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Background: The coronavirus disease-2019 (COVID-19) pandemic worldwide has caused a high burden of mental problems, which may be associated with subjective cognitive impairment in the general population. Objectives: This cross-sectional survey aimed to investigate the level and pattern of cognitive failure (CF) and its negative changes during the COVID-19 pandemic among the general population in China. Methods: The participants completed an online questionnaire between April 18 and May 4, 2020, and those aged between 18 and 70 were included in this study. CF was measured using the 14-item CF Questionnaire (CFQ-14). Factors associated with CF and negative changes in CF were evaluated using multiple linear and logistic regression models. A total of 30,879 eligible participants were recruited; most were female (59.10%) and aged 31–45 (61.51%). Results: The mean CFQ-14 score was 15.62 (standard deviation = 11.55), and 4,619 (14.96%) participants reported negative changes in CF during the pandemic. Multiple regression analyses showed that participants with female gender, history of physical and mental disease, the self-perceived influence of COVID-19, altered appetite and taste preference, worse interpersonal relationships, long sleep duration, poor sleep quality, depressive, anxiety and posttraumatic stress disorder symptoms had a higher level of CF and negative CF changes, while regular exercise was associated with a lower risk of both outcomes. Conclusions: This study indicates that CF symptoms should be monitored in the general population during pandemics. A healthy lifestyle and reduction in psychological stress could help promote normal cognitive function during pandemics. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) should be the optimal choice in patients stratified by diabetes duration and body mass index (BMI) level. Methods: Classification tree analysis was performed to identify the influential factors for surgical procedure selection in real setting. Meta-analyses stratified by influential factors were conducted to compare the complete diabetes remission rates between SG and RYGB. The cost-effectiveness analysis was performed when results from meta-analysis remain uncertain. Results: Among 3198 bariatric procedures in China, 824 (73%) SGs and 191 (17%) RYGBs were performed in patients with T2DM. Diabetes duration with a cutoff value of 5 years and BMI level with 35.5 kg/m2 were identified as the influential factors. For patients with diabetes duration > 5 years, RYGB showed a significant higher complete diabetes remission rate than SG at 1 year: 0.52 (95% confidence interval (CI): 0.46–0.58) versus 0.36 (95% CI: 0.30–0.42). For patients with diabetes duration ≤ 5 years and BMI ≥ 35.5 kg/m2, there was no significant difference between 2 procedures: 0.57 (95% CI: 0.43–0.71) for SG versus 0.66 (95% CI: 0.62–0.70) for RYGB. The cost-effectiveness ratios of SG and RYGB were 244.58 and 276.97 dollars per QALY, respectively. Conclusions: For patients with diabetes duration > 5 years, RYGB was the optimal choice with regard to achieving complete diabetes remission at 1 year after surgery. However, for patients with diabetes duration ≤ 5 years and BMI ≥ 35.5 kg/m2, SG appeared to provide a cost-effective choice. [ABSTRACT FROM AUTHOR]

Terrestrial ecosystems provide multiple services interacting in complex ways. However, most ecosystem services (ESs) models (e.g., InVEST and ARIES) ignored the relationships among ESs. Process‐based models can overcome this limitation, and the integration of ecological models with remote sensing data could greatly facilitate the investigation of the complex ecological processes. Therefore, based on the Carbon and Exchange between Vegetation, Soil, and Atmosphere (CEVSA) models, we developed a process‐based ES model (CEVSA‐ES) integrating remotely sensed leaf area index to evaluate four important ESs (i.e., productivity provision, carbon sequestration, water retention, and soil retention) at annual timescale in China. Compared to the traditional terrestrial biosphere models, the main innovation of CEVSA‐ES model was the consideration of soil erosion processes and its impact on carbon cycling. The new version also improved the carbon‐water cycle algorithms. Then, the Sobol and DEMC methods that integrated the CEVSA‐ES model with nine flux sites comprising 39 site‐years were used to identify and optimize parameters. Finally, the model using the optimized parameters was validated at 26 field sites comprising 135 site‐years. Simulation results showed good fits with ecosystem processes, explaining 95%, 92%, 76%, and 65% interannual variabilities of gross primary productivity, ecosystem respiration, net ecosystem productivity, and evapotranspiration, respectively. The CEVSA‐ES model performed well for productivity provision and carbon sequestration, which explained 96% and 81% of the spatial‐temporal variations of the observed annual productivity provision and carbon sequestration, respectively. The model also captured the interannual trends of water retention and soil erosion for most sites or basins. Plain Language Summary: Terrestrial ecosystems simultaneously provide multiple ecosystem services (ESs). The common environmental drivers and internal mechanisms lead to nonlinear and dynamic relationships among ESs. Assessing the spatiotemporal changes of ESs have recently emerged as an element of ecosystem management and environmental policies. However, appropriate methods linking ESs to biogeochemical and biophysical processes are still lacking. In this study, we developed a process‐based model Carbon and Exchange between Vegetation, Soil, and Atmosphere (CEVSA‐ES) that integrates remote sensing data for evaluating ESs. We first described the model framework and detailed algorithms of the processes related to ESs. Then a model‐fusion method was applied to optimize parameters to which the model was sensitive and to improve model performance based on multi‐source observational data. The calibrated CEVSA‐ES model showed good performance for carbon and water fluxes (i.e., gross primary productivity, ecosystem respiration, net ecosystem productivity, and evapotranspiration). The CEVSA‐ES model performed well for productivity provision, and carbon sequestration. It also captured the interannual trends of water retention and soil erosion for most sites or basins in Chinese terrestrial ecosystems. The CEVSA‐ES model not only has the potential to improve the accuracy of simulated ESs, but also can capture the relationships among ESs, which could support the trade‐offs and synergies among ESs. Key Points: We developed an ecosystem service model Carbon and Exchange between Vegetation, Soil, and Atmosphere‐ecosystem services (CEVSA‐ES) that integrates ecosystem processes with satellite‐based dataAccounting for soil retention/erosion and its impact on carbon cycling was the main difference from other process‐based modelsThe CEVSA‐ES model with optimized parameters explained 47%–96% of the spatial and temporal variations of four ecosystem services in China [ABSTRACT FROM AUTHOR]

Accurate grassland aboveground biomass (AGB) estimation is crucial for effective grassland utilization. However, most current satellites cannot provide data with high spatial and temporal resolutions simultaneously. Spatiotemporal fusion models can combine the resolution advantages of different remote sensing data and support high-precision vegetation monitoring. In order to obtain accurate grassland AGB maps with high resolution in the Three-River Headwaters Region (TRHR) of China, we developed an estimation method based on the synthetic 30 m growing season averaged normalized difference vegetation index (GS-NDVI), which was fused from 30 m Landsat 8 Operational Land Imager (OLI) and 250 m Moderate-resolution Imaging Spectroradiometer (MODIS) NDVI data. To choose the optimal fusion model, we investigated the performances of three spatiotemporal fusion models for NDVI fusion, the spatial and temporal adaptive reflectance fusion model (STARFM), the enhanced spatial and temporal adaptive reflectance fusion model (ESTARFM), and the rule-based piecewise regression tree model (RPRTM). The three models all produced reasonable NDVI predictions, with the coefficient of determination (R2) ranging from 0.58 to 0.86. RPRTM had the highest efficiency and was more suitable for large-scale spatiotemporal data fusion. Compared with the models generated from 250 m MODIS GS-NDVI, the AGB estimation models based on 30 m synthetic GS-NDVI were more accurate, demonstrating the effectiveness of our methods. The resulting AGB map of 30 m resolution provides spatially detailed AGB information that will be useful for regional ecosystem studies and local land management decisions. [ABSTRACT FROM AUTHOR]

Background Except for hypertension control, antihypertensive agents play an essential role in the secondary prevention of coronary artery disease. Objective This study aimed to describe the use of antihypertensive agents in patients with hypertension and coronary artery disease by assessing the compliance to the updated European and Chinese hypertension guidelines through analyzing the frequencies, monthly trends and the influencing factors of antihypertensive agents. Setting Beijing Friendship Hospital, Capital Medical University, a 2000-bed tertiary Chinese university teaching hospital. Method Prescriptions of patients diagnosed with hypertension and coronary artery disease were extracted from medical records of this tertiary hospital from 2013 to 2016. Frequencies, trends, co-existing prescription patterns of five classes of antihypertensive agents were analyzed. Influencing factors of prescription patterns were evaluated by logistic regression. Main outcome measure The frequencies and monthly trends of different antihypertensive agents within four years. Result In total, 286,155 prescriptions met the inclusion criteria. β-blockers (64,0%) were the most widely used antihypertensive agents, followed by calcium channel blockers (53.57%), angiotensin receptor blockers (42.6%), angiotensin-converting-enzyme inhibitors (23.7%) and diuretics (16.4%). During the 4 years, frequencies of β-blockers, angiotensin receptor blockers, calcium channel blockers and diuretics increased over time, while that of angiotensin-converting-enzyme inhibitors declined. Multivariate logistic regression indicated that gender, age and comorbidities including stroke, diabetes, heart failure and arrhythmia could affect antihypertensive selections to varying degrees. Conclusion The compliance to guidelines is overall well for patients with hypertension and coronary artery disease, but improvements is needed for patients with type 2 diabetes. Multi-center studies with large-scale data are required to further assess the usage of antihypertensive agents in patients. [ABSTRACT FROM AUTHOR]

Background The numbers of articles reporting randomized controlled trials (RCTs) on viral hepatitis in China have been increasing, but there have been few systematic studies evaluating the reporting quality of RCTs in this field. This study was performed to assess the reporting quality of RCTs on the treatment of hepatitis B and C in China from 1991 to 2015. Methods Articles published between January 1991 and December 2015 were identified via the PubMed, MEDLINE, and Embase databases using the key words “randomized clinical trials”, “treatment”, “therapy”, “hepatitis B”, “HBV”, “hepatitis C”, “HCV”, “China”, and “Chinese”. The reporting quality was assessed against the Consolidated Standards of Reporting Trials (CONSORT) checklist. Results In total, 211 RCTs on the treatment of hepatitis B or C were included. The number of articles focusing on these RCTs increased rapidly over time, while the reporting quality improved steadily over time. Overall, compliance with the key components of the CONSORT checklist was low, with only 8.5%, 3.8%, and 11.4% of the articles fulfilling the reporting requirements of randomization, allocation concealment, and blinding, respectively. Conclusions Both the number and the quality of RCT articles were found to have increased steadily over the last two decades. However, compliance with the key components of the CONSORT checklist still needs improvement. It is hoped that the results of this study will lead to improvements in the reporting quality of clinical trials on hepatitis B and C in China. [ABSTRACT FROM AUTHOR]

The present study assessed the willingness of the general population to receive COVID-19 vaccines and identified factors that influence vaccine hesitancy and resistance. A national online survey was conducted from 29 January 2021 to 26 April 2021 in China. Multinomial logistic regression analyses were conducted to identify factors that influence vaccine hesitancy and resistance. Of the 34,041 participants surveyed, 18,810 (55.3%) were willing to get vaccinated, 13,736 (40.3%) were hesitant, and 1495 (4.4%) were resistant. Rates of vaccine acceptance increased over time, with geographical discrepancies in vaccine hesitancy and resistance between provinces in China. Vaccine safety was the greatest concern expressed by most participants (24,461 [71.9%]), and the major reason for participants' refusing vaccination (974 [65.2%]). Government agencies (23,131 [68.0%]) and social media (20,967 [61.6%]) were the main sources of COVID-19 vaccine information. Compared with vaccination acceptance, female, young and middle-aged, high income, and perceived low-risk of infection were associated with vaccine hesitancy. Histories of allergic reactions to other vaccines and depression symptoms were related to vaccine resistance. Common factors that influenced vaccine hesitancy and resistance were residing in cities and perceiving less protection with vaccines than with other protective measures. The results indicate that the rate of vaccine resistance is relatively low, but vaccine hesitancy is common. Individuals who are female, young and middle-aged, with a high income, and residing in cities are more likely to be hesitant for vaccination and should be the target populations for vaccination campaigns. Specific vaccine messaging from the government and social media could alleviate public concerns about vaccine safety and efficacy. [ABSTRACT FROM AUTHOR]

Background: The main treatment methods for early gastric cancer (EGC) include endoscopic submucosal dissection (ESD) and radical gastrectomy. However, appropriate treatment for patients who exceed the absolute indications for ESD remains unestablished. In China, evidence-based medicine for the expanding indications of ESD and accurate diagnostic staging for EGC patients are lacking. Thus, clinical studies involving Chinese patients with EGC are necessary to select appropriate treatment options and promote China's expanded indications for ESD and diagnostic staging scheme.Methods: This is a multicenter, ambispective, observational, open-cohort study that is expected to enroll 554 patients with EGC. The study was launched in May 2018 and is scheduled to end in March 2022. All enrolled patients should meet the inclusion criteria. Case report forms and electronic data capture systems are used to obtain clinical data, which includes demographic information, results of perioperative blood- and auxiliary examinations, surgical information, results of postoperative pathology, and the outcomes of postoperative recovery and follow-up. Patients are followed up every 6 months after surgery for a minimum of 5 years. The primary endpoint is the rate of lymph node metastasis (LNM), whereas the secondary endpoints include the following: consistency, sensitivity, and specificity of the results of preoperative examinations and postoperative pathology; cut-off values for LNM; logistic regression model of expanded indications for ESD; and incidence of postoperative complications within the 30-day and 5-year relapse-free survival rates.Discussion: This study will explore and evaluate expanded indications for ESD that match the characteristics of the Chinese population in patients with EGC and will introduce a related staging procedure and examination scheme that is appropriate for China. Ethical approval was obtained from all participating centers. The findings are expected to be disseminated through publications or presentations and will facilitate clinical decision-making in EGC.Trial Registration: The name of the registry is ChiCTR. It was registered on May 9, 2018, with the registration number ( ChiCTR1800016084 ). The clinical trial was launched in May 2018 and will end in March 2022, with enrollment to be completed by December 2021. Trial status: Ongoing. [ABSTRACT FROM AUTHOR]

• 60.6% of participants would be willing to receive COVID-19 vaccine, 33.4% were hesitant to vaccination, and 6.0% were resistant to vaccination. • Social media platforms and government agencies were the main sources of information vaccination. • Worry about the efficacy and adverse effects were the top two common reason of vaccine hesitancy and resistance. Vaccination is an important preventive measure against the coronavirus disease 19 (COVID-19) pandemic. We aimed to examine the willingness to vaccination and influencing factors among college students in China. From March 18 to April 26, 2021, we conducted a cross-sectional online survey among college students from 30 universities in Wuhan, Hubei Province, China. The survey was composed of the sociodemographic information, psychological status, experience during pandemic, the willingness of vaccination and related information. Students' attitudes towards vaccination were classified as 'vaccine acceptance', 'vaccine hesitancy', and 'vaccine resistance'. Multinomial logistic regression analyses were performed to identify the influencing factors associated with vaccine hesitancy and resistance. Among 23,143 students who completed the survey, a total of 22,660 participants were included in the final analysis with an effective rate of 97.9% after excluding invalid questionnaires. A total of 60.6% of participants would be willing to receive COVID-19 vaccine, 33.4% were hesitant to vaccination, and 6.0% were resistant to vaccination. Social media platforms and government agencies were the main sources of information vaccination. Worry about the efficacy and adverse effects of vaccine were the top two common reason of vaccine hesitancy and resistance. Multiple multinomial logistic regression analysis identified that participants who worried about the adverse effects of vaccination were more likely to be vaccine hesitancy (aOR = 2.44, 95% CI = 2.30, 2.58) and resistance (aOR = 2.71, 95% CI = 2.40, 3.05). More than half of college students are willing to receive the COVID-19 vaccine, whereas nearly one-third college students are still hesitant or resistant. It is crucial to provide sufficient and scientific information on the efficacy and safety of vaccine through social media and government agencies platforms to promote vaccine progress against COVID-19 and control the pandemic in China. [ABSTRACT FROM AUTHOR]

• T/ET increased remarkably with a rate of 0.0019 yr−1 in China from 1982 to 2015. • Greening and climate warming dominated the increasing T/ET trend in China. • T and ET observations were used to improve model accuracy based on model-data fusion method. The ratio of transpiration to total terrestrial evapotranspiration (T/ET) plays an important role in the hydrological cycle and in the energy budgets between the land and the atmosphere. Although China has experienced substantial climate warming and vegetation restoration (i.e., greening) over the past decades, the response of T/ET to the changing climate and environmental factors is poorly understood. Here, we apply a model-data fusion method that integrates the Priestly-Taylor Jet Propulsion Laboratory (PT-JPL) model with multivariate observational datasets (transpiration and evapotranspiration) to quantify the relative contributions of multiple factors to the T/ET trend for the terrestrial ecosystem of China from 1982 to 2015. Validation against the observational data indicates that the PT-JPL model performed well. The multi-year average T/ET was estimated to be 0.56 ± 0.05 in China. The T/ET of the forest ecosystems (0.65–0.72) was generally higher than that of the non-forest ecosystems (0.41–0.60). T/ET increased remarkably at a rate of 0.0019 yr−1 (P < 0.01) during the study period. Leaf area index increased significantly over the period, by 0.0031 m2 m−2 yr−1. It appears that greening and climate change were the most likely causes of the increasing T/ET in China, directly explaining 57.89% and 36.84% of the T/ET trend, respectively. Particularly, in the subtropical-tropical monsoonal region, greening directly contributed 24.43% to the T/ET trend whereas climate change contributed 60.95%. The influences of greening and climate change on T/ET trends are mutually reinforcing. Additionally, partial correlation analyses between the climate-driven T/ET and the climate variables indicate that warming (0.04 °C yr−1, P < 0.01) was the major driving force of the climate-induced interannual variability of T/ET across the whole study area (R = 0.84), especially in the subtropical-tropical monsoonal region (R = 0.89). Our results may help elucidate the interactions between terrestrial ecosystems and the atmosphere within the context of long-term global climate changes. [ABSTRACT FROM AUTHOR]

The concept of a healthy lifestyle is receiving increasing attention. This study sought to identify an optimal healthy lifestyle profile associated with sleep health in general population of China. An online cross-sectional survey was conducted from June to July 2022. Six healthy lifestyle factors were assessed: healthy diet, regular physical exercise, never smoking, never drinking alcohol, low sedentary behavior, and normal weight. Participants were categorized into the healthy lifestyle (5-6 factors), average (3-4 factors), and unhealthy lifestyle groups (0-2 factors). The study's primary outcome was sleep health, which included sleep quality, duration, pattern, and the presence of any sleep disorder or disturbance, including insomnia, excessive daytime sleepiness, obstructive apnea syndrome, and narcolepsy. Multivariable logistic regression analysis was applied to explore lifestyles associated with the selected sleep health outcomes. 41,061 individuals were included, forming 18.8% healthy, 63.8% average, and 17.4% unhealthy lifestyle groups. After adjusting for covariates, participants with healthy lifestyle were associated with a higher likelihood of good sleep quality (OR = 1.56, 95% CI = 1.46-1.68), normal sleep duration (OR = 1.60, 95% CI = 1.49-1.72), healthy sleep pattern (OR = 2.15, 95% CI = 2.00-2.31), and lower risks of insomnia (OR = 0.66, 95% CI = 0.61-0.71), excessive daytime sleepiness (OR = 0.66, 95% CI = 0.60-0.73), and obstructive apnea syndrome (OR = 0.40, 95% CI = 0.37-0.43), but not narcolepsy (OR = 0.92, 95% CI = 0.83-1.03), compared to those with unhealthy lifestyle. This large cross-sectional study is the first to our knowledge to quantify the associations of a healthy lifestyle with specific aspects of sleep health. The findings offer support for efforts to improve sleep health by modulating lifestyle., (© 2024. The Author(s).)

Background: Serum uric acid (SUA) is a major cause of cardiovascular and cerebrovascular diseases. Whether and to what extent the excess risk of enlarged perivascular spaces (EPVS) conferred by SUA is unknown. The study was conducted to investigate the association between SUA and EPVS in different brain regions., Methods: Data are from Multi-modality medical imaging study based on Kailuan study (META-KLS) in this cross-sectional study. Participants were divided into five groups based on SUA levels, and EPVS in basal ganglia (BG), centrum semiovale (CSO) and midbrain (MB) was systematically assessed and divided into Low and High group. Odds ratio (OR) and 95% confidence intervals (95% CIs) for high EPVS outcomes were estimated using multivariable logistic regression analysis. Restricted cubic spline (RCS) was used to further investigate dose-response relationship., Results: A total of 1014 participants aged 25-83 years from 11 centers were enrolled in the study. In the multivariable-adjusted model, SUA, as an independent risk factor, correlated positively with high degree of MB-EPVS (OR, 1.002; 95% CI, 1.000 to 1.004; p = 0.023) in general population. In addition, RCS further demonstrated the linear association between SUA and MB-EPVS (p = 0.072). No association was found between SUA and BG-EPVS or CSO-EPVS., Conclusion: SUA was an independent risk factor of MB-EPVS. High SUA levels were more predictive of increased risk occurrence of high degree of MB-EPVS, supporting a linear association between SUA and MB-EPVS and further indicating that SUA may play an important role in cerebral small vessel disease., Trial Registration: The KaiLuan Study and META-KLS were registered online (ChiCTR2000029767 on chictr.org.cn and NCT05453877 on Clinicaltrials.gov, respectively)., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: We hypothesized that increased level of serum β2-microglobulin (β2M) is an independent factor associated with higher mortality in hospitalized patients with exacerbated chronic obstructive pulmonary disease (COPD)., Patients and Methods: We retrospectively analyzed 488 hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital, P. R. China between December 31st, 2012 and December 28th, 2017. Concentrations of serum β2M and other clinical indexes were measured or collected on admission, and all patients were followed up to 90 days. The relationship between β2M and 30- and 90-day all-cause mortality was explored by Cox regression analysis adjusted for age, C-reactive protein values, N-terminal pro-brain natriuretic peptide/100, respiratory failure [RF, defined as partial arterial oxygen pressure (PaO 2 ) <60 mmHg on room air or PaO 2 over the fraction of inspired oxygen (PaO 2 /FiO 2 ) < 300], eosinopenia, consolidation, and acidaemia., Results: Median concentrations of β2M were significantly higher in non-survivals compared to survivals within 30 days (4.11 mg/L (IQR 3.10-6.60) vs 2.79mg/L (IQR 2.13-3.76), P < 0.001) and 90 days (3.79 mg/L (IQR 2.61-6.69) vs 2.79 mg/L (IQR 2.13-3.73), P < 0.001). Serum levels of β2M were correlated with 30-day and 90-day mortality in overall exacerbated COPD patients, with hazard ratios (HRs) of 1.09 (95% CI 1.04-1.14, P = 0.001) and 1.09 (95% CI 1.05-1.14, P < 0.001). In exacerbated COPD patients without RF and with RF, the HRs were 1.06 (95% CI 0.995-1.137, P = 0.069) and 1.14 (95% CI 1.02-1.27, P = 0.021) for 30-day mortality, 1.09 (95% CI 1.02-1.15, P = 0.010) and 1.14 (95% CI 1.03-1.26, P = 0.014) for 90-day mortality, respectively., Conclusion: Our data showed that concentrations of serum β2M were associated with an increased risk of mortality, suggesting that β2M might be a valuable predictor of poor prognosis for hospitalized patients with exacerbated COPD., Competing Interests: The authors declare no conflicts of interest in this work., (© 2020 Mao et al.)

Background : There is a strong need to include training of research methods in training programs for physicians. International clinical research training programs (CRTP) that comprehensively introduce the methodology of clinical research and combined with practice should be a priority. However, few studies have reported a multimodal international CRTP that provides clinicians with an introduction to the quantitative and methodological principles of clinical research. Objective : This manuscript is intended to comprehensively describe the development process and the structure of this multimodal training program. Methods : The CRTP was comprised of three distinct, sequential learning components: part 1 - a six-week online eLearning self-study; part 2 - a series of three weekly interactive synchronous webinars conducted between Durham, North Carolina, USA and Beijing, China; and part 3 - a five-day in-person workshop held at Beijing Friendship Hospital, Capital Medical University (BFH-CMU). Self-assessment quiz scores and participation rates were used to evaluate effectiveness of the training program. Participants' demographic characteristics, research experience, satisfaction and feedback on the program were collected using questionnaires. Results : A total of 50 participants joined the CRTP. Forty-four participants (88%) completed the program satisfaction questionnaires. The average quiz score of the six eLearning units varied from 31% to 73%. Among the three components of the program, the online eLearning self-study was felt to be the most challenging. Thirty-nine (89%) of the surveyed respondents were satisfied with all components of the training program. Among the respondents, 43 (98%) felt the training was helpful in preparing them for future clinical research projects and expressed willingness to recommend the program to other colleagues. Conclusions : We established a multimodal international collaborative training program. The program demonstrated acceptable participation rates and high satisfaction among Chinese clinicians. It provides a model that may be used by others developing similar international clinical research training programs for physicians.

Objective: To evaluate the effectiveness of nutrition and food safety educational programs on primary students from grade 4 to 6 in impoverished areas of Western China, under a school-based cluster-randomized trial., Methods: Twelve primary schools were selected from 2 impoverished counties in West China and assigned to intervention or control groups, randomly, with 6 schools in each group. Self-rating knowledge, attitude and practice questionnaires were used at both baseline and final stages. Textbooks and supportive materials were designed according to the characteristics of baseline data. All students in the intervention group were treated with targeted nutrition and food safety lectures of 0.5 hour per week for 2 semesters. Generalized linear mixed effects model was applied to fit the random effects on individual and clusters as well as to fit the fixed effect of the programs., Results: Three hundred seventy-eight students from grade 4 to 6 were randomly selected at the baseline study and the differences of scores on knowledge, attitude and practice between the 2 groups were statistically insignificant (P > 0.05). No cluster was lost during the trial. In the final investigation, 478 students were randomly selected at the individual level. Scores on knowledge, attitude and practice among students in the intervention group were significantly higher, when comparing to the control group (P < 0.01). At the cluster level, more schools in the intervention group showed significant changes on knowledge and practice, yet the change in attitude was less obvious. Data from the mixed-effects model demonstrated that the program served as an influential factor on scores related to knowledge after the intervention(P = 0.015)but did not affect the scores on related attitude or practice (P > 0.05)., Conclusion: Lectures seemed to have improved the cognition of nutrition and food safety among primary students from grade 4 to 6. However, long-term observation and larger sample size were needed to evaluate the changes on attitude and practice among the students.

Objective: To evaluate the rationality and validity of weighted TOPSIS method and weighted RSR method to evaluate drug supervision and supply networks construction in rural areas of Hunan ., Methods: Data of drug network construction in rural Hunan in 2010 were used to establish a comprehensive evaluation model, and weighted TOPSIS and RSR method were applied to this model and the results of which were compared to that of synthetical scored method to examine the validity., Results: A comprehensive evaluation model was established, comprising of 3 primary indices, 8 secondary indices and 56 tertiary ones. The result of weighted RSR method was highly correlated to that of synthetical scored method, yet the result of TOPSIS was less correlated to the formers. All correlations were significant (P<0.01)., Conclusion: Both weighted RSR and TOPSIS are not perfect methods, but the application of the methods in drug network evaluation is scientific and effective.