Xi-Ping Wang
Runxuan Li2
Kim-Pong Tam- 1Division of Social Science, The Hong Kong University of Science and Technology, Hong Kong, Hong Kong SAR, China
- 2Institute for Management and Innovation (IMI), University of Toronto Mississauga, Toronto, ON, Canada
Purpose: Pneumoconiosis remains a global occupational and public health problem. This scoping review is aimed to identify the psychological symptoms and their correlates among pneumoconiosis patients.
Methods: We conducted a bilingual scoping review following the PRISMA-ScR guidelines. Studies published between 2000 and 2025 were identified through searches of English-language (PubMed, Web of Science, Scopus, ScienceDirect) and Chinese-language (CNKI, CBM, Wanfang, VIP) databases, using English and Chinese descriptors related to pneumoconiosis and psychological symptoms. The search was conducted from June 28 to July 5, 2025. Peer-reviewed empirical studies that reported quantitative psychological outcomes among patients diagnosed with pneumoconiosis were included.
Results: A total of 55 studies were included in this review: 11 in English and 44 in Chinese. Considerable variability in reported prevalence was observed, primarily driven by differences in the instruments used and the cutoff criteria. For depression, with different diagnostic tools and criteria, Chinese studies reported prevalence ranging from 16.3% to 87.22%, and English studies reported prevalence ranging from 75.2% to 86.1%. For anxiety, again with varying assessment tools and criteria, Chinese studies reported rates from 9.5% to 61.97%, and English studies reported rates from 75% to 99.1%. Some studies also reported somatisation, obsessive-compulsive symptoms, and sleep disturbances. Key correlates associated with these symptoms included biological, social, and psychological factors.
Conclusion: This review synthesises evidence on the high prevalence of psychological symptoms among pneumoconiosis patients across diverse regions, which are associated with multifaceted factors. The scarcity of intervention studies, combined with methodological heterogeneity in existing research, underscores the urgent need for standardized assessment tools and the development of context-sensitive, biopsychosocial care models for this population.
1 Introduction
Pneumoconiosis is a category of respiratory diseases that includes asbestosis, silicosis, coal worker’s pneumoconiosis, talc pneumoconiosis, kaolin pneumoconiosis, siderosis of the lung, and other rarer forms, all resulting from sustained inhalation of mineral dust particles during occupational exposure (1). Despite improved occupational safety regulations over the years, pneumoconiosis remains a serious global public health challenge nowadays (2). Annual deaths have exceeded 21,000 each year since 2015, according to estimation (3). The global annual incidence of pneumoconiosis increased by 61.5% between 1990 and 2019, rising from 123,271 cases to 199,125 cases (4).
Research shows that individuals with chronic diseases in general experience poorer mental health more frequently than those without chronic conditions (5). Social, material, and relational problems increase mental health risks. Specific stressors, such as financial strain, housing instability, intimate relationship difficulties, and sexual concerns, occur more often among chronic disease populations (6). Considering that most pneumoconiosis forms are chronic conditions, the mental well-being of pneumoconiosis patients demands attention from public health and occupational health systems. Indeed, existing studies have revealed higher mental health risks among pneumoconiosis patients (7, 8). However, to date, no review has systematically synthesized findings across both publications in the Chinese and English languages. This knowledge gap prevents a complete understanding of the symptom patterns and management needs of pneumoconiosis patients. In response to this situation, the present scoping review aims to map the existing body of evidence across diverse study designs and across the two languages.
Current research on the mental health of pneumoconiosis patients rarely considers the insights from both studies published in English and Chinese. This oversight persists even though the disease poses a severe health challenge in China. Pneumoconiosis is the most prevalent occupational disease in China. Data from China’s National Health Commission reveals that pneumoconiosis accounts for 90% of all occupational diseases (9). In 2019, China reported the highest incidence of the disease among all countries (136,755 cases), followed by India (11,670 cases) and the United States (10,014 cases) (5). Furthermore, China accounted for 68.7% of new pneumoconiosis cases, 44.3% of related deaths, and 66.2% of disability-adjusted life years (DALYs) globally (10). While this review adopts a global perspective, we expected that a substantial part of the evidence would come from China.
According to the data above, China accounts for a significant portion of the global pneumoconiosis cases (5, 10). Consequently, excluding Chinese-language literature would have created a significant evidence gap. Such an exclusion could have biased the overall findings. Therefore, we believe there is a need to consider evidence from both English- and Chinese-language studies. This approach allows our study to present a more comprehensive view of existing research.
In summary, the present scoping review aims to synthesize existing evidence by addressing the following questions:
1. What is the reported prevalence of psychological symptoms (e.g., anxiety, depression) among pneumoconiosis patients in the Chinese and English literature?
2. What biological, psychological, and social factors are associated with these symptoms?
3. What evidence exists regarding the effectiveness of interventions for these symptoms?
By mapping the existing body of research, we attempted to identify crucial directions for future research and strategic priorities for policy decisions.
2 Method
This scoping review follows the procedures recommended by PRISMA Extension for Scoping Reviews (PRISMA-ScR) (11). A preregistration of the review was submitted to Open Science Framework.1 Our approach follows the general scope of inquiry (PCC: Population = pneumoconiosis patients; Concept = psychological symptoms and their correlates; Context = global research literature). Unlike systematic reviews, PRISMA-ScR does not require scoping reviews to include a formal quality assessment (risk of bias appraisal) of the included studies or a statistical meta-analysis (11). The primary goal of a scoping review is to map the scope and nature of the available evidence and to pinpoint gaps in the research (11).
We conducted a systematic search of these databases for English literature: APA Databases (PsycArticles and PsycINFO), ProQuest, PubMed, ScienceDirect, Scopus, and Web of Science. For Chinese-language literature, we used the following databases: Chinese Academic Journal (CNKI), Chinese Biomedical Literature Database (CBM), VIP database, and Wanfang data. We selected databases to ensure comprehensive global and regional literature coverage. English-language databases (including APA Databases for psychology, PubMed for biomedicine, and Scopus/Web of Science for multidisciplinary content) provide international evidence. Due to China’s high pneumoconiosis burden, Chinese medical databases (CNKI, CBM, Wanfang, VIP) were essential.
We used consistent Boolean logic across all databases: (“pneumoconiosis”) AND (“anxiety” OR “depression” OR “mental health” OR “psychological distress”), and then applied filters for time range, language, and human subjects in some databases. However, some databases do not support excluding animal studies, selecting language, or displaying only peer-reviewed articles when performing searches. When searching Chinese databases, we applied semantically equivalent adjustments to the search logic using simplified Chinese terms with identical meanings. Two native Chinese-speaking researchers independently translated core English terms (e.g., “anxiety,” “depression”) using ICD-11 and DSM-5 diagnostic criteria. Separate translators performed back-translation to verify semantic equivalence. The final Chinese terms (e.g., 尘肺病 for pneumoconiosis, 焦虑 for anxiety) underwent validation through test searches across all Chinese databases. This procedure confirmed retrieval accuracy before conducting the complete literature search. Our searches covered title, abstract, and keywords. We provide a supplementary document presenting the specific search query used for each database.
All databases were searched from June 28 to July 5, 2025, covering publications from 2000 to 2025. Over the past few decades, the global incidence of pneumoconiosis has been rising (5). We selected the 2000–2025 timeframe for this review to zoom in on emerging research developments since the onset of the 21st century.
Two reviewers (including the first author and an independent reviewer who has a bachelor’s degree) independently screened the results from the searches in two phases:
1. Title/Abstract Screening: Using Rayyan software, two reviewers assessed eligibility through reading titles and abstracts.
2. Full-Text Review: The same two reviewers evaluated potentially eligible studies based on eligibility criteria as checklists, resolving disagreements through consensus discussion. If a consensus could not be reached, a third senior researcher would arbitrate.
Table 1 shows the eligibility criteria for inclusion and exclusion.
Table 1. Eligibility criteria.
We excluded grey literature (e.g., reports and theses) and non-empirical publications (e.g., editorials, commentaries, and reviews). We excluded grey literature due to its unclear and debated definitional criteria. Moreover, we focused only on peer-reviewed studies to ensure scientific rigor in the evidence to be reviewed.
We excluded qualitative studies; this decision aligned with the specified objectives of our review, which are to map the prevalence of psychological symptoms and identify biological, psychological, and social factors reported in the empirical literature. To meet these objectives, we had to rely on quantitative evidence. In the English-language literature search, we identified 128 articles from the database searches. We initially removed 65 duplicates. Subsequently, based on a review of titles and abstracts, we excluded 48 articles that were not related to the topic, did not report quantitative psychological symptoms, were animal studies, were not written in English, or were not peer-reviewed. Then, we conducted a full-text eligibility assessment of the remaining 15 articles and thereby excluded four additional articles that were unrelated to the topic or not peer-reviewed. In the end, we included 11 articles in the present review.
In the Chinese literature search, we identified 302 articles from the database searches. We initially removed 116 duplicates and then excluded 137 articles that were not related to the topic or did not report quantitative psychological symptoms. Thereafter, we conducted a full-text eligibility assessment on the remaining 49 articles and decided to exclude five articles that were not related to the topic, lacked transparent reporting of the data collection process, or did not report quantitative results. Finally, we included 44 articles in the present review.
Figure 1 shows the screening process.
Figure 1. PRISMA 2020 flow diagram for screening.
3 Results
This analysis included 55 studies, 11 in English and 44 in Chinese, spanning the years 2003–2024. Table 2 details the English-language studies. Publication of these studies occurred mainly after 2010, with over half (six out of 11 studies) appearing in 2020 or later. This pattern suggests a recent increase in international interest. These studies came from specific geographic locations: one from South Korea, one from Japan, one from Romania, one from Taiwan, China, four from Hong Kong SAR, China, and three from mainland China. Table 3 details the Chinese-language studies. All these studies focused exclusively on mainland China. The regions investigated in China were diverse, including Chongqing, Ningxia, Shandong, and Guangdong. Over 80% of these studies (36 out of 44) were published in 2010 or later, with most (28) concentrated in the most recent decade (i.e., 2014–2024).
Table 2. English-language studies.
Table 3. Chinese-language studies.
Before reporting the key results, it is necessary to note that in the reviewed studies, the core concepts were measured in substantially different ways. Assessment tools for depression varied significantly. Studies in English mostly used the Geriatric Depression Scale (GDS, six studies) and the Hospital Anxiety and Depression Scale-Depression subscale (HADS, two studies). Conversely, studies in Chinese most often employed the depression subscales of the Symptom Checklist-90 (SCL-90, 19 studies), the Self-Rating Depression Scale (SDS, 14 studies), and the Hamilton Depression Scale (HAMD, four studies). For anxiety, English studies primarily used the HADS subscale (two studies). Chinese studies mainly used the Self-Rating Anxiety Scale (SAS, 10 studies). Notably, Chinese studies tended to document a wider range of symptoms. They frequently reported multidimensional psychopathology using SCL-90 subscales. For example, 13 studies reported somatization symptoms, and 13 studies reported obsessive-compulsive symptoms. English studies more commonly connected psychological symptoms to specific disease outcomes. These outcomes included Quality of Life (QoL, four studies) or functional impairment, such as activity limitation (three studies).
English-language and Chinese-language studies showed clear differences in research design, suggesting distinct research priorities. The 11 English-language studies (Table 2) included 10 cross-sectional studies and one retrospective cohort study (7). Only the cohort design enabled quantifying depression incidence rates over time (per 1,000 person-years). It allowed calculation of adjusted hazard ratios (aHRs) comparing pneumoconiosis patients with matched controls. This approach directly addressed temporal relationships and quantified risk. The incidence rate reported by Lee et al. (7) indicates an increased risk. However, this study’s cohort design and operational definitions differed significantly from the cross-sectional prevalence studies, contributing to overall heterogeneity. Conversely, among the 44 Chinese language studies (Table 3), 39 employed cross-sectional designs, two employed case–control methodologies (12, 13), 1 employed a retrospective analysis (14), 1 employed an experimental intervention (15), and 1 used a tracking survey (16). The case–control studies specifically enabled direct comparisons. These comparisons examined psychological symptom prevalence and scores between pneumoconiosis patients and non-exposed controls (e.g., depression rates (12)). The experimental study (15) uniquely assessed the effects of a specific intervention (exercise) on symptoms like fatigue and anxiety.
Building on the descriptive findings, a comparative synthesis indicates that differences between the English and Chinese literature go beyond methodological approaches and likely reflect deeper distinctions in research priorities, healthcare systems, and socio-cultural backgrounds. English-language studies predominantly emphasize biological correlates, such as pulmonary function and patient-reported outcomes such as Quality of Life (QoL). Conversely, Chinese-language studies place greater focus on socio-economic mediators, including medical payment burdens, rural residence, and welfare satisfaction. This emphasis may reflect the specific challenges present in China’s social and occupational health environment.
3.1 Prevalence of psychological symptoms
Pneumoconiosis patients experience a substantial burden of psychological symptoms, as revealed in both the reviewed English and Chinese studies. This distress typically involves elevated depression and anxiety symptoms. Most of the studies assessed psychological symptoms using validated screening tools and symptom scales. These studies usually reported either the prevalence of clinically significant symptom levels or mean scores. Most of them did not report rates of formal clinical diagnoses based on diagnostic criteria such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). Therefore, this review is limited to psychological symptoms assessed through screening measures, not clinical diagnosis.
There were substantial differences across the reviewed studies in the reported rates of depression and anxiety among pneumoconiosis patients. These differences may reflect the significant variations in research methods, as discussed earlier. For example, reported prevalence rates may be sensitive to the specific assessment tool used or the diagnostic thresholds set for the tool. For depression, Chinese studies reported prevalence ranging from 16.3% (with HAMD ≥8 (17)) to 87.22% (with SDS index ≥0.5 (18)). English studies reported prevalence ranging from 75.2% (with GDS-15 ≥ 7 (19)) to 86.1% (with HADS-D ≥ 8 (20). For anxiety, Chinese studies reported rates varying from 9.5% (with HAMA ≥7 (17)) to 61.97% (with SAS ≥ 50 (21)). English-language studies reported rates as high as 99.1% (HADS-A ≥ 8 (19)) or 75% (HADS total ≥8 (22)). The heterogeneity in these observations may have reflected the influence of measurement choice, including both the tool and the cutoff criteria used.
Differences in sample characteristics may have further contributed to the observed variations in prevalence. These characteristics included age distribution, such as an older adult focus in Cho and Cho (19) rather than broader age ranges in other studies; specific pneumoconiosis subtypes studied (e.g., Coal Workers’ Pneumoconiosis (CWP), silicosis, silicosis with tuberculosis); and disease severity (e.g., stage I, II, and III). Notably, the reviewed studies differed in their definitions of pneumoconiosis. Some studies focused on the pure forms of the disease, while others included cases with significant comorbidities, such as tuberculosis (13, 23, 24, 25). This complexity makes direct comparisons across studies difficult.
3.2 Significant correlates
Both English and Chinese studies identified biological, psychological, and social risk factors. Biological factors included disease severity. Psychological factors included coping styles. Social factors included social support and socioeconomic status. However, the focus on specific factors differed between the studies. English studies uniquely measured the effect of pulmonary function. For example, Tang et al. (26) and Postolache et al. (22) used measures like FEV1% and FVC%. Furthermore, English studies emphasized death anxiety (19). Chinese studies provided more detailed information on socioeconomic mediators, including medical payment burden (27), rural residence (27), and tuberculosis comorbidity, documented in seven studies (including the seven study references, (13, 17, 23, 24, 25, 28, 41)). Chinese studies investigated specific triggers of social dissatisfaction (13, 25).
Biological factors are important to consider. Comorbid conditions such as tuberculosis and chronic obstructive pulmonary disease (COPD) significantly worsened co-occurring depression and anxiety symptoms (18, 25, 28). Disease progression correlated strongly with severity, with advanced pneumoconiosis stages, particularly Stage III (8, 29), showing greater vulnerability (7, 18). More severe dyspnea correlated with worse mental health (22, 30). Reduced lung function (FEV1%/FVC%) is associated with poorer psychological outcomes (26, 31). Greater functional and activity impairment contributed to disease burden (22, 26, 32, 33). Being female or aged ≥80 years further increases depression risk (7).
Psychological factors also played a role. Diminished self-care capacity directly predicted poorer mental health (34), while maladaptive coping strategies (e.g., self-blame) exacerbated symptom severity (35). Existing depression directly intensified symptom burden (30, 36). Patients with low outcome expectations about physical activity showed higher depression severity, while low self-efficacy predicted this (30).
Social factors are important too. These factors included a lack of spouse, religious, or family support (19, 20, 36). Socioeconomic disadvantages, including low education and income, worsened symptoms (7, 19, 37). Patients experiencing high out-of-pocket medical costs (27), rural residency (27), or insufficient social support (38) faced substantially elevated risks. Lower educational attainment was consistently associated with heightened symptom burden (19, 20, 35, 39). Furthermore, longer hospitalization and caregiving burden impaired mental health (19, 36). Protective factors included greater welfare satisfaction, enhanced healthcare access, and financial compensation, which demonstrably mitigated symptom severity (32, 34).
3.3 Effectiveness of interventions
Evidence directly showing effective management or intervention strategies is limited to date. This review identified one experimental study. Yan et al. (15) found that recipients of an aerobic exercise intervention showed significant reductions in anxiety and fatigue. This finding suggests that structured physical activity may effectively alleviate these specific symptoms in patients with pneumoconiosis.
The findings reviewed in the previous section regarding biological, psychological, and social factors hint at potential areas for future intervention development. For example, some cross-sectional studies revealed a significant negative link between social support levels and anxiety or depression symptoms (20, 38, 40, 41). Researchers measured social support using tools like the Multidimensional Scale of Perceived Social Support (MSPSS), the Lubben Social Network Scale (LSNS), and the Social Support Rating Scale (SSRS). While this observation does not constitute causal evidence, it suggests that social support may be a valuable resource for treatment, pointing to the potential importance of peer support groups, family counseling, or community programs. Kawaji et al. (30) found lower outcome expectations about physical activity related to worse depression. Self-efficacy played a mediating role, highlighting that promoting positive outcome expectations and self-efficacy could be a reasonable intervention goal. Cognitive-behavioral strategies aimed at changing expectations and reducing unhelpful coping methods, such as self-blame (35), are worth exploring.
Strong cross-sectional links existed between worse physical disease and worse psychological symptoms. These links involve greater disease severity (e.g., higher stage (8, 18, 29), worse lung function (26, 31), more severe breathing problems (21), more other illnesses (e.g., TB, COPD (7, 17, 18, 25, 28, 37, 42)), and increased hospital visits (7). Optimizing medical care for pneumoconiosis and other illnesses is obviously essential. The correlational observation suggests that physical disease management might improve the mental health of pneumoconiosis patients. Higher caregiver depression symptoms were associated with worse patient mental health outcomes (36). This link indicates that reducing caregiver strain could be vital for whole-person care. Evaluating support services, like respite care, deserves attention. Overall, an integrated care model is warranted.
4 Discussion
Based on 11 English-language and 44 Chinese-language studies, the review identifies the following key issues.
4.1 Key observations
First, psychological symptoms are prevalent among pneumoconiosis patients. However, the prevalence estimates varied substantially across studies, likely due to their methodological differences (e.g., assessment tool and cutoff criteria). Thus, some differences between the studies published in Chinese and those published in English are worth mentioning. For instance, Chinese studies primarily used assessment instruments such as the SCL-90, SDS, and HAMD, whereas English studies relied more on the GDS and HADS. Due to these variations, direct comparisons across studies become difficult. This situation indicates a need for standardization of methods, such as the use of standardized and clinically validated diagnostic tools and criteria.
Second, the analysis regarding factors associated with psychological symptoms revealed some differences between the studies in the two languages. English studies focused more often on biological factors, such as disease severity, lung function decline, and respiratory impairment. Meanwhile, Chinese research was more strongly oriented toward documenting socioeconomic mediators, such as financial burdens from medical expenses and disparities in rural residence. This emphasis in the Chinese studies potentially reflects the predominant concerns facing patients in the country, such as high treatment costs for occupational lung diseases and significant rural–urban health disparities. It may be that, across countries, given their distinct medical systems and social circumstances, the risk factors associated with psychological symptoms among pneumoconiosis patients may vary accordingly. Future studies must consider the context-specificity of the mechanisms underlying such symptoms and of the intervention or management strategies.
Third, there is very limited evidence on how psychological symptoms among pneumoconiosis patients can be effectively managed. Filling this gap would improve care for these patients, but it would require more future studies with an experimental design.
The prominence of socioeconomic factors in Chinese publications likely reflects the specific challenges within China’s healthcare system—for example, high costs for chronic illness management among rural migrants with restricted health insurance. Conversely, the emphasis on biological markers in English-language studies may reflect a stronger orientation toward a biomedical research model in the international literature. These differences suggest that the understanding of psychological distress could be shaped by broader socioeconomic and healthcare contexts.
The objective of our scoping review is to scope the available evidence broadly (65). It has the potential to identify a focused research question for future systematic reviews and meta-analyses (65). Our scoping review identifies a considerable number of quantitative studies on this topic. The results of a scoping review allow us to determine the potential for conducting further reviews and meta-analyses. Based on the evidence mapping, more focused reviews are now appropriate. For example, a systematic review could be performed to synthesize the consistent findings on key correlates of psychological symptoms. A meta-analysis is possible regarding prevalence rates, although such an analysis needs to take into consideration the heterogeneity of assessment instruments and cutoff values used in different studies.
4.2 Limitations
The insights discussed above should be considered with the following caveats. First, our bilingual search strategy captured a distinct geographic and epidemiological focus. This is reflected in the significantly higher number of Chinese-language studies (n = 44) compared to English-language studies (n = 11). As mentioned in the Introduction, China has an extremely high global burden of pneumoconiosis, so it is conceivable that all of the Chinese-language studies focused only on samples from various provinces in mainland China. Conversely, the English-language studies came from more diverse regions, including South Korea, Japan, Romania, Taiwan (China), Hong Kong (China), and mainland China. Still, these studies were predominantly conducted in Asia, with one exception representing Eastern Europe. Overall, this limited geographic scope could substantially constrain the external validity of the conclusions drawn from the existing research.
We excluded qualitative studies. As explained, this decision aligned with the specified objectives of our review, which are to map the prevalence of psychological symptoms and identify biological, psychological, and social factors reported in the empirical literature. Despite this decision, we do recognize the value of qualitative studies for a thick description of the lived experiences of pneumoconiosis patients. We admit that this decision may have compromised the comprehensiveness of the evidence base of our review.
4.3 Conclusion
This scoping review established that pneumoconiosis patients face a significant and multifaceted psychological burden. To address this issue, a paradigm shift is needed. Moving forward, priorities must include: (1) the adoption of standardized diagnostic tools in both research and clinical practice to enable reliable monitoring and comparison; (2) the development and evaluation of multidisciplinary intervention models that integrate mental health care into standard pneumoconiosis management; and (3) the implementation of policies that integrate mental health assessment into occupational health care programs to ensure a comprehensive approach to the well-being of this vulnerable population. By mapping the available evidence, this review provides a foundation for future systematic reviews and meta-analyses, enabling the synthesis of correlates and prevalence estimates in high-incidence populations.
Data availability statement
The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.
Author contributions
XW: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Validation, Writing – original draft, Writing – review & editing. RL: Formal analysis, Investigation, Writing – original draft. KT: Formal analysis, Supervision, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that financial support was received for the research and/or publication of this article. A portion of the publication fees of this article were provided by the School of Humanities and Social Science and Division of Social Science of The Hong Kong University of Science and Technology.
Acknowledgments
The work in this study was not funded.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Supplementary material
The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2025.1703091/full#supplementary-material
Footnotes
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Keywords: pneumoconiosis, mental health, occupational health, psychological symptoms, pneumoconiosis patients
Citation: Wang X-P, Li R and Tam K-P (2025) Psychological symptoms and their correlates in pneumoconiosis patients: a bilingual scoping review. Front. Public Health. 13:1703091. doi: 10.3389/fpubh.2025.1703091
Edited by:
Sasho Stoleski, Saints Cyril and Methodius University of Skopje, North MacedoniaReviewed by:
Hadiseh Rabiei, Shahid Beheshti University of Medical Sciences, IranAna Rita Pádua, ULSRA, Portugal
Copyright © 2025 Wang, Li and Tam. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xi-Ping Wang, eHdhbmdrYUBjb25uZWN0LnVzdC5oaw==