 mm/10a from 1960 to 2012, while the GWG has decreased slightly by 0.19 mm/10a during the same period. (2) The spatial patterns of BW, GWF, and GWS have been changed obviously from 1980s to 2000s, especially for BW and GWF. The BW and GWF in the west and north of the YRSR where the water resource is relatively less are more sensitive to climate change; (3) the annual average temperature and precipitation in the YRSR are projected to increase by 2.2 °C and 9.8% during 2021 to 2050 compared to that during the 1961 to 1990. There is higher uncertainty in BW and GWS projection and the model-averaged BW and GWS would change little. The projected percent changes of GWF and GWS would be 15% and − 11.1% with less uncertainty. The obvious change of BW, GWF, and GWS in the future would occur in the west and north of the YRSR, which is similar with the spatial change in the historical period. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae (KP) is the most common pathogen isolated in intensive care units (ICUs) and the most frequently encountered carbapenemase-producing Enterobacteriaceae. Increasing antimicrobial drug resistance, especially in carbapenem-resistant KP (CRKP), can limit the choice of antibiotics used for the treatment of infectious diseases and further poses a negative impact on patient outcome. However, the reason behind this increasing resistance is not well known. Patients and methods: A retrospective analysis of laboratory records and clinical cases of KP infection in the ICUs of a hospital from January 2013 to December 2017 was conducted. The disk diffusion method and double-paper synergy test were used to test drug sensitivity for extended-spectrum β-lactamase (ESBL) detection. WHONET5.6 and SPSS 21.0 software were used for statistical analysis. Results: A total of 64.8% (570/847) of patients with KP infection were older than 60 years. The lower respiratory tract was the main infection site, accounting for 70.84% (600/847); the highest rate of ICU admission was for neurosurgery, accounting for 28.69% (243/847). Some 444 multidrug-resistant KP strains were detected, including 69 CRKP and 299 ESBL-producing strains. In the past 5 years, the resistance rate of detected strains to common antibiotics increased to various degrees, particularly carbapenem-resistant strains which increased from 4.76% (9/189) in 2013 to 16.00% (28/175) in 2017. All carbapenem-resistant isolates were resistant to β-lactam antibiotics, and no isolates were resistant to tigecycline. Conclusion: CRKP and ESBLKP prevalence and resistance rates gradually increased in our ICUs in the past 5 years. The reasons for this are manifold. Regular surveillance of resistance, rational use of antibiotics, and other effective infection control measures need to be strengthened to slow down the production of multidrug-resistant bacteria and prevent their spread in ICU settings. [ABSTRACT FROM AUTHOR]

Steam distillation can effectively enhance heavy oil recovery during steam injection process in heavy oil reservoirs. However, the mechanism of steam distillation is complex, and the changes in oil properties during distillation remain unclear. In this study, three comparative steam distillation experiments were designed and conducted, including distillation processes employing saturated steam, steam superheated by 10 °C, and steam superheated by 40 °C. Heavy oil samples were derived from the Jin-1 Block in a typical heavy oilfield, in China. The density, viscosity, SARA fractions, and carbon number distribution of the residual oil were compared to those obtained before conducting steam distillation experiments. The steam distillation rates obtained with steam superheated by 40 °C, steam superheated by 10 °C, and saturated steam were 11.158%, 10.903% and 10.423%, respectively. The results indicate that the steam distillation rate of heavy oil increases significantly with increasing degree of superheating. During the steam distillation process, the density and viscosity of residual oil increase, the contents of saturated hydrocarbons and resin decrease, and the contents of aromatic hydrocarbons and asphaltenes increase. In addition, analysis of the distilled components indicates that lightweight components with smaller carbon numbers are removed firstly by steam distillation, followed by heavier components with larger carbon numbers. Moreover, all hydrocarbons with carbon numbers less than C 22 are removed from heavy oil in the distillation process, while the maximum carbon number of the distilled components was C 34 . This study is favorable for understanding the changes in the properties of residual oil after distillation during the steam injection process for heavy oil recovery. [ABSTRACT FROM AUTHOR]

• A new method for ecosystem stability assessment. • The resistance and resilience of terrestrial ecosystems were quantified. • The vegetation resilience under different disturbance patterns was assessed. With the ongoing impacts of global climate change, the cumulative stress effects of external disturbances on ecosystems are gradually strengthening. Therefore, it is very important to scientifically evaluate the stability of ecosystems. In the terrestrial ecosystems, vegetation serves as a link between the water, energy, and carbon cycles, and is an important index which allows for the measurement of ecosystem stability. In this study, two vegetation indices (normalized difference vegetation index and enhanced vegetation index), along with solar-induced chlorophyll fluorescence data from 2001 to 2021, were used to determine the external disturbance events in the Minjiang river basin using a dynamic time warping (DTW) algorithm. Analyses of the disturbance characteristics during this period, and quantification of the vegetation resistance, resilience, and vegetation regime shift rate were conducted. The results indicated the following. (1) The disturbance results monitored by the DTW algorithm were highly consistent with typical events, and it was feasible to monitor the disturbance of the Minjiang river basin using the DTW algorithm. (2) Disturbance intensity in the river basin increased slightly, while in urban areas it decreased. (3) The resistance of different types of vegetation varied greatly, with the resistance strongest in forests, next in croplands, and weakest in grasslands. In contrast, resilience was the strongest in croplands, next in grasslands, and weakest in forests. (4) The vegetation growth state of the river basin was more significantly affected by external disturbance in 2001–2021, with 58.75% of forest, 54.37% of grassland, and 37.21% of cropland having regime shift rates < 1. Lastly, (5) the response of vegetation to external disturbance was diverse under different disturbance scenarios, with the vegetation recovery rate under gradual disturbance being greater than the rate under abrupt disturbance. [ABSTRACT FROM AUTHOR]

To gain an insight into the spatiotemporal variability of drought events and to assess trends under future climate change scenarios are fundamental for making sound mitigation and adaptation strategies. A new drought index, standardized supply-demand water index (SSDI), has been proposed in this research. The SSDI describes drought from the view of water supply-demand relations using a simple water balance model. It was used to assess historical drought events in the middle and lower Jinsha river basin (MLJRB) located in the southwest China and applied to address the drought conditions in the MLJRB under current and future climates. The results showed the following: (1) The average drought area during 2001 to 2011 reached up to 9.9 × 103 km2, accounting for 35.4% of the whole farmland area in the MLJRB, which was about twice as the drought area during 1961 to 2000. The region for greater drought severity with more drought events and longer duration was mainly distributed in Dali, Chuxiong, Kunming, and Yuxi. (2) For the period 2021 to 2050, total drought area was projected to increase by 43.2%. The drought-prone regions could move further towards the northwest of the MLJRB. [ABSTRACT FROM AUTHOR]

• A new index, i.e., the soil water use efficiencies index was defined. • Significant differences in soil water use efficiency among vegetation. • Significant differences in the contributions of GPP and soil water to SUE. • Compared with PUE, SUE better reflects the water use efficiency of vegetation. Water is a prerequisite for the formation of earth-biochemical-ecological systems. Differences in the spatial and temporal distribution of water resources are important factors in the formation of differences in the distribution of vegetation in terrestrial ecosystems and are key to the differences in vegetation productivity. Vegetation water use efficiency is calculated by the total amount of fixed biogenic carbon per unit mass of water consumed in photosynthesis and can be used to assess the intensity and capacity of an ecosystem to use water biomass. Based on remote satellite sensing data, this study proposes a new water use efficiency assessment model. The model was validated using flux site data, and we analyzed the relative contribution of climate factors to soil moisture use efficiency using a first-difference method. The results revealed the following: (1) The soil moisture use efficiencies (SUE) of remote sensing data inversions that were evaluated using flux site data based on correlation coefficients and Nash coefficients showed high reliability, and only the NMG (Inner Mongolia) station showed low correlation among the nine sites. (2) Among the nine agricultural sub-regions in China, only the SUE of the Qinghai-Tibet Plateau region showed a decreasing trend (−1.08 g C/m−2 kg H 2 O yr), while all other regions showed an increasing trend. (3) The highest vegetation soil moisture use efficiency (1.83 g C/m−2 kg H 2 O) was found in ferralisols, while the lowest vegetation SUE (0.17 g C/m−2 kg H 2 O) was found in arid soils. The SUE of different vegetation types showed the characteristics of forest > scrub > cultivated vegetation > wetland > grassland. (4) The relative contribution of gross primary productivity (GPP) to the change in SUE was 37.53%, while the relative contribution of soil moisture content to the change in SUE was −26.71%. Among the five climatic factors, temperature was the most dominant factor affecting the change in SUE, followed by precipitation, net radiation, leaf area index, and potential evapotranspiration. Revealing the relationship between terrestrial ecosystem GPP, soil moisture content, and their responses to climate factors is a prerequisite for understanding the adaptation strategies of regional terrestrial ecosystems to global climate change, which can help to inform decision-making for the sustainable development of ecosystems. [ABSTRACT FROM AUTHOR]

Investigating changes in extreme precipitation, i.e., maximum precipitation for multiday events, is critical for flood management and risk assessment. Based on the observed daily precipitation from China's Ground Precipitation 0.5° × 0.5° Gridded Dataset (V2.0) and simulated daily precipitation from five general circulation models (GCMs) provided by The Inter-Sectoral Impact Model Intercomparison Project (ISI-MIP), extreme precipitation indices corresponding to annual maximum 1-, 3-, 15-, and 30-day precipitation across China from 1961 to 2011 and 2011 to 2050 were calculated. Relative changes in the 10-, 20-, and 50-year return period estimates, using 1-, 3-, 15-, and 30-day precipitation, are discussed to represent changes in extreme precipitation in the future. Results show that (1) the spatial distribution of annual maximum precipitation for 1, 3, 15, and 30 days is similar with that of annual precipitation. An increasing trend from the northwest to the southeast was found, with the highest values shown to be in the plain region adjacent to the mountains and coastal area; (2) Comparing the observed and simulated data, it could be seen that climate models have good simulation of 10-, 20-, and 50-year return period events. Absolute relative error is less than 30 % in 80 % in the study area; (3) Extreme precipitation in the future has an increasing trend in China. In the south, extreme precipitation associated with short duration as well as the 50-year return period will likely increase to a comparatively large degree in the future. In the north, extreme precipitation associated with long duration and the 10-year return period will likely see a large increase in the future. [ABSTRACT FROM AUTHOR]

Based on fractal geometry and the “matchstick” tubes model, an improved capillary pressure model was theoretically derived to assess capillary pressure data for coal. The model was based on fractal geometry and the “matchstick” tubes model. Our improved model can be simplified as Li model and Brooks-Corey (B-C) model when the fractal dimension and tortuosity parameter take specific values in coal porous media. Furthermore, the capillary pressure data of different coals samples collected in the LZ Coal Mine in China were measured employing mercury intrusion method, and the heterogeneity of typical coal samples were evaluated using the pore volumetric percent curves and SEM images. The matching results of the B-C model, Van Genuchten (V-G) model, Li model, and our improved model were assessed in comparison with the test data. The comparison indicated that our improved model had better agreement with the test data relative to the conventional models. [ABSTRACT FROM AUTHOR]

Based on the national precipitation dataset (0.5×0.5) 1961-2011, published by the National Meteorological Information Center of China and the five Global Climate Models provided by ISI-MIP, annual maximum precipitation for 1 day, 3 days and 7 days could be calculated. Extreme precipitation was fitted via Generalized Extreme Value (GEV) distribution to explore the changes of extreme precipitation with the return period of 20 years and 50 years during 1961-2000 and 2001-2050. Based on this, extreme precipitation projection in Huang-Huai-Hai region was done. The results showed that the five Global Climate Models could simulate the statistical features of extreme precipitation quite well, in which IPSL-CM5A-LR has the highest precision. Simulation of IPSL-CM5A-LR indicates that precipitation with the return period of 20 years and 50 years in the middle reaches of the Yellow River, middle and lower reaches of Huaihe River and plain area of the southern Haihe River will increase considerably in the future. Extreme precipitation in some of the places will even increase by more than 30%, which means that these places will face larger flood risk and their capacity to respond to flood disasters should be improved. [ABSTRACT FROM AUTHOR]

Based on observed data and data simulated by climate models, temporal variation and spatial distribution of precipitation in China from 1961 to 2050 were investigated. The slope of annual precipitation and Mann-Kendall statistical test were applied to quantify the trend magnitude and detect the significant trend, respectively. Besides, decadal and interannual variations of different rain belts were analyzed to reveal the spatial changing pattern of precipitation. Results indicated the following. (1) During 1961–2011, annual precipitation in Haihe River Basin decreased significantly while the annual precipitation in river basins in the northwest increased significantly. Although the annual precipitation of Yangtze River Basin has an indistinctive decreasing trend, that in the middle and lower reaches has increased and that in the upper reaches has decreased. Arid zone and humid zone are shrinking while semiarid and semihumid zone are expanding. Transformation between semiarid and arid zones, humid and semihumid zones is frequent. During 2011–2050, annual precipitation will not change much (−6~12%) except river basins in the southwest (more than 40%) compared with the baseline. Besides, the area of arid zone will decrease and humid zone area will increase. Transformation area between semiarid and arid zone and humid and semihumid zone is small. [ABSTRACT FROM AUTHOR]

Drought is a kind of extreme hydrological event. With the penetration of climate change impact, severity, areal extent, and frequency of drought are increasing, especially in Huang-Huai-Hai River Basin, which plays a key role in China's agriculture production. Analyzing the regional temporal and spatial variability in the context of climate change could provide a basis for the evasion of disasters and risk. The maximum number of consecutive dry days was selected as the indicator to analyze the decadal variability of drought severity, areal extent, and spatial variability of drought frequency in different seasons in Huang-Huai-Hai River Basin. Based on these, temporal and spatial variability of two kinds of special extreme events-consecutive drought and heavy rain after drought-were studied. The results showed that: (1) Huang-Huai-Hai River Basin mainly experienced moderate drought and severe drought. Moderate drought mainly occurs in autumn. High-frequency region of moderate drought is located in the plain of Huang-Huai-Hai River Basin, and its area is approximately 22.7 % of Huang-Huai-Hai River Basin. Severe drought often occurs in spring with high-frequency region in the upstream of the Yellow River. The area of this high-frequency region is about 6 % of Huang-Huai-Hai River Basin. (2) During 1961~2011, the areal extent of summer severe drought, autumn severe drought, and extreme drought all showed increasing trend, in which the increasing trend of the autumn severe drought area in the Yellow River has reached the significance level α = 0.05. (3) Consecutive drought of several seasons often took place in Ningxia plain and Hetao plain which lie in the northwest of the Yellow River Basin. In the recent 20 years, consecutive drought from spring to summer and consecutive drought from summer to autumn occurred frequently. Drought-flood abrupt alternation such as heavy rain after drought often occurred in summer temporally and Huaihe River Basin spatially. [ABSTRACT FROM AUTHOR]

Droughts resulting from global warming severely hamper the healthy development of terrestrial vegetation ecosystems. This paper defines a terrestrial vegetation ecological drought index, i.e., the Standardized Water Supply–Demand Index (SSDI), based on the water balance method using the same calculation model as the SPEI. The theory of run is used to analyze the spatial and temporal distribution of the drought characteristics in the Yangtze River Basin (YRB). The results show that (1) the drought events monitored by the SSDI were in good agreement with historical drought events, and the correlation coefficient between SSDI and NDVI (0.94) was significantly higher than that between SPEI and NDVI (0.88). (2) About 55.4% of the regions in the YRB experienced more than 13 droughts, and about 41.4% of the regions had an average drought duration of more than 3.1 months. In the northern part of the YRB, droughts tend to develop in a short-term high frequency, while in the southern part of the YRB, there is a long-term low-frequency development trend. Nearly 24.5% of the regions have an average drought intensity of more than 1.4, and most of them are located in the lower reaches of the Yangtze River. (3) Over the last 18 years, about 79.5% of the regions in the YRB showed an increasing trend in SSDI, of which 36.8% showed an increasing trend of more than 0.04/yr. In addition, 40.4% of the regions showed a significant upward trend. Precisely analyzing the spatiotemporal variation of drought characteristics in the YRB is critical for drought risk assessment and sustainable development of water resources and could provide a theoretical basis for effective water resource allocation and drought relief. • A new drought monitoring index, i.e., the Standardized Water Supply–Demand Index (SSDI) was defined. • SSDI can effectively monitor drought events. • SSDI is more suitable for monitoring ecological drought. • Drought of vegetation ecosystem in the Yangtze River Basin was assessed and analyzed with the SSDI. • It provides a theoretical basis for drought management and water allocation in the Yangtze River Basin. [ABSTRACT FROM AUTHOR]

Based on daily maximum temperature (Tmax), minimum temperature (Tmin), and precipitation of the Yangtze River Basin (YRB) from 1961 to 2020, we employed the trend analysis method and correlation analysis method to analyze spatiotemporal variations in 10 extreme indices and their associations with atmospheric and oceanic circulations. Results indicated that maximum Tmax (TXx), maximum Tmin (TNx), and minimum Tmin (TNn) all increased significantly, at rates of 0.19 °C, 0.19 °C, and 0.37 °C per decade, respectively, whereas minimum Tmax (TXn) did not show any significant trend. The diurnal temperature range (DTR) decreased by 0.09 °C per decade as minimum temperatures increased faster than maximum temperatures. TNx and TNn increased significantly in the majority of the YRB, but TXn showed no significant increases. TXn increased significantly in the upper reaches of the Yangtze River. The DTR increased significantly in the Jinsha River Basin and the lower reaches of the Yangtze River. Rx1day (maximum 1-day precipitation), SDII (Simple daily intensity index) and R99p (extremely wet-day precipitation) increased significantly, at rates of 1.12 mm, 0.09 mm, and 5.87 mm per decade, respectively, but the trends of Rx5day (maximum 5-day precipitation) and PRCPTOT (total wet-day precipitation) were not significant. However, the trends of precipitation extreme indices were not statistically significant in most of the YRB. In the future, maximum temperature and minimum temperature might increase while DTR might decrease. But, the trends of precipitation extremes in the future were ambiguous. Nearly all the extreme indices were related to the variability of Atlantic multidecadal oscillation (AMO) in the YRB. In addition, the correlations between extreme temperature indices and AMO are higher than that of extreme precipitation indices. [ABSTRACT FROM AUTHOR]

The Yarlung Zangbo River is the largest river on the Tibetan Plateau and a major international river in South Asia. Changes in the blue and green water resources in its basin are of great importance to the surrounding local and Asian regions in the context of global warming. This research used the Soil and Water Assessment Tool model to estimate blue and green flows (BWF and GWF) and analyze the spatial-temporal distribution characteristics under different hypothetical climate change scenarios. The results show that (1) the multi-year average BWF in the middle and upper reaches of the Yarlung Zangbo River Basin is 176.2 mm, the GWF is 213.1 mm, and the difference between precipitation and total water resources is only 5.4 mm; (2) both BWF and GWF in this basin showed a slightly increasing trend from 1980 to 2010, but the distribution of subbasins from upstream to downstream is decreasing; and (3) GWF has a positive correlation with both precipitation and temperature, but BWF only increases with precipitation and decreases with increasing temperature. Moreover, the change in blue and green water resources is more sensitive to the changes in precipitation than to changes in the temperature. [ABSTRACT FROM AUTHOR]

Under the background of global climate change, drought is causing devastating impacts on the balance of the regional water resources system. Hydrological drought assessment is critical for drought prevention and water resources management. However, in China to assess hydrological drought at national scale is still challenging basically because of the difficulty of obtaining runoff data. In this study, we used the state-of-the-art passive microwave remote sensing techniques in river runoff modelling and thus assessed hydrological drought in Mainland China in 1996–2016. Specifically, 79 typical hydrological stations in 9 major basins were selected to simulate river runoff using the M/C signal method based on a high-resolution passive microwave bright temperature dataset. The standardized runoff index (SRI) was calculated for the spatial and temporal patterns of hydrological drought. Results show that passive microwave remote sensing can provide an effective way for runoff modelling as 92.4% and 59.5% of the selected 79 stations had the Pearson correlation coefficient (R) and the Nash-Sutcliffe efficiency coefficient (NS) scores greater than 0.5. Especially in areas located on Qinghai-Tibet Plateau in the Inland and the Southwest River Basin, the performance of the M/C signal method is quite outstanding. Further analysis indicates that stations with small rivers in the plateau areas with sparse vegetation tend to have better simulated results, which are usually located in drought-prone regions. Hydrological drought assessment shows that 30 out of the 79 stations present significant increasing trends in SRI-3 and 18 indicate significant decreasing trends. The duration and severity of droughts in the non-permanent dry areas of the Hai River Basin, the middle reaches of the Yangtze River Basin and the Southwest of China were found out to be more frequent and severe than other regions. This work can provide guidance for extending the applications of remote sensing data in drought assessment and other hydrological research. [ABSTRACT FROM AUTHOR]

Changes in rainfall and streamflow due to climate change have an adverse impact on hydropower generation reliability and scheduling of cascade hydropower stations. To estimate the impact of climate change on hydropower, a combination of climate, hydrological, and hydropower scheduling models is needed. Here, we take the Jinsha River as an example to estimate the impact of climate change on total power generation of the cascade hydropower stations and residual load variance of the power grid. These two goals are solved by applying an improved multi-objective cuckoo search algorithm, and a variety of strategies for the optimal dispatch of hydropower stations are adopted to improve the efficiency of the algorithm. Using streamflow prediction results of CMIP5 climate data, in conjunction with the Xinanjiang model, the estimated results for the next 30 years were obtained. The results indicated that the negative correlation between total power generation and residual load variance under the RCP 2.6 scenario was weaker than that under the RCP 8.5. Moreover, the average power generation and the average residual load variance in RCP 2.6 was significantly larger than that in RCP 8.5. Thus, reducing carbon emissions is not only beneficial to ecological sustainability, but also has a positive impact on hydropower generation. Our approaches are also applicable for cascade reservoirs in other river catchments worldwide to estimate impact of climate change on hydropower development. [ABSTRACT FROM AUTHOR]

Projecting future changes of streamflow in the Jinsha River Basin (JRB) is important for the planning and management of the west route of South-to-North Water Transfer Project (SNWTP). This paper presented an analysis of the implications of CMIP5 climate models on the future streamflow in the JRB, using SWAT model. Results show that: (1) In the JRB, a 10% precipitation decrease might result in a streamflow increase of 15 to 18% and a 1 °C increase in temperature might results in a 2 to 5% decrease in streamflow; (2) GFDL-ESM2M and NORESM1-M showed considerable skill in representing the observed precipitation and temperature, which can be chosen to analyze the changes in streamflow in the future; (3) The precipitation and temperature were projected to increase by 0.8 to 5.0% and 1.31 to 1.87 °C. The streamflow was projected to decrease by 4.1 to 14.3% in the upper JRB. It was excepted to change by −4.6 to 8.1% in the middle and lower JRB (MLJRB). The changes of low streamflow in the MLJRB were −5.8 to 7.4%. Therefore, the potential impact of climate on streamflow will have little effect on the planning and management of the west route of SNWTP. [ABSTRACT FROM AUTHOR]

• China generally showed a greening trend from 2000 to 2020. • The vegetation on the southeastern side of the-line was significantly improved and the vegetation on the northwestern side was significantly degraded. • The spatial distribution of NDVI was dominated by natural factors and its change trend was mainly controlled by human factors. Recent studies revealed that the greening in China has difficulty crossing the Hu-Line. However, the greening pattern and its driving factors remain unclear. Therefore, we explored NDVI spatio-temporal pattern and their key driving forces between southeastern and northwestern of the Hu-line from 2000 to 2020 using GDM (the geographical detector model) and trend analysis method. The following results were obtained: (1) Overall, NDVI showed a fluctuating upward trend in China over the study period, indicating greening. Although vegetation had improved significantly (48.11%) on the southeastern region of the Hu-line, it had significantly degraded (24.71%) on the northwestern region. The degradation of vegetation cover on unused and construction land was larger than the proportion of improvement. (2) GDM could identify the effect of single-factors on the NDVI variables on both side regions of the Hu-line. P (precipitation), POP (population density), and DEM (Digital Elevation), dominated NDVI's spatial pattern in China. ET (evapotranspiration), ST (soil types) and POP had the strongest influence on the southeastern region, whereas P was the dominant factor on the northwestern region. In addition, POP, GDP (gross domestic product) and TEM (temperature) dominated the overall trend of NDVI. (3) Seven factors influenced and verged vegetation NDVI spatial distribution and change trends of vegetation were enhanced by their interaction. Overall, China is becoming greener. For various land-use types, natural factors (such as P and DEM) dominated vegetation NDVI pattern. Nevertheless, anthropogenic factors governed NDVI pattern of construction land. Anthropogenic factors mainly controlled NDVI tendency variations. The findings could effectively explain greening on both side regions of the Hu-line, and provide information for decision-making on vegetation restoration and ecological protection. [ABSTRACT FROM AUTHOR]

The potential influence of natural ecosystems on human health has been widely acknowledged globally. Nevertheless, the causality of such a correlation among the middle-aged and older populations in developing countries awaits further investigations. This study aims to understand how a specific natural ecosystem change, namely the establishment of ecological reserves, improves the physical and mental health of middle-aged and older residents in China. Two batches of national key eco-function zones (NKEFZs) in 2011 and 2016 are selected as a quasi-experiment; and a total of 128,755 middle-aged and older residents from a combined data set from the China Family Panel Studies (CFPS) and China Health and Retirement Longitudinal Studies (CHARLS) from 2010 to 2020. A difference-in-differences method was used to identify the causal effects of the natural ecosystem improvement on human health outcomes. The results indicate significant and sustained improvements in the physical health of local middle-aged and elderly residents following the implementation of the NKEFZs policy. Notably, ecological reserves with a water conservation function and those in Karst area have the most salient effects on physical health. Furthermore, this study shows that the creation of ecological reserves improves the mental health of middle-aged and older residents, with the effect varying based on changes in physical health. This study provides new insights into the positive impact of natural ecosystem improvement on human health outcomes, in particular physical and mental health. • There is a strong link between natural ecosystems and human health. • Establishment of NKEFZs can improve the physical health of middle-aged and elderly residents in China. • Conservation of water resources and maintenance of the Karst landform ecosystem are the greatest improvements to physical health. • Establishment of NKEFZs also had a positive impact on mental health. • Effects of mental health improvement vary subject to changes in physical health. [ABSTRACT FROM AUTHOR]

Improving eco-efficiency is an important way to promote environmental decoupling. Based on the input-output model and data envelopment analysis (DEA), this paper evaluates the eco-efficiency of 44 sectors in China with a new DEA model considering inter-sectoral linkages, then explores how the industrial network would be optimized as inefficient sectors become efficient under constant resources supply and constant final demand. The empirical results indicate that 22 sectors are inefficient and deserve further improvement. Inefficient sectors becoming efficient will drive the industrial network to evolve in a more intensive direction, and allow the economy to achieve greater economic benefits with less energy consumption and pollution. Accounting under constant resources supply suggests that increasing external demand should be a key to promoting environmental decoupling in the economy. Accounting under constant final demand indicates more stringent environmental regulations should be used to drive technology upgrades. • A new eco-efficiency measurement combining the input-output model and DEA is built. • The eco-efficiency and potential deficiencies of 44 sectors in China are evaluated. • The impact of inefficient sectors becoming efficient on the economy is measured. • The industrial network presents significant potential for environmental decoupling. • Key constraints to environmental decoupling in the industrial network are identified. [ABSTRACT FROM AUTHOR]

Background: Percutaneous transluminal septal myocardial ablation (PTSMA) has been introduced as an alternative treatment for hypertrophic obstructive cardiomyopathy (HOCM). We report on the acute, short- and long-term results of our experiences in 119 patients from a single center in China. Methods and results: PTSMA was performed in 119 patients with symptomatic HOCM (mean age 35.4±14.8 years, male 80, female 39). All patients had echocardiography performed prior to the procedure, 2-week post-PTSMA, and 6-month post-PTSMA, and 65 patients had echocardiography repeated at 2-year follow-up. The average left ventricular outflow tract (LVOT) gradient was 67.3±7.8 mm Hg before the procedure, and 15.9±6.8 mm Hg after the procedure (p<0.05). The thickness of interventricular septum (IVS) was 23.3±5.6 mm before the procedure, 18.6±4.8 mm 2-week post-PTSMA (p<0.05), and 16.8±3.4 mm 6-month post-PTSMA in all of the patients, and 15.6±3.1 mm 2-year post-PTSMA in 65 patients. The mean width of LVOT was 6.7±2.0 mm before the procedure, 8.2±3.4 mm 2-week post-PTSMA (p<0.05), 13.7±6.3 mm 6-month post-PTSMA and 15.1±2.4 mm 2-year post-PTSMA. The incidence of right bundle branch block development post-PTSMA was 52.9%, and three patients (2.5%) had complete heart block. There was no death. Conclusions: PTSMA is a promising non-surgical procedure for symptomatic patients with HOCM because of its low risk and its significant hemodynamic, echocardiographic and clinical improvement. The significant therapeutic remodeling period was up to 6 months rather than 2 years following the procedure. [Copyright &y& Elsevier]

Improving the express industry's environmental efficiency is of practical significance to green and sustainable economic development. The development of internet may help achieve this goal. However, previous studies have not provided a consistent result about the relationship between internet development and the express industry's environmental efficiency. This paper provides a deeper understanding of this relationship by analyzing the threshold effects from the perspectives of road network density, openness to international trade and competition, and e-commerce level. Based on Chinese provincial data from 2012 to 2017, we first use a range directional data envelopment analysis model to evaluate the express industry environmental efficiency. Then, a threshold model is constructed to analyze the threshold effects in the relationship between internet development and environmental efficiency. The results show that: (1) The impact of internet development on the express industry's environmental efficiency shows a single threshold effect as road network density increases, which indicates that internet development significantly improves that environmental efficiency when the road network density is above a threshold value. (2) The impact of internet development on express industry environmental performance shows a dual-threshold effect as the degree of openness increases. (3) There is also a dual-threshold effect in this relationship as the proportion of e-commerce business transactions increases, but this effect is not significant. Based on these results, suggestions are given for the express industry to improve its environmental efficiency in China. [ABSTRACT FROM AUTHOR]

• Energy and environmental efficiency of China's transportation sector is investigated. • Uncertainty in estimation of CO 2 emission is considered. • Stochastic multicriteria acceptability analysis and data envelopment analysis are used. • Results show that great efficiency disparities exist among regions. • Uneven development has occurred in areas of China's transportation sectors. China's transportation sector suffers from energy over-consumption and CO 2 over-emission, resulting in increasing pressure to improve energy and environmental efficiency. Current measurement techniques cannot produce precise CO 2 emission data, and this uncertainty makes previous approaches problematic for analyzing energy and environmental efficiency. This study combines stochastic multicriteria acceptability analysis (SMAA-2) with data envelopment analysis (DEA) to evaluate the energy and environmental efficiency of Chinese transportation sectors in the presence of uncertain CO 2 emission data. The improved SMAA-DEA approach effectively handles CO 2 data uncertainty and also considers all possible input and output weights, thus providing meaningful information (such as maximum efficiency, average efficiency, and rank acceptability index) to guide the development of effective policies to improve efficiency. This study's empirical findings show that the energy and environmental efficiency of transportation sectors in 30 provincial regions is poor, great efficiency disparities exist between regions, and uneven development has occurred in China. [ABSTRACT FROM AUTHOR]

Background: The clinical phenotypes of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have been found to overlap with several other diseases. The new criteria proposed in 2023 were designed to better identify the disease but require validation across various populations to ascertain its clinical utility. We aimed to investigate the diagnostic performance in phenotypically diverse patients., Methods: This multicenter study retrospectively included adult and pediatric patients who were hospitalized for a first suspected demyelinating event and tested positive for MOG immunoglobulin G (IgG) during the acute phase. The 2023 Lancet Neurology criteria were assessed against the benchmark of empirical clinical diagnosis, and the 2018 JAMA Neurology and Journal of Neuroinflammation criteria were also evaluated for comparative analysis., Results: Among the 291 eligible patients (82 adults, 209 children), 282 (96.9%) were clinically diagnosed as definite MOGAD (77 adults, 205 children), while 262 (90.0%) fulfilled the 2023 diagnostic criteria (78 adults, 184 children). A total of 265 patients met the criteria for core clinical demyelinating events, and 76 (26.1%) had serum clear positive MOG-IgG (≥ 1:100). The sensitivity of the 2023 criteria was 0.91 (adults vs. children = 0.97 vs. 0.89), the specificity was 0.56 (adults vs. children = 0.40 vs. 0.75), positive likelihood ratio was 2.06 (adults vs. children = 1.62 vs. 3.57), and negative likelihood ratio (NLR) was 0.15 (adults vs. children = 0.06 vs. 0.14). Additionally, 264 and 256 cases were classified as definite MOGAD by the 2018 JAMA Neurology and Journal of Neuroinflammation criteria, respectively. Compared to the 2023 diagnostic criteria, the 2018 JAMA Neurology criteria demonstrated similar diagnostic performance. However, the 2018 Journal of Neuroinflammation criteria exhibited comparable sensitivity (0.92, adults vs. children = 0.96 vs. 0.89), higher specificity (1.00, adults vs. children = 1.00 vs. 1.00) and better NLR (0.09, adults vs. children = 0.04 vs. 0.11)., Conclusions: The 2023 criteria demonstrated good sensitivity in adult and pediatric patients in China yet modest specificity. Close follow-up is needed for patients with atypical phenotypes but high-titer MOG-IgG to avoid underdiagnosis., Competing Interests: Declarations. Ethics approval and consent to participate: This research was approved by the local ethics committee of each participating center (Second Affiliated Hospital, School of Medicine, Zhejiang University [approval number: 2024-LSY-0682], Children’s Hospital, Zhejiang University School of Medicine [approval number: 2024-IRB-0238-P-01], and Zhejiang Hospital [approval number: 2024-095K]). Patient consent was waived for this retrospective study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The ecological environment and water resources of the Han River Basin (HRB) are incredibly susceptible to global warming. Naturally, the analysis of future runoff in HRB is believed to offer a theoretical basis for water resources management and ecological protection in HRB. The purpose of this study is to investigate and forecast the effects of climate change and land use change on runoff in the HRB. This study uses CMIP6 data to simulate three future climate change scenarios (SSP126, SSP245 and SSP585) for changes in precipitation and temperature, a CA-Markov model to simulate future land use change scenarios, and the Budyko framework to predict future runoff changes. The results show that: (1) Between 1974 and 2014, annual runoff ( R ) and annual precipitation ( P ) in the HRB decline not so significantly with a rate of 1.3673 mm/a and 1.2709 mm/a, while maximum temperature ( Tmax ) and minimum temperature ( Tmin ) and potential evapotranspiration ( E 0 ) show a non-significantly increasing trend with 0.0296 °C/a, 0.0204 °C/a and 1.3313 mm/a, respectively. Precipitation is considered as main contributor to the decline in Han River runoff, accounting for 54.1%. (2) In the HRB, overall precipitation and temperature are estimated to rise in the coming years, with all other hydrological variables. The comparison of precipitation rise under each scenario is as follows: SSP126 scenario > SSP585 scenario > SSP245 scenario. The comparison of the temperature increase under each scenario is as follows: SSP585 scenario > SSP245 scenario > SSP126 scenario. (3) In the HRB, farmland and grassland land will continue to decline in the future. The amount of forest acreage is projected to decline but not so significantly. (4) The future runoff of the HRB shows an increasing trend, and the future runoff varies in different scenarios and periods. Under the land use scenarios of maintaining LUCC1992-2014 and LUCC2040 and LUCC2060, the R change rates in 2015-2040 are 8.27-25.47% and -8.04-19.35%, respectively, and the R in 2040-2060 are 2.09-13.66% and 19.35-31.52%. At the same time, it is very likely to overestimate the future runoff of the HRB without considering the changes in the land use data of the underlying surface in the future.

In the context of climate change, ecosystem in Yangtze River Source Region (YRSR) is under threat from severe droughts. This study introduced a new natural vegetation drought index, standardized supply-demand water index (SSDI), and identified natural vegetation drought events and parameters (e.g., duration, severity, peak, and coverage area) based on run theory. Then the drought-prone regions were investigated via 2-dimensional joint copula. The results indicate that (1) compared with traditional meteorological drought index, the SSDI is reliable and can reflect the comprehensive characteristics of the ecological drought information more easily and effectively; (2) the YRSR had witnessed the most severe drought episodes in the periods of late-1970s, mid-1980s, and mid-1990s, but the SSDI showed a wetting trend since the mid-2000s. Additionally, droughts in the Southern YRSR were relatively more severe with longer drought duration; (3) in most areas of Togton River Basin and Dam River Basin, the severe ecological drought events occurred more frequently; (4) drought duration and severity in the YRSR were more susceptible to temperature when the temperature rise was above 1.0 °C. The average drought duration and severity increased by 20.7% and 32.6% with a temperature rise of 1 °C. Investigating and evaluating drought characteristics, causes, and drought index effectiveness provide essential information for balanced water resource allocation, utilization, and drought prevention. Understanding these spatial-temporal characteristics of drought and return period was useful for drought risk assessment and sustainable development of water resources., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Background: The Shexiang Baoxin Pill (MUSKARDIA) has been used for treating coronary artery disease (CAD) and angina for more than 30 years in China. Nevertheless, methodologically sound trials on the use of MUSKARDIA in CAD patients are scarce. The aim of the study is to determine the effects of MUSKARDIA as an add-on to optimal medical therapy (OMT) in patients with stable CAD., Methods: A total of 2674 participants with stable CAD from 97 hospitals in China were randomized 1:1 to a MUSKARDIA or placebo group for 24 months. Both groups received OMT according to local tertiary hospital protocols. The primary outcome was the occurrence of a major adverse cardiovascular event (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction (MI), or non-fatal stroke. Secondary outcomes included all-cause mortality, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or heart failure, peripheral revascularization, angina stability and angina frequency., Results: In all, 99.7% of the patients were treated with aspirin and 93.0% with statin. After 2 years of treatment, the occurrence of MACEs was reduced by 26.9% in the MUSKARDIA group (MUSKARDIA: 1.9% vs. placebo: 2.6%; odds ratio = 0.80; 95% confidence interval: 0.45-1.07; P  = 0.2869). Angina frequency was significantly reduced in the MUSKARDIA group at 18 months (P = 0.0362). Other secondary endpoints were similar between the two groups. The rates of adverse events were also similar between the two groups (MUSKARDIA: 17.7% vs. placebo: 17.4%, P = 0.8785)., Conclusions: As an add-on to OMT, MUSKARDIA is safe and significantly reduces angina frequency in patients with stable CAD. Moreover, the use of MUSKARDIA is associated with a trend toward reduced MACEs in patients with stable CAD. The results suggest that MUSKARDIA can be used to manage patients with CAD., Trial Registration: chictr.org.cn, No. ChiCTR-TRC-12003513., (Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Although the main causative genes for hereditary multiple exostoses (HME) are exostosin (EXT)‑1 and EXT‑2, there are numerous patients with HME without EXT‑1 and EXT‑2 mutations. The present study aimed to identify novel candidate genes for the development of HME in patients without EXT‑1 and EXT‑2 mutations. Whole‑exome sequencing was performed in a Chinese family with HME and without EXT‑1 and EXT‑2 mutations, followed by a combined bioinformatics pipeline including annotation and filtering processes to identify candidate variants. Candidate variants were then validated using Sanger sequencing. A total of 1,830 original variants were revealed to be heterozygous mutations in three patients with HME which were not present in healthy controls. Two mutations [c.C1849T in solute carrier family 20 member 2 (SLC20A2) and c.G506A in leucine zipper and EF‑hand containing transmembrane protein 1 (LETM1)] were identified as possible causative variants for HME through a bioinformatics filtering procedure and harmful prediction. Sanger sequencing results confirmed these two mutations in all patients with HME. A mutation in SLC20A2 (c.C1849T) led to a change in an amino acid (p.R617C), which may be involved in the development of HME by inducing metabolic disorders of phosphate and abnormal proliferation and differentiation in chondrocytes. In conclusion, the present study revealed two mutations [SLC20A2 (c.C1849T) and LETM1 (c.G506A) in a Chinese family with HME. The mutation in SLC20A2 (c.C1849T)] was more likely to be involved in the development of HME.

This study assesses the spatial distribution characteristics and ecological risk of phthalate esters (PAEs) in the surface sediments of the mainstream and tributaries of the Songhua River, China, using concentrations and composition of six PAEs, which were analyzed using gas chromatography-mass spectrometery (GC-MS). We assess the ∑ 6 PAEs ecological risk using the hazard quotient (HQ) method and environmental risk levels (ERL). The results were as follows. ① It was found that the total concentrations of ∑ 6 PAEs ranged from 6832.5 to 36298.9 ng·g -1 dry weight (average 18388.6 ng·g -1 ), with the main contributions coming from di-(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DBP). The difference between the main stream ∑ 6 PAEs (6832.5-36298.9 ng·g -1 , average 18616.9 ng·g -1 ) and the tributary ∑ 6 PAEs (10367.6-26593.3 ng·g -1 , average 18264.1 ng·g -1 ) was not significant ( P >0.05). The mean concentrations of individual PAEs in the tributary stream differed little from that of the main stream. The ∑ 6 PAEs concentration of the Songhua River decreased initially but then increased from the upstream to the downstream. The average ∑ 6 PAEs concentration in natural agricultural areas (18677.5 ng·g -1 ) was similar to that found in urban industrial areas (18063.7 ng·g -1 ), and DBP and DEHP contributed 98% of ∑ 6 PAEs. ② The main sources of ∑ 6 PAEs were domestic, agricultural production, and industrial production using plasticizers. ③ The ecological risk assessment indicated that DMP and BBP in the surface sediments of the Songhua River did not pose an ecological risk for aquatic organisms, and that DEP was associated with a low ecological risk, whereas DEHP and DBP posed a high ecological risk for aquatic organisms.

The Huang-huai-hai River Basin is one of the most economically developed areas, but is also heavily impacted by drought and flood disasters. Research on the precipitation feature of the Huang-huai-hai River Basin is of great importance to the further discussion of the cause of flood disaster. Based on the selected meteorological stations of the study area from 1961-2016, the inverse distance weighting method was used to get daily precipitation grid data. Interannual variation of precipitation intensity and cover area of different precipitation classes was analyzed. The generalized extreme-value distribution method was used to analyze the spatial distribution of extreme precipitation. The results show that: (1) decrease of accumulated precipitation in light precipitation year and moderate precipitation year might be the reason why the precipitation in the whole basin decreased, but the coefficient of variation (CV) of different classes of precipitation and precipitation days does not change significantly; (2) since the cover area of precipitation > 50 mm and precipitation intensity both decreased, the extreme precipitation of the whole basin may be decreasing; (3) extreme precipitation mainly occurred in the loess plateau in the northeast of Huang-huai-hai River Basin, Dabieshan in the middle of Huang-huai-hai River Basin and other areas.

It has become a hot issue to study extreme climate change and its impacts on water quality. In this context, this study explored the evolution characteristics of drought⁻flood abrupt alternation (DFAA) and its impacts on total nitrogen (TN) and total phosphorous (TP) pollution, from 2020 to 2050, in the Luanhe river basin (LRB), based on the predicted meteorological data of the representative concentration pathways (RCPs) climate scenarios and simulated surface water quality data of the Soil and Water Assessment Tool (SWAT) model. The results show that DFAA occurred more frequently in summer, with an increasing trend from northwest to southeast of the LRB, basically concentrated in the downstream plain area, and the irrigation area. Meanwhile, most of the DFAA events were in light level. The incidence of TN pollution was much larger than the incidence of TP pollution and simultaneous occurrence of TN and TP pollution. The TN pollution was more serious than TP pollution in the basin. When DFAA occurred, TN pollution almost occurred simultaneously. Also, when TP pollution occurred, the TN pollution occurred simultaneously. These results could provide some references for the effects and adaptation-strategies study of extreme climate change and its influence on surface water quality.

Projecting future changes in extreme flood is critical for risk management. This paper presented an analysis of the implications of the Fifth Coupled Model Intercomparison Project Phase (CMIP5) climate models on the future flood in the Jinsha River Basin (JRB) in Southwest China, using the Xinanjiang (XAJ) hydrologic model. The bias-corrected and resampled results of the multimodel dataset came from the Inter-Sectoral Impact Model Intercomparison Project (ISI-MIP). Relatively optimal general circulation models (GCMs) were selected with probability density functions (PDFs)-based assessment. These GCMs were coupled with the XAJ model to evaluate the impact of climate change on future extreme flood changes in the JRB. Two scenarios were chosen, namely: a midrange mitigation scenario (Representative Concentration Pathway 4.5, RCP4.5) and a high scenario (RCP8.5). Results show that: (1) The XAJ model performed well in simulating daily discharge and was suitable for the study area, with E NS and R ² higher than 0.8; (2) IPSL-CM5A-LR and MIROC-ESM-CHEM showed considerable skill in representing the observed PDFs of extreme precipitation. The average skill scores across the total area of the JRB were 0.41 to 0.66 and 0.53 to 0.67, respectively. Therefore, these two GCMs can be chosen to analyze the changes in extreme precipitation and flood in the future; (3) The average extreme precipitation under 20- and 50-year return period across the JRB were projected to increase by 1.0⁻33.7% under RCP4.5 and RCP8.5 during 2020 to 2050. The Upper basin is projected to experience the largest increase in extreme precipitation indices, possibly caused by a warmer climate. The extreme flood under 20- and 50-year return period will change by 0.8 to 23.8% and -6.2 to 28.2%, respectively, over this same future period. Most of scenarios projected an increase during the near future periods, implying the JRB would be likely to undergo more flooding in the future.

It is of great significance to study the effects and mechanisms of the key driving forces of surface water quality deterioration-climate change and LUCC (land use and land cover change). The Luanhe River Basin (LRB) in north-eastern China was examined for qualitatively and quantitatively assessing the responses of total nitrogen (TN) and total phosphorus (TP) loads on different climate scenarios and LUCC scenarios. The results show that from 1963 to 2017, the TN and TP loads basically presented a negative correlation with the temperature change (except for winter), while showing a significant positive correlation with the precipitation change. The incidence of TN pollution is sensitive to temperature increase. From 2020 to 2050, the annual average loads of TN and TP were slightly lower than from 1963 to 2017. The contribution of rising temperature was more significant on nutrient loads. Also, the incidence of TN pollution is sensitive to the future climate change. Under LUCC scenarios, the TN and TP loads and pollution incidence increased correspondingly with the decrease of natural land. The evolution characteristics analysis can provide support for the effect and adaptation-strategies study of climate change and LUCC on surface water quality.

Background: Reversible bilateral striatal necrosis associated with Mycoplasma pneumoniae (M. pneumoniae) infection is a rare neurological disease. The exact pathogenic mechanism remains unknown., Patient: We report reversible bilateral striatal lesions with a favorable outcome secondary to M. pneumoniae infection in an 8-year-old Chinese girl. Cranial MRI showed abnormal signals in bilateral striatum, which disappeared 8 months later. To better understand the pathogenesis of this encephalopathy, we examined cytokines levels in serum and cerebrospinal fluid from this patient. The results revealed the concentrations of interleukin-6 and interleukin-8 increased significantly in serum (26 pg/mL and 66 pg/mL, respectively) and cerebrospinal fluid (122 pg/mL and 325 pg/mL, respectively), and were reduced markedly after the therapy. Intrathecal production of interleukin-6 and interleukin-8 is probably related to the pathogenesis of striatal lesions caused by M. pneumoniae. These cytokines may cause local vascular injury, and finally leading to local vascular occlusion., Conclusion: Our results suggest that interleukin-6 and interleukin-8 may play important roles in the pathogenesis of this disease. This is the first report to describe the role of cytokines in this condition and relevant literature is reviewed. Our findings may lead to better understanding of the pathogenesis of M. pneumoniae-associated striatal lesions., (Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Purpose: According to the developmental origins of health and disease theory, fetal nutrition is associated with obesity and chronic diseases in children and adults. However, previous findings regarding the association between birth weight and childhood obesity have been inconsistent. The aim of the present study was to investigate the relationship between birth weight and childhood obesity in China., Methods: The 16,580 subjects (8477 boys and 8103 girls) aged 7-17 years, who participated in this study were recruited from a cross-sectional study in six cities in China. Epidemiological data, including birth information, were collected through face-to-face interviews, and anthropometric indices were measured by trained physicians. Overweight and obese cases were defined using sex-specific and age-specific 85th and 95th percentile body mass index (BMI) cutoffs for Han children and adolescents. Central obesity was defined using sex-specific waist-to-height ratio (WHtR) cutoffs (WHtR ≥0.48 in boys and WHtR ≥0.46 for girls)., Results: The overall rate of overweight status and obesity was 20.3% in the Chinese children and adolescents and that of central obesity was 18.9%. Subjects were stratified into eight groups according to weight at birth. J-shaped relationships were observed between birth weight and BMI for age Z-score and WHtR. After adjusting for confounders such as gender, gestational age, parental factors, and dietary factors, the risk of overweight and obese status was still higher in the children with higher birth weights than in children with birth weights of 3000-3499 g (3500-3999 g: odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.02-1.28; 4000-4499 g: OR = 1.39, 95% CI = 1.19-1.63; and 4500-4999 g: OR = 1.36, 95% CI = 1.06-1.76). Moderately high birth weight also increased the risk of central obesity. Relative to the children with normal birth weights (3000-3499 g), the adjusted OR and 95% CI were 1.33 (1.13-1.56) in children with birth weights of 4000-4499 g. Children with very low birth weight (lower than 1500 g) had the highest risk of central obesity. The adjusted OR was 2.30 (95% CI: 1.03-5.14) relative to children with birth weights of 3000-3499 g., Conclusions: Birth weight was associated with obesity in Chinese children and adolescents. J-shaped relationships were observed between birth weight and BMI and WHtR in childhood, and very low birth weight was associated with a mild increase in the risk of central obesity in Chinese children and adolescents., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Wilson's disease (WD) is an autosomal recessive genetic disorder of copper metabolism, caused by mutations in the ATP7B gene, resulting in copper accumulation in the liver, brain, kidney, and cornea and leading to significant disability or death if untreated. Early diagnosis and proper therapy usually predict a good prognosis, especially in pre-symptomatic WD. Genetic testing is the most accurate and effective diagnostic method for early diagnosis., Methods: The clinical and biochemical features of three unrelated Han Chinese families with pre-symptomatic WD were reported. The molecular defects in these families were investigated by polymerase chain reaction and DNA sequencing. Hundred healthy children with the same ethnic background served as controls. Bioinformatic tools (polymorphism phenotyping-2, sorting intolerant from tolerant, protein analysis through evolutionary relationships, and predictor of human deleterious single nucleotide polymorphisms) were combined and used to predict the functional effects of mutations., Results: We identified 2 novel ATP7B mutations (p.Leu692Pro and p.Asn728Ser) and 3 known mutations (p.Met769fs, p.Arg778Leu and p.Val1216Met) in these Chinese WD families. These mutations were not observed in the 100 normal controls. The bioinformatic method showed that p.Leu692Pro and p.Asn728Ser mutations are pathogenic., Conclusions: Our research enriches the mutation spectrum of the ATP7B gene worldwide and provides valuable information for studying the mutation types and mode of inheritance of ATP7B in the Chinese population. Liver function analysis and genetic testing in young children with WD are necessary to shorten the time to the initiation of therapy, reduce damage to the liver and brain, and improve prognosis.

Objective: This study aimed to evaluate the diagnostic value of Waist-to-Height Ratio in early detection of obesity and metabolic syndrome in Chinese children and adolescents., Method: A cross-sectional study was conducted in six cities in China in 2010 with 16,914 children and adolescents aged 7-17 years. Participants were randomly divided into the training and testing sets. Diagnostic values were estimated using sensitivity, specificity and areas under receiver operating characteristic curves., Results: The coefficients of variation of Waist-to-Height Ratio among age groups were lower than that of body mass index and waist circumstance. The area under receiver operating characteristic curve of Waist-to-Height Ratio was 0.968 in boys and 0.949 in girls for general obesity evaluation, and 0.983 in boys and 0.984 in girls for central obesity. The optimal cut-offs of Waist-to-Height Ratio were 0.47 in boys and 0.45 in girls in the training set and validated in the testing set. For metabolic syndrome evaluation, the sensitivity and specificity were 0.858 and 0.825 in boys, 0.864 and 0.812 in girls under the suggested cut-offs., Conclusion: Waist-to-Height Ratio was a simple, effective and practical tool for mass screening childhood obesity and metabolic syndrome in China. It will have potential values in public health practice., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Although diabetic retinopathy (DR) is considered to be a major cause of blindness, this is the first meta-analysis to investigate the pooled prevalence of DR in mainland China., Methodology/principal Findings: We conducted a search of all English reports on population-based studies for the prevalence of DR using Medline, EMbase, Web of Science, Google (scholar), and all Chinese reports were identified manually and on-line using CBMDisc, Chongqing VIP database, and CNKI database. A meta-analysis was carried out. The fixed effects model or random effects model was used as a statistical test for homogeneity. Nineteen studies were included. The prevalence of DR, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) in the pooled general population was 1.3% (95%CI: 0.5%-3.2%), 1.1% (95%CI: 0.6%-2.1%), and 0.1% (95%CI: 0.1%-0.3%), respectively, but was 23% (95%CI: 17.8%-29.2%), 19.1% (95%CI: 13.6%-26.3%), and 2.8% (95%CI: 1.9%-4.2%) in the diabetic group. The prevalence rate of DR in the pooled rural population was higher than that in the urban population, 1.6% (95%CI: 1.3%-2%), and the diabetic population, 29.1% (95%CI: 20.9%-38.9%). The prevalence of DR was higher in the Northern region compared with the Southern region., Conclusions/significance: The prevalence of DR in mainland China appeared a little high, and varied according to area. NPDR was more common. This study highlights the necessity for DR screening in the rural areas of China.

In the present study, we investigated the diversity distributions of allelic frequencies of 15 short tandem repeats (STRs) loci in a sample of Chinese Hui ethnic group in the Ningxia Hui Autonomous Region. The allelic frequencies of the 15 STR loci (D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818 and FGA) were obtained from 2975 unrelated healthy Hui individuals. The STR genotyping data of all the samples were generated by DNA extraction, multiple amplification, GeneScan and genotype analysis. The genetic distances among different populations were calculated by using Nei's method and a phylogenetic tree was constructed based on the allelic frequencies of the same 15 STR loci using the neighbor-joining method. A total of 185 alleles were observed in the Hui population, with the corresponding allelic frequencies ranging from 0.0002 to 0.5322. Chi-Square tests showed that all STR loci were in Hardy-Weinberg equilibrium. The forensic statistical parameters of all the loci showed high values. The population data in this study were compared with the previously published population data from other ethnics or areas. The Hui population showed significant differences from the Minnan Han, Uigur, Ewenki, Yi, Tibetan, Maonan and Malay ethnic minority groups in some loci, and from the South Morocco population and the Moroccan population in all the loci. Our results are valuable for human individual identification and paternity testing in the Chinese Hui population and are expected to enrich the genetic information resources of Chinese populations.

Myotonia congenita (MC) is a genetic disease characterized by mutations in the muscle chloride channel gene (CLCN1). To date, approximately 130 different mutations on the CLCN1 gene have been identified. However, most of the studies have focused on Caucasians, and reports on CLCN1 mutations in Chinese population are rare. This study investigated the mutation of CLCN1 in two Chinese families with MC. Direct sequencing of the CLCN1 gene revealed a heterozygous mutation (892G>A, resulting in A298T) in one family and a compound heterozygous mutations (782A>G, resulting in Y261C; 1679T>C, resulting in M560T) in the other family, None of the 100 normal controls had these mutations. Our findings add more to the available information on the CLCN1 mutation spectrum, and provide a valuable reference for studying the mutation types and inheritance pattern of CLCN1 in the Chinese population.

The aim of the present study was to investigate the mutation/variant of thyrotropin receptor (TSHR) and thyroid transcription factor-1 (TTF-1) genes in Chinese children with congenital hypothyroidism (CH). Seventy-nine and forty-nine Chinese children with CH were enrolled for molecular analysis of the TSHR gene and TTF-1 gene, respectively. One hundred normal children were evaluated as control. The coding regions of TSHR and TTF-1 genes were amplified by polymerase chain reaction and sequenced. Sequencing of the TSHR gene revealed a compound heterozygous variants (Pro52Thr/Val689Gly) and a heterozygous variant (Gly245Ser) in 2 of 79 patients. In 30 patients and 33 controls the normal cytosine at position 2181 in exon 10 of TSHR gene was replaced by a guanineCresulting in the replacement of Asp (727) by Glu. In 47 patients and 50 controls, the normal thymidine at position 561 in exon 7 of TSHR gene was replaced by a cytosine. This substitution did not change the amino acid in position 187. Sequencing of the TTF-1 gene revealed no mutation or polymorphism in 49 patients and 100 controls. In conclusion, three heterozygous variants (Pro52Thr, Gly245Ser, Val689Gly) of TSHR gene were firstly detected in Chinese children with CH. There were polymorphisms in exon 10 at nucleotide 2181 (C/G) and in exon 7 at nucleotide 561 (T/C) in TSHR gene. No mutation or polymorphism was detected in the coding region of TTF-1 gene. The mutation/variant of TSHR and TTF-1 genes is relatively rare in Chinese children with CH.