Shanghai Research Articles

Global, regional and national burden of neuroblastoma and other peripheral nervous system tumors, 1990 to 2021 and predictions to 2035: visualizing epidemiological characteristics based on GBD 2021.

Neuroblastoma (NB) is the most common extracranial malignant solid tumor in children, accounting for >15 % of cancer-related deaths in children. We analyzed the epidemiological statistical indicators of neuroblastoma and other peripheral nervous system tumors patients from 1990 to 2021 in Global Burden of Disease (GBD) 2021 database, aiming to provide valuable insights for public health interventions and clinical practices. Based on the GBD 2021 database, this study analyzed the incidence, mortality, prevalence, and Disability-Adjusted Life-Years (DALYs) of neuroblastoma and other peripheral nervous system tumors from 1990 to 2021, stratified by sociodemographic development index (SDI) and geographic regions. Cross-country inequalities analysis was conducted to quantify the SDI-related inequality of disease burden across countries. In addition, the average annual percentage change (AAPC) and Age-Period-Cohort (APC) model were used to evaluate the trend of disease burden, while the global burden of disease to 2035 was predicted by Bayesian Age-Period-Cohort (BAPC) model. This study reported the disease burden of neuroblastoma and other peripheral nervous system tumors in GBD 2021 database for the first time. Globally, the incidence and mortality of neuroblastoma have increased year by year from 1990 to 2021, especially in regions with low SDI, such as South Asia and sub-Saharan Africa, where the burden of disease has increased significantly. Regions with high SDI, such as North America and Western Europe, have seen a reduction in disease burden due to higher levels of medical care and earlier diagnosis. The age distribution shows that children under 5 years of age are mainly affected, especially in low- and middle-income areas. In addition, the incidence is slightly higher in men than in women. The BAPC model predicts that the global incidence, mortality, and DALYs of neuroblastoma will continue to increase until 2035. Significant regional and population variation in neuroblastoma and other peripheral nervous system tumors worldwide, with a particularly high disease burden in low SDI areas with limited medical resources. This trend highlights the urgent need for global public health interventions and resource allocation, particularly in low-income countries. Future research should focus on improving early diagnosis, risk stratification and target therapy in order to reduce the global burden of disease and improve patients' prognosis. This study was supported by National Natural Science Foundation of China (No. 82293662, No 82172357 and No 81930066), Key project of Shanghai "Science and Technology Innovation Action Plan (22JC1402304) and Research fund of Shanghai Municipal Health Bureau (No. 2019cxjq03).

A Review of The Research on Shanghai City Image Building

City image is the specific perception, overall view and comprehensive evaluation of the internal and external public of a city on the internal comprehensive strength, external appearance and vitality of the region and its future prospects. As an international metropolis, shanghai's city image is related to the development of shanghai. Accordingly, this paper collects relevant data from academic papers, master and doctoral theses, academic writings, media reports and other channels based on database platforms such as china knowledge, web if science, youtube, dangdang website, etc., and finds that the research on shanghai's urban image mainly focuses on the two major fields of shanghai's urban image and shanghai's urban communication, which involves the city's constructed strength and constructed influencing factors. The study found that the research on shanghai's urban image mainly focuses on the two fields of shanghai's urban image and shanghai's urban communication research, which involves the strength of the city's construction and the influence of the construction. Existing research defines shanghai's city image as "global metropolis", "global first-tier city", "prosperous port and financial center of east asia", and shanghai's city culture as "sea culture", "sea culture", "sea culture" and "sea culture". Shanghai city culture is defined as "sea culture", "red culture" and "jiangnan culture".

Teachers' Growth Mindset, Perceived School Climate, and Perceived Parental Autonomy Support Moderate the Relationship Between Students' Growth Mindset and Academic Achievement.

This study investigates the moderating effects of several contextual factors (i.e., teachers' growth mindset, perceived school climate, and perceived parental autonomy support) on the relationship between students' growth mindset and academic achievement. Drawing on Dweck's growth mindset theory and recent research findings that highlight the context sensitivity of the growth mindset, we hypothesize that supportive environments strengthen the positive impact of students' growth mindset on academic outcomes. A sample of 358 middle school students (53.8% female; Mage = 13.38 years, SD = 2.20) from public schools in Shanghai City, mainland China, was assessed via three validated instruments: (1) the Growth Mindset Inventory, which is used to measure students' and teachers' beliefs about intelligence; (2) the Delaware School Climate Survey for Students, which is used to assess students' perceptions of the school climate; and (3) the Perceived Parental Autonomy Support Scale, which is used to evaluate students' perceived parental autonomy support. Academic achievement was measured by district-level final exam scores. The results of hierarchical regression analyses revealed that teachers' growth mindset, perceived school climate support (e.g., teacher-student and student-student relations, fairness of rules, school safety, liking of school), and the perception of positive parental autonomy support (e.g., choice, rationale, acknowledgment) positively moderated the relationship between students' growth mindset and academic achievement. In contrast, the perception of negative parental autonomy factors (e.g., punishment threats, performance pressure, guilt-inducing criticism) negatively moderated this relationship. These results indicate that the relationship between students' growth mindset and academic achievement may vary depending on contextual factors, highlighting the importance of considering both positive and negative influences when designing educational strategies.

Baseline characteristics of patients in the Chinese Bronchiectasis Registry (BE-China): a multicentre prospective cohort study.

Bronchiectasis is a disease with a global impact, but most published data come from high-income countries. We aimed to describe the clinical characteristics of patients with bronchiectasis in China. The Chinese Bronchiectasis Registry (BE-China) is a prospective, observational cohort enrolling patients from 111 hospitals in China. Data on demographics, comorbidities, and aetiological testing results were collected from adult patients with bronchiectasis at baseline and annual follow-up. Patients who met the inclusion criteria (age ≥18 years; received chest high-resolution CT in the past year showing bronchiectasis affecting one or more lung lobes; and clinical history consistent with bronchiectasis, including chronic cough, daily sputum production, and history of exacerbations) were included. Patients with known cystic fibrosis were excluded. To investigate variations according to different economic regions, two groups were compared based on whether per capita disposable income of residents was greater than US$5553. Clinical characteristics were compared with the European (EMBARC) registry and other national registries. Between Jan 10, 2020, and March 31, 2024, 10 324 patients from 97 centres were included in the study. Among 9501 participants with available data, the most common cause of bronchiectasis was post-infective disease (4101 [43·2%] patients), followed by idiopathic (2809 [29·6%] patients). 6676 (70·0%) of 9541 patients with available data had at least one exacerbation in the year before enrolment and 5427 (57·2%) of 9489 patients with available data were hospitalised at least once due to exacerbations. Treatments commonly used in high-income countries, such as inhaled antibiotics and macrolides, were infrequently used in China. Implementation of airway clearance in China was scarce, with only 1177 (12·2%) of 9647 patients having used at least one method of airway clearance. Compared with upper-middle-income regions, patients from lower-middle-income regions were younger (61·0 years [SD 14·0] vs 63·9 years [14·2]) with a higher proportion of pulmonary comorbidities (521 [17·8%] of 2922 patients vs 639 [8·6%] of 7402 with chronic obstructive pulmonary disease and 194 [6·6%] of 2922 patients vs 364 [4·9%] of 7402 patients with asthma), a higher tuberculosis burden (442 [16·0%] of 2768 patients vs 715 [10·6%] of 6733 patients), more severe radiological involvement (1160 [42·4%] of 2736 patients vs 2415 [35·4%] of 6816 patients with cystic bronchiectasis), more exacerbations (median 1·4 [IQR 0-2] in both groups; mean 1·4 [SD 1·6] vs 1·2 [1·4] in the previous year) and hospitalisations (1662 [60·6%] of 2743 patients vs 3765 [55·8%] of 6746 patients hospitalised at least once in the previous year), and poorer quality of life (median 57·4 [IQR 53·5-63·1] vs 58·7 [54·8-64·8] assessed by the Bronchiectasis Health Questionnaire). The clinical characteristics of patients with bronchiectasis in China show differences compared with cohorts in Europe and India. Bronchiectasis is more severe with a higher burden of exacerbations in lower-income regions. The management of patients with bronchiectasis in China urgently needs standardisation and improvement. National Natural Science Foundation of China, Innovation Program of the Shanghai Municipal Education Commission, Program of the Shanghai Municipal Science and Technology Commission, and Program of the Shanghai Shenkang Development Center. For the Chinese translation of the abstract see Supplementary Materials section.

Immune-cell signatures of persistent inflammation, immunosuppression, and catabolism syndrome after sepsis.

Management of persistent inflammation, immunosuppression, and catabolism syndrome (PICS) after sepsis remains challenging for patients in the intensive care unit, experiencing poor quality of life and death. However, immune-cell signatures in patients with PICS after sepsis remain unclear. We determined immune-cell signatures of PICS after sepsis at single-cell resolution. Murine cecal ligation and puncture models of PICS were applied for validation. Immune functions of two enriched monocyte subpopulations, Mono1 and Mono4, were suppressed substantially in patients with sepsis and were partially restored in patients with PICS after sepsis and exhibited immunosuppressive and pro-apoptotic effects on B and CD8T cells. Patients with PICS and sepsis had reduced naive and memory B cells and proliferated plasma cells. Besides, naive and memory B cells in patients with PICS showed an active antigen processing and presentation gene signature compared to those with sepsis. PICS patients with better prognoses exhibited more active memory B cells and IGHA1-plasma cells. CD8TEMRA displayed signs of proliferation and immune dysfunction in the PICS-death group in contrast with the PICS-alive group. Megakaryocytes proliferation was more pronounced in patients with PICS and sepsis than in healthy controls, with notable changes in the anti-inflammatory and immunomodulatory effects observed in patients with PICS and verified in mice models. Our study evaluated PICS after sepsis at the single-cell level, identifying the heterogeneity present within immune-cell subsets, facilitating the prediction of disease progression and the development of effective intervention. This work was supported by the National Natural Science Foundation of China, Shanghai Municipal Health Commission "Yiyuan New Star" Youth Medical Talent Cultivating Program, and Shanghai Clinical Research Center for Anesthesiology.

Leveraging artificial intelligence for predicting spontaneous closure of perimembranous ventricular septal defect in children: a multicentre, retrospective study in China.

Perimembranous ventricular septal defect (PMVSD) is a prevalent congenital heart disease, presenting challenges in predicting spontaneous closure, which is crucial for therapeutic decisions. Existing models mainly rely on structured echocardiographic parameters or restricted data. This study introduces an artificial intelligence (AI)-based model, which uses natural language processing (NLP) and machine learning with the aim of improving spontaneous closure predictability in PMVSD. We did a multicentre, retrospective analysis using data from 29 142 PMVSD patients across six tertiary centres in China from May, 2004, to September, 2022, for training (70%) and validation (30%; dataset 1, 27 269 patients), and from September, 2001, to December, 2009 for testing (dataset 2, 1873 patients). NLP extracted structured data from echocardiography reports and medical records, which were used to develop machine learning models. Models were evaluated for spontaneous closure occurrence and timing by use of area under the receiver operating characteristic curve (AUC), decision curve analysis, and calibration index. Spontaneous closure occurred in 3520 patients (12·1%) at a median of 31 months (IQR 16-56). Eleven NLP-derived predictors, identified via least absolute shrinkage and selection operator, highlighted the importance of defect morphology and patient age. The random survival forest algorithm, selected for its superior concordance indexes, showed excellent predictive performance with validation set AUCs (95% CI) of 0·95 (0·94-0·96) for 1-year and 3-year predictions, and 0·95 (0·95-0·96) for 5-year predictions; testing set AUCs were 0·95 (0·94-0·97) for 1-year predictions, 0·97 (0·96-0·98) for 3-year predictions, and 0·98 (0·97-0·99) for 5-year predictions. The model showed high clinical utility through decision curve analysis, calibration, and risk stratification, maintaining consistent accuracy across centres and subgroups. This AI-based model for predicting spontaneous closure in PMVSD patients represents a substantial advancement, potentially improving patient management, reducing risks of delayed or inappropriate treatment, and enhancing clinical outcomes. National Natural Science Foundation of China, Shanghai Municipal Hospital Clinical Technology Project, Shanghai Municipal Health Commission, and Clinical Research Unit of XinHua Hospital.

Business Environment Optimization Effects on Enterprise Environmental Protection Investment

The business environment is essential for enterprise survival and development. A favorable business environment promotes high-quality enterprise development; however, research on its impact and mechanism regarding corporate environmental protection investment is lacking. This study examined China's Shanghai and Shenzhen A–share listed companies from 2010 to 2020 to explore the relation between the business environment and corporate environmental protection investment. We found that a positive business environment contributes to increased corporate environmental protection investment, alleviating financing constraints and promoting digital transformation as essential mechanisms. Heterogeneity analysis demonstrates that this promotion effect was more pronounced among nonstate-owned enterprises and nonheavy-polluting industry firms. This study augments the literature concerning business environments and firms’ environmental protection investment by elucidating their impact mechanism and providing a reference for government departments in optimizing business environments.

Knowledge, attitude, and practice toward coronary heart disease secondary prevention among coronary heart disease patients in Shanghai, China.

This study aimed to investigate knowledge, attitude, and practice (KAP) toward coronary heart disease (CHD) secondary prevention among CHD patients. This web-based cross-sectional study enrolled patients with CHD who visited the Yangpu District Central Hospital in Shanghai (China) between October 18, 2022, and March 25, 2023. The administered questionnaire assessed demographic information and KAP; factors associated with good practice were identified by multivariate logistic regression. A total of 507 participants were included in the study, with 361 (71.2%) being male. In terms of education, 125 (24.7%) had a junior high school level or below. The mean scores for knowledge, attitudes, and practices were 31.28 ± 7.30 (possible range: 0-42), 54.09 ± 3.33 (possible range: 12-60), and 35.48 ± 3.36 (possible range: 11-55), respectively. For specific knowledge items on CHD, 57.6% of participants correctly identified that women are more susceptible to CHD. Physical labor and emotional excitement as triggers for CHD were correctly recognized by 94.1%. The need for long-term medication and follow-up after a CHD diagnosis had the highest correctness rate at 98.8%. Additionally, 84.6% correctly understood that recurrence of CHD is possible after PCI surgery. Multivariate analysis indicated that smoking and diabetes status were significantly associated with Practice scores. Current smokers reported lower practice levels than never smokers (OR = 2.858, 95% CI: 1.442-5.662, P = 0.003). Participants with diabetes reported higher practice levels than those without diabetes (OR = 4.169, 95% CI: 2.329-7.463, P < 0.001). Patients with CHD in Shanghai, China, demonstrated good knowledge and positive attitudes toward CHD secondary prevention, although there were some gaps in actual practice behaviors. Enhancing targeted educational interventions and support systems in clinical settings may help bridge these gaps and improve adherence to recommended preventive practices.

Prevalence and transmission of pretreatment drug resistance in people living with HIV-1 in Shanghai China, 2017–2021

ABSTRACT The implementation of pretreatment drug-resistance (PDR) surveillance among people living with HIV-1 (PLWH) is a top priority in countries using efavirenz (EFV)/nevirapine (NVP) for first-line ART. In this study, we assessed the prevalence of PDR among PLWH in Shanghai, China during 2017–2021, and to reveal PDR transmission between Shanghai and other regions of China. A total of 5050 PLWH not on ART during 2017–2021 were included. Partial HIV-1 pol sequences were amplified, sequenced, and analysed for drug-resistance mutations (DRMs). Besides, transmission network of PDR variants was inferred using HIV-TRACE. The overall prevalence of PDR was 4.8% (242/5050; 95% CI, 4.2–5.4). Prevalence of NNRTI-associated PDR was 3.9% (95% CI, 3.4–4.5), higher than those of NRTI-associated (0.8%; 95% CI, 0.5–1.1) and PI-associated PDR (0.9%; 95% CI, 0.6–1.2). High prevalence of PDR (especially high-level resistance) to EFV (132/5050, 2.6%) and NVP (137/5050, 2.7%) were found. CRF01_AE (46.0%) was the predominant HIV-1 genotype with any DRMs, followed by CRF55_01B (21.0%), and CRF07_BC (15.1%). Two NRTI-associated (S68G/N/R and T215A/N/S/Y), five NNRTI-associated (V179D/E/T/L, K103N/R/S/T, E138A/G/K, V106M/I/A and Y181C/I) and two PI-associated mutations (M46I/L/V and Q58E) were the most common observed DRMs in PDR patients in Shanghai. The vast majority of S68G occurred in CRF01_AE (45%). M46I/L/V and Q58E showed a relatively high prevalence in CRF01_AE (4.1%) and CRF07_BC (12.6%). Transmission network analyses demonstrated cross-regional transmission links of PDR variants between Shanghai and other regions of China, which was mainly driven by the potential low-level DRM V179D/E. These results provide crucial information for clinical decision making of first-line ART in PLWH with PDR.

Can ICT investment promote green development? new insights from highly polluting listed enterprises in China.

Green development is related to the long-term sustainable development of enterprises, but there is little literature on the impact of information and communication technology (ICT) investment on green development of enterprises. To fill this gap, based on the sample of A-share high-polluting industry enterprises in China's Shanghai and Shenzhen stock markets from 2007 to 2019, this paper uses the dynamic panel threshold model to deeply study the non-linear impact of ICT investment on green development. This paper found that: (1) there is a threshold effect on the impact of ICT investment on green development of enterprises in high-polluting industries, and when ICT investment breaks through the threshold value, it can promote green development. This conclusion remains robust after the estimation of Multi-period DID model and instrumental variable; (2) ICT investment mainly promotes green development of enterprises by improving production efficiency and promoting green technology innovation; (3) ICT investment has a significant impact on green development of enterprises with higher management level, heavy industrial enterprises and non-state-owned enterprises, but has no significant impact on green development of enterprises with lower management level, light industrial enterprises and state-owned enterprises. And digital technology investment has a stronger role in promoting green development than traditional ICT investment. This paper proposes that enterprises in high-pollution industries can increase ICT investment to promote green development.

Yuanyuzhou 元宇宙: yesterday, today, tomorrow. Historical roots, current visions, and future dynamics of real-world integration in the Chinese governmental narrative on the Metaverse

ABSTRACT As one of the most searched buzzwords on the Chinese Internet in 2021, the ‘Metaverse' (yuan yuzhou 元宇宙) has gained significant momentum in the People’s Republic of China (PRC), attracting the attention of entrepreneurs, politicians, and scholars. To contribute to the understanding of this phenomenon, the present paper provides a historical overview of the Metaverse, highlighting, through a de-Westernized lens, the peculiarities of its development within the specific historical and political context of the PRC. For this purpose, it combines a historical approach with qualitative thematic analysis, examining the Chinese official discourse on the Metaverse, mainly through the scrutiny of governmental papers. Specifically, this study tries to answer the question of how the Chinese official narrative on the Metaverse is being constructed and how it is evolving. In doing so, the essay starts by reconstructing the pre-history of the Chinese Metaverse; then, it focuses on the analysis of plans and action schemes implemented both at the central and national levels, especially in the municipality of Shanghai. The analysis demonstrates how the development of the Chinese Metaverse is in line with previous development goals of the government digital agenda and how its implementation is at the crossroads of technological-cultural progress, regulatory control, and ideological challenges.

Research on the Impact of Financing Constraints on Environmental Investment under Carbon Peaking and Carbon Neutrality Policy

Since the 13th Five-Year Plan, China has solemnly put forward the overall goal of "carbon neutrality and carbon peaking". Toward this goal, in order to increase energy conservation and emission reduction, China has released carbon peaking implementation plans and a series of carbon peaking in key areas and industries, and has built a carbon-peak, carbon-neutral "1+N" policy system. Based on that, this paper takes the A-share listed companies in China's Shanghai and Shenzhen stock exchanges from 2009 to 2020 as a research sample and uses the double difference model to explore the "Notice on Carrying out the Pilot Work of Carbon Emissions Trading". Whether the "dual carbon" policy, represented by the establishment of the pilot carbon emission trading market, has a positive impact on the environmental protection investment of enterprises, and the impact on the relationship between financing constraints and environmental protection investment. In this paper, factors such as company size, profitability are added to the model as control variables, and the differences in policy effects are further studied, and the inhibitory effect of the policy on financing constraints on environmental protection investment is obtained. There is a positive moderating effect, and the effect of policies on promoting environmental protection investment in non-state-owned enterprises is more significant than that of state-owned enterprises. Based on the research results, the article gives some suggestions to the government and enterprise.

Combination of spatial transcriptomics analysis and retrospective study reveals liver infection of SARS-COV-2 is associated with clinical outcomes of COVID-19.

Liver involvement is a common complication of coronavirus disease 2019 (COVID-19), especially in hospitalized patients. However, the underlying mechanisms involved are not fully understood. Immunohistochemistry (IHC) staining of SARS-CoV-2 spike (S) and nucleocapsid (N) proteins was conducted on liver tissues from six patients with COVID-19. The 10x Genomics Visium CytAssist Spatial Gene Assay was designed to analyze liver transcriptomics. TCR CDR3 sequences were analyzed in DNA from liver tissues. Liver function indicators were retrospectively studied in 650 hospitalized patients with COVID-19. SARS-CoV-2 proteins were initially detected in the livers of naturally infected golden (Syrian) hamsters, prompting us to investigate the situation in clinical cases. Thus, we collected liver tissues from patients with abnormal liver biochemical values. Viral S and N proteins were detected in the livers of severe and deceased patients but not in those of moderate patients. We further demonstrated that hepatocytes and erythroid cells in hepatic sinusoids are major cells targeted by SARS-CoV-2. Immune cells, especially T cells, were enriched in surviving severe patients, characterized by enhanced CDR3α clonality and novel CDR3β recombination of the T-cell receptor. In contrast, hepatocyte apoptosis was triggered, and the transcription of albumin (ALB) was obviously impaired in the deceased patients. We then performed a retrospective study including patients with COVID-19. Serum aspartate aminotransferase (AST) and ALB levels at baseline significantly differed in the deceased cohort. However, AST regression did not decrease the risk of death. ALB recovery indicated clinical improvement, and declining or low serum ALB concentrations were associated with death. This study provides clinical evidence for liver infection with SARS-CoV-2, insight into the impact of SARS-CoV-2 on the liver, and a potential way to evaluate the risk of death via assessing serum ALB concentration fluctuations in patients with COVID-19. National Key R&D Program of China (2021YFC2300602), National Natural Science Foundation of China (92369110), National Natural Science Foundation of China (U23A20474), Shanghai Municipal Science and Technology Major Project (ZD2021CY001), Shanghai Jinshan District Medical and Health Technology Innovation Fund Project (2023-WS-31).

Does teachers’ self-reported growth mindset ensure growth mindset-oriented feedback practices in the classroom?

This study examined the congruence/incongruence between teachers’ self-reported mindset beliefs and their actual teaching practices within the framework of implicit theories of intelligence. A total of 226 middle school teachers (65.90% female, average age = 31.70 years, SD = 5.03; average education year = 16.23, SD = 1.49; average teaching experience = 6.52 years, SD = 4.17) from Shanghai City, mainland China, completed the growth mindset inventory (GMI) for measuring self-reported growth mindset beliefs and underwent classroom observations, which recorded the frequency of their growth mindset-oriented feedback practices while teaching. Subsequently, the 20 teachers with the most extreme GMI scores (i.e., the 10 teachers with the highest scores and the 10 teachers with the lowest scores from this initial pool) were invited to take part in semi-structured interviews to understand the reasons behind the possible congruence/incongruence. Interesting results were found. First, the results of the spearman correlation and multiple regression analyses suggested incongruence between teachers’ self-reported mindset beliefs and their actual feedback practices in real classroom settings for those with growth and neutral mindsets but congruence for those with fixed mindsets. Second, the results of the semi-structured interviews further illustrated that whether teachers demonstrated congruence/incongruence in their growth mindset beliefs and actual growth mindset-oriented feedback practices in the classroom was influenced by contextual factors such as institutional policies, cultural orientations, community expectations, and the general educational competition environment. These findings contribute to a deeper understanding of the factors influencing the alignment between mindset beliefs and teaching practices, which highlight the need for addressing these discrepancies in teacher development programs.

Do networks of relationships shape translation policies, or vice versa? The case of telephone interpreting services for quarantine hotels during the pandemic in Shanghai

ABSTRACT In this paper, we explore how translators, foreign nationals and other stakeholders interacted in specific instances of COVID-19 communication in Shanghai, and how their (inter)actions were related to the government’s policy concerning translation services. The focus is on the telephone interpreting services that were commissioned by the Shanghai Municipal Foreign Affairs Office (Shanghai FAO) for quarantine hotels. Centrality concepts in a social network analysis (SNA) were used qualitatively to map the network of relationships in which individuals were embedded. Complexity theory was used to capture the irreducible relationships between individuals and emergent structures. The study revealed that pre-existing networks reinforced Shanghai’s policy of providing multilingual translation services for foreign communities during the pandemic. Moreover, new networks of relationships emerged due to interpreter-mediated interactions, which challenged the Shanghai FAO’s codes of conduct. Reflexivity enabled volunteer interpreters and foreign nationals to mediate between structural opportunities and their subjectively defined concerns, thus leading to multi-layered approaches to COVID-19 communication. Possible solutions to the low degree of centrality of official translation services for COVID-19 communication in Shanghai are discussed based on foreign nationals’ experiences.

Higher Academic Performance, Lower Level of Ethical Responsibility? Analysis of Ethical Responsibility Among Top-Notch Students in Shanghai of China

Purpose Education on the ethics of responsibility is paramount. However, in educational practice, students who perform well academically—often referred to as “top-notch students”—frequently exhibit low levels of ethical responsibility. To explore the validity of this claim, we conducted a survey at a junior high school in Shanghai with a reputation for nurturing top-notch students. Design/Approach/Methods Using the Student Ethics of Responsibility Scale, we compared the levels of ethical responsibility exhibited by top-notch and ordinary students and explored their influencing factors. Findings First, results show that top-notch students outperformed ordinary students across all dimensions of ethical responsibility, particularly in terms of responsibility for the future, collective responsibility, and social responsibility. Second, major influencing factors affecting top-notch students’ levels of collective responsibility and social responsibility were their responsibility for others, their individual responsibility, the levels of collective and social responsibility exhibited by their peers, and parents’ expectations for their children's comprehensive quality. Third, the primary factors influencing students’ responsibility for the future were responsibility for others, individual responsibility, self-education expectation, and their peers’ responsibility for the future. Fourth, gender, grade, and parents’ years of education had minimal impact on the ethical responsibility of top-notch students. Originality/Value The findings of this study refute the stereotype that students who perform better academically have a weaker sense of responsibility.

Analysis of the distribution characteristics of allergen sIgE detection in patients with respiratory and skin mucosal diseases in a hospital in Shanghai City from 2022 to 2023

Analyzing the distribution characteristics of allergen sIgE in the serum of patients with respiratory and skin mucosal diseases in Shanghai City, and to provide epidemiological characteristics and diagnostic basis for the prevention and treatment of allergic respiratory and dermo-mucous diseases in Shanghai City. Adopting cross-sectional research, a total of 3 822 patients who received treatment in Tongren Hospital, Shanghai Jiao Tong University School of Medicine from July 2022 to July 2023 due to respiratory diseases or skin and dermo-mucous symptoms were included. Among them, there were 1 456 males and 2 366 females, with an age range of 1-97 years old. The median age (interquartile range) was 33 (27, 44) years old. The sIgE was detected by using immunoblotting. Statistical analysis was conducted using SPSS 22.0 software, and the comparison of count data (rates) between groups was conducted using χ2 test. The results showed that a total of 3 377 (88.4%) cases among 3 822 patients were at least one allergen sIgE positive, and 72.9% (2 788/3 822) of them were multiple allergies sIgE positive. The top five allergen sIgE positive rates were Dermatophagoides pteronyssinus (37.9%, 1 447/3 822), Dermatophagoides farinae (32.1%, 1 225/3 822), milk (31.7%, 1 211/3 822), fungi (28.3%, 1 080/3 822), and Blomia tropicdis (23.8%, 909/3 822), with only milk was a kind of food allergen. The highest positive rates within the respiratory system disease group or dermo-mucous disease group were also these five allergens, without any difference in disease categories. The positive rates of cat dandruff, Humulusscandens, and juniper/birch in the respiratory system disease group were significantly higher than those in the skin and mucous membrane disease group, while the positive rates of shrimp/crab were relatively low (11.3% vs 14.9%, χ2=9.616,P=0.002). Whether in the respiratory system disease group or the dermo-mucous disease group, the positive rates of Dermatophagoides pteronyssinus in male patients were significantly higher than those of females(42.6% vs 35.7%,41.0% vs 34.4%), with statistical significance (χ2=12.515, P<0.001; χ2=5.143, P=0.023), And the three allergens, Dermatophagoides farinae, cat dander, and egg white allergens are also characterized by this feature.In addition, the positive rates of milk(33.8% vs 30.1%, χ2=3.911, P=0.048), shrimp/crab(13.2% vs 10.0%, χ2=6.423, P=0.014) in the respiratory system disease group were higher in males than in females, while in the dermo-mucous disease group, dog dander(20.5% vs 14.6%, χ2=6.726, P=0.010) and peanuts/soybeans(10.5% vs 6.9%, χ2=4.698, P=0.030) showed this phenomenon. In both the respiratory system disease group and the dermo-mucous disease group, there were 6 types of inhaled allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicdis, cat dandruff, dog dander, fungi) and 4 types of food allergens (egg yolks, egg white allergens, milk, shrimp/crab). However, the positivity rate of Aspergillus fumigatus (7.2% vs 9.3% vs 10.5% vs 15.7%, χ2=10.996, P=0.012)in the respiratory disease group and cockroaches(4.2% vs 11.3% vs 9.6% vs 16.4%, χ2=10.237, P=0.017) in the skin and mucosal disease group was the lowest in the underage group. There are seasonal differences in the positivity rates of allergens, with most allergens having significantly higher positivity rates in summer and autumn. In conclusion, the most common allergens sIgE positive in patients with respiratory and dermo-mucous diseases in Shanghai City are Dermatophagoides pteronyssinus, Dermatophagoides farinae, milk, fungi, and Blomia tropicdis. The trend of allergen sIgE prevalence in the two major categories of diseases is basically consistent. Allergen sIgE distribution varies among patient populations of different gender, age or season, and clinical prevention and treatment can be based on the results of serum allergen testing.

Besides traditional organophosphate esters: The ecological risks of emerging organophosphate esters in the Yangtze River basin cannot be ignored.

In addition to traditional organophosphate esters (tOPEs), emerging organophosphate esters (eOPEs) have increasingly been detected in the environment, but their risks remain unclear. This study detected 12 tOPEs and 7 eOPEs in surface water, sediment, and suspended particulate matter (SPM) samples from important aquatic habitats and drinking water sources in Yibin (YB), Yichang (YC), Shanghai (SH), and Poyang Lake (PY) within the Yangtze River basin. The total concentration of OPEs (ΣOPEs) in surface water, sediment, and SPM from these four regions were 22.86-1398ng/L, 2.39-75.96ng/g dw, and 2.73-1588ng/g dw, respectively. All eOPEs were detected in the collected samples, with tetrakis (2-chloroethyl)dichloroisopentyl diphosphate (V6), cresyl diphenyl phosphate (CDPP), resorcinol bis(diphenyl phosphate) (RDP), and bisphenol A bis(diphenyl phosphate) (BDP) being the dominant compounds. Temperature, dissolved oxygen, and electrical conductivity were identified as important factors influencing the occurrence and distribution of OPEs in water. Source identification revealed that OPEs in PY mainly originated from wastewater treatment plant discharges and traffic-related emissions. It is noteworthy that although the average concentration of ΣtOPEs in water (213.02ng/L) was over two orders of magnitude higher than that of ΣeOPEs (0.81ng/L), eOPEs posed medium to high ecological risks to algae, crustacean, and fish, especially BDP and RDP. For instance, at locations where BDP was detected, it caused medium to high ecological risks to aquatic organisms across three trophic levels [risk quotient (RQ): 0.14-7.71]. The non-carcinogenic and carcinogenic risks of OPEs to human health were negligible. This study provides a scientific basis for the precise identification and scientific management of the environmental risks of eOPEs.

Association between plasma-glycosylated hemoglobin A1c/high-density lipoprotein cholesterol ratio and urinary albumin-creatinine ratio in Chinese adults

Objective: To explore the relationship between glycosylated hemoglobin A1c/high-density lipoprotein cholesterol ratio (HbA1c/HDL-C) and urinary albumin-creatinine ratio (UACR) in Chinese adults. Methods: In this cross-sectional study, the clinical data of 43 820 community residents (age>40 years) from the Risk Evaluation of Cancers in Chinese Diabetic Individuals (REACTION study; March-December 2012) across eight centers (Liaoning, Guangdong, Shanghai, Gansu, Guangxi, Henan, Hubei, and Sichuan) in China were collected and analyzed. Participants were divided into three groups based on UACR levels:<10 mg/g, 10-30 mg/g, and >30 mg/g. The HbA1c/HDL-C ratio was divided into four groups according to quartile division of the subjects: 1st quartile (Q1<3.79), 2nd quartile (3.79≤Q2<4.59), 3rd quartile (4.59≤Q3≤5.66), and 4th quartile (Q4>5.66). Multivariate ordinal logistic regression model was used to analyze the relationship between HbA1c/HDL-C and UACR. Receiver operating characteristic (ROC) analysis was used to explore the predictive value of HbA1c/HDL-C to UACR. Results: The 43 820 subjects included 13 452 (30.70%) male and 30 378 (69.30%) female patients, with an average age of (58.00±0.05) years. According to results of one-way analysis of variance analysis, the HbA1c/HDL-C ratio was significantly associated with the risk of increased UACR (F=495.73, P<0.001). After adjusting for clinically relevant confounding variables in logistic regression model, compared with participants with the lowest HbA1c/HDL-C ratio (Q1), women with the highest HbA1c/HDL-C ratio (Q4) had a 1.483-fold (95%CI 1.376-1.598, P<0.001) and men had a 1.161-fold (95%CI 1.019-1.323, P<0.001) increased risk of UACR. The ROC curve analysis showed that the area under the curve of HbA1c/HDL-C for predicting increased UACR was 0.623 (95%CI 0.597-0.606), with a sensitivity of 60.18% and a specificity of 54.91%. The HbA1c/HDL-C ratio showed the highest predictive value of all glycemic and lipidemic parameters. In individuals with well-controlled blood glucose (HbA1c<6.5%) or lipid levels (HDL-C≥1.0 mmol/L), the HbA1c/HDL-C ratio was still independently associated with the risk of increased UACR after adjusting for confounding variables [OR(95%CI) of quartile 4: 1.563 (1.210-2.019, P=0.001) in participants with HbA1c<6.5% and 1.822 (1.687-1.968, P<0.001) in participants with HDL-C≥1.0 mmol/L]. Conclusion: As a novel compound indicator for evaluating glucose homeostasis and dyslipidemia, the HbA1c/HDL-C ratio was independently associated with increased UACR in the general population aged>40 years in China, which was superior to both glycemic and lipid parameters alone.

Coping Strategies Among Adolescents During the COVID-19 Pandemic: A Cross-Cultural Exploration

PurposeTo identify the patterns of stressors associated with the COVID-19 pandemic among adolescents living in different cultural settings and to explore how adolescents cope with such stressors, particularly by type of stressor, site, and gender. MethodsThe study was based on focus group discussion data from 9 urban poor communities in Kinshasa (Democratic Republic of Congo), Blantyre (Malawi), Shanghai (China), Semarang and Denpasar (Indonesia), New Orleans (USA), Ghent (Belgium), São Paulo (Brazil), and Santiago (Chile). Translated transcripts from the focus group discussions were uploaded into ATLAS.ti (Version 9.1) and analyzed using an inductive thematic analytical approach to code and identify themes related to the primary objectives. ResultsAdolescents in Blantyre and Kinshasa reported stressors primarily related to economic constraints and hardships, whereas adolescents in other sites were more likely to report stressors related to school lockdowns. Patterns of coping strategies also loosely aligned with these differences, as adolescents in Blantyre and Kinshasa were also more likely to report using religious coping strategies compared to any other site. Still, the most common coping mechanism mentioned across sites was obtaining social support, with support from friends and family being the most dominant. DiscussionA comprehensive understanding of adolescent stressors and coping mechanisms is valuable for promoting internal resources and positive outcomes for adolescents. Given that adolescents’ stressors and types of coping strategies varied primarily by socioeconomic factors, interventions that aim to bolster positive coping among adolescents need to consider the local context and available resources.