Search

The analysis of grain starch content is one of the main indices to determine crop quality. The experiment was performed using two broomcorn millet varieties (Neimi 2 and Ningmi 14) in northern China, having 5 different sowing dates. The prediction models for grain starch fraction were constructed by integrating the spectral models and grain starch content with leaf water content using the intersection approach. We have identified 468, 630, 806, and 1488 nm as characteristic bands of the first derivative spectrum having a positive correlation. The correlation coefficient between the vegetation index of 608 nm and 1488 nm was significantly higher than other characteristic bands regarding leaf water contents. It is therefore identified that RDVI (1488, 806) could be used effectively to monitor leaf water content of broomcorn millet under different sowing date treatments, R² = 0.7075, RMSE = 0.073, RPD = 1.430 in the calibration set, R² = 0.8458, RMSE = 0.042, RPD = 2.546 in the validation set. In addition, the monitoring models of RVI (1488, 806), RDVI (1488, 806), and PVI (1488, 806) were superior to other models, and RPD was 0.020, 1.978, and 1.904, respectively. Overall, the RDVI (1488, 806) monitoring model, due to its stability and higher accuracy provided precise data on the grain starch fraction of broomcorn millet. [ABSTRACT FROM AUTHOR]

This paper attempts to assess the genetic diversity and demographic history of the Manchurian wapiti (MW) population in the Gaogesitai region of Inner Mongolia, Northeast China. To this end, a survey was conducted on 108 stool samples collected in the Gaogesitai region. Then, the mitochondrial cytochrome b and 10 microsatellite loci were used to perform the species identification and individual identification, and 49 MW individuals were found. Besides, the cytochrome b, control region and microsatellites were also analyzed to obtain the genetic data of the MWs. The analysis found that the MW population in the Gaogesitai region experienced a recent bottleneck effect, but it did not have a significant impact on the subsequent rapid population growth; the population genetic diversity is at a medium level; gene exchange between individuals within the population is frequent, and there is no inbreeding; a high proportion (50%) of rare haplotypes in the population was detected. Thus, it is recommended to strengthen the protection and management of the MW population in this region to avoid a sharp decline in population genetic diversity. [ABSTRACT FROM AUTHOR]

Objective: To examine the diagnostic test accuracy (DTA) of the FRAIL-NH and four frailty screening instruments among institutionalized older adults. Design: Cross-sectional study. Setting: Institutionalized setting, Jinan, China. Participants: A total of 305 older adults (mean age 79.3 ± 8.4 years, 57.0% female) were enrolled from nursing homes. Measurements: Frailty was assessed by the FRAIL-NH, Physical Frailty Phenotype (PFP), FRAIL, Tilburg Frailty Indicator (TFI), and Groningen Frailty Indicator (GFI), respectively. The Comprehensive Geriatric Assessment (CGA) was used as a reference standard of frailty. The receiver operating characteristic (ROC) curve was plotted to examine the DTA of five frailty screening instruments against the CGA. The optimal cut-point was determined by the maximum value of the Youden index (YI, calculated as sensitivity + specificity − 1). Results: The prevalence of frailty ranged from 25.9% (FRAIL) to 56.4% (GFI). Areas under the curve (AUCs) against the CGA ranged from 0.80 [95% confidence interval (CI) 0.74–0.85: FRAIL] to 0.83 (95% CI 0.78–0.88: PFP). At their original cut-points, all five frailty screening instruments presented low sensitivity (32.9%–69.3%) and high specificity (80.0%–93.8%), as well as high positive predictive values (90.7%–94.9%) and low negative predictive values (33.2%–48.1%). At their optimal cut-points, the sensitivity and specificity of the FRAIL-NH, PFP, and FRAIL tended to be balanced, and their correctly classified rates (76.1%–81.3%) and kappa values (0.465–0.523) increased a lot. ROC contrasts showed that all five frailty screening instruments had similarly good diagnostic accuracy (χ2: 0.0003–1.38, P >.05). Conclusion: In the institutionalized setting, the specific FRAIL-NH, self-report FRAIL, TFI, and GFI as well as hybrid PFP, show similarly good diagnostic properties in identifying frailty against the CGA. [ABSTRACT FROM AUTHOR]

Previously treated TB patients still pose a serious threat to global control of TB, yet new re-treatment therapies were little studied. This study aimed to examine the therapeutic effects of new re-treatment regimens, and explore risk factors associated with recurrence after successful treatment. We conducted a cohort study in nine regions of China and enrolled previously treated TB patients from October, 2008 to December, 2010. Patients were randomly divided into four treatment regimen groups including standard, high-dose, long-course, and individualized treatment. After treatment, those with successful treatment outcomes were followed up to 7 years. The effects of different regimens and the information of recurrence were recorded. Risk factors to poor treatment outcomes were calculated using logistic regression model, while risk factors to recurrence or death were calculated using Cox model. Four hundred ninety-two participants were enrolled during the study time and 419 patients were included in our analysis of treatment effects. Overall, the treatment success rate is 75.9%, and the recurrence and death rate is 6.9% and 3.8%, respectively. Reduced risks of poor outcomes were observed in patients who were treated with high-dose and individualized regimen compared with standard regimen, and the adjusted ORs were 0.3 (0.1–0.6), 0.2 (0.1–0.5), respectively. In our analysis of factors associated with recurrence, all documented variables were not significant. Revised re-treatment regimen has better therapeutic effects compared to standard regimen, but it was not associated with lower risk of TB recurrence. Further studies are warranted to evaluate the role of other revised re-treatment regimens in recurrence risk. Trial registration: chictr.org Identifier: ChiCTR1800017441. [ABSTRACT FROM AUTHOR]

The noninvasive sampling was applied to analyze the winter home range of the Manchurian wapiti (Cervus canadensis xanthopygus) in the east of the Wanda Mountains, north-eastern China's Heilongjiang Province. A total of 210 feces samples of the animal were collected from the study area during two consecutive winters. The DNAs were successfully extracted from 167 samples, and all genotypes of 7 microsatellite loci were obtained. Individual identification shows that the 167 samples belonged to 66 individuals. Through gender identification by the SRY gene, it was learned that the 66 individuals were 22 females and 44 males. Then, the winter home ranges of seven individuals (5 males and 2 females) were determined by Minimum Convex Polygons estimation. The results show that the winter home ranges of male individuals varied from 169.26 to 1,085.61 hm2 (mean: 557.62 ± 411.83 hm2), while those of female individuals were 43.72 hm2 and 14.71 hm2 (mean: 29.21 ± 20.51 hm2). Finally, it is concluded that the noninvasive sampling is a feasible way to study the home range of endangered animals. This technique can be applied in the future to acquire more comprehensive information about the home range of animals. [ABSTRACT FROM AUTHOR]

At present, the air environment in China is characterized by complex pollution. In this paper, the pollutant sources, transport paths and aerosol optical properties during the dust pollution was conducted to analyse based on ground-based lidar, space-borne sensor and atmospheric transmission model. Firstly, the NMMB/BSC-Dust model, the VIIRS-Suomi NPP date and HYSPLIT were carried out to analyse the dust transport paths and the dust particle size, and then the concentration of particles was analysed. Finally, the optical properties of aerosol particles in the dust weather were studied. During the formation of this weather, there is high dust in the Gobi and Taklamakan deserts. With the influence of wind direction, the dust moves from north to south, and the dust load significantly increased in southern China. Dust at the low altitude is generally transported from the Taklamakan Desert, while dust at the high altitude is generally transported from the Gobi Desert. The hourly average change of PM10 is from 36 μg/m3 to 818 μg/m3, while the hourly average change of PM2.5 is from 15 μg/m3 to 197 μg/m3. The dust was the main cause of the pollution weather. In this study, the formation process of the dust pollution revealed which can be used to provide guidance for government for the prevention work of dust pollution. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper is to assess the role of gender on survival rate and causes of death and organ damage in systemic lupus erythematosus (SLE) patients in China from 2009 to 2015. Methods: We conducted a multicenter cohort study to analyze the differences in outcome data between male and female SLE patients. A group of 1494 SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were enrolled in the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) registry from April 2009 to February 2010. All enrolled patients were followed up at least once per year from 2009 to 2015. For patients who could not attend the outpatient clinic, follow-up was conducted by telephone interview. We collected demographic data, clinical manifestations and damage scores (System Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Survival rates were evaluated using the Kaplan-Meier method. Results: This study included 1352 women and 142 men. The five-year survival rates were 92.0% for men and 97.6% for women. The survival rates of males were significant lower than for females (p = 0.019). Male patients received methylprednisolone pulse therapy and cyclophosphamide significantly more than female patients (p = 0.010). During follow-up, 12 male patients and 66 female patients died. The most common cause of death was infection (41.7%) for men and active SLE disease (27.3%) for women. At the end of the study, the major accumulated organ damages included renal (8.5%) and musculoskeletal (7.7%), and nervous system (5.6%) for men and renal (8.8%) and musculoskeletal (6.7%) for women. There were no significant differences in SDI scores between the two groups at baseline and at the end of the study. Conclusions: Male SLE patients had lower survival rates than female patients. Male patients received more methylprednisolone pulse and cyclophosphamide therapy. The most common causes of death were infection for male patients and active SLE disease for female patients. The major accumulated organ damages were renal, musculoskeletal, and nervous system both for male and female SLE patients in China. [ABSTRACT FROM AUTHOR]

Rosa chinensis Jacq., originating from China, occupied a pivotal position in the floral industry all over the world. Drought and soil salinization is a major problem in the Chinese rose planting industry. Therefore, the study on resistance is important to improve R. chinensis breeding. In this work, leaves of twelve samples with three biological repetitions were collected for transcriptome sequencing. In total 83.14 Gigabyte (G) Illumina sequence data were generated and 74 850 unigenes were successfully annotated. Differentially expressed gene (DEG) analysis was performed by comparing the transcriptomes of the 0, 2, 4 and 7 days salt treatment, based upon which several potential candidate genes involved in salt tolerance response had been identified. DEGs involved in plant hormone signal transduction, photosynthesis, and catalytic activity were examined in depth. The experimental result indicated that the R. chinensis showed strong stress signals after being subjected to salt stress. In the initial stage of salt treatment (two days), plant protective process began to take effect, which was embodied in the regulation of oxidoreductase activities and plant hormone signal transduction pathway. In addition, the expression level of P5CS was up-regulated in R. chinensis, but the proline metabolic pathway was not affected. In the late stage of salt treatment (four and seven days), the photosynthesis – antenna proteins pathway has been greatly affected, and the down-regulated PYL, Snrk2 and MRP lead to the salt tolerance decline, which was consistent with the leaf wilting performance of the R. chinensis in four and seven days of treatment. All the candidate genes were verified by RT-qPCR. [ABSTRACT FROM AUTHOR]

Background/objective: Increasing dietary diversity is concurrent with an increasing prevalence of adiposity in China, but the association between these variables remains ambiguous. This study reveals an association between dietary diversity and body mass (underweight, overweight and obesity) in Chinese adults.Subjects/methods: Data from 17 825 participants (age, 18-65 years) were pooled from four survey waves (2004, 2006, 2009 and 2011) of the Chinese Health and Nutrition Survey. Anthropometric data and dietary intake information obtained through a 24-h dietary recall for 3 consecutive days were collected. Information on covariates, namely those regarding the socioeconomic status and lifestyle of each participant, were collected. The dietary diversity score (DDS) and entropy were used to represent dietary diversity. The association between dietary diversity and adiposity was analyzed by using multivariable-adjusted multinomial logistic regression.Results: A positive association between dietary diversity and overweight was detected only in men (DDS: OR=1.09 (1.03-1.17); entropy: OR=1.60 (1.24-2.07)). The results were confirmed by analyzing the interaction between sex and diversity (DDS: OR=1.27 (1.17-1.37); entropy: OR=2.89 (2.11-3.89)). In contrast, no significant association was detected between dietary diversity and underweight/obesity (all P>0.05). Dietary consumption was compared between sexes to explain the different effects of dietary diversity on body mass in men and women. The results indicated that men typically had a higher consumption of meat (P<0.01).Conclusions: Higher dietary diversity is positively associated with overweight in men. Additional preventive strategies that promote a healthy diet should focus on men. [ABSTRACT FROM AUTHOR]

Copyright of BJOG: An International Journal of Obstetrics & Gynaecology is the property of Wiley-Blackwell 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. (Copyright applies to all Abstracts.)

Portulaca oleracea, an r-strategist, is one of the world's most troublesome weeds. During hot seasons, P. oleracea frequently becomes monodominant in choy sum (Brassica parachinensis) fields in Guangzhou city, southern China. Here, we studied the seasonal dynamics of P. oleracea's germinable soil seedbank, population density and above-ground biomass in choy sum fields that had been cultivated continuously for several years. Using P. oleracea seeds collected from these fields, we tested seed dormancy, survival and germination, seedling growth and generation time. Portulaca oleracea occurred at high levels during the hot season, but its occurrence was low, and the germinable soil seedbank was much greater during the cold season. The weed's opportunistic characteristics allowed it to avoid freezing and to proliferate during optimal conditions. Portulaca oleracea's generation time was very flexible, as short as 31 days during the hot season, but longer than 100 days during the colder season. Seed dormancy tended to be shorter when the seeds were stored at a higher temperature. At a temperature of 35°C, both seed germination and seedling growth showed advantages over those of choy sum. Storage for one year at a temperature of -20°C or burial in a paddy field did not significantly reduce P. oleracea seed germination. Nevertheless, seed storage at a temperature of 15°C and soil coverage of 0.5 cm on top of the seeds significantly constrained seed germination. 'Stale seedbed' and/or coverage of the surface with soil are recommended during the hot season. However, rotation of rice and upland crops is not an efficient method for managing Portulaca oleracea infestation. [ABSTRACT FROM AUTHOR]

Abstract: In this study, a combination of low and high density airborne LiDAR and satellite SPOT-5 HRG data were used in conjunction with ground measurements of forest structure to parameterize four models for zero-plane displacement height d(m) and aerodynamic roughness length z 0m (m), over cool-temperate forests in Heihe River basin, an arid region of Northwest China. For the whole study area, forest structural parameters including tree height (Ht) (m), first branch height (FBH) (m), crown width (CW) (m) and stand density (SD)(treesha−1) were derived by stepwise multiple linear regressions of ground-based forest measurements and height quantiles and fractional canopy cover (f c ) derived from the low density LiDAR data. The high density LiDAR data, which covered a much smaller area than the low density LiDAR data, were used to relate SPOT-5''s reflectance to the effective plant area index (PAIe) of the forest. This was done by linear spectrum decomposition and Li–Strahler geometric–optical models. The result of the SPOT-5 spectrum decomposition was applied to the whole area to calculate PAIe (and leaf area index LAI). Then, four roughness models were applied to the study area with these vegetation data derived from the LiDAR and SPOT-5 as input. For validation, measurements at an eddy covariance site in the study area were used. Finally, the four models were compared by plotting histograms of the accumulative distribution of modeled d and z 0m in the study area. The results showed that the model using by frontal area index (FAI) produced best d estimate, and the model using both LAI and FAI generated the best z 0m . Furthermore, all models performed much better when the representative tree height was Lorey''s mean height instead of using an arithmetic mean. [Copyright &y& Elsevier]

The objective of this study was to determine the clinical features of systemic lupus erythematosus (SLE) patients with diffuse alveolar hemorrhage (DAH). The medical records of 29 patients with DAH among 2133 SLE patients admitted to Peking Union Medical College Hospital from January 2004 to January 2009 were reviewed in this retrospective study. It was found that hypoxemia (100%), dyspnea (90%), cough (79%) and fever (72%), rather than hemoptysis (66%), were the most common symptoms. The most common extrapulmonary presentation was renal involvement (90%). In about 60% of patients nosocomial infection was also present. The mean drop in hemoglobin was 32±10.9 g/l. Mean Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was 17±9. All patients received highdose corticosteroid therapy and most were also given immunosuppressive agents. Rates of concomitant nosocomial infection and mechanical ventilation in non-survivors were higher than those of survivors (p<0.05). DAH is a rare and catastrophic event in SLE. DAH can occur at any stage of the disease course; it usually occurs in patients with active SLE, and is frequently complicated by lupus nephritis. Some patients may have no hemoptysis. Early aggressive management with high-dose steroids and cyclophosphamide is advocated. [ABSTRACT FROM AUTHOR]

Background Suicide has been identified as one of the three leading causes of death in adolescents and young adults. No previous study in China has tested the association between protective factors and urban adolescents' suicidal behaviours. In this study we tested the hypothesis that suicidal behaviours would be associated with multiple protective factors. Methods A stratified random of 9015 students from 100 junior middle schools in Beijing, Hangzhou, Wuhan and Urumqi completed the Chinese version of Global School-Based Student Health Survey. Results Overall, 17.4% of students had seriously considered attempting suicide, and 8.1% had made a specific plan to attempt suicide during the 12 months preceding the survey. The students in Wuhan (18.7%) and Urumqi (20.8%) cities were significantly more likely than students in Beijing (14.4%) and Hangzhou (14.4%) to have suicidal ideation (χ2 = 45.9, P < 0.001). Female students were significantly more likely than male students to have suicidal ideation and have made suicide attempts [odds ratio (OR) = 1.4, P < 0.001]. Results indicated that the rates of suicidal ideation and suicide attempts increased with age (OR = 1.44, P < 0.001). Multivariate logistic regression models showed that suicide risk tended to decrease significantly when ‘days of missed classes or school without permission were less than one’, and when students thought students in their school were kind and helpful most of the time or always', ‘parents or guardians checked to see if homework was done most of the time or always’, ‘parents or guardians understood their problems and worries most of the time or always’ and ‘parents or guardians really know what they are doing with their free time most of the time or always’. Conclusions Adolescent suicide behaviour should be a serious problem. Measures can be taken to prevent suicide by observing the factors significantly linked to suicidal behaviour. Steps can then be taken to identify adolescents who have serious suicidal ideation so that intervention can be taken to reduce the suicidal rate. [ABSTRACT FROM AUTHOR]

In 2002, the Beijing Committee for Disease Prevention launched guidelines based on the Ottawa Charter for Health Promotion on health promoting hospitals (HPHs). HPH pilot projects were then initiated, on a voluntary basis, in 44 Beijing hospitals. Evaluations have been undertaken to assess the impacts of the pilot project. This article outlines this HPH project, its development and evaluation and reports on the attitudes and contribution of hospital management as determined by questionnaires and interviews from 281 managerial employees from 106 Beijing hospitals (93 from pilot hospitals and 188 from control). The results of the evaluation indicate that long-term health promotion planning and health promotion specialized funds have been better established in pilot hospitals than in the control group and also that the concept of HPH & better understood by managerial staff in pilot hospitals than by those in control hospitals. The main perceived barriers faced in the development of HPH are shortages of funds, personnel, time management and professional skills. To further develop HPHs in China, effort needs to be made to ensure that hospital leaders and management are considered first. If managerial staff have an appropriate understanding of the concept and principles of HPH, then it is more likely that health promotion activities can be introduced into the daily workings of hospitals, and the necessary funds, personnel and training on health promotion skills be provided. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy, safety and immunogenicity of a human diploid cell SV-1 strain–based live attenuated varicella vaccine in children aged 1 to 12 years. We conducted a randomized, double-blind, placebo-controlled trial in China in which healthy children were randomly assigned in a 1:1 ratio to receive one dose of varicella vaccine or placebo. The efficacy monitoring period was 6 to 7 months for each subject. The primary endpoint was the occurrence of laboratory-confirmed varicella. Efficacy and immunity were assessed in the per-protocol cohort, and safety was assessed in the total vaccinated cohort. The file was registered with ClinicalTrials.gov (NCT02981836). Between 22 August 2016 and 19 September 2016, a total of 5997 children (2997 in the varicella vaccine group and 3000 in the placebo group) were vaccinated, and 5991 children (2995 in the varicella vaccine group and 2996 in the placebo group) were included in the per-protocol efficacy cohort. The efficacy of the vaccine was 87.1% (95% confidence interval, 69.7–94.5) against varicella (six cases vs. 46 cases) and 89.2% (95% confidence interval, 72.9–95.7) breakthrough varicella (five cases vs. 46 cases). No significant difference in solicited adverse reactions was found between the two groups. Serious advent events occurred among 0.8% (25/2998) children in the vaccine group and 0.7% (22/2999) in the placebo group. In the immunogenicity subgroup, the seroconversion rate was 97.1% (339/349) in the vaccine group. An antibody titre of 1:8 was associated with protection against varicella. The varicella vaccine was effective in the prevention of varicella in children. [ABSTRACT FROM AUTHOR]

Purpose/objective(s): Cervical cancer is mainly treated by surgery, radiotherapy and chemotherapy. However, there are also some patients with treatment failure, such as residual tumors, recurrence or metastasis within a short period of time after the initial treatment. Apatinib is a targeted drug for a small molecule vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase inhibitor. We aimed to assess the efficacy and safety of apatinib combined with capecitabine in patients with recurrent/metastatic and persistent cervical cancer after radiochemotherapy.Materials/methods: In this phase Ⅱ, single-arm, prospective study done in Guizhou province in China, eligible patients were aged 18-70 years, had an ECOG performance status of 0 or 1, progressed after at least one line of radiochemotherapy for metastatic, recurrent or persistent cervical cancer, and had measurable lesions. Patients received capecitabine 2000mg/m2 divided into morning and evening every day and apatinib 250mg once daily. Treatment continued until disease progression, unacceptable toxicity, and withdrawal of consent. The primary endpoint was the objective response rate (ORR) assessed by RECIST version 1.1 and Progression-free survival (PFS). Disease control rate (DCR), overall survival (OS),1-year survival rate and safety were the second endpoints.Results: Between August 2018 and May 2020, 28 patients were enrolled and received study treatment. The median age was 52(range, 34-67) years. The median previous treatment lines were 2 (range, 2-5). As of Jan 1, 2021, median follow-up was 10.18 months (range, 3.4-29). 12 (42.9%; 95%: CI 23.5-62.3) of 28 patients who had at least one post-baseline tumor assessment (efficacy evaluation population) achieved an objective response, including 3 (10.7%) complete response (CR), and 9 (32.1%) partial response (PR). The median duration of response was 1.57months(range,0.9-2.17). The DCR was 82.1% (95% CI: 67.3% -97.2%). Median progression-free survival (PFS) was 4.7 months (95% CI: 1.2-18.6). The one-year survival rate was 54.8%, and the longest administration time was 18.2 months.10 (35.7%) patients had grade ≥ 3 treatment-related adverse events (TRAEs). Grade ≥ 3 TRAEs occurring in ≥ 5% of patients were hypertension (7.1%), emesis (7.1%), myelosuppression (7.1%). Notably, one patient discontinued maintenance therapy after 13 months because of coronary artery stenosis which is a rare toxic side effect of apatinib.Conclusion: Apatinib combined with capecitabine showed promising antitumor activity and tolerable toxicities in patients with recurrent/metastatic and persistent cervical cancer after chemotherapy. [ABSTRACT FROM AUTHOR]

Dissolved organic carbon (DOC) components can be highly variable in aquatic ecosystems, and play a pivotal role in the global carbon cycles. To comprehend potential effects of nutrient enrichment on portion of DOC biodegradability (%BDOC), we conducted an extensive investigation on 26 urban lakes in a major metropolitan area in subtropical China in a small gradient of trophic levels from mesotrophic to light and middle eutrophic. In addition to field measurements on lake ambient conditions and laboratory analysis of DOC characteristics, we conducted a 28-day temperature-controlled incubation experiment, in which %BDOC of lake waters was determined. In the mesotrophic waters, %BDOC ranged from 0.6 to 41.4 % (11.2 ± 8.9 %). The %BDOC levels spanned from 5.2 to 20.2 % (10.7 ± 4.0 %) in the light eutrophic waters, and the %BDOC ranged from 2.7 to 35.0 % (13.7 ± 8.4 %) in the middle eutrophic waters. We found a significant change in DOC chemical composition across the study lakes characterized by shifting of trophic levels. Although the experiment found significant changes in the factors that can influence %BDOC, a significant difference was not observed in %BDOC among the three trophic levels. The %BDOC was primarily influenced by the inherent DOC concentration and aromaticity, with eutrophication leading to the varied driving factors of %BDOC in lake systems. We show that most of the lake water DOC was stable. The findings indicate the intricate interplay between biological metabolism and nutrient availability governing %BDOC dynamics in urban lake ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: Ginkgo diterpene lactone meglumine (GDLM) could improve the functional outcome after acute ischemic stroke (AIS). This study aimed to investigate the efficacy of GDLM on the quality of life in patients with AIS in China., Methods: This is a post hoc analysis of Efficacy and Safety of Ginkgo Diterpene Lactone Meglumine in Acute Ischemic Stroke trial. The quality of life was measured using the EuroQoL questionnaire, including EQ-5D and EQ visual analogue scale (EQ-VAS). The primary outcomes were changes in EQ-5D and EQ-VAS from baseline to day 14 and day 90 after randomization., Results: A total of 3219 patients with completed data on outcomes were enrolled, with median age of 63 years (interquartile range, 55-70) and 2,067 (64.2%) men. GDLM was associated with a significant decrease in scores of ED-5Q components (from 0 [no problem] to 3[extreme problem]), the mean difference between GDLM and placebo group was -0.14 for mobility, -0.11 for usual activities and self-care, -0.09 for pain/discomfort, and -0.34 for anxiety/depression on day 14, respectively. Similar results were observed on day 90. Additionally, there was statistically significant difference of changes in EQ-VAS between the GDLM group and the placebo group from baseline to day 14 (mean difference, 1.70; 95% confidence interval [CI], 0.78-2.62; P = 0.0003) and to day 90 after randomization (mean difference, 3.29; 95% CI, 2.37-4.22; P < 0.001)., Conclusions: In this analysis of Chinese patients with AIS, GDLM could improve the 14-day and 90-day quality of life compared with the placebo., Trial Registration: URL: https://www., Clinicaltrials: gov . Unique identifier: NCT02526225. Registration Date: 2016-02-01., Competing Interests: Declarations Ethics approval and consent to participate The trial design is in compliance with the Declaration of Helsinki and was approved by the ethics committee at Beijing Tiantan Hospital and at each participating site. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Men who have sex with men studying in universities (MSM-US) frequently face multiple sexual minority stressors that potentially lead to maladaptive emotional regulations and mental problems. This study compared the prevalence of depression/insomnia between MSM-US and non-MSM male university students (NUS) and hypothesized that the potential differences would be mediated via emotional dysregulation styles (rumination and catastrophizing)., Methods: The study design was a cross-sectional study. NUS were recruited from a university-based survey using cluster sampling in three universities in China from June to October 2018, while MSM-US from the same university-based survey and the other community-based survey using convenience sampling. The effective samples size was 2,531 (292 MSM-US and 2,239 NUS). Structural equation modeling (SEM) was performed., Results: MSM-US had significantly higher prevalence of both probable depression (55.1% versus 35.7%; OR = 4.85, 95% CI: 3.38-6.94) and moderate-to-severe clinical insomnia (17.3% versus 4.1%; OR = 2.21, 95% CI: 1.73-2.83) than NUS. MSM-US were also more likely than NUS to use emotional dysregulation styles (rumination/catastrophizing), which were correlated with probable depression/insomnia (r = 0.17 to 0.31). In the SEM, the differences in depression/insomnia between MSM-US and NUS were partially mediated by the latent variable of emotional dysregulation (rumination and catastrophizing), with effect sizes of 55.0% for probable depression and 33.6% for insomnia, respectively., Conclusions: Depression and insomnia were prevalent among male university students in Sichuan, China. Furthermore, MSM-US were at increased risk than NUS for both mental problems; emotional dysregulation partially explained such differences. Future studies are warranted to confirm the findings, develop tailored interventions to address general and MSM-specific stressors and reduce rumination and catastrophizing, and examine whether similar patterns exist in other sexual minority groups., Competing Interests: Declarations Ethical approval and consent to participate The study was approved by the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong (No. SBRE-21-0635). All participants provided informed consent. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Iron is critical for maternal and fetal health; however, the effect of iron nutrition on fetal intrauterine growth remains unclear. This study aimed to investigate the associations of maternal iron nutrition during pregnancy with fetal intrauterine growth parameters among the Chinese population., Methods: This retrospective birth cohort study included 482 pregnant women. Maternal information was collected by standard questionnaires. Maternal concentrations of serum ferritin and hemoglobin were detected. Fetal ultrasound examinations in the second and third trimesters were conducted. Quantile regression or linear regression models were applied to assess the associations., Results: Participants took iron supplementation in early, mid, and late pregnancy accounted for 19.1%, 40.3%, and 37.8%, respectively. Iron supplementation in the first and second trimesters and total iron intake in pregnancy were positively associated with fetal intrauterine growth parameters at some percentiles. Compared with those without iron supplementation in the second trimester, women with iron supplementation in the second trimester had 0.37 (95%CI = 0.24-0.49), 0.37 (95%CI = 0.26-0.48), 0.15 (95%CI = 0.04-0.26), and 0.52 (95%CI = 0.42-0.61) higher z-scores in fetal biparietal diameter, femur length, abdominal circumference, and estimated fetal weight at the 50th percentile in the second trimester, respectively. Maternal serum ferritin and hemoglobin concentrations in the first and second trimesters were positively correlated with several fetal growth parameters., Conclusions: Fetal intrauterine growth may benefit from maternal iron nutrition in the first and second trimesters., (© 2024. The Author(s).)

Porcine reproductive and respiratory syndrome (PRRS) is one of the most significant diseases affecting the pig industry worldwide and is caused by the PRRS virus (PRRSV), which has complex genetic variation due to frequent mutations, indels, and recombination. The emergence of PRRSV L1C.5 in 2020 in the United States has raised worldwide concerns about PRRSV with the RFLP 1-4-4 pattern and lineage 1C. However, studies on the pathogenic characteristics, epidemiological distribution, and effectiveness of vaccines against PRRSV with L1C and RFLP1-4-4 pattern in China are still insufficient. In this study, a novel recombinant variant of PRRSV with RFLP 1-4-4 and lineage 1C features, different from L1C.5 in the United States, was isolated in China in 2021. In pathogenicity experiments in specific pathogen-free piglets or farm piglets, 60-100% of artificially infected experimental piglets died with high fever and respiratory symptoms. Inflammatory cytokine and chemokine levels were upregulated in infected piglets. A commercially modified live vaccine against highly pathogenic PRRSV did not provide effective protection when the vaccinated piglets were challenged with the novel L1C-1-4-4 variant. Therefore, this strain merits special attention when devising control and vaccine strategies. These findings suggest that extensive joint surveillance is urgently needed and that vaccine strategies should be updated to prevent the disease from spreading further., (© 2024. The Author(s).)

The emergence of multidrug-resistant Citrobacter freundii poses a significant threat to public health. C. freundii isolates were collected from clinical patients in a Chinese hospital during 2020-2022. An unusual strain, GMU8049, was not susceptible to any of the antibiotics tested, including the novel β-lactam/β-lactamase inhibitor combination ceftazidime-avibactam. Whole-genome sequencing (WGS) revealed that GMU8049 harbors a circular chromosome belonging to the rare ST257 and an IncX3 resistance plasmid. Genomic analysis revealed the coexistence of two β-lactamase genes, including plasmid-mediated bla NDM-1 and chromosomal bla CMY encoding a novel CMY variant, combined with an outer membrane porin deficiency, which may account for the extreme resistance to β-lactams. Conjugation experiment confirmed that the bla NDM-1 resistance gene located on pGMU8049 could be successfully transferred to Escherichia coli EC600. The novel CMY variant had an amino acid substitution at position 106 (N106S) compared to the closely related CMY-51. Additionally, a GMU8049-specific truncation in an OmpK37 variant that produces a premature stop codon. Moreover, a variety of chromosome-located efflux pump coding genes and virulence-related genes were also identified. Analysis of strain GMU8049 in the context of other C. freundii strains reveals an open pan-genome and the presence of mobile genetic elements that can mediate horizontal gene transfer of antimicrobial resistance and virulence genes. Our work provides comprehensive insights into the genetic mechanisms of highly resistant C. freundii , highlighting the importance of genomic surveillance of this opportunistic pathogen as a high-risk population for emerging resistance and pathogenicity.IMPORTANCEEmerging pathogens exhibiting multi-, extremely, and pan-drug resistance are a major concern for hospitalized patients and the healthcare community due to limited antimicrobial treatment options and the potential for spread. Genomic technologies have enabled clinical surveillance of emerging pathogens and modeling of the evolution and transmission of antimicrobial resistance and virulence. Here, we report the genomic characterization of an extremely drug-resistant ST257 Citrobacter freundii clinical isolate. Genomic analysis of GMU8049 with a rare ST type and unusual phenotypes can provide information on how this extremely resistant clinical isolate has evolved, including the acquisition of bla NDM-1 via the IncX3 plasmid and accumulation through chromosomal mutations leading to a novel CMY variant and deficiency of the outer membrane porin OmpK37. Our work highlights that the emergence of extremely resistant C. freundii poses a significant challenge to the treatment of clinical infections. Therefore, great efforts must be made to specifically monitor this opportunistic pathogen., Competing Interests: The authors declare no conflict of interest.

Background: As the most malignant type of cancer in the female reproductive system, ovarian cancer (OC) has become the second leading cause of death among Chinese women. Chemotherapy is the main treatment for patients with OC, and its numerous adverse effects can easily lead to malnutrition. It is difficult to centrally manage patients with OC in the intervals between chemotherapy. The use of WeChat, an effective mobile tool, in chronic disease management has been highlighted., Objective: This study aimed to implement a continuous follow-up strategy and health monitoring based on the WeChat platform for patients with OC undergoing chemotherapy to ensure that each phase of chemotherapy was delivered on schedule and to improve the survival rate of patients with OC., Methods: Participants were recruited and randomly assigned to either the WeChat-based nutrition intervention group or the usual care group. A self-administered general information questionnaire was used at enrollment to obtain basic information about the patients. The Patient-Generated Subjective Global Assessment (PG-SGA) Scale was used to investigate the nutritional status of the patients at 3 time points (T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). The blood indices of patients were investigated through the inhospital health care system at 3 times（T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). Patients in the intervention group were introduced to the nutrition applet, invited to join the nutrition management group chat, and allowed to consult on nutritional issues in private chats with nutrition management team members. Linear mixed models were used to analyze changes in each nutritional indicator in the 2 groups, with their baseline measurements as covariates; with group, time, and group-time interactions considered as fixed effects; and with patients considered as random effects., Results: A total of 96 patients with OC undergoing chemotherapy were recruited into the study. Distribution was based on a 1:1 ratio, with 48 patients each in the nutrition intervention group and the usual care group. The attrition rate after the first chemotherapy session was 18.75%. The mixed linear model revealed that the group-based effect and the group-time interaction effect on PG-SGA scores were significant (F38,38=4.763, P=.03; F37,37=6.368, P=.01), whereas the time-based effect on PG-SGA scores was not (F38,38=0.377; P=.54). The findings indicated that the group-based effect, the time-based effect, and the group-time interaction effect on nutrition-inflammation composite indices were significant (F38,38=7.653, P=.006; F38,38=13.309, P<.001; F37,37=92.304, P<.001; F37,38=110.675, P<.001; F38,38=10.379, P=.002; and F37,37=5.289, P=.02)., Conclusions: This study provided evidence that a WeChat-based, multidisciplinary, full-course nutritional management program can significantly improve the nutritional status of patients with OC during chemotherapy., (© Xiaojuan Tian, Yan Liu, Jiahua Zhang, Lixiao Yang, Linyao Feng, Aidong Qi, Hanjiazi Liu, Pengju Liu, Ying Li. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org).)

Background: Multivessel disease(MVD) is linked to a poorer prognosis, increased complications, longer hospital stays, and higher in-hospital mortality when compared to single-vessel disease(SVD).The purpose of this study is to explore the clinically relevant predictors of acute cornary syndrome (ACS) combined with MVD., Methods: This multicenter retrospective study included 68,378 ACS patients from 240 hospitals.The clinical data were retrospectively analyzed with univariate and multivariate analyses to identify the predictive factors for MVD., Results: When compared to SVD group, the MVD group showed a higher incidence of Major Adverse Cardiovascular Events(MACCEs), including all-cause death, myocardial infarction, stent thrombosis, and ischemic stroke during hospitalization, These differences were found to be statistically significant (P < 0.05) .The multivariate analysis revealed that age over 75 years (OR: 1.246, 95% CI: 1.176, 1.319), LDL/HDL ratio > 1.98 (OR: 1.245, 95% CI: 1.192, 1.302), history of heart failure (OR: 1.446, 95% CI: 1.143, 1.829), hypertension (OR: 1.274, 95% CI: 1.225, 1.325), diabetes (OR: 1.341, 95% CI: 1.278, 1.406), eGFRs < 60 ml/min·1.73m2 (OR: 1.179, 95% CI: 1.112, 1.249), family history of CAD (OR: 1.236, 95% CI: 1.108, 1.379), and high homocysteine levels (OR: 1.209, 95% CI: 1.029, 1.420) are independent predictors of MVD. The incidence of multivessel disease increased from 37.7 to 58.6% with an increase in the number of predictive factors, while the incidence of single vessel disease decreased from 62.3 to 41.4%. This trend was statistically significant (P trend < 0.001)., Conclusions: MVD is strongly correlated with a range of risk factors including diabetes, hypertension, LDL/HDL ratio greater than 1.98, hyperhomocysteinemia, family history of CAD, reduced glomerular filtration rate (< 60 ml/(min·1.73m 2 ), age over 75 years, and a history of heart failure. Furthermore, as the number of predictive factors increases, the odds ratio (OR) for patients with MVD also increases, reaching 2.344 times the OR for patients without any predictive factors., (© 2024. The Author(s).)

Aim: To explore the separate and joint association of estimated glucose disposal rate (eGDR) and high-sensitivity C-reactive protein (hsCRP) with cardiometabolic multimorbidity (CMM)., Methods: A total of 6900 participants aged 45 years or older with available data on eGDR and hsCRP and without cardiometabolic diseases at baseline from the China Health and Retirement Longitudinal Study were included. CMM was defined as the coexistence of two or more cardiometabolic diseases, including heart diseases, stroke, and diabetes., Results: During a median follow-up of 9.0 years, 464 (6.7 %) participants developed CMM. Low eGDR and high hsCRP separately and jointly increased the risk of CMM. The adjusted hazard ratio (HR) was 1.67 (95 % confidence interval [CI] 1.33-2.09) for low eGDR versus high eGDR, 1.43 (95 % CI 1.12-1.82) for high hsCRP versus low hsCRP) and 2.40 (95 % CI 1.77-3.27) for low eGDR plus high hsCRP versus high eGDR plus low hsCRP. The C-statistic, discriminatory power and risk reclassification significantly improved with the addition of combined eGDR and hsCRP for CMM (P < 0.001)., Conclusions: Low eGDR and high hsCRP were individually and jointly associated with increased risk of incident CMM. The findings highlighted the importance of joint evaluation of eGDR and hsCRP for primary prevention of CMM., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Tailings pond poses a serious threat to the surrounding environment. This study aimed to explore the current status and mechanism of Hippophae rhamnoides (H. rhamnoides) restoration in the Zhoutaizi magnetite tailings pond in Chengde city by analyzing the physicochemical properties, heavy metal content, and microbial community characteristics of the rhizosphere soil of H. rhamnoides. Rhizosphere soil samples were collected from the planting areas (10 m, 50 m, and 80 m) at distances of 10, 50, and 80 m from the mountain, the dead plants areas (D) at a distance of 80 m from the mountain, and the unplanted areas (U) in the center of the Zhoutaizi magnetite tailings pond. The available manganese (Mn) content in groups 10 m, 50 m, 80 m, and D was higher than in group U (p< 0.05). Mn contributed to the relative abundances of Articulospora, Mortierella, Minimedusa, and Knufia, but negatively correlated with that of Fusarium and Cistella (p< 0.05). These results indicated that H. rhamnoides can improve soil quality and microbial community structure by increasing Mn content. The Chao and Ace indices in groups 10 m, 50 m, 80 m and D were higher than in group U (p< 0.05), implying that H. rhamnoides can increase the total number of soil microbial species. The electrical conductivity (EC) of groups D and U was higher than that of the other groups (p< 0.05). EC was positively correlated with Cistella, while negatively correlated with Minimedusa and Knufia (p< 0.05). Therefore, we speculated that the increase of harmful bacteria and the decrease of beneficial bacteria caused by high EC were one of the reasons for H. rhamnoides death. In short, H. rhamnoides can be used to some extent for restoring magnetite tailings pond, but high EC is the main obstacle to its restoration. This study provides a theoretical basis for the construction of green mines., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Aims: Risk factor modification may decrease the risk of cardiovascular disease (CVD). Whether risk factor modification can mitigate the effect of hyperuricemia on CVD is unclear. This study aimed to investigate the risk of CVD among individuals with hyperuricemia, according to risk factors on target, compared with controls without hyperuricemia., Methods and Results: This prospective study included 91,722 participants free of CVD at baseline (2006-2007) of the Kailuan study. Individuals with hyperuricemia were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking, physical activity, healthy diet, guideline-recommended levels of body mass index, blood pressure, fasting blood glucose, and total cholesterol). During a median follow-up of 13.00 years, 671 out of 6740 individuals (9.96%) with hyperuricemia and 6301 out of 84,982 control subjects (7.41%) had incident CVD. Compared with control subjects without hyperuricemia, individuals with hyperuricemia who had 4 or 5 to 7 risk factors on target had no significant excess CVD risk, the hazard ratio (HR) (95% confidence internal [CI]) was 0.93 (0.79-1.10) and 0.88 (0.71-1.10), respectively. Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors on target, the HR of CVD associated with per additional risk factor within target range was 0.82 (95% CI, 0.77-0.87). Similar results were yielded for CVD subtypes., Conclusions: Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors within target., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

The infant gut microbiome matures greatly in the first year of life. Ambient air pollution (AAP) exposure is associated with the infant gut microbiome. However, whether time-varying AAP influences infant gut microbiome variation is rarely investigated. This study aimed to investigate the effects of PM 2.5 , PM 10 , and O 3 on infant gut microbiome variation longitudinally. Demographic information, stool samples, and AAP exposure concentrations were collected at 6, 12, 24 months from infants. Gut microbiome was processed and analyzed using 16S rRNA V3-V4 gene regions. AAP exposure concentrations were calculated using the China High Air Pollutants (CHAP) database. Multiple pollutant models were used to assess the mixed effects of PM 2.5 , PM 10 , and O 3 on infant gut microbiome variation. Infants' gut microbiomes at 6, 12, 24 months old had significant differences in alpha diversity, beta diversity, and community composition. PM 2.5 and O 3 respectively explained 6.3% and 5.3% of the differences in community composition for 24-month-old infants. Single pollutant exposure and multiple pollutant exposure in different periods were both associated with alpha diversity indices and specific gut microbial phyla and genera. AAP was more associated with infant gut microbial alpha diversity indices, phyla variations, and genera variations at 12-24 months than 6-12 months. Multiple pollutant exposure in 0-2 lag months showed negative correlations with 12-24 months variation in Escherichia-Shigella (β = -0.854, 95%CI: 1.398 to -0.310) and Enterococcus (β = -0.979, 95%CI: 1.429 to -0.530). This study highlighted that time-varying PM 2.5 , PM 10 , and O 3 synergistically influenced the variation of alpha diversity and abundance of gut microbial taxa in infants. Further research is needed to explore the effects and mechanisms of other environmental exposures on infant gut microbiome variation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

This study comprehensively examined the accumulation of cadmium (Cd) in soybeans grown in low- and high-Cd soils around the high geological background areas in Guizhou province. The aim was to analyze the relationship between soybean Cd and soil pH and soil Cd, alongside assessing the potential carcinogenic and non-carcinogenic risks associated with Cd in soybeans. Cd content of soybeans cultivated in the high-Cd area (0.430 mg/kg) was significantly higher than that in low-Cd areas (0.156 mg/kg) (P < 0.05). Biological concentration factors (BCFs) of soybean for Cd in low- and high-Cd areas were 0.282 and 0.314, respectively, with no significant differences (P > 0.05). Multiple linear regression results indicated that soil pH was a determining factor for Cd accumulation in soybeans in both areas. Furthermore, soil pH and soil Cd could accurately predict Cd accumulation in soybeans according to the neural network model. These findings suggest that regulating soil pH could reduce Cd accumulation in soybeans in areas with high geological background. In both areas, there was no significant non-carcinogenic risk for the adult population (HQ value < 1) through soybean consumption. However, according to the Monte Carlo model, the percentage of Cd in soybeans exceeding the acceptable range (CR value > 1.00 × 10 -04) in areas was 99.18%, indicating an unacceptable carcinogenic risk for the adult population. Our discussion revealed that reducing the soybean intake and increasing soil pH did not effectively lower the carcinogenic risk of Cd in soybeans to an acceptable range (CR value ≤ 1.00 × 10 -04). These findings necessitate further exploration of alternative remediation strategies to ensure the safe production of soybeans, such as screening for low-Cd accumulation soybean varieties and implementing the combined remediation strategies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tian 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: Balance dysfunction affects 70% of stroke patients. Emerging neurophysiological approaches, such as virtual reality therapy (VRT) and repetitive transcranial magnetic stimulation (rTMS), have been proven by clinical studies that the balance function of stroke patients can be improved when applied alone, but there are relatively few studies on the combined treatment of balance dysfunction after stroke. This study aimed to evaluate the impact of a 4-week intensive intervention combining VRT and rTMS on both balance function and brain plasticity among stroke patients., Methods: This single-blind, randomized controlled trial was conducted at the Rehabilitation Medical Center of the Rehabilitation General Hospital of Ningxia Medical University. A cohort of 136 stroke patients, with durations of 2 to 24 weeks post-stroke, were enrolled in the study. Participants were randomly allocated in a 1:1:1:1 ratio to four groups: the VR group (n = 34), the rTMS group (n = 34), the combined treatment group receiving both VR and rTMS (n = 34), and the control group undergoing traditional balance training (n = 34). All patients underwent a standardized inpatient rehabilitation program over 4 weeks. The VR group received daily 30-min sessions of VR therapy for 20 days. The rTMS group underwent daily sessions of rTMS stimulation for 20 min, targeting the motor imagery region in the affected hemisphere. The combination group received VR therapy after completing their rTMS treatment. The control group received conventional balance training, with each session lasting 30 min. Additionally, all patients received an extra 60 min of standard rehabilitation therapy twice daily. Assessments were conducted at baseline, 2 weeks, and 4 weeks post-treatment, using the Berg Balance Scale (BBS) as the primary measure, and secondary measures including the Timed Up-and-Go Test (TUGT), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), and 6-m walking test (6MWT), as well as assessments for brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VGEF), tyrosine receptor kinase (TrκB), motor-evoked potential latency (PL), central motor conduction time (CMCT), and amplitude., Discussion: The widespread application of VR technology and rTMS in clinical settings is well-established. However, the potential synergistic effects of combining these modalities on balance function and neuroplasticity in stroke patients remain uncertain. Our hypothesis suggests that the integration of VR with rTMS may result in more pronounced improvements in both balance function and neuroplasticity among stroke patients, surpassing the outcomes achievable with VR alone, rTMS alone, or traditional therapy. The possible mechanism is that VR-based training combined with rTMS plays a superimposed effect, promoting better repair of damaged neurons and ultimately improving balance function in stroke patients. The positive results anticipated from this trial could provide objective evidence advocating for the concurrent use of VR and rTMS in clinical interventions., Trial Registration: The study protocol underwent review and approval by the Medical Research Ethics Committee of the General Hospital of Ningxia Medical University on January 26, 2024 (No. KYLL-2024-0162). Subsequently, it was registered in the Chinese Clinical Trial Registry on March 11, 2024 (registration number: ChiCTR2400081775). Currently, the study is still ongoing., (© 2024. The Author(s).)

Systemic lupus erythematosus (SLE) is becoming a growing public health concern due to increasing disease and economic burdens. Epidemiological information about SLE, especially its incidence rate, is limited in developing countries. In the current study, we sought to investigate the incidence, prevalence, and economic burdens of SLE in urban China. We conducted a nationwide population-based cohort study using databases from Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance between 2013 and 2017, covering approximately 300 million residents in 23 provincial regions in China. Incidence rate and prevalence were standardized by age and gender to China's 2010 national census data. Additionally, we calculated the average annual costs and hospital visit rates. A total of 132,258 SLE patients were identified during the study period, with a mean age of 43.03 years (standard deviation: 15.29 years). Of these patients, 81.33% were women. In 2017, the standardized incidence rate of SLE in China was 14.09 (95% confidence interval (CI), 11.95-16.41) per 100,000 person-years, with a higher incidence in women than in men (26.41 vs. 5.92 per 100,000 person-years). Standardized prevalence in 2017 was 47.61 (41.77-53.83), 94.16 (80.67-108.69), and 17.86 (13.84-22.38) per 100,000 people in the overall, female, and male populations, respectively. The average annual rates of increase in prevalence were 21.50%, 19.72%, and 25.67% from 2013 to 2017 in the overall, female, and male populations, respectively. The age-specific incidence rates peaked at 30-49 years old in women and 40-59 years old in men. SLE incident and prevalent cases were most common in North-West China and less common in southern and eastern China. Distinct variations in incidence rates across different regions are also consistent with the varying levels of ultraviolet radiation exposure in China. Additionally, the average estimated annual per-capita cost was 1599.34 US dollars in SLE patients, with the highest costs observed in adolescent and young adult patients among different age groups. The SLE population in China is rapidly expanding, and younger at onset, especially in women, which has placed significant burdens on China's healthcare system., (Copyright © 2024 Science China Press. Published by Elsevier B.V. All rights reserved.)

Objective: To investigate the association between solid fuel use for heating, smoking, and respiratory diseases. Methods: This study is based on the Qingdao project of the China Kadoorie Biobank. After screening, 26 165 individuals were included in the study. We employed Cox proportional hazards regression models, stratified by risk age (in 5-year intervals) and sex while adjusting for confounding variables such as occupation and physical activity level to analyze the association between solid fuel use for heating, smoking, and increased risk of respiratory diseases. Results: Among the 26 165 participants, the average age of those using solid fuel for heating was (52.57±10.31) years, with females constituting 58.04% and former/current smokers accounting for 65.38%. The results indicated that both the solid fuel group and the former/current smoking group had a higher risk of respiratory diseases, with hazard ratios ( HR ) (95% CI ) of 1.21 (1.04-1.41) and 1.41 (1.16-1.71), respectively. For the duration of solid fuel use, the HR (95% CI ) for 20 years or more, it was 1.27 (1.07-1.51). The multiplicative interaction term between solid fuel use and smoking was statistically significant. Conclusions: The use of solid fuel for heating and smoking significantly increases the risk of respiratory diseases, and there may be a multiplicative interaction between solid fuel use and smoking.

Introduction: CD33 rs3865444 and hypertension (HTN) are related to cognitive impairment, individually. However, little is known about their combined effects on cognitive function in older adults., Methods: This population-based study included 4368 dementia-free participants (age ≥65 years) in the Multimodal Interventions to Delay Dementia and Disability in Rural China (MIND-China), with data available in 1044 persons for gray matter volume and 85 persons for cerebral blood flow (CBF). We used general linear regression and mediation models to examine the associations of rs3865444 and HTN with cognition, brain atrophy, and CBF., Results: Among rs3865444 CC carriers, HTN and late-life HTN were significantly associated with impaired cognition. Midlife and late-life HTN were correlated with brain atrophy. CD33 rs3865444 CC moderated the mediation effect of gray matter volume on the association between HTN and global cognition. HTN was correlated with low CBF in rs3865444 CC carriers., Discussion: There are synergistic associations of CD33 rs3865444 and HTN with brain and cognitive aging in dementia-free older adults., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Background: Previous studies into relationship between high-density lipoprotein cholesterol (HDL-C) and cognitive decline were constrained to a single measurement, leaving the association between HDL-C variability and risk of cognitive decline unclear., Methods: We identified 5930 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were devoid for stroke, dementia, and memory-related diseases at baseline and underwent a minimum of 2 sequential health examinations during 2011-2015. Variability in HDL-C was defined as (1) variability independent of the mean (VIM), (2) average real variability (ARV), and (3) standard deviation (SD) of HDL-C change from baseline and follow-up visits. Cognitive function was evaluated in 2018 by Mini-mental state examination (MMSE) in the Chinese version. Logistic regression was employed to explore the association between HDL-C variability and cognitive decline. Odd ratios (OR) and 95 % confidence intervals (CI) were reported., Results: The study included participants from CHARLS, mean age of 57.84±8.44 years and 44 % male. After adjustment for covariates, the highest quartile of VIM was associated with an increased risk of cognitive decline [OR:1.049, 95 %CI: 1.014-1.086] compared to the lowest quartile. For each SD increment of VIM, the OR was 1.015 (95 %CI:1.003-1.027). Strong dose-response relationships were identified (P for trend: 0.005). Consistent results were obtained for other measures of HDL-C variability (ARV and SD). Similar patterns were identified in different dimensions of cognition., Conclusions: Elevated HDL-C variability was associated with increased cognitive decline risk. Strategies to reducing HDL-C variability may lower the risks of cognitive decline among the general population., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: We sought to examine the associations of the Lifestyle for Brain Health (LIBRA) index with cognitive function among rural Chinese older adults and to explore the potential role of cluster of differentiation 33 gene (CD33) in the associations., Methods: This population-based cross-sectional study included 4914 dementia-free participants (age ≥60 years; 56.43 % women) in the 2018 baseline examination of MIND-China. The LIBRA index was generated from 11 factors. We used a neuropsychological test battery to assess episodic memory, verbal fluency, attention, executive function, and global cognition. The CD33(rs3865444) polymorphism was detected using multiple-polymerase chain reaction amplification. Data were analyzed using the general linear regression models., Results: A higher LIBRA index was associated with multivariable-adjusted β-coefficient (95 %CI) of -0.011(-0.020- -0.001) for global cognitive z-score, -0.020(-0.033- -0.006) for episodic memory, and -0.016(-0.029- -0.004) for verbal fluency. The CD33(rs3865444) was associated with a lower global cognitive z-score in the additive (CA vs. CC: β-coefficient=0.042; 95 %CI=0.008-0.077), the dominant (CA+AA vs. CC: 0.040; 0.007-0.073), and the over-dominant (CA vs. CC+AA: 0.043; 0.009-0.077) models. Similar results were obtained for verbal fluency and attention. The CD33 gene showed statistical interactions with LIBRA index on cognitive function (P interaction <0.05) such that a higher LIBRA index was significantly associated with lower z-scores of global cognition and attention only among CD33 CC carriers (P < 0.05)., Conclusions: This population-based study reveals for the first time that a higher LIBRA index is associated with worse cognitive performance in rural Chinese older adults and that CD33 gene could modify the association., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: Patients with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular and cerebrovascular events (CCEs). Furthermore, CCE was a significant factor contributing to mortality in patients with SLE. However, no clinical model exists that can predict which patients are at high risk. The purpose of this study was to develop a practical model for predicting the risk of CCE in people with SLE., Methods: This study was based on the Chinese SLE Treatment and Research Group cohort. A total of 2399 patients, who had a follow-up period of over 3 years and were diagnosed with SLE for less than 1 year at the start of the study, were included. Cox proportional hazards regression and least absolute shrinkage and selection operator regression were used to establish the model. Internal validation was performed, and the predictive power of the model was evaluated., Results: During the follow-up period, 93 patients had CCEs. The prediction model included nine variables: male gender, smoking, hypertension, age of SLE onset >40, cutaneous involvement, arthritis, anti-β2GP1 antibody positivity, high-dose glucocorticoids and hydroxychloroquine usage. The model's C index was 0.801. Patients with a prognostic index over 0.544 were classified into the high-risk group., Conclusion: We have developed a predictive model that uses clinical indicators to assess the probability of CCE in patients diagnosed with SLE. This model has the ability to precisely predict the risk of CCE in patients with SLE. We recommended using this model in the routine assessment of patients with SLE., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The gut microbiome is central to human health, but the potential impact of ozone (O 3 ) exposure on its establishment in early life has not been thoroughly examined. Therefore, this study aimed to investigate the relationship between prenatal O 3 exposure and the variations of the human gut microbiome during the first two years of life., Design: A cohort study design was used. Pregnant women in the third trimester were recruited from an obstetric clinic, and long-term follow-ups were conducted after delivery. The gut microbiome was analyzed using the 16 S rRNA V3-V4 gene regions. Functional pathway analyses of gut microbial communities in neonates were performed using Tax4fun. The average concentrations of ambient O 3 and other air pollutants from pregnancy to delivery were calculated using the China High Air Pollutants (CHAP) dataset, based on the permanent residential addresses of participants. Multiple linear regression and mixed linear models were utilized to investigate the associations between prenatal O 3 exposure and gut microbiome features., Results: Prenatal O 3 exposure did not significantly affect the gut microbial alpha diversity of mothers and neonates. However, it was found to be positively associated with the gut microbial alpha diversity in 24-month-old infants. Prenatal O 3 exposure explained 13.1 % of the variation in neonatal gut microbial composition. After controlling for potential covariates, prenatal O 3 exposure was associated with neonatal-specific gut microbial taxa and functional pathways. Furthermore, the mixed linear models showed that prenatal O 3 exposure was negatively associated with variations of Streptococcus (p-value = 0.001, q-value = 0.005), Enterococcus (p-value = 0.001, q-value = 0.005), Escherichia-Shigella (p-value = 0.010, q-value = 0.025), and Bifidobacterium (p-value = 0.003, q-value = 0.010)., Conclusions: This study is the first to examine the effects of prenatal O 3 exposure on gut microbial homeostasis and variations. It demonstrates that prenatal O 3 exposure is associated with variations in certain aspects of the gut microbiome. These findings provide novel insights into the dynamics and establishment of the human microbiome during the first two years of life., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Benefit finding (BF) is correlated with mental health and recovery, and its presence will contribute to the recovery of patients with mental disorders. Most of the current tools for assessing BF in patients with somatic disorders are not adequate for patients with mental disorders. The present study proposes to introduce the Benefit Finding Questionnaire for People with Mental Disorders and to validate its psychometric properties., Methods: The Beaton translation model was used to translate and cross-culturally adjust the Japanese version of the Benefit Finding Questionnaire for People with Mental Disorders. A survey of 514 people with mental disorders was conducted from January 2022 to October 2022 using a general information questionnaire and a translated Chinese version of the Benefit Finding Questionnaire for People with Mental Disorders (BFQ-C) using a convenience sampling method. The quality of the questionnaire was examined in terms of item analysis, reliability, and validity., Results: The results of the item analysis showed that all items met the requirements. The interrater agreement of the BFQ-C was good, with an interrater agreement = 0.714; the values of the item-level content validity index ranged from 0.75 to 1.00; and the average of all item-level content validity index on the scale = 0.958. Exploratory factor analysis extracted three main factors "change in relationship with others," "change in spirituality," and "change in values and thinking styles"-and the cumulative variance contribution rate was 57.70%. The results of the confirmatory factor analysis were χ2/df of 2.194, Root Mean Square Error of Approximation of 0.075, and comparative fit index of 0.919, indicating that the model fitted well. The questionnaire had a Cronbach' alpha of 0.936, a split reliability of 0.956, and a retest reliability of 0.939., Conclusion: The BFQ-C demonstrated good reliability and validity, and can be used to assess the BF level of people with mental disorders (e.g., anxiety disorders, depressive disorders, schizophrenia, and bipolar disorders) in China., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Cao 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: Bystander cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) may improve survival in patients with out-of-hospital cardiac arrest (OHCA). The purpose of this study was to investigate the effect of CPR training experience and sociodemographic characteristics on bystander CPR willingness and AED awareness., Methods: In this study, a questionnaire survey was conducted among 3,569 residents in central China. Descriptive statistics, multiple linear regression and multivariate logistic regression modeling were used to investigate the effect of training experience and sociodemographic characteristics on knowledge of cardiac arrest first aid, awareness of AEDs, and willingness for bystander CPR., Results: Of the 3,569 participants, nearly 52% were female, 69.6% were < 23 years old, 23.5% had CPR training and 22.1% had witnessed OHCA. Characteristics of increasing bystander CPR willingness included CPR training experience, male, witnessed OHCA but not acting, knowing whether family members have cardiac disease, older age (>40 years) and lower level of education. Farmers were the subgroup with the least awareness of AED and knowledge of first aid., Conclusion: In China, CPR training experience was an important factor in improving bystanders' CPR willingness, AED awareness and knowledge of cardiac arrest first aid. Additionally, having witnessed OHCA also had a positive effect on bystander CPR willingness., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tian, Zhang and Dou.)

Objective: Idiopathic inflammatory myopathies (IIM) are a heterogeneous and life-threatening group of diseases; in particular, anti-melanoma differentiation-associated gene 5 antibody positive DM (MDA5+ DM) is reportedly strongly associated with high mortality rate. Tacrolimus (TAC) provides an excellent therapeutic option, but the trough concentration (Cmin)-outcome relationship remains unexplored. This study was undertaken to identify optimal Cmin and individualized dose based on CYP3A5 genotype for IIM patients., Methods: A total of 134 IIM patients with 467 Cmin were enrolled. We examined the relationship between TAC Cmin and relapses. The receiver operating characteristic analysis was used to confirm the optimal Cmin. Analyses of factors influencing Cmin were conducted. The dose requirement based on CYP3A5 genotype was confirmed., Results: TAC Cmin is strongly associated with relapses. The optimal cutoff values were 5.30, 5.85, 4.85 and 5.35 ng/ml for acute, subacute, chronic and all-phase IIM patients (P = 0.001, 0.013, 0.002 and <0.001, respectively), as well as 5.35, 5.85, 5.55 and 5.85 ng/ml for acute, subacute, chronic and all-phase MDA5+ DM patients (P = 0.007, 0.001, 0.036 and <0.001, respectively). CYP3A5 genotype was one of the significant factors influencing TAC Cmin. CYP3A5 expressers required 0.059 mg/kg/day to attain the target Cmin, while nonexpressers required 0.046 mg/kg/day (P = 0.019)., Conclusion: TAC treatment may elicit favorable outcome in patients with IIM and MDA5+ DM when Cmin exceeded 5.35 and 5.85 ng/ml, which is crucial to a lower relapse rate. The individualized dose based on the CYP3A5 genotype provides a reference for TAC personalized therapy in IIM., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Nosocomial outbreaks caused by carbapenem-resistant Acinetobacter baumannii (CRAB) strains are rapidly emerging worldwide and are cause for concern. Herein, we aimed to describe the genomic characteristics of CRAB strains isolated from two hospitals in China in 2023. The A. baumannii isolates were mainly collected from the ICU and isolated from the sputum (71.43%, 15/21), followed by urine (14.29%, 3/21). Twenty-one A. baumannii strains possessed a multidrug-resistant (MDR) profile, and whole-genome sequencing showed that they all carried bla OXA-23 . Based on the Pasteur multilocus sequence typing (MLST) scheme, all strains were typed into a sequence type 2 (ST2). Based on the Oxford MLST scheme, six strains belonged to ST540, three of which were ST208, and four strains were assigned to ST784. Kaptive showed most of the strains (38.10%, 8/21) contained KL93. As for the lipoolygosaccharide (OC locus) type, OCL1c and OCL1d were identified, accounting for 33.33% (7/21) and 66.67% (14/21), respectively. Based on the BacWGSTdb server, we found that the strains belonging to ST540 and ST784 were all collected from China. However, the ST938 strains were isolated from Malaysia and Thailand. Comparative genomics analysis showed that the AB10 strain had a closed relationship with SXAB10-SXAB13 strains, suggesting the transmission happened in these two hospitals and other hospital in China. In addition, the 4300STDY7045869 strain, which was collected from Thailand, possessed near genetic relationship with our isolates in this study, suggesting the possible spread among various countries. Additionally, 3-237 single nucleotide polymorphisms were observed among these strains. In conclusion, this study conducted a genome-based study for A. baumannii strains collected from two hospitals in China and revealed their epidemiological and molecular features. Clone spreading occurred in these two hospitals. Hence, there is an urgent need for increased surveillance in hospitals and other clinical settings to prevent and control CRAB spreading., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: The purpose of this study was to explore the impact of central obesity on spinal sagittal balance in adults aged 18 and older by examining correlations between waist circumference (WC) and abdominal circumference (AC) and spinopelvic alignment parameters., Methods: This prospective cohort study included 350 adults aged 18 and older. Participants underwent whole-body biplanar radiography using the EOS imaging system. Spinal and pelvic parameters were measured and correlated with body mass index, WC, and AC. Statistical analyses included one-way analysis of variance, Wilcoxon rank-sum tests for data with nonhomogeneous variances, and chi-squared tests for categorical data. Intra-rater and inter-rater reliability were assessed using intraclass correlation coefficients, with subsequent analyses to explore correlations between body measurements and spinal parameters., Results: The study found significant correlations between increased WC and AC and changes in spinopelvic parameters. However, obesity did not uniformly influence all sagittal alignment parameters. Significant variations in spinal measurements indicate that central obesity plays a role in altering spinal stability and alignment., Conclusions: The findings highlight the impact of central obesity on spinal alignment and emphasize the importance of considering central obesity in clinical assessments of spinal pathologies. Further research is essential to better understand the relationship between obesity, spinal sagittal balance, and related health conditions., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Thalidomide is an effective medication for refractory mucocutaneous lesions of systemic lupus erythematosus (SLE) and can treat arthritis in some autoimmune diseases, but it has some adverse reactions. Recently, the effectiveness of tofacitinib in treating mucocutaneous lesions of SLE has been reported. We aimed to compare the efficacy and safety of tofacitinib with thalidomide in treating mucocutaneous and musculoskeletal lesions in patients with SLE., Methods: This study was a real-world cohort study based on the Chinese SLE Treatment and Research group (CSTAR) registry. SLE patients who manifested mucocutaneous and/or musculoskeletal symptoms and were prescribed tofacitinib or thalidomide were included. We retrospectively conducted comparisons between the tofacitinib and thalidomide groups regarding clinical improvements, SLE disease activity, serological indicators, glucocorticoid doses, and adverse events at the 1, 3, and 6-months time points., Results: At 3 and 6 months, the tofacitinib group exhibited a higher proportion of patients with improvement in mucocutaneous and musculoskeletal issues. Additionally, a greater percentage of patients in the tofacitinib group achieved remission or a low disease activity state (LLDAS) at these time points. No significant serological improvements were observed in either the tofacitinib or thalidomide groups. Fewer adverse events were observed in the tofacitinib group than in the thalidomide group., Conclusions: Tofacitinib might be superior to thalidomide in the improvement of mucocutaneous and musculoskeletal lesions in SLE, and had a good safety profile., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The emergence of carbapenem-resistant Klebsiella pneumoniae presents significant health challenges. Here, we present the structural genome sequence of an NDM-5-producing K. pneumoniae (HZKP2) in China., Methods: Antimicrobial susceptibility tests were conducted via broth microdilution. Whole-genome sequencing was performed for genomic analysis. Wzi and capsular polysaccharide (KL) were analysed using Kaptive. Resistance genes, virulence factors, and comparative genomics analyses were also conducted. Multilocus sequence typing (MLST), replicons type, and core genome MLST analysis were further conducted using BacWGSTdb server., Results: HZKP2 was resistant to cefepime, ceftazidime, ciprofloxacin, ciprofloxacin, meropenem, and ertapenem. It harboured fosA, bla SHV-187 , oqxA, oqxB, sul1, dfrA1, tet(A), floR, aph(6)-Id, aph(3'')-Ib, sul2, bla CTX-M-55 , and bla NDM-5 . Based on the RAST results, 5563 genes that belonged to 398 subsystems were annotated. The complete genome sequence of HZKP2 was characterized as ST1, wzi 19, and KL19, 5 five contigs totalling 5 654 446 bp, including one chromosome and four plasmids. Further analysis found that bla NDM-5 was located in a 46 161 bp IncX3 plasmid (pHZKP2-3). The genetic structure of bla NDM-5 gene was ISKox3-IS26-ble MBL -bla NDM-5 -IS5-ISAb125-IS3000. Further analysis revealed that insertion sequences mediated the dissemination of bla NDM-5 from other species of Enterobacterales. Phylogenetic analysis showed that the closest relative was from a human stool specimen in China, which differed by 53 core genome MLST alleles., Conclusions: Our study provides the first structural perspective of the ST1 K. pneumoniae isolate producing NDM-5 in China. These results could provide valuable insights into the genetic characteristics, antimicrobial resistance mechanisms, and transmission dynamics of carbapenem-resistant K. pneumoniae in clinical settings., Competing Interests: Competing interests None declared., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Currently, the special blood pressure (BP) target for normotensive diabetic patients has not been recommended. We investigated the optimal systolic blood pressure (SBP) for lower cardiovascular disease (CVD) risk in normotensive diabetic patients., Methods: In this 12-year follow-up study using the participants of the Kailuan Study, we mainly compared which SBP, 90-119 mmHg or 120-129 mmHg, had a lower risk of occurrence of CVD (stroke and myocardial infarction) in the 3072 normotensive diabetic participants and 21,532 normotensive and non-diabetic participants, respectively. The SBP was expressed as a mean time-weighted cumulative (MTWC) SBP, calculated from the multiple measurements of SBP during the follow-up. Multivariate competing risk regression analyses were used for the analysis., Results: We found that in normotensive diabetic participants, MTWC SBP of 120-129 mmHg was associated with a lower risk of CVD (HR = 0.69 [0.50-0.95]), myocardial infarction (HR = 0.48 [0.24-0.96]), and trending towards lower risk of stroke (HR = 0.80 [0.55-1.16]), compared to MTWC SBP of 90-119 mmHg. Sensitivity analyses confirmed the relationship between low SBP and increased CVD risk. Whereas, in the normotensive and non-diabetic participants, MTWC SBP of 90-119 mmHg vs 120-129 mmHg did not exhibit any difference in the risk of CVD occurrence (HR = 0.99 [0.83-1.18])., Conclusions: The higher level of SBP in normotensive diabetic patients is especially associated with a lower risk of CVD occurrence., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Borreria latifolia (Aubl.) K. Schum (Rubiaceae) is an annual weed with a strong allelopathic inhibitory effect on malignant weeds in orchards in southern China. This study was carried out to investigate its allelopathic potential and to identify allelochemicals present in B. latifolia., Results: Aqueous extracts of B. latifolia inhibited the germination and radicle growth of Eleusine indica and the radicle growth of Bidens alba in a dose-dependent manner. However, only the high-concentration treatment at 50 mg mL -1 delayed the germination of B. alba and Digitaria sanguinalis. Among the root, stem, and leaf aqueous extracts of B. latifolia, the leaf extract had the strongest inhibitory effects on the germination and seedling growth of E. indica, followed by stem extract and then root extract. A total of 47 published allelochemicals, including coumarin, 4-hydroxybenzoate, salicylic acid, 4-hydroxycinnamic acid, and vanillic acid, were identified in the leaf extract. Among the five allelochemicals, coumarin was found to be present in the highest concentration in the leaf extract. Furthermore, coumarin exhibited a significantly greater inhibitory effect on E. indica (EC 50  = 36.87 mg L -1 ) than did the other allelochemicals (EC 50  = 100.87-156.30 mg L -1 )., Conclusion: This study indicates that the leaf extracts of B. latifolia and their allelochemicals have excellent potential as bioherbicides and that coumarin is one of the key allelochemicals in B. latifolia. © 2024 Society of Chemical Industry., (© 2024 Society of Chemical Industry.)

Clostridium perfringens, as a foodborne pathogen, can cause various intestinal diseases in both humans and animals according to its repertoire of toxins. In recent years, a multitude of studies have highlighted its threat to infants and young children. C. perfringens carries numerous toxins, with the newly identified BEC toxin confirmed as the second toxin to cause diarrheal illness, after CPE. However, the global dissemination of C. perfringens strains carrying becAB genes, which encode BEC toxins, has not been extensively studied. Following epidemiological surveillance of the prevalence of C. perfringens from different sources in various provinces of China, we identified two becAB-carrying strains and one strain carrying a sequence similar to becAB from distinct provinces and sources. When combined with genomic analysis of other becAB-carrying C. perfringens strains from public databases, we found that becAB was present in strains from different lineages. Our analysis of the plasmid and genetic environment corroborates previous findings on becAB-carrying strains, confirming that it currently achieves horizontal transmission through one type of evolutionarily conserved Pcp plasmid. This study provides a comprehensive analysis of the prevalence and transmission patterns of the newly emerged toxin gene locus, becAB, in C. perfringens. Despite the relatively low identification rate of becAB-carrying strains, their potential impact requires ongoing surveillance and investigation of their features, particularly their antimicrobial resistance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)