Eastern China Research Articles

Insights into the molecular network characteristics of major HIV-1 subtypes in developed Eastern China: a study based on comprehensive molecular surveillance data.

This study aimed to conduct a comprehensive molecular epidemiology study of major HIV-1 subtypes in developed Eastern China (Zhejiang Province). Plasma samples and epidemiological information were collected from 4180 newly diagnosed HIV-1 positive patients in Zhejiang Province in 2021. Pol sequences were obtained to determine the subtypes via multiple analytical tools. HIV-1 molecular networks were constructed on the basis of genetic distances to analyze transmission patterns among major subtypes. Furthermore, the birth-death skyline (BDSKY) model was utilized to estimate the transmission risks associated with large clusters (LCs). In 4180 patients, 3699 (88.49%) pol sequences were successfully obtained and classified into four subtype groups. In the networks under an optimal genetic distance of 0.01 substitutions/site, the majority of links (74.52%, 1383/1856) involved individuals within the same city, highlighting the predominant role of local transmission in driving the HIV-1 epidemic. In the CRF07_BC, CRF01_AE, and others/URFs networks, men who have sex with men (MSM) were the primary sexual transmission population, with the younger MSM group (< 30 years old) exhibiting higher linkage frequencies. Within the CRF08_BC network, 93.98% of individuals were infected primarily through heterosexual contact and had a significantly greater risk of localized clustering than other subtypes did. Moreover, fifteen identified LCs were predominantly transmitted through commercial heterosexual contact (CHC), exhibiting localized clustering and high potential for sustained diffusion. Overall, our findings reveal a diverse and heterogeneous distribution of HIV-1 subtypes in Zhejiang Province, with noticeable variations in hotspots across different geographic areas and populations.

PreciDBPN: A customized deep learning approach for hourly precipitation downscaling in eastern China

Long-term series of high-resolution gridded precipitation datasets are essential for hydrological and meteorological research. Producing high-resolution precipitation data from regional models demands substantial computational resources and labor. Global Reanalyses offer long-term coverage and effectively capture annual and seasonal precipitation patterns. However, they have inadequate resolution and frequently have difficulties depicting extreme conditions. This study proposes an efficient and accurate approach for generating long-term series of high spatial and temporal resolution precipitation. It is achieved by leveraging deep learning techniques to integrate the fifth generation of the European Centre for Medium-Range Weather Forecasts (ECMWF) global climate reanalysis (ERA5, 0.25°, hourly) data with high-resolution precipitation fusion datasets. Considering the heavy-tailed distribution of precipitation, we developed the PreciDBPN model structure, which combines a classification network with a super-resolution network and incorporates physically relevant indices into the model's input. We trained and evaluated the PreciDBPN and baseline models in eastern China using the China Meteorological Administration Land Data Assimilation System (CLDAS) precipitation dataset (0.0625°, hourly, 2017–2022). When compared to baseline methods and ERA5, our model excels in multiple metrics and provides a more precise representation of relative rainfall frequency. Independent verification was performed using station observations during the period of 2010–2015 when CLDAS data were unavailable. During this verification, the PreciDBPN demonstrated exceptional performance and greater robustness compared to the baseline models. Because our method can efficiently downscale precipitation and bias-correct reanalysis data using minimal computational resources, it can be used to generate high-resolution precipitation datasets (0.0625°, hourly) from 1979 to 2022 while correcting for heavy precipitation underestimations in reanalysis data.

Increasing evapotranspiration in peatlands from the monsoon regions of East China with the rapid warming during the early Holocene

Peatlands are one of the largest natural terrestrial carbon store, which evolve closely with the hydrological functioning. Evapotranspiration serves as a nexus of the carbon and water cycles in peatlands. Its long-term changes in the geological past are essential to gain a complete understanding of its response to global warming. Here, the evapotranspiration changes in peatlands from the monsoon regions of East China during the significant warming period of ∼ 11.5–10 ka in the Early Holocene are investigated, based on a new leaf wax δD record from the Hani peatland in Northeast China along with the previously reported representative records across monsoonal eastern China. All of the leaf wax δD records exhibit less depleted values during this episode, which follow neither with the changes in precipitation isotopes nor the vegetation compositions. They are thus interpreted as enhanced evapotranspiration. Further comprehensive comparisons based on paleoenvironmental records reveal that evapotranspiration changes are highly sensitive to rising temperatures but are intricately linked with precipitation variations. The strong evapotranspiration appears to be potentially linked to water table drawdown on longer timescales, which further actively interacts with peat-forming plants. Our results suggest that evapotranspiration is expected to increase in peatlands as the climate warms, but its changes might be complicated by accompanying hydrological and vegetational shifts.

Seed Dormancy and Germination Responses to Different Temperatures of Leptochloa chinensis (L.) Nees: A Case Study with 242 Populations Collected from Rice Fields in East China

Leptochloa chinensis (L.) Nees is a troublesome rice weed. We collected 242 L. chinensis populations from rice fields in eastern China and studied the duration of seed dormancy and the seed germination ability at different temperatures. All L. chinensis populations studied exhibited seed dormancy. The periods required to reach 50% germination under optimal conditions were 31–235 days, with an average of 96 days. None of the populations germinated at 15 °C. Under constant temperatures of 20, 25, 30, and 35 °C, the average germination percentages of 242 populations were 0%, 71%, 79%, and 60% at 2 days after treatment (DAT), and were 56%, 84%, 88%, and 88% at 14 DAT, respectively. The duration of seed dormancy, as well as the germination ability of seeds, were significantly (p &lt; 0.05) influenced by the agricultural region and the longitude and latitude of the collection locations. Under constant temperatures of 20 to 35 °C, the average germination percentages of seeds collected from transplanted rice fields were significantly higher than those collected from direct-seeded fields. This is the first study on seed germination biology of L. chinensis with multiple populations systematically collected from rice fields on a regional scale.

Promotion Effects of High-Speed Rail on Urban Development: Evidence from Three Lines in China

Amid the vigorous development of the high-speed rail (HSR) network, local governments in China generally consider the construction of HSR as a crucial task in their regional development strategies. Currently, most provincial capitals and prefecture-level cities in the eastern and central regions of China already have operational HSR services. This study aims to examine a key question: has the objective of local governments to promote urban development through the construction of HSR been effective? The research selects cities along the Beijing–Shanghai, Beijing–Guangzhou, and Harbin–Dalian HSR lines as the study subjects. Based on the principles of proximity and similarity, cities with operational HSR and those without are chosen as the experimental group and the control group, respectively. Following the double difference (difference-in-differences) approach, an advantage index is proposed to systematically evaluate the impact of HSR operation on urban development from three dimensions: population aggregation, economic development, and expansion of construction land. Furthermore, the evaluation results are systematically clustered to identify city types that exhibit different promotional effects in various dimensions. The research findings indicate the following: (1) The promotion effect of HSR on the development of small to medium-sized cities is more reflected in economic growth and construction land growth. (2) The promotion effect of HSR on the development of large cities is more reflected in the growth of the employment population. (3) For smaller or economically less-developed cities, HSR may be detrimental to the aggregation of resident and employment populations. (4) Cities with moderate size and good economic development have the opportunity to use HSR to promote population aggregation. On this basis, combined with the findings above, strategies to promote the coordinated development of high-speed rail construction and urban systems are discussed.

Prediction of Forest-Fire Occurrence in Eastern China Utilizing Deep Learning and Spatial Analysis

Forest fires are a major natural calamity that inflict substantial harm on forest resources and the socio-economic landscape. The eastern region of China is particularly susceptible to frequent forest fires, characterized by high population density and vibrant economic activities. Precise forecasting in this area is essential for devising effective prevention strategies. This research utilizes a blend of kernel density analysis, autocorrelation analysis, and the standard deviation ellipse method, augmented by geographic information systems (GISs) and deep-learning techniques, to develop an accurate prediction system for forest-fire occurrences. The deep-learning model incorporates data on meteorological conditions, topography, vegetation, infrastructure, and socio-cultural factors to produce monthly forecasts and assessments. This approach enables the identification of spatial patterns and temporal trends in fire occurrences, enhancing both the precision and breadth of the predictions. The results show that global and local autocorrelation analyses reveal high-incidence areas mainly concentrated in Guangdong, Fujian, and Zhejiang provinces, with cities like Jiangmen exhibiting distinct concentration characteristics and a varied spatial distribution of fire occurrences. Kernel density analysis further pinpoints high-density fire zones primarily in Meizhou, Qingyuan, and Jiangmen in Guangdong Province, and Dongfang City in Hainan Province. Standard deviation ellipse and centroid shift analysis indicate a significant northward shift in the fire-occurrence centroid over the past 20 years, with an expanding spatial distribution range, decreasing flattening, and relatively stable fire-occurrence direction. The model performs effectively on the validation set, achieving an accuracy of 80.6%, an F1 score of 81.6%, and an AUC of 88.2%, demonstrating its practical applicability. Moreover, monthly fire zoning analysis reveals that high-incidence areas in spring and winter are mainly concentrated in Guangdong, Fujian, Zhejiang, and Hainan, while autumn shows widespread medium-incidence areas, and summer presents lower fire occurrences in most regions. These findings illustrate the influence of seasonal climate variations on fire occurrences and highlight the necessity for enhanced fire monitoring and prevention measures tailored to different seasons.

An automatically recursive feature elimination method based on threshold decision in random forest classification

ABSTRACT The rich feature information contained in the diverse remote sensing data has also exhibited growing potential in the field of image classification. However, the processing of multi-feature data still grapples with the challenges posed by the “curse of dimensionality” and the high computational costs. This paper proposes a remote sensing feature parameter selection method. This method is based on the Gini index of a Random Forest (RF) classifier and employs a 10% threshold decision to identify the optimal combination of remote sensing feature parameters. First, spectral features, texture features, temperature features, elevation features, and principal component features are selected to create a stack of remote sensing images. Second, multiple sets of decision trees are established to cross-validate the contributions of various feature parameters. The feature rankings are determined based on the normalized mean of feature importance. Subsequently, a threshold isset to filter out remote sensing feature parameters that meet the criteria. Finally, an iterative parameter optimization process is carried out to obtain the optimal combination of remote sensing feature parameters. The Landsat 8 image covering Hangzhou Bay in eastern China and the Sentinel-2 remote sensing image of Yancheng Nature Reserve in Jiangsu, China were selected for experiments. The results show that the feature parameters of the remote sensing image screened by the method in this paper are representative, and the proposed method demonstrates strong adaptability and generalization performance in complex environments. The study has important guiding significance for regional spatial planning and sustainable development.

Does the Concept of Green Development Promote High-Quality Urban Development?—An Empirical Analysis Based on the Pilot Policy of the “Zero-Waste City” in China

Since 2019, eighteen major ministries and commissions, including the National Development and Reform Commission, have launched trials for a “zero-waste city”. Shenzhen, Baotou, Tongling, and 16 other cities and regions have entered the practical operation stage, and the significance of the economic effect of the policy pilot needs to be tested through empirical evaluation. This study systematically gathers time series data from 281 prefecture-level cities in China from 2005 to 2022 and constructs an innovative experimental framework for the construction of a zero-waste city. It implements a series of rigorous robustness testing procedures using the difference-in-differences (DID) method to scientifically and objectively measure the actual effects of waste-free city construction strategies in promoting the city’s social development along a high-quality development path. This study provides deep insights into the zero-waste city construction strategy as a strong driving force. Our results indicate that the high-quality development stage has a positive impact on the city as a whole that cannot be ignored. At the same time, in-depth analysis shows that this strategy exhibits strong regional differences in the process of promoting high-quality urban development. For the two core regions of eastern and central China, the implementation of zero-waste city policies has significantly accelerated the pace of high-quality development, and further analysis reveals that, compared with the developed eastern region, the implementation of this policy in the central region has achieved superior results in terms of high-quality development. Third, the benefits of waste-free city policies are related to the economic bases of cities, the number of green patents granted, national policies, geographical location, and other factors.

Disentangling the effects of meteorology and emissions from anthropogenic and biogenic sources on the increased surface ozone in Eastern China

China's Clean Air Actions have substantially improved ambient PM2.5 air quality since 2013. However, ozone (O3) pollution in urban areas has worsened in recent years, particularly in the eastern region. The formation of O3 in these high emission areas is highly complex and regulated by numerous factors. Utilizing the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem), this study conducted a comprehensive analysis through nine sensitivity experiments for the years 2013 and 2017, aimed at disentangling the relative contributions of major factors (e.g., meteorological factors, anthropogenic emissions, biogenic emissions, and aerosol feedback mechanisms) to the observed O3 concentration trends in Jiangsu, a developed region of China with increasing trend of O3 level. Our findings indicate a pronounced increase in mean daily maximum 8-h average (MDA8) O3 levels in the economically vibrant southern Jiangsu, contrasted with a decrease in the less developed northern regions. The study identifies anthropogenic emissions change as the primary driver of O3 variations, with significant impacts also attributed to meteorological conditions and aerosol feedback effects, while biogenic emission shifts play a lesser role. In terms of meteorological factors, we discovered that the alteration in meteorological thermal factors (enhanced solar radiation and temperatures) in 2017, compared to 2013, exerted a more pronounced influence on the formation of O3 than the change in thermally driven dynamic factors (boundary layer height and wind speed). Moreover, the study observes a shift in O3 formation sensitivity from VOC-sensitive to transitional or NOX-sensitive regimes, signifying a notable transformation in the regional atmospheric chemistry conducive to O3 generation. Aerosol feedback effects, through complex pathways including photolysis rate alterations and modifications in the vertical O3 distribution, further compound the challenge of mitigating O3 levels. Our research underscores the necessity for adaptive, region-specific strategies to mitigate O3 pollution, providing potential insights for policymakers to formulate effective control measures.

A Study of the Impact of Informal Finance on the Urban-Rural Income Gap - Evidence from China

ABSTRACT As a supplement to formal finance, informal finance has helped SMEs and rural areas overcome financing constraints. Utilizing China’s provincial data from 2004–2019, this study examines the influence of informal finance on the income disparity from a supply-side view. This Study revealed that informal finance is regionally heterogeneous and has the effect of narrowing the income gap between urban and rural areas, and manifests itself by accelerating the transfer of labor and the accumulation of physical capital, which is obvious in eastern China.

A method for velocity modeling in a volcanic rock zone that integrates the amplitude envelope attribute and grid tomography: application to data from the North Jiangsu Basin

Abstract The complexity of volcanic rocks presents challenges in seismic data quality and fine characterization of structural morphology, making velocity modeling difficult. In this study, we propose a velocity modeling method for volcanic rock areas that combines the use of amplitude envelope attribute and grid tomography inversion. By exploiting the strong reflection characteristics of volcanic rocks, the amplitude envelope attribute is employed to identify volcanic rock structures, eliminating the need for labor-intensive manual interpretation. The grid tomography inversion technique is then used to derive background velocity fields for all strata. These are further refined by incorporating the residual velocity fields of volcanic rocks through fusion and superposition. This integrated approach significantly improves the efficiency and accuracy of velocity modeling in complex volcanic rock areas, overcoming the limitations associated with conventional volcanic rock structural models and resulting in more accurate velocity inversion. The effectiveness and feasibility of the proposed method for velocity modeling in volcanic rock zone are demonstrated through the application of seismic data from an oilfield in eastern China. The results highlight the method's strong industrial application value.

Variations and comparisons in hourly and daily precipitation extremes over eastern China in recent warming periods

Variations and comparisons in hourly and daily precipitation extremes over eastern China in recent warming periods

Examining the influencing effect of EFL students’ digital literacy on their online learning power: the mediating role of perceived teacher support

ABSTRACT The advancement of digital technology has driven digitalization innovation in the field of education. Cultivating digital literacy of college students so as to enhance their online learning power is a new mission for higher education in the digital era. This study investigated the relationship between digital literacy and online learning power of EFL (English as a foreign language) undergraduates, and explored the role of perceived teacher support in it. The three scales concerning digital literacy, online learning power and perceived teacher support were used to conduct a questionnaire survey on 348 EFL undergraduates in a comprehensive university in Eastern China. The participants filled in the questionnaires and reported their survey responses. The results showed that digital literacy positively predicted online learning power, digital literacy was positively associated with perceived teacher support, and perceived teacher support was a positive predictor of online learning power. Perceived teacher support significantly mediated the relationship between digital literacy and online learning power. This study revealed that undergraduate digital literacy has an impact on online learning power through perceived teacher support, thus suggesting the importance of reinforcing teacher support, especially to enhance teachers’ technology acceptance and beliefs.

Mechanism of Coupled Upper Troposphere and Boundary Layer Induces Two Types of Short‐Term Heavy Rainfall Along the Eastern Foothills of the Taihang Mountains

AbstractUsing 11 years of hourly merged rainfall records and ERA reanalysis data, this paper reveals two major circulation modes leading to two types of short‐term heavy rainfall (STHR) along the Taihang Mountains' eastern foothills, and further explains their mechanisms. One circulation mode has a distinct warm anomaly at 300 hPa covering most areas of North China, together with the boundary‐layer westerly anomaly occurring in North China and its southern region (UTWA‐BLWA). UTWA‐BLWA effectively contributes to the reinforcement of the upper‐level divergence and the low‐level moisture convergence by promoting the strengthening of upper anticyclonic and low‐level southwesterly anomalies. The combined effects of low‐level jet (LLJ) and topographic uplift form the central‐northern STHR pattern. The other circulation structure has a 300‐hPa warm anomaly located to the southeastern Russia and a prominent 300‐hPa cold anomaly covering the south, together with the boundary‐layer easterly anomaly occurring over the whole region of eastern China (UTCA‐BLEA). The southern STHR pattern is attributed to the exit of the boundary‐layer jet (BLJ) over lower elevations due to moist transport and dynamic uplift associated with the easterly anomaly. The results indicate that the locations of STHR are related to the direction, intensity, and height of the LLJ. The findings highlight that the upper‐tropospheric temperature anomalies (UTTA) and boundary‐layer easterly flow jointly modulate heavy rainfall. Analysis of the coupled upper troposphere and boundary layer could help understand and forecast heavy rainfall.

Examining the Relationship Between Social Support, Self-Efficacy, Diabetes Self-Management, and Quality of Life Among Rural Individuals With Type 2 Diabetes in Eastern China: Path Analytical Approach.

Patients with type 2 diabetes (T2D) in rural China frequently exhibit inadequate diabetes self-management (DSM) and a reduced quality of life (QoL). Social support and self-efficacy are known to influence DSM and QoL. However, the pathways through which social support and self-efficacy impact DSM and QoL among patients with T2D in rural China has yet to be fully elucidated. This study offers a foundation for developing policies in rural chronic disease management, thereby, contributing to the improvement of T2D prevention and control in China and other transitional countries. This study used a cross-sectional design, collecting data from a survey conducted between May and July 2021 on DSM and QoL among rural patients diagnosed with T2D in 2 townships in East China. All patients with T2D were enrolled through cluster sampling from the township health center database, and a questionnaire survey was administered by investigators. Structural equation modeling and multiple regression analyses were used to explore the pathways through which social support influences DSM and QoL, as well as the mediating role of self-efficacy. It was found that the DSM score (mean 37.42, SD 7.70) was less than half of the maximum theoretical score. The QoL score (mean 48.92, SD 8.88) accounted for 36% of the maximum theoretical score. Social support directly and positively affected the DSM and QoL of Chinese rural patients with T2D (P<.01); an increase of 1 unit in social support was associated with a direct increment of 0.339 units in DSM and 0.397 units in QoL. Self-efficacy played a positive mediating role (P<.01), further increasing DSM and QoL by 0.147 and 0.159 units, respectively. The mediating effect of self-efficacy accounted for 30.2% and 28.6% of the total effect of social support on DSM and QoL. Furthermore, the family and friend dimension of social support, along with the symptom and disease management dimensions of self-efficacy, were significantly associated with DSM or QoL (P<.01). The study confirmed the direct and indirect influences of social support on DSM and QoL and elucidated the mediating effect of self-efficacy among rural patients with T2D in eastern China. Interventions should be developed to enhance both social support and self-efficacy, creating a positive cycle of mutual reinforcement to improve DSM and QoL among this group.

Clinical and genetic characteristics of 100 consecutive patients with Birt-Hogg-Dubé syndrome in Eastern Chinese region

BackgroundAlthough an increasing number of patients with Birt-Hogg-Dubé syndrome (BHD) are being recognized in China, clinical and genetic characteristics are not well-defined. In addition, revised diagnostic criteria for the Chinese population was proposed in 2023, we aimed to explore their utility in clinical practice at a rare lung disease center.MethodsWe retrospectively analyzed the data of 100 consecutive patients with BHD diagnosed according to the revised Chinese BHD criteria, encountered at the First Affiliated Hospital of University of Science and Technology of China from Jan 2017 to June 2023.ResultsThere were 100 patients (including 63 females) from 65 unrelated families in Eastern China, mostly Anhui Province. The common manifestations were pulmonary cysts (99%), pneumothorax (60%), and skin lesions (77%). Renal cancer and renal angiomyolipoma were detected in 5 patients each. 37% of patients had no family history of BHD. In total, 25 FLCN germline mutations were detected, including 6 novel mutations. In addition to hotspot mutation c.1285delC/dupC (17%), the most common mutations were c.1015 C > T (16%), c.1579_1580insA (14%), and exons 1–3 deletion (11%) in FLCN. Higher risk of pneumothorax was associated with exons 1–3 deletion mutation and c.1177-5_1177-3de1CTC compared to the hotspot mutation c.1285dupC (91% [95% CI: 0.31, 46.82, p = 0.015] and 67% [95% CI: 0.35, 71.9, p = 0.302] vs. 30%, respectively). The average delay in diagnosis was 7.6 years after initial symptoms. Chinese diagnostic criteria were mostly consistent with typical pulmonary presentations with supportive genetic evidence.ConclusionIn the Eastern Chinese region, patients with BHD present most commonly with pulmonary cysts associated with pneumothorax and skin lesions. However, low incidence of renal cancer along with unexpected renal angiomyolipoma was observed. Genotypic spectrum differed from that reported from other global regions, and genotype association of pneumothorax warrants further research. The revised Chinese criteria for BHD seem more appropriate in diagnosing BHD in Chinese patients.

How does venture capital play a role in corporate green innovation? Evidence from China

This research underscores the critical role of green innovation in advancing corporate sustainability and green transformation. Analyzing 9048 panel data points from China between 2010 and 2021, we applied a series of fixed effect models to assess how venture capital (VC) influences corporate green innovation. The study examined the effect of VC on two key business aspects: the costs of debt financing and the propensity for corporate risk-taking. The findings confirm that venture capital is essential in promoting corporate green innovation by lowering debt-related financial burdens and diminishing firms' inclination to take risks. Additionally, our heterogeneity analysis indicates that venture capital's impact is more pronounced within eastern China and among state-owned enterprises, suggesting regional and ownership-based variations in green innovation dynamics.

Euphorbia zhongiana (Euphorbia section Helioscopia, subgenus Esula, Euphorbiaceae), a new species from Danxia Landform Areas in Zhejiang Province, Eastern China

Euphorbia zhongiana (Euphorbiaceae), from Zhejiang Province, eastern China, is described and illustrated as a new species. It is morphologically similar to E. fauriei, however, differs in its winter green habit, whole plant being glabrous; cyathophylls 2, broadly ovate, yellow-greenish; involucre 2.5–3.0 × 2.5–3.0 mm; the surface of ovary usually smooth, rare sparsely microtuberous; styles connate at middle towards base; apex slightly 2–lobed; capsules smooth without tuberculate or conical verrucae, rare sparsely and inconspicuously rugose; seed coat with reticulate wrinkle.

Spatial and temporal characteristics of volatiles in the Cenozoic mantle beneath eastern China

Subduction of the paleo-Pacific Plate has transported volatiles from the surface to the interior of the Earth and significantly altered the chemical and physical properties of the Cenozoic mantle beneath eastern China. However, the characteristics of volatiles other than H2O in the Cenozoic mantle remain poorly constrained. To describe the spatiotemporal distribution of volatiles, including S, Cl, and H2O, in the Cenozoic mantle beneath eastern China, we performed reheating experiments and determined the composition of olivine-hosted melt inclusions from a large area (5.9 × 105 km2) of basalts. Calculations of the mantle-source compositions indicate that the Cenozoic mantle in North China is enriched in S but deficient in H2O and Cl, relative to that in South China. The distinctive features of volatiles likely arise from the different types of recycled materials in the mantle sources (such as Cl-containing sediments, carbonates, or sulfides in the altered oceanic crust) and their different proportions (from <1.7 % to 7 % of subducted sediments). Both the North China and South China mantles reached high volatile contents at 17.5–11.9 Ma, indicating that the activation of the South China mantle and the destruction of the North China Craton may have occurred simultaneously. These novel findings improve our understanding of mantle evolution beneath eastern China and will help in evaluating the contributions of slab subduction to the spatiotemporal heterogeneity of the lithospheric mantle during the Cenozoic.

The impact of diabetes mellitus on tuberculosis recurrence in Eastern China: a retrospective cohort study

BackgroundThe comorbidity of tuberculosis (TB) and diabetes mellitus (DM) is a significant global public health issue. This study aims to explore the recurrence risk and related factors of active pulmonary TB, specifically focusing on the impact of DM.MethodsA retrospective cohort study was conducted in Lianyungang City, Jiangsu Province, Eastern China by recruiting 12,509 individuals with newly diagnosed pulmonary TB between 2011 and 2019. The Cox proportional hazards models were performed to identify risk factors of recurrence and assess the association between DM and recurrence. The hazard ratio (HR) and 95% confidence interval (CI) were used to estimate the strength of the association.ResultsAfter a median follow-up period of 5.46 years, we observed 439 recurrent cases (incident recurrence rate: 6.62 per 1000 person-years). Males (HR: 1.30, 95% CI: 1.03–1.64), patients aged ≥ 60 years (HR: 1.39, 95% CI: 1.15–1.70), DM (HR: 2.40, 95% CI: 1.68–3.45), and etiologic positivity in the initial episode (HR: 2.42, 95% CI: 2.00-2.92) had a significantly increased risk of recurrence.ConclusionsRecurrence of pulmonary TB patients who have completed treatment, especially those who also suffer from DM, should be a concern. Enhanced follow-up and targeted surveillance of these high-risk groups are needed.