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Background: To explore the clinical application value of pre‐conception expanded carrier screening (PECS) in the Chinese Han ethnicity population of childbearing age. Methods: The results of genetic testing of infertile parents who underwent PECS in the Reproductive Medicine Center of the Second Affiliated Hospital of Zhengzhou University, China, from September 2019 to December 2021, were retrospectively analyzed. The carrier rate of single gene disease, the detection rate of high‐risk parents, and the clinical outcome of high‐risk parents were statistically analyzed. Results: A total of 1372 Chinese Han ethnicity patients underwent PECS, among which 458 patients underwent the extended 108‐gene test, their overall carrier rate was 31.7%, and the detection rate of high‐risk parents was 0.3%. The highest carrier rates were SLC22A (2.4%), ATP7B (2.4%), MMACHC (2.2%), PAH (1.8%), GALC (1.8%), MLC1 (1.3%), UNC13D (1.1%), CAPN3 (1.1%), and PKHD1 (1.1%). There were 488 women with fragile X syndrome—FMR1 gene detection, and 6 patients (1.2%) had FMR1 gene mutation. A total of 426 patients were screened for spinal muscular atrophy—SMN1, and the carrier rate was 3.5%, and the detection rate of parents' co‐carrier was 0.5%. Conclusion: Monogenic recessive hereditary diseases had a high carrier rate in the population. Pre‐pregnancy screening could provide good prenatal and postnatal care guidance for patients and preimplantation genetic testing for monogenic/single gene disorders (PGT‐M) and prenatal diagnosis could provide more precise reproductive choices for high‐risk parents. [ABSTRACT FROM AUTHOR]

Objective: This survey aims to explore the current medical treatment of major depressive disorder (MDD) in China and match its degree with Canadian Network for Mood and Anxiety Treatments (CANMAT). Methods: A total of 3275 patients were recruited from 16 mental health centers and 16 general hospitals in China. Descriptive statistics presented the total number and percentage of drugs, as well as all kinds of treatments. Results: Selective serotonin reuptake inhibitors (SSRIs) accounted for the largest proportion (57.2%), followed by serotonin-noradrenaline reuptake inhibitors (SNRIs) (22.8%) and mirtazapine (7.0%) in the first therapy, while that of SNRIs (53.9%) followed by SSRIs (39.2%) and mirtazapine (9.8%) in the follow-up therapy. An average of 1.85 medications was administered to each MDD patient. Conclusion: SSRIs were the first choice in the first therapy, while the proportion of those drugs decreased during the follow-up therapy and were replaced by SNRIs. Plenty of combined pharmacotherapies were directly selected as the first trial of patients, which was inconsistent with guideline recommendations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the friendship quantity and quality of urban Chinese anxiously withdrawn children with those of typical children, and to examine the moderating role of friendship in the relation between anxious withdrawal and feelings of loneliness. Anxiously withdrawn (n = 66) and typical children (n = 170) were identified from a complete sample (N = 572) using classroom nominations collected in grades 3–6 (Mage = 10.51, SD = 1.13). At the group level, compared with typical children, anxiously withdrawn children received fewer friendship nominations from their classmates, and particularly from male classmates. Anxiously withdrawn boys nominated fewer male classmates as friends than typical boys and anxiously withdrawn girls had fewer mutual friendships with girls than typical girls. Anxiously withdrawn children reported more conflicts within their friendships than typical children; and anxiously withdrawn girls reported lower positive friendship quality than typical girls. Using a variable‐centred approach with the complete sample, a Bayesian multilevel regression analysis revealed that positive friendship quality moderated the association between anxious withdrawal and feelings of loneliness. [ABSTRACT FROM AUTHOR]

This study was conducted to acknowledge microbiological and clinical characteristics of hospital-acquired pneumonia (HAP) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). A retrospective, 1:1 matched (age, gender, specimen source, and ward) case-control study was conducted during 2015–2017 in a tertiary teaching hospital in Anhui, China. Multivariate logistic regression analysis demonstrated that prior central venous catheter use, sputum suction, continuous renal replacement therapy, and exposure to fluroquinolones were independent risk factors for the morbidity of CRKP infection for HAP. Treatment failure for infection was an independent risk factor for crude in-hospital mortality, while the use of fluroquinolones may improve the effective treatment for infection (p = 0.040). Among 74 CRKP strains, 85.1% of them were positive for the production of KPC-2, and one of them was detected for co-harboring blaKPC-2 and blaIMP-38-like. Separately, sequence type (ST) 11 (81.1%) was the predominant ST in this study, and ST11 CRKP isolates were related with higher detection rate of blaKPC-2 and lower resistance rate to trimethoprim/sulfamethoxazole when compared with non-ST11 ones. Moreover, resistance to carbapenem was associated with higher mortality (35.1%) and hospitalization costs for HAP patients with K. pneumoniae infection. Invasive procedures may increase the morbidity of CRKP infection for HAP. Prior exposure to fluroquinolones is associated with the development of resistance, but as a targeted treatment it may be effective. [ABSTRACT FROM AUTHOR]

[Display omitted] • Flow and sediment connectivity was mapped in the agricultural terraced catchment. • Incorporation of natural-artificial linear landscapes alters spatial patterns of connectivity. • Connectivity gradually increased with the closing of the distance to the linear landscapes. • Artificial ditches enhance both lateral and longitudinal connectivity than road networks. • Introduced weight factor to calculate the index generated more reliable connectivity map. Linear landscape elements, such as man-made ditches and road networks, play a pivotal role in the transport of water and eroded sediments. Yet very few studies have focused on the variations in drainage flow paths disturbed by artificial linear landscapes and their contribution to flow and sediment connectivity (FSC). This study utilized the index of connectivity (IC) to examine and distinguish the impact of natural and artificial linear landscape elements (i.e., natural streams, man-made ditches, and road networks) on the spatial distribution of FSC. The method was employed in a typical agricultural terraced catchment of the Honghe Hani Rice Terraces World Heritage Site of China, based on two weight factors - roughness index (RI) and Rndvic factor. The results indicate that the incorporation of the linear landscape elements for the IC calculation remarkably affected the spatial distribution of FSC. Specifically, FSC values notably increased by closing the distance to linear landscape elements within a specific threshold. Moreover, in the confluence between natural and artificial linear landscape elements, the mean value of FSC was higher compared to scenarios without any or only one linear landscape element. In comparison, the presence of road networks only improved lateral connectivity by modifying the surface flow along east-west directions, while man-made ditches significantly influenced both longitudinal and lateral connectivity to a larger degree, especially in the terraced area. This finding underscores the effectiveness of ditch constructions as management practices for the regulation of water resources and facilitating the downstream transfer of sediment. Field observations and validation confirmed that Rndvic, which incorporates vegetation variable as a weight factor in the calculation of IC, yields more accurate and reliable maps of FSC than that of RI. This study holds far-reaching significance for water resources management and landscape sustainability within terrace-protected areas, providing invaluable insights for decision-makers. [ABSTRACT FROM AUTHOR]

In 2006, organotins pollution were investigated in the coastal environment of Xiamen, China. Six species of organotin compounds including tributyltin, triphenyltin and their degradation compounds were quantified in the dissolved and particulate phases of the water, and in the sediment using GC-FPD. The concentrations of organotin compounds ranged from 2.2 to 160ng (Sn) L−1 dissolved in the water, 0.14–6.7ng (Sn) L−1 in suspended particulate matter and nd∼26ng (Sn) g−1 (dry weight) in the sediment. The highest concentration of total organotin or tributyltin in water was found in a shipyard and at a station near the inlet of the harbor, indicating fresh inputs of antifouling paints to Xiamen’s coastal environment. Organotin speciation was performed on sediment cores to investigate contamination trends over the past ten years in the harbor. The results of 210Pb dating indicated that Xiamen western harbor suffered contamination during 2000. The environmental behavior of organotins such as the enhancement of the microlayer, partitioning between water/suspended particulate matter and between water/sediment are also discussed in this paper. [Copyright &y& Elsevier]

• "New Generation Dispatching and Control System" is being developed in China. • Demand response was involved in many aspects of the power system operations. • Response uncertainties of flexible loads of the power system need to be considered. • Establish the price-based demand response model and incentive-based demand response model, respectively. • A multi-time scale dispatch model considering the response uncertainty of flexible loads for an AC/DC hybrid distribution system is proposed, which involves a day-ahead, intra-day, and real-time dispatch scheme. This paper examines the response uncertainty of flexible loads in the multi-time scale operation of an AC/DC hybrid distribution system. The price-based demand response (PBDR) model is established based on the principle of consumer psychology and the law of actual response uncertainty. The incentive mechanism of the incentive-based demand response (IBDR) model is designed considering the error of actual response capacity. Then, fuzzy chance-constrained programming is adopted to handle the response uncertainty of flexible loads. A multi-time scale dispatch model considering the response uncertainty of flexible loads for an AC/DC hybrid distribution system is proposed, which involves a day-ahead, intra-day, and real-time dispatch scheme. Mixed integer second-order cone programming (MISOCP) is utilized to solve the established multi-time scale dispatch model. Case studies illustrate the effectiveness of the proposed model, by considering the response uncertainty of flexible loads and the coordinated optimization on multiple time scales, peak shaving and valley filling can be realized and the dispatching cost of network can be reduced. [ABSTRACT FROM AUTHOR]

Landform changes caused by human activities can directly affect the recharge of groundwater, and are reflected in the temporal and spatial changes in groundwater stable isotope composition. These changes are particularly evident in high-intensity farming areas. In this study, we tested and analyzed groundwater stable isotope samples at different elevations of rice terraces in a typical agricultural watershed of the Hani Terraces, a World Heritage Cultural Landscape in southwest China. Thus, we determined the characteristic variations and factors that influence the temporal and spatial effects on groundwater stable isotopes in the Hani Terraces, which are under the influence of high-intensity farming activities. The elevation gradients of δ18O and δ2H in groundwater are significantly increased due to farming activities. The values were 0.88‰ (100 m)−1 and −4.5‰ (100 m)−1, respectively, and they changed with time. The groundwater circulation cycle is approximately three months. We also used the special temporal and spatial variation characteristics of the groundwater isotopes as a way to evaluate the source and periodic changes of groundwater recharge. In addition, high-intensity rice farming activities, such as ploughing every year from October to January can increase the supply of terraced water to groundwater, thus ensuring the sustainability of rice cultivation in the terraces during the dry season. This demonstrates the role of human wisdom in the sustainable and benign transformation of surface cover and the regulation of groundwater circulation. [ABSTRACT FROM AUTHOR]

Landslide susceptibility mapping is a prerequisite for preventing and mitigating hazardous risks, especially in landslide-prone mountainous areas. This study applies two well-known models – the information value model (IVM) and maximum entropy (MaxEnt) model, and two additional models – a biological climatic (Bioclim) model and a mean distance (Domain) model, to evaluate the landslide susceptibility of the Honghe Hani Rice Terraces, a World Heritage site in Yuanyang County of Southwest China. A spatial dataset comprising 235 historical landslide locations were used in the models at a training-to-testing data ratio of 75:25. Fifteen commonly used environmental, geological, and meteorological factors, as well as three new factors including proximity to settlements, human activity intensity, and the multi-year average temperature were selected as the impacting factors to landslide occurance. Model validation and comparison were performed using the area under the receiver operating characteristic curve, and several statistical indices (sensibility, specificity, accuracy, precision, recall, true skill statistic or TSS, F-measure). The results show that the MaxEnt model yields the best overall performance for landslide susceptibility analysis, followed by the Domain model, IVM, and the Bioclim model. The jackknife test result shows that the three most important factors contributing to landslide hazard include proximity to roads, annual rainfall, and proximity to settlements. Furthermore, only a small proportion of areas positioned along roads were identified to be at high or very high risk for landslides given the fact the study site is located in a remote and mountainous region with under-developed economy in southwest China. Findings from this study can be used to facilitate landslide risk mitigation and the sustainable conservation of the Honghe Hani Rice Terrace World Heritage site or other similar areas. Unlabelled Image • Four models applied to map landslide susceptibility in a World Heritage site in China. • All except for the Bioclim model were useful with AUC-ROC values near or above 0.8. • The most important factors to landslide susceptibility modeling were identified. [ABSTRACT FROM AUTHOR]

• CHIRPS outperforms the interpolated gauge-based precipitation in landslide prediction. • Urban areas experience lower landslide-trigger precipitation and soil moisture thresholds. • Dynamic urbanization increases the probability of landslides. • Roads and impervious proportions are the primary drivers of landslides in urban areas. Landslides pose a formidable natural hazard. Accurate risk assessment of landslides triggered by precipitation heavily relies on hydrometeorological factors, specifically precipitation and soil moisture. However, the insufficient ground-based observations and the coarse spatio-temporal resolution hinder the performance of landslide prediction. It is not clear what hydrometeorological thresholds and triggering mechanisms are more likely to trigger landslides in China, particularly in the context of rapid urbanization. To address these questions, this study investigated 1504 shallow landslide events in Chinese urban and non-urban areas from 2007 to 2019. It utilized daily 1 km soil moisture at various depths (20–100 cm) and multi-source precipitation datasets, including gauge-based gridded dataset, in conjunction with three multi-source fusion precipitation products (Multi-Source Weighted-Ensemble Precipitation − MSWEP, the Climate Hazards Group InfraRed Precipitation with Station dataset − CHIRPS, and the Integrated Multi-satellitE Retrievals for Global Precipitation Measurement − GPM-IMERG), along with dynamic urban impervious area datasets. It aims to determine the optimal multi-source precipitation predictor, the critical soil moisture depth that triggers landslides, and to establish the hydrometeorological thresholds for landslides. Additionally, the impact of urbanization on landslide occurrences was estimated by comparing antecedent precipitation accumulation, soil moisture, and impervious surface ratio dynamics between urban and non-urban areas. The results indicated that a combination of 2-day cumulative CHIRPS precipitation and 100 cm soil moisture provided the most accurate predictions for landslides in urban regions of China (accuracy = 88.5 %), outperforming interpolated ground-based observations and other fusion products. Specifically, landslides become more prone when antecedent cumulative rainfall surpasses 97.42 mm in 2 days and soil moisture exceeds 39.6 % m3/m3 saturation in China. Urban areas experienced high antecedent precipitation levels, lower precipitation (64.40 mm) threshold and soil moisture threshold (38.9 %), and shorter durations at landslide sites compared to non-urban areas (71.90 mm, 41.4 %, and 7 days, respectively). The process of urbanization is observed to decrease soil moisture levels while concurrently elevating rainfall amounts. This phenomenon, combined with anthropogenic activities, including distance from roads and urban impervious surface expansion, contributes to 44.6 % of the causes of landslides by reducing slope stability and increasing the presence of loose material. These findings have implications for landslide warnings in urban areas with limited measurements and contribute to understanding urbanization's impact on landslide risks in developing nations. [ABSTRACT FROM AUTHOR]

• Future DHW intensity rises over 4 times, population exposed increases by over 1.5 times. • The Yangtze and Yellow River basins undergo a significant DHW increase. • Future DHW-exposed population increase 1.61–2.41 times over the historical baseline. • The temperature increase is the main driver of DHW event escalation. Global warming has accelerated the interregional hydrological cycle, resulting in a significant increase in the frequency and intensity of extreme events worldwide. These events often involve a combination of spatial and temporal factors, giving rise to compound events. Among them are rapid transitions from dry and hot conditions to wet (DHW) events, which can have more severe impacts on human societies and ecosystems than individual extreme events. Urbanization not only heightens the likelihood of disasters but also exacerbates the exposure of affected populations. However, there has been insufficient attention given to understanding the connections between these successive compound events and the heightened risks posed by the increasing urbanization. In this study, we used bias-corrected daily precipitation and maximum temperature data simulated by the Coupled Model Intercomparison Project Phase 6 (CMIP6) model, along with historical and future daily runoff data simulated by the Variable Infiltration Capacity (VIC) model. We systematically investigated the spatiotemporal changes (i.e., frequency, duration, intensity, and compound probability) in DHW events in China during the upper historical period (1979–2014) and under two medium and high emission scenarios (2015–2100) − Shared Socioeconomic Pathways (SSP245 and SSP585). Furthermore, we examined how extreme runoff responds to variations in maximum temperature and daily precipitation during DHW events. We also evaluated the potential population and urban exposure to DHW events using dynamic future population and urban expansion data to assess the potential risks. Our results indicate that the multi-model ensemble predicts varying spatial patterns of future DHW events under SSP245 and SSP585 scenarios. The frequency and duration of these events are expected to decrease by approximately 20–25% in the Northwest region under both scenarios. At the same time, the middle and lower plains of the Yangtze and Yellow River Basins experience increased occurrence, broader geographical impact, and higher DHW event intensity alongside urban expansion and population growth in these regions. Specifically, event intensity is anticipated to increase by a factor of approximately 7–11. Temporally, we expect short-duration, high-intensity DHW events to occur in the Yangtze and Yellow River basins around 2023, 2038, and 2058, respectively. The primary driver for the future rise in population exposure to DHW events is the expected increase in event frequency in the middle and lower plains of the Yangtze and Yellow River basins, concurrent with population growth in these regions. Under the medium emission scenario, the total exposed population to DHW events in China is predicted to be 1.61 times higher than the historical baseline. In contrast, the high-emission scenario estimates a total population of 2.41 times higher than the historical baseline period. Most of the DHW events occurred in regions that exhibit a positive dependence between high temperature and high runoff events, serving as the primary driver of DHW events. Urbanization has a positive impact on DHW events, with the effect under high emissions being approximately 30% higher than during the historical base period. Additionally, it is indicated that future DHW events will exhibit higher sensitivity to global warming, with intensity projected to increase approximately fourfold and the exposed population to rise by about 1.5 times for every 1 °C of global warming. This research enhances our understanding of forecasting future compound hydrometeorological extreme events under different scenarios and provides insight into the role of climate change and urbanization in shaping these events in China. [ABSTRACT FROM AUTHOR]

Objectives: Tuberculous pleurisy is one of the most common types of extra-pulmonary tuberculosis, but the sensitivity of conventional mycobacterial culture (Culture) or Xpert MTB/RIF assay (Xpert) is not satisfying. This multicentre cohort study evaluated the accuracy of a new cell-free DNA droplet digital PCR assay (cf-ddPCR) for diagnosing tuberculous pleurisy., Methods: Patients with suspected tuberculosis (≥5 years of age) with pleural effusion were consecutively recruited from nine research sites across six provinces in China between September 2020 to May 2022. Culture, Xpert, Xpert MTB/RIF Ultra assay (Ultra), real-time PCR, and cf-ddPCR were performed simultaneously for all specimens., Results: A total of 321 participants were enrolled, and data from 281 (87.5%) participants were available, including 105 definite tuberculous pleurisy, 113 possible tuberculous pleurisy and 63 non-tuberculous pleurisy according to the composite reference standard. The sensitivity of cf-ddPCR was 90.5% (95/105, 95% CI, 82.8-95.1%) in the definite tuberculous pleurisy group, which was significantly higher than those of Culture (57.1%, 60/105, 95% CI, 47.1-66.6%, p < 0.001), Xpert (46.7%, 49/105, 95% CI, 37.0-56.6%, p < 0.001), Ultra (69.5%, 73/105, 95% CI, 59.7-77.9%, p < 0.001) and real-time PCR (75.2%, 79/105, 95% CI, 65.7-82.9%, p < 0.001). In possible tuberculous pleurisy, whose results of Culture and Xpert were both negative, the sensitivity of cf-ddPCR was 61.1% (69/113, 95% CI, 51.4-70.0%), which was still significantly higher than that of Ultra (27.4%, 31/113, 95% CI, 19.7-36.8%, p < 0.001) and real-time PCR (38.9%, 44/113, 95% CI, 30.0-48.6%, p < 0.001)., Discussion: The performance of cf-ddPCR is superior to Culture, Xpert, Ultra, and real-time PCR, indicating that improved diagnostic accuracy can be anticipated by incorporating this new assay., (Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Gully erosion is a serious global environmental problem associated with land degradation and ecosystem security. Examining the influencing factors of gullies and determining susceptibility hold significance in environmental sustainability. The study evaluates the spatial distribution, influencing factors, and susceptibility of gullies in the Sunshui River Basin in Sichuan Province, Southwest China. The frequency ratio method supported by satellite images and the gully inventory dataset (1614 gully head points) with different influencing factors were applied to assess the distribution and susceptibility of gullies. Additionally, gully head points were grouped into a training set (70%, 1130 points) and a test set (30%, 484 points). Spatial distribution results indicated that most gullies are located in the middle and upper part of the basin, characterized by moderate elevation (2100-3300 m), steep slopes (11.63-27.34°), abandoned farmland, and Cambisols soil, and fewer gullies are located in lower part characterized by lower elevation, gentle slopes, and low vegetation coverage. Land use and land cover influence on susceptibility is significantly greater than other factors with a prediction rate of 33.9, especially farmland abandonment, while the occurrence of gullies is also more often on southwest-orientated slopes. Gully susceptibility highlighted that the study area affected by the very low, low, moderate, high, and very high susceptibilities to these gullies covered an area of about 16%, 23%, 32%, 26%, and 3% of the total basin respectively, which indicates 61% of the study area is susceptible to gully erosion. Moderate to high susceptibility is situated in the upper and middle part, consistent with the spatial distribution of gullies in the basin, and very high susceptibility (3%) is distributed in both the lower and upper parts of the basin. These results have important implications for soil loss control, land planning, and integrated watershed management in the mountainous areas of Southwest China., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Accumulating evidence has demonstrated that high-risk human papillomaviruses (HR-HPVs) are involved in the etiology of a subset of oropharyngeal squamous cell carcinoma (OPSCC). In this regard, the International Agency for Research on Cancer (IARC) has recommended direct molecular HPV testing. So far, there is no agreement on the most appropriate method for HPV detection on OPSCC formalin-fixed paraffin-embedded (FFPE) materials. In this study, we aimed to evaluate the performance of the high-sensitive SureX HPV assay in OPSCC FFPE tissues compared with LiPA-25 and p16 ink4a immunostaining. A retrospective series of FFPE primary OPSCC cases were diagnosed between 2008 and 2019 and provided by the Henan Cancer Hospital, China. The level of agreement of two assays was determined using Cohen's Kappa (κ) statistics. A total of 230 FFPE OPSCC samples from tumor resections (n = 160) and diagnostic biopsies (n = 70) were detected. Sixty-six (28.7%) and 70 (30.4%) samples were identified as HPV-DNA-positive by LiPA-25 and SureX, respectively, of which HPV16 was largely the most common type (95.5% vs 94.3%). We found a perfect concordance between LiPA-25 and SureX for HPV-DNA status (κ = 0.906, 95% CI: 0.875-0.937) and for HPV16 (κ = 0.925, 95% CI: 0.897-0.953). In addition, SureX and p16 ink4a immunostaining had a perfect concordance (κ = 0.917, 95% CI: 0.888-0.946). Moreover, the HPV-driven fraction, based on double positivity for HPV-DNA and p16 ink4a , was similar between SureX (63 of 230, 27.4%) and LiPA-25 (60 of 230, 26.1%). Similar results were found in samples from resections and biopsies. SureX and LiPA-25 are comparable. SureX could be used for routine HPV-DNA detection and genotyping on archival OPSCC FFPE tissues., (© 2024 Wiley Periodicals LLC.)

Objective: The aim of this study is to identify whether low lupus disease activity status (LLDAS) and clinical remission (CR) of belimumab plus standard of care (SoC) therapy are achievable goals in childhood-onset SLE (cSLE)., Methods: This multicentre, one arm pre-post intervention study was conducted at 15 centres in China. The primary end point was to describe the proportion of patients who achieved LLDAS and CR after 3, 6 and 12 months after treatment with belimumab plus SoC therapy. A multiple regression model was used to impute missing data. A Poisson regression model was used to calculate the effect of belimumab treatment on the reduced risk of serious diseases and the incidence of new damage., Result: A total of 193 (92.2% female) with active cSLE from 15 centres were included. At 3, 6 and 12 months, the proportion of LLDAS (CR) was 12.4% (1.0%), 25.6% (4.5%) and 70.3% (29.7%), respectively. The mean SELENA-SLEDAI score decreased from 11.0 at baseline to 3.7, 2.9 and 1.7 at 3, 6 and 12 months. At baseline, all patients received steroids at a mean (s.d.) prednisone equivalent dose of 31.0 (18.2) mg/day, which decreased to 19.4 (10.8) mg/day at month 3, 12.6 (7.2) mg/day at month 6 and 6.7 (5.3) mg/day at month 12. The symptoms and immunological indicators were also significantly improved., Conclusion: This is the first and largest sample size prospective clinical intervention study of cSLE patients treated with belimumab in China. LLDAS and CR were attainable treat-to-target of belimumab plus SoC therapy in cSLE., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Currently, most work on comparing differences between simplified and traditional Chinese only focuses on the character or lexical level, without taking the global differences into consideration. In order to solve this problem, this paper proposes to use complex network analysis of word co-occurrence networks, which have been successfully applied to the language analysis research and can tackle global characters and explore the differences between simplified and traditional Chinese. Specially, we first constructed a word co-occurrence network for simplified and traditional Chinese using selected news corpora. Then, the complex network analysis methods were performed, including network statistics analysis, kernel lexicon comparison, and motif analysis, to gain a global understanding of these networks. After that, the networks were compared based on the properties obtained. Through comparison, we can obtain three interesting results: first, the co-occurrence networks of simplified Chinese and traditional Chinese are both small-world and scale-free networks. However, given the same corpus size, the co-occurrence networks of traditional Chinese tend to have more nodes, which may be due to a large number of one-to-many character/word mappings from simplified Chinese to traditional Chinese; second, since traditional Chinese retains more ancient Chinese words and uses fewer weak verbs, the traditional Chinese kernel lexicons have more entries than the simplified Chinese kernel lexicons; third, motif analysis shows that there is no difference between the simplified Chinese network and the corresponding traditional Chinese network, which means that simplified and traditional Chinese are semantically consistent., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2020 Zhongqiang Jiang et al.)

Context: Human papillomavirus (HPV) testing is widely used in cervical cancer screening in women; however, its efficiency in triaging women with atypical squamous cells of undetermined significance (ASC-US) needs to be validated., Objective: To evaluate the performance of HPV16/18 in the triage of women with ASC-US., Methods: Women presenting for routine cervical cancer screening had cervical specimens collected, with which both liquid-based cytology (LBC) and hrHPVs were examined; those with ASC-US cytology underwent colposcopy. HPV16/18 and 12 other types were tested with domestic hybridization capture and chemiluminescence signal amplification (DH3). Performance characteristics of HPV test (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for identification of cervical intraepithelium neoplasma (CIN) grade 2 or worse (CIN2+), and CIN grade 3 or worse (CIN3+)) were determined using standard statistical tests., Results: 317 women with ASC-US were eligible for the study. HrHPV prevalence was 15.77% (50/317); HPV16/18 prevalence was 3.61% (20/317). Sensitivity and specificity of HPV16/18 for detection of CIN 2+ were 64.71% and 97% and 64.29% and 96.37% for detection of CIN 3+, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) of HPV16/18 were 55.00% and 97.98% for CIN2+ and 45.00% and 98.32% for CIN3+, respectively., Conclusion: HPV16/18 can be considered as an effective method to triage women with ASC-US as its good clinical performance., Trial Registration: This trial is registered with Henan Cancer Hospital Medical Ethics Committee on July 5, 2016 (http://www.anti-cancer.com.cn), with registry no.: 2016037., Competing Interests: No authors on this manuscript have any conflicts of interest related to this work., (Copyright © 2019 Xiaoqin Cao et al.)

Background: The quality of the family environment-in particular, the kind of parenting children receive in their early years-plays a critical role in influencing children's growth and development. To facilitate the development and delivery of appropriate parenting and family interventions for Chinese parents, this study explores the prevalence of the difficulties that may arise in the course of child-rearing, the associated sociodemographic factors and parents' help-seeking behavior., Methods: A cross-sectional self-reporting survey was conducted with a sample of 2229 parents of children between 6 and 35 months of age. Using a stratified random-digit design, parents from 15 Chinese cities were surveyed to determine their child-rearing difficulties, support-seeking behavior and their preferences for service delivery. The sociodemographic factors that influenced major child-rearing difficulties were analyzed using bivariate and logistic analyses., Results: The majority (87.5%) of Chinese parents of children aged 6-35 months reported experiencing child-rearing difficulties. Nearly one third (31.5%) of parents reported experiencing major difficulties. Feeding and sleep problems were most often reported. Regression analysis revealed that major child-rearing difficulties most often involved male children (OR = 1.35, 95% CI 1.11-1.64), single-child households (OR = 1.38, 95% CI 1.07-1.77), and households with financial problems (OR = 1.40, 95% CI 1.06-1.85). Just over one third of parents (33.44%) sought professional support, while 21.37% had attended a parenting course in the past year. Prefer ways of sourcing parental support included professional online platform (69.24%), self-help books (43.70%), face-to-face consultation (24.99%), and attending lectures (36.57%)., Conclusions: Child-rearing difficulties are common among parents of children between 6 and 35 months of age in Chinese cities. The family with boys, single-child, financial problems, and father not joining in child-rearing may face the high risk to major child-rearing difficulties. The national initiative to provide more guidance and support for child-rearing difficulties is worthwhile, as is the development of online parenting programs.

This study was conducted to perform an epidemiological survey of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates for nosocomial pneumonia (NP) and visit their Gram-negative bacteria neighbors (GNNs) from the respiratory tracts. Pulsed-field gel electrophoresis and multi locus sequence typing were performed to evaluate the clonal relationships of these isolates. Statistical methods were then used to understand their possible relationship between CRKP and their GNNs. Among the 63 CRKP isolates, 84.1% produced a KPC-2 carbapenemase gene, followed by blaNDM-1 and blaIMP-38 like. 13 different STs and 29 clones were identified. Less heterogeneous clone backgrounds were observed in 53 KPC-2 K. pneumoniae isolates, and 6 STs have been found to contain KPC-2, of which the predominant ST11 harbored 47 KPC-2-producing K. pneumoniae isolates. Particularly, the two infrequent isolates co-possessing blaKPC-2 and blaIMP-38 like shared a different clonal relationship. 87 GNNs isolates of CRKP were established, the analysis present that different strains showed significant or no difference with CRKP upon antibiotics susceptibility. Conclusion, ST11 harboring KPC-2-producing K. pneumoniae isolates were dominant for NP, and both clonal spread and horizontal transfer contributed to the dissemination of CRKP. However, additional studies are needed to explore the biological relationship with their GNNs.

Previous research has found butyltin pollution at dumping sites, which are the final fate of dredged material mostly originating from harbors and navigation systems. The distribution and impacts of butyltins were assessed in sediments at 12 dumping sites of China. Total butyltins (monobutyltin, dibutyltin, and tributyltin) concentrations ranged from 1.76 to 486.62 ng Sn g -1 dw. This study also presents evidence of considerable historic inputs of tributyltin (TBT) to Dumping sites 01, 05, 06, 08, 09 and 11, with evidence of heavier recent TBT input at Dumping site 04 and 10. The butyltin contamination at dumping sites was comparatively light and historic compared to research in other countries, but was more serious than other sea regions. TBT levels at Dumping site 09 probably have negative effects on biological systems. Overall, more attention should be paid to the level and impacts of butyltins in the sediment at dumping sites in China., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Semi-permeable membrane devices (SPMDs) were applied to sample some Organochlorinated Pesticides (OCPs), Polycyclic Aromatic Hydrocarbons (PAHs) and Polychlorinated Biphenyls (PCBs) from the seawater of 14 Chinese coastal areas. The total concentrations of OCPs (∑ 16 OCPs), PAHs (∑ 15 PAHs) and PCBs (∑ 35 PCBs) were in the ranges of 489.2-2174, 589.4-53,160, and 133.2-3658 ng/g lipid, respectively. The ∑ 15 PAHs varied significantly with the sampling locations, which were far higher in north Chinese coastal areas than in south areas, whereas ∑ 16 OCPs and ∑ 35 PCBs only slightly fluctuated along the entire coast line. Comparing SPMD to grab sampler, it was found that the distribution patterns of the PCBs and OCPs in seawater were generally similar. However, the compositional profiles of the PAHs, PCBs, DDTs and HCHs in SPMDs were slightly different to grab samplers and organisms. The SPMDs accumulated less lipotropic compounds, which are inclined to dissolve in water rather than in organisms., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to investigate the clinical characteristics of somatic symptoms of patients in China who suffer from major depressive disorder (MDD)., Method: 3273 patients who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) MDD were recruited from 16 general hospitals and 16 mental health centers in China. Physicians and patients completed complementary customized depression disorder symptomatology questionnaires assessing the clinical characteristics of patients with MDD., Result: 1. In this study we analyzed physician-recorded data. The major somatic symptoms in patients with MDD in China were insomnia (64.6%), pre-verbal physical complaints (46.9%), weight loss (38.5%), low appetite (37.6%), circulatory system complaints (31.3%), headache (31.3%), hyposexuality (31.0%), gastrointestinal symptom complaints (29.6%), and respiratory system complaints (29.6%). 2. Compared with MDD patients who sought medical help from mental health centers, MDD patients who sought medical help from general hospitals were more likely to suffer from urinary system complaints, headache, sensory system complaints, trunk pain, and nervous system complaints. A lower prevalence rate of insomnia and hyposexuality was also observed among MDD patients who visited general hospitals (p < .05). 3. Patients aged from 40 to 54 had the highest probability of pre-verbal physical complaints, respiratory system complaints, trunk pain, hyposexuality, limb pain and other pain conditions, while patients over 55 years of age had the lowest prevalence respiratory system complaints, hyposexuality, and other pain conditions, and they also had the highest rate of low appetite and insomnia. 4. Female patients appeared to exhibit higher rates of pre-verbal physical complaints, low appetite, and insomnia than male patients, but had fewer urinary systems complaints than male patients (p < .05)., Conclusion: The major somatic symptoms in patients with MDD in China are insomnia, pre-verbal physical complaints, weight loss, low appetite, circulatory system complaints, headache, hyposexuality, gastrointestinal system complaints, and respiratory system complaints. These symptoms vary by the type of medical setting to which patients present, and well as by age, and gender., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Backgrounds and Objective: Mounting evidence suggests that human leukocyte antigen (HLA) plays a central role in anti-virus and tumor defense. To test whether genetic variation in HLA-DRB1 gene, a key component of HLA system, can predict its predisposition to hepatocellular carcinoma (HCC), we thereby conducted an association study by genotyping 8 nonsynonymous polymorphisms in HLA-DRB1 gene among 257 HCC patients and 264 controls., Results: All polymorphisms respected the Hardy-Weinberg equilibrium. The genotypes and alleles of rs17879599 differed significantly between patients and controls after Bonferroni correction (both P < 0.001), and the power to detect this significance was 94.4%. After adjusting for age, gender, smoking, drinking and hepatitis infection, the mutant allele of rs17879702 was significantly associated with an increased risk for HCC under additive (odds ratio [OR] = 2.12, 95% confidence interval [CI]: 1.20-4.02, P = 0.004) and dominant (OR = 2.51, 95% CI: 1.39-2.96, P = 0.004) models. Haplotype analysis indicated that haplotype A-T-C-T-G-C-T-A (alleles ordered by rs199514452, rs201540428, rs201614260, rs17879702, rs17880292, rs17879599, rs17424145 and rs35445101) was overrepresented in patients and enhanced predisposition to HCC (adjusted OR = 2.72, 95% CI: 1.24-5.78, P = 0.004). In cumulative analysis, carriers of 7-9 unfavorable alleles had a 2.41-fold (95% CI: 1.18-4.92, P = 0.016) increased risk for HCC after adjusting for confounding factors relative to those possessing 4 or less unfavorable alleles., Materials and Methods: Genotypes were determined by ligase detection reaction. HCC patients were newly diagnosed, histopathologically confirmed or previously untreated and controls were cancer-free., Conclusions: Our findings suggest an independent leading contribution of rs17879599 in the 2nd exon of HLA-DRB1 gene to HCC risk in Han Chinese.