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The importance of university students' electronic health (eHealth) literacy has been established in the literature, yet the association with computer skills is absent. In this study, a total of 5,672 university students were recruited from Xinyang University. Data were collected from an online questionnaire, including the Chinese eHealth Literacy Scale (C-eHEALS), online health information and a computer skills questionnaire. Pearson's correlation coefficient and t-tests were used in the analysis. Of the 5,672 university students, 72.36% were female, 93.20% were aged 18-22 years. The total C-eHEALS score was 26.75 ± 5.86 (mean ± SD), and there was a significant difference in the total score between groups with low-level and high- level eHealth literacy (P < 0.001). The most popular three methods for accessing health information among both groups were using search engine (P = 0.035), mobile phone APP (P < 0.001) and face-to-face inquiry (P = 0.697). Students with eHealth literacy used a greater variety of eHealth resources than students with low eHealth literacy to access eHealth information. Pearson's correlation coefficient between C-eHEALS and computer skills was 0.621 (P < 0.001). A positive correlation exists between the eHealth literacy and computer skills of university students. However, both eHealth literacy and computer skills are poor, and targeted improvement is urgently needed.

Future orientation tends to prevent engagement in risk behaviours and results in good academic performance among adolescents. Our study aimed to establish whether genetic factors contributed to future orientation among Chinese adolescents. We recruited 988 pairs of twins from Beijing. By constructing a high-order A (additive genetic variance) C (common environmental variance) E (unique environmental variance) model, we found that heritability and a common environment contributed significantly to the development of future orientation among adolescents. Moreover, this study did not detect significant heritability differences in future orientation between girls and boys. In addition, there was a negative relationship between age and heritability of future orientation but a positive relationship between age and non-shared environmental effect on the development of future orientation. Our findings provide empirical evidence for the heritability of future orientation, suggesting that both genetics and common environment influence its development.

Background: This study investigated the factors influencing the prognosis of children with steroid-resistant nephrotic syndrome (SRNS) in patients from the Guangxi region. Methods: We retrospectively analyzed clinical and pathological data of 279 patients with SRNS from six tertiary hospitals in Guangxi. Clinical data were compared between initial (I-SRNS) and secondary (S-SRNS) steroid resistance subgroups and Cox regression analysis was used to determine risk factors for chronic kidney disease (CKD) and CKD stage 5 (CKD5) in patients with SRNS. Results: The median age of onset was 54 months. Thirty-three patients had extra-kidney manifestations. Fifty-two, 24, 57, 33, and 41 patients had hypertension, acute kidney injury, vitamin D deficiency, high intraocular pressure, and dwarfism, respectively. One hundred eighty-two and 92 patients had I-SRNS and S-SRNS, respectively. There were significant differences in sex, ethnicity, family history, incidence of hematuria, clinical classification, efficacy of immune agents, and prognosis between groups (P < 0.05). Among the 279 cases of SRNS, 239 had normal kidney function, 37 developed CKD, and 16 had CKD5. An increase in serum creatinine level (HR = 1.003) was significantly associated with CKD in children with SRNS, and effective immunosuppressant therapy decreased the CKD risk (HR = 0.168). Patients with increased serum creatinine levels (HR = 1.003) and acute kidney injury (HR = 4.829) were more likely to progress to CKD5. Conclusions: Children with S-SRNS showed a higher response to immunosuppressants than those with I-SRNS. Effective immunosuppressant therapy was found to protect against CKD, whereas increased acute kidney injury was an independent risk factor for CKD5. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is a multifactorial, pervasive, neurodevelopmental disorder, of which intestinal symptoms collectively represent one of the most common comorbidities. Methods: In this study, 1,222 children with ASD and 1,206 typically developing (TD) children aged 2-7 years were enrolled from 13 cities in China. Physical measurement and basic information questionnaires were conducted in ASD and TD children. The Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Behavior Checklist (ABC) were used to evaluate the clinical symptoms of children with ASD. The six-item Gastrointestinal Severity Index (6-GSI) was used to evaluate the prevalence of intestinal symptoms in two groups. Results: The detection rates of constipation, stool odor, and total intestinal symptoms in ASD children were significantly higher than those in TD children (40.098% vs. 25.622%, 17.021% vs. 9.287%, and 53.601% vs. 41.294%, respectively). Autistic children presenting with intestinal comorbidity had significantly higher scores on the ABC, SRS, CARS, and multiple subscales than autistic children without intestinal symptoms, suggesting that intestinal comorbidity may exacerbates the core symptoms of ASD children. Conclusion: Intestinal dysfunction was significantly more common in autistic than in TD children. This dysfunction may aggravate the core symptoms of children with ASD. [ABSTRACT FROM AUTHOR]

Background: Previous studies have established a positive link between nurse managers' caring leadership and nurses' work engagement, but the processes and conditions through which this leadership style influences positive work behaviors remain largely unexplored. To address this gap and contribute to the existing body of knowledge, we developed a chain-mediated effects model to elucidate the impact of caring leadership on nurses' work engagement and the underlying mechanisms. In this model, we identified professional mission and affective organizational commitment as the mediating variables, offering a novel perspective on the relationship between caring leadership and work engagement. Methods: A robust multi-center and large-sample cross-sectional survey was conducted, involving 2502 first-line nurses from six general tertiary hospitals across the eastern, central, and western regions of China. The data collection instruments included a comprehensive questionnaire covering demographic information, the caring leadership scale, the Chinese calling scale, the affective organizational commitment scale, and the Utrecht work engagement scale. Data were meticulously screened and analyzed, employing descriptive analysis to summarize the demographic information, correlation analysis to test the relationship among the variables, stepwise regression analysis to explore the mediating role of calling and affective organization commitment, and the bootstrap method to test the chain mediating effect. This rigorous methodology not only ensures the reliability and validity of research findings but also instills confidence in the robustness of this research. Results: The results indicated a positive relationship among caring leadership, calling, affective organizational commitment, and nurses' work engagement (p < 0.001). Specifically, caring leadership was significantly associated with nurses' calling (β = 0.55, p < 0.001), affective organizational commitment (β = 0.21, p < 0.001), and work engagement (β = 0.05, p < 0.001). And the analysis further revealed that calling and affective organizational commitment mediate the process between caring leadership and work engagement(Effect: 0.17, 0.03, 0.05), with a relative effect size of 89.3% for the total indirect effect. These findings highlight the crucial role of these factors in enhancing nurses' work engagement, providing valuable insights for healthcare leaders and policymakers. Conclusion: Caring leadership positively predicts nurses' work engagement and indirectly mediates calling and affective organizational commitment. The results of this study revealed that the mechanisms of caring leadership influence nurses' work engagement, which provides a new approach to strengthening nurses' work engagement and improving patient healthcare outcomes and organizational performance. Healthcare organizations face continuous challenges; this study embodies the significance of caring leadership in improving nurses' work experience and increasing their work engagement. Nursing managers should enhance their knowledge of caring leadership and receive caring leadership training, thus actively improving their leadership behaviors in nurse management, enhancing leadership effectiveness, and creating more possibilities for developing healthcare organizations. [ABSTRACT FROM AUTHOR]

This study investigates the communication and learning needs of Master of Business Administration (MBA) business English students and their perceptions of effective curriculum design. The research instruments are two-stage surveys of 99 MBA students from a public university in China. The results of the study show that English is not extensively used in the workplaces of MBA business English students, and that the majority of them use Chinese. Most English usage occurs in foreign businesses. The most difficult skills for MBA business English learners are found to be oral communication and listening comprehension. However, there are still very strong needs for further improvement in English communication. For the MBA business English courses, oral communication activities, especially with expatriate teachers, are particularly needed. The MBA business English courses should connect with real-world practice and be relevant to job and business needs. This study has significant implications for MBA business English curriculum reform in both Chinese and international contexts.

Objective: To investigate the status quo of nursing practices, job burnout and social support among private hospitals in Dazhou, Sichuan Province, and perform correlational analysis. Methods: A cross-sectional study was conducted. A total of 244 nurses were surveyed via convenience sampling from 7 private hospitals, which were randomly selected from Dazhou city. A self-designed demographic sociology questionnaire was applied, and the Chinese versions of the Maslach Burnout Scale and the Social Support scale administered from September to November 2022. Results: The investigated nurses were relatively young (26.84 ± 4.90 years), had a short duration of service, a low academic background, a low professional title and a low income; however, they were highly satisfied with their working environment and had a low level of burnout, and their level of personal achievement was low. Overtime work, education level and number of children had significant impacts on the level of nurse burnout. The level of social support was high, and various dimensions were negatively correlated with the emotional exhaustion and depersonalization dimensions of burnout (r=-0.438, P < 0.01; r=-0.372, P < 0.01) and positively correlated with personal achievement (r = 0.291, P < 0.01). However, the level of social support was not significantly associated with burnout (r=-0.060, p = 0.354). Conclusions: Nursing managers in private hospitals should consider ways of improving nurses' education, professional titles, working environment and increasing nurses' income to stabilize the nursing team. Efforts should be made to relieve the nurses' pressure, and notice the overtime work and professional development of nurses to enhance the personal sense of achievement. More measures should be taken to improve the level of social support, thereby promoting the continuous improvement of nursing quality. Due to the uneven level of social and economic development in different parts of China, the extensibility of the research needs to be confirmed by more studies, but it still has important reference significance for Northeast Sichuan, which represents areas with similar social and economic levels. [ABSTRACT FROM AUTHOR]

The stable hydrogen isotope in precipitation is an effective environmental tracer for climatic and hydrologic studies. However, accurate and high-precision precipitation hydrogen isoscapes are currently unavailable in China. In this study, a data fusion method based on Convolutional Neural Networks (CNN) is used to fuse the hydrogen isotopic composition (δ2Hp) of observations and isotope-equipped general circulation model (iGCM) simulations. A precipitation hydrogen isoscape with a temporal resolution of monthly and a spatial resolution of 50–60 km is established for East China for the 1969–2017 period. Prior to building the isoscape, the performance of three data fusion methods (DFMs) and two bias correction methods (BCMs) is compared. The results indicate that the CNN fusion method performs the best with a correlation coefficient larger than 0.90 and root mean square error smaller than 10.5‰when using observation as a benchmark. The fusion methods based on back propagation and long short-term memory neural network perform similarly, while slightly outperforming the bias correction methods. Thus, the CNN method is used to generate the hydrogen isoscape, and the temporal and spatial distribution characteristics of the hydrogen isotope in precipitation are analyzed based on this dataset. The generated isoscape shows similar spatial and temporal distribution characteristics to observations. In general, the distribution pattern of δ2Hp is consistent with the temperature effect in northern China, and consistent with the precipitation amount effect in southern China. The trend of the δ2Hp time series is consistent with that of observed precipitation and temperature. Overall, the generated isoscape effectively reproduces the observations, and has the characteristics of time continuity and relative spatial regularity, which can provide valuable data support for tracking atmospheric and hydrological processes. [ABSTRACT FROM AUTHOR]

Background: Ensuring that the scale and hierarchical structure of health human resources are rational, and that medical services are efficient and fair, is an important task of practical significance. On this basis, examining the impact of health human resources on the level of medical services presents a new and formidable challenge. This study aims to delve into how the scale and hierarchical structure of health human resources in China's four major economic regions affect the fairness and efficiency of medical services, and to identify optimization strategies. Methods: This study utilizes provincial panel data from China's four major economic regions spanning the years 2009 to 2021. Initially, it provides a statistical description of the current state of health human resources and the level of medical services. Subsequently, it employs a fixed-effects model to analyze the impact of the scale and hierarchical structure of health human resources, as well as their interactive effects, on the fairness and efficiency of medical services, and discusses the interactive mechanisms between medical service fairness and medical service efficiency. Furthermore, after conducting a comprehensive evaluation of the level of medical services using the entropy weight method, it explores the regional heterogeneity and temporal dynamics in the influence of the scale and hierarchical structure of health human resources on the level of medical services. Finally, the study examines the scientific validity and rationality of the research findings through various robustness checks, including the substitution of research variables and models. Results: The study found that the scale of health human resources has a promoting effect on the equity of medical services (β ≤ 0.643, p ≤ 0.01), but exhibits an inhibitory effect on the efficiency of medical services (β ≥ -0.079, p ≤ 0.1); the hierarchical structure of health human resources shows a positive impact on both the equity and efficiency of medical services (βequity ≤ 0.160, p ≤ 0.01; βefficiency ≤ 0.341, p ≤ 0.05); at the same time, the results indicate that the interactive effect of the scale and hierarchical structure of health human resources promotes equity in medical services (β = 0.067, p ≤ 0.01), but restricts the efficiency of medical services (β ≥ -0.039, p ≤ 0.01); the mechanism by which health human resources affect the level of medical services in China's western and northeastern regions is more pronounced than in the central and eastern regions; after the implementation of the "Healthy China 2030" Planning Outline, the role of health human resources in the level of medical services has been strengthened; in the robustness tests, the model remains robust after replacing the core explanatory variables, with R2 maintained between 0.869 and 0.972, and the dynamic GMM model test shows a significant second-order lag in the level of medical services (βequity ≤ 0.149, p ≤ 0.01; βefficiency ≤ 0.461, p ≤ 0.01); the channel test results prove that managerial personnel and other technical personnel are key pathways in regulating the impact of medical staff on the level of medical services. Conclusion: This study provides an in-depth analysis of the impact of health human resources on the level of medical services, revealing that both the scale and hierarchical structure of health human resources significantly affect the equity and efficiency of medical services. Furthermore, the influence of health human resources on the level of medical services exhibits regional heterogeneity and temporal characteristics. Robustness tests ensure the scientific validity and robustness of the research conclusions. This provides effective references for optimizing the allocation of health human resources and improving the level of medical services. [ABSTRACT FROM AUTHOR]

Prior research in international markets has yielded two seemly opposing views regarding customer engagement with local/domestic versus foreign-made brands: a preference for foreign brands based largely on country-of-origin effects or a preference for local/domestic brands based primarily on consumer ethnocentrism. In the present research, the authors contextualize the investigation across international markets and propose that, in two national markets with different cultural characteristics, a combination of local and foreign appeals leads to more favorable brand and product evaluations, compared with either local or foreign appeals alone, due to a heightened level of perceived brand globalness, a phenomenon called "the coalescence effect." The authors report results from seven studies conducted in China and the United States and discuss ways to design branding strategies that enhance customer engagement in an era of intensified global competition. [ABSTRACT FROM AUTHOR]

Rainfall-induced landslides are a major hazard in the Three Gorges Reservoir area (TGRA) of China, encompassing 19 districts and counties with extensive coverage and significant spatial variation in terrain. This study introduces the Gradient Boosting Decision Tree (GBDT) model, implemented on the Google Earth Engine (GEE) cloud platform, to dynamically assess landslide risks within the TGRA. Utilizing the GBDT model for landslide susceptibility analysis, the results show high accuracy with a prediction precision of 86.2% and a recall rate of 95.7%. Furthermore, leveraging GEE's powerful computational capabilities and real-time updated rainfall data, we dynamically mapped landslide hazards across the TGRA. The integration of the GBDT with GEE enabled near-real-time processing of remote sensing and meteorological radar data from the significant "8–31" 2014 rainstorm event, achieving dynamic and accurate hazard assessments. This study provides a scalable solution applicable globally to similar regions, making a significant contribution to the field of geohazard analysis by improving real-time landslide hazard assessment and mitigation strategies. [ABSTRACT FROM AUTHOR]

The frequent occurrence of landslides poses a serious threat to people's lives and property. In order to evaluate disaster hazards based on remote sensing images via machine learning means, it is essential to establish an image database with manually labeled boundaries of landslides. However, the existing datasets do not cover diverse types of mountainous landslides. To address this issue, we propose a high-resolution (1 m) diverse mountainous landslide remote sensing dataset (DMLD), including 990 landslide instances across different terrain in southwestern China. To evaluate the performance of the DMLD, seven state-of-the-art deep learning models with different loss functions were implemented on it. The experiment results demonstrate not only that all of these deep learning methods with different characteristics can adapt well to the DMLD, but also that the DMLD has potential adaptability to other geographical regions. [ABSTRACT FROM AUTHOR]

Getah virus (GETV) is a re-emerging mosquito-borne alphavirus that is highly pathogenic, mainly to pigs and horses. There are no vaccines or treatments available for GETV in swine in China. Therefore, the development of a simple, rapid, specific, and sensitive serological assay for GETV antibodies is essential for the prevention and control of GETV. Current antibody monitoring methods are time-consuming, expensive, and dependent on specialized instrumentation, and these features are not conducive to rapid detection in clinical samples. To address these problem, we developed immunochromatographic test strips (ICTS) using eukaryotically expressed soluble recombinant p62-E1 protein of GETV as a labelled antigen, which has good detection sensitivity and no cross-reactivity with other common porcine virus-positive sera. The ICTS is highly compatible with IFA and ELISA and can be stored for 1 month at 37 °C and for at least 3 months at room temperature. Hence, p62-E1-based ICTS is a rapid, accurate, and convenient method for rapid on-site detection of GETV antibodies. Key points: • We established a rapid antibody detection method that can monitor GETV infection • We developed colloidal gold test strips with high sensitivity and specificity • The development of colloidal gold test strips will aid in the field serologic detection of GETV [ABSTRACT FROM AUTHOR]

Pair programming (PP) is a useful approach to fostering computational thinking for young students. However, there are many factors impacting on the effectiveness of PP. The period of switching roles between the driver and the navigator is often ignored by researchers. Therefore, this study aimed to explore the impact of the switching period on PP. We conducted a PP experiment in four classes in the sixth grade in a primary school. The results indicated that (a) the semi-free switch was more effective for the learning achievement than the fixed periods, and the preference for adopting the fixed time interval to switch roles existed in previous studies seems to be a kind of prejudice; (b) students who switched roles every 5 minutes and semi-freely were more enjoyable than those who switched roles in every task and in every class session. Moreover, the period of switching roles in every class session decreased students' enjoyment after PP; (c) the frequency of switching roles decreased significantly, but the negotiation between the driver and the navigator became more active with time going in the semi-free class. Implications for teaching are also discussed.

The rise of extreme precipitation events has attracted wide attention throughout the world. However, the analysis of precipitation extremes is not sufficient in the short period of instrumental observation and it is complicated by their non‐stationary behaviours. As a period dominated by natural forcing, the last millennium is helpful for understanding long‐term changes in precipitation extremes. Therefore, this study aimed to (1) investigate changes in daily and subdaily precipitation extremes in China from the last millennium to the end of the twenty‐first century, (2) detect the non‐stationarity of precipitation extremes and (3) compare design storms by using stationary and non‐stationary distributions. The annual maximum 1‐day precipitation (RX1day) and annual maximum 3‐hour precipitation (RX3hour) are used to quantify variations of precipitation extremes. The results show that the trend of RX1day was insignificant for the Medieval Climate Anomaly (MCA, 950–1250) and the Little Ice Age (LIA, 1500–1800). For the historical period (1850–2014), the trend of RX1day and RX3hour was insignificant in most subregions. In addition, the differences for RX1day between the historical period and the MCA/LIA were mostly in the range of −5% to 5%. For the future period (2015–2100), RX1day and RX3hour are projected to increase in almost all land grids compared with the historical period, and they show greater increases in western China than eastern China. The non‐stationarity of RX1day and RX3hour is mainly found under the high‐emission scenario. Moreover, stationary generalized extreme value (GEV) distribution underestimates 50‐year return levels for RX1day and RX3hour in most areas compared with non‐stationary GEV distribution under the high‐emission scenario. Overall, this study suggests that daily and subdaily extreme precipitation will intensify over China in the future. For design storms, non‐stationary methods need to be used for risk management and engineering design under the high‐emission scenario. [ABSTRACT FROM AUTHOR]

Background: The gaps between estrogenic effect and its effect-active compounds exist frequently due to a large number of compounds that have been reported to induce this effect and the occurrence of pollutants in environments as mixtures. Therefore, identifying the estrogen-active compounds is of importance for environmental management and pollution treatment. In the current study, the effect-directed analysis (EDA) and non-targeted screening (NTS) were integrated to identify the estrogen-active compounds in soils of the rural area with different socioeconomic types (industrial, farming and plantation village) in Northeast China. Results: The cytotoxicity results indicated that the industrial and farming villages showed cytotoxic effects. The detection rates of estrogenic effects for samples of winter and summer were 100% and 87%, respectively. Of which, the effects were found to be stronger in summer than in winter, with significant difference observed from the farming village (0.1–11.3 EEQ μg/kg dry weight). A total of 159 chemicals were detected by NTS. By integrating EDA, triphenyl phosphate (TPhP) and indole were successfully identified from a raw sample and its fraction, explaining up to 19.31% of the estrogen activity. Conclusions: The present study demonstrates that the successful identification of seven estrogen-active compounds in rural areas of northeastern China can be achieved through the combination of effect-directed analysis (EDA) and non-targeted screening (NTS). This finding is beneficial for risk monitoring and pollution management. [ABSTRACT FROM AUTHOR]

Rhizoma Panacis Japonici (RPJ) is an ancient herbal medicine from China that has long been employed for its medicinal benefits in relieving arthritis physical debility and diverse afflictions. The primary bioactive constituents found in RPJ are triterpene saponins, which exhibit numerous pharmacological actions, including anti-inflammatory, antioxidant, and immunomodulating effects. The present study established a straightforward and effective approach for characterizing triterpene saponins in RPJ. An offline HILIC × RP LC/QTOF-MS method was developed, along with a self-constructed in-house database containing 612 saponins reported in the Panax genus and 228 predicted metabolites. The approach achieved good chromatographic performance in isolating triterpene saponins of RPJ, with the HILIC column as the first dimension (1D) and the BEH C18 column as the second dimension (2D). The developed two-dimensional liquid chromatography system exhibited an orthogonality of 0.61 and a peak capacity of 1249. Detection was performed using a QTOF mass spectrometer in a data-independent manner (MSE) in a negative ion mode. Using the in-house database, the collected MS data were processed by an automatic workflow on UNIFI 1.8.2 software, which included data correction, matching of precursor and product ions, and peak annotation. In this study, 307 saponins were characterized from RPJ and 76 saponins were identified for the first time in Panax japonicus. This research not only enhances our understanding of the chemical characteristics of RPJ but also offers a simple and efficient method for analyzing the complex composition of herbal medicine. [ABSTRACT FROM AUTHOR]

There has been a vibrant literature on political trust in China. However, a closer examination of this large literature points to no clear consensus on the measurement and sources of such support. To contribute to this literature, this study is to explore the magnitude, forms, and sources of political trust in urban China. In this study, we explore an alternative approach to the study of political trust, which treats political trust along two straightforward yet distinct dimensions: horizontal and vertical dimensions. Based on this approach, we find that people's political trust in urban China varies vertically, across different levels of government institutions (e.g., central and local governments), while it changes little horizontally, among different government institutions at the same level. Moreover, we find that the formation of political trust in each level of government institutions — along the vertical dimension — is shaped by a distinct combination of sociopolitical factors. We also explore some important theoretical and political implications from our findings. [ABSTRACT FROM AUTHOR]

As an important irritant trace gas in the atmosphere, ammonia (NH3) significantly impacts human health and environment. Bottom-up emission inventories are widely used to estimate ammonia emissions and their geographical distributions over China. However, high uncertainties are still associated with emission inventories due to inaccurate emission factors used. The Differential Evolution (DE) algorithm is a population-based stochastic optimization algorithm used to solve complicated optimization problems. We quantify NH3 emissions and lifetime from Infrared Atmospheric Sounding Interferometer (IASI) NH3 observations together with MERRA-2 wind fields based on the DE algorithm. Two inland cities, Urumchi and Golmud in China, are chosen to study of the NH3 emissions based on the distributions of NH3 total columns and wind fields. The NH3 emissions rate estimated is about 5.84 × 10−11 and 4.19 × 10−11 kg·m−2s−1 in Urumchi and in the Golmud area from May to September from 2008 to 2023, respectively. The lifetime of NH3 estimated in the two areas is 4.31 and 9.19 h, respectively. We compare the NH3 emissions and lifetime estimated in this study with the values in other studies, and the results show the reliability of the method used. This work is one of few quantitative studies of NH3 emissions from cities using satellite observations in China. [ABSTRACT FROM AUTHOR]

Investigating the variations in leaf stoichiometry among plant common species at different altitudes, along with the factors that influence these variations and the adaptative strategies employed, is of significant importance for understanding biogeochemical cycles amidst global environmental changes. In this research, we measured soil organic carbon and nutrient concentrations, as well as leaf stoichiometry for plant common species at five altitudes (2400–3200 m with an interval of 200 m) within the Qilian Mountains of Northwest China. This study aims to enhance our understanding of how plant common species in mountainous regions exhibit adaptable responses to altitude variations and how potential environmental changes in the future may influence their leaf functions. Results showed that the leaf C:N:P stoichiometry of plant common species varied with increasing altitude. Across altitudes, mean annual temperature (MAT), soil total phosphorus, mean annual precipitation (MAP), soil water content, and soil nitrate nitrogen were the main factors influencing leaf element concentrations of plant common species. However, leaf stoichiometric ratios were mainly determined by MAT, MAP, and soil total nitrogen. The effects of MAT and MAP on both leaf element concentrations and leaf stoichiometric ratios of plant common species were found to be significant. Plant growth in the study area was mainly limited by P. The results not only highlight the adaptive strategies employed by plants, but also contribute to understanding of leaf stoichiometry, and establishing connections between individual plant species and broader plant community composed of these common species. [ABSTRACT FROM AUTHOR]

Autologous stem cell transplantation (ASCT) is a salvage therapy for relapsed or refractory diffuse large B-cell lymphoma (DLBCL). We have developed a novel conditioning regimen called CEAC (oral semustine 250 mg/m2 d-6, etoposide 300 mg/m2 d-5 ~ d-2, cytarabine 500 mg/m2 d-5 ~ d-2, and cyclophosphamide 1200 mg/m2 d-5 ~ d-2) In lymphoma patients in China. Here, we conducted a study to compare the conventional BEAM regimen with the CEAC regimen in 110 DLBCL patients. Propensity-score matching was performed in a 1:4 ratio (22 patients received BEAM and 88 received CEAC). Our results showed no significant difference in the overall response rate (95% vs 97%, P = 1.000) and complete response rate (66% vs 73%, P = 0.580) between the two cohorts. The 5-year progression-free survival (PFS), 5-year overall survival (OS), and 5-year cumulative incidence of relapse (CIR) for all patients were 72% (95% CI 62%–82%), 92% (95% CI 86%–97%), and 29% (95% CI 17%–38%), respectively. There was no significant difference in the 5-year PFS (80% vs 70%, P = 0.637), 5-year OS (95% vs 91%, P = 0.496), and 5-year CIR (20% vs 30%, P = 0.733) between cohorts. In terms of safety, the CEAC cohort had a lower incidence rate of grade 1–2 gastrointestinal hemorrhage (P = 0.023) and severe nausea (P = 0.007) compared with the BEAM cohort. In conclusion, the CEAC regimen seems to be a suitable alternative to the BEAM regimen for ASCT in DLBCL patients. [ABSTRACT FROM AUTHOR]

Digitalization has emerged as a new hope for low-carbon sustainable economic growth after its successful trial during the COVID-19 measures. Therefore, both developed and developing economies focus on digitalization to cope with carbon neutrality targets. Thus, this study attempted to generate a meaningful relationship between the digital economy and green energy, innovation, and environmental tax policy to capture the role of factors in acquiring carbon neutrality. For the abovementioned objectives, modern econometric methods, such as the Kilian bias-adjusted bootstrap, were adopted to evaluate the Chinese dataset between 1990 and 2021. The results indicate that the study factors play a significant role in acquiring carbon neutrality in the long-term Chinese economy. Furthermore, quantile autoregressive distributed lag model (QARDL) indicates that all the factors influence carbon neutrality in various quantiles. Consequently, the digital economy, green energy and innovation, and environmental taxes significantly assist in attaining carbon neutrality in the long term, and the ecological Kuznets curve prevails in the economy. Therefore, radical and wide-ranging policy implications are required in many areas including environmental restrictions, digital economy promotion, green and sustainable technologies, and clean energy sources. [ABSTRACT FROM AUTHOR]

This study proposes a new hybrid model for monthly streamflow predictions by coupling a physically based distributed hydrological model with a deep learning (DL) model. Specifically, a simplified hydrological model is first developed by optimally selecting grid cells from a distributed hydrological model according to their soil moisture characteristics. It is then driven by bias corrected general circulation model (GCM) predictions to generate soil moistures for the forecasting months. Finally, model‐simulated soil moisture along with other predictors from multiple sources are used as inputs of the DL model to predict future monthly streamflows. The proposed hybrid model, using the simplified Variable Infiltration Capacity (VIC) as the hydrological model and the combination of Convolutional Neural Network and Gated Recurrent Unit (CNN‐GRU) as the DL model, is applied to predict 1‐, 3‐, and 6‐month ahead reservoir inflows for the Danjiangkou Reservoir in China. The results show that the hybrid model consistently performs better than VIC and CNN‐GRU models with great improvement in Kling‐Gupta efficiency (KGE) values for lead times up to 6 months. Additional tests indicate that hybrid models based on CNN‐GRU outperform those based on LASSO, XGBoost, CNN, and GRU models. Moreover, compared with the distributed hydrological model, the hybrid model greatly reduces the computation burden of rolling prediction. It also saves decision‐makers the time and effort of trying different combinations of predictors, which is indispensable when building DL models. Overall, the new hybrid model demonstrates great potential for monthly streamflow prediction where training data are limited. Key Points: Deep learning and physically based distributed hydrological models are coupled for monthly streamflow predictionsA simplified hydrological model is developed on the basis of the distributed model to reduce computational cost in streamflow predictionsThe hybrid model is an efficient and accurate surrogate tool for real‐time monthly streamflow predictions [ABSTRACT FROM AUTHOR]

The seasonal design flood (SDF) plays an important role in guiding water resources management and floodwater utilization. To estimate the SDF, studies have established the joint distribution of flood peak (i.e., annual maximum daily discharge) and timing (i.e., occurrence date) and assumed a monotonic dependence structure (MDS) between these two flood elements within the bivariate framework. However, the MDS assumption cannot fully represent the flood seasonality dynamics, which might affect the reliable assessments of the bivariate flood risks. To solve this issue, this study proposes a mixed-copula function to model a nonmonotonic dependence structure (NMDS) between flood peak and timing, and then derives the SDFs under nonstationary conditions by using the equivalent reliability method. As the NMDS can characterize the turnaround relationship between peak discharge and timing, the NMDS performs better at modeling observed (1951–2019) flood peaks than the traditional MDS, as reported by a case study in the Wujiang River Basin, China. The results suggest that, within the flood season from May to October, the NMDS-based estimation framework produces higher SDFs in June and July but smaller SDFs in the remaining months than the annual design flood. This allows for reducing the flood control storage capacity to improve floodwater utilization downstream without increasing flood risk. After further investigating the potential effects of a changing environment on peak discharges in the future (2020–2099), it is expected that reservoir regulation might play a more important role in flattening the seasonal fluctuations in floods. These results provide rich information as references for flood risk management and floodwater resources utilization under a changing environment. [ABSTRACT FROM AUTHOR]

Microwave sensors possess the capacity to effectively penetrate through clouds and fog and are widely used in obtaining soil moisture, atmospheric water vapor, and surface temperature measurements. Long time-series datasets play a pivotal role in climate change studies. Unfortunately, the lifespan of operational satellites often falls short of the needs of these extensive datasets. Hence, comparing and cross-calibrating sensors with similar configurations is paramount. The Microwave Radiation Imager (MWRI) onboard Fengyun-3D (FY-3D) is the latest generation of satellite-based microwave remote sensing instruments in China, and its data quality and application prospects have attracted widespread attention. To comprehensively assess the data quality of MWRI, a comparison of the orbital brightness temperature (TB) data between FY-3D/MWRI and Global Change Observation Mission 1st-Water (GCOM-W1)/Advanced Microwave Scanning Radiometer 2 (AMSR2) is conducted, and then a calibration model is established. The results indicate a strong correlation between the two sensors, with a correlation coefficient exceeding 0.9 across all channels. The mean bias ranges from −1.5 K to 0.15 K. Notably, the bias of vertical polarization is more pronounced than that of horizontal polarization. The TB distribution patterns and temporal evolutions are highly consistent for both sensors, particularly under snow and ice. The small intercepts and close-to-1 slopes obtained during calibration further demonstrate the minor data differences between the two sensors. However, the calibration process effectively reduces the existing errors, and the calibrated FY-3D/MWRI TB data are closer to GCOM-W1/AMSR2, with a mean bias approximately equal to 0 K and a correlation coefficient exceeding 0.99. The excellent consistency of the TB data between the two sensors provides a vital data basis for retrieving surface parameters and establishing long time-series datasets. [ABSTRACT FROM AUTHOR]

Background: Virtual simulation and face-to-face simulation are effective for clinical judgment training. Rare studies have tried to improve clinical judgment ability by applying virtual simulation and face-to-face simulation together. This study aimed to evaluate the effect of an integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program on enhancing nursing students' clinical judgment ability and understanding of nursing students' experiences of the combined simulation. Methods: A sequential exploratory mixed-methods study was conducted in a nursing simulation center of a university in Central China. Third-year nursing students (n = 122) taking clinical training in ICUs were subsequentially assigned to the integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program arm (n = 61) or the face-to-face simulation-only arm (n = 61) according to the order in which they entered in ICU training. Clinical judgment ability was measured by the Lasater Clinical Judgment Rubric (LCJR). Focus group interviews were conducted to gather qualitative data. Results: Students in both arms demonstrated significant improvement in clinical judgment ability scores after simulation, and students in the integrated arm reported more improvement than students in the face-to-face simulation-only arm. The qualitative quotes provided a context for the quantitative improvement measured by the LJCR in the integrated arm. Most of the quantitative findings were confirmed by qualitative findings, including the domains and items in the LJCR. The findings verified and favored the effect of the combination of non-immersive virtual simulation and high-fidelity face-to-face simulation integrated program on enhancing nursing students' clinical judgment ability. Conclusions: The integrated virtual simulation and face-to-face simulation program was feasible and enhanced nursing students' self-reported clinical judgment ability. This integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program may benefit nursing students and newly graduated nurses in the ICU more than face-to-face simulation only. [ABSTRACT FROM AUTHOR]

Background: Bibliometric analysis is a mature method for quantitative evaluation of academic productivity. In view of the rapid development of research in the field of systemic lupus erythematosus (SLE) in the past decade, we used bibliometric methods to comprehensively analyze the literature in the field of SLE from 2013 to 2022. Methods: The relevant literature in the field of SLE from 2013 to 2022 was screened in the Web of Science Core Collection database. After obtaining and sorting out the data, CiteSpace and VOSviewer software were used to visualize the relevant data, and SPSS software was used for scientific statistics. Results: A total of 18,450 publications were included in this study. The number of articles published over the past 10 years has generally shown an upward trend, while Altmetric attention scores have also shown a clear upward trend in general and in most countries. Citation analysis and Altmetric analysis can mutually prove and supplement the influence of papers. The USA, China, Japan, Italy, and the UK are the most productive countries, but China and Japan are significantly inferior to other countries in terms of research influence. Four of the top ten authors are at the center of the collaboration network. LUPUS is the most contributing journal. The theme of systemic lupus erythematosus research mainly focuses on the pathogenesis, treatment, and management of SLE, and the emerging trend is related research on machine learning and immune cells. Conclusion: This study shows the research status of SLE, clarifies the main contributors in this field, discusses and analyzes the research hotspots and trends in this field, and provides reference for further research in this field to promote the development of SLE research. Key Points • Through bibliometric analysis, Altmetric analysis, and visual analysis, we reveal the global productivity characteristics of SLE-related papers in the past 10 years. • The number of global SLE-related studies has shown a significant increase, indicating that SLE is still a hot topic and deserves further study. • Citation analysis and Altmetric analysis can mutually prove and supplement the influence of papers, and the attention of related literature among non-professional researchers is increasing. • The theme of SLE research mainly focuses on the pathogenesis, treatment, and management of SLE. The emerging trend is machine learning and immune cells, which may provide new strategies for the diagnosis and treatment of SLE in the future. [ABSTRACT FROM AUTHOR]

We aimed to assess the epidemiological characteristics of respiratory syncytial virus (RSV) infection in Chinese children at different phases of the coronavirus disease 2019 (COVID‐19) pandemic, that is, before, during the pandemic and after easing of restrictive measures. We included 123 623 patients aged 0–18 years with respiratory infection symptoms who were suspected with RSV infection from January 1, 2019 to June 30, 2023 in Hangzhou Children's Hospital. Clinical information and RSV test result were extracted from the laboratory information system. We calculated the positive rate of RSV detection by age groups, gender, seasons, types of patients and phases of COVID‐19 pandemic. Nonlinear associations between age and risk of RSV infection in three phases of pandemic were assessed by restricted cubic spline regression models. Among 123 623 patients, 3875 (3.13%) were tested as positive. The highest positive rate was observed in children aged 0–28 days (i.e., 12.28%). RSV infection was most prevalent in winter (6.04%), and followed by autumn (2.52%). Although there is no statistical significance regarding the positive rate at three phases of the pandemic, we observed that the rate was lowest during the pandemic and increased after easing the measures in certain age groups (p < 0.05), which was consisted with results from the nonlinear regression analyses. In addition, regression analyses suggested that the age range of children susceptible to RSV got wider, that is, 0–3.5 years, after easing all restrictive measures compared with that before (i.e., 0–3 years) and during the pandemic (i.e., 0–1 year). Based on our findings, we called for attention from health professionals and caregivers on the new epidemiological characteristics of RSV infection in the post‐pandemic era after easing the restrictive measures. [ABSTRACT FROM AUTHOR]

Background: Parenting is a common and potent environmental factor influencing adolescent anxiety. Yet, the underlying neurobiological susceptibility signatures remain elusive. Here, we used a longitudinal twin neuroimaging study to investigate the brain network integration and its heritable relation to underpin the neural differential susceptibility of adolescent anxiety to parenting environments. Methods: 216 twins from the Beijing Twin Study completed the parenting and anxiety assessments and fMRI scanning. We first identified the brain network integration involved in the influences of parenting at age 12 on anxiety symptoms at age 15. We then estimated to what extent heritable sensitive factors are responsible for the susceptibility of brain network integration. Results: Consistent with the differential susceptibility theory, the results showed that hypo-connectivity within the central executive network amplified the impact of maternal hostility on anxiety symptoms. A high anti-correlation between the anterior salience and default mode networks played a similar modulatory role in the susceptibility of adolescent anxiety to paternal hostility. Genetic influences (21.18%) were observed for the connectivity pattern in the central executive network. Conclusions: Brain network integration served as a promising neurobiological signature of the differential susceptibility to adolescent anxiety. Our findings deepen the understanding of the neural sensitivity in the developing brain and can inform early identification and personalized interventions for adolescents at risk of anxiety disorders. [ABSTRACT FROM AUTHOR]

Simple Summary: A multitude of microorganisms contribute to the occurrence of bovine mastitis. In addition to familiar pathogenic microorganisms such as Streptococcus, Staphylococcus, and Escherichia coli, Prototheca bovis has attracted more attention in recent years. It is a unicellular, chlorophyll-free, yeast-like algae that thrives in warm, humid environments that are rich in organic matter, resulting in frequent infection of dairy cows. The purpose of this study was to better understand the prevalence of Prototheca bovis infection and its potential effects on dairy cow health and milk production. We investigated the prevalence of Prototheca bovis in a medium-sized dairy farm in central China. Sample collection was extended for 5 months, from August to December 2022. A variety of pathogenic microorganisms were identified, including Prototheca bovis, and its infection rate in raw milk was 50.8–77.5%. Further analysis demonstrated that the infection of Prototheca bovis significantly affected the milk yield, somatic cell count, and protein percentage of raw milk. These results indicated that Prototheca bovis was one of the main factors causing dairy cow mastitis and posed a high threat to the quality of raw milk. This study offers valuable guidance for efficacious prevention of Prototheca bovis infection to dairy farms, such as maintaining a balance between environmental cleaning and humidity, especially during winter seasons. Prototheca bovis (P. bovis), an alga that has attracted considerable attention over the years as a causative microorganism of mastitis in dairy cows, exhibits limited susceptibility to specific aminoglycosides and antifungal agents, and no effective clinical treatment is currently available, thereby posing challenges for both prevention and treatment. To investigate the infection of P. bovis mastitis and its impact on raw milk production, a total of 348 raw milk samples were collected from August to December 2022 from a dairy farm in central China. P. bovis and other bacteria were detected, and the average infection rate of P. bovis in raw milk was 60.34% (210/348). The total number of colonies and the somatic cell count (SCC) of P. bovis positive samples were significantly higher than those of P. bovis negative samples (p < 0.01). The daily milk yield, 305-day milk yield, peak milk yield, and days to peak milk yield of the P. bovis positive samples were significantly lower than those of P. bovis negative samples (p < 0.01). A correlation analysis showed that P. bovis infection was negatively correlated with daily milk yield, 305-day milk yield, peak milk yield, and days to peak milk yield (p < 0.0001), while being positively correlated with the total number of colonies, SCC, milk loss, and protein percentage (p < 0.0001). These findings may help practitioners in comprehending the occurrence of Prototheca mastitis and developing more effective strategies for the prevention of P. bovis infections. [ABSTRACT FROM AUTHOR]

Computational thinking (CT) is a fundamental skill for students, and assessment is a critical factor in education. However, there is a lack of effective approaches to CT assessment. Therefore, we designed the Three-Dimensional Integrated Assessment (TDIA) framework in this article. The TDIA has two aims: one was to integrate three dimensions (directionality, openness, and process) into the design of effective assessment tasks; and the other was to assess comprehensively the three dimensions of CT including computational concepts, practices, and perspectives. Guided by the TDIA framework, we designed three pairs of tasks: closed forward tasks and closed reverse tasks, semiopen forward tasks and semiopen reverse tasks, and open tasks with a creative design report and open tasks without a creative design report. To further confirm each task's applicability and its advantages and disadvantages, we conducted a test experiment at the end of the autumn semester in 2014 in a primary school for 3 weeks. The results indicated that (a) the reverse tasks were not more superior than the forward tasks; (b) the semi-open tasks and the open tasks were more effective than the closed tasks, and the semi-open tasks had higher difficulty and discrimination than the others; (c) the self-reports provided a helpful function for learning diagnosis and guidance; (d) the scores had no significant difference between the schoolboys and the schoolgirls in all six tasks; and (e) the six tasks' difficulty and discrimination were all acceptable, and the semi-open tasks had higher difficulty and discrimination than the others. To effectively apply them, the following suggestions for teachers to design computational tasks are proposed: motivating students' interest and enthusiasm, incorporating semi-finished artifacts, involving learning diagnosis and guidance, and including multiple types of tasks in an assessment.

Pine wilt disease (PWD) is caused by the pine wood nematode (PWN, Bursaphelenchus xylophilus) and transmitted by a vector insect, the Monochamus alternatus. The PWN has caused much extensive damage to pine-dominated forest ecosystems. Trunk injection of emamectin benzoate (EB) has been found to be the most useful protective measure against the PWN, due to its low effective dose and long residence time in the field. However, the interactions between EB and the host or the environment remain largely unknown, which limits the efficacy and stability of EB in practical field settings. In this study, we investigated the impact on PWN from EB injection for both adult and young host plants (Pinus massoniana) by taking a multi-omics (phenomics, transcriptomics, microbiome, and metabolomics) approach. We found that EB injection can significantly reduce the amount of PWN in both living adult and young pine trees. Additionally, EB was able to activate the genetic response of P. massoniana against PWN, promotes P. massoniana growth and development and resistance to Pine wilt disease, which requires the presence of PWN. Further, the presence of EB greatly increased the accumulation of reactive oxygen species (ROS) in the host plant in a PWN-dependent manner, possibly by affecting ROS-related microbes and metabolites. Moreover, we uncovered the function of EB limiting the consumption of P. massoniana by the JPS. Based on biochemical and gut microbial data, we found that EB can significantly reduces cellulase activity in JPS, whose transcription factors, sugar metabolism, and the phosphotransferase system are also affected. These results document the impact of EB on the entire PWD transmission chain through multi-omics regarding the dominant pine (P. massoniana) in China and provide a novel perspective for controlling PWD outbreaks in the field. [ABSTRACT FROM AUTHOR]

Background: The incidence of inflammatory bowel disease (IBD) is rapidly increasing in China, a vast country with significant geographical differences. The socioeconomic status of Eastern China is significantly higher than that of Western China. Objectives: This study aimed to describe the geographical heterogeneity in the characteristics and management of patients with IBD in both Eastern and Western China. Design: This was a multicenter, cross-sectional study. Methods: Patients with IBD with ages ⩾18 years up to 18 January 2023 were included in the analysis from the Chinese database for IBD. Logistic regression was used to identify risk factors associated with surgeries among patients with IBD. Results: Among 8305 patients with IBD, the ratio of ulcerative colitis (UC) to Crohn's disease (CD) was 4.13 and 0.33 in Western and Eastern China, respectively. The median age at diagnosis of UC and CD was 40.69 and 28.58 years, respectively. There was a male predominance among patients with UC (54.3%) and CD (68.0%). The two regions exhibited a similar distribution of disease locations in UC. However, Western China had a higher proportion of L2 involvement (30.0% versus 19.1%) and more advanced disease behavior (B2 and B3) (48.8% versus 39.8%) than Eastern China. Patients with IBD in Western China received more 5-aminosalicylic acid and corticosteroids and fewer immunomodulators and biologicals. In terms of surgical risk, Eastern China [ versus Western China, odds ratios (OR): 5.36, 95% confidence intervals (CI): 2.96–9.68] was associated with a higher risk of surgery in UC, while Western China (versus Eastern China, OR: 3.39, 95% CI: 2.37–4.86) was associated with a higher risk of surgery in CD. Conclusion: Geographical heterogeneity exists in the disease characteristics and management of IBD in Eastern and Western China. These findings have the potential to guide the formulation of location-specific strategies aimed at enhancing the long-term outcomes of patients with IBD. [ABSTRACT FROM AUTHOR]

This study aimed to overcome the difficulty of conducting the horizontal-well cavity leaching test in the field and to investigate the long-term stability of the horizontal-well salt-cavity natural gas storage. The simulation test design is combined with the similarity theory to study the cavity expansion characteristics and the influence law of cavity leaching parameters. Through the design of a rubber hose connection, an integrated closed test system for multi-stage horizontal-well cavity leaching and brine drainage was built. The test system also realises the repeatable backward movement of the injection well during the test. A similarity simulation of the test design was carried out, and the test platform was constructed to carry out multi-stage horizontal-well leaching tests with a nitrogen cushion. In the horizontal-well leaching tests with a nitrogen cushion, the influence laws of the well spacing, flow rate and liquid level position on cavity expansion were investigated. Based on the morphological characteristics of the horizontal-well cavity, a numerical model of the horizontal-well salt cavity was developed, which reflects the real cavity morphology leached in the test. The long-term stability of the horizontal-well salt-cavity natural gas storage under different internal pressures was investigated through numerical simulation. [ABSTRACT FROM AUTHOR]

Chaihu Jia Longgu Muli Decoction (CLMD) is a traditional Chinese medicine for treating depression. This study investigated the effect of CLMD combined with antidepressants on multimorbidity with depression (MMD). Published randomized controlled trials were collected from PubMed, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal, Wanfang and China Biomedical Literature Service System Databases. Participants were divided into study groups (CLMD combined with antidepressants) and control groups (antidepressants). RevMan5.4 software was used for data analysis. Hamilton's Depression Scale score was significantly lower (MD = −5.62, 95%CI [−5.86, −5.37], p < 0.00001), and the effective rate was significantly higher (RR = 1.23, 95%CI [1.17, 1.29], p < 0.00001) in study groups. National Institute of Health Stroke Scale score and Pittsburgh Sleep Quality Index score of study groups were significantly lower (MD = −2.82, 95%CI [−3.84, −1.81], p < 0.00001; MD = −2.26, 95%CI [−3.19, −1.34], p < 0.00001). 5-HT, DA, NE and IL-1β level were significantly lower (SMD = 1.99, p = 0.003; SMD = 1.99, p < 0.00001; SMD = 0.86, p < 0.00001; MD = −14.64, p = 0.003) in study groups. Adverse reaction rate in study groups was significantly lower (RR = 0.47, 95%CI [0.24, 0.91], p = 0.03). The gastrointestinal tract and autonomic nervous system disorders were reduced in study groups. CLMD combined with antidepressants enhances the effect of antidepressants and reduces their adverse reactions, performing a synergistic effect; it may be considered as an effective option in the treatment of MMD. [ABSTRACT FROM AUTHOR]

Environmental innovation is an important driving force for economic sustainable development, and external supervision plays a key role in promoting firms' environmental behavior. However, the existing literature neglects to examine the impact of various external supervision on the environmental innovation of different categories and their underlying mechanisms. To fill this theoretical gap, we examine the influence of three types of supervision on environmental innovation and the moderating role of alertness. Selecting 344 firms as the sample and using multiple regression analysis, we find that law enforcement supervision and media supervision can promote firms' substantive eco-innovation that aims at achieving long-term environmental technology progress, and strategic eco-innovation that pursues short-term approach to environmental development, whereas public supervision only has a positive effect on firms' substantive eco-innovation. Further findings demonstrate that alertness can enhance the positive effect of media supervision on firms' substantive and strategic eco-innovation. [ABSTRACT FROM AUTHOR]

Background and Aims: New nurses are an important part of nursing teams. The failure of new nurses to successfully transition seriously affects personal career development and nursing work quality, and important influencing factors deserve the attention of nursing managers. At present, multicenter, large‐sample investigations of transition shock among new nurses are lacking in China. This study aims to investigate the current level and influencing factors of transition shock among new nurses in China. Methods: We conducted a multicenter, cross‐sectional study with 3414 new nurses from 16 provinces in 7 regions in China from October 22, 2021, to November 8, 2021. We used the snowball sampling method and an online questionnaire produced by the researchers to collect data; the questionnaire included questions on demographic information, a transition shock scale for new nurses and open‐ended questions. Data were analyzed using SPSS version 24. Results: The effective response rate of this study was 97.89%, with 3342 effective participants from 189 hospitals in China, most of whom were female (94.88%). The study showed that the transition shock of new nurses in China was at a moderate level, with pre‐job anxiety, unsatisfactory welfare treatment, resignation intention, adverse events, poor sleep quality, 1 or fewer exercise sessions per week, inability to balance work and life, and gluttony negatively affecting the transition shock of new nurses in China. Psychological shock was the strongest among the four dimensions of transition shock. Conclusions: The transition shock of new nurses, especially their psychological shock, deserves more attention from international society. Nursing managers should continue to take supportive measures to intervene in the factors influencing transition shock, with the aim of reducing the level of transition for new nurses, promoting their personal thriving, improving the quality of nursing work and increasing the retention rate of nurses. [ABSTRACT FROM AUTHOR]

Background: Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life. Aim: This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China. Methods: We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted. Outcomes: Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study. Results: Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period. Clinical Implications: This study highlights the importance of and need for effective dissemination of sexual health–related knowledge and the opening of appropriate communication channels. Strengths and Limitations: By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples. Conclusion: The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women's sexual health and providing relevant professional support and guidance to improve women's overall health-related quality of life. [ABSTRACT FROM AUTHOR]

Esophageal squamous cell carcinoma (ESCC) is a frequently seen esophageal tumor type in China. Activation of signaling proteins and relevant molecular mechanisms in ESCC are partially explored, impairing the antitumor efficiency of targeted therapy in ESCC treatment. Tumor‐associated macrophages (TAMs)‐released C‐C motif chemokine 22 (CCL22) can activate intratumoral focal adhesion kinase (FAK), thus promoting the progression of ESCC. Here, we demonstrated that highly secreted CCL22 by TAMs (CCL22‐positive TAMs) induced ESCC cell stemness and invasion through facilitating transcriptional activity of intratumoral glioma‐associated oncogene 1 (Gli1), a downstream effector for Hedgehog (HH) pathway. Mechanistically, FAK‐activated protein kinase B (AKT) mediated Gli1 phosphorylation at its Ser112/Thr115/Ser116 sites and released Gli1 from suppressor of fused homolog, the endogenous inhibitor of Gli1 to activate downstream stemness‐associated factors, such as SRY‐box transcription factor 2 (SOX2), Nanog homeobox (Nanog), or POU class 5 homeobox (OCT4). Furthermore, inhibition of FAK activity by VS‐4718, the FAK inhibitor, enhanced antitumor effect of GDC‐0449, the HH inhibitor, both in xenografted models and in vitro assays. Clinically, CCL22/Gli1 axis is used to evaluate ESCC prognosis. Overall, our study establishes the communication of FAK with HH pathway and offers the novel mechanism related to Gli1 activation independent of Smoothened as well as the rationale for the anti‐ESCC combination treatment. [ABSTRACT FROM AUTHOR]

Covid-19 out broke gave an extreme impact to the globe, imposing a challenge to health publicly and causing social interruptions. As a result, the role of mainstream media in promoting anti-epidemic measures and disseminating national images has become increasingly important. In this study, we examine the anti-epidemic reports in 2020 from three types of international news sources, identifying 566 samples for content and text analysis. Through our analysis, we found that each component of the anti-epidemic report has a clear focus, and that these reports presented China's national image of anti-epidemic in four dimensions. Notably, the European version of People's Daily exhibited a positive reporting tendency, accounting for 86% of the total, with only 8% of reports being negative. This indicates a relatively comprehensive national image construction and communication strategy amid the COVID-19 pandemic. Overall, our research reveals the important role of media in shaping a nation's image during a global crisis. The positive reporting tendency of the European version of People's Daily reflects an effective strategy for promoting a positive national image, thereby dispelling misunderstandings and prejudices towards China's anti-epidemic measures. Our findings provide inspiration for the dissemination of national images in times of crisis, highlighting the importance of comprehensive and well-coordinated communication strategies to promote a positive image. [ABSTRACT FROM AUTHOR]

Single model initial‐condition large ensembles (SMILEs) are valuable means to study the role of internal climate variability (ICV) in climate change. However, the ability of SMILEs to represent the multi‐timescale ICV is not fully understood, especially in the region of China. The main objective of this work is to assess the ability of six advanced SMILEs with ensemble members ranging from 30 to 100 in simulating ICV of precipitation at various timescales in China, using a set of observational datasets as the benchmark. To have a first insight into the selected models, the mean states and trends of annual precipitation were evaluated at the very beginning. The ICV of precipitation was then calculated at multiple timescales by two widely used methods of representing temporal variability and intermember variability. The minimum required ensemble size for each climate model to robustly capture the true value of ICV is investigated at last. The results show that the multiple SMILEs can capture the basic spatial distribution pattern of ICV across timescales. However, the ICV represented by temporal variability underestimates observed ICV in most regions across timescales. The ICV represented by intermember variability is similar to that represented by temporal variability at the interannual and interdecadal timescales, but significantly larger at the multidecadal timescales. Within ±10% error limit, 20–30 members are sufficient for all climate models at the interannual timescale while ensemble sizes of 74% or more of the full sizes for each climate model are needed at multidecadal timescales. [ABSTRACT FROM AUTHOR]

A good water budget involving four variables, including precipitation (P), evapotranspiration (ET), streamflow (R), and terrestrial water storage change (TWSC), is reflected in two aspects: a high accuracy against observations for each budget component and the low water budget closure residual error (ΔRes). Due to the lack of consideration of observations of budget components in existing water budget closure assessment methods (BCMs), when the ΔRes of budget components is low, their error against respective observations may still be high. In this study, we assess the water budget closure accuracy of satellite/reanalysis-based hydrological data products over mainland China based on six popular P products and multiple datasets of additional budget components (ET, R, and TWSC). The results indicated that the ΔRes changes between ±15 mm over mainland China. Satellite P products such as GPM IMERG showed better performance by comparing them with rain gauge-based observations. However, reanalysis P products such as GLDAS and FLDAS showed a better water budget closure since the selected datasets of additional budget components (ET and R) are also derived from reanalysis datasets. This indicates that these same data sources for budget components make it easier to close the water budget. The further development of satellite P products should consider the closure of the water budget with other water cycle variables. [ABSTRACT FROM AUTHOR]

Understanding the intention of community residents to seek help from mental health professionals (MHPs) is essential in targeting interventions that promote the prevention and treatment of depression. This study aimed to investigate the current status of Chinese community populations' depression help-seeking intentions from MHPs and explore factors influencing the intentions. Data were used from a survey conducted in a city in central China (n = 919 aged 38.68 ± 17.34, 72.1% female). Help-seeking intentions, help-seeking attitude, depression stigma, family function and depressive symptoms were measured. The total mean score on the intent to seek help from MHPs was 11.01 ± 7.78 and most of respondents were unwilling to seek professional help. Multiple linear regression showed that participants who were students, held a positive help-seeking attitude and had low personal stigma were more likely to have the intention to seek help from MHPs. It is necessary to utilize effective interventions to improve community residents' intention to seek professional help. These include promoting the importance of seeking professional assistance, optimizing the quality of mental health services and altering residents' prejudice to seeking professional help. [ABSTRACT FROM AUTHOR]

Modelling hydrological process in the critical zone not only contributes to a better understanding of interactions across different Earth surface spheres but also holds significant practical implications for water resource management and disaster prevention. Rainfall‐runoff simulation in critical zones is particularly challenging due to the amalgamation of temporal and spatial complexity, rainfall variability, and data limitations. As a pivotal input variable of hydrological models, accurate estimation of areal rainfall is critical to successful runoff simulation. However, most estimation methods ignore temporal information, thereby increasing uncertainty in rainfall estimation and constraining the precision of rainfall‐runoff simulation. In this study, the matrix decomposition‐based estimation method (F‐SVD), which considers the spatial and temporal correlation of the rainfall process is employed to estimate areal rainfall. The superiority of the method in producing two‐dimensional rainfall information is evaluated through its application in runoff simulation with the Xin'anjiang model. The simulation results of selected flood events in the Jianxi basin in southeast China, spanning from 2009 to 2019, are compared with those of two widely used rainfall estimation methods, namely Arithmetical Mean (AM) and Thiessen Polygons (TP). The results show that (1) F‐SVD not only produces the highest Pearson correlation coefficient between rainfall and runoff series but also reduces the number of flood events with abnormal rainfall‐runoff relationships; (2) the Xin'anjiang model based on F‐SVD achieves the highest Nash‐Sutcliffe efficiency and lowest Relative Error, and performs best in simulating peak flow and its occurrence time as compared to AM and TP. This study contributes to a finer characterization of watershed rainfall distribution, enhancing the accuracy and sharpness of runoff simulation. It provides reliable data support for critical zone research and offers a scientific foundation for rationally allocating and managing water resources. [ABSTRACT FROM AUTHOR]

Undesirable disturbances (e.g., extraordinary drought) are prone to cause cascading failures of water supply‐hydropower generation‐environment conservation (WHE) nexus system. Simulating a dynamic resilience of the nexus system can provide opportunities for pre‐disturbance effective prevention and post‐disturbance recovery from the cascading failures. Previous dynamic resilience simulating is often based on the linear assumption which is not applicable for the WHE nexus system that involves nonlinear processes. To improve simulation accuracy of the dynamic resilience of the WHE nexus system, a novel nonlinear dynamic resilience model that incorporates both a WHE nexus model and a second‐order Volterra (SOV) model is proposed. The WHE nexus model simulates amount of impact propagated by an original disturbance event on each subsystem, while the SOV model captures nonlinear relationship between the amount of impact and a corresponding dynamic resilience. The proposed model was applied to the Liuchong River Basin, China, under different dry year scenarios. The results show that the dynamic resilience simulated through the SOV model performs better than that through a first‐order Volterra model which is suitable for a linear system, with Nash‐Sutcliffe efficiencies of water supply, hydropower generation, and environment conservation subsystems increasing by 36.8%, 70.9%, and 17% respectively. Among the WHE nexus system, the water supply subsystem is found to be the least resilient. Moreover, the proposed nonlinear model is more suitable for simulating and predicting dynamic resilience when a severer water resources drought occurs. The proposed model helps to guide resilience management of water resource system by combining nexus and resilience thinking. Key Points: A nonlinear dynamic resilience model performs better for simulating and predicting a dynamic resilience with incremental performancesVolterra kernels that quantify the inherent resilience characteristics of a nexus system are compared under different disturbancesA disturbance influences the dynamic resilience of a nexus system by changing the number of feedback loops [ABSTRACT FROM AUTHOR]

Background: Due to the increasing burden of life-limiting illnesses, the need for palliative care has increased. Nurses' palliative care competence is a vital factor in improving its accessibility. A reliable instrument is needed to measure nurses' competence in providing palliative care. Objective: Our aim was to translate and culturally adapt the Palliative Care Nursing Self-Competence Scale (PCNSC) into the Palliative Care Nursing Self-Competence Scale–Simplified Chinese (PCNSC-SC). Methods: Two cross-sectional studies were conducted after content validity had been confirmed during the instrument's translation and adaption. The convergent validity, construct validity, internal consistency, and homogeneity were evaluated in both the first and second studies. Test-retest reliability was assessed only in the first study. Clinical nurses who had a registered nurse qualification certificate and at least 12 months of work experience from a tertiary hospital in Hubei, China participated in the 2 studies. Results: The PCNSC-SC contains 8 dimensions and 34 items, based on goodness-of-fit indices and confirmatory factor analysis. The Cronbach's alpha of the PCNSC-SC was.984 and.990 in the 2 studies, respectively. The test-retest reliability of the PCNSC-SC after 2 weeks was.717. Conclusion: The PCNSC-SC can be used to evaluate perceived self-competence in palliative care of Chinese nurses with good reliability and validity. [ABSTRACT FROM AUTHOR]

Background: Nonpharmacological interventions for COVID-19 could reduce the incidence of children hospitalized in pediatric intensive care units (PICU) and the incidence of children with bacterial infections. This study aimed to evaluate changes in the bacterial profile of children in PICU before and during the COVID-19 pandemics. Methods: This is a retrospective study, involving clinical data of children with positive bacterial cultures admitted to the PICU respectively in 2019 and 2021. Results: In total 652 children were included in this study. The total number of hospitalized patients and the incidence of bacteria-positive children in 2021 were lower than those in 2019. There were no significant differences in the ratio of Gram-positive bacterial infection, Gram-negative bacteria infection or fungi infection between the two years. The rate of Streptococcus pneumoniae in 2021 was higher than that in 2019(p = 0.127). The incidence of Haemophilus influenzae in hospitalized patients decreased with a downward trend(p = 0.002). The distribution of previous underlying diseases in children admitted to PICU with different outcomes of bacterial infection between the two years were homogeneous (p > 0.05). Conclusion: After the implementation of COVID-19 isolation, prevention and control measures, the number of hospitalizations and bacterial infections in PICU decreased, which may be due to changes in population's behavior patterns. Meanwhile, the incidence of Haemophilus influenzae in hospitalized patients decreased with a downward trend. [ABSTRACT FROM AUTHOR]

Objective: To identify the prevalence of obesity, sarcopenia, sarcopenic obesity in end-stage knee osteoarthritis (KOA) patients and analyze influences of obesity and sarcopenia in the progression of KOA. Methods: A cross-sectional study was carried out among end-stage KOA patients who consecutively admitted to Orthopedic Department for TKA. We suppose that the level of decreased physical activities would be influenced by unilateral or bilateral KOA. Patient information, albumin, hemoglobin, pace, step frequency, number of comorbid conditions were collected. Bioelectrical impedance analyzer was used to analyze body composition. Obesity, sarcopenia, sarcopenic obesity rate were analyzed with accepted diagnosis criteria. Correlations between body mass index (BMI) or age and fat mass (FM), appendicular skeletal muscle mass (ASM) were analyzed. Results: 138 patients (male 30, female 108) in southwest of China including 67 patients with unilateral KOA and 71 patients with bilateral KOA were analyzed. No statistic difference was found in mean albumin, prealbumin and hematocrystallin, body composition values and number of comorbid conditions. We found that BMI was positively correlated with FM (Male: R2 = 0.7177, p < 0.0001, Female: R2 = 0.8898, p < 0.0001), ASM (Male: R2 = 0.2640, p = 0.0037, Female: R2 = 0.2102, p < 0.0001), FM index (FMI) (Male: R2 = 0.6778, p < 0.0001, Female: R2 = 0.8801, p < 0.0001), and ASM index (ASMI) (Male: R2 = 0.3600, p = 0.0005, Female: R2 = 0.4208, p < 0.0001) in end-stage KOA patients. However, age was not obviously correlated with FM or FMI (Male: FM, R2 = 0.006911, p = 0.3924; FMI, R2 = 0.7554, p = 0.0009196; Female: FM, R2 = 0.001548, p = 0.8412; FMI, R2 = 0.002776, p = 0.7822). And slightly negatively correlated with ASM (Male: R2 = 0.05613, p = 0.0136, Female: R2 = 0.01327, p = 0.5433) and ASMI (Male: R2 = 0.02982, p = 0.3615; Female: R2 = 0.03696, p = 0.0462). The prevalence of obesity, sarcopenia and obesity sarcopenia differs according to different diagnosis criteria. No difference in the occurrence rate of obesity was found between bilateral KOA and unilateral KOA patients, and occurrence rates of sarcopenia and sarcopenic obesity were statistically higher in bilateral KOA than that in unilateral KOA patients. Conclusions: Obesity, sarcopenia and sarcopenic obesity are highly prevalent in end-stage KOA patients, sarcopenic obesity are more prevalent in bilateral KOA patients than that in unilateral KOA patients. [ABSTRACT FROM AUTHOR]