Exploring the ecological utility of cultivated land\'s carbon metabolism offers policy insights for ensuring its healthy operation and promote the dual carbon goals (carbon peak and carbon neutrality). We employed ecological network analysis (ENA) and kernel density estimation to conduct an empirical study, taking Hubei Province from 2000 to 2020 as an example. The results revealed apparent negative effects of carbon metabolic flow on regional carbon balance. Specifically, cultivated land conversion into transportation and industrial land contributed significantly to the harmful carbon flow. Ecological relationships showed fierce competition for carbon storage, leading to overall adverse ecological effects. The ecological utility indicated detrimental impacts on the orderly functioning of land-use carbon metabolism. Cultivated land\'s carbon metabolism will be essential in achieving land-use carbon neutrality. Therefore, territorial spatial low-carbon optimization should be implemented to realize its green and sustainable development.

OBJECTIVE: To examine the impact of COVID-19 pandemic on the epidemic status of imported malaria and national malaria control program in China, so as to provide insights into post-elimination malaria surveillance.
METHODS: All data pertaining to imported malaria cases were collected from Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 through December 31, 2021. The number of malaria cases, species of malaria parasites, country where malaria parasite were infected, diagnosis and treatment after returning to China, and response were compared before (from January 1, 2018 to January 22, 2020) and after the COVID-19 pandemic (from January 23, 2020 to December 31, 2021).
RESULTS: A total of 2 054 imported malaria cases were reported in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 to December 31, 2021, and there were 1 722 cases and 332 cases reported before and after the COVID-19 pandemic, respectively. All cases were reported within one day after definitive diagnosis. The annual mean number of reported malaria cases reduced by 79.30% in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region after the COVID-19 pandemic (171 cases) than before the pandemic (826 cases), and the number of monthly reported malaria cases significantly reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region since February 2020. There was a significant difference in the constituent ratio of species of malaria parasites among the imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 146.70, P < 0.05), and P. falciparum malaria was predominant before the COVID-19 pandemic (72.30%), while P. ovale malaria (44.28%) was predominant after the COVID-19 pandemic, followed by P. falciparum malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 13.83, P < 0.05), and the proportion of malaria cases that acquired Plasmodium infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; χ2 = 4.34, P < 0.05), while the proportion of malaria cases that acquired Plasmodium infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; χ2 = 9.88, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; χ2= 3.87, P < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; χ2 = 3.95, P < 0.05).
CONCLUSIONS: The number of imported malaria cases remarkably reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region of China during the COVID-19 pandemic, with a decreased proportion of completing case investigations within 3 days. The sensitivity of the malaria surveillance-response system requires to be improved to prevent the risk of secondary transmission of malaria due to the sharp increase in the number of imported malaria cases following the change of the COVID-19 containment policy.
［摘要］ 目的 分析新型冠状病毒感染 (COVID-19) 疫情对我国输入性疟疾疫情及疟疾防控工作的影响, 为消除疟疾后 监测工作提供参考。方法 收集2018年1月1日—2021年12月31日安徽省、湖北省、河南省、浙江省和广西壮族自治区 报告的输入性疟疾病例资料, 比较COVID-19疫情前 (2018年1月1日—2020年1月22日)、后 (2020年1月23日—2021年 12月31日) 上述5省疟疾病例数、感染虫种、感染来源地、回国后诊疗和处置情况。结果 2018年1月1日—2021年12 月31日, 5个省份累计报告输入性疟疾病例2 054例, COVID-19疫情前、后分别报告1 722例和332例, 均为输入性病例, 所有病例均在确诊后1 d内报告。COVID-19疫情后, 5个省份平均每年报告疟疾病例数 (171例) 较疫情前 (826例) 下降 79.30%; 自2020年2月起, 5个省份每月报告疟疾病例数明显减少。COVID-19疫情前后5个省份疟疾病例感染虫种构成 比差异有统计学意义 (χ2 = 146.70, P < 0.05); COVID-19疫情前以恶性疟病例为主 (72.30%); COVID-19疫情后, 恶性疟病 例占比下降至37.65%, 卵形疟病例占比上升至最高 (44.28%)。COVID-19疫情前后, 5个省份疟疾病例感染来源地构成 比差异有统计学意义 (χ2 = 13.83, P < 0.05); 与COVID-19 疫情前相比, 疫情后来自西非的病例占比降低 (44.13% vs. 37.95%; χ2 = 4.34, P = 0.037), 来自东非的病例占比升高 (9.58% vs.15.36%; χ2 = 9.88, P = 0.02)。COVID-19疫情后病例3 d 内流行病学调查完成率 (96.69%) 低于疫情前 (98.32%) (χ2 = 3.87, P < 0.05), 7 d内疫点调查处置完成率 (100.00%) 高于 疫情前 (98.43%) (χ2 = 3.95, P < 0.05)。结论 COVID-19疫情期间, 我国安徽省、湖北省、河南省、浙江省和广西壮族自 治区输入性疟疾疫情大幅下降, 3 d内病例流行病学调查完成率下降。提示需增强监测系统敏感性, 以防范COVID-19疫 情防控政策改变后输入性疟疾病例激增带来的继发传播风险。.

OBJECTIVE: To identify the spatial distribution pattern of Oncomelania hupensis spread in Hubei Province, so as to provide insights into precision O. hupensis snail control in the province.
METHODS: Data pertaining to emerging and reemerging snails were collected from Hubei Province from 2020 to 2022 to build a spatial database of O. hupensis snail spread. The spatial clustering of O. hupensis snail spread was identified using global and local spatial autocorrelation analyses, and the hot spots of snail spread were identified using kernel density estimation. In addition, the correlation between environments with snail spread and the distance from the Yangtze River was evaluated using nearest-neighbor analysis and Spearman correlation analysis.
RESULTS: O. hupensis snail spread mainly occurred along the Yangtze River and Jianghan Plain in Hubei Province from 2020 to 2022, with a total spread area of 4 320.63 hm2, including 1 230.77 hm2 emerging snail habitats and 3 089.87 hm2 reemerging snail habitats. Global spatial autocorrelation analysis showed spatial autocorrelation in the O. hupensis snail spread in Hubei Province in 2020 and 2021, appearing a spatial clustering pattern (Moran\'s I = 0.003 593 and 0.060 973, both P values < 0.05), and the mean density of spread snails showed spatial aggregation in Hubei Province in 2020 (Moran\'s I = 0.512 856, P < 0.05). Local spatial autocorrelation analysis showed that the high-high clustering areas of spread snails were mainly distributed in 50 settings of 10 counties (districts) in Hubei Province from 2020 to 2022, and the high-high clustering areas of the mean density of spread snails were predominantly found in 219 snail habitats in four counties of Jiangling, Honghu, Yangxin and Gong\'an. Kernel density estimation showed that there were high-, secondary high- and medium-density hot spots in snail spread areas in Hubei Province from 2020 to 2022, which were distributed in Jingzhou District, Wuxue District, Honghu County and Huangzhou District, respectively. There were high- and medium-density hot spots in the mean density of spread snails, which were located in Jiangling County, Honghu County and Yangxin County, respectively. In addition, the snail spread areas negatively correlated with the distance from the Yangtze River (r = -0.108 9, P < 0.05).
CONCLUSIONS: There was spatial clustering of O. hupensis snail spread in Hubei Province from 2020 to 2022. The monitoring and control of O. hupensis snails require to be reinforced in the clustering areas, notably in inner embankments to prevent reemerging schistosomiasis.
［摘要］ 目的 分析湖北省钉螺扩散空间分布规律, 为全省精准控制钉螺提供科学依据。方法 收集2020—2022年湖 北省新发和复现钉螺资料, 构建钉螺扩散空间数据库。分别采用全局和局部空间自相关分析识别钉螺扩散空间聚集性; 采用核密度分析法探索钉螺扩散热点区域; 采用近邻分析和Spearman相关分析探索钉螺扩散环境与主要水系长江之间 距离的关系。结果 2020—2022年, 湖北省钉螺扩散主要分布在长江沿线及江汉平原, 累计扩散面积4 320.63 hm2, 其中 新发钉螺面积1 230.77 hm2、复现钉螺面积3 089.87 hm2。全局空间自相关分析发现, 2020年和2021年湖北省钉螺扩散面 积分布存在空间自相关, 呈空间聚集模式 (Moran’s I = 0.003 593、0.060 973, P 均< 0.05)。2020年, 湖北省扩散钉螺平均 密度呈空间聚集现象 (Moran’s I = 0.512 856, P < 0.05)。局部空间自相关分析发现, 2020—2022年湖北省扩散钉螺面积 呈高值 (high-high, H-H) 聚集区域主要分布在武穴市、洪湖市和黄州区等10个县 (市、区) 的50处环境; 扩散钉螺平均密度 呈H-H聚集区域主要分布在江陵县、洪湖市、阳新县和公安县等4个县 (市) 的219处钉螺环境。核密度分析发现, 2020—2022年湖北省钉螺扩散面积存在高、次高和中密度等3类热点区, 分别分布在荆州区、武穴市、洪湖市和黄州区。扩散钉 螺平均密度存在高、中密度等2类热点区, 分别分布在江陵县、洪湖市和阳新县。湖北省钉螺扩散面积与环境距长江距 离呈负相关 (r = −0.108 9, P < 0.05)。结论 湖北省钉螺扩散具有空间聚集性, 需对聚集区域尤其是垸内环境加强钉螺 监测与控制力度, 防止发生血吸虫病疫情反弹。.

Norovirus (NoV) is an important cause of viral acute gastroenteritis (AGE). To gain insights into the epidemiological characteristics and genetic diversity of NoV among children in Hubei, 1216 stool samples from children (≤ 5 years) obtained under AGE surveillance from January 2017 to December 2019 were analyzed. The results showed that NoV was responsible for 14.64% of AGE cases, with the highest detection rate in children aged 7-12 months (19.76%). Statistically significant differences were found between male and female infection rates (χ2 ​= ​8.108, P ​= ​0.004). Genetic analysis of RdRp and VP1 sequences showed that NoV GII genotypes were GII.4 Sydney [P31] (34.35%), GII.3 [P12] (25.95%), GII.2 [P16] (22.90%), GII.4 Sydney [P16] (12.98%), GII.17 [P17] (2.29%), GII.6 [P7] and GII.3 [P16] (each at 0.76%). GII.17 [P17] variants were divided into the Kawasaki323-like lineage and the Kawasaki308-like lineage. A unique recombination event was detected between strains of GII.4 Sydney 2012 and GII.4 Sydney 2016. Significantly, all GII.P16 sequences associated with GII.4/GII.2 obtained in Hubei were correlated with novel GII.2 [P16] variants that re-emerged in Germany in 2016. Antigenic site analysis of complete VP1 sequences from all GII.4 variants from Hubei identified notable variable residues of antibody epitopes. Genotyping under continuous AGE surveillance and observation of the antigenic sites of VP1 are important monitoring strategies for emerging NoV strains.

A series of ecological restoration projects have been proposed to solve ecological problems resulting from human activities. The project of returning farmlands to forests, initiated in 1999, was the most widely implemented ecological restoration project in China. Large amounts of cropland with steep slopes have been converted to forests or grasslands to promote vegetation restoration, reduce soil erosion, and control nonpoint source pollution. Therefore, identifying the dynamics of vegetation and food security is crucial for further decision making. Based on the mean normalized difference vegetation index (NDVI) and grain yield data, this study explored the vegetation dynamics and food security of Hubei Province against the background of ecological restoration. The results show that, on a whole, the NDVI significantly increased from 2000 to 2018. The spatial agglomeration of the NDVI decreased between 2000 and 2008 and then increased from 2009 onwards. High-high NDVI agglomerations were more concentrated in mountainous areas. Food security was not threatened, and the grain yield in Hubei Province and most of the cities exhibited significant upward trends, as a whole. The change trend of the grain yield was not stable during the period from 2000 to 2018. The grain yield for Hubei Province and almost all of the cities decreased during the first 5 to 11 years, probably due to the sharp decrease in the sloping cropland areas against the background of ecological restoration. Grain yield was more sensitive and had a longer downward trend in regions with steeper slopes. Increasing trends in grain yield were detected during the last 6 to 10 years for most of the cities, and this can mainly be attributed to the newly added croplands that were created from land with other kinds of land uses, the increase in grain productivity, and strict cropland protection policies. The project of returning farmlands to forests is suggested as a long-term policy from the perspective of ecological restoration, and effective measures should also be continuously taken to maintain grain production and food security.

OBJECTIVE: In 2017, China launched a new round of medical reform (NMR) to address the inaccessibility of high-priced drugs for patients with serious diseases. This study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies (mAbs), and the effective promotion policies after the NMR.
METHODS: We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province, China. By interviewing hospital pharmacy experts, we identified the potential value of the current NMR in improving the access to therapeutic mAbs.
RESULTS: The average availability of 13 mAbs increased by 8.1% in the surveyed hospitals of Hubei province after the NMR. The median unit price of 10 mAbs dropped by 34.3%. The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident (56.2% reduction). The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of mAbs. However, the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of mAbs.
CONCLUSIONS: Not all current NMR policies play a positive role in promoting the accessibility of mAbs. To further improve the accessibility of mAbs in the future in China, it is therefore critical to increase the investment in independent research and development of high-quality mAbs, establish localized guidelines for the rational use of mAbs in clinical practice, and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.

Based on the successful experience of pesticide reduction in China, this study uses survey data from Hubei Province to measure rice farmers\' technology preferences for pesticide reduction considering their needs, and compare the heterogeneous factors influencing farmers\' adoption behavior. The results show that large-scale farmers prefer drone services and efficient machinery, while small-scale farmers prefer scientific standards and biopesticides for pesticide reduction. Second, farmers\' adoption behavior of pesticide reduction technologies is mostly influenced by education, risk attitude, income, agricultural labor, scale, rice price, residue testing, brand, training, subsidy, and demonstration. Among them, education, risk attitude, scale, rice price, cost, and training, significantly affect farmers\' adoption level of multiple pesticide reduction technologies. Further, higher rice prices and participation in training could promote the use of pesticide reduction technologies in a larger area by farmers. Therefore, the real needs of farmers should be focused on the promotion of pesticide reduction technologies, and pesticide reduction programs in different regions should carry out precise intervention policies. These findings can provide practical policy guidance for effective pesticide reduction in the central region of China.

The coordinated relationship between urban population-land spatial patterns (UPLSPs) and ecological efficiency (EE) is conducive not only to the rational utilization of resources and environment and the sustainable development of society, but also to the provision of a living environment that benefits public health. Identifying the coupling relationship of urban development and EE can provide critical information for urban planning. Previous studies have mainly focused on the coupling relationship between urban population and land, urbanization, and ecological development, while ignoring that between UPLSPs and EE. This study integrates several models to construct a novel framework for coupling UPLSPs and EE. Taking Hubei Province as the research area, we calculate the UPLSPs, EE, and their coupling coordination degree for 12 cities from 2000 to 2019. The paper offers several conclusions. (1) the urban population-land spatial matching degree increased, but the overall matching level was not high; the average value of EE showed an \"N\"-shaped change trajectory, and its overall level was low, with small changes and obvious regional differences. (2) The average value of the coupling coordination degree between UPLSPs and EE was a slow upward trend, with a radial distribution high in the middle and low in the periphery. There was conflict between the spatial patterns and EE, and the former restricted the development of the latter. (3) There were strong correlations between coordination degree and various indicators of UPLSPs and EE. While we should revitalize the stock of construction land and optimize the upgrading of the industrial structure, we also must coordinate human and land resources and the ecological environment, and narrow regional development differences. This study provides a new framework for urban environmental assessment and urban planning decision-making.

Group A human rotaviruses (RVAs) annually cause the deaths of 215,000 infants and young children. To understand the epidemiological characteristics and genetic evolution of RVAs, we performed sentinel surveillance on RVA prevalence in a rotavirus-surveillance network in Hubei, China. From 2013 to 2016, a total of 2007 fecal samples from hospital outpatients with acute gastroenteritis were collected from four cities of Hubei Province. Of the 2007 samples, 153 (7.62%) were identified positive for RVA by real-time RT-PCR. RVA infection in Hubei mainly occurred in autumn and winter. The highest detection rate of RVA infection was in 1-2 years old of outpatients (16.97%). No significant difference of RVA positive rate was observed between females and males. We performed a phylogenetic analysis of the G/P genotypes based on the partial VP7/VP4 gene sequences of RVAs. G9P[8] was the most predominant strain in all four years but the prevalence of G2P[4] genotype increased rapidly since 2014. We reconstructed the evolutionary time scale of RVAs in Hubei, and found that the evolutionary rates of the G9, G2, P[8], and P[4] genotypes of RVA were 1.069 ​× ​10-3, 1.029 ​× ​10-3, 1.283 ​× ​10-3 and 1.172 ​× ​10-3 nucleotide substitutions/site/year, respectively. Importantly, using a molecular clock model, we showed that most G9, G2, P[8], and P[4] genotype strains dated from the recent ancestor in 2005, 2005, 1993, and 2013, respectively. The finding of the distribution of RVAs in infants and young children in Hubei Province will contribute to the understanding of the epidemiological characteristics and genetic evolution of RVAs in China.

We carried out a preliminary investigation to study the impact of COVID-19 on aquaculture in China and identify the strategies and measures that have been taken by the Chinese Government. The investigation involved questionnaire surveys designed for all stakeholders along the industrial chain, including grow-out farmers, seed producers, fish processors, fish traders, and feed companies engaged in the catfish sector in Hubei Province and the tilapia sector in Guangdong Province during the strict period of control and after these control measures were lifted. We also attempted to summarize the government interventions and measures taken by different stakeholders along the value chain to minimize the damage caused by COVID-19 and support the recovery of different sectors in the aquaculture industry. We found that due to delayed harvesting, fish stocks were held-up in ponds and normal farming was interrupted. Farmers and traders were more severely impacted by the pandemic than other sectors. Furthermore, a series of strategies and measures are recommended to cope with the pandemic and other similar risks in the future. We expect that this study will provide good evidence for international societies to support the aquaculture industry in minimizing the impact of the pandemic and the rapid recovery of the industry in the post-pandemic period.