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Coping with evolution and the changes it brings to the workplace remains a major concern for organizational leaders. This study explores the hotspots, trends, and future directions of the field of organizational unlearning to complement the extant research. A bibliometric analysis based on the literature collected by the Web of Science database was used to categorize or cluster different authors, their countries, institutions and different keywords (cooperation among authors, co-citation, co-occurrence of keywords), to discover their uniqueness or determine the relationship between them while using CiteSpace software to draw knowledge graphs and then results. This study advances the debate on sustainable knowledge acquisition in organizations and its interaction with organizational unlearning. It directly aids the process of radical change in workplace learning and training models and provides a clear view of the previous literature on organizational unlearning by laying a solid foundation for future research in the field of learning.

Background: Depression and anxiety symptoms among medical students are often a concern. The Patient Health Questionnaire-Four (PHQ-4), an important tool for depression and anxiety screening, is commonly used and easy to administer. This study aimed to assess and update the longitudinal measurement invariance and psychometric properties of the simplified Chinese version. Methods: A three-wave longitudinal survey was conducted among healthcare students using the PHQ-4. Structural validity was based on one-factor, two-factor, and second-order factor models, construct validity was based on the Self-Rated Health Questionnaire (SRHQ), Sleep Quality Questionnaire (SQQ), and Rosenberg Self-Esteem Scale (RSES), and longitudinal measurement invariance (LMI), internal consistency, and test–retest reliability were based on structural consistency across three time points. Results: The results of the confirmatory factor analysis indicated that two-factor model was the best fit, and LMI was supported at three time points. Inter-factor, factor-total, and construct validity correlations of the PHQ-4 were acceptable. Additionally, Cronbach's alpha, McDonald's omega, and the intraclass correlation coefficient demonstrated acceptable/moderate to excellent reliability of the PHQ-4. Conclusions: This study adds new longitudinal evidence that the Chinese version of the PHQ-4 has promising LMI and psychometric properties. Such data lends confidence to the routine and the expanded use of the PHQ-4 for routine screening of depression and anxiety in Chinese healthcare students. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of ofatumumab in the treatment of neuromyelitis optica spectrum disorders (NMOSDs). Methods The clinical data of 25 patients with NMOSDs hospitalized in The First Affiliated Hospital of Zhengzhou University from April 2022 to March 2023 and treated with ofatumumab were retrospectively analyzed. They were divided into 2 groups, Group A with 12 cases receiving regular medication, and Group B with 13 cases receiving medication based on the percentage of CD19+B lymphocytes. Annual relapse rate (ARR), the number of relapses, the frequency and time of relapses, and the symptoms of relapses were calculated before and at one year of medication. The neurological function was assessed by Expanded Disability Status Scale (EDSS) before and at one year of medication. The adverse drug reactions were recorded during medication. Results After one year treatment with ofatumumab, 3 patients (12%) experienced recurrence. One patient in Group A experienced recurrence twice, one month and 5 months after treatment, respectively. At the second recurrence, the percentage of CD19+B lymphocytes was 2.80%. Two patients in Group B experienced recurrence, one patient relapsed twice at 2 and 6 months after medication. The percentage of CD19+B lymphocytes was 0.80% and 0.21%, respectively; another patient relapsed once at 2 months after medication. At the time of recurrence, the percentage of CD19+B lymphocytes was 0.70%. There was a statistically significant difference in ARR before and after one year treatment (F = 29.061, P = 0.000). After one year's treatment, the ARR of Group A (t = 13.215, P = 0.001) and Group B (t = 19.259, P = 0.000) was decreased than before. There were 8 cases of the injection site pain, 3 cases of fever after injection, and one case of headache after injection. There were no serious adverse reactions such as disability and death, and EDSS scores were not increased. Conclusions Continuous administration of ofatumumab every 3 months or based on the percentage of CD19+B lymphocyte can reduce recurrence. Combination with corticosteroids should be alert to the risk of infection. [ABSTRACT FROM AUTHOR]

Background and Aims: The prevalence of gestational diabetes mellitus (GDM) continues to increase, and the phenomenon of women giving birth at an older age is becoming more common worldwide. Less is known abouts the impact of GDM combined with advanced maternal age (AMA) on pregnancy outcomes. To explore the impact of AMA complicated with GDM on pregnancy outcomes. Methods: This study included 34,602 pregnancies between 2018 and 2020 in Hangzhou, China. The pregnant women were divided into four groups according to advanced age (≥35 years) and GDM as follows: AMA women without GDM (non‐AGDM) group (n = 2614), young pregnant women with GDM (YGDM) group (n = 4016), AMA women with GDM (AGDM) group (n = 850), and young pregnant women without GDM (non‐YGDM) group (n = 27,122). Univariate analysis was carried out by Mann–Whitney U test or Pearson's χ2 test. Multivariate logistic regression analysis was used to investigate the effect of AMA and GDM on pregnancy outcomes. Results: Multivariate logistic regression analysis showed that in the comparison against non‐YGDM garoup, the ORs of fetal chromosome abnormality, parity, urgent cesarean section, gravidity, scheduled cesarean section, body mass index (BMI) ≥30 kg/m2, pre‐eclampsia, thrombocytopenia, hyperlipidemia, BMI 25–29.9 kg/m2, blood urea nitrogen, fasting blood glucose, and creatinine in AGDM group were 16.044, 4.284, 3.530, 3.284, 3.257, 2.049, 1.935, 1.898, 1.690, 1.471, 1.304, 1.216, and 1.026 (all p < 0.05). Conclusions: The prevalence of pregnant women with AGDM was 2.46% in Hang Zhou, China. The increasing gravidity of AMA women was related to a greater risk of GDM. The AGDM group associated with a greater risks of chromosomal abnormality in offspring and cesarean section, especially urgent cesarean section. [ABSTRACT FROM AUTHOR]

To evaluate the associations between serum uric acid (SUA) levels and estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), with a focus on gender differences, and variations among women pre-and post-menopausal stages.Design: A retrospective cohort study.Setting: A large community-based survey was conducted every two years from 2010 to 2018 in Hangzhou, Zhejiang Province, Southeastern China.Participants: 10,218 participants (40 years or above) without CKD at baseline who underwent three physical examinations were enrolled. CKD was defined as an eGFR of less than 60 mL/min/1.73m2.Methods: Participants with SUA levels were divided into four groups (Q1-Q4) based on baseline SUA quartiles. The Q1 was the reference. By stratifying participants by gender, the relationships between SUA levels and eGFR were investigated using the generalized additive mixture model. The associations of SUA and the risk of incident CKD were examined using multivariate logistic regression models in the generalized estimating equation.Results: After adjusting for confounding variables, a nonlinear association between SUA and eGFR was observed in females, while an approximately linear relationship was observed in males, suggesting that elevated SUA levels are associated with renal function decline. Furthermore, the highest quartile of SUA was associated with a 2.16-fold (95% CI: 1.31– 3.58) increased risk of CKD in males and a 2.76-fold (95% CI: 1.59– 4.78) increased risk in females, compared with the lowest quartile. And the spline curves demonstrated a U-shaped pattern, suggesting a potential threshold effect of SUA on the risk of CKD. Additionally, Subgroup analyses revealed significant associations between elevated SUA levels with CKD in postmenopausal women, but not in premenopausal women.Conclusion: Elevated SUA levels are associated with an increased risk of CKD development and renal function decline in middle-aged and elderly individuals, particularly in postmenopausal women. [ABSTRACT FROM AUTHOR]

Aconitine is a crucial toxic component in Chinese herbal medicines such as Aconitum, Aconitum coreanum, and Aconitum soongaricum. The poisoning symptoms of the central nervous system and cardiovascular system caused by it are relatively common in China, and there are many studies on cardiovascular system diseases caused by aconitine. However, the specific mechanism of neurotoxicity induced by aconitine is still unclear. This study explored the effect and mechanism of mitochondrial calcium uniporter on mitochondrial energy metabolism disorder in aconitine poisoning hippocampal neurons. The results showed that after treatment with 400μmol/L aconitine, mitochondrial energy metabolism was abnormal in rat hippocampal neuron cells, the expression of MCU in mitochondria was up-regulated, calcium overload in mitochondria, ATP production decreased, and mitochondrial membrane potential Changes, increased expression of the apoptosis gene Cleaved-Caspase-3. After treatment with the MCU agonist spermine, mitochondrial energy metabolism was significantly abnormal, and cell apoptosis was increased considerably. However, pretreatment with calcium ion channel inhibitor Ruthenium Red (RR) effectively promoted the generation of ATP, thereby improving mitochondrial energy metabolism disorders and reducing cell apoptosis. These results suggest that aconitine induces mitochondrial energy metabolism dysfunction in hippocampal neurons, which may be related to the increased expression of MCU. [Display omitted] • Aconitine affects mitochondrial energy metabolism by inducing mitochondrial calcium overload and inhibiting ATP production. • Aconitine induces mitochondrial energy metabolism disorder by enhancing MCU signaling pathway. • Aconitine increases the apoptosis of HT22 cells by enhancing the MCU signaling pathway. [ABSTRACT FROM AUTHOR]

The association between the prevalence of breast and cervical cancer in Chinese women and air pollution is obscure. The study aims to analyze the correlation between air pollution and the prevalence of breast and cervical cancer, and whether the gross domestic product (GDP) has a modifying effect on the impact of air pollution on the prevalence of breast and cervical cancer. Extracting panel data from 31 provinces and cities between 2006 and 2020, we evaluated the association between breast and cervical cancer prevalence and pollutant emissions from 2006 to 2015 with two-way fixed-effect models. We also analyzed the interaction between GDP and pollutant emissions and further check the robustness of the moderating effect results using group regression from 2016 to 2020. Cluster robust standard errors were used to correct for the heteroskedasticity and autocorrelation. The coefficients of models show that the coefficients of logarithmic soot and dust emissions are estimated to be significantly positive, and the coefficients of their square terms are significantly negative. The robust results suggest that the relationship between soot and dust emissions and breast or cervical cancer prevalence is non-linear, from 2006 to 2015. In the analysis of particulate matter (PM) data in 2016–2020, the PM-GDP interaction term was also significantly negative, indicating that GDP growth weakened the effect of PM on the prevalence of breast cancer and cervical cancer. In provinces with higher GDP, the indirect effect of PM emissions concerning breast cancer is −0.396 while in provinces with lower GDP, it is about −0.215. The corresponding coefficient concerning cervical cancer is about −0.209 in provinces with higher GDP but not significant in provinces with lower GDP. Our results suggest that there is an inverted U-shaped relationship between the prevalence of breast cancer and cervical cancer and air pollutants from 2006 to 2015. GDP growth has a significant negative moderating effect on the impact of air pollutants on the prevalence of breast cancer and cervical cancer. PM emissions have a higher effect on the prevalence of breast and cervical cancer in provinces with higher GDP and a lower impact in provinces with lower GDP. [ABSTRACT FROM AUTHOR]

Background: Evidence on outcomes of catheter ablation (CA) for atrial fibrillation (AF) in patients with autoimmune disease (AD) is limited. Hypothesis: Patients with AD had worse outcomes after CA procedures for AF. Methods: A retrospective analysis was performed in patients undergoing AF ablation between 2012 and 2021. The risk of recurrence after ablation was investigated in patients with AD and a 1:4 propensity score matched non‐AD group. Results: We identified 107 patients with AD (64 ± 10 years, female 48.6%) who were matched with 428 non‐AD patients (65 ± 10 years, female 43.9%). Patients with AD exhibited more severe AF‐related symptoms. During the index procedure, a higher proportion of AD patients received nonpulmonary vein trigger ablation (18.7% vs. 8.4%, p = 0.002). Over a median follow‐up of 36.3 months, patients with AD experienced a similar risk of recurrence with the non‐AD group (41.1% vs. 36.2%, p = 0.21, hazard ratio [HR]: 1.23, 95% confidence interval [CI]: 0.86–1.76) despite a higher incidence of early recurrences (36.4% vs. 13.5%, p = 0.001). Compared with non‐AD patients, patients with connective tissue disease were at an increased risk of recurrence (46.3% vs. 36.2%, p = 0.049, HR: 1.43, 95% CI: 1.00–2.05). Multivariate Cox regression analysis showed that the duration of AF history and corticosteroid therapy were independent predictors of postablation recurrence in patients with AD. Conclusions: In patients with AD, the risk of recurrence after ablation for AF during the follow‐up was comparable with non‐AD patients, but a higher risk of early recurrence was observed. Further research into the impact of AD on AF treatment is warranted. [ABSTRACT FROM AUTHOR]

The outbreak of the COVID-19 pandemic has caused negative impacts on people's lifestyles, as well as considerable indirect social impacts, which has even overshadowed the direct impact of virus infection itself. This study is aimed at examining the changes in physical health-related indexes of Chinese college students before and after the COVID-19 lockdown. The data of this study are from the National Physical Health Testing Program, covering 43 college students (male: 22) from a class of a Chinese university. Paired t -tests were performed on the physical health test data separately collected in November 2019 before the COVID-19 pandemic and October 2020 after the COVID-19 lockdown was lifted. As shown by the test results, compared to the prelockdown data, college students had an increased body mass index (BMI) (0.43 (SD 0.94) P = 0.004), decreased vital capacity (VC) (-128.98 (SD 310.13) ml P = 0.009), and lowered performance in the 800/1000 m endurance (-6.21 (SD 8.81) points P < 0.001) and standing long jump tests (-2.44 (SD 7.37) points P = 0.036) after the lockdown, and the differences in these regards all were significant. In addition, for the students in the overweight/obese group, their pre- and postlockdown physical fitness test results were found to have no statistically significant difference (P > 0.05), but the students in the control group showed a significantly increased BMI, as well as significantly decreased vital capacity and performance in the 800/1000 m endurance and standing long jump tests (P < 0.05). The findings of this study are expected to help government departments and policymakers better understand the impacts of school closures and online learning on the physical health of adolescents, while providing a basis for the formulation of measures that are aimed at reversing adolescents' physical health decline. [ABSTRACT FROM AUTHOR]

Background: Drug-resistant tuberculosis (TB) continues to be a public health threat. There are few studies on transmission and genotyping of MDR-TB family households in China. This study aimed to investigate transmission of multidrug-resistant tuberculosis (MDR-TB) within family households by deletion-targeted multiplex polymerase chain reaction (DTM-PCR), mycobacterial interspersed repetitive unit variable number tandem repeats (MIRU-VNTR) genotyping.Methods: Among 993 MDR-TB patients registered from Wuhan Institute for Tuberculosis Control, drug resistance and the time interval between the index patients and secondary patients were analyzed in 49 MDR-TB patients from 23 families, in which 22 MDR-TB strains from 11 families who had matched strains were genotyped by DTM-PCR and standard 24-loci MIRU-VNTR genotyping method.Results: The time interval between the index patients and the secondary patients ranged from half a month to 110 months. Thirteen secondary patients developed active MDR-TB within two years and accounted for 50% (13/26) of all secondary patients. Among eleven pairs of MDR-TB families, six pairs had identical genotypes, the cluster rate was 54.5% (12/22); three pairs had a single MIRU-VNTR locus variation. If a single MIRU-VNTR locus variation was tolerated in the cluster definition, the cluster rate raised to 81.8% (18/22).Conclusions: The family households of MDR-TB patients are at risk for infection of MDR-TB. To reduce transmission, MDR-TB patients should be diagnosed earlier and promptly treated in an effective manner, meanwhile, the close family contacts should be screened for TB infection. [ABSTRACT FROM AUTHOR]

Objective: To investigate theoptimal idarucizumab (dabigatran antagonist) usage strategy for patients with acute pericardial tamponade receiving uninterrupted dabigatran during catheter ablation for atrial fibrillation (AF). Methods: Ten patients presenting acute pericardial tamponade while receiving uninterrupted dabigatran during catheter ablation for AF in Beijing Anzhen Hospital from January 2019 to July 2020 were enrolled and retrospectively analyzed. A "wait and see" strategy of idarucizumab was carried out for all patients; in brief, idarucizumab was applied following pericardiocentesis, comprehensive evaluation of bleeding and hemostasis. Results: There were five males, five paroxysmal AF, and the average age of the patients was 64.0 ± 9.8 years. Among the 10 patients, four were treated with dabigatran 110 mg, six were treated with dabigatran 150 mg, and one was simultaneously given clopidogrel. The average time from pericardial tamponade to the last dose of dabigatran was 8.2 ± 3.4 h. All patients underwent pericardiocentesis successfully, and the average drainage volume was 322.5 ml (220.0 ± 935.0 ml). For reversal anticoagulation, six patients received protamine, and five patients received idarucizumab. Of the five patients who were treated with idarucizumab, four presented exact hemostasis, except for one patient who underwent continuous drainage and finally received surgery repair. The average time to restart anticoagulation was 1.1 ± 0.3 days after the procedure, and no rebleeding, embolism or deaths were observed. Conclusion: The "wait and see" strategy of idarucizumab for acute pericardial tamponade during the perioperative period of catheter ablation for AF may be safe and feasible. [ABSTRACT FROM AUTHOR]

An integrated observation of NO x that included coastal cities and oceanic cruises covering the Qingdao coastal waters sites (QDCW) and the Yellow Sea and East China Sea sites (YECS) was conducted in spring. The average concentrations of the coastal cities, the QDCW, and the YECS were 5.4 ± 4.1, 4.2 ± 3.5, and 2.9 ± 6.8 ppb for NO while 18.5 ± 7.2, 9.4 ± 5.2, and 4.9 ± 6.4 ppb for NO 2 , depicting lowest levels in the open seas. Atmospheric NO and NO 2 showed similar spatial variations over the seas, the stations where the air masses originated from land or nearshore regions showed higher levels, but the decisive influencing factors were not the same in the different study areas. The calculated NO x flux value in the YECS (−8.7 × 10−17 mol N cm−2) indicated that the sea surface was a net sink of atmospheric NO x. The sea was an important sink of the atmospheric NO x. NO x showed a decreasing trend from the coastal cities to the open seas. Light and wind speed were decisive factors influencing atmospheric NO x distributions. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is common in abdominal solid organ transplant recipients and a cause of morbidity and mortality in this population. However, the outcomes of catheter ablation (CA) in transplant recipients with AF remain unclear. This study aimed to elucidate the outcomes of CA in renal and hepatic transplant recipients. Methods and Results: Between 2015 and 2019, 14 transplant recipients (nine with kidney transplantation and five with liver transplantation) were enrolled from among 10,741 AF patients and underwent CA at Anzhen Hospital. Another 56 patients matched by age, sex, and AF type were selected as the control group (four controls for each transplant recipient). During a mean follow‐up of 30.0 ± 13.3 months after the initial procedure, 10 (71.4%) of the transplant patients, compared to 41 (73.2%) of the control patients, remained free from AF recurrence (p = 1.000). A repeated procedure was performed in one transplant patient and in six control subjects. Consequently, 11 (78.6%) of the transplant patients, compared to 46 (82.1%) of controls, were in sinus rhythm after the repeated ablation (p =.715). Notably, Kaplan–Meier analysis did not demonstrate any significant differences in the atrial arrhythmia‐free rate after the initial and repeated procedure between the two groups. Vascular complications were identified in one transplant patient and two control subjects, while no life‐threatening complications were observed in either group. There was no transient allograft dysfunction in transplant recipients after CA. Conclusion: CA is safe and effective in abdominal solid transplant recipients, and maybe an optimal therapeutic strategy for this group. [ABSTRACT FROM AUTHOR]

Background: Kidney dysfunction frequently occurred after orthotopic liver transplantation (OLT). Chronic renal disease (CKD) is a complicated problem and is associated with increased mortality. The aim of this study is to find the risk factors for the incidence of CKD at 1 year after OLT in China. Methods: From January 2017 to December 2017, we retrospectively assessed 280 recipients in our single center. Chronic renal failure was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for 3 months, regardless of the presence or absence of structural kidney damage. Cox proportional hazard model was used to identify the factors to the incidence of CKD after liver transplantations. Kaplan–Meier plots with log-rank test were presented to evaluate patient survival time in those with and without CKD. Results: With a median follow-up of 17.4 months, 48 patients developed CKD after liver transplantations, representing 17.1% of the cohort. The cox-regression model showed that recipients age (HR = 1.097, P < 0.01), AKI (HR = 1.542, P < 0.01) and MELD score (HR = 1.077, P < 0.01) were significantly associated with the development of post-transplant CKD at 1 year. Recipient survival at 1 year was significantly worse in recipients with CKD compared to those without CKD (P < 0.01) after adjustment by age and gender. Conclusion: Our findings suggested that age, AKI and MELD score were associated with the incidence of CKD 1 year after OLT in a Chinese cohort. Recipients with CKD were associated with worse survival. [ABSTRACT FROM AUTHOR]

Background and objective: Atrioesophageal fistula (AEF) is a rare but devastating complication with high mortality post atrial fibrillation (AF) ablation. The purpose of current study was to determine the epidemiology, clinical features, pathogenesis, and management of AEF after AF ablation. Methods and results: Patients with diagnosed AEF were included and retrospectively analyzed according to the registry of 11 centers in China from January 2010 to December 2019. A total of 16 AEF cases were identified from 44 794 patients who received a left atrial ablation procedure (0.035% per procedure). The interval from procedure to clinical onset of AEF averaged 18.3 days (3‐39 days). The fever ranked the most common symptom, occurred in 14 of the 16 cases, followed by neurological deficits (n = 11), chest pain (n = 5), and hematemesis (n = 4). Patients undergoing surgical repair had a better prognosis compared to those receiving nonsurgical management ([4 of 8] 50.0% vs [8 of 8] 100%, P <.05) with an overall mortality rate of 75.0%. Conclusion: AEF is highly characterized by varied manifestations. Early diagnosis and urgent surgical repair are vital to those patients and associated with improved survival rates. [ABSTRACT FROM AUTHOR]

Aims: We aimed to investigate the safety of discontinuing oral anticoagulation (OAC) therapy after apparently successful atrial fibrillation (AF) ablation, using data from the Chinese Atrial Fibrillation Registry study.Methods and Results: We identified 4512 consecutive patients who underwent successful AF ablation between August 2011 and December 2017. Of them, 3149 discontinued OAC 3 months post-ablation (Off-OAC group) and 1363 continued OAC beyond this period (On-OAC group). Regular follow-up examinations were undertaken to detect AF recurrence, monitor OAC therapy, and measure clinical outcomes. Primary outcomes included thromboembolic and major bleeding (MB) events experienced beyond 3 months after ablation. Low thromboembolic and MB event rates were noted in the on-treatment analysis. The incidence rates for thromboembolism were 0.54 [95% confidence interval (CI) 0.39-0.76] and 0.86 (95% CI 0.56-1.30) per 100 patient-years, and that for MB events were 0.19 (95% CI 0.11-0.34) and 0.35 (95% CI 0.18-0.67) per 100 patient-years, for the Off-OAC and On-OAC groups over mean follow-up periods of 24.2 ± 14.7 and 23.0 ± 13.6 months, respectively. Similar results were observed in the intention-to-treat analysis. Previous history of ischaemic stroke (IS)/transient ischaemic attack (TIA)/systemic embolism (SE) [hazard ratio (HR) 3.40, 95% CI 1.92-6.02; P < 0.01] and diabetes mellitus (HR 2.06, 95% CI 1.20-3.55, P = 0.01) were independently associated with thromboembolic events, while OAC discontinuation (HR 0.71, 95% CI 0.41-1.23, P = 0.21) remained insignificant in multivariable analysis.Conclusions: This study suggests that it may be safe to discontinue OAC in post-ablation patients under diligent monitoring, in the absence of AF recurrence, history of IS/TIA/SE, and diabetes mellitus. However, further large-scale randomized trials are required to confirm this.Trial Registration: Chinese Clinical Trial Registry ChiCTR-OCH-13003729. URL: http://www.chictr.org.cn/showproj.aspx?proj=5831. [ABSTRACT FROM AUTHOR]

Objective: To investigate the feasibility and safety of wire‐guided pericardial access without contrast. Methods: From January 2014 to February 2019, patients who received epicardial mapping and ablation of ventricular tachycardia in the Beijing Anzhen Hospital were entered into the current study. They were divided into contrast‐guided access group or wire‐guided access group according to the pericardial puncture technique used. The baseline variables, procedure parameters, complications were collected and compared. Results: During the study period, a consecutive of 73 patients received epicardial access. The initial 32 patients received contrast‐guided puncture with success achieved in 30 patients, the remaining 41 patients underwent wire‐guided puncture with success achieved in 40 patients (30/32 and 40/41, P =.581). Fluoroscopy time (4.45 ± 0.52 and 4.38 ± 0.46 minutes, P =.891) and access time (5.14 ± 0.58 and 5.34 ± 0.50 minutes, P =.657) were comparable between the two groups. Inadvertent right ventricular puncture occurred more commonly in the contrast‐guided group (5/32 and 1/41, P =.038). Though more pericardial effusions (2/32 and 1/41, P =.575), tamponade (2/32 and 1/41, P =.575), and surgical repair (1/32 and 0/41, P =.432) occurred in the contrast‐guided group, they reached no statistical difference. Conclusion: Wire‐guided pericardial puncture exhibits better safety and similar success rates to contrast‐guided technique with a trend towards less complications. [ABSTRACT FROM AUTHOR]

In southern China, the silver pheasant (Lophura nycthemera) is a widespread species due to complex topography and sufficient habitats and food resources. We investigated the microsatellite and mitochondrial DNA control region sequence of 115 individuals from 7 locations in China to study population dynamics of the silver pheasant during the Pleistocene. The neutrality test and mismatch distribution analyses showed that population expansion began in the interglacial period (76,053 years ago), and the latest common ancestor appeared approximately 970,300 years ago. Most populations exhibited a high level of genetic diversity as well as gene flow. Results of phylogenetic trees and network and STRUCTURE analyses provided insights into the weak population structure of this species. The weak phylogeographic and complex historical expansion population of the silver pheasant during the interglacial period could probably be related to its complex topography and the sufficient amount of suitable habitats and food resources in southern China. [ABSTRACT FROM AUTHOR]

Background: Data on management of maternal arrhythmia among Chinese were limited. Radiofrequency catheter ablation (RFCA) proved to be a reliable treatment choice for sustained tachyarrhythmia but it has rarely been performed during pregnancy due to radiation exposure. Objective: To investigate the incidence of idiopathic sustained maternal arrhythmia and the feasibility of RFCA in the pregnant patients without fluoroscopy. Methods: From January of 2015 to December of 2018, the medical records on pregnancy‐related admissions in Beijing Anzhen Hospital (Beijing, China) were retrospectively analyzed. Patients who had sustained tachyarrhythmia episodes without structural heart disease were identified. Catheter ablation was performed in those with drug resistant and severely frequent tachyarrhythmia under the guidance of electroanatomical mapping system and intracardiac echocardiography catheter (ICE), if appropriate. Results: During the study period, 12 584 consecutive pregnant women were admitted for pregnancy‐related reasons, 156 (1.2%) of them were identified as sustained maternal tachyarrhythmia. Twenty‐eight patients (age 21‐37 years) received catheter ablation because the arrhythmias were drug resistant and severely frequent. The RFCA was successfully performed in all patients with zero fluoroscopy after 72.4 ± 24.7 min. Transseptal puncture was performed in 11 patients under the guidance of ICE. In a median of 37 (interquartile range [IQR]: 34‐39) weeks' pregnancy, 28 healthy fetuses were delivered. No cardiac‐related adverse event occurred during delivery. During later follow‐up, all patients were free of arrhythmia, and all the infants were well developed. Conclusion: Sustained maternal tachyarrhythmia is not uncommon in the clinical practice. To those with drug resistant and severely frequent arrhythmia, RFCA with zero fluoroscopy could be safely performed with acceptable efficacy. [ABSTRACT FROM AUTHOR]

• Design a SIR N model for capturing spatiotemporal characteristics of spreading risks. • Reveal the relation between spreading risk and the network topology of human movement. • Construct a resilient strategy to control and contain the spreading risk of contagious diseases. Spreading risks of contagious diseases have threatened human lives and disrupted the global economy. Protecting humanity from contagious diseases, such as coronavirus, is a critical task of our time. Unlike other types of risks, the spreading of contagious diseases could be enhanced by human movements. As human movements are inherently dynamic and heterogenous, it brings challenges in analyzing the spreading on a large scale. Here, we combine network theory and epidemiology models to construct a SIR N model for capturing spatiotemporal characteristics of spreading risks. With mean-field theory and Lyapunov theorem, our model reveals the relation between spreading risk and the network topology of human movement. The model allows us to construct a resilient strategy to control and contain the risk. The approach is tested retrospectively with coronavirus cases in China and the United States. Our results adequately interpret the historical trends and justify the resilience of nations' strategies. The model demonstrates a pattern of resilience in dynamic networks, which could shed light on handling contagious risks. [ABSTRACT FROM AUTHOR]

Background: Multiple pregnancies are one of the major safety concerns of in vitro fertilization (IVF) due to the increased risk of maternal and neonatal complications. Single embryo transfer is the most effective way to reduce the risk of multiple pregnancies. Selection of the embryo and optimization of the implantation environment are crucial to retain the success rate when the number of transferred embryos is diminished. Fresh embryo transfer with supra-physiological levels of hormones has been suggested to have an adverse effect on implantation. Elective frozen embryo transfer has been suggested to result in a higher rate of live birth than fresh embryo transfer. However, there is still a lack of evidence from randomized clinical trials comparing the efficacy and safety between frozen and fresh single blastocyst transfers.Methods/design: We are conducting a randomized controlled trial in women aged 20-35 undergoing their first cycle of IVF with or without intracytoplasmic sperm injection. After ovarian stimulation with a gonadotropin-releasing hormone antagonist protocol, women who obtain four or more embryos on day 3 of the embryo culture are randomized into two parallel groups: a single fresh blastocyst transfer group and a single frozen blastocyst transfer group (all blastocysts vitrified and a deferred frozen blastocyst transfer). The primary outcome is singleton live birth.Discussion: The results of this study will provide evidence for the efficacy and safety of the strategy of elective frozen single blastocyst transfer in women with a good prognosis.Trial Registration: Chinese Clinical Trial Registry, ChiCTR-IOR-14005405 . Registered on 30 Oct 2014. [ABSTRACT FROM AUTHOR]

To identify sources of heavy metal(loid) (HM) contamination in agricultural soils of Huzhou, surface soil samples were sampled from 89 different agricultural regions in 2012. Concentrations of heavy metal(loid)s, along with pH, total phosphorus (TP), total nitrogen (TN), and soil organic matter (SOM), were determined. Ecological risk was then assessed using a modified Hakanson ecological risk index, and the sources of contamination were determined using principal component analysis (PCA). Mean concentrations of heavy metal(loid)s were 10.26, 23.21, 83.75, 22.81, 0.25, 61.86, 33.03, and 0.15 mg kg−1for As, Cu, Zn, Ni, Cd, Cr, Pb, and Hg, respectively. Cu, Zn, Ni, Cr, Cd, Hg, and Pb were correlated positively with TP and there were obvious positive correlations among Cu, Zn, Ni, Cr, and Cd. Risk index (RI) values varied from 39 to 1246 with a mean value of 137. Enrichment of Pb, Zn, Cu, and especially Cd can be attributed to excessive use of nitrogen and phosphorus fertilizers containing heavy metals, as well to surface irrigation and natural soil formation. While the ecological risk of most agricultural soils in Huzhou is low, it is recommended that the use of phosphate and nitrogen fertilizers be restricted and production technology be improved to reduce the heavy metal(loid) concentrations. Results suggest that the Chinese environmental quality standard for soil should be revised to better address heavy metal(loid) contamination. [ABSTRACT FROM AUTHOR]

Dufulin is a newly developed antiviral agent (or pesticide) that activates systemic acquired resistance of plants. This pesticide is widely used in China to prevent abroad viral diseases in rice, tobacco and vegetables. In this study, the potential impacts such as soil type, moisture, temperature, and other factors on Dufulin degradation in soil were investigated. Degradation of Dufulin followed the first-order kinetics. The half-life values varied from 2.27 to 150.68 days. The dissipation of Dufulin was greatly affected by soil types, with DT (Degradation half time) varying between 17.59, 31.36, and 43.32 days for Eutric Gleysols, Cumulic Anthrosols, and Dystric Regosols, respectively. The elevated moisture accelerated the decay of Dufulin in soil. Degradation of Dufulin increased with temperature and its half-life values ranged from 16.66 to 42.79 days. Sterilization of soils and treatment with HO resulted in a 6- and 8-fold decrease in degradation rates compared to the control, suggesting that Dufulin degradation was largely governed by microbial processes. Under different light spectra, the most effective degradation occurred with 100-W UV light (DT = 2.27 days), followed by 15-W UV light (DT = 8.32 days) and xenon light (DT = 14.26 days). Analysis by liquid chromatography-mass spectroscopy (LC-MS) revealed that 2-amino-4-methylbenzothiazole was one of the major decayed products of Dufulin in soils, suggesting that elimination of diethyl phosphate and 2-fluorobenzaldehyde was most like the degradation pathway of Dufulin in Eutric Gleysols. [ABSTRACT FROM AUTHOR]

Background: Acute gastrointestinal illness (AGI) is an important public-health problem worldwide. Previous national studies of the incidence of AGI in China were performed decades ago, and detailed information was not available. This study therefore sought to determine the magnitude, distribution, and burden of self-reported AGI in China. Methods: Twelve-month, retrospective face-to-face surveys were conducted in 20 sentinel sites from six provinces between July 2010 and July 2011. Results: In total, 39686 interviews were completed. The overall adjusted monthly prevalence of AGI was 4.2% (95% confidence interval, 4.0-4.4), corresponding to 0.56 episodes of AGI per person-year. Rates of AGI were highest in children aged < 5 years. Healthcare was sought by 56.1% of those reporting illness. Of the cases who visited a doctor, 32.7% submitted a stool sample. The use of antibiotics was reported by 49.7% of the cases who sought medical care and 54.0% took antidiarrhoeals. In the multivariable model, gender, age, education, household type, residence, season, province and travel were significant risk factors of being a case of AGI. Conclusions: This first population-based study in China indicated that AGI represents a substantial burden of health. Further research into the specific pathogens is needed to better estimate the burden of AGI and foodborne disease in China. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is recognized worldwide as a public health problem, and its prevalence increases as the population ages. However, the applicability of formulas for estimating the glomerular filtration rate (GFR) based on serum creatinine (SC) levels in elderly Chinese patients with CKD is limited. Materials and methods: Based on values obtained with the technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) renal dynamic imaging method, 319 elderly Chinese patients with CKD were enrolled in this study. Serum creatinine was determined by the enzymatic method. The GFR was estimated using the Cockroft-Gault (CG) equation, the Modification of Diet in Renal Disease (MDRD) equations, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, the Jelliffe-1973 equation, and the Hull equation. Results: The median of difference ranged from -0.3-4.3 mL/min/1.73 m2. The interquartile range (IQR) of differences ranged from 13.9-17.6 mL/min/1.73 m2. Accuracy with a deviation less than 15% ranged from 27.6%-32.9%. Accuracy with a deviation less than 30% ranged from 53.6%-57.7%. Accuracy with a deviation less than 50% ranged from 74.9%-81.5%. None of the equations had accuracy up to the 70% level with a deviation less than 30% from the standard glomerular filtration rate (sGFR). Bland-Altman analysis demonstrated that the mean difference ranged from -3.0-2.4 mL/min/1.73 m2. However, the agreement limits of all the equations, except the CG equation, exceeded the prior acceptable tolerances defined as 60 mL/min/1.73 m2. When the overall performance and accuracy were compared in different stages of CKD, GFR estimated using the CG equation showed promising results. Conclusions: Our study indicated that none of these equations were suitable for estimating GFR in the elderly Chinese population investigated. At present, based on overall performance, as well as performance in different CKD stages, the CG equation may be the most accurate for estimating GFR in elderly Chinese patients with CKD. [ABSTRACT FROM AUTHOR]

Abstract: With high speed of increasement in electrical and electronic products, the relevant wastes turn out to be serious in China. But a corresponding recycling system of WEEE has yet to be established. The actual WEEE flow in China is therefore kind of unknown. Through an in-depth analysis of the recycling system and extended survey of the WEEE recycling process in Beijing, this paper puts forward a WEEE closed loop chain model concerning the source, pathway and volume of the flow. It identified some key control points in the WEEE recycling process, which are taken into account in several policy recommendations. [Copyright &y& Elsevier]

Abstract: Medical waste is one special kind of hazardous wastes. If mishandled, it could cause disease spread and secondary pollution of dioxin. China produced huge amount medical wastes due to large population. Through a decade, medical waste centralized disposal sector rapidly developed with both incineration and non-incineration technology. With fully consideration advanced foreign technology, a set of Best Available Technology system of China gradually formed suitable for Chinese national conditions. This article placed emphasis on best available technology system of medical wastes centralized incineration facilities, and analyzed the application of technique retrofit of medical wastes centralized incineration facilities incorporated with case study. [Copyright &y& Elsevier]

The Bilong Co oil shale is located in the southern part of the Qiangtang basin. This oil shale zone, together with the Shengli River-Changshe Mountain oil shale zone in the northern part of the Qiangtang basin, represents a large marine oil shale resource in China. An organic geochemical investigation of the oil shale was performed to reconstruct paleoenvironment during deposition and to assess petroleum prospects. The TOC content (6.75-19.2 wt.%) and S2 values (5.96-70.2 mg HC/g rock) of oil shale samples from the Bilong Co area are relatively high indicating that the oil shale from the Bilong Co area has shale oil producing potential. The thermal maturity assessed from Tmax and other maturity-related parameters (Ts/(Ts+Tm), C32Hop S/(S+R), C29St S/(S+R), and C29St ββ/(αα+ββ)) shows a mature stage of the organic matter. Analyzed oil shale samples from the Bilong Co area are characterized by a dominance of low carbon number molecular compositions with relatively high C21-/C21+ (0.82-1.95), low Pr/Ph (0.13-0.80), high concentrations of homohopanes (C31-C35), and a slight predominance of C29 steranes, indicating reducing environments, highly saline conditions, a strong contribution of inferior aquatic organisms, and some influence of terrestrial organic matter. Highly similar biomarker characteristics between the Bilong Co oil shale and nearby Zharen-Longeni crude oil in the southern Qiangtang depression suggest that the oil shale from the Bilong Co area has made a strong contribution to the generation of Zharen-Longeni crude oil. [ABSTRACT FROM AUTHOR]

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Abstract: The hotel industry in China faces global competition. Most of the state-owned hotels have struggled during the period of transition from a planned economy to a market economy. Furthermore, international franchising hotel chains have entered China with their different operation modes. Could the franchising hotels bring opportunities for state-owned hotels? In an attempt to answer this question, the researchers carried out a study of state-owned independent hotels and state-owned franchised hotels to analyze their external and internal business factors, their intentions to join international franchise operations and the international hotel franchisors in China. The research technique used was qualitative. Two rounds of in-depth interviews were conducted. Content analysis was used in the data analysis. Results indicate that the majority of state-owned independent hotels have intentions to join an international franchise operation in the next 5 years. It also identified major factors affecting the franchising of state-owned hotels in China. However, franchising may not be attractive to those hotels that want to keep their management culture and characteristics. Implications of the study were discussed. Recommendations were provided to the state-owned hotels. Future research studies have been suggested to examine the relationships between franchisors and franchisees. [Copyright &y& Elsevier]

Objective: The aim of the study was to determine the association between three single nucleotide polymorphism (SNP) variants (rs35368790, rs35069869 and rs684846) of the MCF2 cell line-derived transforming sequence-like 2 (MCF2L2) gene and polycystic ovary syndrome (PCOS) in PCOS family trios. Methods: Genotyping was done by TaqMan assay that incorporates minor groove-binding probe technology for allelic discrimination. One hundred and fifty-two unrelated PCOS probands and their biological parents were recruited. All subjects were of Han Chinese origin and from Shandong Province. Results: The transmission disequilibrium test (TDT) for allelic association demonstrated that a weak association was detected in SNP rs35368790 with p = 0.008. However, we found no significant transmission distortion of the other two SNPs (rs35069869, χ2 = 3.645, p = 0.056; rs684846, χ2 = 1.429, p = 0.232, respectively). Conclusions: These results suggest that the genetic polymorphisms within MCF2L2 are likely to confer an increased susceptibility to PCOS in the Chinese population. Our present data may provide a basis for further studies of the role of the MCF2L2 gene in the etiology of PCOS. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The carbonate chemistry in river-dominated marginal seas is highly heterogeneous, and there is ongoing debate regarding the definition of atmospheric CO 2 source or sink. On this basis, we investigated the carbonate chemistry and air-sea CO 2 fluxes in a hotspot estuarine area: the Changjiang Estuary during winter and summer. The spatial characteristics of the carbonate system were influenced by water mixing of three end-members in winter, including the Changjiang freshwater with low total alkalinity (TA) concentration, the less saline Yellow Sea Surface Water with high TA, and the saline East China Sea (ECS) offshore water with moderate TA. While in summer with increased river discharge, the carbonate system was regulated by simplified two end-member mixing between the Changjiang freshwater and the ECS offshore water. By performing the end-member mixing model on DIC variations in the river plume region, significant biological addition of DIC was found in winter with an estimation of −120 ± 113 μmol kg−1 caused by wintertime organic matter remineralization from terrestrial source. While this biological addition of DIC shifted to DIC removal due to biological production in summer supported by the increased nutrient loading from Changjiang River. The p CO 2 dynamics in the river plume and the ECS offshore were both subjected to physical mixing of freshwater and seawater, whether in winter and summer. In the inner estuary without horizontal mixing, the p CO 2 dynamics were mainly influenced by biological uptake in winter and temperature in summer. The inner estuary, the river plume, and the ECS offshore were sources of atmospheric CO 2 , with their contributions varying seasonally. The Changjiang runoff enhanced the inner estuary's role as a CO 2 source in summer, while intensive biological uptake reduced the river plume's contribution. [Display omitted] • Mixing of end-members drove the variation of carbonate system among seasons. • Winter biological DIC addition and summer DIC removal occurred in the rive plume. • The important role of freshwater inputs in CO 2 emissions from the Changjiang estuary. [ABSTRACT FROM AUTHOR]

We reported genomic profiling, clinical characterization, and treatment efficacy of available therapeutic agents in the largest multicenter cohort of patients with FH-deficient renal cell carcinoma (RCC) to date. First-line combination therapy with an immune checkpoint inhibitor plus a tyrosine kinase inhibitor (ICI/TKI) was associated with more favorable outcomes in comparison to other first-line therapies, including bevacizumab plus erlotinib and TKI monotherapy, suggesting ICI/TKI combinations could be promising in advanced FH-deficient RCC. Further randomized studies in larger data sets are needed for independent validation of these findings. FH-deficient renal cell carcinoma (RCC) is a rare and exceptionally aggressive RCC subtype. There is currently limited understanding of the molecular alterations, pathogenesis, survival outcomes, and systemic therapy efficacy for this cancer. To perform a retrospective multicenter analysis of molecular profiling and clinical outcomes for patients with FH-deficient RCC, with an emphasis on treatment response to first-line immune checkpoint inhibitor plus tyrosine kinase inhibitor (ICI/TKI) versus bevacizumab plus erlotinib (Bev/Erlo) combination therapy in patients with advanced disease. The study included 77 cases of FH-deficient RCC from 15 centers across China. Clinical characteristics, molecular correlates, 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging, and treatment outcomes were analyzed. A total of 77 patients were identified, including 70 cases with a germline FH alteration (hereditary leiomyomatosis RCC syndrome [HLRCC]-associated RCC) and seven patients with somatic FH loss. Recurrent pathogenic alterations were found in NF2 (six/57, 11%), CDH1 (six/57, 11%), PIK3CA (six/57, 11%), and TP53 (five/57, 8.8%). Sixty-seven patients were evaluable for response to first-line systemic therapy with Bev/Erlo (n = 12), TKI monotherapy (n = 29), or ICI/TKI (n = 26). ICI/TKI combination therapy was associated with more favorable overall survival on systemic treatment (hazard ratio [HR] 0.19, 95% confidence interval [CI] 0.04–0.90) and progression-free survival on first-line therapy (HR 0.22, 95% CI 0.07–0.71) compared to Bev/Erlo combination therapy. The main limitation is the retrospective study design. We described the genomic characteristics of FH-deficient RCC in an Asian population and observed a favorable response to ICI/TKI combinational therapy among patients with advanced disease. This real-world study provides evidence supporting the antitumour activity of combining molecular targeted therapy plus immunotherapy for kidney cancer deficient in fumarate hydratase. Further studies are needed to investigate the efficacy of this combination strategy in this rare cancer. [ABSTRACT FROM AUTHOR]

Little is known about Epstein-Barr virus (EBV)-associated intrahepatic cholangiocarcinoma (EBVaICC) because of its rarity. We aimed to comprehensively investigate the clinicopathology, tumor immune microenvironment (TIME) and genomic landscape of this entity in southern China. We evaluated 303 intrahepatic cholangiocarcinomas (ICCs) using in situ hybridization for EBV. We compared clinicopathological parameters between EBVaICC and nonEBVaICC, and we analyzed EBV infection status, tumor-infiltrating lymphocytes (TILs) and genomic features of EBVaICC by immunohistochemistry, double staining, nested PCR, multiplex immunofluorescence staining, fluorescence in situ hybridization and whole-exome sequencing. EBVaICC accounted for 6.6% of ICCs and was associated with EBV latency type I infection and clonal EBV isolates. Patients with EBVaICC were more often female and younger, with solitary tumors, higher HBV infection rates and less frequent cirrhosis; the lymphoepithelioma-like (LEL) subtype was more common in EBVaICC. EBVaICC was associated with a significantly larger TIME component than nonEBVaICC. The LEL subtype of EBVaICC – associated with a significantly increased density and proportion of CD20+ B cells and CD8+ T cells – was associated with significantly higher 2-year survival rates than conventional EBVaICC and nonEBVaICC. Both PD-1 and PD-L1 in TILs, and PD-L1 in tumor cells, were overexpressed in EBVaICC. High PD-L1 expression in tumor cells and high CD8+ TIL densities were significantly more common in EBVaICC than in nonEBVaICC. Seven genes (MUC4 , DNAH1, GLI2 , LIPE , MYH7 , RP11-766F14.2 and WDR36) were mutated in at least 3 patients. EBVaICC had a different mutational pattern to liver fluke-associated cholangiocarcinoma and HBV-associated ICC. EBVaICC, as a subset of ICC, has unique etiological, clinicopathological and genetic characteristics, with a significantly larger TIME component. Paradoxically, patients with EBVaICC could be candidates for immune checkpoint therapy. Epstein-Barr virus (EBV) is associated with a subtype of intrahepatic cholangiocarcinoma, with unique clinicopathological and genetic characteristics. The tumor immune microenvironment is also different in this tumor subtype and patients with EBV-associated intrahepatic cholangiocarcinoma may respond well to immune checkpoint inhibitors. [Display omitted] • EBVaICC accounted for 6.6% of ICCs and was associated with EBV latency type I infection and clonal EBV isolates. • EBVaICChas unique characteristics related to etiology, clinicopathology and molecular genetics. • Both PD-1 and PD-L1 in tumor-infiltrating lymphocytes and PD-L1 in tumor cells are overexpressed in EBVaICC. • Patients with EBVaICC may respond well to immune checkpoint inhibitors. • The lymphoepithelioma-like subtype of EBVaICC is related to favorable survival. [ABSTRACT FROM AUTHOR]

Otolith microchemistry allows reconstructing the life histories and understanding the habitat uses of fishes. In this study, the relationship of Sr:Ca ratios and salinity from various environments, i.e. freshwater of the Min River, brackish water of the estuary and seawater of the coastal marine (Fujian Province, China), were built, revealing a significant positive correlation (p < 0.05). A total of 29 adult Chinese gizzard shad Clupanodon thrissa were collected in 2017–2020 for otolith (sagitta) microchemistry. The specimens were only collected from the Min River and the estuary, with none from the coastal marine regions despite same efforts input. The results confirmed that all 29 individuals hatched in either freshwater or brackish water. Four contingents were recognized based on various life histories, including three migratory contingents (Types A-C, N = 26) and one freshwater residential contingent (Type D, N = 3). The three migratory contingents were the freshwater-brackish migratory contingent (Type A, N = 12), the brackish-freshwater migratory contingent (Type B, N = 10) and the brackish-variable migratory contingent (Type C, N = 4). Only a small proportion of C. thrissa individuals (N = 4) migrated to seawater habitat during the first few months of lifetime, and most individuals preferred freshwater habitat during the first year. There were no significant differences between life history pattern and sex (p = 1.00), and between the number of fish migratory times crossing different habitats and age (p = 0.84). The lower reaches of the Min River and the estuary are confirmed to be important spawning grounds for C. thrissa , based on otolith microchemistry of this study and gonad histology of a previous examination. The findings have significant implications for the Min River and the estuary protection and fishery stock management. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether the common variant rs2305957 spanning PLK4 (Polo-like kinase 4) confers risk to embryo development in Northern Chinese Han (CHN) women.Design: Genetic association study.Setting: University hospital.Patient(s): A total of 2,015 infertile women who underwent in vitro fertilization (IVF), 530 women with early recurrent miscarriage (ERM), and 600 fertile control women in the CHN population.Intervention(s): Genotyping of rs2305957 was performed by means of high-resolution melting analysis.Main Outcome Measure(s): Blastocyst formation, implantation, early miscarriage, and live birth rates in infertile women; genotype distribution at rs2305957 in ERM case and control subjects.Result(s): In the first cohort of this study, infertile women with AA genotype had a lower blastocyst formation rate than those with AG or GG genotype. No significant differences were observed in implantation rate, early miscarriage rate, or live birth rate among AA, AG, and GG subgroups. In the second cohort, common variant rs2305957 was related to ERM. Genotype frequency differences were also significant in both additive model and dominant model.Conclusion(s): Common variant rs2305957 is associated with blastocyst formation and ERM in CHN women. Further investigations of PLK4 gene during embryo development could be worthwhile. [ABSTRACT FROM AUTHOR]

Computerized ionospheric tomography (CIT) technique allows reconstructing the 3-dimensional and even 4-dimensional state of the ionosphere in terms of electron content. It is typically denoted as an inverse problem. Due to the unevenly distributed measurements collected from ground receivers, together with limited cut-off elevation angle and density of observations, the normal matrix of the inverse problem becomes sparse, which makes it difficult to solve and potentially unstable. The main methods to resolve the problem are the constraint algorithms during the process of the electron density inversion. A new approach is proposed for CIT that aims to mitigate the ill-posed problem and improve the precision of ionospheric electron density (IED) resolution by using constrained least squares. In this method, a new scheme of constructing parameter weight matrices in both horizontal and vertical directions is designed using the correlation of IED among those neighboring voxels, which helps to add the information needed in CIT, and the ill-posed problem is efficiently resolved. The accuracy and feasibility of the additional constraints in CIT algorithms are verified by numerical simulation tests. Finally, this newly developed method of constrained least squares is used to effectively perform the tomographic reconstruction of IED distribution over southeast China. [ABSTRACT FROM AUTHOR]

Objective: This study was to evaluate measurement properties of the Chinese version of the Brief Inventory of Perceived Stress (BIPS-C) and confirm possible solutions for measuring the constructs underlying perceived stress., Methods: A total of 1356 community residents enrolled and were randomly split into two halves. The first half was used to explore the underlying constructs of the BIPS-C by exploratory graph analysis (EGA) and the second half was used to compare and confirm the constructs by confirmatory factor analysis (CFA)., Results: The EGA identified a one-factor model of the BIPS-C with an accuracy of 99.3%. One-factor, three-factor, second-order, and bifactor models were compared by CFAs. The bifactor model with one general and three specific factors was found to be the most adequate [comparative fit index (CFI) = 0.990; Tucker-Lewis index (TLI) = 0.979; root mean square error of approximation (RMSEA) = 0.058] and was superior to the other models. The related bifactor indices showed a stronger existence of the general factor. The bifactor model of the BIPS-C also showed adequate internal consistency with McDonald's omega and omega subscales ranging from moderate to strong (0.677-0.869)., Conclusion: The BIPS-C demonstrates sufficient measurement properties for assessing general perceived stress., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population., Methods: Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU&#95;SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test-retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI., Results: We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953-0.989, Tucker-Lewis index = 0.931-0.984, root means square error of approximation = 0.040-0.092, standardized root mean square residual = 0.039-0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU&#95;SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach's alpha = 0.811-0.835, McDonald's omega = 0.805-0.832), and test-retest reliability (intraclass correlation coefficient = 0.829)., Conclusion: The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students., (© 2024. The Author(s).)

Background: A retrospective cohort study was conducted to collect the data of pregnant women who received hospital delivery in Hangzhou Women's Hospital from January 2018 to December 2020, and who participated in the second trimester (15-20 +6  weeks) of free beta human chorionic gonadotropin (free β-hCG). And the study was conducted to explore the relationship between maternal serum free β-hCG and adverse pregnancy outcomes (APO)., Methods: We retrospectively analyzed the clinical data of 1,978 women in the elevated maternal serum free β-hCG group (free β-hCG ≥ 2.50 multiples of the median, MoM) and 20,767 women in the normal group (0.25 MoM ≤ free β-hCG < 2.50 MoM) from a total of 22,745 singleton pregnancies, and modified Poisson regression analysis was used to calculate risk ratios (RRs) and 95% confidence intervals (CI) of the two groups., Results: The gravidity and parity in the elevated free β-hCG group were lower, and the differences between the groups were statistically significant (all, P < 0.05). The risks of polyhydramnios, preeclampsia, and hyperlipidemia, were increased in women with elevated free β-hCG levels (RRs: 1.996, 95% CI: 1.322-3.014; 1.469, 95% CI: 1.130-1.911 and 1.257, 95% CI: 1.029-1.535, respectively, all P < 0.05), intrauterine growth restriction (IUGR) and female infants were also likely to happen (RRs = 1.641, 95% CI: 1.103-2.443 and 1.101, 95% CI: 1.011-1.198, both P < 0.05). Additionally, there was an association between elevated AFP and free β-hCG levels in second-trimester (RR = 1.211, 95% CI: 1.121-1.307, P < 0.001)., Conclusions: APOs, such as polyhydramnios, preeclampsia, and hyperlipidemia, were increased risks of elevated free β-hCG levels, IUGR and female infants were also likely to happen. Furthermore, there was an association between elevated AFP levels and elevated free β-hCG levels in second-trimester. We recommend prenatal monitoring according to the elevated maternal serum free β-hCG level and the occurrence of APO., (© 2024. The Author(s).)

Human milk represents the gold standard for infant nutrition, with approximately 50% of the energy in human milk derived from lipids. Odd-chain fatty acids (OCFAs) have been recognized as a category of bioactive milk fatty acids in recent research; however, limited data exist on OCFAs in human milk. This study collected human milk samples spanning the postpartum period from 0 to 400 days. Phospholipids containing OCFAs (PL-OCFAs) were determined in 486 human milk samples using hydrophilic liquid chromatography-electrospray ionization-triquadrupole-mass spectrometry. Triacylglycerols containing OCFAs (TAG-OCFAs) were analyzed in 296 human milk samples using ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. The average total concentration of PL-OCFA ranged from 30.89 ± 14.27 mg L -1 to 93.48 ± 36.55 mg L -1 during lactation, and the average total TAG-OCFA content ranged from 103.1 ± 147.15 mg L -1 to 965.41 ± 651.67 mg L -1 . Despite the lower absolute concentration of PL-OCFA, its relative concentration (8.75%-11.75%) was significantly higher than that of TAG-OCFA (0.37%-1.85%) throughout lactation. PC-OCFA, SM-OCFA and PE-OCFA are major sub-classes of PL-OCFA. Furthermore, C17:0 was the major chain length in both PL-OCFA and TAG-OCFA, followed by C15:0. C17:1 was characteristic of TAG-OCFA, while long-chain fatty acids C19:0, C21:0 and C23:0 were characteristic of PL-OCFA. Our findings highlighted the importance of bioactive lipids in human milk, suggesting that OCFAs could be targeted in future studies in relation to the health and development of infants.

An integrated observation of NO x that included coastal cities and oceanic cruises covering the Qingdao coastal waters sites (QDCW) and the Yellow Sea and East China Sea sites (YECS) was conducted in spring. The average concentrations of the coastal cities, the QDCW, and the YECS were 5.4 ± 4.1, 4.2 ± 3.5, and 2.9 ± 6.8 ppb for NO while 18.5 ± 7.2, 9.4 ± 5.2, and 4.9 ± 6.4 ppb for NO 2 , depicting lowest levels in the open seas. Atmospheric NO and NO 2 showed similar spatial variations over the seas, the stations where the air masses originated from land or nearshore regions showed higher levels, but the decisive influencing factors were not the same in the different study areas. The calculated NO x flux value in the YECS (-8.7 × 10 -17  mol N cm -2 ) indicated that the sea surface was a net sink of atmospheric NO x ., 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 Ltd. All rights reserved.)

Objective: To evaluate the associations between serum uric acid (SUA) levels and cardiovascular disease (CVD) risk factors, focusing on potential sex-specific differences., Design: A retrospective cohort study., Setting: A large community-based survey was conducted every two years from 2010 to 2018 in Hangzhou, Zhejiang Province, outheastern China., Participants: 6119 participants aged 40 years and above who underwent at least three times of physical examinations were enrolled., Methods: Participants were categorised into four groups (Q1-Q4) based on baseline SUA quartiles within the normal range, with hyperuricaemia (HUA) as the fifth group. The Q1 was the reference. By stratifying participants by gender, the relationships between SUA levels and systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG) and total cholesterol (TC) were investigated using linear regression models in the generalised estimating equation. Additionally, the associations of elevated SUA levels and HUA with hypertension, hyperglycaemia and dyslipidaemia were correspondingly examined using multivariate logistic regression models., Results: After adjusting for confounding variables, we found positive associations between SUA levels and SBP, DBP, FBG and TC in women, and with TC in men (p<0.01). Likewise, elevated SUA quartiles and HUA were linked to increased dyslipidaemia risk in both sexes, and increased hyperglycaemia risk only in women, with HRs (95% CI) of 1.64 (1.05 to 2.55) and 2.37 (1.47 to 3.81) in the Q4 and HUA group, respectively. Women with HUA had higher hypertension risk (HR=1.45, 95% CI 1.21 to 1.73), while no such association was observed in men. Stratified analyses revealed significant associations between elevated SUA levels and CVD risk factors in postmenopausal and non-obese women., Conclusions: Elevated SUA levels increase the risk of dyslipidaemia in both sexes. SUA levels within normal range and HUA are positively associated with hyperglycaemia and hypertension in postmenopausal women, but not in men., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Nitric oxide (NO) is an atmospheric pollutant and climate forcer as well as a key intermediary in the marine nitrogen cycle, but the ocean's NO contribution and production mechanisms remain unclear. Here, high-resolution NO observations were conducted simultaneously in the surface ocean and the lower atmosphere of the Yellow Sea and the East China Sea; moreover, NO production from photolysis and microbial processes was analyzed. The NO sea-air exchange showed uneven distributions (RSD = 349.1%) with an average flux of 5.3 ± 18.5 × 10 -17 mol cm -2 s -1 . In coastal waters where nitrite photolysis was the predominant source (89.0%), NO concentrations were remarkably higher (84.7%) than the overall average of the study area. The NO from archaeal nitrification accounted for 52.8% of all microbial production (11.0%). We also examined the relationship between gaseous NO and ozone which helped identify sources of atmospheric NO. The sea-to-air flux of NO in coastal waters was narrowed by contaminated air with elevated NO concentrations. These findings indicate that the emissions of NO from coastal waters, mainly controlled by reactive nitrogen inputs, will increase with the reduced terrestrial NO discharge.

Pro-environmental behavior can promote the optimization of the living environment and sustainable social development. This paper constructs a theoretical analysis framework of "environmental consciousness, habitat environment-social capital- pro-environmental behavior". By using structural equation modeling and 1005 instances of microscopic research data, we analyzed the influence of environmental awareness and habitat environment on the pro-environmental behavior of community residents. The results of the analysis were combined with the Bootstrap method to verify the mediating role of social capital dimensions in the influence of environmental awareness and habitat quality on the pro-environmental behavior of community residents. The results show that: Firstly, environmental awareness, habitat quality, and social capital have positive effects on the pro-environmental behavior of community residents. Secondly, environmental awareness and habitat quality have positive effects on the five dimensions of social capital. Thirdly, among the five dimensions of social capital, four dimensions of social trust, social norms, sense of community belonging, and community voluntarism play a partially mediating role between environmental awareness, habitat quality, and pro-environmental behavior. This paper enriches the research on the influence of environmental awareness and habitat environment on pro-environmental behavior, reveals the mediating effect of each dimension of social capital, and broadens the horizon for the study of pro-environmental behavior. The results of the study can provide a reference for decision making to promote the implementation of pro-environmental behavior among community residents., Competing Interests: The authors declare no conflict of interest.

Actively promoting the orderly and voluntary withdrawal of idle rural house bases and effectively activating "sleeping" land assets are considered important measures to accelerate the modernization of agriculture and rural areas, as well as promoting the integrated development of urban and rural areas. However, few studies have focused on the superimposed effects of negative psychological and social environmental factors on the willingness of farmers to withdraw from their homestead. Therefore, we conducted this study in order to clarify the logical ideas of rural home base withdrawal, analyze the factors that influence the decision of home base withdrawal behavior of interest subjects, and provide a scientific decision basis for promoting rural home base withdrawal and accelerating the process of transferring citizens of agricultural population in terms of policies, measures, and paths, so as to design and develop an incentive mechanism for home base withdrawal of citizens of agricultural transfer population. The results of the study show that: (1) the findings indicate that social deprivation, economic deprivation, and emotional deprivation all significantly and negatively affect farmers' willingness to withdraw from their homesteads; (2) social trust plays a mediating role between relative deprivation and farmer homestead withdrawal behavior; and (3) urban integration plays a moderating role between social and emotional deprivation and the social trust of farmers, but does not have a significant moderating role in the relationship between economic deprivation and social trust. Furthermore, it plays a moderating role between all deprivation factors (i.e., economic, social, and emotional deprivation) and farmer homestead withdrawal behavior. This study aims to provide useful guidance and policy suggestions for optimizing policies related to farmer homestead withdrawal behaviors, and for scientifically designing the homestead withdrawal mechanism and policy system.

Triacylglycerol (TAG) is the primary constituent of human milk fat and plays a vital role in the healthy development of infants. But few studies reported the sophisticated profile of TAG molecular species in human breast milk and its temporal changes during a prolonged lactation period. An efficient ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) method was adopted to examine TAGs. A total of 128 TAGs in 296 human breast milk samples collected during postnatal 0 to 400 days were identified. The changes in the human milk TAG profile mainly took place in the early stages of lactation (postnatal 0-45 days), and the TAG profile became stable in mature milk after 200 days of lactation. Odd chain fatty acids (OC-FAs) may be important markers for identifying human breast milk of different lactation stages. This study could provide evidence for developing safe and efficacious human-milk substitutes for children without access to human breast milk.

Objective: The characteristics of oxaliplatin-induced hypersensitivity reactions (HSRs) in Chinese patients were investigated to provide a reference for patients treated with oxaliplatin., Methods: The study reviewed the records of patients who developed oxaliplatin-induced HSRs in 17 hospitals from May 2016 to May 2017. We collected and analyzed the basic information, history of oxaliplatin administration and premedication treatments, chemotherapy cycles, HSR symptoms, and the management and outcomes of these patients., Results: Oxaliplatin-induced HSRs were recorded in 137 patients who had been treated with oxaliplatin-containing regimens. Five different chemotherapy regimens were applied. The median infusion cycle when oxaliplatin-induced HSRs occurred was 7, and HSRs occurred during or shortly after oxaliplatin infusion. Most of the patients experienced grade 1 or grade 2 HSRs with mild symptoms of pruritis (49.64%), flushing (46.72%), chest discomfort (26.28%), and urticaria (25.55%). The majority of the patients completely recovered from HSRs following treatment with antihistamines and dexamethasone. Seven patients completed chemotherapy with oxaliplatin after the symptoms resolved with proper management., Conclusion: The results indicate that oxaliplatin-induced HSRs remain an important issue in safely and successfully fulfilling oxaliplatin-containing chemotherapy. Further studies are needed to analyze the risk factors and establish prophylaxis for such reactions., (© 2021. Huazhong University of Science and Technology.)

To improve the diagnostic efficiency of prostate cancer (PCa) and reduce unnecessary biopsies, we defined and analyzed the diagnostic efficiency of peripheral zone prostate-specific antigen (PSA) density (PZ-PSAD). Patients who underwent systematic 12-core prostate biopsies in Shanghai General Hospital (Shanghai, China) between January 2012 and January 2018 were retrospectively identified (n = 529). Another group of patients with benign prostatic hyperplasia (n = 100) were randomly preselected to obtain the PSA density of the non-PCa cohort (N-PSAD). Prostate volumes and transition zone volumes were measured using multiparameter magnetic resonance imaging (mpMRI) and were combined with PSA and N-PSAD to obtain the PZ-PSAD from a specific algorithm. Receiver operating characteristic (ROC) curve analysis was used to assess the PCa detection efficiency in patients stratified by PSA level, and the area under the ROC curve (AUC) of PZ-PSAD was higher than that of PSA, PSA density (PSAD), and transition zone PSA density (TZ-PSAD). PZ-PSAD could amend the diagnosis for more than half of the patients with inaccurate transrectal ultrasonography (TRUS) and mpMRI results. When TRUS and mpMRI findings were ambiguous to predict PCa (PIRADS score ≤3), PZ-PSAD could increase the positive rate of biopsy from 21.7% to 54.7%, and help 63.8% (150/235) of patients avoid unnecessary prostate biopsy. In patients whose PSA was 4.0-10.0 ng ml -1 , 10.1-20.0 ng ml -1 , and >20.0 ng ml -1 , the ideal PZ-PSAD cut-off value for predicting clinically significant PCa was 0.019 ng ml -2 , 0.297 ng ml -2 , and 1.180 ng ml -2 , respectively (sensitivity >90%). Compared with PSA, PSAD, and TZ-PSAD, the efficiency of PZ-PSAD for predicting PCa is the highest, leading to fewer missed diagnoses and unnecessary biopsies., Competing Interests: None