Trends and patterns of human papillomavirus infection among 33.7 million women in mainland China from 2015 to 2025: A nationwide observational study.

Critical windows and joint effects of prenatal heat and relative humidity exposure on stillbirth: A prospective longitudinal cohort study.

Osimertinib after definitive chemoradiotherapy in patients with unresectable stage III EGFR-mutated NSCLC: LAURA China cohort.

Understanding the spatiotemporal distribution of China’s building stock is crucial for effective seismic risk management. Existing studies, however, often overlook significant regional variations in building characteristics. To address this gap, this study introduces a multiscale regional classification method and develops a building stock assessment model that incorporates demolition factors, utilizing 20 years of data from 114 prefecture-level cities. This integrated approach reveals the spatial distribution and dynamic changes of building stock across various scales in Mainland China. The results show that: (1) The proposed regional classifications correlate with geographical, economic, demographic, and administrative factors, enabling the division of 372 prefecture-level cities into four macroregions or nine refined regions, each with distinct building stock profiles. (2) At a macro scale, China’s total building stock expanded steadily from 34.8 billion m2 in 2001 to 83.3 billion m2 in 2020, an average annual growth rate of 7%. The building stock in the eastern and central regions has consistently exceeded that in the western and northeastern areas, with urban construction surpassing rural. (3) From a detailed perspective, while residential buildings comprise a significant proportion of the total stock, analysis of the refined regions indicates different priorities for risk management: Regions I–VI, which experienced extensive construction in earlier periods, require a focus on their aging building stock, whereas for Regions VII–IX, the emphasis should be on rural and residential buildings. These findings offer valuable data support for risk assessors, aiding the development of more precise, rapid, and targeted seismic risk assessment strategies.

Do population changes in the institution of religion contribute to population changes in mental health? To answer this question, we used seven rounds of national trend data from the 2012-2023 Chinese General Social Survey (n = 24,150) to formally test whether population changes in religious involvement were associated with population changes in depressive symptoms among older adults in Mainland China. In terms of changes in religious involvement, we observed secularization or downward trends in (1) any religious belief, (2) affiliation with Buddhism, folk beliefs, Islam, and Christianity, and (3) religious participation. With respect to changes in depressive symptoms, our results suggested downward trends or population improvements from 2015 to 2021. Our most important finding is that trends in religious involvement were unrelated to trends in depressive symptoms. Because religious belief, religious affiliation, and religious participation were mostly unrelated to depressive symptoms in our analyses, adjusting for religious involvement had no substantive impact on trends in depressive symptoms. Although religious involvement and depressive symptoms are changing in the population of older Chinese adults, these fluctuations likely have little to do with each other. Ultimately, our analyses challenge the notion that population-level shifts in religious involvement exert any consistent effect on the depressive symptoms of older adults in Mainland China.

ABSTRACT Purpose While working memory (WM) span (the quantity of working memory storage) is a well-established predictor of reading, the role of WM precision (the quality of working memory representations) has been largely neglected. This study examined the distinct and interactive effects of WM span and precision on Chinese word reading, and how these effects are influenced by phonetic regularity and character frequency. Method A group of 264 Chinese Mandarin-speaking third graders (Mage = 9-year-old, 53.79% male) from Mainland China completed tasks assessing WM span and precision, single- and two-character word reading, nonverbal intelligence, vocabulary, and visual perception. Results For single-character word reading, a three-way interaction between WM span, WM precision, and phonetic regularity showed that WM precision was positively associated with irregular character reading regardless of children’s WM span. However, for regular characters, this positive association was only found in children with low WM span. For two-character words, we found a main effect of WM precision and an interaction effect between WM span and phonetic regularity, whereby WM span was only positively correlated with irregular character reading. Character frequency did not interact with WM span or precision in either word type. Conclusions Our findings suggest a clear dissociation: WM precision is crucial when phonetic irregularity is high, possibly acting as a compensatory mechanism for limited WM span, while WM span supports complex, multi-character irregular word reading. Results highlight the necessity of considering both WM quality and quantity in reading models and refine theoretical accounts such as the lexical constituency model.

Augmentative and alternative communication (AAC) systems support individuals with significant communication challenges. In mainland China, AAC implementation remains limited, particularly within school settings due to a shortage of certified speech-language pathologists (SLPs). This study surveyed AAC-related knowledge, practices, and training needs among special education personnel in Tianjin, China, where educators often serve as de facto AAC providers. A 10-item questionnaire was administered to 383 teaching and non-teaching staff across ten special schools (response rate: 64.6%). The survey explored self-reported AAC competence, populations served, preferred training formats, and reading materials. Respondents reported limited knowledge of AAC, especially in low- and high-tech modalities. Most participants expressed a strong desire for training, favoring mentorship and workshops. Those with experience supporting students with autism, intellectual disabilities, and cerebral palsy showed stronger preferences for evidence-based materials and structured training. Principal component analysis (PCA) revealed a uniformly high interest across training topics, indicating broad foundational needs. Findings highlight the urgent need for accessible, entry-level AAC training tailored to the educational context in China. Results can inform national policy, curriculum development, and cross-sector collaboration to build sustainable AAC capacity.

With China's rapidly aging population, hip fractures have become a leading cause of disability and healthcare burden among older adults. This study examined the incidence and disability burden of hip fractures among adults aged 60 years and above from 1990 to 2023 in mainland China and described sex-specific patterns and changes over time. Data were obtained from the Global Burden of Disease (GBD) 2023 study. We extracted the number of hip fractures, crude incidence rate, and years lived with disability (YLDs) rate for adults aged 60 years and older in mainland China. Age standardization followed the 2020 China census population. Temporal changes were assessed by comparing percent differences between the 1990 and 2023 estimates, with all results reported together with their 95% uncertainty intervals. In 2023, mainland China had an estimated 3.23 million hip fractures among adults aged 60 years and above (2.28 to 4.43 million), including 1.16 million cases among males (0.83 to 1.59 million) and 2.07 million among females (1.45 to 2.85 million). The age-standardized incidence rate reached 1065.47 per 100,000 population (685.35 to 1597.70) in 2023, increasing by 58.3% compared with 1990. The age-standardized rate was higher in females at 1312.98 per 100,000 (833.36 to 1976.11) than in males at 799.29 per 100,000 (517.93 to 1202.45). In contrast, the age-standardized YLD rate showed a modest decline from 1990 to 2023, decreasing from 222.51 (151.48 to 304.89) to 197.35 (135.20 to 277.92). Across causes, falls remained the leading contributor to hip fractures throughout the study period. Hip fractures among older adults in mainland China continued to rise in both number and incidence rate from 1990 to 2023, with women experiencing a consistently higher burden than men. The decrease in age-standardized YLDs suggests some improvement in post-fracture management, although the growing incidence highlights the need for strengthened prevention strategies, particularly fall prevention and osteoporosis management in older adults.

This study aimed to adapt and validate the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC) for infants aged 6-24 months in mainland China (Simplified Chinese version), ensuring its effectiveness in identifying communication delays and neurodevelopmental risks. A cross-sectional validation study was conducted with 296 infants (Mage = 15 months; interquartile range: 11-19 months) recruited from Shanghai Children's Hospital. The CSBS-DP-ITC underwent systematic cross-cultural adaptation (forward translation, synthesis of translations, back-translation, expert committee review, pretesting, and final documentation review). Reliability was assessed using internal consistency (Cronbach's α, McDonald's ω), split-half reliability, and test-retest reliability (Spearman ρ; n = 130). Validity was evaluated using exploratory/confirmatory factor analysis (EFA/CFA), convergent/discriminant validity, and criterion validity against the Gesell Developmental Schedules (GDS)-Chinese version and known-groups validity. The scale demonstrated excellent overall internal consistency (α = .92, ω = .93) and split-half reliability (.91). Test-retest reliability was strong at ≤ 90 days (ρ = .94-.96), but it declined over longer intervals. EFA and CFA confirmed the three-factor structure (social, speech, and symbolic; χ2/df = 2.88, Comparative Fit Index/Tucker-Lewis Index = 0.95, root-mean-square error of approximation = 0.080), although the discriminant validity between the social and symbolic composites was suboptimal (r = .88). Criterion validity with the GDS was moderate for the speech-language domain (κ = .50). Known-groups analysis showed significantly lower CSBS-DP-ITC scores in infants with developmental delay (p < .001). Notable ceiling effects (emotion/eye gaze, communication) and floor effects (words) were observed. The Simplified Chinese CSBS-DP-ITC exhibited robust reliability and acceptable validity for screening early communication skills among mainland Chinese infants. Generalizability may be constrained by urban, highly educated samples, and future studies should include rural populations. https://doi.org/10.23641/asha.32048631.

In traditional Chinese culture, discussing death has always been taboo. The social environment characterized by fear, reluctance, and apprehension toward death significantly impedes the development of palliative care. Therefore, establishing a correct view of life and death and promoting life education are prerequisites for the successful implementation of palliative care. This study aimed to investigate the public acceptance of life education among individuals in China and analyze the explanatory variables. This national cross-sectional study was conducted from June 20 to August 31, 2022, encompassing 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government. A total of 21,875 participants were included. The generalized linear model was used to analyze influencing factors. Gender, major in medicine, place of residence, education level, family health, media use, etc, were analyzed as the potential variables. Acceptance scores were calculated based on a visual analog scale (VAS). Further subgroup analyses were carried out in different age and major subgroups. The median (P25, P75) acceptance score for life education in the survey was 71.00 (50.00-95.00) points. Compared with females, males had lower acceptance (β=-2.39; 95% CI -3.08 to -1.69). Respondents who were majoring in medicine (β=3.13; 95% CI 1.11-5.14), residing in urban areas (β=1.25; 95% CI 0.46-2.04), processing a bachelor's degree or higher (β=4.05; 95% CI 2.97-5.12), or having higher scores on the media use (β=0.49; 95% CI 0.41-0.57) had higher acceptance. Compared with people aged 12-17 years, those aged 25-44 years (β=-6.00; 95% CI -7.34 to -4.66), aged 45-64 years (β=-4.55; 95% CI -5.88 to -3.22), and 65 years or older (β=-2.16; 95% CI -3.78 to -0.55) had lower acceptance. For people majoring in medicine, place of residence, family health, and media use were uniquely relevant factors. Higher scores on the Perceived Social Support Scale (PSSS) and Health Literacy Scale-Short Form (HLS-SF) were also significantly associated with greater acceptance of life education. Gender, place of residence, education level, age, media use, perceived social support, and health literacy were identified as key factors influencing acceptance of life education, providing important evidence to inform targeted policy and educational interventions.

This paper presents a comprehensive comparative study of jury systems from a global perspective. It first examines the institutional evolution, practical characteristics, and existing dilemmas of jury or lay judge systems in common law jurisdictions (the US and the UK) and several civil law or hybrid jurisdictions, including France, Japan, Russia, India, South Korea, and Germany. The analysis reveals a spectrum of models, from the classic jury system (separating fact-finding and law application) to mixed tribunal systems (with judges and citizens sharing powers) and advisory systems. Key cross-jurisdictional challenges identified include the tension between democratic participation and professional expertise, cultural barriers to public acceptance, and the impact of modern technology. The study then investigates the development and current challenges of the People's Assessor system in Mainland China and the ongoing debate over public participation models in the Taiwan region of China. The concluding section synthesizes these global experiences, arguing that a successful public participation system requires clear legal positioning, substantive power for citizens, a scientific selection mechanism, and effective procedures. It suggests that China's reform should further clarify the division of labor between judges and assessors, strengthen assessors' independent authority, and optimize relevant mechanisms, drawing methodological inspiration rather than direct blueprints from foreign practices.

ABSTRACT Investors in Mainland China embrace collectivism and government‐driven socio‐economic development, while their peers in Hong Kong cherish individualistic ethos and democratic governance policies. We test the hypothesis that these conflicts of values and preferences amplify the positive gaps in price and trading volume of dual‐listed A‐ and H stocks in Shanghai and Hong Kong stock exchanges but dampen the associated relative price volatility. Our findings drawn from the stock market integration initiative of Hong Kong and Mainland China in 2014 and the 2018 trade wars between China and the United States offer persuasive support for this novel narrative.

BACKGROUND Adolescent depression is a pressing global public health challenge. Current screening largely depends on self-reported questionnaires, which are vulnerable to response biases and underreporting. Integrating objective behavioral signals with validated scales may bridge this subjective-objective gap and improve detection performance. AIM To develop a novel multimodal protocol integrating video-recorded facial expressions, vocal prosody, and the Chinese Secondary School Students Depression Scale (CSSSDS) to improve the accuracy and robustness of depression detection for adolescents in Mainland China. METHODS A total of 771 adolescents (aged 12-18 years, mean 15.23 ± 1.68) were recruited. Facial expressions, reading-aloud voices, and CSSSDS scale data were collected from all participants. Five machine learning algorithms [extreme gradient boosting (XGBoost), logistic regression, random forest, support vector machine, and artificial neural network] were trained under two conditions: (1) A multimodal protocol that combined facial expressions, vocal prosody, and the CSSSDS; and (2) A bimodal protocol that combined facial expressions and vocal prosody. Performance was evaluated using accuracy, precision, recall, F1 score, area under the receiver operating characteristic curve (AUC-ROC), and area under the precision-recall curve (AUC-PR) with repeated 10-fold cross-validation. RESULTS Statistical analysis confirmed XGBoost as the preferred algorithm in both multimodal and bimodal protocols, showing statistically significant superiority (P &lt; 0.05) across several key metrics (multimodal recall and F1 score; bimodal AUC-ROC, AUC-PR, and F1 score). In stark contrast, the artificial neural network exhibited high volatility and low precision despite achieving perfect recall in both protocols (all P &lt; 0.001). Statistical comparisons further confirmed the superiority of the multimodal XGBoost over its bimodal counterpart, demonstrating higher AUC-ROC (t = 4.52, P &lt; 0.001) and AUC-PR (t = 3.87, P &lt; 0.001), both with large effect sizes (Cohen’s d &gt; 1.0). The multimodal model also demonstrated significantly greater stability in core discriminative metrics (AUC-ROC, AUC-PR, and recall; all P &lt; 0.05). CONCLUSION The XGBoost-driven multimodal model demonstrated superior discriminative power, greater stability, and a balanced precision-recall profile compared with bimodal models and other algorithms. Nevertheless, limitations related to sample size, use of a regionspecific scale, and task-driven data collection mean that further validation in larger, more diverse, and ecologically valid settings is warranted.

Spatiotemporal heterogeneity and multiscale social influencing factors of syphilis in the mainland of China, 2005-2022.

ABSTRACT Productive forces are a critical variable in the social system that profoundly influence the entire structure. Within the social system, the formation and development of new quality productive forces (NQPFs) will inevitably affect the degree of realization of the right to development (RD). This study is based on the concept of NQPFs proposed by the Chinese government, and on the basis of the multidimensional evaluation framework (MEF) index, the Coupled Coordination Degree (CCD) model and the Tapio Decoupling model are utilized to evaluate the interactive relationship between the NQPFs and RD. It can be found that from 2010 to 2022, the index of the NQPFs and the RD in Four Economic Regions of Mainland China (FERMC) and the whole Mainland China showed a continuous growth trend. The CCD of the NQPFs and the RD has been continuously improving, and the trend of virtuous cycle development between the NQPFs and the RD has gradually increased. In Mainland China, the decoupling status between the NQPFs and RD has been in a relatively stable and ideal state for a long time, with the NQPFs exerting a stable positive enabling effect on the RD.

Athletic identity plays a crucial role in athletes' psychological well-being and performance. Although the Athletic Identity Measurement Scale Plus (AIMSP) effectively assesses this construct in Western contexts, its application in diverse cultural settings remains challenging. This study aimed to validate the Chinese version of AIMSP (AIMSP-C) among young basketball players in mainland China. A cross-sectional validation study was conducted with 604 adolescent basketball players (301 males, 303 females; mean age = 15.53 years, SD = 1.42) from secondary schools across Shandong Province, China. Participants completed the 22-item AIMSP-C, which assesses five dimensions of athletic identity using an 11-point Likert scale. The scale underwent rigorous forward-backward translation following standard cross-cultural adaptation procedures. Confirmatory factor analysis (CFA) was performed to examine the structural validity, alongside comprehensive reliability and validity assessments. CFA supported a five-factor structure (Social Identity, Exclusivity, Self-Identity, Negative Affectivity, and Positive Affectivity) after minor modifications, demonstrating acceptable fit indices (CFI = 0.959, TLI = 0.952, SRMR = 0.083, RMSEA = 0.091 [90% CI: 0.086, 0.096]). The AIMSP-C exhibited strong internal consistency (composite reliability: 0.974-0.989), convergent validity (AVE > 0.50), discriminant validity, and test-retest reliability (ICC: 0.936-0.989). These psychometric properties surpassed those of the original AIMSP. The AIMSP-C demonstrates robust psychometric properties for assessing athletic identity among Chinese youth athletes. This validated instrument provides researchers and practitioners with a reliable tool for understanding athletic identity in the Chinese sporting context, facilitating evidence-based approaches to athlete development and psychological support.

Against the backdrop of uneven educational development and structural constraints in rural Mainland China, teacher agency is critical for driving professional growth and instructional improvement. Rural educators face distinct challenges—limited resources, isolated work contexts, and systemic pressures—that shape their capacity to enact change. While scholarship has documented the roles of contextual resources and individual beliefs in shaping teacher agency, less is known about the mediating mechanisms linking job resources and self-efficacy to agency within China’s rural educational landscape. This study examines how perceived job resources (teaching resources, administrative support, colleague support, parental support) and teaching self-efficacy collectively shape rural teachers’ agency, to inform policy and practice for strengthening their professional capacity. Drawing on a quantitative survey of 625 rural teachers, we employ a two-stage analytical approach: first, descriptive statistics, t-tests, ANOVA, and Pearson correlations to map baseline variable relationships; second, Hayes’ PROCESS macro (Model 4) with bootstrapping to test the mediating role of teaching self-efficacy between job resources and teacher agency. Findings reveal the following: (1) Rural teachers report moderate agency (M = 3.53/5), indicating room for growth; (2) All four job resource dimensions significantly and positively predict agency (β = 0.099–0.163); (3) Teaching self-efficacy is a robust predictor of agency (β = 0.785–0.822, p &lt; 0.001) after controlling for resources; (4) Self-efficacy partially mediates the links between each job resource and agency, with indirect effects ranging from 0.269 (teaching resources) to 0.451 (colleague support), highlighting its central role in translating contextual resources into agentic action. We conclude that fostering rural teacher agency requires a holistic approach addressing both external job resources and internal self-efficacy. Policymakers and administrators should prioritize investments in teaching resources, collaborative support structures, and professional development to build educators’ confidence and competence. Limitations include self-report bias, cross-sectional design constraints on causal inference, and limited generalizability. Future research should use longitudinal designs and broader samples to deepen understandings of agency in structurally constrained educational settings.

China's rapid population aging presents profound challenges for equitable institutional elderly care. Traditional spatial accessibility metrics typically neglect affordability constraints, leading to systematic overestimation of effective access for low-income older adults. We developed a national, 1-km resolution accessibility dataset for mainland China using an affordability-constrained Gaussian two-step floating catchment area (AC-Ga2SFCA) method that couples travel-time impedance with price-income affordability weighting. Household payment capacity is represented by a high-resolution per capita disposable income surface downscaled from county statistics, and facility contributions are down-weighted according to fees. Across multiple travel-time catchments, the dataset provides three complementary raster layers-baseline accessibility (spatial reachability), affordability-constrained accessibility (effective access), and the accessibility gap (affordability-driven exclusion)-for both total beds and nursing-care beds, alongside administrative summaries and inequality metrics. Technical validation shows strong performance of the income downscaling model (R2 = 0.889) and near-proportional agreement between OSRM travel times and three commercial routing services. The dataset supports reproducible assessment of spatial equity, identification of service-demand mismatches, and scenario-based planning for long-term care provision.

The implementation of COVID-19 control and prevention measures has significantly influenced the incidence rates of multiple notifiable infectious diseases. We aimed to investigate the epidemiological trends of notifiable infectious diseases in mainland China from 2020 to 2024, a period spanning both stringent interventions and their subsequent relaxation. We systematically analysed surveillance data from the National Center for Disease Control and Prevention (2020-2024). We excluded COVID-19, monkeypox, and neonatal tetanus to ensure methodological consistency and comparability. We classified the diseases into Class A, B, and C notifiable infectious diseases and further grouped them by transmission routes: intestinal, respiratory, sexually transmitted and blood-borne, vector-borne/zoonotic, and others. We focused on incidence rates, mortality rates, seasonal patterns, and trends to inform future prevention and control strategies. Between 2020 and 2024, mainland China recorded 38 notifiable infectious diseases (excluding COVID-19, monkeypox, and neonatal tetanus). The average incidence rate was 734.8945/100 000, showing an upward trend. Class A notifiable infectious diseases were extremely rare, Class B encompassed 25 types and showed a rising trend with minimal seasonal variation, and Class C included 11 types. Class C notifiable infectious diseases incidence remained relatively low from 2020 to 2022, but rose sharply in 2023 after the relaxation of COVID-19 restrictions, maintaining elevated levels in 2024, with pronounced winter/spring peaks observed, especially in 2023-2024. Respiratory infectious diseases (RIDs) exhibited the highest incidence, while blood-borne and sexually transmitted infectious diseases accounted for over 90.35% of the deaths. In mainland China, strict COVID-19 measures between 2020 and 2022 significantly reduced the incidence of RIDs. However, after COVID-19 management was downgraded and restrictions were relaxed in early 2023, these diseases resurged, demonstrating a 'suppression-rebound' effect.

ABSTRACT Despite increasing scholarly attention to Sinophone queer studies, research on mainland China faces critical dilemmas. Due to strict censorship of LGBTQ+ content, scholars often turn to Taiwan and Hong Kong or focus on Republican-era literature. As a result, queer literary discourse on mainland China remains strikingly absent—its narratives seemingly erased, and subjects rendered invisible. How can we navigate this void in the queer literary landscape of the PRC? This paper examines how Cui Zi’en, one of the most prolific openly gay writers in mainland China, navigates this void through his debut novel Peach-Colored Lips 桃色嘴唇 (1997). Drawing on Leo Bersani’s critiques in queer theory, this paper argues that Cui mobilizes “void” not only as an existential condition of queer subjectivity, namely the self-shattering affect of bottomhood sexuality, but also as a narrative strategy that contests historical and ideological frameworks rendering homosexuality invisible.