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Background: Advanced nursing practice and education with a Master's degree as the necessary preparation, is viewed as a major strategy to cultivate senior nursing talents. Competencies are central to advanced nursing practice and education, but how can competencies be measured? Entrustable professional activities (EPAs) have been used widely in medicine as a practical approach for bridging the gaps between competency and clinical practice. Considering the paucity of research in EPAs for nursing graduates in China, it is needed to develop EPAs specifically for Chinese Master of Nursing Specialist (MNS) graduates to improve patient safety and quality patient care. Objectives: To develop and evaluate a core competency-based EPAs framework for Chinese MNS graduates. Methods: A four-stage approach was adopted for the EPAs development, including: (1) forming a research team, (2) drafting an initial EPAs framework, (3) reviewing EPAs framework, and (4) conducting EPAs consensus assessment. Results: A framework containing twelve EPAs was developed, including: 1) perform health assessments, 2) identify and prioritize nursing diagnoses, 3) formulate and implement care plan, 4) perform basic and specialized care operations, 5) recognize and manage medication needs of patients, 6) assess and manage patients with mental health problems, 7) recognize and assist in rescuing critically ill patients, 8) perform transition and handover, 9) participate in multidisciplinary team collaborative care, 10) provide health education and nursing consultation, 11) formulate and implement discharge plans, and 12) instruct nursing students in a clinical setting. The I-CVI score for the two rounds of Delphi ranged from 0.92 ∼ 1.00 and 0.96 ∼ 1.00, respectively. The mean of Equal's score for the three domains ranged from 4.20 ∼ 4.47, 4.25 ∼ 4.51, and 4.23 ∼ 4.37, respectively. Conclusion: The developed EPAs framework in this study is a reliable tool to assess the core competencies of Chinese MNS graduates in clinical practice and assist with their curricula design. [ABSTRACT FROM AUTHOR]

In recent years, there has been significant focus on China's new drug lag, but relevant research is limited. This study explores the reasons for drug lag by assessing the impact of reforms in China's drug review system, particularly focusing on the influence of clinical development strategies. This study selected drugs first launched in the United States between 2017 and 2022, examining absolute and relative lag between China and the first‐launch country (including submission and review lag). These delays with drugs approved in the European Union and Japan during the same period were compared with uncover the roots of delays in China, further identifying potential factors that could reduce these delays. The results indicate that the National Medical Products Administration (NMPA) has a longer relative lag compared with the European Medicines Agency (EMA) and the Pharmaceuticals and Medical Devices Agency (PMDA). The submission lag time of the NMPA significantly surpasses that of the EMA and PMDA, whereas the review lag time of the NMPA exceeds that of the PMDA but falls short of the EMA. Focusing on clinical trial strategies, bridging trials and multiregional clinical trials (MRCTs) are typically required by the NMPA in East Asia, resulting in longer clinical delay time. Whereas the EMA and PMDA primarily require international MRCTs in Europe and America, with a clinical delay of < 5 months. It is evident that there is a significant gap in clinical trial durations between China and other countries. Further optimization of clinical trial management is necessary to address the lag for new drugs in China. [ABSTRACT FROM AUTHOR]

In the northern region of China, freeze–thaw cycles and chloride ion (Cl−) penetration are the primary factors affecting the durability of marine concrete. To investigate the influence of nanoparticles on the Cl− penetration resistance of marine concrete under the action of freeze–thaw cycles, nano-SiO2 and nano-Fe3O4 were added to plain concrete in different amounts. The Cl− penetration resistance of concrete under the action of freeze–thaw cycles was measured in a 5% NaCl solution. The relative dynamic modulus, mass loss rate, and Cl− content at different depths in concrete were measured to evaluate the salt-scaling resistance. The test results show that under salt freeze–thaw cycles, the relative dynamic modulus, bound Cl− content, and Cl− binding capacity of concrete with nanoparticles were higher than those of plain concrete. However, the mass loss, total Cl− content, and free Cl− content in concrete with nanoparticles were lower than those of plain concrete. With increasing nanoparticle content, the relative dynamic modulus, bound Cl− content, and Cl− binding capacity of the concrete first increased and subsequently decreased. However, the mass loss rate, total Cl− content, and free Cl− content first decreased and subsequently increased. The optimum amount of nano-SiO2 and nano-Fe3O4 in the concrete was 2%. The improvement effect of nano-SiO2 on the salt-scaling resistance of concrete was superior to that of concrete with the same amount of nano-Fe3O4. The addition of nanoparticles can accelerate the formation of hydrated products, enhance the chemical binding capacity and physical adsorption capacity of hydrated products to Cl−, and reduce the free Cl− content in concrete. This can improve the Cl− penetration resistance of marine concrete under the action of freeze–thaw cycles. This study provides a reference for the durable design of marine concrete in the northern region. [ABSTRACT FROM AUTHOR]

Background: Elderly patients with acute myeloid leukemia or myelodysplastic syndromes (AML/MDS) have historically had poor prognoses. However, there has been a recent increase in the use of allogenic hematopoietic stem cell transplantation (allo-HSCT) are in this patient population. Nevertheless, the optimal choice of donor type for the patients remains an unmet need. Limited data exist on the use of allo-HSCT in elderly patients with AML/MDS from China. To better understand and optimize the selection of donor type for the elderly patients, particularly for those with refractory or relapsed disease, in comparison with the previous studies in the US and Europe. Methods: Our retrospective study enrolled 259 patients aged over 55 years who underwent their first allo-HSCT between April 2015 and August 2022. These patients were divided into three groups based on donor type: haploidentical related donor group (haploidentical related donor transplantation [HID], n = 184), matched sibling donor group (matched sibling donor transplantation [MSD], n = 39), and matched unrelated donor group (matched unrelated donor transplantation [MUD], n = 36). Statistics were performed with the chi-square test, the log-rank and Fine-Gray tests. Results: The median age of the cohort was 57 years (range: 55–75) and 26.25% of patients were over 60 years old. Younger patients had a higher incidence of acute graft-versus-host disease (HR = 1.942, P = 0.035), faster neutrophil recovery (HR = 1.387, P = 0.012), and better overall survival (HR = 0.567, P = 0.043) than patients aged ≥ 60 years across the entire cohort. Patients with refractory or relapsed (R/R) diseases had delayed neutrophil engraftment (P = 0.010, HR = 0.752) and platelet engraftment (P < 0.001, HR = 0.596), higher incidence of relapses (HR = 2.300, P = 0.013), and inferior relapse-free survival (RFS) (HR = 1.740, HR = 0.016) regardless of donor type. When it came to graft-versus-host-disease-free, relapse-free survival (GRFS), MUDs turned out to be superior to HIDs (HR = 0.472, P = 0.026) according to the multivariable analysis. In contrast, we found MSDs had an inferior GRFS to HIDs in parallel (HR = 1.621, P = 0.043). Conclusion: The choice of donor type did not significantly affect the outcomes of allo-HSCT. However, when considering the quality of post-transplant life, MUDs or HIDs from younger donors may be the optimal choice for elderly patients. [ABSTRACT FROM AUTHOR]

• A Suaeda Salsa spectral index (SSSI) is proposed. • SSSI can be used for both S. salsa mapping and fractional cover (FC) estimation. • S. salsa with FC as low as 20% can be accurately detected. • SSSI performs better than NDVI and SAVI for S. salsa FC estimation. • SSSI alleviates the impact of heterogeneous soil backgrounds in intertidal wetlands. Suaeda Salsa (S. salsa), with short and red-purplish plants, is a typical pioneer saltmarsh species in the intertidal wetlands of temperate East Asia. It has important ecological, economic, and recreational values. In the past few decades, S. salsa has severely degraded in coastal China, which has brought widespread attention from regional and local governments. As a result, extensive S. salsa restoration projects have been initiated in recent years. It is urgently needed to develop satellite-based methods for both S. salsa mapping and fractional cover (FC) estimation because degradation and recovery of S. salsa are manifested by changes in both area and plant cover. However, accurate mapping and FC estimation of S. salsa are challenging because (1) S. salsa in intertidal areas have low FC and (2) heterogeneous soil backgrounds in wetlands greatly impact the spectral reflectance observed by satellites. To address these issues, this study proposed a new Suaeda Salsa Spectral Index (SSSI) to support accurate detection and FC estimation of S. salsa. The SSSI was designed based on the laboratory spectral measurements by considering variations in wetland soil moisture and by taking advantage of the reddish color of S. salsa. It consists of two components, one of which utilized blue, green and red bands to separate S. salsa from green vegetation, and the other component utilized a modification of the Soil Adjusted Vegetation Index (SAVI) to reduce the impact of soil background and maintain a linear relationship with S. salsa FC. SSSI was then applied on Sentinel-2/GF-1 images over the Yellow River Delta (YRD) and Liao River Delta (LRD), China. Based on SSSI, a simple thresholding approach was used to identify S. salsa, and a linear regression model was used to estimate FC. With reference datasets provided from field investigations, Unmanned Aerial Vehicle multispectral images and high-spatial resolution satellite images, our results show that the SSSI was able to detect low-coverage S. salsa (FC > 20 % in YRD and FC > 10 % in LRD), and the S. salsa maps had an overall accuracy over 94%. The SSSI-FC models achieved good estimation accuracies (R2 = 0.77 ∼ 0.86, RMSE = 7.55 % ∼ 9.79 %). Compared to the Normalized Difference Vegetation Index (NDVI) and SAVI, SSSI alleviated the impacts from soil backgrounds and provided better S. salsa FC estimations, particularly for low-coverage S. salsa. SSSI has great potential in supporting continuous monitoring of S. salsa dynamics and evaluating the effectiveness of S. salsa restoration projects. [ABSTRACT FROM AUTHOR]

With the rapid growth of the global population and the increasing urbanization, the urban landscape in China is gradually enriched, and the scale of the landscape that plays a healing role is expanding. However, curing the problem of landscape ecological security is an important part of Homeland security, economic and social sustainable development. We must deal with the relationship between high-quality social development and ecological environment protection on the basis of scientific evaluation. To address this issue, research has provided better data support for feature extraction through image preprocessing. Then the Convolutional neural network in deep learning is trained through a large number of collected measured data. Finally, the pressure state response model is used to evaluate the ecological security of the healing landscape. The results show that the average error of the ground class in 2010 was 13.65%, and the fitting accuracy reached 86.35%, indicating that this method has high accuracy and can be effectively applied in evaluation. Meanwhile, in 2010 and 2019, the average landscape ecological security levels of City A were 7.27 and 6.65, both at a "safe" level, but the overall security level showed a downward trend. It is recommended to optimize the land use pattern in future urban planning and construction, improve the urban landscape ecological security index value, and maintain consistency with the actual situation of the city. This can provide reference for the evaluation model of urban landscape ecological security, and further provide scientific basis and guidance for the ecological civilization construction of urban agglomerations. In subsequent research, the evolution trend of urban landscape ecological security can be taken as the research goal, and finally, guidance on optimizing urban landscape ecological security can be provided. [ABSTRACT FROM AUTHOR]

Background: Requirements of blood transfusions rise rapidly in China. Improving the efficiency of blood donation could help maintaining sufficient blood supplement. We conducted a pilot research to investigate the reliability and safety of collecting more units of red blood cell by apheresis. Methods: Thirty‐two healthy male volunteers were randomized into two groups: red blood cell apheresis (RA) (n = 16) and whole blood (WB) donation (n = 16). RA group donated individualized RBC volumes by apheresis according to the volunteers' basal total blood volumes and haematocrit levels, WB group donated 400 mL whole blood. All volunteers were scheduled seven visit times in 8 weeks' study period. The cardiovascular functions were assessed by laboratory examinations, echocardiography and cardiopulmonary functional tests. All results were compared between groups at the same visit time and compared between visit 1(before donation) and other visit times within the same group. Results: The average donated RBC volume in RA group and in WB group was 627.25 ± 109.74 mL and 175.28 ± 8.85 mL, respectively(p < 0.05); the RBC, haemoglobin and haematocrit levels changed significantly between times and between groups (p < 0.05). Cardiac biomarker levels such as NT‐proBNP, hs‐TnT and CK‐MB did not change significantly between times or between groups (p > 0.05). The echocardiographic and cardiopulmonary results did not change significantly between times or between groups during the whole study period(p > 0.05). Conclusions: We provided an efficient and secure method for RBC apheresis. By harvesting more RBC volumes at one single‐time, the cardiovascular functions did not change significantly compared with traditional whole blood donation. [ABSTRACT FROM AUTHOR]

Background: It is important for anesthesiologists to leave good impressions and build rapport with patients during preoperative visits. However, patient preferences for anesthesiologist attire have not been well studied in China.Purpose: To characterize patient perceptions of anesthesiologist attire during preoperative visits.Patients and Methods: In this cross-sectional survey, we included adult patients who underwent elective operations in various surgical departments. We presented photographs of both male and female models wearing six combinations of attire (formal in a white coat buttoned, formal in a white coat unbuttoned, casual in a white coat buttoned, casual in a white coat unbuttoned, scrubs in a white coat buttoned, and scrubs in a coat of the same green color buttoned) in a randomized sequence. Participants were asked to rate each attire combination in five domains, including professionalism, experience, attitude, approachability, and caring.Results: Of the 541 surveys distributed, 516 (95.4%) were completed and included in the analysis. The majority of respondents were female [389 (75.4%)] and aged 31– 45 years [234 (45.3%)]. The combination of scrubs in a buttoned coat of the same color had the highest composite rating score [median (interquartile range): 50 (45, 50), adjusted P< 0.001 compared with the other five combinations]. There was no significant difference in preference for standardized disposable or personalized cloth operating caps. Respondents' age was independently associated with the perceived importance of anesthesiologist attire (46– 60 years vs 18– 35 years: odds ratio 2.17, 95% confidence interval 1.12– 4.18, P=0.021).Conclusion: Patients prefer anesthesiologists wearing scrubs in coats of the same color. Standardizing anesthesiologist attire based on these findings may improve patient satisfaction. [ABSTRACT FROM AUTHOR]

Although there is a large body of theoretical and empirical research supporting a relationship between Zhongyong thinking and creativity, some studies have found that the association is positive, while others have reported that it is negative. Therefore, we performed a meta-analysis of 18 relevant studies to further clarify this relationship. On the basis of 19 independent effect sizes, the results indicated there was a medium-strength, positive, and significant relationship between Zhongyong thinking and creativity. Moderator analyses suggested that this relationship was stronger in studies in which creativity was self-evaluated than in the studies in which others evaluated the individual's creativity. The moderating effect of the tools used to measure Zhongyong thinking and publication status were not significant. [ABSTRACT FROM AUTHOR]

The prognosis for adults with relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is poor. Blinatumomab is a CD3/CD19-directed BiTE® (bispecific T-cell engager) molecule approved globally for the treatment of BCP-ALL in adults and children. This multicenter open-label single-arm China registrational study evaluated the safety, efficacy, and pharmacokinetics of blinatumomab in Chinese adults with Philadelphia chromosome-negative (Ph−) R/R BCP-ALL (NCT03476239). Patients aged ≥ 18 years were treated with up to 5 cycles of blinatumomab. The primary objective was to evaluate the hematological response rate (complete remission/complete remission with partial hematological recovery [CR/CRh]) within 2 cycles of blinatumomab. At the interim analysis (April 12, 2019), 90 patients (median age 31.5 years [range: 18-74]; 53.3% female; 77.8% with bone marrow blasts ≥ 50% at study entry) were enrolled at 23 study centers in China and had received blinatumomab. As of data cutoff, 43 patients (47.8%) continued the study. The CR/CRh rate within 2 cycles of blinatumomab was 45.6% (41/90 [CR, 37; CRh, 4]; 95% CI: 35.0–56.4). Median overall survival was 9.2 months (95% CI: 6.5–11.7); median relapse-free survival was 4.3 months (95% CI: 3.2–9.4). Mean serum concentration at steady-state and systemic clearance of blinatumomab in Chinese patients were within the range reported in adults from global clinical trials. No new safety risks were identified in Chinese patients. The efficacy and safety of blinatumomab in these heavily pre-treated Chinese patients with Ph− R/R BCP-ALL is comparable to that for patients within global clinical trials. [ABSTRACT FROM AUTHOR]

This paper mainly focuses on the development process and future outlook of ASEAN-China relations. During the past 30 years, China and ASEAN have achieved political, economic, and cultural communication and cooperation, which have had a positive effect on the economic promotion of both sides and the Asia-Pacific region. Given the existing bilateral relations between China and ASEAN countries, there exist both opportunities and risks in tightening ties. China's growing economic and political power may bring low trust ratings in ASEAN, which may paint both sides into a corner. At the same time, ASEAN is also a corridor for Chinese markets and enterprises to reach out to the world. We are willing to witness that both sides will continue to cooperate and exchange ideas and innovations in the future, face the risks, actively seize the opportunities to promote economic development, and bring more benefits to the whole world. [ABSTRACT FROM AUTHOR]

Climate is a key factor to determine the pattern of ecosystems; however, the latitudinal patterns of climatic variables in the arid and semi-arid areas remain largely unclear when compared to humid areas. The topography of the dry valleys of southwestern China plays an important role in the formation of climate. However, its impact on the climate remains qualitative. In this study, eight climatic variables from 12 meteorological stations were analyzed to explore their latitudinal patterns in the wet and dry seasons from 1961 to 2019. We also quantified the effects of local topography (RH10) on the climatic variables. The results were as follows: sunshine duration, total solar radiation, average temperature, and evaporation decreased significantly, and wind speed increased significantly with increasing latitude in the annual, wet, and dry seasons (P<0.001). Relative humidity and precipitation decreased significantly with increasing latitude in the wet season (P<0.001), and no obvious change pattern was observed in the dry season. Aridity index significantly decreased (toward dryness) with increasing latitude in the wet season and increased in the dry season (P<0.001). Wind speed had a significantly positive relationship with topography (RH10) (P<0.01), whereas precipitation and aridity index were negatively associated with topography in the wet season and positively associated with topography in the dry season. Dryness was positively associated with RH10 in the wet season, and negatively in the dry season. The results of our research could provide new perspectives for understanding the relationship between topography and drought in the dry valleys of southwestern China. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer and causes many cancer-related deaths worldwide; in China, it is the second most prevalent cause of cancer deaths. Most patients are diagnosed clinically with advanced stage disease. Summary: For more than a decade, sorafenib, a small-molecular-weight tyrosine kinase inhibitor (SMW-TKI) was the only molecular targeted drug available with a survival benefit for the treatment of advanced HCC. With the development of novel TKIs and immune checkpoint inhibitors for advanced HCC, the management of patients has been greatly improved. However, though angiogenic-based targeted therapy remains the backbone for the systemic treatment of HCC, to date, no Chinese guidelines for novel molecular targeted therapies to treat advanced HCC have been established. Our interdisciplinary panel on the treatment of advanced HCC comprising hepatologists, hepatobiliary surgeons, oncologists, radiologists, pathologists, orthopedic surgeons, traditional Chinese medicine physicians, and interventional radiologists has reviewed the literature in order to develop updated treatment regimens. Key Messages: Panel consensus statements for the appropriate use of new molecular -targeted drugs including doses, combination therapies, adverse reaction management as well as efficacy evaluation, and predictions for treatment of advanced HCC with evidence levels based on published data are presented, thereby providing an overview of molecular targeted therapies for healthcare professionals. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is one of the top ten health threats. We aimed to (1) assess parental Category B vaccines hesitancy and associated sociodemographic factors in China, and (2) explore the association between attitude toward vaccines and self-reported hesitant behavior. A cross-sectional study was performed through a web-based anonymous online questionnaire survey between 9 February and 7 April 2021. Chinese parents aged ≥ 18 years with one child aged < 6 years were included to assess vaccine hesitancy using the vaccine-hesitancy scale (VHS). Structural equation model was used to determine relationships between variables. Of 2952 Chinese parents included in the analysis, 17.5% were highly hesitant in Category B vaccines. Parents who were younger, less educated, engaged in health-related occupations, and had been vaccinated against influenza in the past year were more hesitant when vaccinating their children (P < 0.001). VHS score accuracy to identify vaccine-hesitant behavior was acceptable, and the optimal cutoff was 37.50 (with 61.96% parental vaccine hesitancy). Parents who lack confidence or believe vaccines were risk were more likely to show vaccine hesitant behavior (P < 0.001). In China, effective interventions need to be implemented to eliminate parental Category B vaccines hesitancy. [ABSTRACT FROM AUTHOR]

Background: The benefits and tolerability of transarterial chemoembolization (TACE) combined with regorafenib as a second-line therapy has not been reported for unresectable hepatocellular carcinoma (HCC). This study aimed to explore the benefits and tolerability of TACE combined with second-line regorafenib in patients with unresectable advanced HCC and failure to first-line treatment.Methods: This was a multicenter retrospective study of patients with progression after first-line sorafenib and/or lenvatinib between 01/2019 and 04/2020 at four tertiary hospitals in China. The patients were treated with TACE. Then, 5-7 days after the first TACE, the patients started taking regorafenib for 3 weeks every 4-week cycle. The overall survival (OS), time to progression (TTP), progression-free survival (PFS), and adverse events (AEs) were observed.Results: The median follow-up was 5.6 (range 0.7, 17.0) months. The median age was 60 (range 35, 79) years. There were 32 (84.2%) males. The patients underwent a median of three TACE sessions (range 1-13). The initial doses of regorafenib were 20 mg/d (n = 1, 2.6%), 80 mg/d (n = 10, 26.3%), 120 mg/d (n = 15, 39.5%), and 160 mg/d (n = 11, 28.9%). The incidence of grade 3/4 AEs was 15.8%. Two patients stopped regorafenib due to AEs. The median OS was 14.3 months. The median PFS and TTP were 9.1 (95% CI 4.0, 14.2) and 9.1 (95% CI 5.5, 12.8) months, respectively.Conclusions: The present study provides real-world evidence indicating that regorafenib combined with TACE was beneficial and tolerable in patients with unresectable HCC. Additional prospective large-scale studies are required for confirmation. [ABSTRACT FROM AUTHOR]

We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses. [ABSTRACT FROM AUTHOR]

Pancreatic cancer (PC) is a lethal disease with extremely high mortality. Although surgical resection is the optimal therapeutic approach for PC, about 30%-40% of those patients are not candidates for surgical resection when diagnosed. Chemotherapy and radiotherapy also could not claim a desirable effect on PC. The application of interventional radiology approaches is limited by unavoidable damage to the surrounding vessels or organs. By the superiority of mechanism and technology, IRE could ablate the tumor by creating irreversible pores on the membrane of PC cells with other tissues like vessels and pancreatic ducts untouched. This consensus gathers the theoretical basis and clinical experience from multiple Chinese medical centers, to provide the application principles and experience from Chinese experts in the IRE field. [ABSTRACT FROM AUTHOR]

Purpose: Rapid development of China's rural industry since 1980s has a massive ripple effect on rural China. However, recent rural industrial development in China has received little scholarly attention. The study aims to investigate the development process and spatial differences of China's rural industry as well as its driving forces. Design/methodology/approach: The study is based on the panel data constituting 30 provinces of China during 1984–2011. The factor analysis is used to identify the most significant factors affecting the growth of China's rural industry. The multiple regression analysis is applied to distinguish the driving forces affecting spatiotemporal variations in China's rural industry. Findings: China's rural industry developed rapidly at an average rate of 26% per year during the period 1984–2011. The period 1990–2011 was characterized by remarkable increased spatial disparities in China's rural industrial development. Specifically, such development was markedly better in the east coast areas than in the inland areas in the west. Five driving forces of rural industrial development were recognized representing regional economic fundamentals of market, industry foundation, transportation, communication and degree of opening-up. Originality/value: This paper explores the trajectory of the development of China's rural industry and the related regional economic factors. It suggests that the development of rural enterprises across the regions should be valued by Chinese government as a driving force for reducing regional disparities and future rural revitalization. [ABSTRACT FROM AUTHOR]

Recent in situ pressure test indicates that there is a mudstone interlayer with high permeability in the open hole of the underground gas storage (UGS) salt caverns in Jintan, China. The interlayer is called the "micro-leakage interlayer (MLI)." MLI brings a great new challenge for UGSs construction and operation. The stability evaluation is the main research target of this paper. Laboratory tests have been carried out on samples collected from the target formation to determine the mechanical properties. A 3D geomechanical model of the two adjacent caverns with MLI is established based on the geological data and the laboratory test results. The minimum and maximum limit operating pressures are determined as 6 MPa and 18 MPa based on the numerical simulation results of six operating conditions. Two operating conditions (synchronous and asynchronous injection–production) are designed and discussed. The result shows that the MLI has little effect on the stability of the caverns and can be ignored. The stability under the two operating conditions is quite good, suggesting that asynchronous injection–production can be used in the actual operation. This makes the operation more flexible to meet unpredictable situations. The tightness analysis under the two operating conditions will be the subject of future investigations. [ABSTRACT FROM AUTHOR]

A unique petrified tree fern displaying distinct patterns was recently discovered in northeast China, attracting considerable interest. This study provides a comprehensive set of data for this material obtained through standard gemological testing, petrographic observation, scanning electron microscopy, energy-dispersive spectroscopy, electron probe microanalysis, and Raman spectroscopy. The petrified tree fern exhibits colors ranging from golden yellow to brown, with additional variations caused by iron oxides. Chalcedony is the primary mineral component, while the presence of metastable moganite gives chalcedony its fibrous nature, contributing to the delicate structure of the samples. The surface pattern originates from plant structures preserved during silicification, further confirming the samples belong to the extinct Cretaceous period tree fern Tempskya sp. [ABSTRACT FROM AUTHOR]

Most studies of spatial colocation patterns of crime and land-use features in geographical information science and environmental criminology employ global measures, potentially obscuring spatial inhomogeneity. This study investigated the relationships of three types of crime with 22 types of land-use in Wuhan, China. First, global colocation patterns were examined. Then, local colocation patterns were examined based on the recently-proposed local colocation quotient, followed by a detailed comparison of the results. Different types of crimes were encouraged or discouraged by different types of land-use features with varying intensity, and the local colocation patterns demonstrated spatial inhomogeneity. [ABSTRACT FROM AUTHOR]

Background: Yersinia pestis is the pathogen of the plague and caused three pandemics worldwide. Pneumonic plague is rarer than bubonic and septicemic plague. We report detailed clinical and pathogenic data for all the three sporadic cases of pneumonic plagues in China in 2014.Case Presentation: All the three patients are herders in Gansu province of China. They were all infected by Yersinia pestis and displayed in the form of pneumonic plague respectively without related. We tested patient specimens from the upper (nasopharyngeal swabs) or the lower (sputum) respiratory tract and whole blood, plasma, and serum specimens for Yersinia pestis. All patients had fever, cough and dyspnea, and for patient 2 and 3, unconscious. Respiratory symptoms were predominant with acute respiratory failure. The chest X-ray showed signs consistent with necrotizing inflammation with multiple lobar involvements. Despite emergency treatment, all patients died of refractory multiple organ failure within 24 h after admission to hospital. All the contacts were quarantined immediately and there were no secondary cases.Conclusions: Nowadays, the plague is epidemic in animals and can infect people who contact with the infected animals which may cause an epidemic in human. We think dogs maybe an intermediate vector for plague and as a source of risk for humans who are exposed to pet animals or who work professionally with canines. If a patient has been exposed to a risk factor and has fever and dyspnea, plague should be considered. People who had contact with a confirmed case should be isolated and investigated for F1 antigen analysis and receive post-exposure preventive treatment. A vaccination strategy might be useful for individuals who are occupationally exposed in areas where endemically infected reservoirs of plague-infected small mammals co-exist. [ABSTRACT FROM AUTHOR]

Aims: To assess the demographic, clinical and spinal cord MRI characteristics of clinically definite neuromyelitis optica (NMO) patients for association with anti-aquaporin-4 (AQP4) antibody positivity in Chinese patients. Methods: We recruited 72 consecutive patients with NMO. The clinical assessments, sera and spinal MRI scans were obtained within 1 week after the onset of symptoms of acute myelitis. The statistical significance of potential differences in demographic, clinical and spinal MRI lesion characteristics between the two groups (anti-AQP4 antibody positive vs. negative) was determined using the two-sample t test or Fisher's exact test. Results: Forty-nine patients (49/72, 68.1%) were anti-AQP4 antibody positive and 23 patients (23/72, 31.9%) were anti-AQP4 antibody negative. The only characteristic that was significantly different between the groups was the presence of an enhancing spinal cord lesion (p < 0.001). Conclusion: We found a strong association between serum anti-AQP4 antibody positivity and lesional gadolinium enhancement in patients with clinically definite NMO. These findings support prior evidence that anti-AQP4 antibody could be pathogenic in NMO lesion development. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

There are many factors affecting poverty, among which education is an important one. Firstly, from the perspective of digital statistics, this research quantitatively analyzes the correlation between average education years (AEY) and Gross Domestic Product per capita (GDP/C), and finds that there is a significant positive correlation between AEY and GDP/C in provinces of China. Furthermore, from the perspective of spatial distribution and geostatistics, this research analyzes the correlation between AEY and the distribution of poor counties, revealing the inherent connection between education and poverty. Based on the data processing of nighttime light remote sensing images, this research adopts the machine learning method of random forest to extract the distribution status of spatio-temporal sequences for poor counties. Through the analysis, it is found that poor counties are characterized by centralized distribution and spatial autocorrelation spatially, and the number of poor counties decreases year by year in temporal evolution. On this basis, we analyze the correlation between education levels and the distribution of poor counties. It is found that, on the spatial scale, AEY in poor counties is relatively low, while AEY in non-poor counties is relatively high, showing a significant negative correlation between the two. On the temporal scale, the number of poor counties gradually decreased from 2000 to 2010, and at the same time, the education levels of poor counties also gradually improved. Finally, from the perspective of improving education levels to promote poverty elimination, we analyze the main factors affecting education using Principal Component Analysis (PCA) and other methods and obtain a regression model. This research proposes the Linear and Residual Integration Model (LRIM) to more accurately predict AEY in each province in 2020 based on historical data, and identifies the regions with low AEY as key regions for targeted poverty alleviation through education (TPAE) in the future. This research provides a decision-making basis to achieve TPAE means, helping to achieve the victory of the national education poverty elimination battle. [ABSTRACT FROM AUTHOR]

To determine the distribution of theiceAandbabA2 genotypes ofHelicobacter pyloriin patients with various gastroduodenal diseases in Shanghai, and to explore the association between genotype and the clinical outcome of infection.One hundred and forty-one strains ofH. pyloriwere isolated from gastric biopsies of 43 patients with chronic gastritis, 47 with duodenal ulcer (DU), 30 with gastric ulcer (GU) and 21 with non-cardia gastric carcinoma. TheiceA,babA2, cagAandvacAgenotypes were determined by polymerase chain reaction (PCR).TheiceA1,iceA2 andbabA2 genotypes were detected in 74.5% (105/141), 15.6% (22/141) and 63.8% (90/141), respectively, of theH. pyloristrains studied. TwoH. pyloriisolates (1.4%) were positive for bothiceAalleles and 16 (11.3%) were negative for both. The prevalence ofbabA2 and its combination withcagA(cagA+/babA2+) in DU patients was significantly higher than that in GU patients (74.5%vs50.0% forbabA2,P = 0.028; 70.2%vs46.7% forcagA+/babA2+,P = 0.039). There was no significant difference in the prevalence ofbabA2 among the other disease groups, and no significant association of theiceAgenotypes with the different clinical diseases (P > 0.05).The most predominant genotype of theH. pyloristrains isolated from patients in Shanghai areiceA1+/babA2+, and thebabA2 genotype may play a different role in the pathogenesis of DU and GU. An association betweeniceAstatus and clinical outcome ofH. pyloriinfection could not be confirmed in the present study. [ABSTRACT FROM AUTHOR]

[Display omitted] • A qLAMP method for detection of DIV1 was established and evaluated. • qPCR is more sensitive to DIV1 than qLAMP, and qLAMP is faster than qPCR. • qPCR and qLAMP are suitable methods for the rapid detection of DIV1. Decapod iridescent virus 1 (DIV1) is a new virus discovered in recent years that infects farmed shrimp. DIV1 is highly infectious and causes substantial economic loss to the aquaculture industry of China. To prevent and control the spread and outbreak of DIV1 in a timely manner, it is necessary to establish an efficient method for DIV1 diagnosis. In this study, quantitative real-time polymerase chain reaction (qPCR) and quantitative real-time loop-mediated isothermal amplification (qLAMP) detection methods were established based on the specific sequence of the viral ATPase gene. The results indicated that the minimum detection limits of qPCR and qLAMP were 1.9 × 101 copies/μL and 1.9 × 102 copies/μL, respectively; the designed primer had good specificity for DIV1 and did not react with 13 other viruses, including white spot syndrome virus (WSSV), Enterocytozoon hepatopenaei (EHP), acute hepatopancreatic necrosis disease (AHPND), infectious hypodermal and haematopoietic necrosis virus (IHHNV), etc. A total of 43 clinical samples suspected of DIV1 infection were diagnosed by qPCR and qLAMP. Our qPCR demonstrated results consistent with a qPCR assay published previously, and the diagnostic sensitivity (DSe) and diagnostic specificity (DSp) of qLAMP were 85.71% and 100%, respectively. This result indicates that qPCR and qLAMP have good accuracy in the detection of DIVI in clinical samples. As established in this study, qPCR and qLAMP combined with a comprehensive comparative analysis can provide effective new solutions for the detection of DIV1. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to (1) assess parental hesitancy about category A (Expanded Program on Immunization (EPI)) and B (non-EPI) vaccines, (2) assess parental willingness for COVID-19 and influenza vaccinations, and (3) explore the association of vaccination hesitancy of parents and healthcare workers (HCWs). Methods: The study was performed in Wuxi, eastern China between 21 September 2020 and 17 October 2020. Parents of children aged <18 years and HCWs were recruited from the selected immunization clinics. Vaccine hesitancy was assessed using the Strategic Advisory Group of Experts (SAGE) vaccine hesitancy survey (VHS) by summing the total score for 10 items (maximum 50 points). Results: A total of 3009 parents and 86 HCWs were included in the analysis. The category A VHS scores were significantly higher than the category B VHS scores (p = 0.000). Overall, 59.3% and 52.4% of parents reported willingness to avail COVID-19 and influenza vaccination for their children, respectively; 51.2% of the HCWs wanted to be vaccinated against COVID-19. Parental category B VHS scores were associated with HCW category B VHS scores (r = 0.928, p = 0.008). Conclusions: In China, parents are more hesitant about category B vaccines than category A vaccines. More than 40% of parents showed hesitancy and a refusal to use COVID-19 and influenza vaccines. [ABSTRACT FROM AUTHOR]

Increasing afforestation efforts are made in the southeastern Gobi in the Inner Mongolia Autonomous Region of China, where tree and grass coexist. However, afforestation that does not consider climate carrying capacity and afforestation at the cost of grassland reduction have caused more and more drawbacks, although forests are of global significance for preventing dust storm emission. Reconstructions of historical forest and grassland cover, forest-grassland interactions, and drivers are urgently required to test the predictions of ecosystem models that support afforestation. Based on a robust reconstruction method applied to a 19,000-year long pollen sequence from northern China, we show that tree cover peaked during the early Holocene (30.7 ± 12.3%) and gradually declined to 13.2 ± 4.3% during the last two centuries. Temperature, precipitation, and fire drove the postglacial evolution of tree and grass cover, and forest may suppress grassland when tree cover is higher than 13.8%. Our study suggests that a cautious approach should be taken regarding the risks posed by afforestation efforts in the southeastern Gobi. • Reconstruction of tree and grass cover based on random forest model. • Tree cover peaked during the early Holocene (30.7 ± 12.3%). • Climate and fire are the main drivers of tree and grass cover. • Forest may suppress grassland when tree cover is higher than 13.8%. • Afforestation should weigh tree cover and grass cover. [ABSTRACT FROM AUTHOR]

Underground salt caverns provide appropriate space for storing natural gas. However, salt caverns have to be constructed in bedded salt formations in China. The traditional construction method of salt cavern encounters serious problems in such formations. Instead, horizontal salt caverns are proposed as a possible alternative for gas storage. Horizontal caverns can be created by "multi-step retreating" (MSR) method. Two laboratory tests were conducted to understand the shape development and flow field of such cavern. In one test, we measured fluid velocity distribution in a simulated salt cavern environment by particle image velocimetry technology. In another test, the construction process of a salt cavern was simulated through MSR method. Results show that the flow field in horizontal cavern can be divided into five regions. The flow characteristics and rock salt dissolution properties in these regions are different. A semi-cylindrical cavern with similar cross section shape along the horizontal direction is obtained through the physical experiment. This study provides important guidance for analyzing the flow field and construction process of the horizontal salt cavern. • The fluid velocity distribution in a simulated horizontal salt cavern was obtained by PIV technology. • Five different flow zones are delimited and described according to their properties. • A physical test is conducted to simulate the construction process of horizontal cavern through MSR method. [ABSTRACT FROM AUTHOR]

The post-collisional ultramafic intrusions within the northern margin of the North China Craton (NCC) preserve important imprints of crust-mantle interaction. Here we investigate ultramafic intrusions from the Luojianggou complex composed of pyroxenite and hornblendite associated with serpentine, with a view to gain insights into the nature of orogenic lithospheric mantle in this major continental collision zone. Zircon U Pb data from the ultramafic suite define different age populations, with Paleoproterozoic ages (>2.2 Ga and 1.82 Ga) representing xenocrystic grains captured from the basement. The magmatic zircon grains range in age from 872 Ma to 458 Ma, and are possibly related to multiple magma emplacement associated with the Paleo-Asian Ocean closure. The youngest age of ca. 230 Ma is related to a period of post-collisional extension in the northern margin of the NCC, and this inference is further supported by apatite U Pb ages of ∼207 Ma. Phase equilibrium modeling suggests temperatures of 700–800 °C and pressures of 11–13 Kbar. The pyroxenite and hornblendite show similar geochemical features and REE patterns, indicating the same magma source and formation through differentiation and accumulation. The arc-like geochemical features of the rocks with enrichment of LILE (Rb, Th and La) and LREE, but depletion of HFSE (Nb, Zr and Hf), possibly formed at the boundary of sub-continental lithospheric mantle (SCLM) and crust through metasomatic reaction of peridotite with felsic melts derived from subduction-related components. The arc-like features, zircon rare earth element patterns and obvious positive Pb anomaly in primitive mantle-normalized trace element spidergrams also indicate the mixing of continental materials in the magma source. The post-collisional extensional setting is correlated to the tectonics associated with the assembly of the Mongolian arc terranes within the northern NCC during the Triassic. • U Pb zircon (∼230 Ma) and apatite (∼205 Ma) ages constrain the timing of Triassic magmatism. • Fractional crystallization and crystal accumulation from tholeiitic mafic magma. • Crust-mantle interaction with emplacement in post-collisional setting. • Tectonics related to the assembly of Mongolian arc terranes within the northern NCC. [ABSTRACT FROM AUTHOR]

Small Tail Han Sheep are an excellent local sheep breed in China, and their outstanding reproductive performance is one of their very important biological characteristics. Clarifying the ovary development process of these ewes should provide a theoretical basis for improving their reproductive efficiency. In this study, we identified the differentially expressed (DE) microRNAs (miRNAs) in 2-, 6-, and 12-month-old small-tail Han sheep ovaries by constructing and analyzing the miRNA expression profiles. These findings clarify the molecular mechanisms regulating the excellent reproductive performance of small-tail Han ewes. We used RNA-Seq technology and bioinformatic to analyze these profiles. Eleven, 13, and 19 DE miRNAs were identified in the 2- vs 6-, 6- vs 12-, and 2- vs 12-month-old ovaries, respectively. In total, 54, 37, and 198 predicted target genes of these DE miRNAs were identified in these three groups, respectively. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses showed that in the 2- vs 6-month-old ovaries, the target genes of DE known sheep miRNAs were involved in 102 GO terms and seven signaling pathways; in the 6- vs 12-month-old ovaries, the target genes of DE known sheep miRNAs were involved in 52 GO terms and three signaling pathways; and in the 2- vs 12-month-old ovaries, the target genes of DE known sheep miRNAs were involved in 88 GO terms and six signaling pathways. Three miRNA–target regulatory networks were constructed based on these DE miRNA–target interactions. Nine miRNAs were selected to confirm to the accuracy of the miRNA sequencing data with qRT-PCR. The site at which oar-miR-432 binds RPS6KA1 was determined with a dual-luciferase system. This is the first integrated analysis the expression profiles of miRNAs and their targets during ovarian development in small-tail Han sheep. These data clarify the molecular regulatory mechanisms underlying sheep ovarian development and identify biomarkers that influence the reproductive performance of small-tail Han ewes. • cDNA library was constructed in 2- vs 6-, 6 vs 12-, and 2- vs 12-month-old ovaries of Small Tail Han Sheep. • Eleven, 13, and 19 DE miRNAs and miRNA–targets were identified in 2- vs 6-, 6 vs 12-, and 2- vs 12-month-old ovaries respectively by RNA-seq and bioinformatics analyses. • In total, 54, 37, and 198 predicted target genes of DE miRNAs were identified; also GO and KEGG analyses were showed. • Our study is the first to reveal that RPS6KA1 was targeted by oar-miR-432 and played an important role in Small Tail Han Sheep ovarian development. [ABSTRACT FROM AUTHOR]

Soil aggregate stability is critical to ensure the provision of agricultural land. Mulched drip irrigation (MDI) is widely used in arid region of northwest China, but the response of soil aggregate stability to soil organic carbon (SOC) and salinity as affected by continuous MDI is still unclear. In this study, we examined four MDI ages (9, 13, 15, and 23 years) of cotton fields that were converted from wasteland (CK, 0 year) and evaluated the impact of MDI age on soil aggregate size distribution, aggregate stability, and aggregate-associated SOC/salinity. The results showed that the proportion of macro-aggregates (>0.25 mm) and aggregate stability (MWD, GMD) initially decreased and then increased as MDI age progressed. As MDI age increased, the concentration of aggregate-associated SOC in all fractions significantly increased, while salt concentration significantly declined. Compared to the CK (0 year), the total SOC stock in cotton fields aged 9, 13, 15 and 23 years increased by −0%, 11%, 17%, and 87%, respectively; whereas the total salt stock decreased by 33%, 68%, 67%, and 76%, respectively. Moreover, due to the significant increase in macro-aggregate content and associated SOC concentration with MDI age, the storage of SOC in older MDI ages (15–23 years) was more reliant on macro-aggregates. Pearson correlation and principal component analysis indicated a negative correlation between salinity and macro-aggregates, aggregate stability, and SOC, while there was a positive correlation among MDI age, SOC, macro-aggregates, and aggregate stability. Based on our findings, we concluded that long-term MDI promotes the formation of macro-aggregates, enhances aggregate stability by reducing soil salinity and increasing SOC stock. • Long-term MDI strongly affects soil aggregate characteristics. • Long-term MDI significantly increased SOC stock and decreased soil salt stock. • SOC and salinity are key factors affecting macro-aggregates formation under MDI. • SOC storage is primarily dependent on macro-aggregates under long-term MDI. [ABSTRACT FROM AUTHOR]

[Display omitted] • SOC, microbial PLFAs and aggregate fractions analyzed across soil-landscapes. • Macroaggregate abundance and pore structure shifted with soil-landscapes change. • Macroaggegate porosity closely linked to SOC and microbial PLFA abundance. • Paddy conserved macroaggregate functionality rather than dry cropland. • Combination of CT and PFLA methods provides more information about C turnover. Mosaic soil-landscapes with varying landforms and land covers are common in hilly areas of the lower Yangtze Valley in China. Soil-health variations, primarily driven by soil organic matter (SOM) and aggregation, across these soil-landscapes affect agro-industrial development in rural areas. Macroaggregates, through their pore structure, SOM storage and microbial community habitat, the variation among soil-landscape remains unaddressed. In this study, undisturbed topsoils (0–15 cm) were collected from forestland (FL) on hillslope, orchards (OR) and uplands (UL) on downland, and paddy fields (PF) in basin of a small watershed in Nanjing suburb. Soil organic carbon (SOC) pools and microbial phospholipid fatty acids (PLFAs) were measured while water-stable aggregates were size-fractionated. Macroaggregate samples were analyzed for micro-pore structure with X-ray micro-computed tomography (X-ray μCT). Compared with FL, topsoil SOC was lower by 54 %-70 %, mean weight diameter by 41–67 %, and total PLFAs by 14 %-42 % in agriculture landscapes (OR, DL and PF). Meanwhile, macroaggregates mass proportion was more than 44 % lower in OR, UL and PF than in FL. The macroaggregate total porosity was lower by 17 % and 33 % in UL and OR, respectively, although it was unchanged in PF. The connected, elongated and meso- porosities as well as total throat area exhibited a similar trend. Except for pore number but total, connected, elongated and meso- porosities, as well as total throat area were significantly positively correlated with SOC or microbial PLFAs in macroaggregate. The results indicated that the agricultural activity altered the pore structure of macroaggregates, potentially reducing the functional services of macroaggregates such as SOC preservation and microbial biomass conservation. Furthermore, the positive correlation between SOC content, microbial abundance and macroaggregate porosity indicated enhancing the aggregate structure was essential for improving the aggregate function, which was crucial for comprehending the mechanism of soil-landscapes affecting soil aggregation and function. [ABSTRACT FROM AUTHOR]

Biodegradable film (BF), as a superior substitute for traditional polyethylene film (PF), has experienced a consistent increase in China. However, a significant research gap persists regarding the utilization of BF in assessing farmland carbon balance. This experiment examined the responses of maize growth, yield, irrigation water productivity (IWP), CO 2 emissions, and field net carbon sequestration (NCS) to two BF types (BF 1 , 100-day induction period, and BF 2 , 80-day induction period), and PF, and three irrigation amounts (I 1 , I 2 , I 3 : 5250, 5625, and 6000 m3 ha–1), by conducting a two-year (2019–2020) field trial in a typical arid and semi-arid region of China. The results indicated that biodegradable film mulching (BFM) negatively affected maize growth, resulting in reduced yield and IWP. Especially under the I 1 irrigation level, the biodegradable film reduced maize yield by 6.26%–13.99% and IWP by 6.64–13.85%. Notably, in the I 2 irrigation level, BF 1 mulching had a comparable impact on maize yield and IWP to that of PF. Additionally, the increase in irrigation amounts exerted a more pronounced promoting effect on maize total biomass than on yield and IWP. Concerning carbon balance, short-term BF application resulted in reduced CO 2 emissions (5.74–6.30% under BF 1 and 9.27–12.37% under BF 2), without any significant impact on NCS in cropland. Taking into account the economic value of maize and farmland ecology, we recommended utilizing irrigation amounts of 5625 m3 ha–1 for BF application in arid areas, while opting for a BF with a longer induction period whenever feasible. • Biodegradable film mulching reduces maize yield and irrigation water productivity. • Biodegradable film mulching significantly decreases soil CO 2 emissions. • Increasing irrigation compensates for yield loss due to biodegradable film mulching. • Biodegradable film with a 100-day induction period is an ideal covering material. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the work status of clinicians in China and their management strategy alteration for patients with hepatocellular carcinoma (HCC) during the COVID-19 pandemic. A nationwide online questionnaire survey was conducted in 42 class-A tertiary hospitals across China. Experienced clinicians of HCC-related specialties responded with their work status and management suggestions for HCC patients during the pandemic. 716 doctors responded effectively with a response rate of 60.1%, and 664 were included in the final analysis. Overall, 51.4% (341/664) of clinicians reported more than a 60% reduction of the regular workload and surgeons declared the highest proportion of workload reduction. 92.5% (614/664) of the respondents have been using online medical consultation to substitute for the "face-to-face" visits. Adaptive adjustment for the treatment strategy for HCC was made, including the recommendations of noninvasive and minimally invasive treatments such as transcatheter arterial chemoembolization for early and intermediate stage. Targeted therapy has been the mainstay for advanced stage and also as a bridge therapy for resectable HCC. During the COVID-19 pandemic, online medical consultation is recommended to avoid social contact. Targeted therapy as a bridge therapy is recommended for resectable HCC considering the possibility of delayed surgery. [ABSTRACT FROM AUTHOR]

• Effect of tidal creeks on S. alterniflora invasion at both landscape and patch scales. • Medium-resolution images reveal tidal creeks promoting S. alterniflora expansion. • An improved spatially explicit individual-based model for expansion simulation. • High-resolution images help better simulate long-distance seed dispersal. Rapid expansion of Spartina Alterniflora (S. alterniflora) has led to severe ecological consequences in coastal wetlands in China. Better understanding of the mechanism of S. alterniflora expansion is of great importance for its control and management. Although previous research has reported that the expansion of S. alterniflora is closely related to tidal creeks via field investigations, few studies have quantitatively investigated their relationships using remote sensing at different scales. In this study, we utilized time series satellite remote sensing imagery with different spatial resolutions to investigate the effects of tidal creeks on S. alterniflora expansion at both landscape scale and patch scale. We took the Yellow River Delta (YRD), China as our study area, where S. alterniflora has spread across the intertidal wetlands during the past decade. At landscape scale, we first derived the yearly maps of S. alterniflora and tidal creeks during 2009–2020 based on Landsat-series satellite imagery, then analyzed the spatio-temporal relationship between S. alterniflora and tidal creeks. By using grid analysis method, we evaluated the change of S. alterniflora area and tidal creek length and compared their change time. The results showed that 30.46 % of the grids experienced no change in tidal creeks while expansion of S. alterniflora , and 54.02 % of the grids experienced S. alterniflora area increase after the lengthening of tidal creeks. The results indicated that relationship between tidal creeks and S. alterniflora in YRD was dominated by "tidal creeks promoting S. alterniflora expansion". We then simulated the S. alterniflora expansion at patch scale using an improved spatially explicit individual-based model based on S. alterniflora maps derived from Landsat imagery (30 m) and GF-1 high spatial resolution imagery (2 m), respectively. The results showed that consideration of long-distance dispersal of seeds along the direction of tidal creeks considerably enhanced the simulation accuracy, regardless of the spatial resolution of the S. alterniflora maps. High-resolution S. alterniflora maps yielded higher simulation accuracies. Our study suggests that the long-distance dispersal of seeds led by tidal creeks is an important manner for S. alterniflora expansion. Satellite remote sensing imagery have great potential to discover the mechanism of S. alterniflora expansion, facilitating control of S. alterniflora at the early invasion stage. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) can be classified into 4 subgroups based on genotype variation of the glycoprotein B (gB) encoded by UL55 gene. Little is known about the CMV gB genotype distribution and its clinical implication in patients who receive hematopoietic stem cell transplant (HSCT) in China. In this study, which comprises 101 HSCT patients with CMV infection, we have found that 36 patients (35.64%) were infected with CMV genotype gB1, 3 patients (2.97%) with gB2, 39 patients (38.61%) with gB3, 1 patient (0.99%) with gB4, and 17 patients (16.83%) were infected with mixed CMV genotypes. We also found that CMV gB3 was associated with a high risk of CMV pneumonitis; nevertheless, there were no significant differences among patients with gB genotypes with respect to the other CMV diseases; no significant differences between patients with gB genotypes with respect to type II-IV acute graft-verses-host disease (aGVHD) and chronic GVHD (cGVHD) was found either. Interestingly, 5 patients (4.95%) were infected with a CMV variant that lacked a signature RsaI digestion site determined by Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), subsequent cloning and sequencing identified this CMV RsaI minus variant to be novel, herein designated as gB5. Overall, these findings suggest that CMV gB1 and gB3 are prevalent among HSCT recipients with CMV infections, and gB3 CMV infection is a risky indicator for CMV pneumonitis; furthermore, a novel CMV variant in a subset of Chinese HSCT recipients is identified and designated as gB5. [Copyright &y& Elsevier]

To better understand the nature and causes of boreal forest change and, in particular, the role of permafrost dynamics, we reconstruct the recent vegetation history of the Greater Hingan Mountains of northeast China based on a lake sediment core. This core is located in an area of boreal forest underlain by permafrost, and spans a 1000-year warming-to-cooling cycle. Palynological assemblages indicate that, throughout most of its history, vegetation was characterized by changes in the relative proportions of taxa, including the cold-resistant boreal conifer species Larix and Pinus, and warmth-adapted temperate broadleaf shrub species Corylus and Rhododendron, corresponding to variations in temperature. However, after ~1950 CE, rapid warming led to the breakdown of this relationship between vegetation and climate, and the proportion of conifers increased in the short term, most likely due to permafrost thawing. This effect was most pronounced in lowland areas whose frost table depth was initially ~20 cm closer to the surface than the corresponding frost table on mountain slopes. The increase in frost table depth due to warmer temperatures provided greater root space for shallow-rooted conifers in lowlands, as well as meltwater from thawing permafrost. We speculate that the coupled system of vegetation, climate and permafrost was stable before ~1950 CE; however, most recently, there has been a transition due to warming-induced permafrost thawing. As the southern boundary of permafrost moves poleward, it is suspected that lowland rather than slope sites will witness the sharpest vegetation shifts. • Vegetation development at the southern boreal forest margin was reconstructed • Coupling system of vegetation, climate and permafrost was stable before 1950s • Accelerated permafrost melting has changed the lowland vegetation since 1950s • Lowland rather than slope could witness the sharpest vegetation shift [ABSTRACT FROM AUTHOR]

Forest-steppe ecotones are generally regarded as very sensitive to climate change. However, it is still unclear whether they can be used to track past climate changes due to the combined effects of climate forcing and topographic factors. We first explored shifts of the whole forest-steppe ecotone in northern China during the Holocene by collecting 383 topsoil pollen samples to establish discriminant functions representative of forest, forest-steppe ecotone, and temperate steppe. The discriminant functions were applied to 39 fossil pollen sites to reconstruct the range of the forest-steppe ecotone during the Holocene. Our results showed that the shift of the forest-steppe ecotone exhibited a generally consistent trend with the intensity of the EASM, which was characterized by southward retreat during the early Holocene from 12,000 to 8000 cal. yr BP, northward expansion during the middle Holocene from 8000 to 4000 cal. yr BP, and southward retreat during the late Holocene from 4000 to 0 cal. yr BP, suggesting a dominant role of precipitation provided by the EASM. However, some sites in mountainous regions still indicated forest group membership within the ecotone, implying possible vertical forest migration. We stress that EASM and topography co-determine the shift of the forest-steppe ecotone in northern China, and mountainous terrain differences also benefit the vertical forest migrations when threatened by the dry climate. Our study implies that future climate change may cause three-dimensional changes in vegetation, which should be considered in climate change mitigation. • East Asian summer monsoon and topography co-determine the shift of the forest-steppe ecotone in northern China. • Mountainous terrain differences also benefit the vertical forest migrations when threatened by the dry climate. • The climate indication of the forest-steppe ecotone needs to be considered from three dimensions. [ABSTRACT FROM AUTHOR]

• Grassland was more effective to reduce soil erodibility on steep gully slopes. • Vegetation growth induced temporal variations in soil erodibility indicators. • Temporal variations in soil erodibility indicators related to root mass density. • Bothriochloa ischaemum (Linn.) Keng was the most effective grass community. Near soil-surface characteristics change considerably with vegetation growth during one growing season, and thus likely induce the temporal variations in soil erodibility indicators. This study was performed to investigate the temporal variations in soil erodibility indicators under different vegetation-restored gully slope lands on the Loess Plateau of China. Soil erodibility indicators included the K factor, mean weight diameter (MWD), mean number of drop impacts (MND), saturated conductivity (K s), cohesion (Coh), penetration resistance (PR), and one comprehensive soil erodibility index (CSEI). One slope cropland (as the control) and seven vegetation-restored gully slope lands were selected to measure soil erodibility indicators for seven times from April 23 to October 10, 2018. Near soil-surface characteristics were also measured to explain the temporal variations in soil erodibility indicators. The results showed that the temporal variations in soil erodibility indicators of different vegetation lands were similar. The K factor fluctuated considerably, while the MWD , MND , K s , Coh , and PR gradually increased over time. However, all erodibility indicators of the control cropland fluctuated over time with no distinctive trend. The CSEI of all sites fluctuated significantly over time. Compared to the control cropland, the mean K factors of different vegetation lands decreased by 2%–24%, but the mean values of MWD , MND , K s , Coh , and PR increased by 108%–217%, 152%–343%, 94%–306%, 73%–175%, and 30%–199%, respectively. Consequently, the mean CSEI of different vegetation lands was reduced by 41% to 86%. The temporal variations in soil erodibility indicators were closely related to the seasonal changes in root mass density. Bothriochloa ischaemum (Linn.) Keng was considered the most effective restoration community to reduce soil erodibility of steep gully slope lands. The results contribute to improving the eco-environment on the Chinese Loess Plateau. [ABSTRACT FROM AUTHOR]

Landfill leachate contributes significantly to the presence of pharmaceuticals and personal care products (PPCPs) in the environment, and is a crucial source of contamination. To examine the occurrence of PPCPs and microbial communities, this study comprehensively investigated the concentrations of PPCPs and the abundance of microorganisms in the leachate from 17 municipal landfills across China. Generally, Lidocaine, Linear alkylbenzene sulfonate-C11, and Triclocarban, which are closely associated with human activities, exhibited a detection frequency of 100 % in the leachate. Driven by consumer demand, analgesic and antipyretic drugs have emerged as the most prominent PPCPs in leachate (accounting for 39.9 %). Notably, the Ibuprofen peaked at 56.3 μg/L. Regarding spatial distribution, the contamination of PPCPs in leachates from the eastern regions of China was significantly higher than that in other regions, owing to the level of economic development and demographic factors. Furthermore, the 16S rRNA results revealed significant differences in microbial communities among the leachates from different areas. Although the impact of PPCPs on microbial communities may not be as significant as that of environmental factors, most positive correlations between PPCPs and microorganisms indicate their potential role in providing nutrients and creating favorable conditions for microbial growth. Overall, this research offers new perspectives on the residual features of PPCPs and the microbial community structure in leachates from various regions in China., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

As the primary goal of the 17 Sustainable Development Goals (SDGs), poverty eradication is still one of the major challenges faced by countries around the world, and relative poverty is a comprehensive poverty pattern triggered by the superposition of economic, social, and environmental dimensions. Therefore, Therefore, this paper introduces the perspective of coupled coordination to consider the formation of relative poverty, constructs indicators in three major dimensions: economic, social, and environmental, proposes a fast and more accurate method of identifying relative poverty in a region by using machine learning, measures the degree of coupled coordination of China's relatively poor provinces using a coupled coordination model and analyzes the relationship with the level of relative poverty, and puts forward suggestions for poverty management on this basis using typology classification. The results of the study show that: 1) the fusion of data crawlers, remote sensing space, and other multi-source data to construct the dataset and propose a fast and efficient regional relative poverty identification method based on big data with low comprehensive cost and high identification accuracy of 0.914. 2) Currently, 70.83% of the economic-social-environmental systems of the relatively poor regions are in the dysfunctional type and are in a state of disordered development and malignant constraints. The regions showing coupling disorders are mainly clustered in the three southern prefectures of Xinjiang, Qinghai, Gansu, Yunnan, and Sichuan, and their spatial distribution is relatively concentrated. 3) The types of poverty and their coupled and coordinated development in each region show large spatial variability, requiring differentiated poverty eradication countermeasures tailored to local conditions to achieve sustainable regional economic-social-environmental development., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Water replenishment is an important measure for maintaining and improving the aquatic environmental quality of lakes. The problems of water quality deterioration and water shortage can be alleviated by introducing water of higher quality. However, the mechanism of water replenishment in the improvement of the water quality and trophic status of lakes remains unclear. This study investigated water replenishment in Wuliangsuhai Lake (WLSHL) from 2011 to 2021 by collecting seasonal water samples and conducting laboratory analyses. Water replenishment was found to be capable of significantly improving lake water quality and alleviating eutrophication. It is worth noting that single long-term water replenishment measures have limitations in improving the water quality and trophic status. The whole process was divided into three stages according to the water quality and trophic status, namely the buffer period, decline period, and stable period. During the buffer period, the water quality and trophic status showed only slight improvement because of the small amount of water replenishment and the low proportion of higher-quality water from the Yellow River. In the decline period, with increasing water replenishment, the proportion of higher-quality water from the Yellow River gradually increased, leading to the most significant and stable degree of improvement. In the stable period, increases in the amount of water replenishment had little effect on improving the water quality and trophic status, which is attributable to the balance between internal pollutants (lake water-sediment), and the balance between internal-external pollutants (lake water-irrigation return flow + Yellow River water). On the premise of stable water quality, with eutrophication control as the management goal, the optimal water replenishment would be approximately 10.58 ×10 8 m 3 . Further necessary measures for solving aquatic environmental problems include the combination of sediment dredging, optimization of the water replenishment route, and implementation of quality management in water replenishment., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Campylobacter upsaliensis was the most common Campylobacter species in pets' gastrointestinal tracts and has been isolated from patients with bacteremia, hemolytic-uremic syndrome, spontaneous abortion, and Guillain-Barré syndrome. However, the genetic characteristics and the full extent of its significance as a human pathogen remain to be fully understood. This study involved an investigation for genomic analysis of 154 strains from different sources and additional antimicrobial resistance profiles of 26 strains for this species. The genomes contained 1,558-1,971 CDS and the genome sizes were estimated to vary from 1.53 Mb to 1.86 Mb, with an average GC content of  34.71%. The entire analyzed genomes could be divided into three clades (A, B, and C) based on ANI and phylogenomic analysis. Significantly, nearly all strains in Clade B were isolated from patient samples, and the virulence-related sequences FlgD, GmhA, and CdtC might serve as determining factors for the classification of Clade B. Half of the tested isolates had MIC values over 64 μg mL -1 for nalidixic acid, gentamicin, and streptomycin. Isolates from pets in China carried more resistant elements in the genomes. This study both provided a comprehensive profile of C. upsaliensis for its genomic features and suggested some pathogenic agents for human infection with this species.

HLA-DRB5*01:01:01:07 differs from HLA-DRB5*01:01:01:01 by two nucleotide changes in intron 1 and intron 2., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The present study validated the bifactor model of the Material Values Scale (MVS) and examined the association between materialism and subjective well-being (SWB). Study 1 utilized a material values questionnaire that 1673 college students completed. Confirmatory factor analysis results indicated that the bifactor model of the MVS had a better fit than other models. Likewise, the findings were replicated in Study 2 using a larger sample size ( N = 2627). Through structural equation modeling, only the general and specific factors of success were found to be negative predictors of SWB. Our study both provides a methodological reference for measuring the MVS and compensates for the limitations of MVS measurement results., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Vaccination uptake rates for adolescents are still low in China despite safe and effective human papillomavirus vaccines being available. The awareness and attitudes of parents to HPV vaccines play a decisive role in adolescents' HPV vaccination uptake., Methods: A cross-sectional study was conducted from March, 2022 to May, 2022 using an anonymous questionnaire among parents of 9 to 18 years of age from 73 cities in 23 provinces in mainland China. Demographic characteristics of parents, their knowledge and attitudes about HPV and HPV vaccination, as well as factors influencing HPV vaccination in adolescents were assessed., Results: More than two-thirds of parents heard of HPV (75.5%) and HPV vaccines (84.7%). Of these participants, mothers (83.8%) were in the majority. Parents willing to vaccinate themselves and their children against HPV were 84.9% and 87.6%, respectively. Parents were more likely to vaccinate their daughters against HPV than their sons (P < 0.001). Parents who had heard of the HPV vaccines (P = 0.028) or had vaccinated themselves (P < 0.001) were more likely to have HPV vaccination for their children. Parents who accepted the price of the HPV vaccines (P = 0.005) were more likely to have their children vaccinated against HPV., Conclusions: Children's gender, awareness of the HPV vaccines, parental HPV vaccination, and the price of the HPV vaccines are likely to be the reason for parents' vaccine hesitancy for adolescents., Practice Implications: Nurses have a critical role in identifying parental hesitancy and providing individualized education to expand the parental awareness and knowledge and encourage on-time adolescents vaccination., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Vaccine hesitancy was listed as one of the top 10 issues threatening global health in 2019. The objectives of this study were to (a) use an extended protection motivation theory (PMT) with an added trust component to identify predictors of vaccine hesitancy and (b) explore the predictive ability of vaccine hesitancy on vaccination behavior., Methods: We conducted an online questionnaire from February 9 to April 9, 2021, in China. The target population was Chinese residents aged 18 and over. A total of 14,236 responses were received. Structural equation modeling was used to test the extended PMT model hypotheses., Results: A total of 10,379 participants were finally included in this study, of whom 52.0% showed hesitancy toward vaccination. 2854 (27.5%) participants reported that they got flu shots in the past year, and 2561 (24.7%) participants were vaccinated against COVID-19. 2857 (27.5%) participants engaged in healthcare occupation. The model explained 85.7% variance of vaccine hesitancy. Self-efficacy was the strongest predictor, negatively associated with vaccine hesitancy ( β  = -0.584; p < .001). Response efficacy had a negative effect on vaccine hesitancy ( β  = -0.372; p < .001), while threat appraisal showed a positive effect ( β  = 0.104; p < .001). Compared with non-health workers, health workers showed more vaccine hesitancy, and response efficacy was the strongest predictor ( β  = -0.560; p < .001). Vaccine hesitancy had a negative effect on vaccination behavior ( β  = -0.483; p < .001), and the model explained 23.4% variance of vaccination behavior., Conclusions: This study demonstrates that the extended PMT model is efficient in explaining vaccine hesitancy. However, the predictive ability of vaccine hesitancy on vaccination behavior is limited.

Based on a nationwide micro-survey in China from 2018 to 2021, this paper empirically estimates the causal impact of the COVID-19 pandemic on the mental health of Chinese residents, by exploiting the distribution of the outflow population from Wuhan as an instrumental variable (IV). Our findings suggest that for every 10% increase in the cumulative confirmed cases, the number of mentally unhealthy days reported by urban residents in the past 30 days will increase by 2.19, an increase of 46.90% compared with the mean value. The impact is more significant among females, people aged 30 or above, and private-sector employees. Further evidence highlights the negative impact of the COVID-19 pandemic on residents' expectations of future income and confidence in macroeconomic development, both of which we interpret as mechanisms related to economic concerns. In addition, application of the multi-period difference-in-differences (DID) strategy revealed that the negative impact still exists two years post-pandemic, but it has been dramatically alleviated since the initial stage.