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Investigate the effect of long-term COVID-19 on maternal and fetal complications. A retrospective cohort study was conducted. A total of 623 pregnant women who delivered in Kunming First People's Hospital from November 1, 2022 to July 31, 2023 were selected. By employing statistical methods, we compared the associations between maternal and fetal complications in pregnant women with acute COVID-19 during pregnancy, long-term COVID-19, and non-COVID-19 pregnant women. In the final 623 samples, there were 209 pregnant women with acute COVID-19, 72 pregnant women with long-term COVID-19, and 342 pregnant women without COVID-19. The epidemiological and clinical characteristics of all subjects were similar. Pregnant individuals who developed long-term COVID-19 during their pregnancy had an increased risk of experiencing gestational hypertension (OR 3.344, 95% CI 1.544–7.243), gestational diabetes mellitus (OR 2.301, 95% CI 1.290–4.102), and fetal intrauterine growth restriction (OR 2.817, 95% CI 1.385–5.952). Multivariate binary logistic regression analysis showed that this association remained consistent even after adjusting for confounders and performing subgroup analyses. Other maternal and fetal complications, such as premature rupture of membranes, preterm delivery, neonatal asphyxia, and transfer of neonates to NICU, did not exhibit statistically significant associations. After linear regression analysis, the platelet count (β: − 0.127, 95% CI − 0.001–0.000) of pregnant women with long-term COVID-19 was slightly lower than that of non-COVID-19 pregnant women, and the other coagulation parameters were not statistically significant. The incidence of gestational hypertension, gestational diabetes mellitus and fetal intrauterine growth restriction in pregnant women with long-term COVID-19 is significantly increased, but it does not further increase the coagulation status. [ABSTRACT FROM AUTHOR]

Objective: Adverse childhood experiences (ACEs) have been associated with a range of adverse health outcomes, with pain being potentially one of them. This population-based cross-sectional study aimed to investigate the associations between Adverse Childhood Experiences (ACEs) and pain in Chinese adults and evaluate whether physical activity and demographic and socioeconomic characteristics modify this associations. Methods: Cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), were utilized in this study. A total of 9923 respondents with information on 12 ACE indicators and 15 self-reported body pains were included. Logistic regression models were used to assess associations of the ACEs and pain. Modification of the associations by physical activity, demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. Results: Among the 9923 individuals included in the primary analyses, 5098 (51.4%) males and the mean (SD) age was 61.18 (10·.44) years. Compared with individuals with 0 ACEs, those who with ≥ 5 ACEs had increased risk of single pains and multiple pain. A dose–response association was found between the number of ACEs and the risk of pain (e.g. neck pain for ≥ 5 ACEs vs. none: OR, 1.107; 95% CI, 0.903–1.356; p < 0.001 for trend). In the associations of each body pain with each ACE indicator, most ACE indicators were associated with an increased risk of pain. In addition, physical activity, sociodemographic and socioeconomic characteristics, such as age, sex, educational level, area of residence, childhood economic hardship, did not demonstrate a significant modify on the associations between ACEs and pain. Conclusions: These findings indicate that cumulative ACE exposure is associated with increased odds of self-reported pain in Chinese adults, regardless of adult physical activity, sociodemographic and socioeconomic characteristics. [ABSTRACT FROM AUTHOR]

There exists mutual improvement and restriction between regional tourism industry and the development of the tourism subject. With the rapid development of the tourism industry, it has set up the tourism program in the universities of Yunnan Province. However, the regional development of the construction of tourism subject is not balanced and its construction is still at the primary stage. Therefore, in spatial dimension, the method of principal components analysis is firstly adopted to construct comprehensive evaluation index system of the tourism development and subject construction. According to the results of the evaluation and analysis, the authors have ranked and classified 16 cities in Yunan province and summarized 5 synchronous development types of the tourism subject and industry. Finally, according to the different regions, the authors have proposed the different modes of subject construction and the strategies of optimal allocation.

Objective: To evaluate the preference of primary HCWs and residents on vaccination consultation in community health services to provide evidence for vaccine hesitancy intervention strategies. Methods: A discrete choice model (DCM) was constructed to evaluate the preference difference between primary HCWs and residents on vaccination consultation in community health services in China during May–July 2022. Results: A total of 282 residents and 204 HCWs were enrolled in this study. The residents preferred consulting with an HCW-led approach (β = 2.168), with specialized content (β = 0.954), and accompanied by telephone follow-up (β = 1.552). In contrast, the HCWs preferred face-to-face consultation (β = 0.540) with an HCW-led approach (β = 0.458) and specialized content (β = 0.409), accompanied by telephone follow-up (β = 0.831). College residents and residents with underlying self-reported disease may be near-critically inclined to choose traditional consultation (an offline, face-to-face consultation with standardized content and more prolonged duration) rather than a new-media consulting group (an online consultation with specialized content within 5 min). Urban HCWs preferred long-term consultation groups (the resident-led offline consultation with follow-up lasting more than 5 min). In contrast, rural HCWs preferred efficient consultation (the HCW-led, short-duration, standardized offline consultation mode). Conclusion: The selection preference for vaccine consultation reveals a gap between providers and demanders, with different groups exhibiting distinct preferences. Identifying these targeted gaps can help design more acceptable and efficient interventions, increasing their likelihood of success and leading to better resource allocation for policymakers to develop targeted vaccination policies. [ABSTRACT FROM AUTHOR]

Purpose: Pseudomonas aeruginosa is a common causative bacteria in nosocomial infections. This study aims to describe the structure and evolutionary characteristics of mobile genetic elements (MGEs) carrying antibiotic resistance genes (ARGs) from P. aeruginosa and to conduct bioinformatics and comparative genomic analysis to provide a deeper understanding of the genetic characteristics and diversity of MGEs in P. aeruginosa. Methods: Fifteen clinical isolates of P. aeruginosa from China were collected and sequenced in this study, and 15 novel MGEs were identified. Together with four MGEs from GenBank, a total of 19 MGEs were used to perform detailed modular structure dissection and sequence comparison. Then, the biological experiments were carried out to verify the biological characteristics of these isolates and MEGs. Results: The novel MGEs identified in this study displayed diversification in modular structures, which showed complex mosaic natures. The seven types of 19 MGEs included in this study were divided into three groups: i) novel MGEs (firstly identified in this study): four IncpSE5381-aadB plasmids and three Tn 7495-related integrative and mobilizable elements (IMEs); ii) newly defined MGEs (firstly designated in this study, but with previously determined sequences): four Tn 7665-related IMEs; iii) novel transposons with reference prototypes identified in this study: two Tn 6417-related integrative and conjugative elements (ICEs), two IS-based transposition units, two Tn 501-related unit transposons, two Tn 1403-related unit transposons. At least 36 ARGs involved in resistance to 11 different classes of antimicrobials and heavy metals were identified. Additionally, three novel blaOXA variants were identified. Antimicrobial susceptibility testing showed that these variants were resistant to some β-lactamase antibiotics and blaOXA-1204 was additionally resistant to cephalosporins. Conclusion: The continuous evolution of ARG-carrying MGEs during transmission, leading to the emergence of novel MGEs or ARGs, which facilitates the spread of antibiotic resistance in P. aeruginosa and enhances the diversity of transmission modes of bacterial resistance. [ABSTRACT FROM AUTHOR]

The mid‐high latitude intraseasonal oscillation (ISO) has remarkable impacts on the Northern Hemisphere. However, the interannual variance of the mid‐high latitude ISO and its underlying mechanism are rarely explored. Here, we find that the tropical stratospheric Quasi‐Biennial Oscillation (QBO) has notable impacts. A statistically significant contrast in the interannual variability of intraseasonal 2‐m temperature (T2m) over northern Eurasia is detected between the easterly (EQBO) and westerly (WQBO) QBO phase. The influence of the QBO could be attributed to the interactions of ISO perturbation and QBO‐related winter‐mean flow. Specifically, the ISO perturbation is more efficient in extracting kinetic and potential energy from the winter‐mean flow in EQBO. Additionally, the northern Eurasia ISO propagates southeastward and exert effects on China. Due to this, the subseasonal forecast system of NUIST (NUIST CFS1.1) displays higher skill in predicting the T2m in China during EQBO phase at 3, 4, and 5 pentads in advance. Plain Language Summary: Extreme weather and climate in winter, such as cold waves, snowstorms, and prolonged low temperature, have severe impacts on the society, therefore it is of great value to improve subseasonal prediction of 2‐m temperature (T2m). In this study, we find that the variability of intraseasonal T2m over northern Eurasia varies from year to year during boreal winter, which is negatively correlated with the tropical stratospheric Quasi‐Biennial Oscillation (QBO). The variability of intraseasonal T2m is enhanced during QBO easterly phase (EQBO). In accordance with the higher variance of intraseasonal T2m, the extreme temperature events display higher frequency and stronger intensity in EQBO. We also find that the intraseasonal oscillation (ISO) in the northern Eurasia is not stationary, it often propagates southeastward, impacting the weather and climate in China. This has implications for the prediction of intraseasonal T2m in China. These results help understanding the relationship between the tropical QBO and mid‐high latitude ISO and provide a potential way to improve the subseasonal forecasts. Key Points: The interannual variability of intraseasonal 2‐m temperature (T2m) is amplified during easterly Quasi‐Biennial Oscillation (EQBO) in winterThe likelihood of extreme temperature events, particularly cold extreme events with intensified high‐pressure systems, is enhanced in EQBOThe southeastward propagation of the intraseasonal oscillation over northern Eurasia has impacts on winter temperature in China [ABSTRACT FROM AUTHOR]

Objective: To develop a Risk Assessment Tool for Cancer-related Venous Thrombosis in China. Methods: A modified two-round Delphi method was employed to establish consensus within a field to reach an agreement via a questionnaire or by interviewing a multidisciplinary panel of experts by collecting their feedback to inform the next round, exchanging their knowledge, experience, and opinions anonymously, and resolving uncertainties. Furthermore, The AHP (Analytic Hierarchy Process) was used to determine the final quality indicators' relative importance. Results: The expert's positive coefficient was 85.19% in the first round and 82.61% in the second round, with authoritative coefficients of 0.89 and 0.92 in the respective surveys. The P-value of Kendall's W test was all less than 0.001 for each round, and the W-value for concordance at the end of the two rounds was 0.115. The final Risk Assessment Tool for Cancer-related Venous Thrombosis consisted of three domains, ten subdomains, and 39 indicators, with patient factors weighing 0.1976, disease factors weighing 0.4905, and therapeutic factors weighing 0.3119. Conclusion: The tool is significantly valid and reliable with a strong authority and coordination degree, and it can be used to assess the risk of cancer-related VTE and initiate appropriate thrombophylactic interventions in China. [ABSTRACT FROM AUTHOR]

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Background: Despite major advances in cancer therapeutics, the therapeutic options of Lung Squamous Cell Carcinoma (LSCC)-specific remain limited. Furthermore, the current staging system is imperfect for defining a prognosis and guiding treatment due to its simplicity and heterogeneity. We sought to develop prognostic decision tools for individualized survival prediction and treatment optimization in elderly patients with LSCC. Methods: Clinical data of 4564 patients (stageIB-IIIB) diagnosed from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for prognostic nomograms development. The proposed models were externally validated using a separate group consisting of 1299 patients (stage IB-IIIB) diagnosed from 2012–2015 in China. The prognostic performance was measured using the concordance index (C-index), calibration curves, the average time-dependent area under the receiver operator characteristic curves (AUC), and decision curve analysis. Results: Eleven candidate prognostic variables were identified by the univariable and multivariable Cox regression analysis. The calibration curves showed satisfactory agreement between the actual and nomogram-estimated Lung Cancer-Specific Survival (LCSS) rates. By calculating the c-indices and average AUC, our nomograms presented a higher prognostic accuracy than the current staging system. Clinical usefulness was revealed by the decision curve analysis. User-friendly online decision tools integrating proposed nomograms were created to estimate survival for patients with different treatment regimens. Conclusions: The decision tools for individualized survival prediction and treatment optimization might facilitate clinicians with decision-making, medical teaching, and experimental design. Online tools are expected to be integrated into clinical practice by using the freely available website (https://loyal-brand-611803.framer.app/). [ABSTRACT FROM AUTHOR]

Anthracnose is a common disease found in Camellia oleifera producing areas across China, whose primary pathogen is Colletotrichum fructicola. We previously revealed that autophagy is essential for the pathogenicity of C. fructicola. However, the function of ubiquitin–proteasome system (UPS), which is a parallel protein degradation pathway to autophagy, remains elusive. Here, we report that CfRad6, an E2 conjugating enzyme in UPS, interacts with three putative E3 ubiquitin ligases, namely CfRad18, CfUbr1, and CfBre1. Importantly, we presented evidence showing that CfRad6 negatively regulates autophagy, revealing the first link between UPS and autophagy in pathogenic fungi. Targeted gene deletion showed that CfRad6 is involved in growth and conidiation. We further found that the ΔCfrad6 mutant is defective in appressoria formation and responses to environmental stresses. These combined effects, along with the abnormal autophagy level, lead to the pathogenicity defects of the ΔCfrad6 mutant. Taken together, our study indicates the pleiotropic functions of CfRad6 in the development and pathogenicity of C. fructicola. [ABSTRACT FROM AUTHOR]

Background: Patients with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer and primary resistance to trastuzumab have a poor clinical outcome and lack good evidence to inform clinical decision. This study investigated the efficacy and safety of pyrotinib plus capecitabine in this population. Methods: This phase 2 trial was conducted at 16 sites in China. Patients received oral pyrotinib 400 mg once daily and capecitabine 1000 mg/m2 twice a day on days 1–14 of each 21-day cycle until disease progression or intolerable toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS). Results: Between June 2019 and September 2021, 100 patients were enrolled with a median age of 51 years (range, 24–69). All patients had been treated with trastuzumab and 21 (21.0%) patients had prior use of pertuzumab. As of August 31, 2022, the median follow-up duration was 20.1 months (range, 1.3–38.2). The median PFS was 11.8 months (95% confidence interval [CI], 8.4–15.1), which crossed the pre-specified efficacy boundary of 8.0 months. The objective response rate was 70.0% (70/100), with a median duration of response of 13.8 months (95% CI, 10.2–19.3). The disease control rate was 87.0% (87/100). The median overall survival was not reached. The most common grade ≥ 3 treatment-emergent adverse event was diarrhea (24 [24.0%]). No treatment-related deaths occurred. Conclusions: Pyrotinib plus capecitabine can be considered to be a treatment option in HER2-positive advanced breast cancer patients who have shown primary resistance to trastuzumab. Even in the era of modern anti-HER2 treatments, this clinical setting warrants more investigations to meet unmet needs. Trial registration: ClinicalTrials.gov, NCT04001621. Retrospectively registered on June 28, 2019. [ABSTRACT FROM AUTHOR]

Retrogressive thaw slumps (RTSs), which frequently occur in permafrost regions of the Qinghai-Tibet Plateau (QTP), China, can cause significant damage to the local surface, resulting in material losses and posing a threat to infrastructure and ecosystems in the region. However, quantitative assessment of ground ice ablation and hydrological ecosystem response was limited due to a lack of understanding of the complex hydro-thermal process during RTS development. In this study, we developed a three-dimensional hydro-thermal coupled numerical model of a RTS in the permafrost terrain at the Beilu River Basin of the QTP, including ice–water phase transitions, heat exchange, mass transport, and the parameterized exchange of heat between the active layer and air. Based on the calibrated hydro-thermal model and combined with the electrical resistivity tomography survey and sample analysis results, a method for estimating the melting of ground ice was proposed. Simulation results indicate that the model effectively reflects the factual hydro-thermal regime of the RTS and can evaluate the ground ice ablation and total suspended sediment variation, represented by turbidity. Between 2011 and 2021, the maximum simulated ground ice ablation was in 2016 within the slump region, amounting to a total of 492 m3, and it induced the reciprocal evolution, especially in the headwall of the RTS. High ponding depression water turbidity values of 28 and 49 occurred in the thawing season in 2021. The simulated ground ice ablation and turbidity events were highly correlated with climatic warming and wetting. The results offer a valuable approach to assessing the effects of RTS on infrastructure and the environment, especially in the context of a changing climate. [ABSTRACT FROM AUTHOR]

(1) Background: To explore the influencing factors of human papillomavirus (HPV) vaccination among mothers and daughters so as to provide evidence and strategies for improving the HPV vaccination rate of 9–18-years-old girls. (2) A questionnaire survey was conducted among the mothers of 9–18-year-old girls from June to August 2022. The participants were divided into the mother and daughter vaccinated group (M1D1), the mother-only vaccinated group (M1D0), and the unvaccinated group (M0D0). Univariate tests, the logistic regression model, and the Health Belief Model (HBM) were employed to explore the influencing factors. (3) Results: A total of 3004 valid questionnaires were collected. According to the regions, Totally 102, 204, and 408 mothers and daughters were selected from the M1D1, M1D0, and M0D0 groups, respectively. The mother having given her daughter sex education (OR = 3.64; 95%CI 1.70, 7.80), the mother's high perception of disease severity (OR = 1.79; 95%CI 1.02, 3.17), and the mother's high level of trust in formal information (OR = 2.18; 95%CI 1.26, 3.78) were all protective factors for both the mother and her daughter's vaccination. The mother's rural residence (OR = 0.51; 95%CI 0.28, 0.92) was a risk factor for vaccination of both mother and daughter. The mother's education of high school or above (OR = 2.12; 95%CI 1.06, 4.22), the mother's high level of HPV and HPV vaccine knowledge (OR = 1.72; 95%CI 1.14, 2.58), and the mother's high level of trust in formal information (OR = 1.72; 95%CI 1.15, 2.57) were protective factors of mother-only vaccination. The older the mother (OR = 0.95; 95%CI 0.91, 0.99) was classed as a risk factor for mother-only vaccination. "Waiting until the daughters are older to receive the 9-valent vaccine" is the main reason why the daughters of M1D0 and M0D0 are not vaccinated". (4) Chinese mothers had a high willingness to vaccinate their daughters with the HPV vaccine. The higher education level of the mother, giving sex education to the daughter, the older ages of mothers and daughters, the mother's high level of HPV and HPV vaccine knowledge, a high level of perception of the disease severity, and a high level of trust in formal information were promoting factors of HPV vaccination for mother and daughter, and rural residence was a risk factor to vaccination. To promote HPV vaccination in girls from 9–18 years old, communities could provide health education to rural mothers with low education levels; the government could advocate for HPV vaccination through issuing policy documents; and doctors and the CDC could popularize the optimal age for HPV vaccination to encourage mothers to vaccinate their daughters at the age of 9–14 years old. [ABSTRACT FROM AUTHOR]

The identification of priority restoration areas (PRAs) for ecosystems is a critical step in establishing restoration programs. Because the majority of existing studies focused on improving the ecosystem supply, the PRAs selected are likely to be remote from human demand, and the restoration benefits will not flow to humans. To fill this gap, we constructed an improved framework integrating the ecological restoration projects' cost and benefits as indicators for choosing PRAs. Then, we identified PRAs for each ecosystem service (ES) with Marxan, and ranked the restoration priority grades according to the superimposed value of PRAs for each ES. Finally, we adjusted the restoration priority grades based on human demand and the concentration of those areas, and chose PRAs with a high ES supply and demand. This framework was applied to the Dongting Lake Eco-Economic Zone, one of China's most significant ecological restoration project sites. The results indicated that the areas with "high"-, "sub-high"-, and "low"-grade PRAs, based only on the increase in the ES supply, were equal to 82, 410, and 1696 km2, respectively. After considering human demand, the PRAs moved continuously towards places with a high human demand; high-priority areas grew to reach 144 km2, while low-priority areas decreased to 1498 km2. The upgrade of the proposed framework for the identification of PRAs can contribute to increasing human well-being, while also serving as a support tool for environmental restoration management. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a risk factor for suicide. This study aimed to investigate the prevalence of NSSI and professional psychological help-seeking status and influencing factors among left-behind children (LBC) in China. Methods: We implemented a population-based cross-sectional study in participants aged 10–18 years. Sociodemographic characteristics, NSSI, help-seeking status and coping style were measured by self-reported questionnaires. A total of 16,866 valid questionnaires were collected, including 6096 LBC. Binary logistic regression models were used to analyze the factors influencing NSSI and professional psychological help-seeking. Results: The incidence of NSSI among LBC was 4.6%, significantly higher than that of non-left-behind children (NLBC). This incidence was higher among girls. Moreover, 53.9% of LBC with NSSI did not receive any treatment and only 22.0% sought professional psychological help. LBC often adopt emotion-oriented coping styles, specifically, those with NSSI. LBC with NSSI who seek professional help tend to adopt problem-oriented coping styles. Logistic regression analysis revealed that girls, learning stage, single-parent, remarried families, patience, and emotional venting were risk factors for NSSI in LBC, while problem-solving and social support seeking were protective factors. Moreover, problem-solving was also a predictor for seeking professional psychological help, patience will prevent it. Limitations: This was an online survey. Conclusions: The prevalence of NSSI in LBC is high. Gender, grade, family structure, and coping style affect the occurrence of NSSI among LBC. Only a few LBC with NSSI seek professional psychological help, while the coping style will affect the help-seeking behavior. [ABSTRACT FROM AUTHOR]

With the spread of the COVID-19 pandemic and the implementation of closure measures in 2020, population mobility and human activities have decreased, which has seriously impacted atmospheric quality. Huaibei City is an important coal and chemical production base in East China, which faces increasing environmental problems. The impact of anthropogenic activities on air quality in this area was investigated by comparing the COVID-19 lockdown in 2020 with the normal situation in 2021. Tropospheric NO2, HCHO and SO2 column densities were observed by ground-based multiple axis differential optical absorption spectroscopy (MAX-DOAS). In situ measurements for PM2.5, NO2, SO2 and O3 were also taken. The observation period was divided into four phases, the pre-lockdown period, phase 1 lockdown, phase 2 lockdown and the post-lockdown period. Ground-based MAX-DOAS results showed that tropospheric NO2, HCHO and SO2 column densities increased by 41, 14 and 14%, respectively, during phase 1 in 2021 vs. 2020. In situ results showed that NO2 and SO2 increased by 59 and 11%, respectively, during phase 1 in 2021 vs. 2020, but PM2.5 and O3 decreased by 15 and 17%, respectively. In the phase 2 period, due to the partial lifting of control measures, the concentration of pollutants did not significantly change. The weekly MAX-DOAS results showed that there was no obvious weekend effect of pollutants in the Huaibei area, and NO2, HCHO and SO2 had obvious diurnal variation characteristics. In addition, the relationship between the column densities and wind speed and direction in 2020 and 2021 was studied. The results showed that, in the absence of traffic control in 2021, elevated sources in the Eastern part of the city emitted large amounts of NO2. The observed ratios of HCHO to NO2 suggested that tropospheric ozone production involved NOX-limited scenarios. The correlation analysis between HCHO and different gases showed that HCHO mainly originated from primary emission sources related to SO2. [ABSTRACT FROM AUTHOR]

An hourly scale precursor of inland earthquakes (EQs) is revealed in this paper. Several EQ cases in China have been reported. As indicated by a table listing 23 inland EQs and their shock time, epicenter location, magnitude, near-epicenter weather conditions, precursor start time and precursor duration, when the weather conditions are fair near the epicenter, an anomalously negative atmospheric electrostatic signal is readily observable approximately 2–48 h before the EQ occurs. Moreover, a successful single-station alarm for nearby moderate-magnitude EQs is demonstrated, and a possible mechanism for the precursor signal is proposed. The change in the electrostatic field during an EQ process is explained as the release of radioactive gases from the subsurface into the atmosphere via large (regional-scale) preexisting microfractures in the rock at the source depth. These gases considerably ionize the atmosphere, and the separated positive and negative ions establish a special macroscopic electric field. The final critical stage of 2–48 h before an EQ may indicate a stable tectonic process. [ABSTRACT FROM AUTHOR]

The white yak, a type of unique and valuable farm animals on the Qinghai-Tibet Plateau, are mainly distributed in Tianzhu (County of Gansu Province), Menyuan, Huzhu and Ledu (three Counties of Qinghai Province) in China. In the present study, the Y-chromosomal genetic diversity, differentiation and phylogeny of three Chinese white yak breeds/populations (Tianzhu, Huzhu and Menyuan) were comprehensively explored using five Y-SNPs (SRY4, USP9Y, UTY19, AMELY3 and OFD1Y10) and one Y-STR (INRA189) markers. The results showed that six Y-haplotypes (H1Y1, H9Y1, H10Y1, H11Y2, H12Y2 and H13Y2) were identified in 97 male yak from three white yak breeds/populations. Among these haplotypes, H1Y1, H10Y1 and H11Y2 were shared by all of breeds/populations and H12Y2 was shared by Tianzhu and Huzhu populations. However, H9Y1 and H13Y2 haplotypes were only detected in Menyuan and Tianzhu white yak populations, respectively. The Y-haplotype diversity was maximum in Huzhu white yak (0.7500 ± 0.0349), the medium in Tianzhu white yak (0.6881 ± 0.0614) and the lowest in Menyuan white yak (0.5720 ± 0.0657). The total Y-haplotype diversity of three white yak breeds/populations was 0.7567 ± 0.0233, indicating rich paternal genetic diversity in white yak. The FST values showed a moderate differentiation between Tianzhu and Menyuan (FST = 0.0763, P < 0.05) populations, but a weak differentiation between Huzhu and Tianzhu white yak breeds/populations (FST = 0.0186, P > 0.05) and Huzhu and Menyuan (FST = − 0.005, P > 0.05) populations. The clustering analysis revealed a close genetic relationship between Huzhu and Menyuan white yak, both were far from Tianzhu white yak breed. The phylogenetic analyses showed that white yak had two Y-haplogroups/lineages (Y1 and Y2) with two potential paternal origins. The findings of present study provide new insight into the basic information for the formulation of molecular breeding programs of white yak. Moreover, it also contributes to the conservation and utilization of this special animal genetic resource. [ABSTRACT FROM AUTHOR]

Ice-rich permafrost in the Qinghai–Tibet Plateau (QTP), China, is becoming susceptible to thermokarst landforms, and the most dramatic among these terrain-altering landforms is retrogressive thaw slump (RTS). Concurrently, RTS development can in turn affect the eco-environment, and especially soil erosion and carbon emission, during their evolution. However, there are still a lack of quantitative methods and comprehensive studies on the deformation and volumetric change in RTS. The purpose of this study is to quantitatively assess the RTS evolution through a novel and feasible simulation framework of the GPU-based discrete element method (DEM) coupled with the finite difference method (FDM). Additionally, the simulation results were calibrated using the time series observation results from September 2021 to August 2022, using the combined methods of terrestrial laser scanning (TLS) and unmanned aerial vehicle (UAV). The results reveal that, over this time, thaw slump mobilized a total volume of 1335 m3 and approximately 1050 m3 moved to a displaced area. Additionally, the estimated soil erosion was about 211 m3. Meanwhile, the corresponding maximum ground subsidence and headwall retrogression were 1.9 m and 3.2 m, respectively. We also found that the amount of mass wasting in RTS development is highly related to the ground ice content. When the volumetric ice content exceeds 10%, there will be obvious mass wasting in the thaw slump development area. Furthermore, this work proposed that the coupled DEM-FDM method and field survey method of TLS-UAV can provide an effective pathway to simulate thaw-induced slope failure problems and complement the research limitations of small-scale RTSs using remote sensing methods. The results are meaningful for assessing the eco-environmental impacts on the QTP. [ABSTRACT FROM AUTHOR]

Aims: To investigate the proportion and risk factors of diabetic retinopathy (DR) by stages in less-developed rural areas in Hunan Province of China.Background: DR is common among people with diabetes but not well recognized in less-developed rural areas. There is insufficient evidence on the risk factors of DR by stages, making it challenging to develop targeted prevention and intervention programs for DR in primary care settings.Methods: A multi-site cross-sectional survey was conducted among people with type 2 diabetes mellitus (T2DM) from four less-developed counties in Hunan Province of China. All participants underwent the screening of DR via digital fundus photography and completed self-reported questionnaires on their socio-demographic and clinical characteristics, diabetes self-efficacy, diabetes self-care behaviors, social support, family function, and health service accessibility. The multinomial logistic regression models were employed to explore the risk factors of DR by stage, which were selected based on the socio-ecological model, literature, and clinical experience.Results: A total of 196 participants were included in this study with an average age of 57.43 ± 10.26. 59.6% (117/196) of the participants were identified as DR, including 37.2% (73/196) non-proliferative DR and 22.4% (44/196) proliferative DR. Compared to the non-DR group, the risk factors of non-proliferative DR and proliferative DR were diabetes duration (OR: 1.10, 95 CI%: 1.04-1.17; OR: 1.14, 95 CI% 1.06-1.22) and self-monitoring of blood glucose (OR: 1.09, 95 CI% 1.01-1.17; OR: 1.11, 95 CI%: 1.02-1.20); the protective factors of non-proliferative DR was accessible complication prevention and management education (OR: 0.37, 95 CI% 0.14-0.94) while the protective factors of proliferative DR were physical activities (OR: 0.89, 95 CI%: 0.80-0.98). Compared to the non-proliferative DR group, the protective factors of proliferative DR were physical activities (OR: 0.89, 95 CI% 0.02-0.89) and family function (OR: 0.84, 95 CI%: 0.04-0.84).Conclusion: DR was prevalent among people with T2DM in less-developed rural areas, indicating the need of strengthening DR screening. Risk factors of DR varied by stage while sharing some common factors. Future DR prevention and intervention programs may benefit from improving these factors to reduce the risk of DR by stage. [ABSTRACT FROM AUTHOR]

Background: Assessment of immune function is of key importance in recognition of disease or healthy status, which still faces challenge in clinical practice. We conducted a 10-center study to investigate lymphocyte parameters including the number, phenotype and IFN-γ-producing ability, and routine laboratory indicators by using the standard method. Results: Although the heterogeneity of lymphocyte parameters was widely found, we have established the normal ranges of these parameters by using pooled data which showed no significant difference among centers. Cluster analysis of 35 parameters found 3 interesting clusters which represented different immunological status. Cluster 1 (parameters: IFN-γ+CD4+ T cell percentage and IFN-γ+CD8+ T cell percentage) represented current lymphocyte function, which was associated with indicators such as body mass index and red blood cell; Cluster 2 (parameters: NK cell number and CD45RA+CD4+ T cell percentage) represented potential of lymphocytes, which was associated with indicators such as albumin and high-density lipoprotein. Cluster 3 (parameters: HLA-DR+CD8+ T cell percentage) represented inflammatory status, which was associated with indicators such as low-density lipoprotein, globulin and age. Correlation analysis found that nutritional indicator albumin is significantly positively correlated with lymphocyte potential. Triglyceride and body mass index were positively correlated with current lymphocyte function rather than lymphocyte potential. The loss of CD8+ T cells was extremely pronounced with increasing age and was one of the most important factors to cause immunosenescence, which may be associated with increased glucose. Conclusions: We have established the normal ranges of lymphocyte parameters in different areas. This study elucidates the key indicators used to reflect the current function or potential of lymphocytes, which may provide a valuable clue for how to keep immunity healthy. [ABSTRACT FROM AUTHOR]

Soil moisture (SM), an important variable in water conversion between the atmosphere and terrestrial ecosystems, plays a crucial role in ecological processes and the evolution of terrestrial ecosystems. Analyzing and exploring SM's processes and influencing factors in different permafrost regions of the Qinghai-Tibet Plateau (QTP) can better serve the regional ecological security, disaster warning, water management, etc. However, the changes and future trends of SM on the QTP in recent decades are uncertain, and the main factors affecting SM are not fully understood. The study used SM observations, the Global Land Evapotranspiration Amsterdam Model (GLEAM) SM products, meteorological and vegetation data, Mann–Kendall test, Theil–Sen estimation, Ensemble Empirical Mode Decomposition (EEMD), and correlation methods to analyze and explore the characteristics and influencing factors of SM change in different permafrost regions of the QTP. The results show that: (1) At the pixel scale, GLEAM SM products can better reflect SM changes in the QTP in the warm season. The seasonal permafrost region is closer to the real SM than the permanent region, with a median correlation coefficient (R) of 0.738, median bias of 0.043 m3 m−3, and median unbiased root mean square errors (ubRMSE) of 0.031 m3 m−3. (2) The average SM in the QTP warm season increased at a rate of 0.573 × 10−3 m3 m−3 yr−1 over the recent 40 years, and the trend accelerated from 2005–2020. In 64.31% of the region, the soil was significantly wetted, mainly distributed in the permafrost region, which showed that the wetting rate in the dry region was faster than in the wet region. However, the wetting trend does not have a long-term continuity and has a pattern of "wetting–drying-wetting" on interannual and decadal levels, especially in the seasonal permafrost region. (3) More than 65% of the SM wetting trend on the QTP is caused by temperature, precipitation, and vegetation. However, there is apparent spatial heterogeneity in the different permafrost regions and vegetation cover conditions, and the three factors have a more substantial explanatory power for SM changes in the seasonal permafrost region. With the global climate change, the synergistic SM–Climate–Vegetation effect on the QTP tends to be more evident in the seasonal permafrost region. [ABSTRACT FROM AUTHOR]

Future changes in the frequency of extreme drought events are of vital importance for risk assessment and relevant policy making. But a reliable estimation of their probability is intrinsically challenging due to limited available observations or simulations. Here, we use two large ensemble simulations, 50 members from CanESM2 and 40 members from CESM1 under the future RCP8.5 scenario, to elaborate a reliable projection of the 100-yr drought events (once in a century) under different warming levels. It is however necessary to first remove systematic biases for the simulated temperature and precipitation through a bias-correction method based on quantile mapping. Droughts are diagnosed with the standardized precipitation evapotranspiration index (SPEI), which considers both precipitation and potential evapotranspiration (PET, involving temperature). The results show that the frequency of extreme droughts increases with the continued global warming. Some differences between the two ensembles are also observed, especially for high warming levels. The China-averaged probability of 100-yr droughts that occur once in a century in the current climate increase by a factor of 1.52 (1.44) and 1.90 (2.02) under 1.5°C and 2°C warming levels in CanESM2-LE (CESM1-LE), respectively. A simple statistical scheme shows that the increasing future risk of extreme droughts is mainly due to the increasing effect of PET on the occurrence of extreme drought events, while the effect of precipitation almost keeps constant with global warming. [ABSTRACT FROM AUTHOR]

The enrichment mechanism and process of shale oil are key issues in the studies on shale oil. To date, a variety of methods have been applied to describe the characteristics of typical shale oil reservoirs and reveal the potential influencing factors on marine and freshwater continental shale. However, geological characteristics and influencing mechanism of saline lake shale oil reservoirs remain poorly understood. Here, we report our investigation on the petrological, organic geochemical, and pore structure characteristics of the 10th cyclothem of the third member (Eq3410) of the saline lake–formed Qianjiang Formation in Jianghan Basin using X‐ray fluorescence spectroscopy, X‐ray diffraction, field emission scanning electron microscopy, low‐temperature nitrogen adsorption, and high‐pressure mercury intrusion. The shales of Eq3410 contain high average carbonate contents (45.53%) and clay minerals (20.89%), as well as anisometric glauberite, quartz, feldspar, rock salt, and pyrite. The main lithofacies are dolomitic mudstone, argillaceous dolomite, and calcareous mudstone. The shale samples tested yield total organic carbon (TOC) and S1 + S2 values of 1.94 wt% and 10.46 mg HC/g rock, respectively, and are primarily types II1 and II2 kerogen with thermal maturities between 0.5 and 1.0%. The abundance of organic matter in calcareous mudstone and dolomitic mudstone facies of the Eq3410 shales was relatively high. Inorganic pores are the dominant pore types, including intercrystalline pores within the carbonate and clay minerals, while mesopores and macropores contribute most to the pore volume. Better pore structures exist in argillaceous dolomite and dolomitic mudstone facies, and their characteristics are mainly affected by the compositions of dolomite, clay minerals, and glauberite and, thus, the TOC and oil contents of the shale oil reservoir. [ABSTRACT FROM AUTHOR]

Dynamics of the East Asian spring rainband are investigated with a reanalysis dataset and station observations. Here, it is revealed that the rainband is anchored by external forcings. The midtropospheric jet core stays quasi-stationary around Japan. It has two branches in its entry region, which originate from the south and north flanks of the Tibetan Plateau and then run northeastward and southeastward, respectively. The southern branch advects warm air from the Tibetan–Hengduan Plateau northeastward, forming a rainband over southern China through causing adiabatic ascent motion and triggering diabatic feedback. The rainband is much stronger in spring than in autumn due to the stronger diabatic heating over the Tibetan–Hengduan Plateau, a more southward-displaced midtropospheric jet, and the resulting stronger warm advection over southern China. The northern jet branch forms a zonally elongated cold advection belt, which reaches a maximum around northern China, and then weakens and extends eastward to east of Japan. The westerly jet also steers strong disturbance activities roughly collocated with the cold advection belt via baroclinic instability. The high disturbance activities belt causes large cumulative warm advection (CWA) through drastically increasing extremely warm advection days on its eastern and south flanks, where weak cold advection prevails. CWA is more essential for monthly/seasonally rainfall than conventionally used time-average temperature advection because it is shown that strengthened warm advection can increase rainfall through positive diabatic feedback, while cold advection cannot cause negative rainfall. Thus, the rainband is collocated with the large CWA belt instead of the warm advection south of it. This rainband is jointed to the rainband over southern China, forming the long southwest–northeast-oriented East Asian spring rainband. Increasing moisture slightly displaces the rainband southeastward. [ABSTRACT FROM AUTHOR]

The wide-spread culture of transgenic Bt cotton resisting the infamous cotton bollworms has reduced the adoption of broad-spectrum insecticides to a large extent. Consequently, the non-targeted insect Adelphocoris suturalis Jakovlev has become a major cotton pest in China. Entomopathogenic microbes show promising results for controlling this pest in the future, but A. suturalis innate immune responses to these pathogens are poorly understood. Here, we used the entomopathogenic fungus Beauveria bassiana and the Gram-negative pathogenic bacteria Enterobactor cloacae to infect A. suturalis nymphs, followed by high throughput RNA-seq to analyze the immune transcriptomes of A. suturalis in response to the two pathogens. A total of 150 immunity-related genes were identified, including pattern recognition receptors, extracellular signal modulators, signal pathways (Toll, IMD, JNK, and JAK/STAT), and response effectors. Further quantitative real-time PCR analysis demonstrated that B. bassiana and E. cloacae were recognized by different receptors (GNBP and PGRP, respectively); activated Toll pathway and IMD pathway respectively; and both induced expression of the effector gene Defensin. However, melanization is suppressed in B. bassiana -infected nymphs. Collectively, this study provides a transcriptomic snapshot of the A. suturalis immune system, and at the genetic level, gains multifaceted insights of the immune response to fungal and Gram-negative bacterial pathogens. Ultimately this work pioneers the study of molecular mechanisms underlying immune interactions between A. suturalis and its pathogens and assists in the development of novel mitigation strategies to control this pest. [ABSTRACT FROM AUTHOR]

Background: Immunophenotyping of blood lymphocytes is an essential tool to evaluate the immune function of patients with immunodeficiency or autoimmunity. Predominately identified CD4+T cell subsets, Th1, Th2, Th17, as well as regulatory T (Treg) cells, play crucial roles in several immunological and pathological conditions. Considering the variations in cell counts among populations and ethnicities, specific CD4+T cell subset reference values need to be locally established to enable meaningful comparisons and accurate data interpretation in clinical and research settings. Therefore, the aim of this study was to establish distributions and reference ranges for blood CD4+T cell subpopulations in age- and sex-balanced healthy adults of a Han Chinese population in Shanxi Province, North China. Methods: Peripheral blood CD4+T cell subsets were examined in 150 healthy volunteers (75 males, 75 females) aged 20–70 years with a four-color FACSCalibur flow cytometer. Results: Reference value percentages (absolute counts, cells/μl) were defined as 95% of the population for cell types as follows: CD4+T, 23.78–51.07 (360–1127); Th1, 0.43–39.62 (2.64–276.21); Th2, 0.27–3.57 (1.80–27.14); Th17, 0.22–2.62 (1.10–19.54); and Treg, 2.17–7.94 (13.47–64.58). The ranges for the Th1:Th2 and Th17:Treg ratios were 0.59–52.37 and 0.04–0.76, respectively. Notably, a significant increase was observed in the values of Treg cells in older individuals, and the numbers of Treg cells in females also tended to decrease when compared to those in males. Therefore, we established the distribution and reference range of CD4+T cell subsets based on age and sex, demonstrating the lowest values of Treg cells in younger females. Conclusions: Collectively, our data provide population-, age-, and sex-specific distributions and reference ranges of circulating CD4+T cell subpopulations, which can be adopted to guide clinical decisions and interpretation of immunophenotyping data in the Han Chinese population in Taiyuan, Shanxi Province, China. In addition, the low expression of peripheral Treg cells in younger females may be associated with the predisposition of females to autoimmune diseases. [ABSTRACT FROM AUTHOR]

The development of a rodent ambient particulate matter (PM) inhalation system is critical for drawing causal inferences between PM exposure and the onset of human diseases. In this study, we constructed a real-ambient PM exposure system to investigate multi-organ injury and the reversibility of the impairments in C57BL/6 J male mice exposed to PM with a duration of up to three months in Shijiazhuang, a city with the highest PM2.5 concentration in China. This unique exposure system provided an optimal scenario for round-the-clock PM exposure absent a change in the physiochemical properties of PM and minimized the disturbance to the mice habitat. The mean concentration of PM2.5 in the exposure chambers was 89.95, 79.98, and 87.87 μg/m3 at three different time points, respectively: weeks 1–3, week 1–6, and week 1–12. The injury in multiple organs, including lung, brain, heart, testis, and intestine, was profound and was evident by the significant pathological and functional alterations. Pulmonary pathological examination revealed severe interstitial inflammatory and alveolar hemorrhage throughout the exposure, which was in line with the reduced lung function and the increased cytokine excretion in bronchoalveolar lavage fluid and blood plasma. Notably, the PM-mediated inflammatory response in different systems was correlated with the severity of the injury and the attenuation of pulmonary lesions in the recovery group. Thus, the PM2.5-induced inflammatory response, the chemical components-induced cytotoxicity, genetic damage, and oxidative stress might be implicated in the impairment of multiple murine organs. These findings revealed the severity, sensitivity, and reversibility of multi-organ injury in response to a real-ambient PM exposure. Image 1 • A real-ambient inhalation system was constructed to resemble the natural state of human exposures to the greatest extent. • PM-induced inflammation, cytotoxicity, oxidative stress, and genotoxicity cooperate to contribute to multiple organ injury. • The injury in most of the organs is irreversible. A novel real-ambient PM exposure system provide a scenario to faithfully recapitulate the severity, sensitivity, and reversibility of systemic responses to PM exposure in a mouse model. [ABSTRACT FROM AUTHOR]

Rhesus macaques (Macaca mulatta) are hosts to a range of zoonotic and potentially zoonotic pathogens. The present study firstly provides a broader investigation of the presence and prevalence of zoonotic fecal pathogens in wild Taihangshan macaques, a subspecies of rhesus macaque in China. A total of 458 fecal samples were collected between September 2015 and November 2016. Fourteen genera of intestinal parasites (four genera of protozoans and ten genera of helminths) and twelve genera of bacteria were tested for using PCR amplification. The overall samples prevalence of parasitic infection was 98.25%. Entamoeba spp. (89.96%), Balantidium coli (70.09%), and Isospora spp. (28.38%) were the most prevalent protozoa, whereas the predominant prevalent helminths were Trichuris sp. (93.23%), Strongyloides spp. (73.36%), and Oesophagostomum sp. (31.66%). Ten genera of intestinal bacteria were detected in samples of rhesus macaques, including Shigella (31.66%), Escherichia coli (29.91%), Klebsiella pneumoniae (28.38%), Leptospira (26.64%), Campylobacter jejuni (18.34%), Salmonella (13.32%), etc. Eight samples (1.75%) were tested Hafnia-positive based on sequences analysis of 16S rRNA and ampC gene. This is the first molecular characterization of Hafnia infection in NHPs. Our cross-sectional prevalence study provides important information for monitoring the potential transmission of zoonotic infections from wild rhesus macaques. [ABSTRACT FROM AUTHOR]

Abstract The Hongshiyan landslide, the largest landslide (volume ~ 12.24 Mm3) triggered by 2014 Mw 6.2 Ludian earthquake, blocked the Niulan river forming a rockslide dam; the failure potential of the dam created an elevated risk to population and infrastructure downstream. We provide insight into the failure mechanics of the Hongshiyan landslide using data obtained by means of remote sensing techniques and traditional in-situ surveys. Geological data obtained by these methods was then used for kinematic and numerical analyses. Our study shows that failure of the Hongshiyan landslide involved a high rock slope with an average slope of 55° and aspect of 185° SSW, in which the geological setting consists of an upper strong limestone slab and an underlying weak silty mudstone. The geological setting allowed the landslide to develop, as follows: i) the silty mudstone, due to its poor mechanical properties, was subject to ductile deformation under the compressive loading from the overlying strong limestone slabs; ii) a large number of release fractures in the limestone developed as a consequence of pre-failure progressive deformation in the underlying weak mudstone; iii) the oxidation and solution along steep joint walls in the upper limestone indicates that the joints are pathways that allow water ingress into the mudstone, further promoting the degradation of shear strength in this layer. Distinct element modelling (UDEC) was used to back analyse the failure mechanism and develop the geological model that best reproduced the Hongshiyan failure geometry. Results show that the failure surface consisted of two elements. The upper steeply dipping release surface formed along the slope-parallel steep cross joints defining a jointed, strong limestone slab, and the toe of the failure formed a curved failure surface through the ductile weak silty mudstone, underlying the limestone slab, independent of any discontinuities within it. The pre-failure observations and numerical analysis suggest that the Hongshiyan slope was in a state of marginal static stability prior to the earthquake as a result of pre-failure progressive deformation controlled by the shear strength of the underlying mudstone. Overall, the marginal pre-earthquake stability of the Hongshiyan slope, coupled with the strongest seismic loading, which the Hongshiyan slope has been historically subjected to, are the reasons why this moderate earthquake induced a large-scale catastrophic rock slope failure. Highlights • We study a large-scale deep-seated rockslide triggered by a moderate earthquake. • Through a successful numerical analysis we show the mechanics of co-seismic failure. • The slope had been deforming prior to its catastrophic failure as a result of the earthquake. • Instability was only possible because of a weak element in the slope system. • The key to failure was an upper rigid layer overlying a lower ductile layer. [ABSTRACT FROM AUTHOR]

Utilizing the specially designed low‐warming experiments of the fully coupled Community Earth System Model, we investigate the evolutions of Eurasian climate and extreme events if global mean temperature would stabilize at 1.5 °C and 2 °C above preindustrial levels or overshoot the 1.5 °C (1.5 °C OS) threshold. We find that distinctive evolutions of surface temperature (TS) and extreme events appear in different regions of Eurasia, particularly over East China and Northern Eurasia. In the course of global warming, before global mean temperature stabilizes, the two regions display similar changes of TS and extreme events. However, after global warming halts, the two regions experience distinctive evolutions of local warming and extreme events. Over East China, where the adjacent ocean exhibits stronger‐than‐global mean warming, the local TS and both the strength and frequency of heat extremes keep increasing continuously. The extreme precipitation intensity increases even more rapidly compared to the change of heat extremes. In stark contrast, TS and heat extremes intensity over northern Eurasia decrease in both the 1.5 °C and 1.5 °C OS cases, except that the extreme precipitation experiences little change. We find that the most vulnerable period over northern Eurasia is the transition period, in which TS increases till its maximum and then decreases. The heat extremes during the transition period are also stronger and more frequent compared to the end of the 21st century over northern Eurasia. Plain Language Summary: Utilizing the specially designed model experiments, we investigate the evolutions of Eurasian climate and extreme events if global mean temperature would stabilize at 1.5 °C and 2 °C above pre‐industrial levels. We find that distinctive evolutions of surface temperature (TS) and extreme events appear in different regions of Eurasia, particularly over East China and Northern Eurasia. Before global mean temperature stabilizes, the two regions display similar changes of TS and extreme events. However, after global warming halts, the two regions experience distinctive evolutions of local warming and extreme events. Over East China, adjacent a stronger‐than‐global mean ocean warming, the local TS and both the strength and frequency of heat extremes keep increase continuously. The extreme precipitation intensity increases even more rapidly compared to the change of heat extremes. In stark contrast, TS and heat extremes intensity over northern Eurasia decrease at 1.5 °C, except that the extreme precipitation experiences little change. We find that the most vulnerable period over northern Eurasia is the transition period, in which TS increases till its maximum and then decreases. The heat extremes during the transition period are also stronger and more frequent compared to the end of the 21st century over northern Eurasia. Key Points: Distinctive regional changes would occur over Eurasia, when global mean temperature stabilizes at 1.5 °CEast China would experience amplified warming and more extreme events, in association with strong SST warming in the adjacent oceanNorthern Eurasia would have transitions from increase to decrease in mean and extreme surface temperatures [ABSTRACT FROM AUTHOR]

A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed “two-step optimization for spatial accessibility improvement (2SO4SAI).” The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China. [ABSTRACT FROM AUTHOR]

H9N2 influenza A viruses have become endemic in different types of terrestrial poultry and wild birds in Asia, and are occasionally transmitted to humans and pigs. To evaluate the role of black-billed magpies (Pica pica) in the evolution of influenza A virus, we conducted two epidemic surveys on avian influenza viruses in wild black-billed magpies in Guangxi, China in 2005 and characterized three isolated black-billed magpie H9N2 viruses (BbM viruses). Phylogenetic analysis indicated that three BbM viruses were almost identical with 99.7 to 100% nucleotide homology in their whole genomes, and were reassortants containing BJ94-like (Ck/BJ/1/94) HA, NA, M, and NS genes, SH/F/98-like (Ck/SH/F/98) PB2, PA, and NP genes, and H5N1-like (Ck/YN/1252/03, clade 1) PB1 genes. Genetic analysis showed that BbM viruses were most likely the result of multiple reassortments between co-circulating H9N2-like and H5N1-like viruses, and were genetically different from other H9N2 viruses because of the existence of H5N1-like PB1 genes. Genotypical analysis revealed that BbM viruses evolved from diverse sources and belonged to a novel genotype (B46) discovered in our recent study. Molecular analysis suggested that BbM viruses were likely low pathogenic reassortants. However, results of our pathogenicity study demonstrated that BbM viruses replicated efficiently in chickens and a mammalian mouse model but were not lethal for infected chickens and mice. Antigenic analysis showed that BbM viruses were antigenic heterologous with the H9N2 vaccine strain. Our study is probably the first report to document and characterize H9N2 influenza viruses isolated from black-billed magpies in southern China. Our results suggest that black-billed magpies were susceptible to H9N2 influenza viruses, which raise concerns over possible transmissions of reassortant H9N2 viruses among poultry and wild birds. [ABSTRACT FROM AUTHOR]

Abstract: Recent years saw the global wave of new low-carbon economy which is a new strategic measure to cope with global warming, and it has gained lots of concerns from many government s. China is undertaking the “common, but different responsibility for global climate change” and it has made a lot of guidelines of low-carbon economy development. Under this circumstance, as the most potential sector for low-carbon transformation, Chinese tourism becomes the pioneer to try low-carbon industry construction. According to development of Chinese tourism, the authors first discussed the connotation and denotation of low-carbon tourism industry, and then analyzed the feasibility of promotion of low-carbon tourism in China, and finally proposed the policy design and development idea for low-carbon tourism economy in the aspects of different subjects of government, tourism area, tourists etc. [Copyright &y& Elsevier]

Collections of Bionectriaceae and Nectriaceae from Henan, Hubei and Guangdong provinces, China, were examined. Three new species, Neonectria confusa, N. shennongjiana and N. sinensis, are described and illustrated. Distinctions between the new species and their related taxa are discussed. Phylogenetic relationships among some Neonectria species are investigated based on analyses of nuclear ribosome DNA ITS1-5.8S-ITS2 and β-tubulin partial sequences. Combined analyses of molecular and morphological data suggest that N. confusa and N. shennongjiana can be classified in Neonectria sensu stricto and N. sinensis in the N. mammoidea-Group. A key to the known species of Neonectria from China is provided. [ABSTRACT FROM AUTHOR]

The article examines the evolution of the intellectual property rights (IPR) protection regime in China in the narrow context of well-known marks. The 2001 Chinese Trademark Law (CTL) cites several factors to be considered in determining whether a mark is well-known, including the reputation of the mark to the relevant public and the time period for the owner's continued use of the mark. In 2001, judicial recognition of well-known marks became a viable option, in addition to administrative determination. Several Chinese cases are presented which illustrate the well-known mark enforcement practice.

The middle and lower reaches of the Yangtze River valley (YRV), which are among the most densely populated regions in China, are subject to frequent flooding. In this study, the predictor importance analysis model was used to sort and select predictors, and five methods (multiple linear regression (MLR), decision tree (DT), random forest (RF), backpropagation neural network (BPNN), and convolutional neural network (CNN)) were used to predict the interannual variation of summer precipitation over the middle and lower reaches of the YRV. Predictions from eight climate models were used for comparison. Of the five tested methods, RF demonstrated the best predictive skill. Starting the RF prediction in December, when its prediction skill was highest, the 70-year correlation coefficient from cross validation of average predictions was 0.473. Using the same five predictors in December 2019, the RF model successfully predicted the YRV wet anomaly in summer 2020, although it had weaker amplitude. It was found that the enhanced warm pool area in the Indian Ocean was the most important causal factor. The BPNN and CNN methods demonstrated the poorest performance. The RF, DT, and climate models all showed higher prediction skills when the predictions start in winter than in early spring, and the RF, DT, and MLR methods all showed better prediction skills than the numerical climate models. Lack of training data was a factor that limited the performance of the machine learning methods. Future studies should use deep learning methods to take full advantage of the potential of ocean, land, sea ice, and other factors for more accurate climate predictions. [ABSTRACT FROM AUTHOR]

Seoul virus (SEOV), which causes hemorrhagic fever with renal syndrome (HFRS) in humans, has spread all over the world, especially in mainland China. Understanding basic mechanisms of SEOV evolution is essential to better combat and prevent viral diseases. Here, we examined SEOV prevalence and evolution in the residential area of four districts in Guangzhou city, China. The carriage of SEOV was observed in 33.33% of the sampled rodents, with 35.96% of the sampled Rattus norvegicus and 13.33% of R. tanezumi. Based on the comprehensive analyses of large (L), medium (M), and small (S) segments, our study first demonstrated that the genetic characterization of urban SEOV was shaped by high nucleotide substitution rates, purifying selection, and recombination. Additionally, we detected mutational saturation in the S segment of SEOV, which may lead to the biases of genetic divergence and substitution rates in our study. Importantly, we have filled the gap of SEOV evolution in the urban area. The genetic variation of SEOV may highlight the risk of HFRS, which merits further investigation. [ABSTRACT FROM AUTHOR]

Permafrost is degrading on the Qinghai-Tibet Plateau (QTP) due to climate change. Permafrost degradation can result in ecosystem changes and damage to infrastructure. However, we lack baseline data related to permafrost thermal dynamics at a local scale. Here, we model climate change impacts on permafrost from 1986 to 2075 at a high resolution using a numerical model for the Beiluhe basin, which includes representative permafrost environments of the QTP. Ground surface temperatures are derived from air temperature using an n-factor vs Normalized Differential Vegetation Index (NDVI) relationship. Soil properties are defined by field measurements and ecosystem types. The climate projections are based on long-term observations. The modelled ground temperature (MAGT) and active-layer thickness (ALT) are close to in situ observations. The results show a discontinuous permafrost distribution (61.4%) in the Beiluhe basin at present. For the past 30 years, the permafrost area has decreased rapidly, by a total of 26%. The mean ALT has increased by 0.46 m. For the next 60 years, 8.5–35% of the permafrost area is likely to degrade under different trends of climate warming. The ALT will probably increase by 0.38–0.86 m. The results of this study are useful for developing a deeper understanding of ecosystem change, permafrost development, and infrastructure development on the QTP. [ABSTRACT FROM AUTHOR]

Background: Sex hormone-binding globulin (SHBG), a glycoprotein synthesized by hepatocytes, has been linked to insulin resistance and hepatic lipid metabolism and is suggested to be associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of SHBG with NAFLD in Chinese adults. Methods: We conducted a community-based, cross-sectional study in China involving 2912 participants aged 40–75 years old. All participants underwent detection for hepatic fat infiltration by ultrasound in addition to providing complete medical history and undergoing physical and blood biochemical examinations. The association of serum SHBG with the presence of NAFLD was reported by adjusted odds ratio after applying logistic regression models. To further explore the relationship between SHBG and NAFLD, mRNA expression of SHBG and hepatocyte nuclear factor 4-α (HNF4α), as well as intrahepatic triglycerides, were determined from the liver tissues of 32 subjects with different degrees of steatosis. Results: Serum SHBG levels in patients with NAFLD (median, 43.8 nmol/L; interquartile range, 33.4–56.8 nmol/L) were significantly lower than those in non-NAFLD subjects (median, 63.4 nmol/L; interquartile range, 47.6–83.1 nmol/L). Serum SHBG levels were inversely correlated with WHR, trunk fat percentage, glucose, HOMA-IR, TG, UA and DHEAS, and were positively correlated with HDL-C levels (all p < 0.001). Logistic regression analysis indicated that serum SHBG levels were negatively associated with the presence of NAFLD in all subjects, as well as the subgroups stratified by sex, BMI and HOMA-IR (all p < 0.05). In human liver tissues, SHBG and HNF4α mRNA expression decreased along with the elevated grade of hepatic steatosis. Both SHBG and HNF4α mRNA expression levels were negatively correlated with intrahepatic triglycerides. Conclusions: These results demonstrate that SHBG levels were negatively associated with the presence of NAFLD in middle-aged and elderly Chinese adults. [ABSTRACT FROM AUTHOR]

Embankment deformation is a key consideration in high speed railway construction. Frost heave due to temperature and moisture variation is critical to consider in areas of seasonally frozen ground. This paper examined ground temperatures, frost heave, and moisture content in 2013–2014 at two sites along the embankment of the Harbin-Dalian Passenger Dedicated Line (HDPDL) railway. The railway is in seasonally-frozen ground of Jilin Province, China. The embankment at one site (K977) was built on the undisturbed ground surface while the other was in a cut section (K1004). Displacement measurements over one year indicated that frost heave of 14 mm at K977 and 25 mm at K1004 occurred in ballast during the freezing season. During the annual freeze-thaw period, soil moisture content varied drastically in the upper 0.6 m. The frost depth and freezing index were strongly and positively correlated during the freezing season. Soil moisture content was regarded as the primary control on the amount of frost heave, while frost depth was secondary. Furthermore, water vapor diffusion may have been an important contributor to the formation of near-surface ice. At K1004 site, the maximum recorded deformation was large and exceeded the 15 mm Chinese standard for maximum allowable heave. This suggested that high ground water level increased the amount of frost heave. [ABSTRACT FROM AUTHOR]

• The two CnmeGV isolates came from the same region and were collected 35 years apart. • CnmeGV hr4 presents a nested repeating pattern. • Tandem repeats were the only highly variable region of CnmeGV during replication. • CnmeGV obtained a non-coding sequence from its host. Cnaphalocrocis medinalis granulovirus (CnmeGV), belonging to Betabaculovirus cnamedinalis , can infect the rice pest, the rice leaf roller. In 1979, a CnmeGV isolate, CnmeGV-EP, was collected from Enping County, China. In 2014, we collected another CnmeGV isolate, CnmeGV-EPDH3, at the same location and obtained the complete virus genome sequence using Illumina and ONT sequencing technologies. By combining these two virus isolates, we updated the genome annotation of CnmeGV and conducted an in-depth analysis of its genome features. CnmeGV genome contains abundant tandem repeat sequences, and the repeating units in the homologous regions (hrs) exhibit overlapping and nested patterns. The genetic variations within EPDH3 population show the high stability of CnmeGV genome, and tandem repeats are the only region of high genetic variation in CnmeGV genome replication. Some defective viral genomes formed by recombination were found within the population. Comparison analysis of the two virus isolates collected from Enping showed that the proteins encoded by the CnmeGV-specific genes were less conserved relative to the baculovirus core genes. At the genomic level, there are a large number of SNPs and InDels between the two virus isolates, especially in and around the bro genes and hrs. Additionally, we discovered that CnmeGV acquired a segment of non-ORF sequence from its host, which does not provide any new proteins but rather serves as redundant genetic material integrated into the viral genome. Furthermore, we observed that the host's transposon piggyBac has inserted into some virus genes. Together, dsDNA viruses could acquire non-coding genetic material from their hosts to expand the size of their genomes. These findings provide new insights into the evolution of dsDNA viruses. [ABSTRACT FROM AUTHOR]

Variations of East Asian westerly jet (EAJ) drastically affect the rainfall in southern China (SC) during Meiyu season. Previous studies conventionally focused on the entire EAJ's variations and their impacts. In this study, we find that the variations of EAJ eastern section (EAJE) and western section (EAJW) are mostly independent of each other. Moreover, the independent components of EAJE and EAJW's variations have different impacts on the rainfall in SC. Southward-displaced and intensified EAJE (SI-EAJE) and southward-displaced and weakened EAJW (SW-EAJW), the first two leading modes of EAJ variations, are associated with increased rainfall anomalies centred over central and southern parts of SC, respectively. Associated with the SI-EAJE (SW-EAJW), anomalous cold cyclone is centred around the Japan Sea (central China). The associated anomalous westerly wind and northward-decreasing (northwestward-decreasing) temperature centred over the central (southern) SC together induce midtropospheric warm advection and thus positive rainfall anomalies centred over the central (southern) SC. The anomalous circulations also cause moisture convergences roughly collocated with the anomalous warm advections over the SC, which intensifies the rainfall anomalies. Warm sea surface temperature anomalies in the equatorial central-eastern Pacific during boreal spring induce meridional teleconnection along the coastal East Asia in Meiyu season through suppressing the convective activities in the northwestern Pacific. The resultant SI-EAJE and associated anomalous circulations increase the rainfall over the central SC, and vice versa. Dipole of increased (decreased) spring snow anomalies on the eastern (western) Tibetan Plateau suppresses (intensifies) convective activities in Meiyu season. The resultant SW-EAJW and associated anomalous circulations increase the rainfall in the southern SC. • Interannual variations of EAJ eastern and western section are primarily independent. • The two EAJ sections cause different Meiyu rainfall anomalies in the southern China. • Thermal advection and moisture anomalies induce the different rainfall anomalies. • Variations of EAJ eastern section can be induced by preceding ENSO in boreal spring. • Dipole of spring snow anomalies on Tibetan Plateau changes the EAJ western section. [ABSTRACT FROM AUTHOR]

Complex mutual feedback relationships exist between hydrological and meteorological elements in hydrological cycle processes, which may show dynamic changes in a changing environment. Nevertheless, the feedback dynamics between precipitation (P), temperature (T), and soil moisture (SM) and corresponding driving mechanisms remain unknown. And the mutual feedback types are different in space, the mutual feedback strength may change with time. To this end, the Granger causality test was adopted in this study to examine the feedback relationship between P, T, and SM in China. Then, the Sliding Window was used to explore the dynamic characteristics of their mutual feedback relationships. Finally, the Geographical Detector and Random Forest were applied to reveal their spatial and time dynamic driving forces, respectively. Results indicate: (1) generally, the feedback relationships among P, SM, and T are significant, in which the feedback relationship between P and SM is the most extensive in China; (2) the feedback strength between P, T, and SM generally show significant increasing trend, and different types of feedback relationship are different in spatial distribution. Specifically, the feedback strength between P and SM increased in the northwest and southwest of China; (3) the driving forces of the feedback relationships between P, T and SM were analyzed spatial driving forces, Evapotranspiration (ET) and P have strong driving effects, while Potential Evapotranspiration (PET), Wind speed (wind), and Leaf Area Index (LAI) have weaker driving effects, ET is the core hub of the mutual feedback relationship among multiple factors, and meteorological factors are the main driving factors for the time dynamic evolution of mutual feedback relationships between P, T, and SM, followed by circulation factors, and finally underlying surface factors. This study sheds new insights into hydrometeorological feedback, which will help improve understanding of how extreme events such as droughts, heat waves and floods develop, thus being beneficial for their precise defense. [Display omitted] • The feedback dynamics between P, T and SM and their driving force were explored. • The mutual feedback intensity of P, T, and SM tends to increase in northwestern China. • P and ET are the main drivers of the spatial pattern of the mutual feedback relationship. • Meteorological factors play a dominant role in the temporal dynamics of their feedback. [ABSTRACT FROM AUTHOR]

Improving soil aeration in paddy fields using mechanical device reduces methane (CH 4) emissions, whereas it also increases the contribution of other sources (device production, agricultural inputs, etc.). Here, this study applied the life cycle assessment (LCA) method to evaluate the carbon footprint of a soil air injection device (SAID) in rice field. We further analyzed the prospects of this device in promoting carbon emission reduction in China's main rice-producing areas, which was combined with economic benefit calculation and revised knowledge-attitude-practice (KAP) model. Results showed that the reduction of net carbon emissions from paddy fields under SAID treatment was 4.51–241.95% higher than the total carbon emissions from the production, transportation, operation, and recycling of SAID. The economic output of using SAID in rice fields could just offset the cost of it. With reasonable government subsidies (142.80–349.95 yuan SAID−1 yr−1), SAID can reduce carbon emissions from Chinese rice fields by ∼ 41.60 Tg CO 2 -eq yr−1. This study suggests that using SAID in some rice planting areas in China may be an effective way to reduce carbon emissions. [Display omitted] • SAID could reduce carbon footprint of rice production system. • The limiting factor for the development of SAID is mainly low economic efficiency. • The cost of emission reduction in each region is 0.16–6.07 yuan per kg CO 2 -eq. [ABSTRACT FROM AUTHOR]

Background and Objectives: To investigate the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and the factors involved.Methods and Study Design: We used the Subjective Global Assessment (SGA) of nutritional status, a general questionnaire, dietary records, and laboratory parameters from 3 consecutive days to develop a NS assessment with it, we assessed 240 patients undergoing CAPD at a dialysis center in Henan Province.Results: In this setting, the prevalence of malnutrition in patients undergoing CAPD was 11.7%. Univariate analysis showed that patient characteristics related to NS included energy and protein intakes, weight and BMI, dialysis duration, urinary creatinine, and total creatinine clearance rate. Multiple linear regression analysis revealed that dialysis duration (p<0.001) and energy intake (p=0.01) were the principal predictors of nutritional status and allowed 81% of the variance in nutritional status to be explained.Conclusions: Effective collaboration between nutritionists and other health care workers to minimise dialysis duration and optimize energy intake should improve the nutritionally-related quality of life and well-being among CAPD patients. [ABSTRACT FROM AUTHOR]

Lakes are the main water resource for migrating animals and herdsmen in permafrost regions along the Qinghai-Tibet Engineering Corridor (QTEC) and play a crucial role in regulating the balance between regional surface water and groundwater. Hydrochemical properties also affect the soil environment, ecological conditions, and hydrological cycle. In this study, 127 water samples were collected from lakes to analyze hydrochemistry characteristics. The results are discussed in the context of relationships between water chemistry and local conditions including climate, topography, and geology. The results showed that 43.3% of lakes are fresh, 19.7% are brackish, 18.9% are saline, 17.3% are brine, and only 0.8% are bitter. The dominant cation is Na + , followed by Mg 2 + , Ca 2 + , and K + . The dominant anion is Cl − , followed by SO 4 2 − and HCO 3 – in the northern section of study region; whereas Ca 2 + , Na + , and HCO 3 – are the dominant ions in the lakes of the southern section. The higher concentrations of carbonate in the southern lakes reflect contributions from groundwater discharge. In contrast, the higher concentrations of sodium, chloride, and sulfate in the northern section indicate that they are dominated by the interaction of evaporates. Additionally, cation exchange, precipitation, and dissolution have also modified the distribution of hydrochemical compositions. Thermokarst processes, in particular, have induced changes in the hydrochemistry of lake waters in the permafrost regions of the QTEC, in that the ion concentrations are closely related to ground ice content. In the context of persistent climatic warming and steadily increasing anthropogenic activities, the salinity of lakes along the QTEC is likely to increase in the future. [ABSTRACT FROM AUTHOR]

The present study investigates the association of East Asian westerly jet (EAWJ) variations with spring rainfall anomalies in Northern China and Yangtze-Huaihe River Valley (NC-YHV) and the dynamics using reanalysis datasets. Based on the climatology and interannual variation in 200-hPa zonal winds, the index EAWJI is defined as the average 200-hPa zonal wind velocity over a zonal 10-degree-width belt centered around the seasonal-mean jet axis between 105°E and 145°E. Associated with anomalously strengthened EAWJ, significant negative rainfall anomalies are observed over NC-YHV. The dynamics are as follows. When the EAWJ is anomalously intensified, a quasi-barotropic Pacific-Japan-like (PJ) teleconnection along coastal China and an associated anomalous westerly flow over NC-YHV are observed. In middle-lower troposphere, Tibetan Plateau (TP) drastically reduces the anomalous southwesterly momentum transported into NC-YHV, turning the westerly anomalies into northwesterly anomalies. The anomalous northwesterly winds over NC-YHV advect cold and dry air southeastward toward NC-YHV, which induce downward motion (diabatic heating feedback is weak) and negative moisture anomalies, respectively, and thus cause reduced rainfall anomalies over NC-YHV. Anomalous winter SSTAs in western Pacific and tropical Indian Ocean associated with ENSO are sustained until spring, inducing barotropic waves that propagate northwards to cause EAWJ-associated circulation anomalies and thus bring about spring rainfall anomalies in NC-YHV. The quasi-barotropic features of the EAWJ-associated circulation anomalies and their association with the northward propagation of tropical SSTA-induced barotropic waves together suggest that EAWJ-associated circulation variations are at least partly among the external forcings responsible for spring rainfall anomalies in NC-YHV. • Anomalously intensified EAWJ causes negative rainfall anomalies ineastern China (EC) • TP causes northerly component of EAWJ-related westerly anomalies over EC by blocking the southerly momentum flowing into EC.. • The EAWJ-related northwesterly anomalies over EC cause cold advection anomalies over EC and transport dry air toward EC. • The cold advection and resultant descent anomalies reduce the rainfall in EC together with the reduced moisture anomalies. • Quasi-barotropic feature of these circulation anomalies suggests the external forcings of EAWJ for spring rainfall anomalies. [ABSTRACT FROM AUTHOR]

The Harbin–Dalian Passenger Dedicated Line (HDPDL) is the first high-speed railway in deep seasonally frozen ground in China. Frost heave is among the most difficult problems in roadbed deformation control in such area. In this study, the ground temperatures and frost heave in a road cut section (K865) and an embankment section (K866) along the HDPDL were analyzed based on monitoring data in situ. From 2012 to 2018, the maximum frost heave in the cut section ranged from 4.52 mm to 9.18 mm, while in the embankment section this value ranged from 1.86 mm to 5.28 mm. The data clearly show that frost heave in the cut section was much more serious than that in the embankment section, although the frozen depth of the road cut was approximately 20 cm shallower than that of the embankment. The frost heave ratios of the roadbed filling materials in the well-graded gravel layer (0–0.5 m), non-frost susceptibility A/B group fill layer (0.5–1.5 m), and A/B group layer (1.5–2.7 m) were 1.20%, 0.14%, and 0.08% on average in the cut section and generally higher than 0.63%, 0.04%, and 0.02% in the embankment over six freezing seasons, respectively. The investigation of frost heave in different soil layers at 24 monitoring sites indicated that most frost heave occurred in the top well-graded gravel layer (0–0.5 m), account for averagely 66% of the total deformation. The frost heave of the subgrade along the HDPDL mainly developed during the early period of each freezing season and an abrupt increase typically occurred during the initial period of the thawing process. • Long-term monitored data are presented for the cut and embankment sections along the Harbin-Dalian Passenger Dedicated Line. • The difference of ground temperature and frost heave between cut and embankment sections is analyzed. • The mechanism of frost heave of high speed railway subgrade in seasonally frozen regions is discussed. [ABSTRACT FROM AUTHOR]

Herein, the spatial evolution characteristics of high-level Grade A tourist attractions in the Yangtze River Delta (YRD) urban agglomeration, from 2001 to 2021, are studied by comprehensively applying the nearest neighbor index, kernel density analysis, standard deviation ellipse, and spatial autocorrelation. High-level Grade A tourist attractions are investigated using the random forest model as the driving mechanism of the spatial pattern. Results show that 1) the spatial distribution of high-level Class A tourist attractions in the YRD city cluster has grown to be an agglomeration, and the high-density areas have evolved from "point-like dispersion to regiment-like combination," gradually forming a B-shaped core density structure. 2) The spatial distribution comprises an overall "northwest-southeast" direction, a small counterclockwise rotation, the distribution of the center of gravity to the southwest migration, and the center of gravity from the territory of Suzhou City to the territory of Huzhou City. 3) The high-level Class A tourist attractions in the YRD city cluster as a whole show a strong positive spatial correlation, and the significantly clustered areas include three types: high-high (H-H), low-low (L-L), and low-high (L-H). 4) The spatial distribution of high, A-level tourist attractions in the YRD city cluster results from the combined action of the natural environment, resource endowment, socioeconomy, and policy background. Each element has a nonlinear and complex influence on the distribution of scenic spots., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)