This research examines the contentious issue of euthanasia and physician-assisted suicide in the context of China's unique conditions.Historically,the debate over euthanasia has been influenced by moral philosophy...This research examines the contentious issue of euthanasia and physician-assisted suicide in the context of China's unique conditions.Historically,the debate over euthanasia has been influenced by moral philosophy and ethics,and euthanasia is illegal in China at present.The research explores the difficulty in making euthanasia legalized across five key dimensions:financial,medical,social,legal,and psychological factors.We conclude that while there is a desire among some terminally ill patients for euthanasia,the current situation in China makes it unsuitable for legalization.The profound question of one's right to die remains a significant moral and judicial challenge,indicating the need for continued dialogue and nuanced understanding of this complex issue.展开更多
A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in weste...A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in western China,identifies the three pillars(absorptive capacity,adaptive capacity,and transformative capacity)contribution to resilience,and then establishes the estimated Resilience Capacity Index(RCI)linked with food security and dietary diversity supported by the multiple indicator multiple cause(MIMIC)model.Results show that,despite geographical heterogeneity,the RCI consistently increased from 2015 to 2021.Households with a higher RCI inheriting better capacity to deal with risk and shocks are significantly and positively correlated with increasing food expenditure and diversifying food choices.It can be because resilient households will allocate more money to food expenditure instead of saving for livelihood uncertainty.Thus,policymakers can provide more incentives for rural households to adopt more dynamic and effective risk management strategies.This,in turn,could yield positive spillover effects by preventing human capital loss associated with dietary-related chronic diseases and mortality.展开更多
The aim of this study is to investigate the impacts of the sampling strategy of landslide and non-landslide on the performance of landslide susceptibility assessment(LSA).The study area is the Feiyun catchment in Wenz...The aim of this study is to investigate the impacts of the sampling strategy of landslide and non-landslide on the performance of landslide susceptibility assessment(LSA).The study area is the Feiyun catchment in Wenzhou City,Southeast China.Two types of landslides samples,combined with seven non-landslide sampling strategies,resulted in a total of 14 scenarios.The corresponding landslide susceptibility map(LSM)for each scenario was generated using the random forest model.The receiver operating characteristic(ROC)curve and statistical indicators were calculated and used to assess the impact of the dataset sampling strategy.The results showed that higher accuracies were achieved when using the landslide core as positive samples,combined with non-landslide sampling from the very low zone or buffer zone.The results reveal the influence of landslide and non-landslide sampling strategies on the accuracy of LSA,which provides a reference for subsequent researchers aiming to obtain a more reasonable LSM.展开更多
Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access sig...Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access significantly impacts agricultural production and improves smallholder farmers’income.Beyond these,the Internet can affect other dimensions of social welfare.However,research about the impact of Internet access on dietary quality in rural China remains scarce.This study utilizes multi-period panel data from Fixed Observation Point in rural China from 2009 to 2015 to estimate the impact of Internet access on dietary quality and food consumption of rural households and conducts a causal analysis.Regression models with time and household fixed effects allow robust estimation while reducing potential issues of unobserved heterogeneity.The estimates show that Internet access has significantly increased rural household dietary quality(measured by the Chinese Diet Balance Index).Further research finds that Internet access has increased the consumption of animal products,such as aquatic and dairy products.We also examine the underlying mechanisms.Internet access improves dietary quality and food consumption mainly through increasing household income and food expenditure.These results encourage the promotion of Internet access as a valuable tool for nutritional improvements,especially in rural areas.展开更多
Pinus is an economically and ecologically important genus whose members are dominant components globally in low-latitude mountainous and mid-latitude temperate forests.Pinus species richness is currently concentrated ...Pinus is an economically and ecologically important genus whose members are dominant components globally in low-latitude mountainous and mid-latitude temperate forests.Pinus species richness is currently concentrated in subtropical mid-low latitudes of the Northern Hemisphere,differing from the latitudinal diversity gradient mostly recognized in woody angiosperms.How the present pattern was developing in Earth's past is still poorly studied,particularly in eastern Asia.Here,a new fossil species,Pinus shengxianica sp.nov.is described based on a fossil seed cone from the Late Miocene Shengxian Formation in Zhejiang,southeast China.A co-occurring cone is recognized as a known fossil species,Pinus speciosa Li.Extensive comparison of extant and fossil members of Pinus suggests P.shengxianica shares a striking cone similarity to Pinus merkusii and Pinus latteri(subsection Pinus)from tropical Southeast Asia in having annular bulges around the umbo on the apophysis.The morphological resemblance indicates these two extant low-latitude pines probably possess a close affinity with the present newly-discovered P.shengxianica and originated from East Asian mid-low latitude ancestors during this generic re-diversification in the Miocene.This scenario is consistent with the evolutionary trajectory reflected by the pine fossil history and molecular data,marking the Miocene as a key period for the origin and evolution of most extant pines globally.The co-occurrences of diverse conifers and broadleaved angiosperms preferring diverse niches demonstrate Late Miocene eastern Zhejiang was one of the hot spots for coniferophyte diversity and hosted a needled-broadleaved mixed forest with complex vegetation structure and an altitudinal zonation.展开更多
Composite analyses were performed in this study to reveal the difference in spring precipitation over southern China during multiyear La Ni?a events during 1901 to 2015. It was found that there is significantly below-...Composite analyses were performed in this study to reveal the difference in spring precipitation over southern China during multiyear La Ni?a events during 1901 to 2015. It was found that there is significantly below-normal precipitation during the first boreal spring, but above-normal precipitation during the second year. The difference in spring precipitation over southern China is correlative to the variation in western North Pacific anomalous cyclone(WNPC), which can in turn be attributed to the different sea surface temperature anomaly(SSTA) over the Tropical Pacific. The remote forcing of negative SSTA in the equatorial central and eastern Pacific and the local air-sea interaction in the western North Pacific are the usual causes of WNPC formation and maintenance.SSTA in the first spring is stronger than those in the second spring. As a result, the intensity of WNPC in the first year is stronger, which is more likely to reduce the moisture in southern China by changing the moisture transport, leading to prolonged precipitation deficits over southern China. However, the tropical SSTA signals in the second year are too weak to induce the formation and maintenance of WNPC and the below-normal precipitation over southern China. Thus, the variation in tropical SSTA signals between two consecutive springs during multiyear La Ni?a events leads to obvious differences in the spatial pattern of precipitation anomaly in southern China by causing the different WNPC response.展开更多
Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic ...Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.展开更多
Central Asia consists of the former Soviet Republics,Kazakhstan,Kyrgyz Republic,Tajikistan,Turkmenistan,and Uzbekistan.The region’s climate is continental,mostly semi-arid to arid.Agriculture is a significant part of...Central Asia consists of the former Soviet Republics,Kazakhstan,Kyrgyz Republic,Tajikistan,Turkmenistan,and Uzbekistan.The region’s climate is continental,mostly semi-arid to arid.Agriculture is a significant part of the region’s economy.By its nature of intensive water use,agriculture is extremely vulnerable to climate change.Population growth and irrigation development have significantly increased the demand for water in the region.Major climate change issues include melting glaciers and a shrinking snowpack,which are the foundation of the region’s water resources,and a changing precipitation regime.Most glaciers are located in Kyrgyzstan and Tajikistan,leading to transboundary water resource issues.Summer already has extremely high temperatures.Analyses indicate that Central Asia has been warming and precipitation might be increasing.The warming is expected to increase,but its spatial and temporal distribution depends upon specific global scenarios.Projections of future precipitation show significant uncertainties in type,amount,and distribution.Regional Hydroclimate Projects(RHPs)are an approach to studying these issues.Initial steps to develop an RHP began in 2021 with a widely distributed online survey about these climate issues.It was followed up with an online workshop and then,in 2023,an in-person workshop,held in Tashkent,Uzbekistan.Priorities for the Global Energy and Water Exchanges(GEWEX)project for the region include both observations and modeling,as well as development of better and additional precipitation observations,all of which are topics for the next workshop.A well-designed RHP should lead to reductions in critical climate uncertainties in policy-relevant timeframes that can influence decisions on necessary investments in climate adaptation.展开更多
Eremurus was described at the beginning of the 19th century.However,due to limited sampling and the small number of gene markers to date,its phylogeny and evolution are largely unknown.In this study,we analyzed plasto...Eremurus was described at the beginning of the 19th century.However,due to limited sampling and the small number of gene markers to date,its phylogeny and evolution are largely unknown.In this study,we analyzed plastomes from 27 species belonging to 2 subgenera and 3 sections of Eremurus,which are found in Central Asia(its center of diversity)and China.We also analyzed nuclear DNA ITS of 33 species,encompassing all subgenera and sections of the genus in Central Asia,southwest Asia and China.Our findings revealed that the genus was monophyletic,although both subgenera Eremurus and Henningia were found to be paraphyletic.Both plastome and nrDNA-based phylogenetic trees had three clades that did not reflect the current taxonomy of the genus.Our biogeographical and time-calibrated trees suggest that Eremurus originated in the ancient Tethyan area in the second half of the Eocene.Diversification of Eremurus occurred from the early Oligocene to the late Miocene.Paratethys Sea retreat and several orogenetic events,such as the progressive uplift of the Qinghai-Tibet Plateau and surrounding mountain belts(Altai,Pamir,Tian Shan),caused serious topographic and climate(aridification)changes in Central Asia that may have triggered a split of clades and speciation.In this transformed Central Asia,speciation proceeded rapidly driven mainly by vicariance caused by numerous mountain chains and specialization to a variety of climatic,topographic and soil conditions that exist in this region.展开更多
The deep structure,material circulation,and dynamic processes in the Southeast Asia have long been an elusive scientific puzzle due to the lack of systematic scientific observations and recognized theoretical models.B...The deep structure,material circulation,and dynamic processes in the Southeast Asia have long been an elusive scientific puzzle due to the lack of systematic scientific observations and recognized theoretical models.Based on the deep seismic tomography using long-period natural earthquake data,in this study,the deep structure and material circulation of the curved subduction system in Southeast Asia was studied,and the dynamic processes since 100 million years ago was reconstructed.It is pointed out that challenges still exist in the precise reconstruction of deep mantle structures of the study area,the influence of multi-stage subduction on deep material exchange and shallow magma activity,as well as the spatiotemporal evolution and coupling mechanism of multi-plate convergence.Future work should focus on high-resolution land-sea joint 3-D seismic tomography imaging of the curved subduction system in the Southeast Asia,combined with geochemical analysis and geodynamic modelling works.展开更多
Drought events have become more frequent and intense over East Asia in recent decades,leading to huge socioeconomic impacts.Although the droughts have been studied extensively by cases or for individual regions,their ...Drought events have become more frequent and intense over East Asia in recent decades,leading to huge socioeconomic impacts.Although the droughts have been studied extensively by cases or for individual regions,their leading variability and associated causes remain unclear.Based on the Standardized Precipitation Evapotranspiration Index(SPEI)and ERA5 reanalysis product from 1979 to 2020,this study evealuates the severity of spring droughts in East Asia and investigates their variations and associated drivers.The results indicate that North China and Mongolia have experienced remarkable trends toward dryness during spring in recent decades,while southwestern China has witnessed an opposite trend toward wetness.The first Empirical Orthogonal Function mode of SPEI variability reveals a similar seesawing pattern,with more severe dryness in northwestern China,Mongolia,North China,South Korea,and Japan but increased wetness in Southwestern China and southeast Asia.Further investigation reveals that the anomalously dry(wet)surface in North(Southwestern)China is significantly associated with anomalously high(low)temperature,less(more)precipitation,and reduced(increased)soil moisture during the previous winter and early spring,regulated by an anomalous anticyclone(cyclone)and thus reduced(increased)water vapor convergence.The spring dry-wet pattern in East Asia is also linked to cold sea surface temperature anomalies in the central-eastern Pacific.The findings of this study have important implications for improving the prediction of spring drought events in East Asia.展开更多
This study investigates the evolution of an extreme anomalous anticyclone(AA)event over Northeast Asia,which was one of the dominant circulation systems responsible for the catastrophic extreme precipitation event in ...This study investigates the evolution of an extreme anomalous anticyclone(AA)event over Northeast Asia,which was one of the dominant circulation systems responsible for the catastrophic extreme precipitation event in July 2021 in Henan,and further explores the significant impact of this AA on surface temperatures beneath it.The results indicate that this AA event over Northeast Asia was unprecedented in terms of intensity and duration.The AA was very persistent and extremely strong for 10 consecutive days from 13 to 22 July 2021.This long-lived and unprecedented AA led to the persistence of warmer surface temperatures beyond the temporal span of the pronounced 500-hPa anticyclonic signature as the surface air temperatures over land in Northeast Asia remained extremely warm through 29 July 2021.Moreover,the sea surface temperatures in the Sea of Japan/East Sea were extremely high for 30 consecutive days from 13 July to 11 August 2021,persisting well after the weakening or departure of this AA.These results emphasize the extreme nature of this AA over Northeast Asia in July 2021 and its role in multiple extreme climate events,even over remote regions.Furthermore,possible reasons for this long-lasting AA are explored,and it is suggested to be a byproduct of a teleconnection pattern over extratropical Eurasia during the first half of its life cycle,and of the Pacific-Japan teleconnection pattern during the latter half.展开更多
Soaring bird migration often relies on suitable terrain and airflow;therefore,route selection is vital for successful migration.While age and experience have been identified as key factor influencing migration route s...Soaring bird migration often relies on suitable terrain and airflow;therefore,route selection is vital for successful migration.While age and experience have been identified as key factor influencing migration route selection among soaring raptors in the African-Eurasian Flyway,how they shape the migration route of soaring raptors in East Asia is still largely unknown.In this study,we investigated potential variations in the routes and timing in autumn migration of juvenile and older soaring birds,using count data of Greater Spotted Eagles(Clanga clanga)from two coastal sites and two inland sites in China.From 2020 to 2023,we recorded a total of 340 individuals,with the highest site averaging over 90 individuals per autumn,making it one of the world’s top single-season counts and thus a globally important site for this species.We found that 82% and 61% records from coastal sites were juveniles,significantly higher than inland sites(15% and 24%).Juveniles at all four sites exhibited markedly earlier median passage time than non-juveniles,with brief overlapping in their main migration periods.Both coastal sites are located on the tip of peninsulas stretching southwest,requiring long overwater flights if crossing the Bohai Bay or Beibu Gulf,which would be energetically demanding and increase mortality risk.Experienced individuals may have learned to avoid such terrain and subsequent detour,while juveniles are more prone to enter these peninsulas due to lack of experience and opportunities for social learning,or following other raptor species that are more capable of powered flight.Our findings highlight the importance of age and experience in migration route selection of large soaring birds.展开更多
High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to ana...High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to analyze it in a 3D environment and understand its intricate role as the Water Tower of Asia.The science teams of NASA realized an 8-m DEM using satellite stereo imagery for HMA,termed HMA 8-m DEM.In this research,we assessed the vertical accuracy of HMA 8-m DEM using reference elevations from ICESat-2 geolocated photons at three test sites of varied topography and land covers.Inferences were made from statistical quantifiers and elevation profiles.For the world’s highest mountain,Mount Everest,and its surroundings,Root Mean Squared Error(RMSE)and Mean Absolute Error(MAE)resulted in 1.94 m and 1.66 m,respectively;however,a uniform positive bias observed in the elevation profiles indicates the seasonal snow cover change will dent the accurate estimation of the elevation in this sort of test sites.The second test site containing gentle slopes with forest patches has exhibited the Digital Surface Model(DSM)features with RMSE and MAE of 0.58 m and 0.52 m,respectively.The third test site,situated in the Zanda County of the Qinghai-Tibet,is a relatively flat terrain bed,mostly bare earth with sudden river cuts,and has minimal errors with RMSE and MAE of 0.32 m and 0.29 m,respectively,and with a negligible bias.Additionally,in one more test site,the feasibility of detecting the glacial lakes was tested,which resulted in exhibiting a flat surface over the surface of the lakes,indicating the potential of HMA 8-m DEM for deriving the hydrological parameters.The results accrued in this investigation confirm that the HMA 8-m DEM has the best vertical accuracy and should be of high use for analyzing natural hazards and monitoring glacier surfaces.展开更多
Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-...Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-risk Population Screening and Intervention Program,an estimated 17.8 million[95%confidence interval(CI)17.6–18.0million]adults in China had experienced a stroke in 2020,with 3.4 million(95%CI 3.3–3.5 million)experiencing their first-ever stroke and another 2.3 million(95%CI 2.2–2.4 million)dying as a result.Additionally,approximately 12.5%(95%CI 12.4%–12.5%)of stroke survivors were left disabled,as defined by a modified Rankin Scale score greater than 1,equating to 2.2 million(95%CI 2.1–2.2 million)stroke-related disabilities in 2020.As the population ages and the prevalence of risk factors like diabetes,hypertension,and hyperlipidemia continues to rise and remains poorly controlled,the burden of stroke in China is also increasing.A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%;the awareness,treatment,and control rates in hypertensive patients were:60.1%,42.5%,and 25.4%,respectively.A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%,suggesting there are 120 million adults with diabetes in China,and the awareness,treatment,and control rates in diabetic patients were:43.3%,49.0%,and 49.4%,respectively.The“Sixth National Health Service Statistical Survey Report in 2018”showed that the proportion of the obese population in China was 37.4%,an increase of 7.2 points from 2013.Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China(BOSC)showed that a total of 3,418,432 stroke cases[mean age±standard error(SE)was(65.700±0.006)years,and 59.1%were male]were admitted during 2020.Of those,over 80.0%(81.9%)were ischemic stroke(IS),14.9%were intracerebral hemorrhage(ICH)strokes,and 3.1%were subarachnoid hemorrhage(SAH)strokes.The mean±SE of hospitalization expenditures was Chinese Yuan(CNY)(16,975.6±16.3),ranging from(13,310.1±12.8)in IS to(81,369.8±260.7)in SAH,and out-of-pocket expenses were(5788.9±8.6),ranging from(4449.0±6.6)in IS to(30,778.2±156.8)in SAH.It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion,of which the patient pays approximately CNY 19.8 billion.In-hospital death/discharge against medical advice rate was 9.2%(95%CI 9.2%–9.2%),ranging from 6.4%(95%CI 6.4%–6.5%)for IS to 21.8%(95%CI 21.8%–21.9%)for ICH.From 2019 to 2020,the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy(IVT),49,845 patients receiving mechanical thrombectomy(MT),and 14,087 patients receiving bridging(IVT+MT)were collected through BOSC.The incidence of intracranial hemorrhage during treatment was 3.2%(95%CI 3.2%–3.3%),7.7%(95%CI 7.5%–8.0%),and 12.9%(95%CI 12.3%–13.4%),respectively.And in-hospital death/discharge against medical advice rate was 8.9%(95%CI 8.8%–9.0%),16.5%(95%CI 16.2%–16.9%),and 16.8%(95%CI 16.2%–17.4%),respectively.A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals(Level III)from 31 provinces in China through BOSC from January 2019to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up.Of those,over 86.9%were IS,10.8%were ICH strokes,and 2.3%were SAH strokes.The disability rate[%(95%CI)]in survivors of stroke at 3-month and 12-month was 14.8%(95%CI 14.6%–15.0%)and 14.0%(95%CI 13.8%–14.2%),respectively.The mortality rate[%(95%CI)]of stroke at 3-month and 12-month was 4.2%(95%CI 4.1%–4.3%)and 8.5%(95%CI 8.4%–8.6%),respectively.The recurrence rate[%(95%CI)]of stroke at 3-month and 12-month was 3.6%(95%CI 3.5%–3.7%)and 5.6%(95%CI 5.4%–5.7%),respectively.The Healthy China 2030 Stroke Action Plan was launched as part of this review,and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China.展开更多
Objective: IMpower210(NCT02813785) explored the efficacy and safety of single-agent atezolizumab vs.docetaxel as second-line treatment for advanced non-small cell lung cancer(NSCLC) in East Asian patients.Methods: Key...Objective: IMpower210(NCT02813785) explored the efficacy and safety of single-agent atezolizumab vs.docetaxel as second-line treatment for advanced non-small cell lung cancer(NSCLC) in East Asian patients.Methods: Key eligibility criteria for this phase Ⅲ, open-label, randomized study included age ≥18 years;histologically documented advanced NSCLC per the Union for International Cancer Control/American Joint Committee on Cancer staging system(7th edition);Eastern Cooperative Oncology Group performance status of 0 or 1;and disease progression following platinum-based chemotherapy for advanced or metastatic NSCLC. Patients were randomized 2:1 to receive either atezolizumab(1,200 mg) or docetaxel(75 mg/m^(2)). The primary study endpoint was overall survival(OS) in the intention-to-treat(ITT) population with wild-type epidermal growth factor receptor expression(ITT EGFR-WT) and in the overall ITT population.Results: Median OS in the ITT EGFR-WT population(n=467) was 12.3 [95% confidence interval(95% CI),10.3-13.8] months in the atezolizumab arm(n=312) and 9.9(95% CI, 7.8-13.9) months in the docetaxel arm[n=155;stratified hazard ratio(HR), 0.82;95% CI, 0.66-1.03]. Median OS in the overall ITT population was 12.5(95% CI, 10.8-13.8) months with atezolizumab treatment and 11.1(95% CI, 8.4-14.2) months(n=377) with docetaxel treatment(n=188;stratified HR, 0.87;95% CI, 0.71-1.08). Grade 3/4 treatment-related adverse events(TRAEs) occurred in 18.4% of patients in the atezolizumab arm and 50.0% of patients in the docetaxel arm.Conclusions: IMpower210 did not meet its primary efficacy endpoint of OS in the ITT EGFR-WT or overall ITT populations. Atezolizumab was comparatively more tolerable than docetaxel, with a lower incidence of grade3/4 TRAEs.展开更多
The magma sources,origins and precise forming ages of the miarolite from Qishan and Kuiqi intrusions are still uncertain.New results reveal that,miarolites from the Qishan and Kuiqi intrusions yield crystallization ag...The magma sources,origins and precise forming ages of the miarolite from Qishan and Kuiqi intrusions are still uncertain.New results reveal that,miarolites from the Qishan and Kuiqi intrusions yield crystallization ages of~101 and~98 Ma,and they have a high formation temperature(~910℃)and low oxygen fugacity value,indicating crystallization condition at low pressure in the upper crust with temperature of 678℃.The Qishan and Kuiqi miarolites are characterized by enrichment in SiO_(2) and high-K alkali,depletion in Ca and Mg,and belong to the high-K weak peraluminous rock series.The samples are enriched in HFSEs(i.e.,Ta,Zr and Hf)and LILEs(i.e.,Ba,P and Sr),depleted in Ba and Sr with the negative anomaly of Eu.In the primitive mantle normalized trace element spider diagram,the samples show a right-inclined‘seagull-type’pattern,combined the ratios of(La/Yb)_(N),10000×Al/Ga,Rb/Nb and Nb/Ta etc.,they were proved to be alkaline A-type granite.Combined the characterize of the trace elements,they were derived from clay-rich source accompanied pelite melting,and subjected to K-feldspar crystallization fractional.The values of ε_(Hf)(t)and tDM2 are distributed in the range of-2.8 to 3.3 with~1.2 Ga,and-6.0 to 4.0 with~1.2 Ga,revealing that they were generated from the Mesoproterozoic Cathaysia basement rocks.The comprehensive research reveals the Kuiqi and Qishan intrusions derived from crust-mantle mixing and partial melting of the crust,respectively,resulting from lithospheric extension generated by the Paleo-Pacific Plate subducted into the European-Asian Plate.展开更多
In recent decades,the spatio-temporal patterns of China’s croplands have been reshaped by disturbances from anthropogenic activities,with complex changes in the topographic characteristics of croplands.Slope-climbing...In recent decades,the spatio-temporal patterns of China’s croplands have been reshaped by disturbances from anthropogenic activities,with complex changes in the topographic characteristics of croplands.Slope-climbing of croplands(SCCL)is an important issue that threatens sustainable agricultural development.While providing land with prominent location advantages,SCCL weakens the water and fertilizer retention capacity for cropland,intensifies various geological disasters,and adversely affects the ecological environment and food yield of these croplands.It is crucial to determine the spatio-temporal variation features and effects of SCCL in China to formulate more accurate cropland protection policies and to maintain food security;however,the current lack of relevant studies is detrimental for capturing trends in cropland resources and sustainable cropland use.In this study,we constructed a multi-scale slope spectrum for cropland and total terrain to explore the spatial differences and trends of SCCL from a three-dimensional view.We evaluated the natural and socioeconomic effects of SCCL in China from multiple perspectives.Results indicate that the proportion of cropland with slopes below 2°,5°,and 6°in China decreased by 0.43%,0.47%,and 0.50%from 1980 to 2020,respectively.SCCL became apparent during 1980-1990 and 2010-2020,especially over the recent decade.The cropland climbing index(CCI)and upper limited slope change(ULSC)to measure the spatio-temporal pattern of SCCL were 0.99%and 1.17°,respectively,during 2010-2020.At the agricultural regional scale,the SCCL was also concentrated in 1980-1990 and 2010-2020,and it is more pronounced in the southern areas.The proportion of provinces and prefecture-level cities with high-intensity SCCL during 1980-2020 were 87.10%and 49.73%,respectively.SCCL was comparatively more pronounced and broader from 2010 to 2020.During this period,17.84%of prefecture-level cities had no SCCL,and the average CCI for all prefecture-level cities peaked at 1.62%.In this study,we also evaluated the pros and cons of SCCL and provided targeted suggestions for decision makers and farmers to refine cropland protection policy systems and further develop the sustainable use of croplands.展开更多
文摘This research examines the contentious issue of euthanasia and physician-assisted suicide in the context of China's unique conditions.Historically,the debate over euthanasia has been influenced by moral philosophy and ethics,and euthanasia is illegal in China at present.The research explores the difficulty in making euthanasia legalized across five key dimensions:financial,medical,social,legal,and psychological factors.We conclude that while there is a desire among some terminally ill patients for euthanasia,the current situation in China makes it unsuitable for legalization.The profound question of one's right to die remains a significant moral and judicial challenge,indicating the need for continued dialogue and nuanced understanding of this complex issue.
基金This paper was supported by the National Natural Science Foundation of China(NSFC)(71973138 and 72061137002)the Ministry of Science and Technology of China(2023YFE0105009).
文摘A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in western China,identifies the three pillars(absorptive capacity,adaptive capacity,and transformative capacity)contribution to resilience,and then establishes the estimated Resilience Capacity Index(RCI)linked with food security and dietary diversity supported by the multiple indicator multiple cause(MIMIC)model.Results show that,despite geographical heterogeneity,the RCI consistently increased from 2015 to 2021.Households with a higher RCI inheriting better capacity to deal with risk and shocks are significantly and positively correlated with increasing food expenditure and diversifying food choices.It can be because resilient households will allocate more money to food expenditure instead of saving for livelihood uncertainty.Thus,policymakers can provide more incentives for rural households to adopt more dynamic and effective risk management strategies.This,in turn,could yield positive spillover effects by preventing human capital loss associated with dietary-related chronic diseases and mortality.
文摘The aim of this study is to investigate the impacts of the sampling strategy of landslide and non-landslide on the performance of landslide susceptibility assessment(LSA).The study area is the Feiyun catchment in Wenzhou City,Southeast China.Two types of landslides samples,combined with seven non-landslide sampling strategies,resulted in a total of 14 scenarios.The corresponding landslide susceptibility map(LSM)for each scenario was generated using the random forest model.The receiver operating characteristic(ROC)curve and statistical indicators were calculated and used to assess the impact of the dataset sampling strategy.The results showed that higher accuracies were achieved when using the landslide core as positive samples,combined with non-landslide sampling from the very low zone or buffer zone.The results reveal the influence of landslide and non-landslide sampling strategies on the accuracy of LSA,which provides a reference for subsequent researchers aiming to obtain a more reasonable LSM.
基金This study was supported in part by the National Natural Science Foundation of China(71973136 and 72061147002)the 2115 Talent Development Program of China Agricultural University.
文摘Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access significantly impacts agricultural production and improves smallholder farmers’income.Beyond these,the Internet can affect other dimensions of social welfare.However,research about the impact of Internet access on dietary quality in rural China remains scarce.This study utilizes multi-period panel data from Fixed Observation Point in rural China from 2009 to 2015 to estimate the impact of Internet access on dietary quality and food consumption of rural households and conducts a causal analysis.Regression models with time and household fixed effects allow robust estimation while reducing potential issues of unobserved heterogeneity.The estimates show that Internet access has significantly increased rural household dietary quality(measured by the Chinese Diet Balance Index).Further research finds that Internet access has increased the consumption of animal products,such as aquatic and dairy products.We also examine the underlying mechanisms.Internet access improves dietary quality and food consumption mainly through increasing household income and food expenditure.These results encourage the promotion of Internet access as a valuable tool for nutritional improvements,especially in rural areas.
基金This work was funded in part by the National Natural Science Foundation of China(No.41872017)the Foundation of State Key Laboratory of Palaeobiology and Stratigraphy(Nanjing Institute of Geology and Palaeontology,CAS)(Nos.193113 and 183125)+1 种基金the Fundamental Research Funds for the Central Universities,CHD(Nos.300102272206,300102271402 and 300102271403)the Undergraduate Innovation and Entrepreneurship Project(No.S202210710194).
文摘Pinus is an economically and ecologically important genus whose members are dominant components globally in low-latitude mountainous and mid-latitude temperate forests.Pinus species richness is currently concentrated in subtropical mid-low latitudes of the Northern Hemisphere,differing from the latitudinal diversity gradient mostly recognized in woody angiosperms.How the present pattern was developing in Earth's past is still poorly studied,particularly in eastern Asia.Here,a new fossil species,Pinus shengxianica sp.nov.is described based on a fossil seed cone from the Late Miocene Shengxian Formation in Zhejiang,southeast China.A co-occurring cone is recognized as a known fossil species,Pinus speciosa Li.Extensive comparison of extant and fossil members of Pinus suggests P.shengxianica shares a striking cone similarity to Pinus merkusii and Pinus latteri(subsection Pinus)from tropical Southeast Asia in having annular bulges around the umbo on the apophysis.The morphological resemblance indicates these two extant low-latitude pines probably possess a close affinity with the present newly-discovered P.shengxianica and originated from East Asian mid-low latitude ancestors during this generic re-diversification in the Miocene.This scenario is consistent with the evolutionary trajectory reflected by the pine fossil history and molecular data,marking the Miocene as a key period for the origin and evolution of most extant pines globally.The co-occurrences of diverse conifers and broadleaved angiosperms preferring diverse niches demonstrate Late Miocene eastern Zhejiang was one of the hot spots for coniferophyte diversity and hosted a needled-broadleaved mixed forest with complex vegetation structure and an altitudinal zonation.
基金The National Natural Science Foundation of China under contract Nos 41576029, 41976221 and 42030410the National Key Research and Development Program of China under contract No. 2019YFA0606702the Startup Foundation for Introducing Talent of Nanjing University of Information Science and Technology。
文摘Composite analyses were performed in this study to reveal the difference in spring precipitation over southern China during multiyear La Ni?a events during 1901 to 2015. It was found that there is significantly below-normal precipitation during the first boreal spring, but above-normal precipitation during the second year. The difference in spring precipitation over southern China is correlative to the variation in western North Pacific anomalous cyclone(WNPC), which can in turn be attributed to the different sea surface temperature anomaly(SSTA) over the Tropical Pacific. The remote forcing of negative SSTA in the equatorial central and eastern Pacific and the local air-sea interaction in the western North Pacific are the usual causes of WNPC formation and maintenance.SSTA in the first spring is stronger than those in the second spring. As a result, the intensity of WNPC in the first year is stronger, which is more likely to reduce the moisture in southern China by changing the moisture transport, leading to prolonged precipitation deficits over southern China. However, the tropical SSTA signals in the second year are too weak to induce the formation and maintenance of WNPC and the below-normal precipitation over southern China. Thus, the variation in tropical SSTA signals between two consecutive springs during multiyear La Ni?a events leads to obvious differences in the spatial pattern of precipitation anomaly in southern China by causing the different WNPC response.
基金supported by the National Key Research and Development Project,No.2019YFA0112100(to SF).
文摘Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.
基金The National Research University Tashkent Institute of Irrigation and Agricultural Mechanization Engineers of Uzbekistan hosted and provided financial support for the in-person workshop in May of 2023
文摘Central Asia consists of the former Soviet Republics,Kazakhstan,Kyrgyz Republic,Tajikistan,Turkmenistan,and Uzbekistan.The region’s climate is continental,mostly semi-arid to arid.Agriculture is a significant part of the region’s economy.By its nature of intensive water use,agriculture is extremely vulnerable to climate change.Population growth and irrigation development have significantly increased the demand for water in the region.Major climate change issues include melting glaciers and a shrinking snowpack,which are the foundation of the region’s water resources,and a changing precipitation regime.Most glaciers are located in Kyrgyzstan and Tajikistan,leading to transboundary water resource issues.Summer already has extremely high temperatures.Analyses indicate that Central Asia has been warming and precipitation might be increasing.The warming is expected to increase,but its spatial and temporal distribution depends upon specific global scenarios.Projections of future precipitation show significant uncertainties in type,amount,and distribution.Regional Hydroclimate Projects(RHPs)are an approach to studying these issues.Initial steps to develop an RHP began in 2021 with a widely distributed online survey about these climate issues.It was followed up with an online workshop and then,in 2023,an in-person workshop,held in Tashkent,Uzbekistan.Priorities for the Global Energy and Water Exchanges(GEWEX)project for the region include both observations and modeling,as well as development of better and additional precipitation observations,all of which are topics for the next workshop.A well-designed RHP should lead to reductions in critical climate uncertainties in policy-relevant timeframes that can influence decisions on necessary investments in climate adaptation.
基金supported by grants from the Key Projects of the Joint Fund of the National Natural Science Foundation of China (U23A20149)the Second Tibetan Plateau Scientific Expedition and Research (STEP) program (2019QZKK0502)+3 种基金the Strategic Priority Research Program of the Chinese Academy of Sciences (XDA20050203)International Partnership Program of the Chinese Academy of Sciences (151853KYSB20180009)the state research project Taxonomic revision of polymorphic plant families of the flora of Uzbekistan’ (FZ-20200929321)the State Programs for the years 2021-2025 ’Grid mapping of the flora of Uzbekistan’ and the ’Tree of life:monocots of Uzbekistan’ of the Institute of Botany of the Academy of Sciences of the Republic of Uzbekistan
文摘Eremurus was described at the beginning of the 19th century.However,due to limited sampling and the small number of gene markers to date,its phylogeny and evolution are largely unknown.In this study,we analyzed plastomes from 27 species belonging to 2 subgenera and 3 sections of Eremurus,which are found in Central Asia(its center of diversity)and China.We also analyzed nuclear DNA ITS of 33 species,encompassing all subgenera and sections of the genus in Central Asia,southwest Asia and China.Our findings revealed that the genus was monophyletic,although both subgenera Eremurus and Henningia were found to be paraphyletic.Both plastome and nrDNA-based phylogenetic trees had three clades that did not reflect the current taxonomy of the genus.Our biogeographical and time-calibrated trees suggest that Eremurus originated in the ancient Tethyan area in the second half of the Eocene.Diversification of Eremurus occurred from the early Oligocene to the late Miocene.Paratethys Sea retreat and several orogenetic events,such as the progressive uplift of the Qinghai-Tibet Plateau and surrounding mountain belts(Altai,Pamir,Tian Shan),caused serious topographic and climate(aridification)changes in Central Asia that may have triggered a split of clades and speciation.In this transformed Central Asia,speciation proceeded rapidly driven mainly by vicariance caused by numerous mountain chains and specialization to a variety of climatic,topographic and soil conditions that exist in this region.
基金Support by the National Natural Science Foundation of China(No.92258303)the Project of Donghai Laboratory(No.DH-2022ZY0005)。
文摘The deep structure,material circulation,and dynamic processes in the Southeast Asia have long been an elusive scientific puzzle due to the lack of systematic scientific observations and recognized theoretical models.Based on the deep seismic tomography using long-period natural earthquake data,in this study,the deep structure and material circulation of the curved subduction system in Southeast Asia was studied,and the dynamic processes since 100 million years ago was reconstructed.It is pointed out that challenges still exist in the precise reconstruction of deep mantle structures of the study area,the influence of multi-stage subduction on deep material exchange and shallow magma activity,as well as the spatiotemporal evolution and coupling mechanism of multi-plate convergence.Future work should focus on high-resolution land-sea joint 3-D seismic tomography imaging of the curved subduction system in the Southeast Asia,combined with geochemical analysis and geodynamic modelling works.
基金National Natural Science Foundation of China(42230603,42275020)Guangdong Major Project of Basic and Applied Basic Research(2020B0301030004)+3 种基金Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies(2020B1212060025)Innovation Group Project of Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)(311021001)Open Fund of State Key Laboratory of Satellite Ocean Environment Dynamics,Second Institute of Oceanography,MNR(QNHX2310)Future Earth Early-Career Fellowship of the Future Earth Global Secretariat Hub China。
文摘Drought events have become more frequent and intense over East Asia in recent decades,leading to huge socioeconomic impacts.Although the droughts have been studied extensively by cases or for individual regions,their leading variability and associated causes remain unclear.Based on the Standardized Precipitation Evapotranspiration Index(SPEI)and ERA5 reanalysis product from 1979 to 2020,this study evealuates the severity of spring droughts in East Asia and investigates their variations and associated drivers.The results indicate that North China and Mongolia have experienced remarkable trends toward dryness during spring in recent decades,while southwestern China has witnessed an opposite trend toward wetness.The first Empirical Orthogonal Function mode of SPEI variability reveals a similar seesawing pattern,with more severe dryness in northwestern China,Mongolia,North China,South Korea,and Japan but increased wetness in Southwestern China and southeast Asia.Further investigation reveals that the anomalously dry(wet)surface in North(Southwestern)China is significantly associated with anomalously high(low)temperature,less(more)precipitation,and reduced(increased)soil moisture during the previous winter and early spring,regulated by an anomalous anticyclone(cyclone)and thus reduced(increased)water vapor convergence.The spring dry-wet pattern in East Asia is also linked to cold sea surface temperature anomalies in the central-eastern Pacific.The findings of this study have important implications for improving the prediction of spring drought events in East Asia.
基金the National Natural Science Foundation of China(Grant Nos.42005029 and 42130504)the Research Program on Decision Services of China Meteorological Administration(Nos.JCZX2023026 and JCZX2022021).
文摘This study investigates the evolution of an extreme anomalous anticyclone(AA)event over Northeast Asia,which was one of the dominant circulation systems responsible for the catastrophic extreme precipitation event in July 2021 in Henan,and further explores the significant impact of this AA on surface temperatures beneath it.The results indicate that this AA event over Northeast Asia was unprecedented in terms of intensity and duration.The AA was very persistent and extremely strong for 10 consecutive days from 13 to 22 July 2021.This long-lived and unprecedented AA led to the persistence of warmer surface temperatures beyond the temporal span of the pronounced 500-hPa anticyclonic signature as the surface air temperatures over land in Northeast Asia remained extremely warm through 29 July 2021.Moreover,the sea surface temperatures in the Sea of Japan/East Sea were extremely high for 30 consecutive days from 13 July to 11 August 2021,persisting well after the weakening or departure of this AA.These results emphasize the extreme nature of this AA over Northeast Asia in July 2021 and its role in multiple extreme climate events,even over remote regions.Furthermore,possible reasons for this long-lasting AA are explored,and it is suggested to be a byproduct of a teleconnection pattern over extratropical Eurasia during the first half of its life cycle,and of the Pacific-Japan teleconnection pattern during the latter half.
基金Counting at GTL funded by the Shenzhen Zhilan FoundationAlashan SEE Ecological Association+1 种基金Beijing Xianfeng FoundationCounting at PXL was funded by the Alashan SEE Chongqing Center
文摘Soaring bird migration often relies on suitable terrain and airflow;therefore,route selection is vital for successful migration.While age and experience have been identified as key factor influencing migration route selection among soaring raptors in the African-Eurasian Flyway,how they shape the migration route of soaring raptors in East Asia is still largely unknown.In this study,we investigated potential variations in the routes and timing in autumn migration of juvenile and older soaring birds,using count data of Greater Spotted Eagles(Clanga clanga)from two coastal sites and two inland sites in China.From 2020 to 2023,we recorded a total of 340 individuals,with the highest site averaging over 90 individuals per autumn,making it one of the world’s top single-season counts and thus a globally important site for this species.We found that 82% and 61% records from coastal sites were juveniles,significantly higher than inland sites(15% and 24%).Juveniles at all four sites exhibited markedly earlier median passage time than non-juveniles,with brief overlapping in their main migration periods.Both coastal sites are located on the tip of peninsulas stretching southwest,requiring long overwater flights if crossing the Bohai Bay or Beibu Gulf,which would be energetically demanding and increase mortality risk.Experienced individuals may have learned to avoid such terrain and subsequent detour,while juveniles are more prone to enter these peninsulas due to lack of experience and opportunities for social learning,or following other raptor species that are more capable of powered flight.Our findings highlight the importance of age and experience in migration route selection of large soaring birds.
基金The authors gratefully acknowledge the science teams of NASA High Mountain Asia 8-meter DEM and NASA ICESat-2 for providing access to the data.This work was conducted with the infrastructure provided by the National Remote Sensing Centre(NRSC),for which the authors were indebted to the Director,NRSC,Hyderabad.We acknowledge the continued support and scientific insights from Mr.Rakesh Fararoda,Mr.Sagar S Salunkhe,Mr.Hansraj Meena,Mr.Ashish K.Jain and other staff members of Regional Remote Sensing Centre-West,NRSC/ISRO,Jodhpur.The authors want to acknowledge Dr.Kamal Pandey,Scientist,IIRS,Dehradun,for sharing field-level information about the Auli-Joshimath.This research did not receive any specific grant from funding agencies in the public,commercial,or not-for-profit sectors.
文摘High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to analyze it in a 3D environment and understand its intricate role as the Water Tower of Asia.The science teams of NASA realized an 8-m DEM using satellite stereo imagery for HMA,termed HMA 8-m DEM.In this research,we assessed the vertical accuracy of HMA 8-m DEM using reference elevations from ICESat-2 geolocated photons at three test sites of varied topography and land covers.Inferences were made from statistical quantifiers and elevation profiles.For the world’s highest mountain,Mount Everest,and its surroundings,Root Mean Squared Error(RMSE)and Mean Absolute Error(MAE)resulted in 1.94 m and 1.66 m,respectively;however,a uniform positive bias observed in the elevation profiles indicates the seasonal snow cover change will dent the accurate estimation of the elevation in this sort of test sites.The second test site containing gentle slopes with forest patches has exhibited the Digital Surface Model(DSM)features with RMSE and MAE of 0.58 m and 0.52 m,respectively.The third test site,situated in the Zanda County of the Qinghai-Tibet,is a relatively flat terrain bed,mostly bare earth with sudden river cuts,and has minimal errors with RMSE and MAE of 0.32 m and 0.29 m,respectively,and with a negligible bias.Additionally,in one more test site,the feasibility of detecting the glacial lakes was tested,which resulted in exhibiting a flat surface over the surface of the lakes,indicating the potential of HMA 8-m DEM for deriving the hydrological parameters.The results accrued in this investigation confirm that the HMA 8-m DEM has the best vertical accuracy and should be of high use for analyzing natural hazards and monitoring glacier surfaces.
基金supported by the National Major Public Health Service Projects(Z135080000022)。
文摘Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-risk Population Screening and Intervention Program,an estimated 17.8 million[95%confidence interval(CI)17.6–18.0million]adults in China had experienced a stroke in 2020,with 3.4 million(95%CI 3.3–3.5 million)experiencing their first-ever stroke and another 2.3 million(95%CI 2.2–2.4 million)dying as a result.Additionally,approximately 12.5%(95%CI 12.4%–12.5%)of stroke survivors were left disabled,as defined by a modified Rankin Scale score greater than 1,equating to 2.2 million(95%CI 2.1–2.2 million)stroke-related disabilities in 2020.As the population ages and the prevalence of risk factors like diabetes,hypertension,and hyperlipidemia continues to rise and remains poorly controlled,the burden of stroke in China is also increasing.A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%;the awareness,treatment,and control rates in hypertensive patients were:60.1%,42.5%,and 25.4%,respectively.A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%,suggesting there are 120 million adults with diabetes in China,and the awareness,treatment,and control rates in diabetic patients were:43.3%,49.0%,and 49.4%,respectively.The“Sixth National Health Service Statistical Survey Report in 2018”showed that the proportion of the obese population in China was 37.4%,an increase of 7.2 points from 2013.Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China(BOSC)showed that a total of 3,418,432 stroke cases[mean age±standard error(SE)was(65.700±0.006)years,and 59.1%were male]were admitted during 2020.Of those,over 80.0%(81.9%)were ischemic stroke(IS),14.9%were intracerebral hemorrhage(ICH)strokes,and 3.1%were subarachnoid hemorrhage(SAH)strokes.The mean±SE of hospitalization expenditures was Chinese Yuan(CNY)(16,975.6±16.3),ranging from(13,310.1±12.8)in IS to(81,369.8±260.7)in SAH,and out-of-pocket expenses were(5788.9±8.6),ranging from(4449.0±6.6)in IS to(30,778.2±156.8)in SAH.It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion,of which the patient pays approximately CNY 19.8 billion.In-hospital death/discharge against medical advice rate was 9.2%(95%CI 9.2%–9.2%),ranging from 6.4%(95%CI 6.4%–6.5%)for IS to 21.8%(95%CI 21.8%–21.9%)for ICH.From 2019 to 2020,the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy(IVT),49,845 patients receiving mechanical thrombectomy(MT),and 14,087 patients receiving bridging(IVT+MT)were collected through BOSC.The incidence of intracranial hemorrhage during treatment was 3.2%(95%CI 3.2%–3.3%),7.7%(95%CI 7.5%–8.0%),and 12.9%(95%CI 12.3%–13.4%),respectively.And in-hospital death/discharge against medical advice rate was 8.9%(95%CI 8.8%–9.0%),16.5%(95%CI 16.2%–16.9%),and 16.8%(95%CI 16.2%–17.4%),respectively.A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals(Level III)from 31 provinces in China through BOSC from January 2019to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up.Of those,over 86.9%were IS,10.8%were ICH strokes,and 2.3%were SAH strokes.The disability rate[%(95%CI)]in survivors of stroke at 3-month and 12-month was 14.8%(95%CI 14.6%–15.0%)and 14.0%(95%CI 13.8%–14.2%),respectively.The mortality rate[%(95%CI)]of stroke at 3-month and 12-month was 4.2%(95%CI 4.1%–4.3%)and 8.5%(95%CI 8.4%–8.6%),respectively.The recurrence rate[%(95%CI)]of stroke at 3-month and 12-month was 3.6%(95%CI 3.5%–3.7%)and 5.6%(95%CI 5.4%–5.7%),respectively.The Healthy China 2030 Stroke Action Plan was launched as part of this review,and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China.
基金funded by F. Hoffmann-La Roche Ltd. F. Hoffmann-La Roche Ltd sponsored the IMpower210 study。
文摘Objective: IMpower210(NCT02813785) explored the efficacy and safety of single-agent atezolizumab vs.docetaxel as second-line treatment for advanced non-small cell lung cancer(NSCLC) in East Asian patients.Methods: Key eligibility criteria for this phase Ⅲ, open-label, randomized study included age ≥18 years;histologically documented advanced NSCLC per the Union for International Cancer Control/American Joint Committee on Cancer staging system(7th edition);Eastern Cooperative Oncology Group performance status of 0 or 1;and disease progression following platinum-based chemotherapy for advanced or metastatic NSCLC. Patients were randomized 2:1 to receive either atezolizumab(1,200 mg) or docetaxel(75 mg/m^(2)). The primary study endpoint was overall survival(OS) in the intention-to-treat(ITT) population with wild-type epidermal growth factor receptor expression(ITT EGFR-WT) and in the overall ITT population.Results: Median OS in the ITT EGFR-WT population(n=467) was 12.3 [95% confidence interval(95% CI),10.3-13.8] months in the atezolizumab arm(n=312) and 9.9(95% CI, 7.8-13.9) months in the docetaxel arm[n=155;stratified hazard ratio(HR), 0.82;95% CI, 0.66-1.03]. Median OS in the overall ITT population was 12.5(95% CI, 10.8-13.8) months with atezolizumab treatment and 11.1(95% CI, 8.4-14.2) months(n=377) with docetaxel treatment(n=188;stratified HR, 0.87;95% CI, 0.71-1.08). Grade 3/4 treatment-related adverse events(TRAEs) occurred in 18.4% of patients in the atezolizumab arm and 50.0% of patients in the docetaxel arm.Conclusions: IMpower210 did not meet its primary efficacy endpoint of OS in the ITT EGFR-WT or overall ITT populations. Atezolizumab was comparatively more tolerable than docetaxel, with a lower incidence of grade3/4 TRAEs.
基金granted by Opening Foundation of State Key Laboratory of Continental Dynamics(Grant No.21LCD08),Northwest University。
文摘The magma sources,origins and precise forming ages of the miarolite from Qishan and Kuiqi intrusions are still uncertain.New results reveal that,miarolites from the Qishan and Kuiqi intrusions yield crystallization ages of~101 and~98 Ma,and they have a high formation temperature(~910℃)and low oxygen fugacity value,indicating crystallization condition at low pressure in the upper crust with temperature of 678℃.The Qishan and Kuiqi miarolites are characterized by enrichment in SiO_(2) and high-K alkali,depletion in Ca and Mg,and belong to the high-K weak peraluminous rock series.The samples are enriched in HFSEs(i.e.,Ta,Zr and Hf)and LILEs(i.e.,Ba,P and Sr),depleted in Ba and Sr with the negative anomaly of Eu.In the primitive mantle normalized trace element spider diagram,the samples show a right-inclined‘seagull-type’pattern,combined the ratios of(La/Yb)_(N),10000×Al/Ga,Rb/Nb and Nb/Ta etc.,they were proved to be alkaline A-type granite.Combined the characterize of the trace elements,they were derived from clay-rich source accompanied pelite melting,and subjected to K-feldspar crystallization fractional.The values of ε_(Hf)(t)and tDM2 are distributed in the range of-2.8 to 3.3 with~1.2 Ga,and-6.0 to 4.0 with~1.2 Ga,revealing that they were generated from the Mesoproterozoic Cathaysia basement rocks.The comprehensive research reveals the Kuiqi and Qishan intrusions derived from crust-mantle mixing and partial melting of the crust,respectively,resulting from lithospheric extension generated by the Paleo-Pacific Plate subducted into the European-Asian Plate.
基金This research was supported in part by grants from the Natural Science Foundation of China(Grant No.42371258 and 42001187)The project was also supported by the Key Laboratory of Natural Resources Monitoring and Supervision in Southern Hilly Region,Ministry of Natural Resources(NRMSSHR2023Y02)Yunnan Key Laboratory of Plateau Geographic Processes and Environmental Changes,Faculty of Geography,Yunnan Normal University(PGPEC2304).
文摘In recent decades,the spatio-temporal patterns of China’s croplands have been reshaped by disturbances from anthropogenic activities,with complex changes in the topographic characteristics of croplands.Slope-climbing of croplands(SCCL)is an important issue that threatens sustainable agricultural development.While providing land with prominent location advantages,SCCL weakens the water and fertilizer retention capacity for cropland,intensifies various geological disasters,and adversely affects the ecological environment and food yield of these croplands.It is crucial to determine the spatio-temporal variation features and effects of SCCL in China to formulate more accurate cropland protection policies and to maintain food security;however,the current lack of relevant studies is detrimental for capturing trends in cropland resources and sustainable cropland use.In this study,we constructed a multi-scale slope spectrum for cropland and total terrain to explore the spatial differences and trends of SCCL from a three-dimensional view.We evaluated the natural and socioeconomic effects of SCCL in China from multiple perspectives.Results indicate that the proportion of cropland with slopes below 2°,5°,and 6°in China decreased by 0.43%,0.47%,and 0.50%from 1980 to 2020,respectively.SCCL became apparent during 1980-1990 and 2010-2020,especially over the recent decade.The cropland climbing index(CCI)and upper limited slope change(ULSC)to measure the spatio-temporal pattern of SCCL were 0.99%and 1.17°,respectively,during 2010-2020.At the agricultural regional scale,the SCCL was also concentrated in 1980-1990 and 2010-2020,and it is more pronounced in the southern areas.The proportion of provinces and prefecture-level cities with high-intensity SCCL during 1980-2020 were 87.10%and 49.73%,respectively.SCCL was comparatively more pronounced and broader from 2010 to 2020.During this period,17.84%of prefecture-level cities had no SCCL,and the average CCI for all prefecture-level cities peaked at 1.62%.In this study,we also evaluated the pros and cons of SCCL and provided targeted suggestions for decision makers and farmers to refine cropland protection policy systems and further develop the sustainable use of croplands.