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Objective To evaluate potential improvements in the diagnosis of thyroid nodules when conventional ultrasound (US) is combined with contrast-enhanced US (CEUS). Methods We recruited 515 participants with 323 malignant and 192 benign nodules, who underwent both US and CEUS examinations at 8 different medical centers in China between October 2020 and October 2021. We assessed the malignancy of thyroid nodules in US using the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS). Diagnostic criteria for US and US + CEUS were developed by investigators based on evaluations of sonographic features. Using multivariate logistic regression and receiver operating characteristic (ROC) analysis, we compared diagnostic performance between the 2 methods based on criteria identified by investigators and via statistical models. Results On the basis of diagnostic criteria identified by investigators, we measured statistically significant differences in area under the curve (AUC) values between ACR TIRADS (0.83) and CEUS TIRADS (0.87; P <.001). On the basis of diagnostic regression models, we found statistically significant differences in AUC values between US (0.76) and US + CEUS (0.84; P =.001). Models based on US + CEUS outperformed those based on US alone (Akaike information criterion of 347.7 and significant improvement in integrated discrimination). These results were confirmed by similar analyses applied to a validation cohort. Conclusion The accuracy of conventional US for differentiating between benign and malignant thyroid nodules can be improved by combining this approach with CEUS. [ABSTRACT FROM AUTHOR]

Terrestrial water storage (TWS) is a pivotal component of the global water cycle, profoundly impacting water resource management, hazard monitoring, and agriculture production. The Gravity Recovery and Climate Experiment (GRACE) and its successor, the GRACE Follow-On (GFO), have furnished comprehensive monthly TWS data since April 2002. However, there are 35 months of missing data over the entire GRACE/GFO observational period. To address this gap, we developed an operational approach utilizing singular spectrum analysis and principal component analysis (SSA-PCA) to fill these missing data over mainland China. The algorithm was demonstrated with good performance in the Southwestern River Basin (SWB, correlation coefficient, CC: 0.71, RMSE: 6.27 cm), Yangtze River Basin (YTB, CC: 0.67, RMSE: 3.52 cm), and Songhua River Basin (SRB, CC: 0.66, RMSE: 7.63 cm). Leveraging two decades of continuous time-variable gravity data, we investigated the spatiotemporal variations in TWS across ten major Chinese basins. According to the results of GRACE/GFO, mainland China experienced an average annual TWS decline of 0.32 ± 0.06 cm, with the groundwater storage (GWS) decreasing by 0.54 ± 0.10 cm/yr. The most significant GWS depletion occurred in the Haihe River Basin (HRB) at −2.07 ± 0.10 cm/yr, significantly substantial (~1 cm/yr) depletions occurred in the Yellow River Basin (YRB), SRB, Huaihe River Basin (HHB), Liao-Luan River Basin (LRB), and Southwest River Basin (SWB), and moderate losses were recorded in the Northwest Basin (NWB, −0.34 ± 0.03 cm/yr) and Southeast River Basin (SEB, −0.24 ± 0.10 cm/yr). Furthermore, we identified that interannual TWS variations in ten basins of China were primarily driven by soil moisture water storage (SMS) anomalies, exhibiting consistently and relatively high correlations (CC > 0.60) and low root-mean-square errors (RMSE < 5 cm). Lastly, through the integration of GRACE/GFO and Global Land Data Assimilation System (GLDAS) data, we unraveled the contrasting water storage patterns between northern and southern China. Southern China experienced drought conditions, while northern China faced flooding during the 2020–2023 La Niña event, with the inverse pattern observed during the 2014–2016 El Niño event. This study fills in the missing data and quantifies water storage variations within mainland China, contributing to a deeper insight into climate change and its consequences on water resource management. [ABSTRACT FROM AUTHOR]

The Eastern Staging System, which was specially developed for patients undergoing surgical resection for hepatocellular carcinoma (HCC), has been proposed for more than ten years. To prospectively validate the predictive accuracy of the Eastern staging on long-term survival after HCC resection. Patients who underwent hepatectomy for HCC from 2011 to 2020 at 10 Chinese hospitals were identified from a prospectively collected database. The survival predictive accuracy was evaluated and compared between the Eastern Staging with six other staging systems, including the JIS, BCLC, Okuda, CLIP, 8th AJCC TNM, and HKLC staging. Among 2365 patients, the 1-, 3-, and 5-year overall survival rates were 84.2%, 64.5%, and 52.6%, respectively. Among these seven staging systems, the Eastern staging was associated with the best monotonicity of gradients (linear trend χ2: 408.5) and homogeneity (likelihood ratio χ2: 447.3), and the highest discriminatory ability (the areas under curves for 1-, 3-, and 5-year mortality: 0.776, 0.787, and 0.768, respectively). In addition, the Eastern staging was the most informative staging system in predicting survival (Akaike information criterion: 2982.33). Using a large multicenter prospectively collected database, the Eastern Staging was found to show the best predictive accuracy on long-term overall survival in patients with resectable HCC than the other 6 commonly-used staging systems. [Display omitted] [ABSTRACT FROM AUTHOR]

Iatrogenic biliary injury (IBI) following laparoscopic cholecystectomy (LC) is the most serious iatrogenic complications. Little is known whether LC-IBI would lead to surgeon's severe mental distress (SMD). A cross-sectional survey in the form of electronic questionnaire was conducted among Chinese general surgeons who have caused LC-IBI. The six collected clinical features relating to mental distress included: 1) feeling burnout, anxiety, or depression, 2) avoiding performing LC, 3) having physical reactions when recalling the incidence, 4) having the urge to quit surgery, 5) taking psychiatric medications, and 6) seeking professional psychological counseling. Univariable and multivariable analyses were performed to identify risk factors of SMD, which was defined as meeting ≥3 of the above-mentioned clinical features. Among 1466 surveyed surgeons, 1236 (84.3%) experienced mental distress following LC-IBI, and nearly half (49.7%, 614/1236) had SMD. Multivariable analyses demonstrated that surgeons from non-university affiliated hospitals (OR:1.873), patients who required multiple repair operations (OR:4.075), patients who required hepaticojejunostomy/partial hepatectomy (OR:1.859), existing lawsuit litigation (OR:10.491), existing violent doctor–patient conflicts (OR:4.995), needing surgeons' personal compensation (OR:2.531), and additional administrative punishment by hospitals (OR:2.324) were independent risk factors of surgeon's SMD. Four out of five surgeons experienced mental distress following LC-IBI, and nearly half had SMD. Several independent risk factors of SMD were identified, which could help to make strategies to improve surgeons' mental well-being. [ABSTRACT FROM AUTHOR]

This paper examines the threshold effect of resource misallocation between specialization and technological innovation performance in the high-tech industry in China. Contrary to the existing literature, this paper applies the static panel threshold model to evaluate the threshold effect of industrial specialization on the innovation performance, including the single threshold effect and double threshold effect. The empirical results shed new light on the topic and signified that high-tech industry specialization has a nonlinear effect on innovation performance and the resource misallocation threshold. This paper unveils a novel, double threshold effect of resource misallocation between industrial specialization and innovation performance. Moreover, the twenty-eight regions in China are divided into three types according to a resource misallocation, which unfold the current situation of the resource misallocation in pharmaceutical manufacturing—providing directional guidance for structural reforms of the supply side of pharmaceutical manufacturing in various regions. [ABSTRACT FROM AUTHOR]

More than two‐thirds of patients with hepatocellular carcinoma (HCC) cannot receive curative therapy and have poor survival due to late diagnosis and few prognostic directions. In our study, nontargeted and targeted metabolomics analyses were conducted by liquid chromatography–mass spectrometry to characterize metabolic features of HCC and identify diagnostic and prognostic biomarker candidate incorporating liver tissue and serum metabolites. A total of 552 subjects, including 432 with liver tissue and 120 with serum specimens, were recruited in China. In the discovery cohort, a series of 138 metabolites were identified to discriminate HCC tissues from matched nontumor tissues. Retinol presented with the highest area under the curve (AUC) of 0.991 and associated with Edmondson grade. In the validation cohort, all metabolites in retinol metabolism pathway were examined and the levels of retinol and retinal in tumor tissue and serum decreased in the order of normal to cirrhosis to HCC of Edmondson Grades I to IV. Retinol and retinal levels could also differentiate between HCC and cirrhosis, with AUCs of 0.996 and 0.994, respectively, in tissue and 0.812 and 0.744, respectively, in serum. The AUC of the combined retinol and retinal panel in serum was 0.852. Univariate and multivariate Cox regression identified this panel as an independent predictor for HCC and showed that low expression of retinol and retinal correlated with decreased survival time. In conclusion, the retinol metabolic signature had considerable diagnostic and prognostic value for identifying HCC patients who would benefit from prompt therapy and optimal prognostic direction. What's new? Currently, α‐fetoprotein (AFP) is the most practical screening biomarker for early hepatocellular carcinoma (HCC) detection and prognostic tool for tumor recurrence and patient survival, but the relatively poor sensitivity and specificity remain unsatisfactory. Here, retinol metabolism was found to be closely associated with the malignant transformation of HCC. Retinol and retinal displayed great diagnostic ability for HCC both in liver tissue and serum samples. The two‐metabolite panel could serve as an independent predictor for HCC; low expression of retinol and retinal correlated with decreased survival time. Retinol metabolism thus hold great promise for clinical application in HCC diagnosis and prognosis. [ABSTRACT FROM AUTHOR]

The increasing need for repairs of polygonized wheels on high-speed railways in China is becoming problematic. At high speeds, polygonized wheels cause abnormal vibrations at the wheel-rail interface that can be detected via axle-box accelerations. To investigate the quantitative relationship between axle-box acceleration and wheel polygonization in both the time and frequency domains and under high-speed conditions, a dynamics model was developed to simulate the vehicle-track coupling system and that considers both wheel and track flexibility. The calculated axle-box accelerations were analyzed by using the improved ensemble empirical mode decomposition and Wigner-Ville distribution time-frequency method. The numerical results show that the maximum axle-box accelerations and their frequencies are quantitatively related to the harmonic order and out-of-roundness amplitude of polygonized wheels. In addition, measuring the axle-box acceleration enables both the detection of wheel polygonization and the identification of the degree of damage. [ABSTRACT FROM AUTHOR]

Machine‐induced soil disturbance may negatively impact the sustainability of a smallholder farming system. On‐farm studies at 143 fields were conducted over three crop seasons with the goal of quantifying the effect of soil disturbance on rice (Oryza sativa L.) paddy productivity induced by small harvesters (i.e., power <75 kW, weight < 3.5 Mg, and working width <2200 mm). A field survey toolbox containing fine‐layered cone penetration test, soil micro‐relief measurement, soil physics test (water content, bulk density, and porosity), documentation of field attributes, harvesters' technical specifications, cropping systems, and farmers' practices was used for field observation. Results showed that harvester traffic increased soil bulk density and decreased soil porosity. However, harvester‐induced soil changes in statistics were not detected. In addition, trafficked lanes had great soil strength (P =.05) than non‐trafficked lanes, and equipment induced compaction was limited to the surface 150 mm. Therefore, small harvesters minimized subsurface soil damage. However, regardless of the model and specification, all harvesters caused ruts. Small field sizes, irregular field shapes, inconsistent field management practices, lacking soil protection awareness, excessive soil water content during rice harvesting and random field traffic were identified as major factors aggravating soil disturbance. Above these, several well‐established approaches to alleviate machine‐induced soil damage were also observed during the field survey, including pre‐harvesting drainage, floating chassis, ultra‐narrow wheels, and puddling. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association of age and sex on survival in non-metastatic colorectal cancer (CRC) patients and to identify groups at high risk for poor outcomes. Materials and methods: We performed a retrospective analysis of 5,047 non-metastatic CRC patients from 2008 to 2013. Data regarding age at diagnosis; gender; tumor site; tumor stage; differentiation; lymphatic, neural or vascular invasion; and survival outcomes were collected. Patients were stratified into 10-year age groups (≤35, 36–45, 46–55, 56–65, 66–75, >75) and then further analyzed in three age groups (≤35, 36–75, >75). Disease-free survival (DFS) and overall survival (OS) were evaluated using univariate and multivariate Cox regression models. Results: Of the 5,047 eligible patients, 41.3% were female. The tumor stages were balanced between the genders. In the female patients, the tumor stages were similarly distributed among the different age groups, while younger male patients were diagnosed with more advanced disease (P<0.001 for trend). When stratified into three age groups, young females experienced significantly poorer survival than young males (DFS: hazard ratio [HR]=1.85 [1.04–3.30], OS: HR=2.65 [1.11–6.34]). After adjusting for tumor stage, site, differentiated grade and lymphatic or vascular invasion status, females ≤35 and >75 had shorter DFS than patients between 36 and 75 years old (HR=1.57 [1.03–2.38] and HR=1.51 [1.11–2.05, respectively]), while there was no difference in DFS between females ≤35 and those >75. For male patients, older age was associated with poorer OS after the same adjustment. Conclusion: Young female CRC patients (≤35 years old) had the poorest DFS and quite poor OS compared to the other age groups. This emphasizes the need for health care providers to have a heightened awareness and to conduct further research when caring for young female CRC patients. [ABSTRACT FROM AUTHOR]

Taxonomy of a tetrigid genus Teredorus Hancock is reviewed. Two new species, Teredorus parvipulvillus sp. n. and Teredorus hunanensis sp. n. are described from China and an updated identification key to all known species of the genus is given, as well as brief comments on phylogenetic relationships, biology and ecology. [ABSTRACT FROM AUTHOR]

Abstract: A Fiber Bragg Grating sensor network is designed to implement the real-time health monitoring of port machinery. This paper describes the system design and its application in port-machinery monitoring. The results of field test on port machinery in Qing Huangdao (China) are discussed. Through the long-term monitoring on running state, especially the structure strain of port machinery, the status of the port machinery including security and fatigue life could be acquired and estimated exactly. It could provide the foundation for the use and maintenance of port machinery, and the security of the port machinery is improved. Long-term test results show good stability and repeatability of <8με over two years operation with a precision of ±4με and a resolution of 1με. [Copyright &y& Elsevier]

[image omitted] Following Ligeti's guidance, Xiaoyong Chen (b.1955) has consistently steered away from both the Chinese and the avant-garde establishments. His music explores the infinite richness of individual tones. The Duet for Violin and Zheng (1989) employs microtonal tuning, and focuses on the inter-resonance of colliding sonorities and tuning systems. Evapora (for small chamber ensemble, 1996) demonstrates his interest in juxtaposing harmonic and/or non-harmonic fusion. With a minimum of means, his highly personal musical vocabulary reveals a pluralistic world of clashing tuning systems, modes and individual voices; it also captures both the integration and tension between contrasting cultural elements. [ABSTRACT FROM AUTHOR]

The subterranean termite Odontotermes forrrugsanus Shiraki is an important pest of agronomic crops, plantations, and forestry, and it endangers earthen dikes and dams in China. A fipronil bait consisting of straw pulp and white sugar was evaluated against field colonies of O. formosanus. Triple mark-capture with Nile blue dye was used to delineate foraging territories and to estimate foraging populations of four O. formosanus colonies locating in the campus of Huazhong Agricultural University, Wuhan, China. Termite activity was monitored by number of termite workers and straw board consumption in underground monitoring stations. Consumption of bait matrix and fipronil was estimated for each testing site. The results showed that ≈3–5 mg of fipronil could suppress foraging populations of O. formosanus containing 0.4–0.7 million foragers per colony. Baits containing fipronil seem to be a feasible alternative for controlling O. formosanus. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a recognized sequalae of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. This study aimed to identify long-term survival and prognostic factors after curative resection for HCC among patients with chronic HCV infection. From a Chinese multicenter database, the data of consecutive patients with HCV infection undergoing curative liver resection for initial HCC between 2006 and 2015 were retrospectively reviewed. Postoperative 30-day mortality and morbidity, long-term overall survival (OS) and recurrence-free survival (RFS) were evaluated. Among 382 HCC patients with HCV infection, 68 (18%) had concurrent HBV infection and 110 (29%) had portal hypertension. Postoperative 30-day morbidity and mortality rates were 45% and 2.9%, respectively. The 5-year OS and RFS rates were 45% and 34%, respectively. Multivariable Cox-regression analyses identified that concurrent HBV infection, presence of portal hypertension, largest tumor size > 5 cm, and macrovascular and microvascular invasion were independently associated with worse OS and RFS, while postoperative regular anti-HCV therapy was independently associated with better OS. Long-term prognosis after HCC resection among patients with HCV infection was worse in those with concurrent HBV infection and concomitant portal hypertension. Postoperative regular anti-HCV therapy was associated with better OS. [ABSTRACT FROM AUTHOR]

Abstract Shallow carbonate platforms exhibit major changes in faunal composition and facies types during the latest Permian and earliest Triassic. Although the microbialites that developed following the latest Permian mass extinction (LPME) have attracted wide attention, temporal variations in shallow-platform facies and faunas prior to the LPME have been less thoroughly studied. Here, we analyze diversity patterns and variation in skeletal composition in three Upper Permian sections from isolated carbonate platforms of the Nanpanjiang Basin. In addition to the well-known transition from fossil-rich Upper Permian limestones to fossil-poor Permian-Triassic boundary (PTB) microbialites, these sections exhibit several distinct changes that predate the LPME. First, foram faunas show a shift from non-fusulinid-dominated to fusulinid-dominated communities in the <1-m interval below the LPME horizon of each section, reflecting a shallowing trend over ~20–30 kyr preceding the mass extinction. Second, a "foram gap" and concurrent "detrital event" are observed below the LPME in all three sections, recording a rapid influx of detrital siliciclastics that predated the mass extinction by <60 kyr. These features reflect a degree of marine environmental instability prior to the end-Permian mass extinction. The sudden influx of siliciclastics may represent an early perturbation to terrestrial ecosystems linked to incipient Siberian Traps magmatism, resulting in secondary effects in marine environments through increased sediment yields. Highlights • Analysis of carbonate microfacies and foraminifer abundances in three P-Tr sections (Wengna, Taiping, Lung Cam) • Environmental instability on carbonate platforms of Nanpanjiang Basin, South China up to 60 kyr preceding mass extinction • A discrete episode of detrital siliciclastic influx to carbonate platforms initiated major pre-extinction faunal changes. • Shift to fusulinid-dominated foram assemblages at ~20–30 kyr prior to mass extinction owing to platform shallowing • Pre-extinction perturbations possibly caused by terrestrial ecosystem deterioration and increased subaerial erosion. [ABSTRACT FROM AUTHOR]

The beet armyworm, Spodoptera exigua Hübner 1808 is an outbreak herbivore and results in serious economic losses in many areas of the world. One of causes of population outbreak could be attributed to miss the optimal control chance based on incomprehension of the population source. We reviewed the advances of overwintering and migration of S. exigua based on geographic distribution to understand the population sources. The distribution regions of S. exigua increased 34 countries since 1972. Population dynamics of S. exigua during winter were different, but the overwintering regions are still vague and migratory trajectories are incomplete. The migratory phenomena, demonstrating moths have strong flight capacity, had been recorded in the United States, United Kingdom, Fennoscandia and Japan in spring and early summer, and back track in the United Kingdom and China in fall. On the basis of monsoon, geographic distribution and population dynamics during winter, we speculated that the population of S. exigua migrate northward in spring and early summer in China, and southward in fall in the United States and Japan. [ABSTRACT FROM AUTHOR]

The marine calcium (Ca) cycle is controlled by rates of continental weathering, seawater pH, and carbonate deposition on the seafloor and is linked to atmospheric CO 2 , climate change, and marine biotic evolution. Here, we provide the first continuous seawater Ca isotope profile from conodont apatite in South China for the latest Permian to early Middle Triassic, revealing major fluctuations in the Early Triassic calcium cycle. Three episodes of decreasing conodont δ44/40Ca (by 0.16–0.23‰) occurred around the Permian-Triassic, Smithian-Spathian, and Olenekian-Anisian boundaries. The first episode, coincident with a negative excursion of carbonate carbon isotopes, global warming, oceanic anoxia, enhanced weathering, and sea-level fall, was likely caused by a combination of volcanic CO 2 release, ocean acidification, a reduced skeletal carbonate sink, and enhanced weathering of shelf carbonates. The latter two episodes, coincident with positive excursions of carbon isotopes, global cooling, and oceanic anoxia, possibly resulted from upwelling-driven shelf acidification and reduced skeletal carbonate burial. All three events were associated with marine biotic diversity losses, demonstrating a link between the calcium cycle and mass extinctions. • Conodont δ44/40Ca curve is established for the latest Permian to Middle Triassic. • Three episodes of decreasing δ44/40Ca (0.16–0.23‰) occurred in the Early Triassic. • Negative δ44/40Ca shift in the PTB suggests a CO 2 -driven ocean acidification event. • Negative δ44/40Ca shifts in SSB & OAB suggest upwelling-driven shelf acidification. [ABSTRACT FROM AUTHOR]

Unitary Association Method (UAM) analyses of conodont faunas from 28 sections spanning the biggest Phanerozoic end-Permian mass extinction and significant global environmental and ecosystem perturbations during the succeeding Early Triassic are presented. Based on 72 conodont species, 26 Unitary Association Zones (UAZs) are established for the latest Permian to earliest Middle Triassic of South China. These UAZs provide quantitative high-resolution tools to correlate sequences in the Early Triassic of South China and to compare and test high-resolution conodont biostratigraphy based on interval conodont zones developed over the past three decades. Our quantitative analyses provide insights on ongoing debates relating to the First Appearance Datum (FAD) of the conodont Hindeodus parvus which is used to place and subsequently correlate the "Golden Spike" defining the base of the Triassic (Permian-Triassic Boundary) at the base of Bed 27c at the GSSP Meishan D Section. Previous proposals that suggested potential earlier occurrences of H. parvus below its FAD at Meishan section are not supported by our results. In deep water sections, the First Occurrence (FO) of H. parvus lies at the base of UAZ 5 at the Bianyang section while it lies within UAZ 6 at the Meishan section. This indicates that the earliest occurrence of H. parvus in South China is in the Bianyang section but this conclusion needs further testing due to the reliance on "spot" data by the UAM. Anomalously high occurrences of Hindeodus in the Mingtang section (close to the Bianyang section) further suggests that the Bianyang-Mingtang area may have provided a temporally extended habitable zone for anchignathodontid conodonts. Stage boundaries currently proposed or established using interval conodont zones locate within or between UAZs and are difficult to correlate with carbon isotope curves. UAZs are useful in helping to define GSSPs by recognizing which correlations are most robust and in the selection of the most appropriate species and level for GSSPs. [ABSTRACT FROM AUTHOR]

Objective: To explore the genetic basis for a patient with Alport syndrome (AS) and confirm the existence of a splicing variant., Methods: An AS patient diagnosed at the Affiliated Hospital of Inner Mongolia Medical University on January 8, 2021 for significant proteinuria and occult hematuria was selected as the study subject. Clinical data was collected. Peripheral blood samples were collected for the extraction of genomic DNA. Whole exome sequencing and Sanger sequencing were carried out to identify potential genetic variants. An in vitro experiment was also conducted to verify the abnormal mRNA splicing. Bioinformatic software was used to analyze the conservation of amino acids of the variant sites and simulate the 3D structure of the variant collagen IV protein. Immunofluorescence and immunohistochemistry were carried out on renal tissues from the patient to confirm the presence of AS kidney injury., Results: The patient, a 21-year-old male, had a 24-hour urine protein of 3.53 g/24 h, which fulfilled the diagnostic criteria for proteinuria. His blood uric acid has also increased to 491 μmol/L. DNA sequencing revealed that he has harbored a c.835-9T>A splice variant of the COL4A5 gene, which was not found in either of his parents. In vitro experiment confirmed that the variant has removed 57 bp from the exon 15 of the mRNA of the COL4A5 gene. The deletion may cause loss of amino acid residues from positions 279 to 297, which in turn may affect the stability of the secondary structure of the α5 chain encoded by the COL4A5 gene. The amino acids are conserved across various species. The result of homology modeling indicated that the trimerization of Col-IV with the mutated α5 chain could be achieved, however, the 3D structure was severely distorted. The AS kidney damage was confirmed through immunofluorescence assays. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.835-9T>A variant was classified as likely pathogenic (PVS1&#95;Moderate+PS3&#95;Moderate+PM2&#95;Supporting+PS2+PP3+PP4)., Conclusion: The c.835-9T>A variant of the COL4A5 gene probably underlay the AS in this patient. In vitro experiment has confirmed the abnormal splicing caused by the variant. Histopathological examination of the kidney tissue has provided in vivo evidence for its pathogenicity. Above finding has expanded the mutational spectrum of the COL4A5 gene.

Tea is the most popular drink worldwide, and China is the largest producer of tea. Therefore, tea is an important commercial crop in China, playing a significant role in domestic and foreign markets. It is necessary to make accurate and timely maps of the distribution of tea plantation areas for plantation management and decision making. In the present study, we propose a novel mapping method to map tea plantation. The town of Menghai in the Xishuangbanna Dai Autonomous Prefecture, Yunnan Province, China, was chosen as the study area, andgg GF-1 remotely sensed data from 2014-2017 were chosen as the data source. Image texture, spectral and geometrical features were integrated, while feature space was built by SEparability and THresholds algorithms (SEaTH) with decorrelation. Object-Oriented Image Analysis (OOIA) with a Support Vector Machine (SVM) algorithm was utilized to map tea plantation areas. The overall accuracy and Kappa coefficient ofh the proposed method were 93.14% and 0.81, respectively, 3.61% and 0.05, 6.99% and 0.14, 6.44% and 0.16 better than the results of CART method, Maximum likelihood method and CNN based method. The tea plantation area increased by 4,095.36 acre from 2014 to 2017, while the fastest-growing period is 2015 to 2016., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Liang 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.)

Background: Hepatocellular carcinoma (HCC) is common among adolescents and young adults (AYAs) in areas with endemic hepatitis B virus infection. We sought to characterize clinical features and long-term outcomes among AYAs versus older adults (OAs) who underwent HCC resection., Methods: From a Chinese multicenter database, patients were categorized as AYA (aged 13-39 years) versus OA (aged ≥40 years). Patient clinical features, perioperative outcomes, overall survival (OS) and time-to-recurrence (TTR) were compared. Multivariable Cox-regression analyses were performed to identify the impact of age on OS and TTR., Results: Among 1952 patients, 354(22.2%) were AYAs. AYAs were less likely to have cirrhosis yet were likely to have advanced tumor pathological characteristics than OAs. Postoperative morbidity and mortality were comparable. Compared with OAs, AYAs had a comparable OS but a decreased TTR. Multivariable analyses identified that young age (<40 years) was independently associated with poorer TTR., Conclusions: Compared with OAs, AYAs had a higher incidence of recurrence following liver resection among patients with HCC, suggesting that enhanced surveillance for postoperative recurrence may be required among AYAs., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Daily intake of tea has been known to relate to a low risk of depression. In this study, we report that a special variety of tea in China, Camellia assamica var. kucha ( kucha ), possesses antidepressant effects but with less adverse effects as compared to traditional tea Camellia sinensis . This action of kucha is related to its high amount of theacrine, a purine alkaloid structurally similar to caffeine. We investigated the antidepressant-like effects and mechanisms of theacrine in chronic water immersion restraint stress and chronic unpredictable mild stress mice models. PC12 cells and primary hippocampal neural stem cells were treated with stress hormone corticosterone (CORT) to reveal the potential antidepression mechanism of theacrine from the perspective of adult hippocampus neurogenesis. Results of behavioral and neurotransmitter analysis showed that intragastric administration of theacrine significantly counteracted chronic stress-induced depression-like disorders and abnormal 5-hydroxytryptamine (5-HT) metabolism with less central excitability. Further investigation from both in vivo and in vitro experiments indicated that the antidepressant mechanism of theacrine was associated with promoting adult hippocampal neurogenesis, via the modulation of the phosphodiesterase-4 (PDE4)/cyclic adenosine monophosphate (cAMP)/cAMP response-element binding (CREB)/brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) pathway. Collectively, our findings could promote the prevalence of kucha as a common beverage with uses for health care and contribute to the development of theacrine as a potential novel antidepressant medicine.

Background: To develop an easy-to-use model to predict the probability of perioperative blood transfusion (PBT) in patients undergoing liver resection for hepatocellular carcinoma (HCC)., Method: 878 patients from Eastern Hepatobiliary Surgery Hospital of Shanghai were enrolled in the training cohort, while 691 patients from Tongji Hospital of Wuhan and 364 patients from two hospitals from Europe and America served as the Eastern and Western external validation cohorts, respectively. Independent predictors of PBT were identified and used for the nomogram construction. The predictive performance of the model was assessed using the concordance index (C-index) and calibration plot, and externally validated using the two independent cohorts. This model was compared with four currently available prediction risk scores., Results: Eight preoperative variables were identified as independent predictors of PBT, which were incorporated into the new nomogram model, with a C-index of 0.833 and a well-fitted calibration plot. The nomogram performed well on the externally Eastern and Western validation cohorts (C-indexes: 0.786 and 0.777). The discriminatory ability of the nomogram was superior to the four currently available prediction scores (C-indexes: 0.833 vs. 0.671-0.770). The nomogram was programmed into an online calculator, which is available at http://www.asapcalculate.top/Cal3&#95;en.html., Conclusion: A nomogram model, using an easy-to-access website, can be used to calculate the PBT risk and identify which patients undergoing HCC resection are at high risks of PBT and can benefit most by using blood conservation techniques., (Copyright © 2020 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)

Background: Morbidity remains a common problem following hepatic resection. The aim of this study was to investigate the association between preoperative body mass index (BMI) and morbidity in patients undergoing liver resection for hepatocellular carcinoma (HCC)., Methods: Patients were divided into three groups according to preoperative BMI: low-BMI (≤18.4 kg/m 2 ), normal-BMI (18.5-24.9 kg/m 2 ) and high-BMI (≥25.0 kg/m 2 ). Baseline characteristics, operative variables, postoperative 30-day mortality and morbidity were compared. Univariable and multivariable analyses were performed to identify independent risk factors associated with postoperative morbidity., Results: Among 1324 patients, 108 (8.2%), 733 (55.4%), and 483 (36.5%) were low-BMI, normal-BMI, and high-BMI, respectively. There were no differences in postoperative 30-day mortality among patients based on BMI (P = 0.199). Postoperative 30-day morbidity was, however, higher in low-BMI and high-BMI patients versus patients with a normal-BMI (33.3% and 32.1% vs. 22.9%, P = 0.018 and P < 0.001, respectively). Following multivariable analysis low-BMI and high-BMI remained independently associated with an increased risk of postoperative morbidity (OR: 1.701, 95%CI: 1.060-2.729, P = 0.028, and OR: 1.491, 95%CI: 1.131-1.966, P = 0.005, respectively). Similar results were noted in the incidence of postoperative 30-day surgical site infection (SSI)., Conclusion: Compared with normal-BMI patients, low-BMI and high-BMI patients had higher postoperative morbidity, including a higher incidence of SSI after liver resection for HCC., (Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)

Background: The role of liver resection for multinodular (≥3 nodules) hepatocellular carcinoma (HCC) remains unclear, especially among patients with severe underlying liver disease. We sought to evaluate surgical outcomes among patients with cirrhosis and multinodular HCC undergoing liver resection., Methods: Using a multicenter database, outcomes among cirrhotic patients who underwent curative-intent resection of HCC were examined stratified according to the presence or absence of multinodular disease. Perioperative mortality and morbidity, as well as overall survival (OS) and recurrence-free survival (RFS) were compared between the two groups., Results: Among 1066 cirrhotic patients, 906 (85.0%) had single- or double-nodular HCC (the non-multinodular group), while 160 (15.0%) had multinodular HCC (the multinodular group). There were no differences in postoperative 30-day mortality and morbidity among non-multinodular versus multinodular patients (1.8% vs. 1.9%, P = 0.923, and 36.0% vs. 39.4%, P = 0.411, respectively). In contrast, 5-year OS and RFS of multinodular patients were worse compared with non-multinodular patients (34.6% vs. 58.2%, and 24.7% vs. 44.5%, both P < 0.001). On multivariable analyses, tumor numbers ≥5, total tumor diameter ≥8 cm and microvascular invasion were independent risk factors for decreased OS and RFS after resection of multinodular HCC in cirrhotic patients., Conclusions: Liver resection can be safely performed for multinodular HCC in the setting of cirrhosis with an overall 5-year survival of 34.6%. Tumor number ≥5, total tumor diameter ≥8 cm and microvascular invasion were independently associated with decreased OS and RFS after resection in cirrhotic patients with multinodular HCC., (Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

Recent studies indicated that preoperative radiotherapy significantly reduces the lymph nodes (LNs) harvest from patients with rectal cancer. This may weaken the prognostic value of current standard of LNs retrieval (≥12 LNs). This study investigates the prognostic impact of the LN counts on pathologically LN-negative (ypN0) after preoperative radiotherapy for patients with rectal cancer.Surveillance, Epidemiology and End Results (SEER) registered nonmetastatic rectal cancer patients diagnosed between 1998 and 2005 were included in this study. Optimal cutoff value for number of LNs retrieved was determined by X-tile program. Log-rank tests were adopted to compare the rectal cause specific survival (RCSS) for ypN0 patients using separated cutoff value of LN counting from 2 to 20. Correlation between LN count and tumor regression was investigated in an additional 221 patients from Fudan University Shanghai Cancer Center (FUSCC).The results showed that there were fewer number of LNs examined in patients with preoperative radiotherapy than those without (8.9 vs 10.9, P < 0.001). X-tile program identified the difference in survival was most significant (maximum of χ log-rank values) for the number 4. And 5-year RCSS increased accordingly with the cutoff values ranging from 4 to 15, which were confirmed as optimal cutoff and validated as independent prognostic factors in multivariate regression analysis (χ = 50.65, P < 0.001). Patients in FUSCC set were found to have fewer LNs retrieval in group of good tumor regression than in that of poor one (P = 0.01).These results confirmed the reduced number of LN retrieval in patients with rectal cancer treated with preop-RT. LN count is still an independently prognostic factor for ypN0 rectal cancer.

Background: Low back pain affects approximately 80% of people at some stage in their lives. Exercise therapy is the most widely used nonsurgical intervention for low back pain in practice guidelines. Whole body vibration exercise is becoming increasingly popular for relieving musculoskeletal pain and improving health-related quality of life. However, the efficacy of whole body vibration exercise for low back pain is not without dispute. This study aims to estimate the effect of whole body vibration exercise for chronic low back pain., Methods/design: We will conduct a prospective, single-blind, randomized controlled trial of 120 patients with chronic low back pain. Patients will be randomly assigned into an intervention group and a control group. The intervention group will participate in whole body vibration exercise twice a week for 3 months. The control group will receive general exercise twice a week for 3 months. Primary outcome measures will be the visual analog scale for pain, the Oswestry Disability Index and adverse events. The secondary outcome measures will include muscle strength and endurance of spine, trunk proprioception, transversus abdominis activation capacity, and quality of life. We will conduct intention-to-treat analysis if any participants withdraw from the trial., Discussion: Important features of this study include the randomization procedures, single-blind, large sample size, and a standardized protocol for whole body vibration in chronic low back pain. This study aims to determine whether whole body vibration exercise produces more beneficial effects than general exercise for chronic low back pain. Therefore, our results will be useful for patients with chronic low back pain as well as for medical staff and health-care decision makers., Trial Registration: Chinese Clinical Trial Registry: ChiCTR-TRC-13003708.