Regions Of China Research Articles

The prevalence of monotherapy and combination therapy in hypertension in China from 2019 to 2021: A nationwide population-based cross-sectional study.

There are no nationwide surveys on antihypertensive drugs in China. In order to assess the current status of antihypertensive drug therapy in patients with hypertension and analyzed factors that may affect combination therapy, using convenience sampling, we recruited 305,624 patients with hypertension from the Chinese Cardiovascular Association Database-Hypertension Center between January 2019 and December 2021. Chi-squared test was performed to analyze the administered antihypertensive drug types and their combinations in different hospital settings. Logistic regression was used to assess the factors influencing combination therapy. We found around 33.1% of the participants had stage 2 and above hypertension, of which 67.9% were treated with combination therapy. In community or general hospitals, the most common monotherapy was calcium channel blockers (CCB), angiotensin-converting enzyme inhibitor/angiotensin II receptor inhibitor (ACEI/ARB) and diuretic were the main single-pill combinations (SPCs), and ACEI/ARB and CCB were the main free combination. From 2019 to 2021, the rates of combination therapy increased (58.8%-64.1%) with SPCs from 25.9% to 31.0% and free combination from 31.9% to 32.6%. Patients aged<60 years, with stage 2 and above hypertension, with an education level of high school and above, visiting general hospitals, living in the eastern region of China, with hypertension risk factors and comorbidities, and without anxiety or depression were more likely to receive combination therapy (all P<.05). The combination therapy use rate increased yearly and the rate of SPCs rose obviously. Individual, hospital, and regional differences in patients with hypertension influenced combination therapy.

Short-Term Power Load Forecasting Method Based on GRU-Transformer Combined Neural Network Model

Load Forecast (LF) is an important task in the planning, control and application of public power systems. Accurate Short Term Load Forecast (STLF) is the premise of safe and economical operation of a power system. In the research of short-term power load forecasting, machine learning and deep learning are the most popular methods at present, but there still exists a problem that the single and simple structure of power load forecasting model leads to low accuracy of load forecasting. In order to improve the accuracy of STLF, a Gated Cycle Unit (GRU)-Transformer combined neural network model is proposed. Transformer encoder structure is used as feature extractor to mine the complex mapping relationships between the input features and load. The advantage of self-attention mechanism is used to solve the problem of information loss of long sequences in short-term power load forecasting. At the same time, the multivariate time series model of GRU is used for model training. The experimental results on the power load data set of a certain region in southwest China and Panama City show that the proposed combined model prediction method has higher accuracy than those proposed in other literatures, which further proves its feasibility and superiority.

Deficit Irrigation as an Effective Way to Increase Potato Water Use Efficiency in Northern China: A Meta-Analysis

Water scarcity poses a significant threat to the sustainable production of crops in Northern China. Despite this, the effect of water management practices, such as deficit irrigation, on the yield and WUE of potatoes has been rarely explored. Based on the meta-analysis of field experiment data, this study evaluated the influence of deficit irrigation on potato yield, evapotranspiration (ET), water use efficiency (WUE) and irrigation water use efficiency (IWUE) under variable soil types, water-saving ratio, irrigation methods, soil organic carbon (SOC) content, and fertilizer rate in Northern China. Here, we determined that potato WUE and IWUE were significantly increased by 10.0 and 31.6%, respectively, under deficit irrigation, while ET was significantly decreased by 26.3% compared to full irrigation. Conclusively, deficit irrigation significantly reduced potato yields by 16.4% compared to full irrigation. Furthermore, SOC content played a vital role in improving the WUE and alleviating potato yield losses under deficit irrigation. Our study suggested that maximum WUE with lower potato yield losses under deficit irrigation can be achieved in the Central Plains region of China or in yellow loam soil, brown soil, and meadow soil under alternate root-zone irrigation when the water-saving ratio was less than 45% and fertilizer application rates were 300 kg N ha−1, &gt;240 kg P2O5 ha−1, and 181–300 kg K2O ha−1. Overall, these findings highlight the need for a comprehensive understanding of various agricultural management practices and local environmental conditions to optimize the benefits of deficit irrigation in potato-growing regions across Northern China.

Research Trends and ‘Space-Sky-Ground-Underground’ Monitoring Technology Analysis of Landslide Hazard

Landslide is a typical geological disaster distributed in most countries worldwide. Due to long-term natural weathering and human engineering disturbances, the instability of landslides is prone to occur. Once monitoring and disposal methods are implemented inappropriately, they can lead to landslide hazards, seriously threatening the safety of people’s lives and property. For a long time, extensive research on landslide monitoring has been conducted from various countries, providing crucial technical support for reducing the incidence and severity of landslide hazards. However, considering the complex geological conditions of actual landslides and the direct impact of internal and external factors such as rainfall, storms, and earthquakes, the early warning accuracy of landslide hazards is still relatively low. Therefore, based on advanced research achievements, it is significant to carry out research on the current status and development trends of landslide monitoring technology. Based on the Web of Science core database, this study quantitatively analyzes the advanced research achievements in global landslide monitoring in the past decade using bibliometric analysis. A systematic analysis of landslide monitoring technology development is conducted according to each study’s publication time, keywords, and countries. On this basis, a multi-dimensional monitoring system for landslides was proposed, which utilizes the complementary advantages of multi-dimensional monitoring technology to achieve all-round, high-precision, and real-time monitoring of landslides. Finally, taking the Xinpu landslide in the Three Gorges Region of China as an example, a multi-source and multi-field-monitoring experiment was conducted. The application of landslide multi-field-monitoring technology provides an essential reference for monitoring, early warning, as well as the scientific prevention and control of landslide hazard.

Substantial increase in perfluorocarbons CF4 (PFC-14) and C2F6 (PFC-116) emissions in China

The perfluorocarbons tetrafluoromethane (CF4, PFC-14) and hexafluoroethane (C2F6, PFC-116) are potent greenhouse gases with near-permanent atmospheric lifetimes relative to human timescales and global warming potentials thousands of times that of CO2. Using long-term atmospheric observations from a Chinese network and an inverse modeling approach (top-down method), we determined that CF4 emissions in China increased from 4.7 (4.2-5.0, 68% uncertainty interval) Gg y-1 in 2012 to 8.3 (7.7-8.9) Gg y-1 in 2021, and C2F6 emissions in China increased from 0.74 (0.66-0.80) Gg y-1 in 2011 to 1.32 (1.24-1.40) Gg y-1 in 2021, both increasing by approximately 78%. Combined emissions of CF4 and C2F6 in China reached 78 Mt CO2-eq in 2021. The absolute increase in emissions of each substance in China between 2011-2012 and 2017-2020 was similar to (for CF4), or greater than (for C2F6), the respective absolute increase in global emissions over the same period. Substantial CF4 and C2F6 emissions were identified in the less-populated western regions of China, probably due to emissions from the expanding aluminum industry in these resource-intensive regions. It is likely that the aluminum industry dominates CF4 emissions in China, while the aluminum and semiconductor industries both contribute to C2F6 emissions. Based on atmospheric observations, this study validates the emission magnitudes reported in national bottom-up inventories and provides insights into detailed spatial distributions and emission sources beyond what is reported in national bottom-up inventories.

Enhancing Environmental Sustainability: Risk Assessment and Management Strategies for Urban Light Pollution

Light pollution imposes significant and far-reaching adverse effects on human society, necessitating its stringent regulation. However, intervention policies could be customized to suit the unique characteristics of each region, taking into account local conditions. To address this challenge, we have developed a comprehensive light pollution risk assessment model using a combination of objective and subjective weighting methods, including analytic hierarchy process (AHP), independent weighting method (IWM), entropy weight method (EWM), coefficient of variation (CV), criteria importance through intercriteria correlation (CRITIC), and principal component analysis (PCA). This model facilitates a systematic evaluation of light pollution risk levels across diverse regions in China. Subsequently, we have proposed intervention policies targeting light pollution risk reduction and assessed their efficacy using the synthetic control method. Our findings reveal elevated light pollution risk levels in coastal and mountainous regions with heightened concentrations closer to urban centers. Strategies focused on enhancing lighting hardware, optimizing lighting schedules, and upgrading light sources demonstrated the impact on reducing light pollution risk levels (LPRL). This study not only lays a solid theoretical foundation for assessing urban light pollution risks but furnishes empirical evidence to aid relevant authorities in formulating effective light pollution control strategies.

Epidemiology of carbapenem-resistant Klebsiella pneumoniae in China and the evolving trends of predominant clone ST11: a multicentre, genome-based study.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major nosocomial infectious pathogen with rapidly increasing prevalence. The genomic epidemiological characteristics of CRKP nationwide, especially the evolving trends within the predominant clones, should be evaluated clearly. We collected 3415 K. pneumoniae strains from 28 hospitals across China. Antimicrobial susceptibility testing and WGS were performed. Subsequent genomic analyses, including sequence typing, K-locus (KL) identification, antimicrobial resistance gene screening, and virulence score assessment were performed. The phylogenetic relationship of clonal group 11 was determined based on core-genome analysis, and the presence of the pLVPK-like virulence plasmid in ST11 isolates was confirmed using plasmid core-gene analysis. Additionally, the trends of the ST11 lineage with different KL types on a global scale were investigated using Beast2. Of the K. pneumoniae strains, 708 were identified as CRKP isolates (20.7%), of which 97.7% were MDR. ST11 was the predominant clone, and KPC-2 was the prevalent carbapenemase in China, although the prevalence of specific clones and carbapenemases varied by geographic region. Among ST11 isolates, KL47 and KL64 were the predominant KL types, and KL64 gradually replaced KL47, with a higher percentage of KL64 isolates harbouring the pLVPK-like plasmid. Global genome data showed a significant increase in the effective population size of KL64 over the last 5 years. The prevalence of CRKP was very high in certain regions in China. The increasing convergence of virulence and resistance, particularly in ST11-KL64 isolates, should be given more attention and further investigation.

Global Optimization and Quantitative Assessment of Large-Scale Renewables-Based Hydrogen System Considering Various Transportation Modes and Multi-Field Hydrogen Loads

In the past, hydrogen was mostly produced from fossil fuels, causing a certain degree of energy and environmental problems. With the development of low-carbon energy systems, renewable energy hydrogen production technology has developed rapidly and become one of the focuses of research in recent years. However, the existing work is still limited by small-scale hydrogen production systems, and there is a lack of comprehensive research on the whole production-storage-transportation-utilization hydrogen system (PSTUH2S), especially on the modeling of different hydrogen transportation modes and various hydrogen loads in different fields. To make up for these deficiencies, the specific physical and mathematical models of the PSTUH2S are firstly described in this paper, with a full account of large-scale water-electrolytic hydrogen production from renewable power curtailment and grid power, various hydrogen storage and transportation modes, and multi-field hydrogen consumption paths. Furthermore, to achieve the maximum economic, energy, and environmental benefits from the PSTUH2S, a multi-objective nonlinear optimization model is also presented herein and then solved by the hybrid method combining the nonlinear processing method, the CPLEX solver and the piecewise time series production simulation method. Lastly, case studies are conducted against the background of a region in northwest China, where hydrogen consumption capacity in various years is accurately assessed and the potential advantages of the PSTUH2S are demonstrated. As the simulation results show, the power curtailment of renewable energy generation can be reduced by 3.61/11.87/14.72 billion kW·h in 2025/2030/2035, respectively, thus contributing to a 4.98%~10.09% increase in the renewable energy consumption rate and millions of tons of carbon emission reduction in these years. In terms of the total equivalent economic benefits, the proposed method is able to bring about a cost saving of USD 190.44 million, USD 634.66 million, and USD 865.87 million for 2025, 2030, and 2035, respectively.

Prevalence and Characteristics of Salmonella from Tibetan Pigs in Tibet, China.

This study aimed to understand the epidemiological characteristics of Salmonella in Tibetan pigs. We isolated, identified, and examined via antimicrobial susceptibility testing on Salmonella from Tibetan pigs breeder farms and slaughterhouses in Tibet, China. A genetic evolutionary tree was constructed on the basis of whole genome sequencing (WGS). A total of 81 Salmonella isolates were isolated from 987 samples. The main serovars were Salmonella Typhimurium and Salmonella London in Tibetan pigs. The isolated Salmonella Typhimurium isolates subjected to antimicrobial susceptibility testing showed varying degrees of resistance to β-lactams, aminoglycosides, fluoroquinolones, sulfonamides, tetracyclines, and amphenicols. WGS analysis was performed on 20 Salmonella Typhimurium isolates in Tibet (n = 10), Jiangsu (n = 10), and 205 genome sequences downloaded from the Enterobase database to reveal their epidemiological and genetic characteristics. They were divided into two clusters based on core genome single-nucleotide polymorphisms: Cluster A with 112 isolates from Tibet and other regions in China and Cluster B with 113 isolates from Jiangsu and other regions. The isolates in Cluster A were further divided into two subclusters: A-1 with 40 isolates including Tibet and A-2 with 72 isolates from other regions. Virulence factors analysis revealed that all isolates from Tibet carried adeG, but this observation was not as common in Salmonella isolates from Jiangsu and other regions of China. Antibiotic resistance genes (ARGs) analysis showed that all isolates from Tibet carried blaTEM-55 and rmtB, which were absent in Salmonella isolates from Jiangsu and other regions of China. Genetic characteristic analysis and biofilm determination indicated that the biofilm formation capabilities of the isolates from Tibet were stronger than those of the isolates from Jiangsu and other regions of China. Our research revealed the epidemic patterns and genomic characteristics of Salmonella in Tibetan pigs and provided theoretical guidance for the prevention and control of local salmonellosis.

Microbial Organic Fertilizer Combined with Magnetically Treated Water Drip Irrigation Promoted the Stability of Desert Soil Aggregates and Improved the Yield and Quality of Jujubes

In the southern Xinjiang region of China, developing efficient irrigation and fertilization strategies to enhance resource utilization and prevent desertification is of critical importance. This study focuses on jujubes in Xinjiang, China, and involves a three-year field experiment aimed at exploring the optimal application strategy of magnetically treated water combined with microbial organic fertilizer to provide scientific support for high-quality jujube production. The experiment included a control group (using only fresh water, denoted as CK) and combinations of magnetically treated water drip irrigation with varying amounts of microbial organic fertilizer: in 2021, treatments included M0 (only irrigating with magnetically treated water), M6 (0.6 t/ha), M12 (1.2 t/ha), M18 (1.8 t/ha), and M24 (2.4 t/ha); in 2022 and 2023, treatments included M0, M6 (0.6 t/ha), M12 (1.2 t/ha), M24 (2.4 t/ha), and M48 (4.8 t/ha). This study investigated the effects of magnetically treated water drip irrigation combined with microbial organic fertilizer on soil physical properties, hydraulic parameters, enzyme activity, aggregate stability, and jujube yield and quality. The application of microbial organic fertilizer significantly reduced the soil bulk density by 3.07% to 11.04% and increased soil porosity by 1.97% to 14.75%. Soil saturated hydraulic conductivity gradually decreased with the increasing amount of microbial organic fertilizer, with a reduction range of 5.95% to 13.69%, while the water-holding capacity significantly improved (from 0.217 cm3/cm3 to 0.264 cm3/cm3). Additionally, microbial organic fertilizer significantly enhanced the activities of urease, catalase, and sucrase in the soil and significantly increased the proportion of large soil aggregates. Jujube yield increased by 3.66% to 21.38%, and the quality significantly improved, as evidenced by the increase in soluble sugar and flavonoid content. The Gauss model calculation results recommended 3.09 t·hm2 as the optimal amount of microbial organic fertilizer for comprehensively improving jujube yield and quality. These findings indicate that magnetically treated water drip irrigation combined with high amounts of microbial organic fertilizer significantly improved soil physical properties, hydraulic parameters, enzyme activity, aggregate stability, and jujube yield and quality, providing scientific evidence for desert soil improvement and agricultural production.

Measurement of regional green finance development and its coordination with economic development: a study on the Yangtze River Delta region of China

The green transformation of industry and sustainable economic development both require considerable investment. In this regard, green finance that is compatible with economic development can help cope with the massive demand for capital. Taken China’s Yangtze River Delta (YRD) as an example, this study is to measure the coordination degree between green finance and economic development. First, the concept, content and scope of green finance is defined based on the new financial regulation mechanism. Second, a green finance measurement index is built to calculate the green finance index for 30 Chinese provinces by the CFA test. Third, based on the economic structure index, an economic development index is built. Testing the rationality of green financial index and the economic development index, this paper finally measures the degree of coordination between green finance and economic development in the YRD. The results reveal that, first, green finance is a financial instrument that integrates financial industry development, environmental improvement, and economic growth. The measurement of the green financial development index includes the sum of regional green credit, green investment, green securities, and green insurance. Second, after years' development, the comprehensive score of YRD’s coupling coordination degree exceeds 0.8 in 2020, which shows a high level of coordinated development between green finance and economic construction. However, there is a 2-year timing effect between the economic development and green finance index increase, which reveals that green finance development in the YRD requires further policy guidance and support. This study’s findings can provide a theoretical reference and case support for the further development of green finance and related policies in China.

Linguistic landscape in the Inner Mongolia autonomous region: the case of a multilingual and multi-ethnic region in China

ABSTRACT This article focuses on the linguistic landscape of the Inner Mongolia Autonomous Region, investigates factors contributing to this distinctive landscape, and examines its role in maintaining two ethnic languages, Mongolian and Korean. 1046 language signs in three major cities were analysed and 28 interviews were conducted to evaluate interviewee attitudes towards the linguistic landscape. The results indicate that the Inner Mongolian linguistic landscape is one of abundant linguistic diversity, with the majority of signs (61.9%) displaying more than one language; that this landscape is influenced by factors such as language planning, language preferences, economic development needs, and tourist demands; and that Mongolian and Korean have high levels of visibility on both official and private signs. Mongolian and Korean interviewees expressed delight in seeing their ethnic languages displayed and believed that public displays of local languages could help maintain ethnic languages by providing a physical and visual representation of linguistic presence and ethnic identity.

Evolution and influential factors of inbound tourist flow network in China: a two-mode network perspective

ABSTRACT Different from existing studies focusing on tourist flow networks at the destination level, this study adopts a two-mode network analysis to identify the network structure, market groupings, and evolution of inbound tourist flows from 13 major origin countries to 31 destination provinces (municipalities, autonomous regions) in China. Furthermore, the quadratic assignment procedure (QAP) method is applied to analyse the influential factors of the formation of market groupings in the network. The results show that: (1) The connections within the destination-destination network and the origin-origin country network show a fluctuating increase trend. (2) Eastern provincial destinations occupy important positions in the network, and central and western destinations have played increasingly important roles in recent years. (3) Japan, South Korea, and the United States are the most important origin countries, and markets in Europe and Oceania have great potential. (4) Two market groupings led by Russia and Asian countries are relatively stable, while other origin countries have no specific regional preference. (5) Geographical distance exerts the most significant impact on the formation of market groupings, followed by tourism resources, economic development, and traffic accessibility.

Breaking the financial bottleneck of local universities of China: an analysis of the current situation of university intellectual property

PurposeWith the global economic slowdown in 2023, most universities in the central and western regions of China may face the problem of shortage of government financial funding, which is directly related to the development of science and technology of the universities. With the support of the local government, most of the ordinary universities have shifted attention to the transfer and transformation of intellectual property based on school-enterprise cooperation, hoping to seek more commercialization income as an extra source of income. Therefore, this paper aimed to study the current situation of university intellectual property, i.e. the reserve and distribution of transferable patents, discipline distribution of patents, and regional cooperation of university patents.Design/methodology/approachA patent database of 10 key universities in Henan Province of China from 2012 to 2021 was established. The evaluation indicator model by the Entropy method was conducted to reveal the interaction mechanism between quantity indicators, quality indicators, and value indicators. Based on the data analysis, the development direction of the discipline construction and school-enterprise cooperation for local universities was clear.FindingsThe findings indicated that the number of patent applications from ten key universities in Henan Province has been increasing rapidly over the years. The trend for authorized invention patents has remained relatively stable. Compared with the patent applications and authorizations, the growth of transferable patents was notably slow. The significance of strategic layout of dominant disciplines and related high-value patents was not appreciated enough by Chinese government and universities. There was a large difference of dominant disciplines between 10 key universities, and the patent level of each university was directly proportional to the number of dominant disciplines. The university patent level heavily relied on the researchers' contributions and the distribution mechanism of scientific research resources within the university. Guangdong Province and the Yangtze River Delta of China, being economically developed regions, exhibited the most active engagement in patent technology cooperation. Conversely, the central and western regions displayed relatively lower participation in high-value patent research and development.Research limitations/implicationsThis study can provide a unique perspective to understand and solve the financial bottleneck problem of ordinary universities in the central and western regions of China. The discipline construction and school-enterprise cooperation are just one of the existing schemes, but it still cannot solve the financial problems faced by local universities in China towards the government.Practical implicationsThe findings of this study can serve as a foundation for further investigation into policies aimed at improving the financial problems of ordinary universities in the central and western regions of China.Originality/valueAs an important attempt, the study tried to focus the financial problem of universities in the central and western regions of China based on the evaluation of the current situation of university intellectual property. This research findings are of great value in finding optimal layout between university patents, disciplines and school-enterprise cooperation.

Survey of physicians' knowledge about pediatric nonalcoholic fatty liver disease in China.

To evaluate physicians' awareness and knowledge towards pediatric nonalcoholic fatty liver disease (NAFLD) and their attitude toward change in nomenclature from NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) in China. The questionnaire survey contained five parts (characteristics of the participants, epidemiology, diagnosis, management of NAFLD, and attitudes toward the nomenclature of MAFLD/MASLD). The participants included 53 hepatologists, 88 gastroenterologists (GEs), 74 endocrinologists (ENDOs), 61 primary care physicians (PCPs), and 157 pediatricians across 31 municipalities, provinces and autonomous regions of China's mainland. Hepatologists saw the largest number of pediatric NAFLD patients annually (median 9 [range 1-20]), with the lowest number by PCPs (even notwithstanding one patient annually). The primary sources of pediatric NAFLD knowledge were acquired via guidelines. Hepatologists had the highest total knowledge score among all five types of physicians. Approximately one-third of nonspecialists (ENDOs and PCPs) considered liver biopsy necessary for pediatric NAFLD patients, and this percentage increased to half in specialists (hepatologists and GEs). For nonspecialists, the major barriers to the management of pediatric NAFLD were poor patient adherence to lifestyle modifications and lacking confidence in managing NAFLD. Above 90% physicians agreed to change the nomenclature NAFLD to MAFLD; however, they were not sure whether it could reduce the economic burden. Despite the epidemic of pediatric NAFLD in China, a significant knowledge gap remains in the identification, diagnosis, and treatment of pediatric NAFLD, particularly among frontline workers such as pediatricians and PCPs. More education programs should be carried out in the future.

Efficacy and safety of oral semaglutide vs sitagliptin in a predominantly Chinese population with type 2 diabetes uncontrolled with metformin: PIONEER 12, a double-blind, Phase IIIa, randomised trial.

The aim of this study was to assess the efficacy and safety of oral semaglutide vs sitagliptin in a predominantly Chinese population with type 2 diabetes inadequately controlled with metformin treatment. The Peptide Innovation for Early Diabetes Treatment (PIONEER) 12 trial was a randomised, double-dummy, active-controlled, parallel-group, Phase IIIa trial conducted over 26 weeks at 90 sites across the China region (including mainland China, Taiwan and Hong Kong) and five other countries. Adults aged ≥18 years (≥20 years in Taiwan) with a diagnosis of type 2 diabetes, HbA1c between 53 and 91 mmol/mol (inclusive) and treated with a stable daily dose of metformin were eligible for inclusion. Participants were randomised (1:1:1:1) using a web-based randomisation system to either once-daily oral semaglutide (3 mg, 7 mg or 14 mg) or once-daily oral sitagliptin 100 mg. Treatment allocation was masked to both participants and investigators. Randomisation was stratified according to whether participants were from the China region or elsewhere. The primary endpoint was change in HbA1c from baseline to week 26. The confirmatory secondary endpoint was change in body weight (kg) from baseline to week 26. All randomised participants were included in the full analysis set (FAS). All participants exposed to at least one dose of trial product were included in the safety analysis (SAS). Of 1839 participants screened, 1441 were randomly assigned to oral semaglutide 3 mg (n=361), 7 mg (n=360), 14 mg (n=361) or sitagliptin 100 mg (n=359) and included in the FAS. A total of 1438 participants were included in the SAS. In total, 75.2% of participants were from the China region. A total of 1372 (95.2%) participants completed the trial and 130 participants prematurely discontinued treatment (8.3%, 8.6% and 15.0% for oral semaglutide 3 mg, 7 mg and 14 mg, respectively; 4.2% for sitagliptin 100 mg). Significantly greater reductions in HbA1c from baseline to week 26 were reported for all doses of oral semaglutide vs sitagliptin 100 mg. For oral semaglutide 3 mg, 7 mg and 14 mg vs sitagliptin 100 mg, the estimated treatment differences (ETDs [95% CI]) were -2 (-4, -1) mmol/mol, -8 (-9, -6) mmol/mol and -11 (-12, -9) mmol/mol, respectively. The corresponding ETDs (95% CI) in percentage points vs sitagliptin 100 mg were -0.2 (-0.3, -0.1), -0.7 (-0.8, -0.6) and -1.0 (-1.1, -0.8), respectively. Reductions in body weight were significantly greater for all doses of oral semaglutide vs sitagliptin 100 mg (ETD [95% CI] -0.9 [-1.4, -0.4] kg, -2.3 [-2.8, -1.8] kg and -3.3 [-3.8, -2.8] kg for 3 mg, 7 mg and 14 mg, respectively). In the subpopulation of participants from the China region (75.2% of trial participants), reductions in HbA1c and body weight from baseline to week 26 were similar to those seen in the overall population. The most frequent adverse events in the semaglutide treatment arms were gastrointestinal, although these were mostly transient and mild/moderate in severity. Significantly greater reductions in both HbA1c and body weight over 26 weeks were seen with oral semaglutide 3 mg, 7 mg and 14 mg than with sitagliptin 100 mg in a predominantly Chinese population with type 2 diabetes inadequately controlled with metformin treatment. Oral semaglutide was generally well tolerated, with a safety profile consistent with that seen in the global PIONEER trials. ClinicalTrials.gov NCT04017832. This trial was funded by Novo Nordisk A/S, Søborg, Denmark.

Efficacy and safety of oral semaglutide monotherapy vs placebo in a predominantly Chinese population with type 2 diabetes (PIONEER 11): a double-blind, Phase IIIa, randomised trial.

The aim of this study was to evaluate the efficacy and safety of oral semaglutide monotherapy vs placebo in a predominantly Chinese population with type 2 diabetes insufficiently controlled with diet and exercise alone. The Peptide Innovation for Early Diabetes Treatment (PIONEER) 11 trial was a double-blind, randomised, Phase IIIa trial conducted across 52 sites in the China region (mainland China and Taiwan), Hungary, Serbia and Ukraine. Eligible participants were ≥18 years (≥20 years in Taiwan), had a diagnosis of type 2 diabetes with HbA1c 53-86 mmol/mol (7.0-10.0%) and were not receiving any glucose-lowering drugs. After a 4-week run-in period in which participants were treated with diet and exercise alone, those who fulfilled the randomisation criteria were randomised (1:1:1:1) using a web-based randomisation system to receive once-daily oral semaglutide 3 mg, 7 mg or 14 mg or placebo for 26 weeks (using a 4-week dose-escalation regimen for the higher doses). Randomisation was stratified according to whether participants were from the China region or elsewhere. The primary and confirmatory secondary endpoints were change from baseline to week 26 in HbA1c and body weight (kg), respectively. Safety was assessed in all participants exposed to at least one dose of the trial product. Between October 2019 and October 2021, a total of 774 participants were screened and 521 participants were randomised to oral semaglutide 3 mg (n=130), 7 mg (n=130), 14 mg (n=130) or placebo (n=131); most participants (92.5%, n=482) completed the trial, with 39 participants prematurely discontinuing treatment. The number of participants contributing to the trial analyses was based on the total number of participants who were randomised at the beginning of the trial. The majority of participants were male (63.7%), and the mean age of participants was 52 years. At baseline, mean HbA1c and body weight were 63 mmol/mol (8.0%) and 79.6 kg, respectively. Oral semaglutide resulted in significantly greater reductions in HbA1c than placebo at week 26 (p<0.001 for all doses). The estimated treatment differences (ETDs [95% CIs]) for oral semaglutide 3 mg, 7 mg and 14 mg vs placebo were -11 (-13, -9) mmol/mol, -16 (-18, -13) mmol/mol and -17 (-19, -15) mmol/mol, respectively. The corresponding ETDs in percentage points (95% CI) vs placebo were -1.0 (-1.2, -0.8), -1.4 (-1.6, -1.2) and -1.5 (-1.8, -1.3), respectively. Significantly greater reductions in body weight were also observed for oral semaglutide 7 mg and 14 mg than for placebo at week 26 (ETD [95% CI] -1.2 kg [-2.0 kg, -0.4 kg; p<0.01] and -2.0 kg [-2.8 kg, -1.2 kg; p<0.001], respectively), but not for oral semaglutide 3 mg (ETD [95% CI] -0.0 kg [-0.9 kg, 0.8 kg; not significant]). Similar reductions in HbA1c and body weight were observed in the Chinese subpopulation, which represented 74.9% of participants in the overall population. Adverse events (AEs) occurred in between 65.4% and 72.3% of participants receiving oral semaglutide (for all doses) and 57.3% of participants with placebo. Most AEs were mild to moderate in severity, with few serious AEs reported; the most commonly reported AEs were gastrointestinal-related and were more frequent with semaglutide (all doses) than with placebo. The proportion of AEs was slightly higher in the Chinese subpopulation. Oral semaglutide resulted in significantly greater reductions in HbA1c across all doses and in significant body weight reductions for the 7 mg and 14 mg doses when compared with placebo in predominantly Chinese participants with type 2 diabetes insufficiently controlled by diet and exercise alone. Oral semaglutide was generally well tolerated, with a safety profile consistent with that seen in the global PIONEER trials. ClinicalTrials.gov NCT04109547. Novo Nordisk A/S.

Impact of China’s Digital Economy on Integrated Urban–Rural Development

This paper measures the comprehensive level of the digital economy and integrated urban–rural development across Chinese provinces from 2013 to 2022. Using a two-way fixed effects model, it explores the nonlinear relationship, regional heterogeneity, and underlying causes of how the digital economy empowers integrated urban–rural development. The study finds that: (1) The digital economy promotes integrated urban–rural development, with a quadratic polynomial regression model and threshold regressive model revealing an inverted U-shaped relationship. The turning point has not yet been reached, and the promoting relationship shows a diminishing marginal trend. (2) In terms of sub-dimensions, the strengths of the promoting effect are ranked as follows: digital infrastructure construction, industrial digitization, and digital industrialization. (3) Regionally, the digital economy’s promoting effect on integrated urban–rural development is strongest in Central China, followed by Eastern China, and weakest in Western China. The innovation and contribution of this paper lie in discovering the nonlinear impact of the digital economy on China’s integrated urban–rural development, analyzing its intrinsic driving forces and regional differences, and providing valuable references for implementing regionally differentiated development policies for the digital economy and integrated urban–rural development in various regions of China.

Dynamic changes and improvement paths of China’s emergency logistics response capabilities under public emergencies—research based on the entropy weight TOPSIS method

IntroductionDue to global industrialization and urbanization, natural disasters, accidents, and public health emergencies happen frequently. These events cause significant loss of life and property damage to countries worldwide. In the context of frequent public emergencies, enhancing emergency logistics response capabilities is crucial, ensuring rapid supply of rescue materials and support for rescue personnel, thereby saving lives and reducing economic losses.MethodsIn order to identify the changes and enhancement paths of the emergency logistics response capability of Chinese regions under the shocks of public emergencies, this paper innovatively constructs emergency logistics response capability measurement indicators. This paper uses the entropy weight TOPSIS method and panel quantile regression model to quantify the change and enhancement paths of China’s regional emergency logistics response capability under different events.ResultsIt is found that: (1) The gap in emergency logistics response capability among Chinese regions is widening, with the internal difference in the eastern region higher than that in the west, while the difference in the central region is relatively low. (2) China’s emergency management department can effectively transform social logistics into emergency logistics, thereby promoting the improvement of emergency logistics response capabilities. (3) Sudden geological disasters break through the limits of social logistics resources when they cross lower scales, resulting in the failure of emergency logistics response capabilities.DiscussionThis paper expands research on assessing emergency logistics capabilities, addressing issues in existing assessments such as reliance on single indicators and subjective measurement methods. Additionally, it quantifies the dynamic changes in China’s regional emergency logistics response capabilities under public emergencies by extending the study of event content, types, and impacts. This enhances discussions on the effects of public emergencies. Finally, from an empirical perspective, the paper explores pathways to enhance regional emergency logistics response capabilities in China. In practice, this paper assists countries worldwide in assessing whether different regions of China can effectively provide emergency support for various resources in direct investments, thus providing a scientific basis for investment decisions.

Factors Influencing the Intention of Chinese Adults to Recommend COVID-19 Vaccination for Specific or Non-Specific Groups

The widespread availability of vaccines has profound implications for sustainable public health. Positive recommendation on vaccination is one of the most effective ways to increase the willingness to vaccinate against COVID-19. This study aims to investigate the factors influencing the intentions to recommend COVID-19 vaccination for specific groups (IRCVSG) and the intentions to recommend COVID-19 vaccination for non-specific groups (IRCVNSG) in China and explore the mediating role of vaccine hesitancy and perception of vaccination information. This study conducted a cross-sectional anonymous online survey of adults (N = 903) in 28 provincial-level administrative regions in China in May 2022. The prevalence of IRCVSG and IRCVNSG was 60.5% and 93.0%, respectively. Health information literacy has a significant direct and indirect impact on IRCVSG through safety hesitancy and the perceived adequacy and usefulness of vaccination information. The relationship between health information literacy and IRCVNSG is entirely mediated via hesitation about the effectiveness and perceived usefulness of vaccination information. Special attention should be paid to the safety hesitation of COVID-19 vaccination for specific groups. This study tests these effects from both theoretical and practical perspectives, helping to address barriers to promoting the vaccination of specific groups for COVID-19 in clinical practice, improving health and sustainability.