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Objective To explore the relationship between the levels of serum 8-hydroxy deoxyguanosine (8 - OHdG) and malondialdehyde (MDA) and cognitive dysfunction in patients with Parkinson's disease (PD). Methods From February 2021 to February 2022, 126 patients with PD in The Affiliated Hospital of Xuzhou Medical University were divided into normal cognitive function group (PDN group, n = 41), mild cognitive impairment group (PD-MCI group, n = 47) and Parkinson's disease dementia group (PDD group, n = 38), and 50 healthy subjects were selected as control group. Hoehn-Yahr staging was used to evaluate the severity of patients with PD during the "close" period of anti-PD drugs, and the motor function of patients with PD was evaluated by the Unified Parkinson's Disease Rating Scale III (UPDRS III). Montreal Cognitive Assessment (MoCA) was used to evaluate the severity of cognitive dysfunction at rest and in the "on" period of anti-PD drugs, and the serum 8-OHdG and MDA of PD patients and controls were collected. Pearson and partial correlation analyses were used to analyze the correlation between the levels of serum 8-OHdG and MDA and MoCA score in PD patients. Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of cognitive dysfunction in PD patients. The efficacy analysis of serum 8-OHdG and MDA levels in predicting the risk of cognitive dysfunction in PD patients was carried out by using receiver operating characteristic curve (ROC curve). Results The results of correlation analysis showed that there was a negative correlation between the MoCA score and the duration (r = - 0.241, P = 0.007), Hoehn-Yahr staging (r = - 0.333, P = 0.007), 8-OHdG (r = - 0.310, P = 0.000) and MDA (r = - 0.291, P = 0.004) in PD patients. The results of Logistic regression analysis showed that the elevated levels of 8-OHdG (OR = 1.335, 95%CI: 1.137-1.568; P = 0.000) and MDA (OR = 2.928, 95%CI: 1.676-5.115; P = 0.000) were risk factors for cognitive dysfunction in PD patients. The results of ROC curve showed the areas under the curve of 8-OHdG, MDA and their combination in predicting cognitive dysfunction in PD patients were 0.831 (95%CI: 0.761-0.902, P = 0.000), 0.846 (95%CI: 0.775-0.916, P = 0.000) and 0.922 (95%CI: 0.878-0.966, P = 0.000), respectively. Conclusions The detection of 8-OHdG and MDA in peripheral blood is expected to be a serum marker to evaluate the severity of cognitive dysfunction in patients with PD, and to predict cognitive dysfunction in patients with PD. [ABSTRACT FROM AUTHOR]

Dictyophora indusiata is one of the most famous edible mushrooms in China. D. indusiata polysaccharide (DP) has attracted increasing attention because of its multiple beneficial effects. In this study, the in vitro simulated digestion and microbial fermentation were designed to reveal the potential catabolic property of DP and its impacts on the modulation of gut microbial composition. The results showed that the reducing sugar content, total polysaccharides content, molecular weight, and rheological property of DP were not significantly altered under in vitro simulated digestive conditions. However, the molecular weight, apparent viscosity, and total polysaccharides content of indigestible DP (DPI) significantly decreased during in vitro fecal fermentation, and the reducing sugar content and the release of free monosaccharides notably increased, suggesting that DP could be degraded and used by gut microbiota. Additionally, the relative abundances of several beneficial bacteria, such as Bacteroides, Catenibacterium, Parabacteroides, and Megamonas, increased significantly, indicating that DP can regulate the composition and abundance of gut microbiota. Moreover, DP could also promote the production of SCFAs, thus changing the acid–base environment of the large intestine. The results of this study are beneficial for deeply clarifying the catabolic behavior of DP in the gastrointestinal tract, which can provide a theoretical basis for developing microbiota-directed products based on DP. [ABSTRACT FROM AUTHOR]

Both vegetation coverage rates and arrangement patterns have important influences on erosion. Very little previous research focuses on the impacts of spatial vegetation distribution patterns on erosion. The slope-gully system was taken as the research object, which is composed of a 5.0 m long hillslope with a slope gradient of 20° and a 3.0 m long gully slope with a gradient of 50°. A series of scouring experiments with two inflow discharges (3.2 L min−1, 5.2 L min−1) was carried out. The effects of the flow discharges, spatial grass arrangement patterns (US, MS, and DS represent the presence of grass covering on up-hillslope, middle-hillslope, and down-hillslope, respectively) and grass coverage rates (0%, 30%, 50%, 70%, and 90%) on runoff and sediment were studied in this paper. The results indicated that either runoff or sediment yielding was significantly decreased with the grass coverage rates increasing and with the variation of grass arrangement patterns on a hillslope. While grass coverage had more effectiveness in controlling erosion compared with runoff reduction, and DS can control erosion more effectively than US and MS erosion controlling. For the gully slope, erosion significantly increased with the grass coverage rates increasing no matter how the grass arrangement patterns on the hillslope. Therefore, both different grass coverage and different grass arrangement patterns have an influence on erosion processes; any research that only takes care of the single factor mentioned above is not enough to reveal the effects of grass on erosion. In the process of erosion control in the Loess Plateau, taking effective measures both on the hillslope and gully slope will be effective methods of reducing soil erosion. [ABSTRACT FROM AUTHOR]

Objective: Reliable electrophysiological indicators are urgently needed in the precise evaluation of Parkinson's disease (PD). It is still elusive whether oculomotor performance is impaired or has clinical value in early PD. This study aims to explore oculomotor performance in newly diagnosed, drugnaïve PD and its correlation with clinical phenotype. Methods: Seventy-five patients with de novo PD, 75 patients with essential tremor (ET), and 46 gender-and age-matched healthy controls (HCs) were included in this cross-sectional study. All subjects underwent oculomotor test via videonystagmography. Visually guided saccade latency, saccadic accuracy and gain in smooth pursuit eye movement (SPEM) at three frequencies of the horizontal axis were compared among the three groups. Patients with PD also received detailed motor and non-motor evaluation by serial scales. The association between key oculomotor parameters and clinical phenotypes were explored in PD patients. Results: Both de novo PD and ET patients showed prolonged saccadic latency and decreased saccadic accuracy relative to HCs. SPEM gain in PD was uniformly reduced at each frequency. SPEM gain at 0.4 Hz was also decreased in ET compared with HCs. However, there was no significant difference of oculomotor parameters between de novo PD and ET patients. Furthermore, prolonged saccadic latency was correlated with long disease duration, whereas decreased SPEM gain was associated with severe motor symptoms in de novo PD patients. Conclusion: Ocular movements are impaired in de novo, drug naïve PD patients; these changes could be indicators for disease progression in PD. [ABSTRACT FROM AUTHOR]

As the labor relations climate in China has deteriorated in recent years, some firms have turned to partnership approaches. Using data collected from HR managers and employees in 190 companies in five provinces of China, this study tests the applicability of partnership theory for Chinese enterprises. It identifies eight dimensions of partnership practices and examines their effectiveness in improving the labor relations climate and employee attitudes. Results show that partnership practices are positively associated with labor relations climate and employee attitudes and that labor relations climate mediates the relationship between partnership practices and employee attitudes (i.e., affective commitment, job satisfaction and turnover intention). These findings contribute to the literature on partnership and labor relations climate and the operationalization of partnership and its effects, in the Chinese context. [ABSTRACT FROM AUTHOR]

Background: Urban green infrastructure (GI) networks play a significant role in ensuring regional ecological security; however, they are highly vulnerable to the influence of urban development, and the optimization of GI networks with better connectivity and resilience under different development scenarios has become a practical problem that urgently needs to be solved. Taking Harbin, a megacity in Northeast China, as the case study, we set five simulation scenarios by adjusting the economic growth rate and extracted the GI network in multiple scenarios by integrating the minimal cumulative resistance model and the gravity model. The low-degree-first (LDF) strategy of complex network theory was introduced to optimize the GI network, and the optimization effect was verified by robustness analysis. Results: The results showed that in the 5% economic growth scenario, the GI network structure was more complex, and the connectivity of the network was better, while in the other scenarios, the network structure gradually degraded with economic growth. After optimization by the LDF strategy, the average degree of the GI network in multiple scenarios increased from 2.368, 2.651, 2.189, 1.972, and 1.847 to 2.783, 3.125, 2.643, 2.414, and 2.322, respectively, and the GI network structure connectivity and resilience were significantly enhanced in all scenarios. Conclusions: Economic growth did not necessarily lead to degradation of the GI network; there was still room for economic development in the study area, but it was limited under existing GI conditions, and the LDF strategy was an effective method to optimize the GI network. The research results provide a new perspective for the study of GI network protection with urban economic growth and serve as a methodological reference for urban GI network optimization. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a population pharmacokinetic (PPK) model of valproic acid (VPA) in adult Chinese patients with bipolar disorder, and provide guidance for individualized therapy in this population. Methods: A total of 1104 serum concentrations from 272 patients were collected in this study. The data analysis was performed using a nonlinear mixed-effects modeling approach. Covariates included demographic parameters, biological characteristics, and concomitant medications. Bootstrap validation (1000 runs), normalized prediction distribution error (NPDE), and external validation of 50 patients were employed to evaluate the final model. Results: A one-compartment model with first-order absorption and elimination was developed for VPA extended-release tablets. VPA clearance was significantly influenced by three variables: sex (12% higher in male patients), daily dose (increasing with the 0.13 exponent), and body weight (increasing with the 0.56 exponent). Typical values for the absorption rate constant (Ka), apparent clearance (CL/F), and apparent distribution volume (V/F) for a female patient weighing 70 kg administered VPA 1000 mg/day were 0.18 h−1, 0.46 L/h, and 12.84 L, respectively. The results of model evaluation indicated a good stable and precise performance of the final model. Conclusions: A qualified PPK model of VPA was developed in Chinese patients with bipolar disorder. This model could be used as a suitable tool for the personalization of VPA dosing for bipolar patients. [ABSTRACT FROM AUTHOR]

The thermal and optical performance in coating material of exterior walls affected the thermal action from the outdoor thermal environment indirectly, but there was the contrary thermal requirement in winter and summer, which could not be met by the constant-reflectivity coating. To overcome this drawback, the variable-reflectivity coating was analyzed and evaluated by taking three constant-reflectivity coatings as the references. The thermal transfer model with dynamic radiation reflectivity was built to simulate the thermal process of exterior walls in the whole year. Numerical results showed that the constant-reflectivity coating had poor seasonal adaptability with the best performance in some certain months and the poorest behavior in other months, while the variable-reflectivity coating had the better seasonal adaptability to dampen the heat gain in summer and promote the heat gain in winter. Although the variable-reflectivity coating could not show the optimal in all months, its overall performance played the best in the whole year. And compared with constant-reflectivity coating with radiation reflectivity of 90%, 50% and 10%, the variable-reflectivity coating could reduce the annual heating and cooling loads by 2.45%, 16.67% and 46.46%, respectively, in the studied Nanjing City of China. [ABSTRACT FROM AUTHOR]

Indoor plants have great benefits to humans, including physical health, cognition and emotion through their repair and purification capabilities, but most of these positiv e effects have not been quantified and valued. In this study, the Corona Virus Disease 2019 (COVID-19), when people must be self-isolated at home and avoid outdoor activities in China, was utilized adequately and the influence of indoor plants was analyzed via the 2031 valid questionnaires, in which indoor plant status, interest degree, interaction frequency and anxiety alleviation were surveyed. Results showed that indoor plants were widely cultivated especially in the living room. Compared to before the COVID-19, the interest degree with indoor plants increased by ~33% and their overall interaction frequency increased by ~78% during the COVID-19. More than 70% of the surveyed people exhibited anxiety during the COVID-19, and the overall anxiety level was 1.17 (between 'Slight anxiety' and 'Anxiety'). And ~61% of the surveyed people supported that indoor plants could alleviate self-isolation anxiety, and the anxiety alleviation degree was 0.79 (tend to 'Releasing the certain anxiety'), which showed that indoor plants had also shown to have an indirect psychological effect on anxiety alleviation. [ABSTRACT FROM AUTHOR]

This paper examines the effects of occupants' behaviour on the thermal environment in air-conditioned rooms. Typical occupants' behaviours were determined from survey results in the hot summers and cold winters region of China. The temperature setpoint, intermittent operation and door opening were determined as influencing factors in a theoretical model for maintaining thermal comfort with minimal energy consumption. The concepts of the temperature change index and characteristic temperature were introduced to predict the relationship between the indoor thermal environment and occupants' behaviour. The model was validated with empirical experiments and numerical simulations. The results indicated that continuous opening of doors and windows in air-conditioned rooms would increase the energy consumption that is needed to maintain a desirable indoor thermal environment. The average indoor temperature at 25°C setpoint heating temperature with the door open at 90° was found equal to the average indoor setpoint temperature of 22°C with the door open at 45°. The relative effects of the tested occupants' behaviours were also evaluated. [ABSTRACT FROM AUTHOR]

• Variation of atomic ratio and microcrystalline structure with temperature under nitrogen atmosphere were explored. • Abrupts of H/C and O/C occured as rising the temperature of coal samples. • Correlation was established by thermal property with atomic ratio and microcrystalline structure. To explore the main influencing factors of atomic ratio (O/C, N/C, and H/C) as well as microcrystalline structure (d 002 , L a , L c , and M c) on thermal properties (specific heat capacity, thermal conductivity, and thermal diffusivity) at certain temperatures within 30.0–300.0 °C, three coal samples were collected from coal mines of Dafosi, Yangjiaping, and Hujiahe in Binchang coalfield, Shaanxi Province, PR China. Thermal properties of coal samples were determined by laser-flash apparatus in nitrogen atmosphere. After temperature treated at 30.0, 60.0, 90.0, ..., 300.0 °C in nitrogen atmosphere, the atomic ratio and microcrystalline structure of samples were measured by proximate analyser and X-ray diffractometer. The results indicated that with an increment in the temperature, the value of H/C for three coal samples diminished slightly and then promptly, whereas O/C diminished slightly and then increased before 120.0 °C, as well as finally increasing, and the N/C had no obvious change. Concurrently, the microcrystalline structure of coal samples became more orderly and complete. Furthermore, the TD decreased with temperature, the SHC and TC showed an opposite trend with TD. Based upon grey correlation analysis, the major influencing factors of atomic ratio and microcrystalline structure on thermal property were approached. The results provided insight into the physicochemical properties of the coal of interest for predicting the progress of coal spontaneous combustion. [ABSTRACT FROM AUTHOR]

The demand for fertility preservation (FP) in cancer patients has increased rapidly nowadays. Breast cancer is the most common malignant tumor in women worldwide, and the survival rate has increased with the advancement of treatment. However, the alkylating agents such as cyclophosphamide used in postoperative chemotherapy will lead to ovarian failure. Cancer FP is a multidisciplinary field centered on reproductive medicine. It provides options for future fertility and endocrine therapy for patients through freezing of oocytes, embryos and ovarian tissues. Due to legal restrictions, FP started relatively late in China. Our reproductive center has led the clinical practice of cancer FP in China. This study aims to analyze the clinical practice of FP in young female breast cancer patients in a single reproductive center in China. This is a retrospective study of patients who underwent FP due to breast cancer in the Reproductive Medical Center of International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2020. In total, 35 patients experienced FP procedures. After signing the informed consents, a minimal/mild ovarian stimulation protocol with letrozole combined with gonadotropin (Gn) was used in follicle phase or luteal phase in patients, or even used natural cycle protocol according to patient's wishes. Oocyte/embryo vitrification will be performed after egg retrieval. Data collection includes patients' basic information, biochemical indicator levels and controlled ovarian stimulation conditions (medication use, duration, Gn start amount, Gn total amount, follicle growth, egg retrieval number and frozen oocyte/embryo number etc.). The patients were followed up for 2 years to find out whether there is cancer recurrence or other implications after FP. SPSS16.0 was used for statistical analysis. Among all the patients, 22 were married and 13 were unmarried. The average age of the patients was 31.46±4.04 years old. Thirty patients completed the fertility preservation procedure. Nineteen patients had frozen embryos, and five of them underwent PGT. In total, 27 cycles of controlled-ovarian stimulation were performed, with an average of 2.81±4.41 frozen embryos. Eleven patients had frozen oocytes, with an average of 9.91±4.41 frozen oocytes. All of them use vitrification freezing. Three married patients underwent frozen egg transplantation. One of them successfully got pregnant and gave birth to a healthy offspring by PGT-A. One had missed abortion after clinical pregnancy, and one did not get pregnant. The incidence rate of tumor recurrence and other implications has not increased after FP in 2 years follow-up. Oocyte/embryo vitrification is the preferred solution in breast cancer patients for FP. Controlled ovarian stimulation using letrozole combine with gonadotropin protocol seem to be a safe strategy for breast cancer FP after 2 years follow-up. Yet, the breast cancer recurrence risk after FP procedure and post-fertility still needs to be evaluated. Moreover, how to evaluate the effectiveness of FP in breast cancer patients, promoting the awareness of breast cancer FP, improving communication between clinical departments, and enhancing the breast cancer FP clinical practice in China is still needs to be promoted. [ABSTRACT FROM AUTHOR]

Although occupants play a critical role in a building's energy consumption, their air-conditioning use behaviour is often ignored, with it usually approximated as being a continuous operation. This in turn leads to a large difference between the actual and expected levels of energy consumption, raising the need to study air-conditioning use behaviour of building occupants. In this survey, 3083 questionnaires dealing with air-conditioning use behaviour were received from 34 cities distributed throughout China. The results show occupancy rates of 20% to 75% in residences and around 80% in office buildings during the period of 8:00–18:00. Air-conditioning use behaviour only meets a liveable requirement in residences and reaches a comfortable level in office buildings. This leads to daily air-conditioning operation times of between 0.85 and 4.31 hours in residences, and between 1.67 and 7.22 hours in office buildings, indicating most air-conditioning systems do not run continuously but intermittently, and that the assumption of continuous operation is far removed from reality. Based on these survey results, the large differences between the realistic (intermittent) and assumed (continuous) use of air-conditioning are employed to reveal the weaknesses in the present standards and to examine the optimization of building energy efficiency. [ABSTRACT FROM AUTHOR]

Prefabricated buildings (PBs) play an important role in the reconstruction process. However, the PBs actual indoor thermal environment located in earthquake disaster region occur deviation because of the result of various factor comprehensive roles, such as the more diverse climate and environmental conditions. According to this situation, field test and questionnaire are carried out under the winter climatic condition of Lushan County, China to explore the actual indoor thermal environment state. Measured and surveyed results show that the average indoor air temperature of the prefabricated classroom and the brick-concrete structure classroom are 10.17 ℃ and 9.29 ℃, respectively. Surface temperature of the prefabricated classroom changes synchronously with the air temperature while its indoor air temperature is little higher. The peak temperature difference of inner and outer surface can be reached to 5.9 ℃ and 5.24 ℃, respectively. Meanwhile, in the case of the overall average clothing thermal resistance of 1.57clo, ASHRAE scales for 0 thermal sensation vote is only 20%, and most people expect that temperature should be higher, which agree with that of the field test analysis. These results reveal that the actual indoor thermal environment inside the measured prefabricated building cannot meet the students’ thermal comfort requirements and sometimes it is also worse than that of brick-concrete classroom, due to low thermal inertia and poor thermal insulation of the in-walled light steel envelope. [ABSTRACT FROM AUTHOR]

Since the Guideline of Strengthen Preservation and Development of Traditional Village enacted, the traditional villages gradually gain academic concern and many achievements are acquired. But the study about outdoor wind environment is still insufficient. In this paper, the outdoor wind environment of Liyuanba Village in Bazhong City of Sichuan Province – a typical traditional village in the northeastern Sichuan Basin, is simulated by CFD methods. According to the simulation result, the outdoor wind environment in winter is comfortable for people in general, but there are still eddies and corner flows in some areas. To improve the outdoor wind environment, the suggestions such as changing the direction of courtyard and building are put forward. Furthermore, the optimization is also simulated and these two simulation results are compared in the end. [ABSTRACT FROM AUTHOR]

Blood donors not only save the lives of patients but also play an important role in the development of medical and health services. Therefore, it is particularly important to pay attention to the blood health of blood donors who are at a high risk of iron deficiency. Detection of serum ferritin and transferrin is an important basis for the diagnosis of iron deficiency anemia. However, to the best of our knowledge, the levels of serum ferritin and transferrin, and the influencing factors, such as age and type of donation, in blood donors have not been clarified. In the present study, the serum ferritin and transferrin levels of donors from two blood centers were investigated. Demographic data were collected from the donors, and their serum ferritin and transferrin levels were tested. A total of 1,817 donors were enrolled and were eligible for evaluation. Reference intervals (RIs) for ferritin and transferrin were obtained from blood donors, and it was revealed that the ferritin and transferrin levels of blood donors were associated with age. Furthermore, serum transferrin levels were associated with the type of donation; the serum transferrin RI level was significantly higher in platelet-only donors compared with in whole blood donors. It was also demonstrated that ferritin levels were negatively associated with transferrin levels. The present study identified RIs for ferritin and transferrin levels in blood donors, and indicated that age and type of donation were important factors affecting ferritin and transferrin levels in blood donors. These findings may prove useful for blood donation recruitment and screening strategies in China, and could promote the health of blood donors. [ABSTRACT FROM AUTHOR]

The application of a lightweight building is limited because its indoor temperature is highly affected by the outdoor environment due to the low thermal inertia of the lightweight envelope. In order to improve the thermal performance, this study focuses on lightweight buildings integrated with phase change materials. EnergyPlus software with building model validated by experimental data is used to analyze the thermal performance improvement of lightweight buildings by integrating with phase change materials under typical weather conditions in five climate zones in China. The results show that phase change materials can reduce temperature fluctuations through improving the heat stability of the lightweight envelope. Phase change materials can effectively improve the indoor thermal environment throughout the whole year in a temperate zone. Also, phase change materials can improve the indoor thermal environment of lightweight buildings significantly in the transition seasons, but it also reduces the hours of the indoor air temperature within the range 18°C (64.4°F) to 26°C (78.8°F) during cold winters and hot summers. For the lightweight buildings with air conditioning, due to the addition phase change material, heating loads can be reduced by 40–70%, while cooling loads increase slightly in the summers with the higher air temperature.ABSTRACT FROM PUBLISHERCopyright of Science & Technology for the Built Environment is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. [ABSTRACT FROM AUTHOR]

Student developmental guidance has been developed for more than 100 years. After the four periods of career guidance, adaptive guidance, developmental guidance and comprehensive promotion, mature patterns of student developmental guidance are built and present different characteristics across the world. According to the theory of individual development, ecological system theory and positive psychology, this paper puts forward the "5L &- 5S" three-level high school students' developmental guidance program on foreign typical models and current situation of students' guidance in China. "5L &. 5S" program based on the theory of relationship system expounds the changes of eight concepts: guiding position, importance, object, staff, content, model, scope, basis which differently with the past, builds the system, institutions and mechanisms of developmental guidance which is suitable for high school. Meanwhile, aimed at promoting the healthy and personal growth of the students, comprehensive and hierarchical guidance content of morality, psychology, academic, career and life five aspects, three-level developmental guidance which is directed at different needs of students, specific and operable process of developmental guidance are established. [ABSTRACT FROM AUTHOR]

To extend the research on Gibrat's law in transformational countries, this article uses quantile regression to test whether the Law holds for Chinese listed companies in six industries from 1997 to 2003. Results indicate that Gibrat's law demonstrated a behaviour dependent on the length examined. Although it was rejected in four out of six industries for the 6-year period, it received strong support in five industries year by year, which implied that size convergence was a slow process in China. Results also show that Gibrat's law is conditional on industrial characters. It received unbalanced support from different industries, suggesting that the industries examined had distinct growth trajectories. [ABSTRACT FROM AUTHOR]

Summary: Background: The pterosaur record is generally poor, with little information about their populations, and pterosaur eggs are even rarer, with only four isolated and flattened eggs found to date. Results: We report here a population of a new sexually dimorphic pterosaur species (Hamipterus tianshanensis gen. et sp. nov.), with five exceptionally well-preserved three-dimensional eggs, from the Early Cretaceous deposit in northwestern China. About 40 male and female individuals in total were recovered, but the actual number associated might be in the hundreds. All of the discovered skulls have crests, which exhibit two different morphologies in size, shape, and robustness. The eggs show pliable depressions with cracking and crazing on the outer surface. The eggshell, observed by scanning electron microscopy and energy-dispersive spectroscopy, comprises a thin calcareous external hard shell followed by a soft membrane. Conclusions: These fossils shed new light on the reproductive strategy, ontogeny, and behavior of pterosaurs. The cranial crests show sexually dimorphic morphologies, with presumed males and females differing in crest size, shape, and robustness. Ontogenetic variation is reflected mainly in the expansion of the rostrum. The eggs have some external rigidity of the general pliable eggshell, and the microstructure of the eggshell is similar to that of some modern “soft” snake eggs. We suggest that this new pterosaur nested in colonies and thus exhibited gregarious behavior, a possible general trend for at least derived pterodactyloid pterosaurs. [ABSTRACT FROM AUTHOR]

Aeromonas salmonicida is the typical pathogen causing furunculosis, reported widely in salmonids. Because of multiple serotypes, the control of A. salmonicida-caused disease has increasingly received much attention. Recently, A. salmonicida infection was reported in non-salmonid fish species. Here, a pathogenic A. salmonicida, named as As-s, was isolated from cultured snakehead (Channa argus) in a local fish farm in Shandong, China. As-s displayed clear hemolysis, amylase, and positive catalase activities, and grew at a wide range of temperatures (10-37 °C) and pH values (5.5-8.5). As-s was highly sensitive to cefuroxime sodium, ceftriaxone, ceftazidime, piperacillin, and cefoperazone and also apparently sensitive to chloramphenicol, erythromycin, and 25% cinnamaldehyde. The Virulence array protein gene cloning' results suggested that As-s has this gene compared with the other two vapA-containing strains, despite a close relationship of these strains via phylogenetic analysis. Severe ulcers on skin, muscle, and abnormal liver, and hemorrhage in pectoral/ventral fins and anal region were observed, and exophthalmos were also noticed in infected juvenile snakehead, as well as necrosis and infiltration of blood cells emerged in the internal organs using pathological section. In addition, As-s caused high mortality in snakehead, consistently with its immune gene response. This study reports the first isolation of vapA-absent A. salmonicida in snakehead., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Positive correlation between examination time and neoplasm detection using esophagogastroduodenoscopy (EGD) has been described by observational studies, but the effect of setting minimal examination time still requires investigation., Methods: This prospective, 2-stage, interventional study was conducted in 7 tertiary hospitals in China, enrolling consecutive patients undergoing intravenously sedated diagnostic EGDs. In stage I, the baseline examination time was collected without informing the endoscopists. In stage II, the minimal examination time was set for the same endoscopist according to the median examination time of normal EGDs in stage I. The primary outcome was the focal lesion detection rate (FDR), defined as the proportion of subjects with at least one focal lesion among all subjects., Results: A total of 847 and 1,079 EGDs performed by 21 endoscopists were included in stages I and II, respectively. In stage II, the minimal examination time was set as 6 minutes, and the median time for normal EGD increased from 5.8 to 6.3 minutes ( P < 0.001). Between the 2 stages, the FDR was significantly improved (33.6% vs 39.3%, P = 0.011), and the effect of the intervention was significant (odds ratio, 1.25; 95% confidence interval, 1.03-1.52; P = 0.022) even after adjusting for subjects' age, smoking status, endoscopists' baseline examination time, and working experience. The detection rate of high-risk lesions (neoplastic lesions and advanced atrophic gastritis) was also significantly higher in stage II (3.3% vs 5.4%, P = 0.029). In the endoscopist-level analysis, all practitioners reached a median examination time of 6 minutes, and the coefficients of variation of FDR (36.9%-26.2%) and examination time (19.6%-6.9%) decreased in stage II., Discussion: Setting a 6-minute minimal examination time significantly improved the detection of focal lesions during EGDs and has the potential to be implemented for quality improvement., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

Introduction: Conventional intracytoplasmic sperm injection (ICSI) is a widely used treatment for couples with severe male infertility. However, there are controversies regarding the selection and the damage to gametes during the ICSI procedure. Although preimplantation genetic testing for aneuploidies (PGT-A) can give genetic information about embryos for transfer and improve fertility rate, and it is widely used in women with recurrent spontaneous abortion or advanced age, PGT-A is not only more expensive but also has unclear effectiveness with respect to the improvement of fertility rate among couples with severe male infertility. High-quality, well-powered randomised clinical trials (RCTs) comparing ICSI+PGT-A and ICSI are lacking., Methods and Analysis: This is a protocol for a multicenter, open-label RCT in four reproductive medical centers qualified for PGT technique in China. We will study couples with severe male infertility scheduled for their fertility treatment. After the blastocyst culture, eligible participants are randomised to the ICSI+PGT-A group or the conventional ICSI group in a 1:1 ratio. Other assisted reproductive procedures are similar and parallel between the two groups. The primary outcome will be live birth rate and cumulative live-birth rate . Secondary outcomes will be embryo implantation rate, biochemical pregnancy rate, clinical pregnancy rate, spontaneous abortion rate, ongoing pregnancy rate, preterm birth rate, fetal chromosomal abnormality rate, birth defect rate and treatment complications. To demonstrate or refute a difference between the two groups, we plan to include 188 participants in each group; taking consideration of 20% of dropout, the total target sample size is 450., Ethics and Dissemination: Ethical approval was obtained from International Peace Maternity and Child Health Hospital of Shanghai Jiao Tong University Medical Science Research Ethics Committee (GKLW2016-16). Informed consent will be obtained from each participant. The findings will be disseminated to the public through conference presentations and publication in peer-reviewed scientific journals., Trial Registration Number: ClinicalTrials.gov, NCT02941965., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with sex-specific pathophysiology. Estrogen deficiency is believed to be responsible for the development of HFpEF in women. However, estrogen deficiency does not seem to be completely responsible for the differences in HFpEF prevalence between sexes. While diabetes mellitus (DM) frequently coexists with HFpEF in women and is associated with worse outcomes, the changes in myocardial contractility among women with HFpEF and the DM phenotype is yet unknown. Therefore, we aimed to investigate sex-related differences in left ventricular (LV) contractility dysfunction in HFpEF comorbid with DM., Methods: A total of 224 patients who underwent cardiac cine MRI were included in this study. Sex-specific differences in LV structure and function in the context of DM were determined. LV systolic strains (global longitudinal strain [GLS], circumferential strain [GCS] and radial strain [GRS]) were measured using cine MRI. The determinants of impaired myocardial strain for women and men were assessed., Results: The prevalence of DM did not differ between sexes (p > 0.05). Despite a similar LV ejection fraction, women with DM demonstrated a greater LV mass index than women without DM (p = 0.023). The prevalence of LV geometry patterns by sex did not differ in the non-DM subgroup, but there was a trend toward a more abnormal LV geometry in women with DM (p = 0.072). The magnitudes of systolic strains were similar between sexes in the non-DM group (p > 0.05). Nevertheless, in the DM subgroup, there was significant impairment in women in systolic strains compared with men (p < 0.05). In the multivariable analysis, DM was associated with impaired systolic strains in women (GLS [β = 0.26; p = 0.007], GCS [β = 0.31; p < 0.001], and GRS [β = -0.24; p = 0.016]), whereas obesity and coronary artery disease were associated with impaired systolic strains in men (p < 0.05)., Conclusions: Women with DM demonstrated greater LV contractile dysfunction, which indicates that women with HFpEF comorbid with DM have a high-risk phenotype of cardiac failure that may require more aggressive and personalized medical treatment., (© 2021. The Author(s).)

The recommendations for the diagnosis of stage 1 hypertension were recently revised by the American Heart Association primarily based on its impact on cardiovascular disease risks. Whether the newly diagnosed stage 1 hypertension impacts pregnancy complications remain poorly defined. We designed a retrospective cohort study to investigate the associations of stage 1 hypertension detected in early gestation (<20 weeks) with risks of adverse pregnancy outcomes stratified by prepregnancy body mass index. A total of 47 874 women with singleton live births and blood pressure (BP) <140/90 mm Hg were included, with 5781 identified as stage 1a (systolic BP, 130-134 mm Hg; diastolic BP, 80-84 mm Hg; or both) and 3267 as stage 1b hypertension (systolic BP, 135-139 mm Hg; diastolic BP, 85-90 mm Hg; or both). Slightly higher, yet significant, rates and risks of gestational diabetes mellitus, preterm delivery, and low birth weight (<2500 g) were observed in both groups compared with normotensive controls. Importantly, women with stage 1a and stage 1b hypertension had significantly increased incidences of hypertensive disorders in pregnancy compared with normotensive women (adjusted odds ratio, 2.34 [95% CI, 2.16-2.53]; 3.05 [2.78-3.34], respectively). After stratifying by body mass index, stage 1a and 1b hypertension were associated with increased hypertensive disorders in pregnancy risks in both normal weight (body mass index, 18.5-24.9; adjusted odds ratio, 2.44 [2.23-2.67]; 3.26 [2.93-3.63]) and the overweight/obese (body mass index, ≥25; adjusted odds ratio, 1.90 [1.56-2.31]; 2.36 [1.92-2.90]). Current findings suggested significantly increased adverse pregnancy outcomes associated with stage 1 hypertension based on the revised American Heart Association guidelines, especially in women with prepregnancy normal weight.

Purpose: To examine the role of ocular axial length as an ocular parameter for the prevalence and severity of diabetic retinopathy (DR)., Methods: The cross-sectional Kailuan Diabetic Retinopathy Study included patients with diabetes who participated in the community-based longitudinal Kailuan Study and who had undergone ocular fundus photography. The fundus photographs were graded using the Early Treatment of Diabetic Retinopathy Study criteria., Results: The study included 1096 patients with diabetes (mean age: 60.8 ± 9.4 years; axial length: 23.37 ± 0.92 mm). In binary regression analysis, a higher DR prevalence was associated with shorter axial length (P = 0.007; odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.70, 0.95) after adjusting for longer known duration of diabetes (P = 0.02; OR: 1.13; 95%CI: 1.02, 1.24) and higher fasting blood glucose concentration (P < 0.001; OR: 1.38; 95%CI: 1.26, 1.52). A more severe DR stage was associated (regression coefficient r: 0.46) with shorter ocular axial length (P = 0.047; standardized regression coefficient β: -0.06) after adjusting for higher fasting blood glucose (P < 0.001; β: 0.41) and longer known duration of diabetes (P = 0.045; β: 0.07). Longer axial length was associated with a lower DR prevalence (P = 0.003; β: -0.10) after adjusting for younger age (P < 0.001), male sex (P < 0.001), higher body mass index (P = 0.016), and lower fasting blood glucose concentration (P = 0.036)., Conclusions: After adjusting for systemic risk factors, DR prevalence decreased by 19% (95%CI: 5, 30) for each millimeter increase in axial length. With longer axial length being a surrogate for axial myopia, the marked increase in myopia prevalence worldwide may lead to a relative decrease in the prevalence and incidence of DR in future.

Background Cystinosis is a rare autosomal-recessive disorder caused by a defective transport of cystine across the lysosomal membrane. Previous studies have mapped cystinosis to the CTNS gene which is located on chromosome 17p13, and various CTNS mutations have been identified to correlate them with this disease. Methods We analyzed six patients from five unrelated families who were diagnosed with cystinosis in our hospital. We described the diagnostic procedures for all the patients and proposed alternative therapies for cystinosis patients instead of using cysteamine, an orphan drug which was commercially unavailable in China. Moreover, genetic analysis of all patients' samples was carried out to identify novel CTNS gene mutations. Results and conclusions The patients in this study were followed up from 1 to more than 10 years to monitor their growth and development, which indicated that the alternative therapies we used were helpful to ameliorate the complications of the cystinosis patients without cysteamine. Furthermore, by sequencing the patients' genome, we identified novel mutations in the CTNS gene including: c.477C > G (p.S159R), c.274C > T (p.Q92X) and c.680A > T (p.E227V); these mutations were only observed in cystinosis patients and had never been reported in any other populations, suggesting they might be specific to Chinese cystinosis patients.

Vitamin D deficiency is highly prevalent all over the world and dietary intakes of vitamin D are very low in China. In this study we aimed to determine whether vitamin D deficiency is associated with increased risk of metabolic syndrome (MetS) among Chinese type 2 diabetes mellitus (T2DM) patients aged over 50 y. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured in a cross-sectional sample of 270 T2DM patients aged over 50 y from Zhejiang. Data on demographic characteristics, anthropometry and other variables were collected. The mean of serum 25(OH)D was 22.93 ng/mL, and percentages of vitamin D deficiency and insufficiency were 43.71% and 39.63%, respectively. Serum 25(OH)D concentrations were significantly lower in subjects with MetS than in those without MetS (21.74 vs 24.96 ng/mL, p=0.001), and the prevalence of MetS significantly increased according to tertiles of serum 25(OH)D concentrations. After adjusting for multivariate factors, the adverse effect of lower serum 25(OH)D concentrations was significant (OR: 3.26, 95% CI: 1.03-7.34; p=0.044) in the group with BMI≥24 kg/m 2 while the change in OR of MetS for each 10 ng/mL decrease in the serum 25(OH)D concentrations was 2.03 (95% CI: 1.10-3.79). These results suggest that serum 25(OH)D deficiency may be a risk factor of MetS among Chinese type 2 diabetic patients, especially in the T2DM with BMI≥24 kg/m 2 . The challenge is determining the mechanisms of vitamin D action for recommendation of vitamin D supplementation that reduces the risks of MetS and progression to T2DM.

Background: The incidence of type 1 diabetes mellitus (T1DM) is increasing rapidly worldwide for children of every age group., Materials and Methods: A retrospective analysis of hospital registration data from five tertiary hospitals in Beijing, China, identified 485 patients (210 boys, 275 girls) younger than 15 years of age with newly diagnosed T1DM between 1995 and 2010., Results: From 1995 to 2010, the incidence of T1DM in patients <15 years of age ranged from 0.935-3.26 per 100,000 per year. During this period, the average age-standardized incidence rate was 1.7 per 100,000 per year, and the average annual increase in T1DM incidence was 4.36%. The highest rate increases occurred in boys and in patients <5 years of age. For both genders and all age groups, T1DM incidence increased at an accelerated rate after 2006. By 2020, the incidence of T1DM among children in Beijing is projected to increase by a factor of 1.69., Conclusions: The incidence of T1DM among patients younger than 15 years of age in Beijing increased from 1995 to 2010, with rates growing at an accelerated pace since 2006. Based on recent trends, we project continued rapid growth in the number of new childhood T1DM cases in Beijing.

Objectives: To study the incidence trend of type 1 diabetes mellitus (T1DM) in children in Beijing from 1995 to 2010, to compare it with incidences reported worldwide and to predict the requirement of medical resources in the future., Methods: This study involved newly diagnosed T1DM cases younger than 15 years of age in the Beijing Children's Hospital from January 1995 to December 2010. We calculated the incidence of T1DM children in Beijing according to hospitalization data and Beijing's population. We defined it as the underestimated incidence rate (UE-IR)., Results: The UE-IRs of T1DM ranged from around 0.88/100,000 to 2.37/100,000 for children in Beijing younger than 15 years of age from 1995 to 2010. The UE-IR increased faster in boys (1.47 times) and in the age group of 0-4 years (1.89 times) after 2003. The UE-IR was greatest in children aged 5-9 years (1.81/100,000) followed by the age of puberty (10-14 years, 1.76/100,000). The predicted number of new T1DM cases in Beijing will increase 1.97 times over the next 10 years., Conclusions: The incidence trend of T1DM was increasing gradually in those younger than 15 years of age in Beijing. The incidence of younger children and boys grew faster. The 5- to 14-year-old children represented a high-risk population of T1DM. The number of predicted new T1DM cases will grow rapidly. This means that we should train more health care providers for pediatric diabetes patients, in order to achieve high-quality medical care and to be able to prevent or postpone chronic complications.

Two almost complete long-tailed pterosaurs from the Linglongta, Jianchang County, western Liaoning, China, are described and represent new taxa referred to the non-pterodactyloid clade Wukongopteridae. Kunpengopterus sinensis gen. et sp. nov. differs from other members of this clade mainly by the rounded posterior region of the skull, thick lacrimal process of the jugal and lack of a bony premaxillary crest. This species further shows a soft tissue crest above the frontal, a comparatively larger wing finger, and the proximal segment of the second pedal phalanx of the fifth toe shorter than in other wukongopterids. The second new species is referred to the genus Darwinopterus, D. linglongtaensis sp. nov. based on the posterior region of the skull. It further differs from other wukongopterid pterosaurs by the thin lacrimal process of the jugal, foramen on nasal process rounded, and by having the second pedal phalanx of the fifth toe less curved (115°). Several differences among the Wukongopteridae can be found in the dentition and the feet, suggesting that they might have occupied slightly different ecological niches. The long-tailed Changchengopterus pani is tentatively referred to this clade and new diagnosis for the wukongopterids Wukongopterus lii and Darwinopterus modularis is provided.

The soft tissue preserved in the holotype (IVPP V12705) of Jeholopterus ningchengensis from the Daohugou Bed (Late Jurassic or Early Cretaceous) of China is described in detail. The plagiopatagium can be divided into the distal, comparatively more rigid actinopagatium and a proximal, more tensile tenopatagium. The actinopatagium extends from the wing finger to the articulation between the humerus and the forearm, and shows the presence of at least three layers containing actinofibrils. In each layer, the actinofibrils are parallel to subparallel, but this direction diverges from layer to layer. When distinct layers of actinofibrils are superimposed (owing to taphonomic compression), a reticular pattern is generated. The presence of layers with differently oriented actinofibrils is widespread in this pterosaur. A well-developed integumental covering formed by fibres (here named pycnofibres) that are thicker than the actinofibrils is present. Ungual sheaths that extend the length of the pedal and manual claws of this taxon are also observed. Although the understanding of the mechanical properties of the wing membrane is hampered by the lack of knowledge regarding the composition of the actinofibrils, the configuration observed in Jeholopterus might have allowed subtle changes in the membrane tension during flight, resulting in more control of flight movements and the organization of the wing membrane when the animal was at rest.

A new long-tailed pterosaur, Wukongopterus lii gen. et sp. nov, is described based on an almost complete skeleton (IVPP V15113) representing an individual with an estimated wing span of 730 mm. The specimen was discovered in strata that possibly represent the Daohugou Bed (or Daohugou Formation) at Linglongta, Jianchang, Liaoning Province, China. Wukongopterus lii is a non-pterodactyloid pterosaur diagnosed by the first two pairs of premaxillary teeth protruding beyond the dentary, elongated cervical vertebrae (convergent with Pterodactyloidea), and a strongly curved second pedal phalanx of the fifth toe. The specimen further has a broken tibia that indicates an injury occurred while the individual was still alive. Taphonomic aspects provide indirect evidence of an uropatagium, supporting the general hypothesis that at least all non-pterodactyloid pterosaurs show a membrane between the hind limbs. A phylogenetic analysis including most non-pterodactyloid pterosaurs shows that Wukongopterus lii gen. et sp. nov. lies outside the Novialoidea, being cladistically more primitive than the Rhamphorhynchidae and Capylognathoides. This analysis differs from previous studies and indicates that more work is needed before a stable picture of non-pterodactyloid pterosaur relationships is achieved.