Geographical Regions In China Research Articles

Geographic variations and determinants of EPA plus DHA and EPA alone in pregnant and lactating women from China.

EPA and DHA are essential for maternal and fetal health, but epidemiological data are sparse in China. We examined the trends of EPA alone and a combination of EPA plus DHA in pregnant and lactating women in three distinct geographic regions in China and explored their potential influencing factors. A total of 1015 healthy women during mid-pregnancy, late pregnancy or lactation were recruited from Weihai (coastland), Yueyang (lakeland) and Baotou (inland) cities of China between May and July of 2014. Maternal EPA and DHA concentrations (percentage of total fatty acids) in plasma and erythrocytes were measured by capillary GC. Adjusted EPA plus DHA concentrations in both plasma and erythrocytes significantly declined from mid-pregnancy (2·92 %, 6·95 %) to late pregnancy (2·20 %, 6·42 %) and lactation (2·40 %, 6·29 %) (Ptrend < 0·001); and both concentrations were highest in coastland, followed by lakeland, and lowest in inland (P < 0·001). Regarding EPA alone, the concentrations were higher in women during lactation or late pregnancy and in women in coastland and inland areas. Moreover, concentrations of EPA or EPA plus DHA were higher in women with older age, higher education, higher annual family income per capita and higher dietary intake of marine aquatic product and mutton. In lactating women, erythrocyte EPA concentration was higher in those having breast-feeding partially v. exclusively. In conclusion, maternal plasma and erythrocyte concentrations of EPA plus DHA or EPA alone differed with geographic regions, physiological periods and maternal characteristics, indicating a need of population-specific health strategies to improve fatty acids status in pregnant and lactating women.

Smartphone Use and Psychological Well-Being Among College Students in China: A Qualitative Assessment.

Background: Problematic smartphone use is widespread, and college-age youth faces an especially high risk of its associated consequences. While a promising body of research has emerged in recent years in this area, the domination of quantitative inquiries can be fruitfully and conceptually complemented by perspectives informed through qualitative research. Toward that end, this study aimed to interrogate the myriad behavioral, attitudinal, and psychological tendencies as a side effect of college students’ engagement with the smartphone in their everyday lived experience through in-depth interviews.Methods: We recruited 70 participants from seven college campuses hailing from different geographic regions in China, and conducted semi-structured in-depth virtual interviews via WeChat in November and December 2020. Subjective experiences, personal narratives and individual perceptions in the context of routine interaction with the smartphone were thematically analyzed through a reiterative process in an effort to detect prevailing threads and recurring subthemes.Results: The smartphone has established a pervasive presence in college students’ everyday life. Time-based use characteristics generated a typology of four distinct user groups: hypo-connected antagonists, balanced majority, hyper-connected enthusiasts, and indulgent zealots. Habitual usage falls on predictable patterns matched onto temporal, locale-based and contextual cues and triggers. Students’ dependency relationships with the smartphone have both functional and emotional dimensions, as prominently manifested in occasions of detachment from the device. Self-regulatory effort in monitoring and limiting use is significantly impacted by mental focus and personal goal setting. Perspectives from our qualitative data suggest the need for taking into account a variety of contextual cues and situational factors in dissecting psychological and emotional outcomes of smartphone use and abuse.

Profile, treatment patterns, and influencing factors of anthracycline use in breast cancer patients in China: A nation‐wide multicenter study

BackgroundAnthracycline‐based chemotherapy (ABC) is one of the standard therapies against breast cancer. However, few guidelines are currently available to optimize the use of ABC. Therefore, the present analysis aimed at determining the profile and treatment patterns of ABC and the association of clinicopathological characteristics with ABC selection.MethodsWe retrospectively analyzed the data of a nation‐wide multicenter epidemiological study, which collected the medical records of breast cancer patients receiving chemotherapy in different settings from seven geographic regions in China (NCT03047889).ResultsIn total, 3393 patients were included, with 2917 treated with ABC. Among them, 553 (89.8%), 2165 (81.7%), and 814 (25.7%) were subjected to ABC as neoadjuvant, adjuvant, and advanced chemotherapy, respectively. The most frequently used regimens were anthracycline‐taxane‐based combinations for neo‐ and adjuvant chemotherapy, along with taxanes and oral fluorouracils for the palliative stages. In the overall cohort, patients aged < 40 or 40‐65 (p < 0.001), in premenopause (p < 0.001), without comorbidities (p = 0.016), with invasive ductal carcinoma (p= 0.001), high lymph node involvement (p < 0.001), in the pTNM stage II, III, or IV versus stage I (p < 0.001), subjected to mastectomy (p < 0.001) or subjected to sentinel lymph node biopsy combined with axillary lymph node dissection (p = 0.044), or with a decreased disease‐free survival (p < 0.001) were more likely to be recommended to ABC.ConclusionTaken together, ABC remained the mainstay of breast cancer treatment, especially in neo and adjuvant therapy. ABC was mainly used as a combination therapy, and the correlation between influencing factors and ABC choice varied during different settings, indicating the preference and different perspectives of medication considered by medical oncologists regarding the use ABC in China.

A Preliminary Study of Antibiotic Resistance Genes in Domestic Honey Produced in China.

Antibiotic resistance genes (ARGs) are emerging contaminants that pose a health risk to humans worldwide. Little information on ARGs in bee honey is available. This study profiles ARGs in bee honey samples produced in China, the biggest producer in the world. Of 317 known ARGs encoding resistance to 8 classes of antibiotics, 212 were found in collected honey samples by a real-time quantitative polymerase chain reaction approach. Occurrence frequencies of genes providing resistance to FCA (fluoroquinolone, quinolone, florfenicol, chloramphenicol, and amphenicol) and aminoglycosides were 21.0% and 18.5%, respectively. Frequencies of genes encoding efflux pumps were 42.5% and those of destructase genes 36.6%, indicating that these two mechanisms were predominant for resistance. Nine plasmid-mediated quinolone resistance genes were detected. Of the nine transposase genes known to be involved in antibiotic resistance, eight were found in the samples examined, with tnpA-4, tnpA-5, and tnpA-6 being more abundant. The abundance of the transposase genes was associated with genes conferring resistance to tetracyclines (r = 0.648, p < 0.01), macrolide-lincosamide-streptogramin B (r = 0.642, p < 0.01), FCA (r = 0.517, p < 0.01), and aminoglycosides (r = 0.401, 0.01 < p < 0.05). This is the first study on the abundance and diversity of ARGs in Chinese bee honey products. These findings suggest that bee honey may be a significant source of ARGs that might pose threat to public health. Further research is required to collect more samples in diverse geographic regions in China to make a more comprehensive judgment of ARG in bee honey.

Random Trees Are the Cornerstones of Natural Forests

Natural forests serve as the main component of the forest ecosystem. An in-depth interpretation of tree composition and structure of forest community is of great significance for natural forest conservation, monitoring, management, and near-natural silviculture of plantation forest. In this study, we explored the importance of key tree groups—random trees—in natural communities, compared the similarity between the random trees and the communities. This research studies six stem-mapped permanent plots (100 × 100 m2) of the typical natural forests in three different geographic regions of China. Several variables and their distributions were applied to study community characteristics comprehensively, including species abundance, diameter distribution, spatial pattern, mingling, crowding, and competition. The genetic absolute distance method is used to analyze the similarity between the random trees and the communities. Our results show that the features of random trees are highly consistent with the communities. The study proposes that random trees are the cornerstones of natural forests. Its quantitative advantage explains the key role that random trees play in natural forests. The study could provide a scientific insight into the protection, monitoring, and management of forests.

The national dental undergraduate clinical skills competition known as the Guanghua Cup: an innovative and effective program that promoted undergraduate dental education in China

BackgroundThe National Dental Undergraduate Clinical Skills Competition known as the Guanghua Cup was held in Guangzhou, China, for three consecutive years from 2017 to 2019 to promote the clinical teaching of undergraduate dental education and to enhance communication among different universities. The present study aimed to introduce the organization, procedures, and consequences of the competition, in addition to analyzing the influences of competition on the reform of undergraduate dental education.MethodsBy analyzing the descriptive statistics of the Guanghua Cup, the competitions’ organization, the participating students’ performances, and the outcomes of competitions were analyzed. After distributing questionnaires to all participants of the 2nd and 3rd Cups, their attitudes towards the competition and their evaluation of the role of the competitions in promoting undergraduate dental education were analyzed.ResultsA total of 24 schools participated in the 3 competition years. The contents of the competitions covered cariology, endodontics, periodontology, prosthodontics, oral and maxillofacial surgery, dental anatomy, and first aid (e.g., operative skills and theoretical knowledge). Compared with those of the 2nd Cup, the mean scores of the operative skills significantly improved in the stations related to periodontology, prosthodontics, and dental anatomy (p < 0.05) in the 3rd Cup. In addition, 338 valid questionnaires were collected, for a response rate of 87.79 %. Overall, the participants spoke highly of the Guanghua Cup. Based on their self-perception and self-evaluation, the majority of interviewees agreed that the competition helped develop collegiality and teamwork among the participating students, improved the students’ clinical skills and promoted the improvement of teaching resources (e.g., purchasing and updating equipment, models or experimental materials).ConclusionsThe competition enjoyed the widest coverage since it involved dental schools from all of the different geographical regions of China. Dental students could exhibit their clinical skills in a competitive environment and develop collegiality and teamwork. Future competitions should be optimized through their organization and contents. The education quality of the participating schools affected by such competition should be investigated in a more objective and comparable way.

Both sampling seasonality and geographic origin contribute significantly to variations in raw milk microbiota, but sampling seasonality is the more determining factor

Accurately profiling and characterizing factors shaping raw milk microbiota would provide practical information for detecting microbial contamination and unusual changes in milk. The current work was an observational study aiming to profile the microbiota of raw milk collected across wide geographic regions in China in different seasons and to investigate the contribution of geographical, seasonal, and environmental factors in shaping the raw milk microbiota. A total of 355 raw cow milk samples from healthy Holsteins and 41 environmental samples (farm soil and surface of milking room floor) were collected from 5 dairy farms in 5 Chinese provinces (namely, Daqing in Heilongjiang province, Jiaozuo in Henan province, Qingyuan in Guangdong province, Suqian in Jiangsu province, and Yinchuan in Ningxia Hui Autonomous Region) in January, May, and September 2018. The microbial communities in raw milk and farm environmental samples were determined using the PacBio small-molecule real-time circular consensus sequencing, which generated high-fidelity microbiota profiles based on full-length 16S rRNA genes; such technology was advantageous in producing accurate species-level information. Our results showed that both seasonality and sampling region were significant factors influencing the milk microbiota; however, the raw milk microbiota was highly diverse according to seasonality, and sampling region was the less determining factor. The wide variation in raw milk microbial communities between samples made it difficult to define a representative species-level core milk microbiota. Nevertheless, 3 most universal milk-associated species were identified: Lactococcus lactis, Enhydrobacter aerosaccus, and Acinetobacter lwoffii, which were consistently detected in 99%, 95%, and 94% of all analyzed milk samples, respectively (n = 355). The top taxa accounting for the overall seasonal microbiota variation were Bacillus (Bacillus cereus, Bacillus flexus, Bacillus safensis), Lactococcus (Lactococcus lactis, Lactococcus piscium, Lactococcus raffinolactis), Lactobacillus (Lactobacillus helveticus, Lactobacillus delbrueckii), Lactiplantibacillus plantarum, Streptococcus agalactiae, Enhydrobacter aerosaccus, Pseudomonas fragi, and Psychrobacter cibarius. Unlike the milk microbiota, the environmental microbiota did not exhibit obvious pattern of seasonal or geographic variation. However, this study was limited by the relatively low number and types of environmental samples, making it statistically not meaningful to perform further correlation analysis between the milk and environmental microbiota. Nevertheless, this study generated novel information on raw milk microbiota across wide geographic regions of China and found that seasonality was more significant in shaping the raw milk microbiota compared with geographic origin.

Analysing wastewater to estimate fentanyl and tramadol use in major Chinese cities

The misuse of fentanyl and more recently tramadol in the population has caused an opioid crisis in several countries and drawn much public attention worldwide. However, there is a gap of information on the potential misuse of fentanyl and tramadol in China. This study aims to fill this gap by analysing fentanyl and tramadol in wastewater of major cities across China to estimate their use. Wastewater samples were collected from 30 cities located across all seven geographic regions of China, from 2016 to 2019. Fentanyl was detected in only a few samples, suggesting a low prevalence of this potent opioid drug in China. Meanwhile, tramadol was found in most samples with concentrations ranging up to 186 ng/L. The per capita daily consumption of tramadol estimated from wastewater across China ranged from 6 mg/d/1000 in. to 213 mg/d/1000 inh. The consumption of tramadol seems to be similar among all the days of the week. Tramadol use is overall higher in Northeast China than in other regions, which is different from heroin, another popular opioid in China. Temporally, there is a significant decrease in tramadol use in major cities of China from 2016 to 2019. The results of our study suggested that tramadol use in China was predominantly from pharmaceutical prescription and not as prevalent as in other countries.

A fusion decision system to identify and grade malnutrition in cancer patients: Machine learning reveals feasible workflow from representative real-world data

Most nutritional assessment tools are based on pre-defined questionnaires or consensus guidelines. However, it has been postulated that population data can be used directly to develop a solution for assessing malnutrition. This study established a machine learning (ML)-based, individualized decision system to identify and grade malnutrition using large-scale data from cancer patients.This was an observational, nationwide, multicenter cohort study that included 14134 cancer patients from five institutions in four different geographic regions of China. Multi-stage K-means clustering was performed to isolate and grade malnutrition based on 17 core nutritional features. The effectiveness of the identified clusters for reflecting clinical characteristics, nutritional status and patient outcomes was comprehensively evaluated. The study population was randomly split for model derivation and validation. Multiple ML algorithms were developed, validated and compared to screen for optimal models to implement the cluster prediction.A well-nourished cluster (n = 8193, 58.0%) and a malnourished cluster with three phenotype-specific severity levels (mild = 2195, 15.5%; moderate = 2491, 17.6%; severe = 1255, 8.9%) were identified. The clusters showed moderate agreement with the Patient-Generated Subjective Global Assessment and the Global Leadership Initiative on Malnutrition criteria. The severity of malnutrition was negatively associated with the nutritional status, physical status, quality of life, and short-term outcomes, and was monotonically correlated with reduced overall survival. A multinomial logistic regression was found to be the optimal ML algorithm, and models built based on this algorithm showed almost perfect performance to predict the clusters in the validation data.This study developed a fusion decision system that can be used to facilitate the identification and severity grading of malnutrition in patients with cancer. Moreover, the study workflow is flexible, and might provide a generalizable solution for the artificial intelligence-based assessment of malnutrition in a wider variety of scenarios.

P-217 The knowledge and awareness for colorectal cancer in advanced colorectal cancer patients in China: A national multicenter study

Colorectal cancer is the third most common malignant tumor globally, affecting public health seriously. In decades, the disease burden of colorectal cancer in China has been increasing significantly. However, the profile for colorectal cancer patients, especially advanced stage groups, is still not clear currently. Therefore, the current study evaluated the knowledge and awareness of colorectal cancer in advanced colorectal cancer patients. This study was a multicenter, cross-sectional study which launched in December 2019. To improve the representation of the study population, nineteen sites were included based on stratified sampling across seven geographical regions in China. Of these, ten sites were tertiary cancer hospitals and nine were tertiary general hospitals. And it also allocated the sample size to each site according to the total population data and gender ratio released by government. After written informed consent was obtained, each subject would complete a semi-structured questionnaire interview about the knowledge and awareness of colorectal cancer. All data were input and checked independently by two persons to build the database. In total, 4589 advanced colorectal cancer patients were enrolled. The mean age was 61 years old. There were 2730 males and 1859 females, with a ratio of 1.47. Before colorectal cancer was diagnosed, a majority of patients had limited knowledge and awareness about colorectal cancer. For risk factors, screening, and treatment of colorectal cancer, the proportion of “Don’t know” was up to 65%, 84.4%, and 55.8%, respectively. Of the patients, 69.3% paid little attention to the relevant information of colorectal cancer. Meanwhile, 97.4% did not do colonoscopy screening before being diagnosed, and the major reason was “Don’t know that they needed to do colonoscopy screening regularly” (86.9%). Logistic regressions analysis revealed that the low education level (P < 0.001), family income (P < 0.001), and clinical stage (P = 0.0046) were correlated with the low knowledge and awareness. The findings suggested that advanced colorectal cancer patients had limited knowledge and awareness of colorectal cancer in China, which affected the screening, early diagnosis, and treatment. In the future, it is necessary to enhance the health education and propaganda activities in relation to colorectal cancer to improve the public's knowledge and awareness.

Geographic Variation Did Not Affect the Predictive Power of Salivary Microbiota for Caries in Children With Mixed Dentition.

Dental caries is one of the most prevalent chronic oral diseases, affecting approximately half of children worldwide. The microbial composition of dental caries may depend on age, oral health, diet, and geography, yet the effect of geography on these microbiomes is largely underexplored. Here, we profiled and compared saliva microbiota from 130 individuals aged 6 to 8 years old, representing both healthy children (H group) and children with caries-affected (C group) from two geographical regions of China: a northern city (Qingdao group) and a southern city (Guangzhou group). First, the saliva microbiota exhibited profound differences in diversity and composition between the C and H groups. The caries microbiota featured a lower alpha diversity and more variable community structure than the healthy microbiota. Furthermore, the relative abundance of several genera (e.g., Lactobacillus, Gemella, Cryptobacterium and Mitsuokella) was significantly higher in the C group than in the H group (p<0.05). Next, geography dominated over disease status in shaping salivary microbiota, and a wide array of salivary bacteria was highly predictive of the individuals’ city of origin. Finally, we built a universal diagnostic model based on 14 bacterial species, which can diagnose caries with 87% (AUC=86.00%) and 85% (AUC=91.02%) accuracy within each city and 83% accuracy across cities (AUC=92.17%). Although the detection rate of Streptococcus mutans in populations is not very high, it could be regarded as a single biomarker to diagnose caries with decent accuracy. These findings demonstrated that despite the large effect size of geography, a universal model based on salivary microbiota has the potential to diagnose caries across the Chinese child population.

Prevalence of Thyroid Nodules in China: A Health Examination Cohort-Based Study.

BackgroundThyroid nodules are a common clinical problem and some are potentially cancerous; however, little is known about the prevalence of thyroid nodules in China. The objective of this study was to investigate the prevalence of thyroid nodules in a healthy Chinese population.MethodsWe reviewed electronic medical records of 13,178,313 participants from 30 provinces and regions who received health examinations and underwent thyroid ultrasound at Meinian Onehealth Healthcare in 2017. Among them, 6,192,357 were excluded based on predefined criteria. All thyroid nodules were diagnosed by ultrasonography, and standardized protocols were adopted for data collection, quality control, and data management.ResultsA total of 6,985,956 participants (mean age: 42.1 ± 13.1 years) were included in this study. The overall prevalence of thyroid nodules was 36.9% (95% CI, 35.7%–38.1%; age- and sex-standardized prevalence 38.0% [95% CI, 37.0%–39.1%]). The prevalence of thyroid nodules in females (44.7% [95% CI, 43.4%–45.9%], age-standardized prevalence: 45.2% [95% CI, 44.1%–46.4%]) was significantly higher than that in males (29.9% [95% CI, 28.8%–31.0%], age-standardized prevalence 31.2% [95% CI, 30.1%–32.2%]; P < 0.001). The prevalence of thyroid nodules decreased from <18 to 25 years, while increased with age over 25 years old. The top three provinces with the highest prevalence of thyroid nodules were Jilin (47.6%), Liaoning (44.8%), and Shandong (43.9%), whereas Guizhou (23.9%), Chongqing (26.2%), and Shaanxi (26.4%) had the lowest prevalence. Females had more than 10% higher rates of thyroid nodules than males in all included provinces and regions, except for Tianjin (8.0%). Based on the geographical regions of China, the northeast had the highest prevalence (46.8% [95% CI, 44.1%–49.2%]), whereas northwest had the lowest prevalence (28.9% [95% CI, 26.9%–31.6%]. Based on multivariable logistic regression analysis, factors including age, gender, body mass index, systolic blood pressure, diastolic blood pressure, uric acid, fasting blood glucose, triglycerides, high-density lipoproteins, and low-density lipoproteins were significantly associated with the presence of thyroid nodules.ConclusionThis study provides the first nationwide analysis of the prevalence of thyroid nodules in China. Our results showed that the prevalence of thyroid nodules was high in health screening Chinese people with regional-specific patterns.

A new study on passive radiative sky cooling resource maps of China

Passive radiative cooling utilizes atmospheric transparency window (8–13 µm) to discharge heat into outer space and inhibits solar absorption. Recently, due to the rapid development of daytime radiative cooling materials synthesized at micro or nano scales, radiative cooling has attracted substantial attention due to its energy-saving potential without generating carbon emissions. This study newly explores radiative cooling resources across China by using the radiative cooling model and extensive meteorological data retrieval. Temporal and spatial variability characteristics of cooling power across seven geographic regions of China are comprehensively analyzed. In particular, the annual, seasonal and daily variations of radiative cooling resources are given in detail. The influence of the spectral properties from different radiative coolers on the cooling potential is clarified. The annual maximum cooling potential is between 36.7 and 71.9 W/m2, among which the humid region of South China demonstrates the lowest cooling power with an average of 48.8 W/m2. In comparison, Northwest China with comparatively dry climate shows the cooling power of 60.1 W/m2 on average. Seasonal distribution of radiative cooling resources varies discrepantly. The cooling power in spring, summer, autumn and winter deviates + 4.02%, −7.22%, −0.34% and + 3.6% from that of annual average, respectively. South China has the lowest cooling potential in all seasons, especially in summer when the net cooling power below 50 W/m2 accounts for the largest geographic share of 42%. In 38.51% of China, the cooling power during the daytime is higher than 60 W/m2, and the ratio at night is reduced to 10.87%. Compared with the ideal broadband cooler, due to the uneven regional distribution of solar radiation, a practical radiative cooler with the solar absorption of 4% and an inferior nonblackbody thermal emittance reduces the annual net cooling power of 15.4% on average. In addition, the practical cooler shows the nighttime cooling power of 24.8% higher than that of the daytime. Finally, a radiative cooling potential-based regional division map is newly displayed, which provides a clear picture for the deployment of radiative cooling technology in China.

Diversity of 3\u2032 variable region of cagA gene in Helicobacter pylori strains isolated from Chinese population

BackgroundThe cytotoxin-associated gene A (cagA) is one of the most important virulence factors of Helicobacter pylori (H. pylori). There is a highly polymorphic Glu-Pro-Ile-Tyr-Ala (EPIYA) repeat region in the C-terminal of CagA protein. This repeat region is thought to play an important role in the pathogenesis of gastrointestinal diseases. The aim of this study was to investigate the diversity of cagA 3′ variable region and the amino acid polymorphisms in the EPIYA segments of the CagA C-terminal region of H. pylori, and their association with gastroduodenal diseases.MethodsA total of 515 H. pylori strains from patients in 14 different geographical regions of China were collected. The genomic DNA from each strain was extracted and the cagA 3′ variable region was amplified by polymerase chain reaction (PCR). The PCR products were sequenced and analyzed using MEGA 7.0 software.ResultsA total of 503 (97.7%) H. pylori strains were cagA-positive and 1,587 EPIYA motifs were identified, including 12 types of EPIYA or EPIYA-like sequences. In addition to the four reported major segments, several rare segments (e.g., B′, B″ and D′) were defined and 20 different sequence types (e.g., ABD, ABC) were found in our study. A total of 481 (95.6%) strains carried the East Asian type CagA, and the ABD subtypes were most prevalent (82.1%). Only 22 strains carried the Western type CagA, which included AC, ABC, ABCC and ABCCCC subtypes. The CagA-ABD subtype had statistical difference in different geographical regions (P = 0.006). There were seven amino acid polymorphisms in the sequences surrounding the EPIYA motifs, among which amino acids 893 and 894 had a statistical difference with gastric cancer (P = 0.004).ConclusionsIn this study, 503 CagA sequences were studied and analyzed in depth. In Chinese population, most H. pylori strains were of the CagA-ABD subtype and its presence was associated with gastroduodenal diseases. Amino acid polymorphisms at residues 893 and 894 flanking the EPIYA motifs had a statistically significant association with gastric cancer.

Relationships between above- and below-ground carbon stocks in mangrove forests facilitate better estimation of total mangrove blue carbon

BackgroundAlthough great efforts have been made to quantify mangrove carbon stocks, accurate estimations of below-ground carbon stocks remain unreliable. In this study, we examined the distribution patterns of mangrove carbon stocks in China and other countries using our own field survey data and datasets from published literature. Based on these data, we investigated the possible relationships between above-ground carbon stock (AGC) and below-ground carbon stock (BGC) for mangrove forests, aiming to provide a scientific basis for estimation of total mangrove carbon stocks.ResultsThe average above-ground carbon stock in each region was sizeable (ranging from 12.0 to 150.2 Mg/ha), but average below-ground carbon stock was dominant (ranging from 46.6 to 388.6 Mg/ha), accounting for 69–91% of total carbon stock at the sites studied in China. Significant positive relationships were found between above-ground and below-ground mangrove carbon stocks, with the best fitting equation as BGC = 1.58 * AGC + 81.06 (Mg/ha, R2 = 0.62, p < 0.01, n = 122) for China. Such linear relationships vary for mangrove forests of different types and locations, from different geographical regions in China to other countries worldwide.ConclusionThe positive relationship we found between above- and below-ground carbon stocks of mangrove forests in China and worldwide can facilitate more accurate assessments of mangrove blue carbon stocks at regional or global scales using modern techniques including remote sensing.

Heartbeat: the global burden of atrial fibrillation and ensuring anticoagulation persistence

Atrial fibrillation (AF) is the most common sustained arrhythmia, with an increasing worldwide prevalence related to a progressively ageing population. Most of the worldwide AF burden is concentrated in low-income...

Chronic and non-communicable disease mortality and trends in Chinese elderly, 2004-2018

Objective: To analyze the mortality level and trend of chronic and non-communicable diseases (NCDs) among elderly residents aged 65 and over in China from 2004 to 2018, and predict the age-standardized mortality rate of NCDs from 2019 to 2023. Methods: Data on resident death was collected from the National Mortality Surveillance data set and used to analyze the unstandardized mortality rates, age-standardized mortality rates, composition ratios and changing trends of NCDs among different genders, urban and rural areas, and geographical regions in China during 2004 to 2018. The age-standardized mortality rates were calculated based on the Year 2010 Population Census of China. The Joinpoint Regression Models were fitted by the weighted least squares method. The average annual percent change (AAPC) and its 95% confidence interval for the entire time period were calculated. Log-linear models were used to predict age-standardized mortality rates. Results: From 2004 to 2018, the age-standardized mortality rates of NCDs decreased from 4 697.05 per 100 000 to 3 555.35 per 100 000, with an average annual decline of 2.0% (95%CI: -2.7%- -1.3%). The age-standardized mortality rates among different genders, urban and rural areas, and regions showed a downward trend. The age-standardized mortality rates of eastern region (AAPC = -2.1%, 95%CI: -2.8%- -1.3%) and central region (AAPC = -2.8%, 95%CI: -3.4%- -2.1%) fell faster than that of western region (AAPC = -0.8%, 95%CI: -1.8%-0.2%). The proportion of deaths caused by NCDs increased from 89.82% to 91.41%, with an average annual increase of 0.1% (95%CI: 0.1%-0.2%). Expected to 2023, the age-standardized mortality rates for male (3 906.23 per 100 000) will be significantly higher than female's (2 708.43 per 100 000); and that in rural areas (3 283.20 per 100 000) will be approximately equal to that in urban areas (3 250.01 per 100 000); the gap of age-standardized mortality rate between the western (3 782.48 per 100 000), eastern (3 037.01 per 100 000), and central region (3 249.24 per 100 000) will be further increased. Conclusion: From 2004 to 2018, age-standardized mortality rates of NCDs of the elderly residents in China showed a downward trend, and the proportion of deaths of NCDs showed an upward trend. Male and the western region elderly residents should be the key population for prevention and control of chronic diseases in the future.

Research on Spatial Correlation Characteristics and Their Spatial Spillover Effect of Local Government Debt Risks in China

Scholars have proposed a series of methods, such as “sustainability of local government debt”, to measure local government debt risks. However, these methods have caused a lot of controversy. Based on a macro balance sheet, this study uses an improved “distance to distress” to measure China’s local government debt risks and applies a social network model to identify the spatial correlation characteristics, as well as the spillover effect. The results are as follows: (1) The data show multiple and heterogeneous spatial correlations for China’s local government debt risks; (2) there are some similarities between the subgroups and seven major geographic regions in China. The links among subgroups are randomly distributed and external; (3) the data manifest a “small world”, with a decreasing transitivity since 2014; (4) between these two significant factors, the positive impact of local government competition is more obvious than the division of powers and responsibilities; and (5) the spatial spillover effect of China’s local government debt risks results from the combination of local government competition, the division of powers and responsibilities, and local government intervention. This paper provides a scientific basis for obtaining a deeper understanding of China’s local government debt risks, and puts forward policy recommendations to strengthen China’s debt management.

Current status and distribution of hip fractures among older adults in China.

To assess hip fracture incidence in China and examine the heterogeneity of hip fracture in seven geographical regions of China. There were 238,230 hip fracture patients aged 65 years or older from 2013 to 2016 from a large national in-patients database (HQMS) involving 30.6 million hospitalizations. Taking into account the total national hospitalization rate per calendar year, we estimated the incidence of hip fracture per 100,000 residents older than 65 years in China overall and in seven geographical Chinese regions. The proportion of men and women older than 65 years with hip fractures was 1.00:1.95. Between 2013 and 2016, the number of hip fractures per 100,000 people age 65+ was 278. China has vast territories; the number of hip fractures per 100,000 people over 65 years old was 202 in Northeast China and 374 in Northwest China. Northwest has higher altitude, lower population density, is less developed with lower urbanization than Northeast China which is low altitude, and highly urbanized. China should no longer be regarded as a low-risk country for hip fracture. By 2050, the total number of hip fractures in people older than 65 years in China is predicted to be 1.3 million. Higher altitude areas had higher hip fracture rates than lower altitude, higher urbanized areas.

Metabolomics analysis of dandelions from different geographical regions in China.

Dandelion (Taraxacum mongolicum Hand.-Mazz.) is a perennial herb with diverse pharmacological effects. The development and utilization of dandelion have attracted much attention. Our aims were to provide a reference basis for the identification of the origin of dandelions and to study the influence of their origin on their quality. Methods High-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry was used to analyze metabolites from dandelions from four different geographical regions in China, namely Gansu, Henan, Shanxi, and Jiangsu. Metabolite analysis was performed using orthogonal partial least-squares discriminant analysis, and to identify potential metabolic pathways, MBRole was used to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Principal component analysis revealed that the chemical components of dandelions sampled from the four regions showed noticeable differences. Twenty-six, six, six, eight, eight, and fifteen differentially produced metabolites were identified upon comparison between Gansu and Jiangsu, Gansu and Shanxi, Gansu and Henan, Henan and Shanxi, Henan and Jiangsu, and Shanxi and Jiangsu, respectively. These differentially produced metabolites were mainly phenolic compounds. Further, KEGG pathway enrichment analysis showed that the main metabolic pathways involved were biosynthesis of phenylpropanoids and flavonoids. The methods reported herein can be used to identify the origin of dandelions; moreover, our results can serve as a reference basis for future studies.