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Purpose: To evaluate measurement properties of the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) instrument among Chinese overweight and obese populations. Methods: A representative sample of Chinese overweight and obese populations was recruited stratified by age, sex, residence and body mass index (BMI). Social-demographic characteristics, self-reported EQ-5D-5 L and IWQOL-Lite responses were collected through the online survey. Test-retest reliability was assessed using intraclass correlation coefficient (ICC) among a subgroup of the total sample. Structural validity was evaluated by confirmatory factor analysis (CFA). Convergent validity and known-group validity were examined using Spearman's rank correlation and effect sizes, respectively. Results: A total of 1000 respondents (48% female; mean age: 51.7 years; mean BMI: 27.4) were included in this study. Ceiling and floor effects of the IWQOL-Lite were 5.4% and 0.67%, respectively. The ICC between the two tests was 0.992 for IWQOL-Lite among the subgroup (N = 150). The results of the CFA suggested that the five-factor model had an acceptable structural validity (GFI = 0.894, CFI = 0.960, TLI = 0.957, RMSEA = 0.054 and SRMR = 0.033). The Spearman's rank correlation (range: 0.413–0.611) indicated a satisfactory convergent validity. The effect sizes values of IWQOL-Lite total score and different dimensions were moderate. Conclusions: The IWQOL-Lite has been demonstrated to have satisfactory validity and reliability in measuring the HRQoL of Chinese overweight and obese populations. Further research is needed to confirm the sensitivity and responsiveness. Highlights: Overweight and obesity are one of the major public health problems worldwide, with serious negative impacts on health-related quality of life (HRQoL). The impact of weight on quality of life-lite (IWQOL-Lite) is a widely used measure to evaluate HRQoL for overweight and obese populations. However, no study has validated the measurement properties of the IWQOL-Lite among Chinese population. Our study aimed to evaluate the measurement properties of the IWQOL-Lite in China. We evaluated several measurement properties, including ceiling and floor effects, test-retest reliability, structural validity, convergent validity and known-group validity, of the IWQOL-Lite in a representative sample of Chinese overweight and obese individuals. We found that the IWQOL-Lite is a valid and reliable tool for measuring the HRQoL of overweight and obese populations in China. This supports the use of the IWQOL-Lite in overweight and obese populations in the future. [ABSTRACT FROM AUTHOR]

Background: Self-directed learning ability is crucial for lifelong learning. The inadequate self-directed learning ability of nursing students in China may be due to their deficiency in self-management or learning initiative. Objective: To explore the effect of online learning platform (Tronclass) combined with team-based learning on nursing students' self-directed learning and academic performance. Design: Pretest-posttest design. Participants: From March to July 2023, 69 undergraduate third-year nursing students from a university in Hunan Province were selected through a whole-group sampling method. Methods: This study used Tronclass to carry out team-based learning in the teaching process of pediatric nursing courses. It compared the self-directed learning ability nursing students before and after courses, and juxtaposed their academic performance with those of their counterparts who graduated in previous years. Results: When comparing compare motivation, self-management, teamwork and information literacy, which are four subscale aspects of the self-directed Learning Ability Scale, the post-survey scores for these four dimensions are greater than the pre-survey results. The results of the study showed a statistically significant difference (P < 0.05), in the students who engaged in Tronclass combined with team-based learning. Specifically, these students received higher midterm and final grades than to those who had already graduated and did not participate in these activities. (P < 0.05). Conclusion: Combining Tronclass with team-based learning enhances nursing students' ability to engage in self-directed learning and improves their performance in midterms and finals, thereby fostering the development of comprehensive competence. [ABSTRACT FROM AUTHOR]

Background: The herbaceous peony (Paeonia lactiflora Pall.) is extensively cultivated in China due to its root being used as a traditional Chinese medicine known as 'Radix Paeoniae Alba'. In recent years, it has been discovered that its seeds incorporate abundant unsaturated fatty acids, thereby presenting a potential new oilseed plant. Surprisingly, little is known about the full-length transcriptome sequencing of Paeonia lactiflora, limiting research into its gene function and molecular mechanisms. Results: A total of 484,931 Reads of Inserts (ROI) sequences and 1,455,771 full-Length non-chimeric reads (FLNC) sequences were obtained for CDS prediction, TF analysis, SSR analysis and lncRNA identification. In addition, gene function annotation and gene structure analysis were performed. A total of 4905 transcripts were related to lipid metabolism biosynthesis pathway, belonging to 28 enzymes. We use these data to identify 10 oleosin (OLE) and 5 diacylglycerol acyltransferase (DGAT) gene members after de-redundancy. The analysis of physicochemical properties and secondary structure showed them similarity in gene family respectively. The phylogenetic analysis showed that the distribution of OLE and DGAT family members was roughly the same as that of Arabidopsis. Quantitative real-time polymerase chain reaction (qRT–PCR) analyses revealed expression changes in different seed development stages, and showed a trend of increasing and then decreasing. Conclusion: In summary, these results provide new insights into the molecular mechanism of triacylglycerol (TAG) biosynthesis and storage during the seedling stage in Paeonia lactiflora. It provides theoretical references for selecting and breeding oil varieties and understanding the functions of oil storage as well as lipid synthesis related genes in Paeonia lactiflora. [ABSTRACT FROM AUTHOR]

In this study, a comprehensive analysis is presented on the complete mitochondrial genome and phylogenetic relationships of Devario shanensis, an endemic species to the Irrawaddy drainage in southwestern China. The complete mitogenome sequence of D. shanensis was sequenced to be 16,860 bp long and encompassed 13 protein-coding genes, 22 tRNA genes, two rRNA genes and a non-coding control region. The overall AT content (61.1%) was much higher than GC content (38.9%). Phylogenetic analyses employing maximum-likelihood and Bayesian inference methods on the complete mitogenomes, including D. shanensis and 13 other species, unveiled a close genomic relationship between D. shanensis and Devario interruptus. This work will contribute to the genetic resource enrichment and phylogenetic researches on genus Devario. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic has continued for 5 years. Sporadic cases continue to occur in different locations. Type 2 diabetes mellitus (T2DM) is associated with a high risk of a poor prognosis in patients with COVID-19. Successful control of blood glucose levels can effectively decrease the risks of severe infections and mortality. However, the effects of different treatments were reported differently and even adversely. This retrospective study included 4,922 patients who have been diagnosed as COVID-19 and T2DM from 138 Hubei hospitals. The clinical characteristics and outcomes were compared and calculated their risk for death using multivariate Cox regression and Kaplan–Meier curves. After adjustment of age, sex, comorbidities, and in-hospital medications, metformin and alpha-glucosidase inhibitor (AGI) use performed lower all-cause mortality (adjusted hazard ratio [HR], 0.41; 95% confidence interval [CI]: 0.24–0.71; p = 0.001 for metformin; 0.53, 0.35–0.80, p = 0.002 for AGIs), while insulin use was associated with increased all-cause mortality (adjusted HR, 2.07, 95% CI, 1.61–2.67, p < 0.001). After propensity score-matched (PSM) analysis, adjusted HRs for insulin, metformin, and AGIs associated with all-cause mortality were 1.32 (95% CI, 1.03–1.81; p = 0.012), 0.48 (95% CI, 0.23–0.83, p = 0.014), and 0.59 (95% CI, 0.35–0.98, p = 0.05). Therefore, metformin and AGIs might be more suitable for patients with COVID-19 and T2DM while insulin might be used with caution. [ABSTRACT FROM AUTHOR]

Background: Primary care providers play an important role in home health care, and their practice behavior is significant for care quality and patient outcomes. This study aimed to assess the home care practice behavior of Chinese primary care providers and to explore the factors associated with the practice behavior. Methods: A multicenter cross-sectional design with a convenience sample was used to survey 863 registered primary care providers from 62 primary health care settings in Sichuan Province, China. Descriptive statistics, t-test or ANOVA for one-way analysis, and Pearson's correlation analyses were used to compare the differences and examine the relationships between participants' demographics and experience of home care services and practice behavior. Multiple linear regression models were performed to identify salient variables associated with the practice behavior from among demographic and home care experience. Results: The score of home care practice behavior questionnaire was 97.25 ± 21.05. The average scores for the dimensions of home visit preparation, assessment, medical care behavior and safety practice were 3.70 ± 0.95, 3.76 ± 1.02, 3.66 ± 1.03, and 3.20 ± 0.46, respectively. Home care practice behavior was associated with working years, working experience in general hospitals, work area, home care experience such as client types of home care, service frequency and willingness, explaining 21.5% of the total variance. Conclusion: Chinese primary care providers had a medium to high level of home care practice behavior but poor implementation of safety practice. The results may provide clues to increased focus and implementation of safety practice, as well as providing targeted measures based on influencing factors. [ABSTRACT FROM AUTHOR]

Background: In China, the world's largest developing country, low back pain (LBP) is a common public health issue affecting workability. This meta-analysis aimed to systematically assess the risk factors of LBP in the Chinese population. Methods: Four English language and four Chinese databases were searched, and cross-sectional studies on the risk factors for LBP in Chinese populations were identified and collected. The search timeframe covered the period from the establishment of the database to November 2023. Two researchers independently reviewed the literature, extracted the data, and evaluated the risk of bias. Begg's and Egger's tests were used to evaluate publication bias. Results: Fifteen cross-sectional studies involving 86,575 people were included. Seven risk factors for LBP were identified. Six risk factors were statistically significant: Cigarette smoking (odds ratio [OR] = 1.55; 95% confidence interval [CI]: 1.15, 2.08, P = 0.004, I2 = 72%), body mass index (BMI) ≥ 28 kg/m² (OR = 4.51; 95% CI: 3.36, 6.07, P < 0.00001, I2 = 8%), female sex (OR = 1.54; 95% CI: 1.25, 1.90, P < 0.0001, I2 = 63%), vibration exposure at work (OR = 1.65; 95% CI: 1.16, 2.34, P = 0.006, I2 = 84%), working overtime (OR = 2.57; 95% CI: 1.12, 5.91, P = 0.03, I2 = 85%), and lack of exercise (OR = 2.48; 95% CI: 1.62, 3.78, P < 0.0001, I2 = 0%). One risk factor that was not statistically significant was standing for long periods (OR = 1.02; 95% CI: 0.82, 1.26, P = 0.88, I2 = 73%). Conclusions: This study found that smoking, a BMI ≥ 28 kg/m², female sex, vibration exposure at work, working overtime, and lack of exercise may be risk factors for LBP in the Chinese population. Because the included studies were cross-sectional and the certainty of the evidence was very low, the results need to be interpreted cautiously. Multicentre, high-quality studies should be conducted in the future. To reduce the prevalence of LBP, the Chinese government and hospitals must develop early screening programs and implement effective preventive and interventional measures. Trial registration: This study is registered in the PROSPERO database (No. CRD42023447857). [ABSTRACT FROM AUTHOR]

Background: This multicenter observational study aimed to determine whether dyslipidemia or obesity contributes more significantly to unfavorable clinical outcomes in patients experiencing a first-ever ischemic stroke (IS). Methods: The study employed a machine learning predictive model to investigate associations among body mass index (BMI), body fat percentage (BFP), high-density lipoprotein (HDL), triglycerides (TG), and total cholesterol (TC) with adverse outcomes in IS patients. Extensive real-world clinical data was utilized, and risk factors significantly linked to adverse outcomes were identified through multivariate analysis, propensity score matching (PSM), and regression discontinuity design (RDD) techniques. Furthermore, these findings were validated via a nationwide multicenter prospective cohort study. Results: In the derived cohort, a total of 45,162 patients diagnosed with IS were assessed, with 522 experiencing adverse outcomes. A multifactorial analysis incorporating PSM and RDD methods identified TG (adjusted odds ratio (OR) = 1.110; 95% confidence interval (CI): 1.041–1.183; P < 0.01) and TC (adjusted OR = 1.139; 95%CI: 1.039–1.248; P < 0.01) as risk factors. However, BMI, BFP, and HDL showed no significant effect. In the validation cohort, 1410 controls and 941 patients were enrolled, confirming that lipid levels are more strongly correlated with the prognosis of IS patients compared to obesity (TC, OR = 1.369; 95%CI: 1.069–1.754; P < 0.05; TG, OR = 1.332; 95%CI: 1.097–1.618; P < 0.01). Conclusion: This study suggests that dyslipidemia has a more substantial impact on the prognosis of IS patients compared to obesity. This highlights the importance of prioritizing dyslipidemia management in the treatment and prevention of adverse outcomes in IS patients. [ABSTRACT FROM AUTHOR]

Karst spring water dynamic characteristics and its response to atmospheric precipitation are of great significance for water resources utilization under the background of climate change. This paper selects Longzici spring area, North China, as the study area. Based on a long series of spring water flow and precipitation data, the dynamic characteristics of spring flow were analyzed and the numerical simulation of the groundwater flow model was established. The results show that the groundwater kept the sustained decline over the past decades which is in a negative equilibrium state, with a storage variable of − 2.26 million m3/year. The sensitivity of spring flow to precipitation under different precipitation scenarios shows that the water level changes in the recharge and drainage areas are similar about (3–5 cm) and slightly larger than that in the runoff area(1.5 cm) when minimum rainfall (287.24 mm) happens. When the precipitation is at its maximum (867.66 mm), the water level change in the runoff area can reach 95 cm which is much larger than those in the recharge and discharge areas. The results indicate that Longzici karst spring has a relatively good regulation water resource capacity and the runoff area is more sensitive which plays an important role in response to climate change. [ABSTRACT FROM AUTHOR]

The skin coloration is one of the key characteristics of fish morphological diversity; understanding the molecular regulation mechanism of fish skin coloration has attracted a mounting number of attention and is also an important prerequisite for the future research on fish skin coloration genetics and skin coloration improvement breeding of fish. Pearlscale angelfish (Centropyge vrolikii) is a unique marine ornamental fish with tremendous market potential and is well favored by consumers in China, which has a wide variety of colorations and shapes. In this study, the distribution of pigment cells in the fins and scales was observed, and the pigment cells were mainly composed of melanocytes, xanthophore, iridophore, and erythrophore in C. vrolikii. The distribution of pigment cells in the tail scales is more concentrated than that in other parts. There are mainly melanocytes and yellow pigment cells in the anal fin, tail fin, and dorsal fin, and mainly xanthophore with a few melanocytes in the pectoral fin and abdominal fin. The tissues of the pectoral fin (PF), anal fin (AF), tail fin (TF), and eyeballs (EB) were sequenced by SOAPdenovo-Trans technology, the differentially expressed genes (DEGs) of skin coloration were screened, and the expression pattern of these genes in different tissues was analyzed. The results represented that a total of 159,213 all-unigene was assembled and gene annotation was carried out using COG, GO, KEGG, KOG, Pfam, Swissprot, eggNOG, and NR functional database. The Tyrp1, Slc45a2, Xdh, Mitf, Tyr, Hps5, Pomc, Pmel, and other genes related to the skin coloration were annotated. Through KEGG pathway enrichment analysis, it was found that tyrosine metabolism, MAPK, Wnt, and melanin production were involved in the regulation of skin coloration. At the same time, the DEGs related to melanin production (Mitf, Mc1r, Sox10, Tyr, Tyrp1, and Pomc) were screened to verify their expression in various tissues. The results also showed that Mitf and Tyr were highly expressed in eyeballs, Tyrp1 was highly expressed in skin, Sox10 and Pomc were highly expressed in the tail fin, and Mc1r was highly expressed in the heart and tail fin. The results suggested that these genes may play an important role in the process of skin coloration in C. vrolikii. This study will help to further understand the molecular regulatory mechanism of skin coloration and provide essential clues for accelerating skin coloration improvement in the future in C. vrolikii. [ABSTRACT FROM AUTHOR]

With the aggravation of population aging, the health of the elderly has become an important issue in the aging society. The Mediterranean diet (MD) contributes to healthy aging by changing dietary patterns to delay and prevent disease onset. This paper summarizes the concepts related to the MD pattern and its relationship with cardiovascular diseases, cognitive dysfunction, depression, chronic inflammation and other brain and heart comorbidity in the elderly, so as to provide thinking and reference for the optimization and upgrading of the elderly, and contribute to the development of healthy China. [ABSTRACT FROM AUTHOR]

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This section dissects cardiovascular risk factors in China which including hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease, metabolic syndrome and air pollution. Hypertension prevalence has steadily increased in China, with efforts to control it facing challenges in achieving optimal rates, especially in rural areas. Interventions like salt substitutes and intensive blood pressure control show promise but need improvement. Abnormal lipid levels, indicative of dyslipidemia, have risen significantly, posing a risk for cardiovascular diseases. Despite efforts, many patients struggle to achieve target lipid levels, necessitating improved treatment strategies. Both type 1 and type 2 diabetes mellitus affect millions of adults in China, with long-term complications adding to the disease burden. Early intervention and effective management are crucial to mitigate its impact. Prevalent among older adults, chronic kidney disease is associated with diabetes mellitus, hypertension, and cardiovascular diseases, necessitating comprehensive management approaches. The prevalence of metabolic syndrome, characterized by a cluster of risk factors, has increased in both adults and adolescents, calling for lifestyle modifications and public health interventions. Ambient and household air pollution remain significant environmental risk factors, despite some improvements in air quality. Continued efforts to reduce emissions are essential for mitigating associated health risks. Addressing these risk factors requires a multifaceted approach, including public health initiatives, policy interventions, and individual-level strategies to promote healthy lifestyles and reduce environmental exposures. Surveillance and research efforts are crucial for monitoring trends and developing effective strategies to lessen the burden of cardiovascular diseases in China. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM), one of the most common public diseases threatening human health, is always accompanied by infection. Though there are still a variety of flaws in the treatment of some infectious diseases, metabolomics provides a fresh perspective to explore the relationship between T2DM and infection. Our research aimed to investigate the association between plasma free amino acids (PFAAs) and T2DM complicated with infection in Chinese patients. Methods: A cross-sectional study was conducted from May 2015 to August 2016. We retrieved the medical records of 1032 inpatients with T2DM from Liaoning Medical University First Affiliated Hospital and we used mass spectrometry to quantify 23 PFAAs. Infections contained 15 individual categories that could be retrieved from the database. Principal component analysis was used to extract factors of PFAAs. Multi-variable binary logistic regression was used to obtain odds ratios (OR) and their 95% confidence intervals (CI). Results: Among 1032 inpatients,109 (10.6%) had infectious diseases. Six factors, accounting for 68.6% of the total variance, were extracted. Factor 4 consisted of Glu, Asp and Orn. Factor 5 consisted of Hcy and Pip. After adjusting for potential confounders, factor 4 was positively correlated with T2DM complicated with infection in Chinese T2DM patients (OR: 1.27, 95%CI: 1.06–1.52). Individual Hcy in factor 5 was positively associated with T2DM complicated with infection (OR: 1.33, 95%CI: 1.08–1.64). Furthermore, factor 4 (OR: 1.44, 95%CI: 1.11–1.87), Orn (OR: 1.01, 95%CI: 1.00-1.02) and Hcy (OR: 1.56, 95%CI: 1.14–3.14) were positively associated with bacterial infection in Chinese T2DM patients, while factor 5 (OR: 0.71, 95%CI: 0.50-1.00) was negatively associated with bacterial infection. Conclusions: Urea cycle-related metabolites (Orn, Asp, Glu) and Hcy were positively associated with T2DM complicated with infection in China. Orn and Hcy were positively associated with bacterial infection in T2DM patients in China. [ABSTRACT FROM AUTHOR]

Objectives: Immune checkpoint inhibitors (ICIs) are one of the most significant oncological treatment modalities as a result of the rapid advancement of immunotherapy. Programmed Cell Death-Ligand 1 (PD-L1) and tumor mutational burden (TMB) have emerged as key markers for predicting the efficacy and prognosis of ICIs in non-small cell lung cancer (NSCLC), and the predictive role of tumor-infiltrating lymphocytes (TILs) has also received significant attention. However, the prognosis of some individuals cannot be determined by these indicators; for instance, some patients with low PD-L1 expression also benefit from longer survival. Therefore, the purpose of this research was to investigate the connection between new haematological and pathological markers and clinical outcomes in NSCLC patients receiving ICIs. Methods: Seventy-six patients with stage III-IV NSCLC treated with ICIs were included in this study. We used the Mann-Whitney test, COX regression and Kaplan-Meier analysis to retrospectively analyze peripheral blood indicators and survival prognostic data of 76 patients in order to investigate the relationship between baseline neutrophil-to-lymphocyte ratio (NLR) and the efficacy of ICIs. To investigate the correlation between CXCL13, CXCR5, CD8 and the efficacy of ICIs, we assessed the expression levels of aforementioned indicators in biopsied tissues of 10 non-small cell lung tumors by immunohistochemistry (IHC) and immunofluorescence (IF) and performed statistical analysis. Results: Disease control rate (DCR) was higher in patients with baseline NLR <3.4 (p=0.016) and neutrophil percentage <71% (P=0.015). Baseline NLR (HR=2.364, P=0.003) and neutrophil percentage (HR=2.824, P=0.013) had the greatest influence on patients' survival prognosis, with baseline NLR exhibiting a stronger predictive value (AUC=0.717), according to univariate and multifactorial COX regression analyses of progression-free survival (PFS) and overall survival (OS). In NSCLC tissues, higher expression of CXCL13 was associated with better clinical outcomes (P=0.032) and higher expression of CD8 was associated with prolonged survival (P=0.022). Conclusion: Low baseline NLR in peripheral blood and high expression of CD8 in tissues are associated with longer PFS and may have a potential predictive value for patients with stage III-IV NSCLC using ICIs. [ABSTRACT FROM AUTHOR]

The complex topology of river networks and the numerous factors influencing streamflow make it challenging to forecast streamflow in large river basins. Improving the accuracy of streamflow forecasting in these basins is of great importance for water resource planning and management. In this paper, considering the spatial variability of impacts of human activities on streamflow, a streamflow forecasting method with a hybrid physical process-mathematical statistic is proposed to obtain better results by realizing the complementary advantages of conventional methods and the streamflow into Hongze Lake in China is forecasted by the proposed method. Firstly, the physical process-based Soil and Water Assessment Tool (SWAT) is used to forecast the streamflow of tributaries with few water storage projects such as reservoirs in the catchment area. Secondly, considering the correlation between mainstream streamflow and tributaries streamflow as well as the correlation between mainstream streamflow and its previous streamflow, streamflow forecasting models based on the vine copula function are constructed to forecast the mainstream streamflow and its confidence intervals, where there are many water storage projects in the catchment area. Then, the total streamflow into Hongze Lake and its confidence intervals are obtained by coupling the outputs of the above two parts. Finally, statistical indicators are chosen to evaluate the forecasting effects in terms of the credibility of deterministic forecasting as well as the reliability and acuity of probabilistic forecasting. The results demonstrate that the proposed method outperforms existing SWAT and long and short-term memory (LSTM) neural network methods in terms of forecasting performance. Consequently, it presents an effective alternative for addressing complex hydrological forecasting tasks in large river basins. [ABSTRACT FROM AUTHOR]

Pinus yunnanensis Franch. is an economically and ecologically important pine endemic to southwest China. A large number of low-quality and low-efficiency individuals have appeared in P. yunnanensis forests due to climate change, environmental stress, and human overexploitation. There is a lack of comprehensive information about the genetic diversity, population structure and a core germplasm collection establishment with individuals taken across its natural range. Understanding the important information will be invaluable for germplasm efficient conservation and utilization. A total of 287 individuals from 10 populations across its range were analyzed using 17 polymorphic microsatellite markers. The research revealed P. yunnanensis was a typical outcrossing plant (Fis = − 0.1), maintaining moderately high genetic diversity (He = 0.540). The continuous distribution and wind-dispersal traits of two-sacs pollen and winged seeds may have promoted gene flow (Nm = 12.71) and lessened genetic differentiation between populations (Fst = 0.023). There was a lack of significant isolation by distance (P = 0.07). Geographical and ecological isolation following the uplift of the southeastern margin of the Tibetan Plateau may have contributed to the formation of three discrete groups (K = 3). A core collection of 72 individuals (25% of the whole collection) was established, of which genetic diversity parameters showed no-significance from the whole collection. In situ conservation of the three populations (XC, CY, and XP) showing distinct genetic diversity was recommended, and ex situ conservation for individuals with private alleles. The core collection was recommended as a possible germplasm resource for tree breeding and improvement. [ABSTRACT FROM AUTHOR]

Purpose: Much attention has been paid to anthropogenic activities in the metropolitan zone and associated with their organic pollutants i.e. polycyclic aromatic hydrocarbons (PAHs) discharge. This work aims to explore the impact factors, sources, and cancer risks of soil PAHs from the northern Taihu Basin, China, providing worthwhile information for soil remediation and health risk management. Materials and methods: In this study, soil samples were collected from 43 residential areas in the northern Taihu Basin of the Yangtze River Delta. Determination of 16 PAHs performed by gas chromatography-mass spectrometry. The primary sources of PAHs were discriminated by a positive matrix decomposition (PMF) model and the contributions were quantitatively evaluated. The health risk of PAHs was assessed by the increased lifetime cancer risk (ILCR) model. Results and discussion: Results showed that the PAH concentration ranged from 87.15 − 947.02 ng g−1, and the compounds were mainly composed of 4–6-ring monomers, accounting for 84.11%. The soil erosion-derived input of PAHs from land to water was determined to be 15.27 kg yr−1. Source identification of PAHs by the PMF model revealed a 50.96% contribution of vehicle emission, 34.07% of coke and coal combustion, and 14.97% of the petroleum-derived source. The correlation analysis indicated that the distance from the nearest trunk road was the key factor influencing PAHs value in soils, followed by coal/coke consumption and the age of the residential area. The changes in TOC and TN contents greatly affected the adsorption of PAHs. The ILCR value was in a range of (1.09–34.00) × 10−6. Conclusions: The highest concentrations of PAHs in soils were found in the oldest urban district. PAHs in sediments are caused by soil erosion attributing approximately 10% of the total sediments in the northern Taihu Basin. Vehicle emissions were the dominant sources. The total ILCR value ranged from 10–6 to 10–4, reflecting that potential risks would occur occasionally for residents exposed to soil PAHs, with higher cancer risk for adults, and food ingestion was the dominant exposure pathway. [ABSTRACT FROM AUTHOR]

With the wide application of the "Tender, Auction, and Listing" system for land in China, it is of paramount importance to establish a sound land auction mechanism so as to avoid unreasonable land allocation. However, existing studies only focus on developers who are merely concerned about land combinations and offline auctions with low efficiency and high land unsold rate. To further improve land auction mechanism, we modeled the problem of land allocation as an online combinatorial auction. On this basis, we defined a land correction coefficient and designed an optimal online combinatorial auction mechanism that enabled developers to submit multiple combinations of land. Our designed mechanism proved to satisfy both incentive compatibility (IC) and individual rationality (IR), which can prevent developers from lying in the auction while winning higher revenue, reducing land unsold rate, increasing developer turnover rate and promoting the stability of land resource allocation rate. Therefore, online combinatorial auction mechanism, both applicable and efficient, is a practical solution for improving land auctions in China. [ABSTRACT FROM AUTHOR]

Understanding the dynamic link between the development of COVID-19 pandemic and industry sector risk spillovers is crucial to explore the underlying mechanisms by which major public health events affect economic systems. This paper applies ElasticNet method proposed by Diebold and Yilmaz (2009, 2012, 2014) to estimate the dynamic risk spillover indicators of 20 industrial sectors in China from 2016 to 2022, and systematically examines the impact of industry risk network fluctuations and the transmission path caused by COVID-19 shock. The findings reveal that risk spillovers of Chinese industries show a dynamic change of "decline-fluctuation-rebound" with the three phases of COVID-19 epidemic. At the beginning of the epidemic, machinery and equipment, paper and printing, tourism and hotels, media and information services, and agriculture were the exporters of epidemic risk, while materials, transportation equipment, commercial trade, health care, and environmental protection were the importers of epidemic risk; However, as the epidemic developed further, the direction and effect of risk transmission in the industry was reversed. Examining the network characteristics of the pair sectors, we found that under the epidemic shock, the positive risk spillover from tourism and hotels, culture, education and sports to consumer goods, finance, and energy industries was significantly increased, and finance and real estate industries were affected by the risk impact of more industries, while the number of industries affected by information technology and computer industry was significantly reduced. This paper shows that there is inter-industry risk transmission of the COVID-19 epidemic shock, and the risk transmission feeds back in a cycle between industries as the epidemic develops, driving the economy into a vicious circle. The role of the service sector in blocking the spread of negative shocks from the epidemic should be emphasized and brought into play to avoid increasing the overall economic vulnerability. This study will help to deepen the understanding of scholars and policy makers on the network transmission effects of the epidemic. [ABSTRACT FROM AUTHOR]

Propionic acidemia (PA) is a rare autosomal recessive congenital disease caused by mutations in the PCCA or PCCB genes. Elevated propionylcarnitine, 2-methylcitric acid (2MCA), propionylglycine, glycine and 3-hydroxypropionate can be used to diagnose PA. Early-onset PA can lead to acute deterioration, metabolic acidosis, and hyperammonemia shortly after birth, which can result in high mortality and disability. Late-onset cases of PA have a more heterogeneous clinical spectra, including growth retardation, intellectual disability, seizures, basal ganglia lesions, pancreatitis, cardiomyopathy, arrhythmias, adaptive immune defects, rhabdomyolysis, optic atrophy, hearing loss, premature ovarian failure, and chronic kidney disease. Timely and accurate diagnosis and appropriate treatment are crucial to saving patients' lives and improving their prognosis. Recently, the number of reported PA cases in China has increased due to advanced diagnostic techniques and increased research attention. However, an overview of PA prevalence in China is lacking. Therefore, this review provides an overview of recent advances in the pathogenesis, diagnostic strategies, and treatment of PA, including epidemiological data on PA in China. The most frequent variants among Chinese PA patients are c.2002G > A in PCCA and c.1301C > T in PCCB, which are often associated with severe clinical symptoms. At present, liver transplantation from a living (heterozygous parental) donor is a better option for treating PA in China, especially for those exhibiting a severe metabolic phenotype and/or end-organ dysfunction. However, a comprehensive risk–benefit analysis should be conducted as an integral part of the decision-making process. This review will provide valuable information for the medical care of Chinese patients with PA. [ABSTRACT FROM AUTHOR]

Promoting electric vehicles (EVs) adoption has become one of the important paths for countries around the world to address climate change and accelerate the transformation of energy system for achieving sustainable development. As one of the important psychological factors, the research on the explanatory power of emotions to EVs purchase intention is still insufficient. This paper collected 400 valid questionnaires all around China. By incorporating emotions and moral norms into the Theory of Planned Behavior (TPB) model, this study used structural equation model to estimate the impact of positive anticipated emotion (PAE), negative anticipated emotion (NAE), and moral norms together with TPB elements on EVs purchase intention. In order to explore the heterogeneity effect of the above factors on EVs purchase intention among consumers of different income groups, we divided the total sample into high-income subsample and low-income subsample according to the household monthly disposable income. We concluded as follows: for the total sample, PAE has the greatest impact on EVs purchase intention, followed by attitude, NAE, and perceived behavioral control (PBC). In particular, the purchase intention of high-income consumers mainly depends on NAE, while the purchase intention of low-income consumers mainly depends on PAE. Additionally, PBC has more significant impact on EVs purchase intention of high-income group. Finally, targeted policy implications are proposed to promote EVs purchase. [ABSTRACT FROM AUTHOR]

Background: Thoracic aortic aneurysm or dissections (TAADs) represent a group of life-threatening diseases. Genetic aetiology can affect the age of onset, clinical phenotype, and timing of intervention. We conducted a prospective trial to determine the prevalence of pathogenic variants in TAAD patients and to elucidate the traits related to harbouring the pathogenic variants. One hundred and one unrelated TAAD patients underwent genetic sequencing and analysis for 23 TAAD-associated genes using a targeted PCR and next-generation sequencing-based panel. Results: A total of 47 variants were identified in 52 TAAD patients (51.5%), including 5 pathogenic, 1 likely pathogenic and 41 variants of uncertain significance. The pathogenic or likely pathogenic (P/LP) variants in 4 disease-causing genes were carried by 1 patient with familial and 5 patients with sporadic TAAD (5.9%). In addition to harbouring one variant causing familial TAAD, the FBN1 gene harboured half of the P/LP variants causing sporadic TAAD. Individuals with an age of onset less than 50 years or normotension had a significantly increased genetic risk. Conclusions: TAAD patients with a younger age at diagnosis or normotension were more likely to carry a P/LP variant; thus, routine genetic testing will be beneficial to a better prognosis through genetically personalized care prior to acute rupture or dissection. [ABSTRACT FROM AUTHOR]

Background: Aging is associated with an increased prevalence of non-communicable chronic diseases (NCDs), functional impairments, and diverse demands for health services. This study analyzed the trends in older adults' needs and utilization of health services from 1993 to 2018 in China, as well as chronic disease-related economic burdens. Methods: The research data were collected from the six cross-sectional National Health Service Survey (NHSS), implemented every 5 years from 1993 to 2018. A multi-stage stratified random cluster sampling method has been adopted in the NHSS. The data on the older population's socio-economic characteristics, health service needs, and utilization were collected from the 6 waves National Health Service Survey (NHSS) 1993–2018. In the 2013 and 2018 NHSSs, EQ-5D-3L and visual analogue scale were used to evaluate the health condition. And the prevalence of NCDs and related Out-of-pocket (OOP) expenditures were collected. Functional dependency and impairment were collected in 2018. The Katz Activities of Daily Living scale was used to evaluate six functions, including self-feeding, dressing, bathing, transferring, toilet hygiene, and controlling bowel movements. Results: The two-week morbidity rate and prevalence of NCDs showed a rapid upward trend in older adults. With the development of health system reform and universal health insurance coverage, older adults' two-week medical consultation rate increased from 25.6% in 1993 to 40.1% in 2018, and the hospitalization rate rose from 6.1% to 24.9%. The difference in health service needs and utilization between urban and rural areas decreased, and the hospitalization rate in rural areas (26.3%) exceeded that in urban areas (23.6%) for the first time in 2018. Functional independence become more severe as aged. The proportion of severe functional impairment was 6.9% and 2% in the group aged 80 or over and group 70–79 years, respectively. Regarding disability status, 32.5% had hearing problems and 31.4% had visual impairment. The highest prevalence rates of NCDs in older adults were found in hypertension (36.9%), followed by diabetes (10.6%), cerebrovascular disease (5.4%), ischemic heart disease (4.5%), and intervertebral disc disease (4.2%). The average annual OOP expenditures attributed to NCDs increased from ¥2481.8 RMB in 2013 to ¥8255.9 RMB in 2018 for older adults. About 90.7% of older adults prefer to live in the residential community, leading to the demands for preventive healthcare (30.4%), medical treatment (14.1%), and elderly education (8.6%). Conclusion: The elevated risks of age-related impairments and chronic morbidities, and increased demands for preventive healthcare are critical public health issues. Policymakers should strengthen primary healthcare and move towards integrated delivery to improve access and quality of care for older adults. The integration of healthcare and social security constitutes an adaptive trend in meeting the multi-level demands of an aging society. [ABSTRACT FROM AUTHOR]

Background: The application of virtual reality (VR) in gastroscopic operation teaching can be safe and effective, but the advantages can be realized only when students accept and use it. This study aims to identify the factors influencing Chinese clinical medical postgraduates on their intention to use the 3D gastroscopic model constructed based on VR technology using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Students' demographic factors are also taken into consideration. Methods: All methods were carried out in accordance with relevant guidelines. Data were collected from clinical medical postgraduates students in China using stratified sampling. A total of 292 questionnaires including valid responses were used in this study. Data were processed using Amos 24.0 and SPSS 26.0 software and the statistical analysis technique was based on structural equation modeling (SEM). Results: The results showed that different from the mediator of home location and year of clinical learning, mediator of gender, university kind and graduate degree did not affect the behavioral intention. In addition, performance expectancy, facilitating condition, and social influence directly and indirectly have effect on behavioral intention. Also, the significance between social influence and performance expectancy, social influence and effort expectancy were verified. Conclusions: This study manifested that the proposed framework based on the UTAUT had explanatory power to identify the factors influencing the students' behavioral intention to use the 3D gastroscopic model constructed based on VR technology. Whereas, an important variable of effort expectancy in the frame of the SEM were not certified, thereby indicating that particular attention should be paid to this variable by universities and teachers before applying 3D gastroscopic model constructed based on VR technology in teaching. Added preparatory work is required such as explaining the basic knowledge of the operating steps of VR model and make students adequately understand its accessibility, which can probably improve the intentions of them to use it. The positive effects of social influence on performance expectancy and effort expectancy we proposed was also verified in this study, which provided a direction for future research. [ABSTRACT FROM AUTHOR]

With the expansion of China's automobile market and the increase in the proportion of electric vehicles, the influence of the automobile industry on water resources has been increasingly, and as a result, water resources will become an important factor restricting the development of the electric vehicle industry in China. Until now, there are still no in-depth studies on the influences of the water footprint of electric vehicles. The paper establishes a life cycle assessment model by which to analyze the reduction potential of the water footprint of various types of passenger vehicles in their operation. The paper also compares the water footprint of passenger vehicles under different power structures, revealing the potential influence of developing electric vehicles on the demand of water resources. The results show that at the base year (2019), the plug-in hybrid electric vehicles and battery electric vehicles consume more water than the gasoline-based internal combustion engine vehicles do, while water consumption of the hybrid electric vehicles and fuel cell vehicles is lower than that of the gasoline-based internal combustion engine vehicles; as for the year 2035, even after the proportion of renewable energy generation increases, the water withdrawal and consumption of the battery electric vehicles and plug-in hybrid electric vehicles will still be larger than those of the gasoline-based internal combustion engine vehicles. [ABSTRACT FROM AUTHOR]

Heavy metals in reservoir sediments were analyzed to assess the pollution level and to understand the potential risk on water supply safety. Heavy metals in sediments will enter the biological chain through bio-enrichment and bio-amplification in water and eventually pose a threat to the safety of drinking water supply. Analysis of eight sampling sites in JG (Jian gang) drinking water reservoir of the sediments showed that from Feb 2018 to Aug 2019 heavy metals including Pb, Ni, Cu, Zn, Mo, and Cr increased by 1.09–17.2%. Vertical distributions of heavy metals indicated that the concentrations increased gradually by 9.6–35.8%. Risk assessment code analysis indicated that Pb, Zn, and Mo were of high risk in the main reservoir area. What is more, enrichment factors of Ni and Mo were 2.76–3.81 and 5.86–9.41, respectively, showing the characteristics of exogenous input. The continuous monitoring results of the bottom water showed that the concentration of heavy metals in the bottom water exceeded the environmental quality standard value of surface water in China, and exceeded the standard by 1.76 times (Pb), 1.43 times (Zn), and 2.04 times (Mo), respectively. Heavy metals in the sediments of JG Reservoir, especially in the main reservoir area, have a potential risk of release from the sediment to the overlying water. Water supply reservoir as a source of drinking water, its quality is directly related to human health and production activities. Therefore, this first study on JG Reservoir is of great significance for the protection of drinking water safety and human health. [ABSTRACT FROM AUTHOR]

The latest discovery of sulfurous natural gas marked a breakthrough in the Cenozoic natural gas exploration in the southwestern margin of Qaidam Basin. The 16S rRNA analyses were performed on the crude oil samples from H2S-rich reservoirs in the Yuejin, Shizigou and Huatugou profiles, to understand the sulfurous gas origin, which was also integrated with carbon and hydrogen isotopes of alkane and sulfur isotopes of H2S collected from the Yingxiongling Area. Results show that the microorganisms in samples can survive in the hypersaline reservoirs, and can be classified into multiple phyla, including Proteobacteria, Planctomycetes, Firmicutes, Bacteroidetes, and Haloanaerobiaeota. Methanogens are abundant in all of the three profiles, while sulfate-reducing bacteria are abundant in Yuejin and Huatugou profiles, contributing to the methane and H2S components in the natural gas. The carbon, hydrogen and sulfur isotopes of sulfurous natural gas in the Yingxiongling Area show that the natural gas is a mixture of coal-type gas and oil-type gas, which was primarily derived from thermal degradation, and natural gas from the Yuejin and Huatugou profiles also originated from biodegradation. The isotopic analysis agrees well with the 16S rRNA results, i.e., H2S-rich natural gas from the Cenozoic reservoirs in the southwest margin of the Qaidam Basin was primarily of thermal genesis, with microbial genesis of secondary importance. [ABSTRACT FROM AUTHOR]

The lack of medical humanistic care has led to the tension between doctors and patients and frequent incidences of violence against doctors. In the past few years, doctors reported feeling insecure due to the frequent occurrence of killing or maiming doctors. Conditions in medicine are not conducive to China's medical development and progress. This manuscript suggests that the violence against doctors caused by the tension between doctors and patients mainly stems from the lack of medical humanistic care, the overemphasis on technical rationality, and the lack of knowledge on humanistic care for patients. Therefore, the improvement of medical humanistic care is an effective way to reduce the occurrence of violence against doctors. The manuscript describes the steps to improve medical humanistic care and establish a harmonious relationship between doctors and patients to further reduce violence against doctors, improve the quality of humanistic care of medical staff, re-introduce the medical humanistic spirit by ending the dominance of technical rationality, optimize medical treatment processes, and establish the idea of humanistic care for patients. [ABSTRACT FROM AUTHOR]

Findings from prior studies regarding the relationship between national institutional pressures and corporate green innovation have been mixed. To address this gap, we consider the moderating effects of public agents (provincial officials) and private agents (corporate CEOs) to investigate corporate green innovation in response to institutional pressures. Using the method of difference-in-difference, we examine the data from 722 publicly listed Chinese firms between 2007 and 2019, a period associated with the implementation of China's Twelfth Five-Year Plan which increase the emphasis on social indicators for national development. Our results firstly show that institutional pressures caused by Twelfth Five-Year Plan significantly facilitate polluting-firms' green innovation relative to clean-firms, and the effect is stronger when public agents are more concerned about promotion to the central government or private agents have greater concerns for legitimacy, meanwhile not producing an a real "incentive effect" on corporate green innovation, but a "crowding-out effect" on existing innovation. Furthermore, results also suggest institutional pressures mainly induced polluting-firms' strategic innovation behaviors, and the incentive effects of institutional pressures on polluting-firms' green innovation are different in terms of firms' ownership and size. Our results generate important theoretical and practical implications. [ABSTRACT FROM AUTHOR]

With the use of vehicles, large amounts of carbon dioxide are emitted by combustion of gasoline and energy consumes in their lifecycle. Therefore, the objective of this study is to evaluate the lifecycle carbon emission and primary energy input of a widely used sport utility vehicle (SUV) in China with the lifecycle assessment method. The results show that total petrol consumption of an SUV in lifetime is 21,300 kg; the CO2 emissions and primary energy input in the manufacturing, assembly, operation, and decommissioning phase are respectively 8857, 443, 54,925, and 443 kg and 123,413, 6171, 12,341, and 6171 MJ. The average CO2 emission intensity and energy input intensity of materials are respectively 2.74 kg/kg and 64.9 MJ/kg. The primary energy input of materials in manufacturing phase occupies 83.3%, and CO2 emission in use phase is 64,267.3 kg (occupied 92.62%), mainly attributed to the combustion of petrol. [ABSTRACT FROM AUTHOR]

Internal phosphorus (P) loading from sediments is an important cause of eutrophication, and inorganic-phosphate-solubilizing bacteria (IPB) are known to play a vital role in the process of sediment P release. In this study, 10 IPB strains were isolated from the sediments of a lagoon suffering from macroalgal blooms dominated by Chaetomorpha linum – Rongcheng Swan Lagoon, China – and their taxonomy was determined by 16S rRNA sequence analysis. The phosphate-solubilizing characteristics of the obtained IPB strains were evaluated using a liquid medium, and the ability of IPB strains to dissolve P from sediments and the transformation of inorganic phosphorus (IP) fractions were investigated by inoculating IPB strains into a sediment–water experimental system. The 10 isolated IPB strains belonged to one family, two genera, and four species. All IPB strains in the liquid medium culture dissolved tricalcium phosphate, but the phosphate-solubilizing ability of IPB varied greatly between strains and appeared to be promoted when the strains were grown in mixed-strain cultures. Bacillus megaterium showed the strongest phosphate-solubilizing ability. The IPB inoculation experiment showed a large decrease in the Ca-bound P (HCl-P) concentration of sediments in various IPB inoculation treatments, especially in sediments from the central lake. Our results indicate that, under the action of IPB, there is great potential for the release of HCl-P, which is the primary IP fraction of lagoon sediments, and more attention should be given to the endogenous P pollution in Swan Lagoon Wetland. [ABSTRACT FROM AUTHOR]

Large amounts of carbon dioxide (CO2) are discharged into air by combustion of gasoline and energy is input in a passenger internal combustion engine vehicle (ICEV) system through lifecycle phases. Thus, this study aims to evaluate the lifecycle carbon emissions and primary energy input of passenger ICEVs. With the life cycle assessment method, the calculations of carbon emission intensity and energy input intensity of materials used in lifecycle phases were made. The results show that the total lifecycle gasoline consumption of a vehicle was estimated to be 33,000 kg and the lifecycle CO2 emissions reached 81,311 kg per vehicle. Lifecycle CO2 emissions in use period occupied 89.43%, mainly attributed to the combustion of petrol. The average lifecycle CO2 emission intensity of the materials used was 2.33 kg/kg. The lifecycle carbon footprint of the passenger ICEVs was 163 g/km. The total CO2 emissions of ICEVs in Beijing were largest of all cities due to the maximum owning amount. The ratio of total lifecycle CO2 emissions of ICEVs in 13 large cities studied in this work to those of nationwide ICEVs was 0.179. Thus, more new energy vehicles will be given the prioritized choice in the future. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) is one of the most important neglected tropical diseases. Although VL was controlled in several regions of China during the last century, the mountain-type zoonotic visceral leishmaniasis (MT-ZVL) has reemerged in the hilly areas of China in recent decades. The purpose of this study was to construct an indicator framework for assessing the risk of the MT-ZVL in China, and to provide guidance for preventing disease. Methods: Based on a literature review and expert interview, a 3-level indicator framework was initially established in November 2021, and 28 experts were selected to perform two rounds of consultation using the Delphi method. The comprehensive weight of the tertiary indicators was determined by the Delphi and the entropy weight methods. Results: Two rounds of Delphi consultation were conducted. Four primary indicators, 11 secondary indicators, and 35 tertiary indicators were identified. The Delphi-entropy weight method was performed to calculate the comprehensive weight of the tertiary indicators. The normalized weights of the primary indicators were 0.268, 0.261, 0.242, and 0.229, respectively, for biological factors, interventions, environmental factors, and social factors. The normalized weights of the top four secondary indicators were 0.122, 0.120, 0.098, and 0.096, respectively, for climatic features, geographical features, sandflies, and dogs. Among the tertiary indicators, the top four normalized comprehensive weights were the population density of sandflies (0.076), topography (0.057), the population density of dogs, including tethering (0.056), and use of bed nets or other protective measures (0.056). Conclusions: An indicator framework of transmission risk assessment for MT-ZVL was established using the Delphi-entropy weight method. The framework provides a practical tool to evaluate transmission risk in endemic areas. [ABSTRACT FROM AUTHOR]

The Yihe River is an important river in Shandong Province, China. It is a catchment river for the South-to-North Water Diversion Project (SNWDP-ER), providing a variety of benefits and ecosystem services, such as flood and drought regulation, fishery and aquaculture, drinking water sources, and biodiversity conservation. In order to objectively reflect the status and changing trend of water environmental quality of the Yihe River, reduce the cost of detection, and improve the efficiency of water quality evaluation, samples were collected at 8 sampling sites in the 220 km main stream of the Yihe River from 2009 to 2019. The spatiotemporal variations of 10 water quality indicators were analyzed, including pH, water temperature (WT), dissolved oxygen (DO), 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD), total phosphorus (TP), ammonia nitrogen (NH3-N), nitrate (NO3-N), fluoride (F−), and sulphate (SO42−). The water quality index (WQI) was used to evaluate the spatiotemporal water quality changes, and the minimum WQI (WQImin) model consisting of five key indicators, i.e., NH3-N, BOD5, DO, SO42−, and WT, was built by using stepwise multiple linear regression analysis. The results indicated that the water quality indicators in the Yihe River showed significant spatiotemporal variations. With the exception of the COD and TP, the other water quality indicators conformed to the Class I or II standards of China, indicating that the water quality of the Yihe River was better than most natural water bodies. Seasonally, the WQI was better in the autumn and higher in the upstream area compared to the downstream. The water quality remained at the "good" level. The weighted WQImin model performed well in evaluating water quality, with coefficient of determination (R2), mean square error (MSE), and percentage error (PE) values of 0.903, 3.05, and 1.70%, respectively. [ABSTRACT FROM AUTHOR]

Urban freshwaters containing arsenic are facing an increasing problem of eutrophication. This study evaluated the spatial distribution, ecological risk, and origin of As in surface sediments obtained from Caohai Lake, a typical hypertrophic urban lake in China. It revealed that the total As concentration in surface sediments decreased gradually from north to south, consisted with the lake eutrophication status. The average As level was 161 mg/kg, dominated by reducible and oxidisable fractions. The analyses of geoaccumulation index and enrichment factor indicated that As ranged between moderately-to-heavily and heavily contamination, was severely influenced by anthropogenic factors, i.e. industrial discharges and agricultural activities. Risk assessment code and potential ecological risk index results showed moderate to high potential ecological risk could be observed although the current As risk was low, supporting by the experimentally quantified As release data. [ABSTRACT FROM AUTHOR]

Background: In the prevention and treatment of hypertension, patient education is an important measure to improve the awareness rate and control rate of patients. The professional and geographical advantages of community pharmacists enable them to play an important role in the patient education in hypertension. The purpose of this study was to understand the situation of patient education in hypertension conducted in Chinese community pharmacies, and put forward measures according to the problems.Methods: A multi-stage competitive sampling by convenience was used to select community pharmacists working in community pharmacies in China for the study. Based on KAP theory, the first draft of the questionnaire was designed and the Delphi method was used to improve the questionnaire and a pre-study was conducted to test the reliability of the questionnaire. In January 2020, electronic questionnaires were distributed to 143 community pharmacists in Chinese community pharmacies. SPSS24 software was used for descriptive statistics and subgroup analysis of data.Results: One hundred and eight valid questionnaires were collected, and the efficiency rate was 75.5%. Most of the respondents were younger than 30 years old (98.1%), and had bachelor's degree (95.4%). In terms of knowledge, only 15.7% considered themselves "very good" and even 10.2% considered themselves "very bad". Only 35%-55% of respondents answered correctly for patient education content that requires more specialized knowledge, such as treatment and medication. Respondents generally had a positive attitude on the effect of hypertension patient education, but slightly less recognition of their role in patient education. In terms of practice, programs related to patient education have been conducted to different degrees. More than 30% of the community pharmacists interviewed implemented them occasionally or never.Conclusions: Despite a positive attitude, most of the respondents did not have a high level of knowledge or practice. In China, more research evidence and new guidelines are needed to emphasize the importance and responsibilities of community pharmacists. Continuing education should be certificated at the national level and meet the various needs of community pharmacists. And salary incentives can be tried to motivate them. [ABSTRACT FROM AUTHOR]

Short tandem repeats (STRs) are consecutive repetition of a repeat motif and widely used in forensic medicine and human genetics because of their high polymorphism. In the current study, 23 autosomal STR loci were genotyped from 1263 unrelated healthy individuals living in Panjin City, Liaoning Province, Northeastern China using the VeriFilerTM Express PCR Amplification Kit. The population comparison was performed between the Panjin Han population and the other relevant groups to further explore the structure of Panjin Han and its relationship with the other groups. The results found 316 alleles across the 23 STRs and the corresponding allelic frequencies ranged from 0.5198 to 0.0004. Except for D3S1358, TPOX, TH01, and D3S1358, all STR loci were highly polymorphic (PIC > 0.7), with the Penta E locus having the highest degree of polymorphism (0.9147). For population comparison, the exact test of population differentiation found that no significant difference was observed between the Panjin Han and the other Han populations, except for Guangdong Han and Jiangxi Han. The Panjin Han population showed significant differences with the other ethnic groups in China (Bouyei, Dong, Hui, Miao, Tibetan, and Uygur) and the foreign ethnic groups. [ABSTRACT FROM AUTHOR]

Ecosystem services (ESs) synergies have been broadly studied, whose synergy control areas and driving mechanisms were still not fully understood. Here, We analyzed soil conservation (SC), water yield (WY), net primary productivity (NPP) and food supply (FS) on the basis of geospatial analysis techniques from 1992 to 2015. The results showed that the SW karst areas contributed 23.7% of SC and 14.56% of NPP with only 8.4% of China's continent. 49.28% of China's land was synergy control areas, while accounted for 82.23% in the SW karst areas. The cause of this phenomenon was twofold, one was the significant increase in NDVI was mainly due to human activities (HA), and the coincidence rates between the HA dominated areas and the synergies control areas up to 90.7%. These results emphasized that ecological engineering was a key factor of the synergy among multi-ESs, the synergy control areas should be priority for ecological restoration. [ABSTRACT FROM AUTHOR]

Non-muscle invasive bladder cancer (NMIBC) is a major type of bladder cancer with a high incidence worldwide, resulting in a great disease burden. Treatment and surveillance are the most important part of NIMBC management. In 2018, we issued "Treatment and surveillance for non-muscle-invasive bladder cancer in China: an evidence-based clinical practice guideline". Since then, various studies on the treatment and surveillance of NMIBC have been published. There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China. Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated. We formed a working group of clinical experts and methodologists. Through questionnaire investigation of clinicians including primary medical institutions, 24 clinically concerned issues, involving transurethral resection of bladder tumor (TURBT), intravesical chemotherapy and intravesical immunotherapy of NMIBC, and follow-up and surveillance of the NMIBC patients, were determined for this guideline. Researches and recommendations on the management of NMIBC in databases, guideline development professional societies and monographs were referred to, and the European Association of Urology was used to assess the certainty of generated recommendations. Finally, we issued 29 statements, among which 22 were strong recommendations, and 7 were weak recommendations. These recommendations cover the topics of TURBT, postoperative chemotherapy after TURBT, Bacillus Calmette–Guérin (BCG) immunotherapy after TURBT, combination treatment of BCG and chemotherapy after TURBT, treatment of carcinoma in situ, radical cystectomy, treatment of NMIBC recurrence, and follow-up and surveillance. We hope these recommendations can help promote the treatment and surveillance of NMIBC in China, especially for the primary medical institutions. [ABSTRACT FROM AUTHOR]

The relationship between soil properties and environmental covariates is mostly nonlinear for human impacted areas. Herein, we proposed a nonlinear model for mapping soil organic carbon (SOC) and total nitrogen (TN) in a typical human impacted area (a small watershed of Poyang Lake, China), namely radial basis function neural network combined with agricultural land use (RBFNN_ALU). The results showed that the RBFNN_ALU performs better than the ordinary kriging (OK), the OK combined with agricultural land use (OK_ALU), the geographically weighted regression (GWR), the multiple linear regression (MLR), the MLR combined with agricultural land use (MLR_ALU) and the RBFNN. In addition, RBFNN_ALU provided a more detailed and accurate description of the spatial SOC and TN patterns. The results indicate that when predicting spatial distribution of SOC and TN for human impacted areas, non-linear models are critical for predicting the spatial distribution of soil properties. [ABSTRACT FROM AUTHOR]

Background: The nematodes of the genus Helicotylenchus are root parasites of a wide variety of plants, and certain species can cause serious damage to their hosts. During a survey of the plant-parasitic nematode associated with tomato, a population of Helicotylenchus was collected from tomato roots and soil samples. Thus, one of the objectives of the study was to confirm the specie of Helicotylenchus obtained from the tomato samples based on morphological and molecular characteristics. In addition, a mass pure culture of plant-parasitic nematodes is key to pathogenicity studies and many other biological studies. However, a successful mass rearing method for Helicotylenchus has not been reported. Thus, the other objective of the study was to establish a method of culturing Helicotylenchus. Results: Based on both the morphological characteristics and molecular analysis of the internal transcribed spacer (ITS) and D2-D3 expansion region of 28S ribosomal RNA (rRNA) sequences the specimens were identified as Helicotylenchus microlobus. Phylogenetic analysis with the rRNA sequences of the ITS and 28S D2-D3 regions was consistent with molecular identification, suggesting this population formed a highly supported clade with other H. microlobus populations. Additionally, a method for culture of H. microlobus on carrot disks was established, and the effect of temperature on the reproduction rate (Rr) of H. microlobus was investigated. The optimum temperature for culturing H. microlobus on carrot disks was 27.5 °C and, after inoculation with 30 females of H. microlobus at 27.5 °C for 90 days, Rr reached 406. Conclusions: To our knowledge, this is the first detailed description of H. microlobus from tomato in China. This study also demonstrated that the carrot disk method is suitable for the culture of H. microlobus. This study lays a foundation for other related research on H. microlobus, and has significance for the study of Helicotylenchus. [ABSTRACT FROM AUTHOR]

Urban water pollution has been well controlled by strict management in the past few decades in China. Thus, the central government started to place emphasis on rural water pollution, and increasing number of sewage treatment facilities have been constructed, and currently, they are operating in China. Therefore, thoroughly assessing the operating conditions and the performance of these facilities is important. This article analyzes life cycle assessment and life cycle cost to evaluate the environmental and economic performance of four common technologies to determine how the emerging rural sewage treatment facilities in China are running. The results showed that the plant-adopted anaerobic-anoxic–oxic process was an optimal scheme for lower environmental impact that was also cost-effective. All technologies had similar impacts on eleven environmental categories. Due to cement consumption during the construction phase and electricity consumption during the operation phase, the marine aquatic ecotoxicity potential was the greatest contributor, accounting for approximately 90% of the total potential impact. In addition, this research revealed that electricity consumption during the operation phase was responsible for almost all environmental impact categories, except for eutrophication potential and ozone layer depletion potential categories. Lastly, scenario analysis indicated that reusing treated water and adjusting power structure could be useful measures to promote the sustainable development of rural water environments. [ABSTRACT FROM AUTHOR]

Excess heavy metals increase the risk of various diseases. Electronic waste (e-waste) is a potential route to heavy metal exposure, and Taizhou is a large e-waste dismantling area in China. In this study, we acquire blood samples from residents living near an e-waste recycling area (exposed group) and other residents in a selected reference area (reference group) for a comparative study in Taizhou in December 2017. Seven heavy metals, including cobalt (Co), nickel (Ni), cadmium (Cd), tin (Sn), copper (Cu), zinc (Zn), and lead (Pb), are quantitatively determined in all blood samples. It is discovered that the levels of Co, Ni, Sn, and Pb in the exposed group are higher than those in the reference group. Additionally, two crucial biomarkers of coronary heart disease (CHD), i.e., troponin (Tn) and myeloperoxidase (MPO), and two biomarkers of oxidative stress, i.e., malondialdehyde (MDA) and 8-isoprostane (8-I), are measured. We discovered that the levels of these indicators in the exposed group are significantly higher than those in the reference group. Meanwhile, both the Spearman correlation and multiple linear regression analysis show that Ni is positively correlated with Tn, MPO, 8-I, and MDA. Hence, we hypothesize that exposure to e-waste increases the risk of CHD and that Ni is an important contributor to the initiation of the disease. [ABSTRACT FROM AUTHOR]

A high calcium level is an important ecological factor in karst regions. Studying the adaptation mechanism of karst plants to high-calcium environments can provide a theoretical support for revealing biodiversity maintenance mechanisms and for the comprehensive management of rocky desertification. Based on a field investigation, 59 common epilithic moss species were selected for the determination of the calcium content of the plants and soils. By chemical measurement and biostatistical analysing the calcium contents in the soil and epilithic mosses. It was found that the average calcium content of the epilithic mosses was 19.03 mg/g and the average calcium content of the soil was 14.41 ± 8.41 g/kg. The effect of soil calcium content on plant calcium content is not significant, indicating that soil is not the main source of calcium in mosses. There were significant differences in the calcium contents of different families and genus. The average calcium content of Pottiaceae was highest in different regions and habitats than that of other families, and the average calcium content of Brachytheciaceae was loweret. Based on the relationship between the calcium content in epilithic mosses and soil to classify the adaptation methods of the epilithic mosses to the high-calcium environment in karst. The strategies of epilithic mosses adapting to high-calcium environment can be categorised into 3 types: 1) Random, in which the calcium content in plants varies widely with the change in the soil calcium content, which does not significantly affect the growth of the plant; 2) High-calcium, in which the calcium content in the plant remains high at different soil calcium levels; and 3) Low-calcium, in which the calcium content in the plant remains low at different soil calcium levels. [ABSTRACT FROM AUTHOR]

The Yellow River basin (YRB) is China's most critical energy consumption and coal production area. The improvement of carbon emission reduction efficiency in this area is the key for the Chinese government to achieve the 2030 carbon peak and 2060 carbon neutral ("30.60"). Given this, this study first calculates the carbon emission efficiency of YRB from 2005 to 2019 based on the slack-based measured directional distance function (SBM-DDF) model and combined with Malmquist–Luenberger (ML) index and decomposes the carbon emission efficiency of each province. Then, a panel Tobit model with random effect is constructed to measure the influencing factors and their influence degree of carbon emission efficiency of YRB. Finally, the main influencing factors are selected, and policy suggestions on how to improve the carbon emission efficiency of each province are put forward with the help of the coupling coordination degree (CCD) model. The results show that first, the carbon emission efficiency of each province is significantly different, but it shows a fluctuating upward trend on the whole. Second, the reasons for the rise or decline of the ML index in different provinces are different. Therefore, the development strategies of different provinces should be formulated from the perspective of accelerating technological progress and improving technical efficiency. Finally, the calculation results of influencing factors and coupling coordination degrees show that provinces with high coupling coordination degrees should focus on developing per capita power consumption and controlling per capita power consumption to consolidate the actual urbanization process and industrial structure adjustment. Provinces with low coupling coordination degrees should focus on maintaining the urbanization process and increasing the development of the tertiary industry. Therefore, to fundamentally reduce carbon emissions in YRB areas, we need to consider implementing differentiated emission reduction schemes based on national strategic objectives and in combination with the development characteristics of various provinces. [ABSTRACT FROM AUTHOR]

Background: High incidence of deep vein thrombosis (DVT) has been observed in patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 and those by bacterial pneumonia. However, the differences of incidence and risk factors of DVT in these two groups of ARDS had not been reported before. Study design and methods: We performed a retrospective cohort study to investigate the difference of DVT in incidence and risk factors between the two independent cohorts of ARDS and eventually enrolled 240 patients, 105 of whom with ARDS caused by COVID-19 and 135 caused by bacterial pneumonia. Lower extremity venous compression ultrasound scanning was performed whenever possible regardless of clinical symptoms in the lower limbs. Clinical characteristics, including demographic information, clinical history, vital signs, laboratory findings, treatments, complications, and outcomes, were analyzed for patients with and without DVT in these two cohorts. Results: The 28-days incidence of DVT was higher in patients with COVID-19 than in those with bacterial pneumonia (57.1% vs 41.5%, P = 0.016). Taking death as a competitive risk, the Fine-Gray test showed no significant difference in the 28-day cumulative incidence of DVT between these two groups (P = 0.220). Fine-Gray competing risk analysis also showed an association between increased CK (creatine kinase isoenzyme)-MB levels (P = 0.003), decreased PaO2 (partial pressure of arterial oxygen)/FiO2 (fraction of inspired oxygen) ratios (P = 0.081), increased D-dimer levels (P = 0.064) and increased incidence of DVT in COVID-19 cohort, and an association between invasive mechanical ventilation (IMV; P = 0.001) and higher incidence of DVT and an association between VTE prophylaxis (P = 0.007) and lower incidence of DVT in bacterial pneumonia cohort. The sensitivity and specificity of the corresponding receiver operating characteristic curve originating from the combination of CK-MB levels, PaO2/FiO2 ratios, and D-dimer levels ≥0.5 μg/mL were higher than that of the DVT Wells score (P = 0.020) and were not inferior to that of the Padua prediction score (P = 0.363) for assessing the risk of DVT in COVID-19 cohort. Conclusions: The incidence of DVT in patients with ARDS caused by COVID-19 is higher than those caused by bacterial pneumonia. Furthermore, the risk factors for DVT are completely different between these two ARDS cohorts. It is suggested that COVID-19 is probably an additional risk factor for DVT in ARDS patients. [ABSTRACT FROM AUTHOR]

Esophageal squamous cell carcinoma (ESCC) is a malignant tumor developing from the esophageal squamous epithelium, and is the most common histological subtype of esophageal cancer (EC). EC ranks 10th in morbidity and sixth in mortality worldwide. The morbidity and mortality rates in China are both higher than the world average. Current treatments of ESCC are surgical treatment, radiotherapy, and chemotherapy. Neoadjuvant chemoradiotherapy plus surgical resection is recommended for advanced patients. However, it does not work in the significant promotion of overall survival (OS) after such therapy. Research on targeted therapy in ESCC mainly focus on EGFR and PD-1, but neither of the targeted drugs can significantly improve the 3-year and 5-year survival rates of disease. Phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway is an important survival pathway in tumor cells, associated with its aggressive growth and malignant progression. Specifically, proliferation, apoptosis, autophagy, and so on. Related genetic alterations of this pathway have been investigated in ESCC, such as PI3K , AKT and mTOR-rpS6K. Therefore, the PI3K/AKT/mTOR pathway seems to have the capability to serve as research hotspot in the future. Currently, various inhibitors are being tested in cells, animals, and clinical trials, which targeting at different parts of this pathway. In this work, we reviewed the research progress on the PI3K/AKT/mTOR pathway how to influence biological behaviors in ESCC, and discussed the interaction between signals downstream of this pathway, especially eukaryotic translation initiation factors (eIFs) and the development and progression of ESCC, to provide reference for the identification of new therapeutic targets in ESCC. [ABSTRACT FROM AUTHOR]

Freeway networks are vulnerable to natural disasters and man-made disruptions. The closure of one or more toll stations of the network often causes a sharp decrease in freeway performance. Therefore, measuring the probability and consequences of vulnerability to identify critical parts in the network is crucial for road emergency management. Most existing techniques only measure the consequences of node closure and rarely consider the probability of node closure owing to the lack of an extensive historical database; moreover, they ignore highways outside the study area, which can lead to errors in topological analysis and traffic distribution. Furthermore, the negative effects produced by the operation of freeway tunnels in vulnerability assessment have been neglected. In this study, a framework for freeway vulnerability assessment that considers both the probability and consequences of vulnerability is proposed, based on the perspective of network cascade failure analysis. The cascade failure analysis is conducted using an improved coupled map lattice model, developed by considering the negative effects of tunnels and optimizing the rules of local traffic redistribution. The perturbation threshold and propagation time step of network cascade failure are captured to reflect the probabilities and consequences of vulnerability. A nodal vulnerability index is established based on risk assessment, and a hierarchical clustering method is used to identify the vulnerability classification of critical nodes. The freeway network of Fuzhou in China is utilized to demonstrate the effectiveness of the proposed approach. Specifically, the toll stations in the study area are classified into five clusters of vulnerability: extremely high, high, medium, low, and extremely low. Approximately 31% of the toll stations were classified as the high or extremely high cluster, and three extremely vulnerable freeway sections requiring different precautions were identified. The proposed network vulnerability analysis method provides a new perspective to examine the vulnerability of freeway networks. [ABSTRACT FROM AUTHOR]

Objective: Myocardial injury leads to higher mortality in COVID‐19, but the causes and risk factors are variable. We evaluated the potential risk factors for myocardial injury in COVID‐19 patients to improve treatment strategies and reduce mortality. Methods: This retrospective analysis enrolled 325 COVID‐19 patients in Shanghai, China. Results: The median age in our cohort was 51 [range 15‐88] years, 26 (8%) were critically ill, and 177 patients (19.7%) had myocardial injury. The myocardial injury group comprised older, more critically ill patients with hypertension, other comorbidities, history of angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker use, lower peripheral blood lymphocyte count and higher D‐dimer levels. Binary logistic regression analysis identified only age was an independent risk factor for myocardial injury (odds ratio 1.019; 95% confidence interval 1.003‐1.036; age increase by 1 year = myocardial injury risk increase by 1.9%). Conclusions: Older age was associated with a higher incidence of myocardial injury for COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Understanding the impact of the heterogeneity of the ecological environment on biodiversity is a key issue in ecology. Topographical heterogeneity was potentially important in grassland systems to create or change habitats for grasshopper settlement and foraging. Yet, there was little knowledge of how grasshopper communities respond to plant communities along the altitude gradient. We investigated the role of plant communities on grasshopper diversity with geostatistical methods to test the effects of heterogeneity in the natural grassland on the upper reaches of the Heihe River, Qilian Mountains. To aim the goal of the study, nonreturn experiments were used to collect the grasshoppers' diversity and populations, and the plant's community was sampled at the same location. The results showed that the semivariograms of grasshopper abundance and plant communities were both nonlinear models, while the grasshopper abundance typically produces heterogeneity with a larger range and nuggets than plant communities (except the plant coverage range in the model, range <1.5 m). The two communities presented the spatial distribution pattern of aggregated distribution, and the spatial trend is more intense in the northeast-southwest direction than in the northwest-southeast. The grasshopper species developed a good selection on microenvironment to habitat and the distribution consistent with plants, forming the horizontal distribution with a flaky and plaque distribution pattern. The relationship between grasshoppers and plants was highly dependent on the altitude, and grasshopper abundance has a positive correlation with plant richness (F = 0.68) and plant coverage (F = 0.32) and has a negative correlation with plant height (F = 0.13). In summary, the spatial distribution and correlation characteristics of plant communities and grasshoppers formed a plaque heterogeneity structure under the altitude gradients. [ABSTRACT FROM AUTHOR]