Coupled seasonal and intraseasonal variability in the South China Sea

Based on 10 year climatological data and simulations from a regional atmosphere–ocean coupled model (FVCOM-RegCM3), this study examined the coupled seasonal and intraseasonal variability of atmospheric–oceanic variables [sea surface temperature (SST), winds, rainfall and heat fluxes] and important roles of coupling in the South China Sea. It is showed that even though both coupled and uncoupled models in general are able to capture observed seasonal and intraseasonal variability, the coupled model demonstrates stronger coupling relationship than the uncoupled model. For seasonal variability, the atmosphere–ocean relationship is presented as SST forcing atmosphere. Atmospheric variables are significantly influenced by strong seasonally-varied SST. The coupled model very accurately reproduced the observed SST variation with a stable equilibrium state, while SST from the uncoupled model gradually drifted away from the equilibrium state lacking of the so-called negative SST-heat flux feedback. Lead-lag analysis showed that the coupled variables demonstrated stronger SST-atmosphere relationship than the uncoupled and even observed variables. For intraseasonal variability, the atmosphere–ocean relationship is presented as atmosphere forcing SST. Wind becomes a dominant forcing and demonstrates robust negative relationship with SST and positive relationship with rainfall/LHF. Both coupled and uncoupled models are able to reproduce this observed relationship. In wind-SST relationship, compared to uncoupled and observed variables, the coupled model produced the smallest SST variances and therefore the strongest negative coupling feedback. Sensitivity experiments were also carried out to examine the roles of coupling by directly comparing differences between the coupled and uncoupled experiments with initial temperature perturbations. It is showed that the differences can be up to 50 % of the standard deviations of the variables. Root-mean-square errors of the uncoupled model can be effectively reduced by ~65 % in the coupled model.National Natural Science Foundation (China) (No. 41106003)Chinese Academy of Sciences. Strategic Priority Research Program (No. XDA11010303)Singapore. National Research Foundation (Center for Environmental Sensing and Monitoring (CENSAM) under the Singapore-MIT Alliance for Research and Technology (SMART) program

Comparative Study of Soil Grouting with Cement Slurry and Cement-Sodium Silicate Slurry

Cement slurry and cement-sodium silicate slurry are most widely applied for soil grouting reinforcement project. The viscosity change of cement slurry is negligible during grouting period and presumed to be time independent, while the viscosity of cement-sodium silicate slurry increases with time quickly and is presumed to be time dependent. Due to the significant rheological differences between them, the grouting quality and the increasing characteristics of grouting parameters may be different. Those are main factors for grouting design. In this paper, a large-scale 3D grouting simulation device was developed to simulate the surrounding curtain grouting for a tunnel. Two series of surrounding curtain grouting experiments under different initial pressures of 100 kPa, 150 kPa, and 200 kPa were performed. The overload test on the tunnel was performed to evaluate the grouting quality of all surrounding curtain grouting experiments. The results show that the increasing trend of grouting pressure for cement-sodium silicate is similar to its viscosity; the setting time of cement-sodium silicate slurry obtained from the laboratory test is less than that in the practical grouting environment where grout slurry solidifies in soil; the grouting quality of cement-sodium silicate slurry is better than cement slurry, and the grouting quality decreases with initial pressure

Roles of the Indo-Pacific subsurface Kelvin waves and volume transport in prolonging the triple-dip 2020-2023 La Niña.

The rare triple-dip 2020–2023 La Niña event has resulted in a series of extreme climate events across the globe. Here, we reveal the role of tropical Indo-Pacific oceanic interactions in driving the first triple-dip La Niña of the twenty-first century. Specifically, we found that the eastern Indian Ocean subsurface warming anomalies were associated with the re-intensification of the subsequent La Niña event. The subsurface warming anomaly signals were propagated eastward by equatorial and coastal subsurface Kelvin waves from the eastern Indian Ocean to the western Pacific Ocean through the Indo-Pacific oceanic pathway, which contributes to the accumulation of heat content and deepens the thermocline in the western tropical Pacific. The westward Indonesian Throughflow (ITF) transported more heat during multi-year La Niña events from the western Pacific Ocean to the eastern Indian Ocean than during single-year events, resulting in the injection of more warm water into the eastern Indian Ocean. The combination of subsurface Kelvin wave propagation and increased ITF volume transport in the Indo-Pacific region acted to prolong the heat content in the western Pacific during the decay phase of La Niña, ultimately leading to the rare triple-dip 2020–2023 La Niña event

Dyslipidemia Prevalence in Chinese Older Adults：a Meta-analysis

BackgroundChina has stepped into an aging society, and its aging population is rapidly increasing. Recent years have seen a notable increased dyslipidemia prevalence in older adults, which has gained growing attentions as a major risk for cardiovascular and cerebrovascular diseases in this population. There is little consistency between studies on dyslipidemia prevalence in Chinese older adults due to differences of size and features of sample, design and setting.ObjectiveTo systematically evaluate the prevalence of dyslipidemia among Chinese older adults.MethodsCross-sectional studies relevant to the prevalence of dyslipidemia among Chinese elderly population were searched in databases including CNKI, CBM, CQVIP, WanFang, PubMed, Web of Science, Embase and the Cochrane Library from inception to May 2021. Two researchers performed literature screening and data extraction, separately. The Agency for Healthcare Research and Quality methodology checklist was used to assess the risk of bias. Stata 15.1 was adopted for meta-analysis.ResultsA total of 19 cross-sectional studies were included, involving 101 931 cases, and 45 785 of them had dyslipidemia. Meta-analysis results showed that the overall prevalence of dyslipidemia among the participants was 48.0%〔95%CI (41.0%, 54.0%) 〕. Specifically, the prevalence of elevated total cholesterol (TC) , triglyceride (TG) , and low-density lipoprotein cholesterol (LDL-C) as well as lowered low high-density lipoprotein cholesterol (HDL-C) was 19.7%〔95%CI (13.8%, 25.5%) 〕, 20.8%〔95%CI (16.2%, 25.4%) 〕, 15.3%〔95%CI (10.7%, 19.8%) 〕, and 20.2%〔95%CI (7.9%, 32.4%) 〕, respectively. Sex-specific analysis found that men had higher prevalence of elevated LDL-C than women (17.2% vs 9.0%) . Women had higher overall prevalence of dyslipidemia than men (48.8% vs 39.5%) . Moreover, women also had higher prevalence of elevated TC (24.0% vs 12.9%) , and TG (23.4% vs 19.0%) , as well as lowered HDL-C (20.4% vs 14.7%) . Age-specific analysis revealed that dyslipidemia prevalence in age groups of 60-69, 70-79, and ≥80 years old was 39.9%, 31.8%, and 31.4%, respectively, showing a trend of decrease with age. The prevalence of elevated TC in 60-69 year-olds (12.9%) was higher than that of 70-79 year-olds (12.1%) or 80 year-olds and above (9.5%) . The prevalence of elevated LDL-C in 60-69 year-olds (10.0%) was higher than that of 70-79 year-olds (9.4%) or 80 year-olds and above (6.5%) . The prevalence of elevated TG in 70-79 year-olds (19.3%) was higher than that of 60-69 year-olds (16.4%) or 80 year-olds and above (15.5%) . The prevalence of lowered HDL-C in 70-79 year-olds (10.5%) was higher than that of 60-69 year-olds (9.7%) or 80 year-olds and above (9.5%) . Those aged ≥80 years had lower prevalence of various forms of dyslipidemia than 60-69 year-olds and 70-79 year-olds. Region-specific analysis indicated that compared to those from western China, participants from eastern China had higher overall prevalence of dyslipidemia (49.3% vs 36.8%) . Moreover, they also showed higher prevalence of elevated TC (23.0% vs 11.4%) , elevated LDL-C (21.3% vs 7.8%) and lowered HDL-C (13.5% vs 7.8%) . However, they had slightly lower prevalence of elevated TG (19.7% vs 20.0%) .ConclusionThe overall prevalence of dyslipidemia was high in Chinese older adults. Sex-, age group- and region-specific differences were found in the overall prevalence of dyslipidemia, and prevalence of various forms of dyslipidemia. Due to limited number and non-ideal quality of the included studies, the above conclusions need to be verified by more high-quality studies

Is knowledge retained by healthcare providers after training? A pragmatic evaluation of drug-resistant tuberculosis management in China.

OBJECTIVES: Considering the urgent need of training to improve standardised management of drug-resistant infectious disease and the lack of evidence on the impact of training, this study evaluates whether training participants' knowledge on multidrug-resistant tuberculosis (MDR-TB) is improved immediately and a year after training. SETTING AND PARTICIPANTS: The study involved 91 MDR-TB healthcare providers (HCPs), including clinical doctors, nurses and CDC staff, who attended a new MDR-TB HCP training programme in Liaoning and Jiangxi provinces, China. MAIN OUTCOME MEASURES: A phone-based assessment of participants' long-term retention of knowledge about MDR-TB management was conducted in July 2017, approximately 1 year after training. The proportion of correct responses in the long-term knowledge assessment was compared with a pretraining test and an immediate post-training test using a χ2 test. Factors influencing participants' performance in the long-term knowledge assessment were analysed using linear regression. RESULTS: Across both provinces, knowledge of definitions of drug-resistant TB, standardised MDR-TB case detection protocols and laboratory diagnosis was improved 1 year after the training by 14.5% (p=0.037), 32.4% (p<0.001) and 31% (p<0.001) relative to pretraining. However, compared with immediately after training, the knowledge of the three topics declined by 26.5% (p=0.003), 19.8% (p=0.018) and 52.7% (p<0.001) respectively in Jiangxi, while no significant decline was observed in Liaoning. Additionally, we found that obtaining a higher score in the long-term knowledge assessment was associated with longer years of clinical experience (coefficient=0.51; 95 CI% 0.02 to 0.99; p=0.041) and attending training in Liaoning (coefficient=0.50; 95% CI 0.14 to 0.85; p=0.007). CONCLUSION: Our study, the first to assess knowledge retention of MDR-TB HCPs 1 year after training, showed an overall positive long-term impact of lecture-style group training on participants' knowledge. Knowledge decline 1 year after training was observed in one province, Jiangxi, and this may be partly addressed by targeted support to HCPs with fewer years of clinical experience

The Role of the Mindoro-Sibutu Pathway on the South China Sea Multi–layer Circulation

The role of the Mindoro Strait–Sibutu Passage pathway in influencing the Luzon Strait inflow to the South China Sea (SCS) and the SCS multilayer circulation is investigated with a high-resolution (0.1830.18) regional ocean model. Significant changes are evident in the SCS upper-layer circulation (250–900 m) by closing the Mindoro–Sibutu pathway in sensitivity experiments, as Luzon Strait transport is reduced by 75%, from 24.4 to 21.2 Sv (1 Sv [ 106m3 s21). Because of the vertical coupling between the upper and middle layers, closing the Mindoro–Sibutu pathway also weakens clockwise circulation in the middle layer (900–2150 m), but there is no significant change in the deep layer (below 2150 m). The Mindoro–Sibutu pathway is an important branch of the SCS throughflow into the Indonesian Seas. It is also the gateway for oceanic waves propagating clockwise around the Philippines Archipelago from the western Pacific Ocean into the eastern SCS, projecting El Niño–Southern Oscillation sea level signals to the SCS, impacting its interannual variations and multilayer circulation. The results provide insights into the dynamics of how upstream and downstream passage throughflows are coupled to affect the general circulation in marginal seas

Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China

Conclusion: Needle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations

The trends and hotspots of immunotherapy for metastatic colorectal cancer from 2013 to 2022: A bibliometric and visual analysis

An increasing body of research indicates that immunotherapy has demonstrated substantial effectiveness in the realm of metastatic colorectal cancer(mCRC), especially among patients with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H) (dMMR/MSI-H mCRC). This study constitutes the inaugural bibliometric and visual analysis of immunotherapy related to mCRC during the last decade. Between 2013 and the conclusion of 2022, we screened 306 articles from Web of Science and subjected them to analysis using Cite Space and VOS viewer. The United States stood out as the primary contributor in this area, representing 33.33% of the publications, with China following closely at 24.51%. The most prolific institution has the lowest average citation rate. Sorbonne University were the most highly cited institutions. Notably, Frontiers In Oncology published the largest quantity of articles. Andre, Thierry, and Overman, Michael J. were prominent authors known for their prolific output and the high citation rates of their work. The focus areas in this field encompass “tumor microenvironment,” “liver metastasis,” “tumor-associated macrophages,” “combination therapy” and “gut microbiota.” Some keywords offer promise as potential biomarkers for evaluating the effectiveness of immunotherapeutic interventions

Eff ect of a comprehensive programme to provide universal access to care for sputum-smear-positive multidrugresistant tuberculosis in China: a before-and-after study

Background China has a quarter of all patients with multidrug-resistant tuberculosis (MDRTB) worldwide, but less than 5% are in quality treatment programmes. In a before-and-after study we aimed to assess the eff ect of a comprehensive programme to provide universal access to diagnosis, treatment, and follow-up for MDRTB in four Chinese cities (population 18 million). Methods We designated city-level hospitals in each city to diagnose and treat MDRTB. All patients with smear-positive pulmonary tuberculosis diagnosed in Center for Disease Control (CDC) clinics and hospitals were tested for MDRTB with molecular and conventional drug susceptibility tests. Patients were treated with a 24 month treatment package for MDRTB based on WHO guidelines. Outpatients were referred to the CDC for directly observed therapy. We capped total treatment package cost at US$4644. Insurance reimbursement and project subsidies limited patients’ expenses to 10 (2011) to those from a retrospective survey of all patients with MDRTB diagnosed in the same cities during a baseline period (2006–09). Findings 243 patients were diagnosed with MDRTB or rifampicin-resistant tuberculosis during the 12 month programme period compared with 92 patients (equivalent to 24 per year) during the baseline period. 172 (71 243 individuals were enrolled in the programme. Time from specimen collection for resistance testing to treatment initiation decreased by 90 started on appropriate drug regimen increased 2·7 times (from nine [35 172), and follow-up by the CDC after initial hospitalisation increased 24 times (from one [4 163 [99 increased ten times (from two [8 programme period had negative cultures or clinical–radiographic improvement. Patients’ expenses for hospital admission after MDRTB diagnosis decreased by 78$796 to $174), reducing the ratio of patients’ expenses to annual household income from 17·6% to 3·5% (p<0·0001 for all comparisons between baseline and programme periods). However, 36 (15%) patients did not start or had to discontinue treatment in the programme period because of fi nancial diffi culties. Interpretation This comprehensive programme substantially increased access to diagnosis, quality treatment, and aff ordable treatment for MDRTB. The programme could help China to achieve universal access to MDRTB care but greater fi nancial risk protection for patients is needed