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The genus Neocaridina, originating from East Asia and representing a small-size landlocked shrimp group of the family Atyidae, is an important group of ornamental shrimps and plays significant ecological roles in their natural habitats. Owing to the considerable variability of the taxonomic characters it employed, Neocaridina is constantly under revision, and the validation of several species is currently questionable. In the present study, several Neocaridina shrimps were collected from the Baiyangdian drainage area. Through morphological examination, they exhibited delicately diagnostical differences in the dactyli of the third pereiopod and the endopod of the first and second pleopod and were classified into morph A, morph B and morph C. According to the literature description, morph A and morph C were identified as N. denticulata denticulata and N. denticulata sinensis, respectively. Among them, morph B presents an intermediate state between morph A and morph C. Subsequently, we determined the mitogenomes of morph A, morph B and morph C. Based on the morphological characteristics, genetic variation and phylogenetic tree, we contend that N. davidi, N. d. denticulata, N. d. sinensis and N. heteropoda should belong to the same species, and we propose retaining the name N. denticulata. The reconstructed mitogenomic phylogeny indicated that the monophyly of several genera within Atyidae has been challenged, suggesting that the established classification of Atyidae requires substantial taxonomic revision at all taxonomic levels. Furthermore, the tree’s topologies supported Atyidae at a deeper base within Caridea. More comprehensive taxon sampling is still needed to resolve the explicit internal relationships among Caridea.

Objectives: This study aimed to develop a new instrument called the Mental eHealth Literacy Scale (MeHLS) to specifically measure mental eHealth literacy and to assess its psychometric properties in the Chinese population of Hong Kong. Methods: The MeHLS was developed by a mixed-method study design with five phases. Psychometric properties were evaluated using both classical test theory and item response theory (IRT) approaches. For construct validity, we used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We assessed convergent validity through hypothesized correlation analysis and known-group validity via ANOVA. We measured internal consistency using Cronbach's Alpha and test-retest reliability using the intraclass correlation coefficient. Receiver Operating Characteristic (ROC) was used to determine the optimal cut-off point of the MeHLS. Results: A total of 2064 individuals completed the survey. Both EFA and CFA demonstrated a three-factor structure of the MeHLS, aligning with the design. The IRT analysis showed the discrimination value ranged between 1.580 and 3.296, with no items having disordered thresholds. Correlation analysis revealed that MeHLS was significantly associated with all concept-related instruments, indicating good convergent validity. ANOVA results demonstrated that MeHLS can significantly differentiate individuals in all risk groups. The MeHLS showed good reliability, with a Cronbach's Alpha of 0.95 and an Intraclass Correlation Coefficient of 0.75. ROC analysis confirmed a cut-off score of 67 to differentiate individuals with high and low MeHL. Conclusion: The MeHLS is a multidimensional instrument that shows good psychometric properties for measuring web-based mental health literacy.

BackgroundComplicated intra-abdominal infections (cIAIs), often caused by multidrug-resistant bacteria such as carbapenem-resistant A. baumannii (CRAB) and carbapenem-resistant Enterobacteriaceae (CRE) are a critical challenge in ICUs. Owing to their high mortality and treatment failure rates, there is an urgent need for effective therapies. This trial will compare eravacycline to tigecycline for treating cIAIs in patients in the ICU, aiming to provide a superior treatment option.MethodsThis is a multicenter, single-blind, parallel randomized controlled trial. Adult patients in the ICU with complex abdominal infections who meet the eligibility criteria will be included. The main outcome is the all-cause 30-day mortality of patients in clinically evaluable and microbiologically evaluable populations. Secondary outcomes include the proportion of total responsive patients in the clinically evaluable population at the end of treatment and test of cure visits; the proportion of total responsive patients in the microbiologically evaluable population at the end of treatment and test of cure visits; and ICU hospitalization time and costs. Safety assessments include the incidence of various adverse events and changes in clinical laboratory test results. The subjects will be randomly assigned to receive treatment with either eravacycline or tigecycline at a 1:1 ratio. The all-cause mortality rates of patients treated with eravacycline and TGC were 17.7 and 18.7%, respectively, with an estimated actual mortality rate of 0.95. A total sample size of 262 subjects is required to reach 80% power with an α of 0.05. Considering a 10% loss rate, 292 patients will be enrolled and randomly assigned to the three groups in equal proportions.Ethics and communicationThis trial was approved by the Ethics Committee of Ansteel Group General Hospital. The communication plan includes presentations at scientific conferences, scientific publications, and presentations to the public through nonprofessional media.Clinical trial registrationhttps://clinicaltrials.gov/, ChiCTR2300078646.

Abstract Objective The objective of this study was to examine the psychometric properties of the EQ-5D-Y-3 L, Patient Reported Outcomes Measurement System 25-item version profile v2.0 (PROMIS-25), and Pediatric Quality of Life Inventory™ version 4.0 Generic Core Scale (PedsQL 4.0) in Chinese pediatric patients with spinal muscular atrophy (SMA). Methods The data used in this study were obtained via a web-based cross-sectional survey. Parents of pediatric patients with SMA completed the proxy-reported EQ-5D-Y-3 L, PedsQL 4.0, and PROMIS-25 measures. Information about socioeconomic and health status was also obtained. The ceiling and floor effects, factorial structure, convergent validity, and known-group validity of the three measures were assessed. Results Three hundred and sixty-three parents of children aged from 5 to 12 completed the questionnaires. Strong floor effects were observed for the physical function components of the PROMIS-25 (41.3%) and PedsQL 4.0 (67.8%). For EQ-5D-Y-3 L, 84.6% of the respondents reported having “a lot of” problems with the dimensions “walking” and “looking after myself.” Minimal ceiling or floor effects were observed for the EQ-5D-Y-3 L index value. The confirmatory factor analysis supported a six-factor structure for the PROMIS-25, but did not support a four-factor structure for the PedsQL 4.0. All hypothesized correlations of the dimensions among the three measures were confirmed, with coefficients ranging from 0.28 to 0.68. Analysis of variance showed that EQ-5D-Y-3 L demonstrated better known-group validity than the other two measures in 14 out of 16 comparisons. Conclusions The EQ-5D-Y-3 L showed better discriminant power than the other two measures. The physical health dimensions of all three measures showed the significant floor effects. These findings provide valuable insights into the effectiveness of these measures at capturing and quantifying the impact of SMA on patients’ health-related quality of life.

Abstract Background Although it is widely acknowledged that access to civil justice (ATJ) is a key social determinant of health (SDOH), the existing literature lacks empirical evidence supporting ATJ as a SDOH for specific dimensions of health. Methods A legal epidemiological, cross-sectional, postal survey was conducted on n = 908 randomly sampled participants in Hong Kong in March 2023. Data collected were perceptions of the civil justice system, health, and sociodemographics. Perceived ATJ was assessed using a modified version of the Inaccessibility of Justice scale (IOJ) and Perceived Inequality of Justice scale (PIJ), i.e. the “modified IOJ-PIJ”, consisting of 12 of the original 13 items from both scales divided into two subdomains: “procedural fairness”, and “outcome neutrality”. For health data, quality of life was assessed using the Hong Kong version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF(HK)), psychological distress (including symptoms of anxiety and depression) was assessed using the four-Item Patient Health Questionnaire (PHQ-4), and having comorbidities was assessed using Sangha’s Self-Administered Comorbidity Questionnaire (SCQ). Structural equation modelling (SEM) was used to investigate the relationships between perceived ATJ and the measured health outcomes. Results SEM demonstrated that both subdomains for ATJ had significantly negative associations (B 0; p 0; p

Solemyidae is an ancient group of protobranch bivalves that typically inhabit unusual environments, such as deep-sea chemosynthetic environments, and are symbiotic with chemoautotrophic and gill-hosted bacteria. In May 2018, a living solemyid bivalve was collected using a remotely operated vehicle at a depth of 1,390 m from the Haima cold seep in the northwestern slope of the South China Sea. Through a comprehensive taxonomic approach combining morphological observations and molecular phylogeny reconstruction of concatenated mitochondrial COI,16S rRNA and 18S rRNA gene sequences, a new species, Acharax haimaensis sp. nov. is identified and described. The discovery of this new species contributes to the diversity of known solemyids in deep-sea chemosynthetic environments.

Abstract Background Myasthenia gravis (MG), a rare chronic neuromuscular disorder, is characterized by progressive physical decline and requires long-term pharmacological treatment. Due to the decline of physical and social abilities, MG patients are in great need of social support, including tangible and emotional support. This study aims to examine the association between social support and medication adherence and the possible mediating effects of mental health and self-efficacy among MG patients. Methods A cross-sectional analysis of a nationwide MG registry was conducted on 865 patients under oral medication treatment in China between June and July 2022. Validated scales were used to measure the respondent’s mental distress (Four-item Patient Health Questionnaire), social support (Modified Medical Outcomes Study Social Support Scale), self-efficacy for medication use (Self-efficacy for Appropriate Medication Use Scale), and medication adherence (Morisky Medication Adherence Scale, MMAS). Results The association between social support and medication adherence and possible mediating effects of mental distress and self-efficacy were tested by structural equation model, with significant demographic and disease-related factors adjusted. The respondents showed a very low level of medication adherence (71.2% poor adherence; 1.4% high adherence; mean MMAS = 4.65). The level of social support was positively associated with medication adherence, and such association was fully mediated by two indirect pathways: through self-efficacy (β = 0.07, proportion mediated = 63.8%); and through mental distress and then self-efficacy (β = 0.01, proportion mediated = 6.7%). Conclusion Provision of social support and interventions on mental health with emphasis on improving self-efficacy for medication use may effectively improve medication adherence among MG patients.

Key Clinical Message We report a rare case of thyroid diffuse large B‐cell lymphoma with a BRAFV600E mutation, which mimics poorly differentiated thyroid cancer in fine needle aspiration cytology.

BackgroundRare diseases (RDs) affect millions of individuals collectively worldwide, contributing to significant burdens on patients and families in various aspects. However, there is a lack of evidence on the underlying patterns of burdens among diverse RDs for informing targeted social and health policies to address the unmet needs of this vulnerable population. ObjectiveThis study aimed to examine the underlying patterns of the health and economic burden of 33 different RDs in China and identify the potential determinants. MethodsA nationwide internet-based cross-sectional survey was conducted in China between 2019 and 2020. Physical and mental health burden was measured by health-related quality of life. Economic burden was evaluated based on the proportions of direct medical, direct nonmedical, and indirect costs relative to household income. We used cluster analysis to identify patterns of health and economic burdens and conducted multinomial logistic regression to explore potential predictors of cluster membership. ResultsThe study included 8454 adults and 8491 children affected by 33 RDs. The following 3 clusters were identified: “extremely high burden” (representing 92/8454, 1.1% and 19/8491, 0.2% of adult and pediatric patients, respectively), “overall high burden” (5933/8454, 70.2% and 4864/8491, 57.3%, respectively), and “overall low burden” (2429/8454, 28.7% and 3608/8491, 42.5%, respectively). Wilson disease, Marfan syndrome, and Langerhans cell histiocytosis more likely resulted in an “extremely high burden” than others. Poverty was significantly associated with being in this extremely high burden group. Diseases causing neuromuscular symptoms and requiring long-term treatment (eg, amyotrophic lateral sclerosis, spinocerebellar ataxia, and Dravet syndrome) were prevalent in the “overall high burden” group. Key predictors of this group included older age, lower socioeconomic status, diagnostic delay, and comorbidity. ConclusionsThis study provides novel and valuable evidence on the burden of RDs in developing regions like China. The findings reveal significant disparities in the impact of RDs, emphasizing the need for targeted health care interventions and policies.

BackgroundElectronic mental health literacy (eMHL) is critical for accessing and effectively using digital mental health resources. However, there is a paucity of research on how eMHL varies across age groups. ObjectiveThis study aimed to investigate differences in eMHL among young, middle-aged, and older adults; provide insights into the needs, behaviors, and attitudes of different age groups in relation to digital mental health resources; and ultimately, inform the improvement of mental health services. MethodsA qualitative investigation was conducted to examine the differences in eMHL across different age demographics in the Chinese population in 2023. The study sample comprised 3 distinct age groups: 18-34 years, 35-64 years, and 65 years and older. Participants were recruited through purposive sampling to ensure a diverse representation of the population. Data were collected through semistructured one-on-one interviews, which allowed for in-depth exploration of individual experiences and perceptions. The gathered data were subsequently subjected to rigorous thematic analysis to enable the identification and interpretation of recurring patterns and themes. ResultsThe principal outcomes derived from these interviews were synthesized into 5 distinct dimensions: emotional needs, use of digital mental health resources, assessment of digital mental health information, engagement with social media to regulate emotions, and coping strategies. These dimensions were uniformly observed across the 3 age groups. ConclusionsWe identified differences in knowledge, skills, and attitudes regarding the use of web-based information for managing mental health problems between the 3 age groups. The findings highlight the importance of age-specific strategies for improving eMHL.

Objective This study aimed to develop and validate robust predictive models for patients with oesophageal cancer who achieved a pathological complete response (pCR) and those who did not (non-pCR) after neoadjuvant therapy and oesophagectomy.Design Clinicopathological data of 6517 primary oesophageal cancer patients who underwent neoadjuvant therapy and oesophagectomy were obtained from the National Cancer Database for the training cohort. An independent cohort of 444 Chinese patients served as the validation set. Two distinct multivariable Cox models of overall survival (OS) were constructed for pCR and non-pCR patients, respectively, and were presented using web-based dynamic nomograms (graphical representation of predicted OS based on the clinical characteristics that a patient could input into the website). The calibration plot, concordance index and decision curve analysis were employed to assess calibration, discrimination and clinical usefulness of the predictive models.Results In total, 13 and 15 variables were used to predict OS for pCR and non-pCR patients undergoing neoadjuvant therapy followed by oesophagectomy, respectively. Key predictors included demographic characteristics, pretreatment clinical stage, surgical approach, pathological information and postoperative treatments. The predictive models for pCR and non-pCR patients demonstrated good calibration and clinical utility, with acceptable discrimination that surpassed that of the current tumour, node, metastases staging system.Conclusions The web-based dynamic nomograms for pCR (https://predict-survival.shinyapps.io/pCR-eso/) and non-pCR patients (https://predict-survival.shinyapps.io/non-pCR-eso/) developed in this study can facilitate the calculation of OS probability for individual patients undergoing neoadjuvant therapy and radical oesophagectomy, aiding clinicians and patients in making personalised treatment decisions.

Abstract Background Noninvasive biomarkers for the assessment of response to chemotherapy in advanced breast cancer (BCa) are essential for optimized therapeutic decision-making. We evaluated the potential of soluble Periostin (POSTN) in circulation as a novel biomarker for chemotherapy efficacy monitoring. Methods Two hundred and thirty-one patients with different stages of BCa were included. Of those patients, 58 patients with inoperable metastatic disease receiving HER2-targeted or non-targeted chemotherapy were enrolled to assess the performances of markers in recapitulating the chemotherapy efficacy assessed by imaging. POSTN, together with CA153 or CEA at different time points (C0, C2, and C4) were determined. Results POSTN levels were significantly associated with tumor volume (P

Abstract The molecular profiles and tumor immune microenvironment (TIME) of multiple primary lung cancers (MPLCs) presenting as concurrent lung adenocarcinoma (ADC) and squamous cell carcinoma (SQCC) remain unknown. We aimed to clarify these factors. We performed whole-exome sequencing (WES), RNA sequencing (RNA-Seq), and multiplex immunohistochemistry (mIHC) for five patients with concurrent ADC and SQCC. We found the genetic mutations were similar between ADC and SQCC groups. RNA-Seq revealed that the gene expression and pathways enriched in ADC and SQCC groups were quite different. Gene set enrichment analysis (GSVA) showed that nine gene sets were significantly differentially expressed between the ADC and SQCC groups (p

PCB layouts with different polygon shapes and insulation distances were prepared and their surface flashover voltage subjected to different ramping rates were measured at different temperatures and different low gas pressures for emulated high-altitude conditions. The dependence of the surface flashover voltage on effects of gas pressure, surface insulation distance, temperature, and polygon shape was studied. Modulation efforts which include tailoring the local surface conductivity and local topography modification were performed to increase the flashover of PCB, and the related mechanism was studied. The results showed that the voltage ramping rate plays an important role in determining flashover voltage. The flashover voltage is lower when the sample is subjected to a rapid voltage ramping rate than with a slow ramping rate. This phenomenon is more prominent towards ambient pressure. The increase in temperature results in a decrease in flashover voltage at 100 kPa, while at 20 kPa and 10 kPa, the influence of temperature on flashover becomes less significant. Through-holes designed in the PCB have a positive role in increasing flashover voltage at lower pressures. However, at 100 kPa, the holes no longer contribute to any higher flashover voltage. Modification of local surface conductivity has no contribution in increasing the flashover voltage, while a surface coating with a surface conductivity of $10^{-10}$ S dramatically decreases the flashover voltage. The work presented in this paper provides a reference for the design and modification of PCB layouts for use in future aerospace hybrid propulsion systems.

Background Given the rapid advancement in technology, the Internet has grown to play a significant role in the field of healthcare. Individuals can now access a profusion of easily available materials for self-management of their health. The purpose of this review is to describe Web/App-based interventions that are primarily or secondarily designed to improve mental health literacy (MHL) and to investigate the effectiveness of online interventions for improving mental health. Materials and Method A scoping review was conducted by searching five databases: PsycINFO, EMBASE, PubMed, CINAHL, and Web of Science. The search was limited to peer-reviewed journals published in English between 2000 and 2022. Studies focusing on enhancements of MHL or its constituent components were included. Results Twenty-four studies met the inclusion criteria. The interventions primarily targeted patients or individuals exhibiting symptoms of mental disorders, with a higher representation of female participants. All the interventions yielded positive outcomes. The included studies were categorized according to three themes: knowledge, attitude, and self-care skills. Although numerous studies have focused on knowledge improvement, research on interventions targeting self-care skills is scarce. Furthermore, existing literature on knowledge enhancement is limited in terms of the coverage of risk factors. Conclusion This review indicates gaps in web/app interventions including limited evidence on risk factors, inconsistent help-seeking awareness, and inadequate self-care skills training. Further research is critically needed to address these deficiencies and promote comprehensive MHL.

The current work aimed to evaluate the effect of ensiling density on the fermentation quality and aerobic stability of Pennisetum giganteum silages. The silage was ensiled in laboratory silos (1 L), and three treatments were designed according to different ensiling densities: (1) low density (LD, 750 kg/m3); (2) medium density (MD, 900 kg/m3); and (3) high density (HD, 1050 kg/m3). During ensiling, the silage was sampled for a fermentation quality analysis. All silages were well preserved, as indicated by the high lactic acid (LA) content and low pH (3-N) content (68.2 g/kg total nitrogen, TN) among all silages after 45 days of ensiling. The aerobic stability of HD, MD, and LD persisted for 51 h, 54 h, and 48 h, respectively. The NH3-N contents of HD and MD were below 80 g/kg TN during aerobic exposure. These results show that the increase in ensiling density improved the fermentation quality and aerobic stability of Pennisetum giganteum silages.

Abstract Skin wound healing often leads to scar formation, presenting physical and psychological challenges for patients. Advancements in messenger RNA (mRNA) modifications offer a potential solution for pulsatile cytokine delivery to create a favorable wound‐healing microenvironment, thereby preventing cutaneous fibrosis. This study aimed to investigate the effectiveness of human adipose‐derived stem cells (hADSCs) enriched with N1‐methylpseudouridine (m1ψ) modified transforming growth factor‐β3 (TGF‐β3) and interleukin‐10 (IL‐10) mRNA in promoting scar‐free healing in preclinical models. The results demonstrated that the modified mRNA (modRNA)‐loaded hADSCs efficiently and temporarily secreted TGF‐β3 and IL‐10 proteins. In a dorsal injury model, hADSCs loaded with modRNA TGF‐β3 and IL‐10 exhibited multidimensional therapeutic effects, including improved collagen deposition, extracellular matrix organization, and neovascularization. In vitro experiments confirmed the ability of these cells to markedly inhibit the proliferation and migration of keloid fibroblasts, and reverse the myofibroblast phenotype. Finally, collagen degradation mediated by matrix metalloproteinase upregulation was observed in an ex vivo keloid explant culture model. In conclusion, the synergistic effects of the modRNA TGF‐β3, IL‐10, and hADSCs hold promise for establishing a scar‐free wound‐healing microenvironment, representing a robust foundation for the management of wounds in populations susceptible to scar formation.

Due to advancements in information technology and growing eco-tourism demand, National Park Network Attention (NPNA) has emerged as a novel indicator of tourism appeal and ecological value recognition. Utilizing Baidu search index (accessed in 2023) data from 2013 to 2022, this study employs time series analysis, index analysis, and spatial statistics to measure and differentiate the spatial and temporal aspects of NPNA across 31 provinces, regions, and municipalities in mainland China, while systematically assessing the impact of various factors from both source and destination perspectives. Over the period of 2013 to 2022, NPNA has increased annually, peaking around holidays and during spring and autumn, demonstrating pronounced seasonality and precursor effects, while exhibiting volatility due to external events. Influenced by factors from both source and destination perspectives, the spatial distribution of NPNA displays a trend of being “high in the east and low in the west” and “high in the south and low in the north”, though regional disparities are diminishing. The population size in the source areas remains the dominant factor influencing NPNA, while the concept of national parks is not yet widely recognized. The destination’s tourism resource endowment, media publicity, accessibility, and level of informatization are significant influences. An effective integration of resources and marketing is essential for boosting NPNA. The findings provide valuable insights for optimizing the spatial layout of national parks, enhancing the tourism service system, innovating communication and promotional strategies, and improving national park governance effectiveness.

Mycoplasma ovipneumoniae (M. ovipneumoniae) causes a fatal infection in goats, leading to significant economic losses in the small-ruminant industry worldwide. The present study aimed to characterize the strains of M. ovipneumoniae infecting goats with pneumonia in Anhui Province, China. From November 2021 to January 2023, among 20 flocks, a total of 1320 samples (600 samples of unvaccinated blood, 400 nasal swabs, 200 samples of pleural fluid, and 120 samples of lung tissue) were obtained from goats with typical signs of pneumonia, such as a low growth rate, appetite suppression, increased temperature, discharge from the nose, and a cough. Necropsied goats showed increased pleural fluid, fibrinous pleuropneumonia, and attached localized pleural adhesions. M. ovipneumoniae isolated from the samples were subjected to an indirect hemagglutination test (IHA), PCR amplicon sequencing, phylogenetic analysis, and biochemical identification tests. The overall positivity rate of M. ovipneumoniae was 27.50%. Mycoplasmas were obtained from 80 (20.0%) nasal swabs, 21 (10.5%) pleural fluid samples, and 15 (12.5%) lung samples. PCR amplicon (288 bp) sequencing identified eight strains of M. ovipneumoniae. In a phylogenetic tree, the isolated strains were homologous to the standard strain M. ovipneumoniae Y-98 and most similar to M. ovipneumoniae FJ-SM. Local strains of M. ovipneumoniae were isolated from goats in Anhui province. The identified genomic features and population structure will promote further study of M. ovipneumoniae pathogenesis and could form the basis for vaccine and therapy development.

We report the detection of a pair of massive quiescent galaxies likely in the process of merging at the center of the spectroscopically confirmed, extremely massive protocluster BOSS1244 at z = 2.24 ± 0.02. These galaxies, BOSS1244-QG1 and BOSS1244-QG2, were detected with Hubble Space Telescope grism slitless spectroscopic observations. These two quiescent galaxies are among the brightest member galaxies, with z = 2.223–2.255 in BOSS1244, and reside at redshifts z = 2.244 and z = 2.242, with a half-light radius of 6.76 ± 0.50 kpc and 2.72 ± 0.16 kpc, respectively. BOSS1244-QG1 and BOSS1244-QG2 are separated by a projected distance of about 70 physical kpc, implying that the two galaxies likely merge to form a massive brightest cluster galaxy (BCG) with size and mass similar to the most massive BCGs in the local Universe. We thus infer that BCG formation through dry major mergers may happen earlier than the full assembly of a cluster core, which broadens our previous understanding of the coevolution of mature galaxy clusters and BCGs in the nearby Universe. Moreover, we find a strong density–star formation relation over a scale of ∼18 comoving Mpc in BOSS1244, i.e., star formation activity decreases as density increases, implying that the quenching of star formation in BCGs and their progenitors is likely governed by environment-related processes before the virialization of the cluster core.