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Irrigated artificial grasslands can help in achieving a large amount of forage in the Inner Mongolia typical steppe areas of China. However, developing irrigated artificial grasslands requires the consumption of water resources, and also affects the hydrological cycle. In this study, mapping evapotranspiration at high resolution with internalized calibration (METRIC) model has been used to estimate regional evapotranspiration during the crop growth season (from May to September) in irrigated artificial grasslands in 2011. The results were verified based on the data obtained from eight monitoring points of irrigated silage maize farms using water balance method, with a mean relative error value of 13.8%. The average evapotranspiration for irrigated artificial grasslands during the crop growth season is 611.42 mm. To further analyze the consumption of local water resources, concept of groundwater consumption (GW) is proposed. The GW value for irrigated artificial grasslands during the crop growth season was estimated to be 457.96 mm; the GW values at each of these farms, including Woyuan cow, Maodeng, Baiyinxile, Hezhongmumin, exceeded 400 mm. The results show that these areas, which exhibit high water consumption face difficulties in water resource management, particularly when there is no external water supply. [ABSTRACT FROM AUTHOR]

Highlights: [•] Spartina alterniflora litter decomposes faster than Phragmites australis. [•] Decomposition starts whilst these macrophytes remain standing. [•] Decomposition speeds up on transfer to the sediment surface. [•] Decomposition rates are also affected by litter quality. [Copyright &y& Elsevier]

In this paper, reasonable paths in transit networks are defined as possible paths that satisfy the acceptable time criterion and transfer-walk criterion. A recursive algorithm for finding all of the reasonable paths in a transit network that does not involve a rapid increase in program run-time with network size is presented. Realistic transit networks in Hong Kong and Guangzhou were selected as case studies of the different phases of the development of a trip planning system. Transport planning practitioners and potential users were invited to test the system to evaluate its performance. The results of the prototype evaluation were satisfactory, and the viability of the system as a useful tool for supporting decision-making has been confirmed by the positive feedback that was obtained from survey questionnaires. [ABSTRACT FROM AUTHOR]

This paper describes the parking demand models for private cars and goods vehicles developed as part of a parking demand study that was completed in Hong Kong in 1995. In the model, it is assumed that there is a linear and additive demand function relating land-use variables in a zone (such as jobs, schools, or households) with parking demand. Further, the parking activity associated with each land-use variable is assumed to have a unique parking accumulation profile. Surveys were conducted to determine these profiles. A unitgraph, which is defined as the parking accumulation profile per parking activity, was constructed for each land-use variable. Given the land-use variables, the parking demand function, and the unitgraphs, the total parking accumulation profile in each zone is determined. [ABSTRACT FROM AUTHOR]

This paper reports on a study of the implementation and evaluation of learning contracts in a clinical context for a group of students who were in their third year of study in a pre-registration bachelor of nursing degree programme in Hong Kong. A learning contract was implemented as a learning tool in the students' clinical placement in mental health nursing. An action research approach was used in this study. Data were collected from questionnaires and interviews with students and clinical instructors. Results showed that students and clinical instructors generally agreed that there was an increase in students' autonomy and motivation in learning with the use of a learning contract. It also increased the sharing between students and clinical instructors. The findings of the questionnaire and interviews supported each other. However, the lack of experience in using contract learning and the limited time in the clinical areas created difficulties for both students and clinical instructors. Despite the limitations, contract learning is considered beneficial to students' learning and has the potential to be used in clinical learning. [ABSTRACT FROM AUTHOR]

This paper describes the land use and transport characteristics of a strip of urban development located along the northern shore of Hong Kong Island. The strip of land, with an area of 22.5 sq. km, is 17 km long and has an average width of 1.3 km. It has a population of approximately one million and provides over 700,000 jobs. Despite its small size, it accommodates the CBD, residential districts, shopping complexes as well as most of the civic/institutional facilities that a city needs. Its urban form is linear not by design but by default – the topography of the area has constrained the development from spreading sideways. Surprisingly however, apart from economy in land utilization, it is considered to possess three other good qualities: high accessibility enjoyed by residents; few roads and commercially viable public transport. Its travel characteristics are analyzed, using results of a home interview survey conducted by the Government in 1992. In addition, various statistics published by the Government and public transport authorities are also used in the analysis. [ABSTRACT FROM AUTHOR]

Describes a calibration procedure for the Lowry model, which was formulated and calibrated for the Hong Kong, China. Determination of potentials using a genetic algorithm; Relationships between potentials and land use variables; Model validation; Case study and results.

We present the first three-dimensional seismic velocity model of the Hong Kong region, including the Dangan Island fault zone (DIFZ). The crust beneath Hong Kong is predominantly igneous, and is characterized by relatively high seismic velocity. Further south, we observe an elongated velocity anomaly beneath part of the DIFZ where significant seismicity has been recorded. This anomaly demarcates the contrasting seismic velocity structures on the opposite sides of the fault zone from the surface to a depth of at least 20 km, suggesting that the DIFZ extends to the lower crust and dips subvertically. Our model also indicates that there is an abrupt change in the along-strike crustal structure of the fault zone, with a significantly higher seismic velocity in the region west of the seismically active area. We anticipate that this first three-dimensional subsurface tectonic model of Hong Kong and the DIFZ will help assess the influence of crustal heterogeneities on the spatial pattern of intraplate earthquakes in this densely populated region of south China. [ABSTRACT FROM AUTHOR]

This paper describes the background, objectives, surveys, models, findings and recommendations of the Hong Kong second parking demand study. This study aims to give strategic directions to guide the planning and management of parking facilities in Hong Kong. It comprises extensive surveys to determine the parking inventory, parking characteristics and driver behaviour. Demand models were developed to predict the future night-time and daytime parking demand over a planning horizon of 15 years. All types of vehicle, including private cars, taxis, motorcycles, coaches and goods vehicles, were included in the analysis. The recommendations of a previous parking demand study have been reviewed, and new recommendations are given. [ABSTRACT FROM AUTHOR]

Ecosystem respiration ( R eco ) is an important pathway for gaseous carbon loss in coastal wetland environments. However, little is known regarding the dynamics of R eco and its temperature sensitivity ( Q 10 ) under different tidal stages, and vegetation types. In this study, R eco was measured with dark chambers for nearly 2 years in three different brackish marsh stands dominated by Cyperus malaccensis , Phragmites australis , and Spartina alterniflora , respectively, in the Min River estuary of southeast China. The mean R eco across tidal stages and vegetation types exhibited strong temporal variations, and the Q 10 value for R eco was higher in the warm months than in the cold months. The mean annual R eco was negatively correlated with electrical conductivity and soil water content, but positively correlated with both tidal water level and soil pH ( P  < 0.05). On the other hand, the seasonal variation in R eco and Q 10 was largely driven by the thermal regimes and soil salinity. Also, we found that the mean R eco and Q s10 value were both relatively higher when the site was exposed before tidal inundation, as compared to that after tidal inundation for all the vegetation types studied ( P >  0.05). Overall, the C. malacensis and S. alterniflora stands had the highest and lowest average rates of R eco , respectively, while the mean Q s10 values were lower in the Phragmites australis stand than the other two vegetation types. Our findings point to the need of strengthening the in situ measurements of gas fluxes at multiple time scales in order to develop a better understanding of the response of R eco to changing environmental conditions in the subtropical coastal wetlands. Our results also reiterate the importance of considering the influence of vegetation types in characterizing the magnitude and temperature sensitivity of R eco in estuarine tidal marshes for predicting ecosystem responses to future global change. [ABSTRACT FROM AUTHOR]

Assessing the diverse communities of methanogenic Archaea and sulfate-reducing bacteria (SRB) is important to understand methane (CH 4 ) production in wetland ecosystems. However, the vertical distribution of composition and diversity, and the effects of environmental factors on the methanogen and SRB communities in the sediments of subtropical estuarine brackish marshes have been poorly characterized. To assess the effects of variable environmental conditions on methanogenic and SRB communities in marshes, we studied three brackish marsh zones dominated by Phragmites australis , Cyperus malaccensis and Spartina alterniflora , respectively, in the Min River estuary, southeastern China. Methanogens of the Methanomicrobiales order was the dominant group at sediment depths of 0–30 cm, which indicated that the main pathway of methane production was H 2 /CO 2 in this zone. In general, methanogens of the genus Methanoregula were dominant in the three marsh zones. For SRB, Desulfobacterales was the dominant group, and Desulfobacterium and Desulfosarcina were the predominant genera at the depth of 0–30 cm. The community composition of methanogens and SRB changed with vegetation type and soil depth. Compared with SRB, vegetation type demonstrated a stronger influence on the community composition of methanogens. Canonical correspondence analysis (CCA) analysis further revealed that the main factors affecting the methanogens community composition were EC (electric conductivity) and pH, and the main factors affecting SRB community composition were pH, SOC and TN, suggesting that pH is a common factor influencing the community compositions of both methanogen and SRB in the sediments of brackish marshes. [ABSTRACT FROM AUTHOR]

Although bovine mastitis caused by Streptococcus strains is the most economically important disease affecting the dairy industry worldwide, the development of an effective vaccine has been hampered for many years. In this study, five S. agalactiae, three S. dysgalactiae, and three S. uberis were identified out of thirteen Streptococcus strains isolated during a study of clinical bovine mastitis from seven farms in China. The gapC genes, encoding the cell surface-associated GapC proteins of S. agalactiae, S. dysgalactiae and S. uberis were cloned and sequenced. To further identify potential vaccine candidates against Streptococcus-induced bovine mastitis, mice were vaccinated with GapC of S. agalactiae, S. dysgalactiae and S. uberis, resulting in a significant humoral immune for three weeks post-challenge. This observation together with previous studies conducted in our laboratory on GAPDH activity of Staphylococcus aureus possibly makes this protein an important target for vaccine development against bovine mastitis. [ABSTRACT FROM AUTHOR]

Asia is responsible for over 90% of the world's rice production and hence plays a key role in safeguarding food security. With China being one of the major global producers and consumers of rice, achieving a sustainable balance in maximizing crop productivity and minimizing greenhouse gas emissions from paddy fields in this country becomes increasingly important. This study examined the effects of applying steel slag, a residual product derived from the steel industry, on crop yield and CH 4 and N 2 O emissions over multiple growing seasons in a Chinese subtropical paddy field. Average CH 4 emission was considerably higher during the periods of rice crop growth compared to that during the periods of fallowing and vegetable crop growth, regardless of the amount of steel slag applied. When compared to the controls, significantly lower mean emissions of CH 4 (1.03 vs. 2.34 mg m −2 h −1 ) and N 2 O (0.41 vs. 32.43 μg m −2 h −1 ) were obtained in plots with slag addition at a rate of 8 Mg ha −1 over the study period. The application of slag at 8 Mg ha −1 increased crop yields by 4.2 and 9.1% for early and late rice crops, respectively, probably due to the higher availability of inorganic nutrients such as silicates and calcium from the slag. Slag addition had no significant effect on the concentrations of heavy metals in either the soil or the rice grains, although a slight increase in the levels of manganese and cobalt in the soil and a decrease in the levels of manganese and zinc in the rice grains were observed. Our results demonstrate the potential of steel slag as a soil amendment in enhancing crop yield and reducing greenhouse gas emissions in subtropical paddy fields in China, while posing no adverse short-term impacts on the concentrations of heavy metals in the soil or the rice grains. However, long-term implications of this management practice and the cost/benefit remain unknown, so further studies to assess the suitability at large scale are warranted. [ABSTRACT FROM AUTHOR]

This paper summarises the process, findings and recommendations of a recently completed joint university consultancy project that reviewed the annual traffic census (ATC) in Hong Kong. The results of a survey that assessed the usefulness of the census report are presented, together with an overview of the existing traffic data collection process and traffic detection equipment. Areas for improvement are then identified, including the sampling strategies for the collection of vehicle classification and occupancy data, the procedure for the development of group scaling factors, the method for the selection of core and coverage stations, the approaches to developing growth factors and traffic flow estimation, the presentation method and database structure of the census framework, and the manpower requirements. Based on these identified areas, a new computer program is developed to integrate all of the tasks of the census report and to produce the results in CD-ROM format. Finally, concluding remarks are given together with recommendations for further study. [ABSTRACT FROM AUTHOR]

Although enhancing the knowledge of nitrogen (N) dynamics in aquatic systems is crucial for basin N management, there is still a lack of theories on the patterns of basin N sources and transport because of the intricate influence of human activities, climatic conditions, landscape patterns, and topography on the trajectory of basin N. To shed new light on the patterns of basin N sources and transport in the Chinese subtropical monsoon region, this study provides a comprehensive approach combining multiple isotopes and hydrological model based on monthly records of hydro-chemistry and isotopes ( 18 O-NO 3 - / 15 N-NO-3 and 18 O-H 2 O / 2 H-H 2 O) for river water, groundwater and rainfall in three basins over multiple years. Our observations of hydro-chemistry showed that fluvial N levels in highly urbanized basins (3.05 ± 1.42 mg·L -1 ) were the highest and were characterized by higher levels in the dry season. In the agricultural basin, fluvial N levels in February and March were approximately 1.9 times higher than those in the other months. The fluvial N load was higher in agricultural basins (0.624-0.728 T N km -2 y -1 ) than in urban basins (0.558 T N km -2 y -1 ), primarily because of variations in sewage treatment rates and fertilizer application. In highly urbanized basin, manure and sewage (46.9 %) were the dominant sources of fluvial N, which were discharged into rivers after treatment. In the plain agricultural basin, a substantial portion of diffused residential sewage leaches into aquifers and is stored. In the hilly agro-forest mixed basin, the high baseflow coefficient (75.8 %) and the key role of groundwater N, mainly from soil N (27.3 %), chemical fertilizers (20.2 %), manure and sewage (46.6 %), to fluvial N (26.5 %) indicated that a high proportion of the N sources leached into the aquifer and were then transported to rivers. For the first time, this study integrated multiple methods to substantiate the proposed typical patterns of N sources and transport within the basins. These findings have significant implications for tailored basin-specific N management strategies., 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.)

This meta-analysis aimed to systematically review and analyze parental awareness of human papillomavirus (HPV) and its vaccine, as well as parental willingness of the HPV vaccine in China. The literature search selected studies that met the following criteria: study published between 2009 and 2023, study design involving parents with at least one child aged ≤ 18 years, sample sizes exceeding 300, availability of data on parental willingness of the HPV vaccine or sufficient information to calculate effect sizes, and studies published in either English or Chinese. Studies that did not meet one of the above points were excluded. From an initial pool of 660 papers, 33 studies were included, encompassing a total sample size of 92,802. The analysis revealed that the pooled awareness rates of HPV and the HPV vaccine among Chinese parents were 45.0% (95% CI: 36.1-54.0%) and 41.4% (95%CI: 30.7-52.5%), respectively. The overall parental willingness for vaccinating children against HPV was 61.0% (95% CI: 53.5-68.3%). Both parental awareness and willingness of the HPV vaccine in China were found to remain low when compared to other countries.

The indications for collagenase ointment (CO) and its efficacy are not clearly established in the treatment of second-degree burn wounds. To evaluate the efficacy of CO versus silver sulfadiazine ointment (SSD) in the treatment of second-degree burn wounds. A total of 170 eligible patients with deep second-degree burns, aged 18-65 years, with injuries occurring within 48-96 h, and having a total wound area of less than 30% of the total body surface area were included from 5 centers in China. The primary outcome was the wound healing time, and the secondary outcomes were the clearance time of wound necrotic tissues, wound healing rate, and wound inflammation. The study included 85 patients in SSD group and 84 in CO group in the modified intention-to-treat (mITT) population. The median time of wound healing was comparable in both groups (10 days vs. 10.5 days P = 0.16). The time for wound necrotic tissue removal was significantly shortened by CO compared with SSD (5 vs. 10 days P < 0.01). Wound inflammation, pain, wound healing rate, and scar were compared with SSD (all P-values > 0.05). No adverse events, such as infection or allergic reactions to the drugs and materials used, were reported. Both CO and SSD could heal the burn wounds at 10 days of treatment. However, CO significantly shortened the time of wound necrotic tissue removal by 5 days. Trial Registration: ChiCTR2100046971., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

As an emerging business modality and Internet format, live streaming e-commerce has developed rapidly since its emergence in 2016, especially since the outbreak of the COVID-19 epidemic in late 2019, when an increasing number of businesses from other industries attracted participation. However, with the development of the live streaming e-commerce industry, the industry's market environment is becoming increasingly chaotic. Therefore, during this period, government departments continuously formulate and implement relevant industry policies. In order to exploring the cooperation network structure, policy content distribution, and implementation effectiveness characteristics among publishers, this paper constructs a three-dimensional analysis framework of policy from the perspective of policy tools, policy effectiveness evaluation and policy publishers. The results show that in terms of policy tools, the overall structure of policy tools in the live streaming e-commerce industry is unreasonable, and different types of policy tools are significantly diverse. The proportion of environmental policy tools is greater than that of demand-based and supply-based policy tools, accounting for 62.97%, and among them, the tools related to industry regulation and management account for the largest proportion of the total, which greatly suppresses the enthusiasm of various entities in the industry for development. In terms of policy effectiveness evaluation, most of the policies do not formulate detailed long-, medium-, or short-term goals, nor are the policy priorities, incentive measures, or action modes perfect, indicating that the government's pushing and pulling forces for the live streaming e-commerce industry are insufficient. Finally, in the subject dimension of policy release, the synergy of relevant subjects is constantly improving, but there is also a phenomenon of over-concentration in the synergistic departments., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wang 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: New clinically important postoperative atrial fibrillation (POAF) is the most common arrhythmia after thoracoscopic anatomical lung cancer surgery and is associated with increased morbidity and mortality. The full spectrum of predictors remains unclear, and effective assessment tools are lacking. This study aimed to develop and externally validate a novel model for predicting new clinically important POAF., Methods: This retrospective study included 14 074 consecutive patients who received thoracoscopic anatomical lung cancer surgery from January 2016 to December 2018 in Shanghai Chest Hospital. Based on the split date of 1 January 2018, we selected 8717 participants for the training cohort and 5357 participants for the testing cohort. For external validation, we pooled 2941 consecutive patients who received this surgical treatment from July 2016 to July 2021 in Shanghai Ruijin Hospital. Independent predictors were used to develop a model and internally validated using a bootstrap-resampling approach. The area under the receiver operating characteristic curves (AUROCs) and Brier score were performed to assess the model discrimination and calibration. The decision curve analysis (DCA) was used to evaluate clinical validity and net benefit. New clinically important POAF was defined as a new-onset of POAF that causes symptoms or requires treatment., Results: Multivariate analysis suggested that age, hypertension, preoperative treatment, clinical tumor stage, intraoperative arrhythmia and transfusion, and operative time were independent predictors of new clinically important POAF. These seven candidate predictors were used to develop a nomogram, which showed a concordance statistic (C-statistic) value of 0.740 and good calibration (Brier score; 0.025). Internal validation revealed similarly good discrimination (C-statistic, 0.736; 95% CI: 0.705-0.768) and calibration. The decision curve analysis showed positive net benefits with the threshold risk range of 0-100%. C-statistic value and Brier score were 0.717 and 0.028 in the testing cohort, and 0.768 and 0.012 in the external validation cohort, respectively., Conclusions: This study identified seven predictors of new clinically important POAF, among which preoperative treatment, intraoperative arrhythmia, and operative time were rarely reported. The established and externally validated model has good performance and clinical usefulness, which may promote the application of prevention and treatment in high-risk patients, and reduce the development and related adverse outcomes of this event., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

'General requirements for the production of extracellular vesicles derived from human stem cells' is the first guideline for stem cells derived extracellular vesicles in China, jointly drafted and agreed upon by experts from the Chinese Society for Stem Cell Research. This standard specifies the general requirements, process requirements, packaging and labelling requirements and storage requirements for preparing extracellular vesicles derived from human stem cells, which is applicable to the research and production of extracellular vesicles derived from stem cells. It was originally released by the China Society for Cell Biology on 30 August 2022. We hope that the publication of this guideline will promote institutional establishment, acceptance and execution of proper protocols, and accelerate the international standardisation of extracellular vesicles derived from human stem cells., (© 2023 The Authors. Cell Proliferation published by Beijing Institute for Stem Cell and Regenerative Medicine and John Wiley & Sons Ltd.)

Aquaculture ponds are potential hotspots for carbon cycling and emission of greenhouse gases (GHGs) like CO 2 and CH 4 , but they are often poorly assessed in the global GHG budget. This study determined the temporal variations of CO 2 and CH 4 concentrations and diffusive fluxes and their environmental drivers in coastal aquaculture ponds in southeastern China over a five-year period (2017-2021). The findings indicated that CH 4 flux from aquaculture ponds fluctuated markedly year-to-year, and CO 2 flux varied between positive and negative between years. The coefficient of inter-annual variation of CO 2 and CH 4 diffusive fluxes was 168% and 127%, respectively, highlighting the importance of long-term observations to improve GHG assessment from aquaculture ponds. In addition to chlorophyll-a and dissolved oxygen as the common environmental drivers, CO 2 was further regulated by total dissolved phosphorus and CH 4 by dissolved organic carbon. Feed conversion ratio correlated positively with both CO 2 and CH 4 concentrations and fluxes, showing that unconsumed feeds fueled microbial GHG production. A linear regression based on binned (averaged) monthly CO 2 diffusive flux data, calculated from CO 2 concentrations, can be used to estimate CH 4 diffusive flux with a fair degree of confidence (r 2  = 0.66; p < 0.001). This algorithm provides a simple and practical way to assess the total carbon diffusive flux from aquaculture ponds. Overall, this study provides new insights into mitigating the carbon footprint of aquaculture production and assessing the impact of aquaculture ponds on the regional and global scales., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Vegetation is an essential component of terrestrial ecosystems, influenced by climate change and human activities. Quantifying the relative contributions of climate change and human activities to vegetation dynamics is crucial for addressing global climate change. Sichuan Province is one of the essential ecological functional areas in the upper reaches of the Yangtze River, and its vegetation change is of great significance to the environmental function and ecological security of the Yangtze River Basin and southwest China. In this paper, the modified Carnegie-Ames-Stanford Approach(CASA) model was used to estimate the monthly NPP (Net Primary Productivity) of vegetation in Sichuan Province from 2000 to 2018, and the univariate linear regression analysis was used to analyze the temporal and spatial variation of vegetation NPP in Sichuan Province from 2000 to 2018. In addition, taking vegetation NPP as an index, Pearson correlation analysis, partial correlation analysis, and second-order partial correlation analysis were carried out to quantitatively analyze the contribution of climate change and human activities to vegetation NPP. Finally, the Hurst index and nonparametric Man-Kendall significance test were used to predict the future change trend of vegetation NPP in Sichuan Province. The results show that (1) from 2000 to 2018, the NPP of vegetation in Sichuan Province has a significant increasing trend (Slope = 6.09gC·m -2 ·a -1 ), with a multi-year average of 438.72 gC·m -2 ·a -1 , showing a trend of low in the east and high in the middle. The response of vegetation NPP to altitude is different at different elevations; (2) the contribution rates of climate change and human activities to vegetation NPP change are 4.12gC·m -2 ·a -1 and 1.97gC·m -2 ·a -1 , respectively. In contrast, the impact of human activities on NPP is more significant than climate change. Human activities are the main factors affecting vegetation restoration and degradation in Sichuan Province. However, the positive contribution to NPP change is less than climate change; (3) the future vegetation NPP change trend in Sichuan Province is mainly rising, and the same direction change trend is much larger than the reverse change trend. The areas with an increasing trend in the future account for 89.187% of the total area. This research helps understand the impact of climate change and human activities on vegetation change in Sichuan Province. It offers scientific bases for vegetation restoration and ecosystem management in Sichuan and the surrounding areas., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations.

Complete ammonia oxidizers (comammox Nitrospira ) are ubiquitous in coastal wetland sediments and play an important role in nitrification. Our study examined the impact of habitat modifications on comammox Nitrospira communities in coastal wetland sediments across tropical and subtropical regions of southeastern China. Samples were collected from 21 coastal wetlands in five provinces where native mudflats were invaded by Spartina alterniflora and subsequently converted to aquaculture ponds. The results showed that comammox Nitrospira abundances were mainly influenced by sediment grain size rather than by habitat modifications. Compared to S. alterniflora marshes and native mudflats, aquaculture pond sediments had lower comammox Nitrospira diversity, lower clade A.1 abundance, and higher clade A.2 abundance. Sulfate concentration was the most important factor controlling the diversity of comammox Nitrospira . The response of comammox Nitrospira community to habitat change varied significantly by location, and environmental variables accounted for only 11.2% of the variations in community structure across all sites. In all three habitat types, dispersal limitation largely controlled the comammox Nitrospira community assembly process, indicating the stochastic nature of these sediment communities in coastal wetlands. IMPORTANCE Comammox Nitrospira have recently gained attention for their potential role in nitrification and nitrous oxide (N 2 O) emissions in soil and sediment. However, their distribution and assembly in impacted coastal wetland are poorly understood, particularly on a large spatial scale. Our study provides novel evidence that the effects of habitat modification on comammox Nitrospira communities are dependent on the location of the wetland. We also found that the assembly of comammox Nitrospira communities in coastal wetlands was mainly governed by stochastic processes. Nevertheless, sediment grain size and sulfate concentration were identified as key variables affecting comammox Nitrospira abundance and diversity in coastal sediments. These findings are significant as they advance our understanding of the environmental adaptation of comammox Nitrospira and how future landscape modifications may impact their abundance and diversity in coastal wetlands., Competing Interests: The authors declare no conflict of interest.

The extensive conversion of carbon-rich coastal wetland to aquaculture ponds in the Asian Pacific region has caused significant changes to the sediment properties and carbon cycling. Using field sampling and incubation experiments, the sediment anaerobic CO 2 production and CO 2 emission flux were compared between a brackish marsh and the nearby constructed aquaculture ponds in the Min River Estuary in southeastern China over a three-year period. Marsh sediment had a higher total carbon and lower C:N ratio than aquaculture pond sediment, suggesting the importance of marsh vegetation in supplying labile organic carbon to the sediment. Conversion to aquaculture ponds significantly decreased sediment anaerobic CO 2 production rates by 69.2% compared to the brackish marsh, but increased CO 2 emission, turning the CO 2 sink (-490.8 ± 42.0 mg m -2 h -1 in brackish marsh) into a source (6.2 ± 3.9 mg m -2 h -1 in aquaculture pond). Clipping the marsh vegetation resulted in the highest CO 2 emission flux (382.6 ± 46.7 mg m -2 h -1 ), highlighting the critical role of marsh vegetation in capturing and sequestering carbon. Sediment anaerobic CO 2 production and CO 2 uptake (in brackish marsh) and emission (in aquaculture ponds) were highest in the summer, followed by autumn, spring and winter. Redundancy analysis and structural equation modeling showed that the changes of sediment temperature, salinity and total carbon content accounted for more than 50% of the variance in CO 2 production and emission. Overall, the results indicate that vegetation clearing was the main cause of change in CO 2 production and emission in the land conversion, and marsh replantation should be a primary strategy to mitigate the climate impact of the aquaculture sector., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background and Aims: Serum uric acid to creatinine ratio (SUA/Cr) may be associated with metabolic syndrome (MS). Here, we investigated the correlation between SUA/Cr and MS in Chinese residents aged ≥ 45 years., Methods and Results: Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS) database. MS was diagnosed using the Chinese Diabetes Society 2017 criteria. We grouped the population according to SUA/Cr quartiles and compared the index differences between groups. We used spearman correlation analysis and binary logistic regression. The possible dose-response association of SUA/Cr with MS were analyzed using restricted cubic spline model. Of 12,946 included participants, 3370 (26.0%) had MS, and 1900 (56.4%) were female. After adjusting for multiple confounders, binary logistic regression analysis showed that compared with Quartile 1, the odds ratio (95% confidence interval) of the MS risk was 1.29 (1.09-1.52), 1.47 (1.25-1.74), and 1.80 (1.53-2.12) in Quartiles 2, 3, and 4, respectively. The restricted cubic spline model indicated a significant nonlinear dose-response association (P overall < 0.001, P non-linearity  = 0.029) between SUA/Cr and strength of MS prevalence association; MS risk began increasing when SUA/Cr > 6.22., Conclusions: A significant positive correlation existed between SUA/Cr and MS risk in Chinese individuals aged ≥ 45 years, which may be a new predictive marker for MS risk., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2023 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.)

Functional traits of seeds reflect plant reproductive strategies adapting to environmental changes, which is an evolutionary behavior in natural selection and genetics. Study on seed functional traits is of great significance to deeply understand the long-term adaptive evolution of plants and seeds. We measured seed functional traits of a main indigenous species Phragmites australis , including seed size, seed weight, seed set, and seed production, in nine coastal marshes of the six provinces/cities along the coastal zone of China (21°29'-40°57' N), and analyzed latitudinal variations of functional traits. The results showed that seed functional traits of P. australis in Chinese coastal marshes varied significantly with latitude and that there were significant correlations among different traits. Seed size (including seed length, seed width, seed shape index, aspect ratio, and seed surface area), and 100-seed weight showed significant quadratic function relation with latitude, which firstly decreased and then increased with the increases of latitude, while seed setting rate firstly increased and then reduced. There was a trade-off between the number and size of P. australis seeds. Seed production per unit area significantly increased with latitude. Results of stepwise regression analysis showed that climatic factors were the main driver resulting in the difference of seed functional traits of P. australis between latitudes, followed by pH and salinity of soil porewater.

Methane emissions from aquatic ecosystems play an important role in global carbon cycle and climate change. Reclamation of coastal wetlands for aquaculture use has been shown to have opposite effects on sediment CH 4 production potential and CH 4 emission flux, but the underlying mechanism remained unclear. In this study, we compared sediment properties, CH 4 production potential, emission flux, and CH 4 transport pathways between a brackish marsh and the nearby reclaimed aquaculture ponds in the Min River Estuary in southeastern China. Despite that the sediment CH 4 production potential in the ponds was significantly lower than the marsh, CH 4 emission flux in the ponds (17.4 ± 2.7 mg m -2 h -1 ) was 11.9 times higher than the marsh (1.3 ±  0.2 mg m -2 h -1 ). Plant-mediated transport accounted for 75% of the total CH 4 emission in the marsh, whereas ebullition accounted for 95% of the total CH 4 emission in the ponds. CH 4 emission fluxes in both habitat types were highest in the summer. These results suggest that the increase in CH 4 emission following the conversion of brackish marsh to aquaculture ponds was not caused by increased sediment CH 4 production, but rather by eliminating rhizospheric oxidation and shifting the major transport pathway to ebullition, allowing sediment CH 4 to bypass oxidative loss. This study improves our understanding of the impacts of modification of coastal wetlands on greenhouse gas dynamics., (Copyright © 2022. Published by Elsevier Ltd.)

Study Objective: Although combined thoracic paravertebral blockade (TPVB)-general anesthesia (GA) could improve pain control compared to GA alone after thoracoscopic lung cancer surgery, it has not been established whether this improvement in pain control could reduce associated adverse outcomes. Thus, this study aimed to explore the association between TPVB usage and adverse outcomes after thoracoscopic lung cancer surgery., Design: Retrospective cohort study from a prospective database., Setting: A high-volume thoracic center in China., Patients: 13966 consecutive patients who received thoracoscopic lung cancer surgery from January 2016 to December 2018 in Shanghai Chest Hospital were enrolled., Measurements: With a 1:1 propensity score matching (PSM) analysis, adverse outcomes between GA alone and GA-TPVB were investigated. Multivariate and multiple linear regression analysis were used to identify factors and calculate odds radio (OR) for adverse outcomes., Results: The rate of TPVB usage was 14.8% (2070 out of 13,966). TPVB combined with GA was associated with lower rates of postoperative pulmonary complications (PPCs) (30.4% vs 33.5%, P = 0.005) and postoperative atrial fibrillation (POAF) (2.1% vs 2.9%, P = 0.041), and shorter length of hospital stay (LOS) (Median [IQR]; 5[4-5] vs 5[4-6]) days, P < 0.001) compared to GA alone. After a 1:1 PSM analysis, we investigated adverse outcomes in 2640 (1320 pairs) patients with or without TPVB usage, and this association remained existed, namely, the rates of PPCs (29.8% vs 34.2%, P = 0.014) and POAF (2.2% vs 3.6%, P = 0.028) were lower and LOS was shorter (5[4-5] vs 5[4-6] days, P < 0.001) in the GA-TPVB group. In multivariate analysis, the combination of GA plus TPVB was independent predictor for PPCs (OR = 0.879, 95%CI, 0.793-0.974, P = 0.014) and POAF (OR = 0.714, 95%CI, 0.516-0.988, P = 0.042), respectively. However, in multiple linear analysis, lower rates of PPCs and POAF associated with TPVB usage, rather than TPVB usage, were responsible for the reduced LOS., Conclusions: The usage of TPVB may be a feasible and adjustable approach to reduce the rates of PPCs and POAF and associated LOS in thoracoscopic lung cancer surgery., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Flooding is one of the key environmental factors affecting the carbon sequestration potential of estuarine tidal flat wetlands. In order to reveal the effect of flooding on soil carbon (C) sinks in estuarine tidal wetlands, we investigated and analyzed the soil organic carbon (SOC) storage, the contents of active SOC components, and SOC stability indicators across a tidal flat in the Jiulong River estuary in southeast China. The results showed that the SOC storage gradually decreased by 54% with the increase in flooding frequency. The change pattern of microbial biomass carbon (MBC), dissolved organic carbon (DOC), and liable organic carbon (LOC) followed the change pattern of the SOC storage. With the increase in flooding frequency, DOC/SOC and LOC/SOC increased by 80% and 26%, respectively, whereas MBC/SOC decreased by 29%. As flooding frequency increased, particulate organic carbon (POC) and mineral-associated organic carbon (MAOC) contents decreased by 81% and 35%, respectively. The decreases in POC contents were correlated with the increases in soil pH, whereas the decreases in MAOC contents were associated with the decline in clay contents. Soil carbon stability index (CSI) increased by 246% with increasing flooding frequency. These combined results indicated that SOC storage decreased, but SOC stability increased, with the increased flooding frequency. Mineral-bound organic carbon was the main protection mechanism for the SOC stability, which was of great significance to the soil C sink of the estuarine tidal wetlands.

Background: High Blood Urea Nitrogen (BUN) and high Serum Creatinine (SCr) levels are risk factors for Coronary Artery Disease (CAD). However, the relationship between the Blood Urea Nitrogen to Creatinine (BUN/SCr) ratio (UCR) and the risk of CAD in patients living with new-onset diabetes is unclear. This study aimed to examine the relationship between blood UCR and the risk of CAD in patients living with new-onset type 2 diabetes mellitus (T2DM)., Methods: We analyzed the data from the cohort of 12,299 patients living with type 2 diabetes mellitus. Primary endpoints were the events of CAD. The ANOVA test (continuous indicators) and χ 2 test (categorical indicators) were used to assess the differences of baseline characteristics across the groups of UCR. In order to understand the correlation between variables, we performed correlation analysis on variables that have significant differences between CAD group and non-CAD group. Multivariate-adjusted Cox proportional hazard regression models were applied to estimate the association of the blood UCR with the risk of CAD in patients living with T2DM. The Kaplan-Meier survival function plotting and the log-rank test were used to evaluate the event-free survival according to the groups of UCR. The restricted cubic spline model was used to show the adjusted association between blood UCR and risk of CAD in patients living with T2DM., Results: During a median follow-up of 2.66 years, 1173 CAD were recorded with an event rate of 28.49 events per 1000 person-years. In multivariate-adjusted Cox regression models, elevated blood urea nitrogen to creatinine ratio (UCR) was associated with higher risk of CAD in patients living with T2DM [hazard ratio (HR), 1.782; 95% confidence interval (CI), 1.237-2.567]. The Kaplan-Meier survival curves indicated that the high group of UCR tended to have a lower event-free survival than the low group and medium group. There was a nonlinear trend toward increasing risk of CAD across the groups of UCR. And cubic spline function graph suggested that the influence of UCR level on HR for CAD increased significantly at UCR levels above 6.67., Conclusions: An elevated UCR was significantly associated with an increased risk for CAD in patients living with T2DM., (© 2022. The Author(s).)

While Asia is projected to be one of the major nitrous oxide (N 2 O) sources in the coming decades, a more accurate assessment of N 2 O budget has been hampered by low data resolution and poorly constrained emission factor (EF). Since urbanized coastal reservoirs receive high nitrogen loads from diverse sources across a heterogeneous landscape, the use of a single fixed EF may lead to large errors in N 2 O assessment. In this study, we conducted high spatial resolution sampling of dissolved N 2 O, nitrate-nitrogen (NO 3 -N) and other physico-chemical properties of surface water in Wenwusha Reservoir and other types of water bodies (river, drainage channels, and aquaculture ponds) in its catchment areas in southeastern China between November 2018 and June 2019. The empirically derived EF (calculated as N - -N) and other physico-chemical properties of surface water in Wenwusha Reservoir and other types of water bodies (river, drainage channels, and aquaculture ponds) in its catchment areas in southeastern China between November 2018 and June 2019. The empirically derived EF (calculated as N 2 O-N:NO 3 - -N) for the reservoir showed considerable spatial variations, with a 10-fold difference ranging from 0.8 × 10 -3 to 8.8 × 10 -3 . The average EF varied significantly among the four types of water bodies in the following descending order: aquaculture ponds > river > drainage channels > reservoir. Across all the water bodies, the mean EF in summer was 1.8-3.5 and 1.7-2.8 fold higher than that in autumn and spring, respectively, owing to the elevated water temperature. Overall, our derived EF deviated considerably from the IPCC default value, which implied that the use of default EF could result in over- or under-estimation of N 2 O emissions by up to 42%. We developed a multiple regression model that could explain 82% of the variance in EF based on water temperature and the ratio between dissolved organic carbon and nitrate-nitrogen (p < 0.001), which could be used to improve the estimate of EF for assessing N 2 O emission from coastal reservoirs and other similar environments., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Sexuality has an important impact on people's physical and mental health, but current research on the sexual activity of older Chinese women has many limitations and more detailed studies are needed., Aim: The objective was to determine the prevalence of sexual activity and related factors in women aged 55 to 85 years in Hunan, China., Methods: Based on the data from the Hunan Provincial Women Health Needs Survey in 2018, we conducted a secondary analysis of 2,401 older women aged 55 and above. The dependent variable was sexual activity, and independent variables included sociodemographic characteristics, health behaviors, reproductive and chronic medical history, and psychological characteristics. All statistical analyses were performed using SPSS 26.0. Chi-square test was used to assess the association between categorical variables, and binary logistic regression was used to examine factors related to sexual activity., Outcomes: Sexual activity and related factors., Results: The prevalence of sexual activity among older women was 12.5% (301/2401) in the past month. Having a partner (OR = 1.484; 95% CI, 1.048-2.101; P = .026), jogging (OR = 2.061; 95% CI, 1.391-3.054; P < .001), dancing (OR = 1.477; 95% CI, 1.106-1.974; P = .008), vegetarian-based diet (OR = 2.197; 95% CI, 1.334-3.618; P = .002), meat-based diet (OR = 2.196; 95% CI, 1.144-4.216; P = .018) were positively associated with being sexually active. Whereas, aging (OR = 0.781; 95% CI, 0.647-0.942; P = .010), living in the urban (OR = 0.628; 95% CI, 0.488-0.808; P < .001), hypertension (OR = 0.702; 95% CI, 0.520-0.949; P = .021), and anxiety (OR = 0.680; 95% CI, 0.475-0.972; P = .034) were negatively associated with being sexually active., Clinical Implications: Health care workers need to be aware that older women still have sexual activity and understand the needs of older women for sex education, take the initiative to discuss safe sex with them, and solve their sexual problems., Strengths and Limitations: This is one of the largest studies to determine the prevalence of sexual activity among older women in China and its related factors. In addition, new factors such as exercise types and eating habits related to sexual activity were discovered. The limitation of this study is that it did not use a specific questionnaire to assess the sexual activity and did not consider physical tenderness other than sexual intercourse., Conclusions: Some older women still have had sexual activity in the past month and factors such as lifestyles that can be changed and chronic diseases that can be self-managed were found to predict sexual activity. Li T, LuoY, Meng Y, et al. Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study. J Sex Med 2022;19:302-310., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Spatial and temporal variations in soil denitrification and anaerobic ammonium oxidation (anammox) across the freshwater-oligohaline wetlands in subtropical estuary have not been well understood. In this study, continuous-flow soil core incubation combined with nitrogen isotope tracer was used to determine denitrification and anammox rates across freshwater-oligohaline tidal wetlands in Min River Estuary, Southeast China. Areal rates of denitrification and anammox varied from 3.89 to 19.0 μmol m -2 h -1 and from 0.15 to 1.11 μmol m -2 h -1 , respectively, across these wetlands and throughout sampling months. Denitrification rates were higher in warm months (July, September) than in cool months (November, January), whereas anammox did not vary significantly across the sampling months. Average denitrification rates throughout the sampling months were higher in freshwater than in oligohaline wetlands, while anammox rates did not vary among the wetlands. Relative contribution of anammox (R a ) to N 2 production (including denitrification and anammox) varied from 1.03 to 18.3% across the sampling months and wetlands. Denitrification rates differed significantly across the wetlands and sampling months. Anammox rates and R a did not vary significantly among the sampling months. Denitrification rates were positively correlated with water content, total organic carbon (TOC), total nitrogen, dissolved organic nitrogen, NH 4 + , NO x - , Fe 2+ , and Fe 2+ /Fe 3+ , but negatively related to pH. Anammox rates showed negative relationships with water content and TOC. Water content, temperature, and pH were crucial for organic carbon and Fe 2+ availability with important implications on denitrification and anammox. Therefore, denitrification rates vary significantly, whereas anammox rates do not vary significantly across freshwater-oligohaline wetlands in the Min River Estuary., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Enterocytozoon bieneusi is a common gastrointestinal parasite that has a broad range of hosts, including birds, mammals, and even humans. The changes of gut bacterial communities have been demonstrated during the course of E. bieneusi. This study aimed to examine the infection status, and assess the zoonotic potential and influence of E. bieneusi on gut bacterial communities of captive foxes in Xinxiang, central China. Fecal samples were collected from 216 captive foxes, and amplification of the internal transcribed spacer (ITS) gene of each sample was performed by nested polymerase chain reaction. E. bieneusi was detected in 48 (22.2%) samples, and five previously reported genotypes CHN-F1 (n = 25), D (n = 18), BEB6 (n = 3), NCF2 (n = 1), and CHN-DC1 (n = 1) were identified, with CHN-F1 being the dominant genotype (25/48, 52.1%). Phylogenetic analysis further revealed that CHN-F1, D, NCF2, and CHN-DC1 genotypes belonged to the zoonotic group 1 of E. bieneusi, whereas BEB6 belonged to group 2. Moreover, sequencing and bioinformatics analysis of the V3-V4 region of 16S rRNA gene in five E. bieneusi-positive and five negative samples showed that gut microbial diversity was higher in the infected animals. In both groups, Firmicutes and Bacteroidetes were the two most abundant phyla, but the Firmicutes/Bacteroidetes ratio was lower in E. bieneusi-positive foxes (7.9:1) as compared with E. bieneusi-negative foxes (5:1). More importantly, at the phylum level, "beneficial bacteria" such as Firmicutes (1.6%) and Bacteroides (5.8%) increased, whereas "opportunistic pathogens" such as Fusobacteria (8.2%) decreased. Similarly, at the genus level, the pathogenic Clostridiaceae&#95;Clostridium (10.0%) decreased, whereas the "beneficial bacteria" Lactococcus (6.6%) increased. These interesting phenomena warrant further investigation., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Since the effectiveness of low-dose aspirin (LDA) in twin pregnancies is uncertain, we aimed to preliminarily assess whether LDA is beneficial in preventing preeclampsia in twin pregnancies., Methods: This study is an observational study in two hospitals in China. Among 932 women, 277 in the First Affiliated Hospital of Chongqing Medical University were routinely treated with aspirin (100 mg daily) from 12 to 16 weeks to 35 weeks of gestational age, while 655 in Chongqing Health Center for Women and Children were not taking aspirin during pregnancy. We followed each subject and the individual details were recorded., Results: LDA significantly reduced the risk of preeclampsia (RR 0.48; 95% CI 0.24-0.95) and preterm birth 34 weeks (RR 0.50; 95% CI 0.29-0.86) and showed possible benefits to lower the rate of SGA babies (RR 0.74; 95% CI 0.55-1.00). Moreover, the risk of postpartum hemorrhage was not increased by LDA (RR 0.89; 95% CI 0.35-2.26)., Conclusions: Treatment with low-dose aspirin in twin pregnancies could offer some protection against adverse pregnancy outcomes in the absence of significantly increased risk of postpartum hemorrhage., Trial Registration: Chinese Clinical Trial Registry (ChiCTR); ChiCTR-OOC-16008203 , Retrospectively registered date: April 1st, 2016., (© 2021. The Author(s).)

Carbon dioxide (CO 2 ) emissions from aquatic ecosystems are important components of the global carbon cycle, yet the CO 2 emissions from coastal reservoirs, especially in developing countries where urbanization and rapid land use change occur, are still poorly understood. In this study, the spatiotemporal variations in CO 2 concentrations and fluxes were investigated in Wenwusha Reservoir located in the southeast coast of China. Overall, the mean CO 2 concentration and flux across the whole reservoir were 41.85 ± 2.03 µmol/L and 2.87 ± 0.29 mmol/m 2 /h, respectively, and the reservoir was a consistent net CO 2 source over the entire year. The land use types and urbanization levels in the reservoir catchment significantly affected the input of exogenous carbon to water. The mean CO 2 flux was much higher from waters adjacent to the urban land (5.05 ± 0.87 mmol/m 2 /hr) than other land use types. Sites with larger input of exogenous substance via sewage discharge and upstream runoff were often the hotspots of CO 2 emission in the reservoir. Our results suggested that urbanization process, agricultural activities, and large input of exogenous carbon could result in large spatial heterogeneity of CO 2 emissions and alter the CO 2 biogeochemical cycling in coastal reservoirs. Further studies should characterize the diurnal variations, microbial mechanisms, and impact of meteorological conditions on reservoir CO 2  emissions to expand our understanding of the carbon cycle in aquatic ecosystems., (Copyright © 2021. Published by Elsevier B.V.)

Background: With the prevalence of infertility increasing every year around the world, it has seriously impacted the individual quality of family and social life. Anxiety is one of the most prevalent anxiety disorders among infertile patients. After the two-child policy, whether it affected the prevalence of anxiety is controversial. This study aimed to determine the prevalence of anxiety and its potential risk factors among Chinese infertile women after the enforcement of 'two-child policy'., Methods: This cross-sectional study included 693 infertile patients in a reproductive medical center in Chongqing, China, between February 2016 and December 2018. Data was collected by Self-filling questionnaires including basic demographic information and the Generalized Anxiety Disorder-7 (GAD-7). SPSS statistical software (IBM SPSS version 25) was used to analyse the obtained data. Descriptive analysis was used to describe basic information and anxiety scores, the chi-square test and binary logistic regression were used to analyse the relationship between anxiety and other variables., Results: The prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients (FI), and 18.4% among second-child infertile patients (SI) respectively (P > 0.05). Binary logistic regression showed that patients with lower education levels were more likely to have anxiety (P < 0.01). Patients with middle salary incomes were more likely to have anxiety (OR = 1.860, 95% CI: 1.068-3.238). Oral contraception taking history (OR = 1.778, 95% CI: 1.186-2.667), and history of allergy (OR = 2.098, 95% CI: 1.219-3.612) were associated with anxiety., Conclusions: Under the full liberalization of the "two-child policy", the total prevalence of anxiety among Chinese infertile female is comparatively high. Low education levels, middle incomes, oral contraception taking and allergy history can be the related risk factors of anxiety. We promote that all infertile patients should be evaluated for the prevalence of anxiety, especially those with potential risks, and receive consultant or targeted treatment when needed., (© 2021. The Author(s).)

Objective: Twin-twin transfusion syndrome (TTTS) causes perinatal mortality and morbidity in monochorionic twins. The early recognition of and interventional therapy for TTTS is associated with a more favorable overall prognosis. However, the prediction by the use of ultrasound in the first trimester has relatively poor sensitivity and specificity. This study aimed to identify metabolic biomarkers to aid in ultrasound screening of TTTS., Methods: Maternal plasma was prospectively collected between 11 and 15 weeks of gestation in apparently uncomplicated monochorionic-diamniotic twin pregnancies. This cohort was divided into: (i) patients who were subsequently diagnosed with TTTS by using ultrasound; (ii) uncomplicated matched controls. Metabolome was profiled by using gas chromatography-mass spectrometry., Results: The levels of fatty acids, organic acids, oxaloacetic acid, and beta-alanine were significantly lower in the TTTS maternal plasma at 11-15 weeks of gestation, and methionine and glycine were also higher (p < 0.05, FDR<0.12). Generally, in TTTS pregnancies, the metabolisms of amino acid, carbohydrate, cofactors, vitamins, and purine were "down-regulated"; whereas bile secretion and pyrimidine metabolism were "upregulated.", Conclusions: The metabolomics scanning of early gestation maternal plasma may identify those pregnancies that subsequently develop TTTS; in particular, downregulated fatty acid levels may be biologically plausible to be implicated in the pathogenesis of TTTS., (© 2021 John Wiley & Sons Ltd.)

Aquaculture ponds are important anthropogenic sources of nitrous oxide (N 2 O). Direct N 2 O emissions arising from feed application to ponds have been widely investigated, but indirect emissions from N 2 O production from residual feeds in pond water are much less understood and characterized to refine the IPCC emission factor. In this study, we determined the concentrations and spatiotemporal variations of dissolved N 2 O and NO 3 -N in situ in three aquaculture ponds at the Min River Estuary in southeastern China during the culture period over two years, and calculated the indirect N - -N in situ in three aquaculture ponds at the Min River Estuary in southeastern China during the culture period over two years, and calculated the indirect N 2 O emission factor (EF 5 ) for aquaculture ponds using the N 2 O-N/NO 3 - -N mass ratio methodology. Our results indicated that the EF 5 values in the ponds over the culture period ranged between 0.0007 and 0.0543, with a clear seasonal pattern which closely followed that of the DOC:NO 3 - N ratio. We also observed significant spatial variations in EF 5 among the three ponds, which could be attributed to the difference in feed conversion rate. In addition, we assessed the EF 5 values from aquaculture ponds in five regions of the Chinese coastline across the latitudinal gradient from the tropical to the temperate zones. The average EF 5 value from aquaculture ponds across the five coastal regions was 0.0093±0.0024, which was approximately 3.7 times of the IPCC default value for rivers and estuaries (0.0025). Moreover, the EF 5 values demonstrated considerable spatial variations across these coastal regions with a coefficient of variation of 59%, which were largely related to the difference in water salinity. Our findings filled a key knowledge gap about the indirect N 2 O emission factor from aquaculture ponds, and provided field evidence for the refinement of EF 5 value currently adopted by IPCC in the national greenhouse gas inventory., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Readmission to intensive care unit (ICU) after esophageal cancer surgery is a major concern and can be associated with increased adverse outcomes. This study aims to explore causes, risk factors and early outcomes., Methods: We performed a monocentric retrospective analysis in 1140 patients who received esophageal cancer surgery in a higher volume surgeon group between January 2016 and December 2019, at Shanghai Chest Hospital. Univariate and multivariate analysis were performed to identify risk factors, and 1:4 propensity score matching (PSM) analysis was conducted to compare early outcomes., Results: The incidence of ICU readmission was about 3.8% (43 of 1140). The most common cause was respiratory failure, found in 30 patients (70%). ICU readmission mainly occurred within 3 days after surgery, accounting for 46.5% (20 of 43), with the median length of stay was 3 days. Multivariate analysis identified heavy smoking (odds ratio[OR] = 2.445, 95% CI = 1.128 to 5.301, P = 0.024), intraoperative hypoxemia (OR = 2.461, 95% CI = 1.078 to 5.621, P = 0.033), mechanical ventilation during initial ICU stay (OR = 16.036, 95% CI = 7.332 to 35.074, P < 0.001), postoperative anemia (OR = 3.993, 95% CI = 1.893 to 8.420, P < 0.001) and unplanned reoperation (OR = 45.378, 95% CI = 13.023 to 158.122, P < 0.001) as independent risk factors for ICU readmission. Compared with no-readmitted patients, patients readmitted to ICU were associated with increased postoperative pulmonary complications (44.2% vs 97.7%, P < 0.001), prolonged median length of hospital stay (9[7-11] vs 19[13-30], P < 0.001) and ICU stay (1[1-3] vs 7[4-11], P < 0.001), higher hospitalization expenses (14,916 ± 3483 vs 19,850 ± 7595 dollars, P < 0.001) and 30-day readmission rates (1.8% vs 9.3%, P = 0.011). After 1:4 PSM, the baseline characteristics were comparable and the matched results were similar., Conclusions: This study identified five independent risk factors for ICU readmission, which were associated with adverse early outcomes. Preemptive attention given to pulmonary complications within three days after surgery may be important to prevent patients from ICU readmission.

Background: Liver resection is recommended for T2 gallbladder cancer, but the optimal hepatectomy strategy remains controversial. We aimed to assess the safety and effectiveness of segment IVb and V resection versus wedge resection in patients with T2 gallbladder cancer., Methods: This is a retrospective multicenter propensity score-matched study in China. Overall survival, disease-free survival, perioperative complications, and hospital length of stay were used to evaluate safety and effectiveness., Results: There are a total of 512 patients. 112 of 117 patients undergoing segment IVb and V resection were matched to 112 patients undergoing wedge resection. After matching, segment IVb and V resection demonstrated no statistical difference in overall survival (hazard ratio, 0.970 [0.639-1.474]; P = .886), but significance in disease-free survival (hazard ratio, 0.708 [0.506-0.991]; P = .040). Patients with incidental gallbladder cancer (hazard ratio, 0.390 [0.180-0.846]; P = .019), stage T2b (hazard ratio, 0.515 [0.302-0.878]; P = .016), and negative lymph nodes status (hazard ratio, 0.627 [0.406-0.991]; P = .043) were associated with improved disease-free survival after segment IVb and V resection, but not in wedge resection. However, perioperative complications occurred more frequently after segment IVb and V resection (28.5% vs 9.1%, P < .001) along with the longer hospital length of stay (17.3 vs 10.2 days, P < .001). Notably, patients with jaundice (odds ratio, 4.053 [1.361-12.23]; P = .013), undergoing laparoscopic resection (odds ratio, 2.387 [1.059-4.484]; P = .028) or surgeon performing per the first 10 segment IVb and V resections (odds ratio, 2.697 [1.035-6.998]; P = .041), were the independent risk factors for perioperative complications in the segment IVb and V resection group., Conclusion: T2 gallbladder cancer patients undergoing segment IVb and V resection rather than wedge resection have an improved disease-free survival, especially for incidental gallbladder cancer or hepatic-sided (T2b) gallbladder cancer. However, high rates of perioperative complications and longer hospital length of stay after segment IVb and V resection indicated that surgeons must rely on their own surgical skills and the patient profile to decide the optimal hepatectomy strategy., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Estuarine sediment denitrification and anammox in response to increased nitrogen (N) loads remain poorly understood. In this study, we used N isotope tracer approach to investigate the spatial distribution of denitrification and anammox and identified the crucial controls on the partitioning of dinitrogen gas (N 2 ) production along the Min River Estuary (MRE), a highly impacted estuary in southeast China. The results indicated that denitrification and anammox rates ranged from 10.5 to 70.7 nmol g -1 h -1 and from 0.44 to 4.31 nmol g -1 h -1 , respectively. Relative contribution of anammox to N 2 production (R a ) was in a range of 1.04-15.1%, tending to increase toward estuary mouth. Denitrification rates were significantly higher in upper (high N loads) than in lower estuary (low N loads), while anammox rates and R a showed inverse distributions along the MRE. Wastewater discharge caused the N point pollution triggering denitrification but inhibiting anammox. The best predictor of the variations in denitrification rates was total nitrogen, whereas pH and NH 4 + could explained the variations in anammox rates across the estuary. The crucial predictors for the partitioning of N 2 production between denitrification and anammox were NH 4 + and NO x - . These results suggest that the increase in human activities intensity can alter the partitioning of N 2 production between denitrification and anammox, and the magnitude of this switch can be predicted by N loads in MRE and other highly impacted estuaries., 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 © 2021 Elsevier Ltd. All rights reserved.)

Background: Vitamin D deficiency is a global public health issue in women and children and is associated with adverse impacts on child growth, such as rickets. However, prior studies have mainly focused on measuring vitamin D levels in singleton pregnant women and their offspring, and very limited studies have revealed the prevalence of vitamin D deficiency in twin pregnant women and their offspring. The aim of this study was to investigate vitamin D levels in twin-pregnant women and their neonates. We also explored the correlation of maternal vitamin D levels with neonatal outcomes and infant growth., Methods: A prospective subcohort investigation was carried out among 72 dichorionic, diamniotic twin-pregnant mothers and their twin offspring from the Longitudinal Twin Study. Peripheral blood was collected from the mothers in the third trimester, and cord blood was collected from neonates at birth to identify 25[OH]D levels. Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected., Results: The average maternal 25[OH]D level was 31.78 ng/mL, with 19.4% being deficient and 20.8% insufficient, while the average neonatal 25[OH]D level was 15.37 ng/mL, with 99.3% being deficiency or insufficient. A positive correlation was found between maternal and neonatal 25[OH]D levels (beta-value: 0.43, 95% CI: 0.37, 0.49). Interestingly, the higher the maternal 25[OH]D level was, the smaller the cotwin birthweight discordance (beta-value: -2.67, 95% CI: - 5.11, - 0.23). In addition, the infants of mothers with vitamin D deficiency were more likely to be allergic to foods at 6 months than those of mothers with vitamin D sufficiency., Conclusions: Twin neonates were at high risk of vitamin D deficiency, although their mothers' vitamin D deficiency partially improved. Higher maternal vitamin D levels were associated with smaller discordance of cotwin birthweight., Trial Registration: Chinese Clinical Trial Registry ChiCTR-OOC-16008203 , 1st April 2016.

Background: Previous studies on perfluoroalkyl and polyfluoroalkyl substances (PFAS) showed inconsistent results when biological samples were collected in different time of pregnancy., Objectives: To describe the change of PFAS concentration during pregnancy and to identify a sensitive window for adverse effects of PFAS on the fetus., Methods: A total of 255 pregnant women were selected from the Shanghai Birth Cohort (SBC). We quantified 10 PFAS with high-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) in maternal plasma at three trimesters and cord blood at delivery. Multiple linear regression analyses were used to analyze the association between PFAS and birth outcomes, including birth weight, birth length, and head circumference., Results: The concentrations of most PFAS declined substantially during pregnancy. PFOS, PFNA, PFDA, PFUA and PFDoA were negatively related to birth length only in the first trimester. The coefficients and 95% confidence intervals (CI) of birth length change with a log-unit increase in PFOS, PFNA, PFDA, PFUS and PFDoA concentrations were -0.27 cm (-0.51, -0.02), -0.34 cm (-0.65, -0.03), -0.27 cm (-0.53, -0.01), -0.29 cm (-0.58, -0.01), and -0.54 cm (-1.00, -0.08), respectively. The effects were only observed for female fetuses. No association between PFAS and birth weight or head circumference was observed., Conclusion: The concentrations of most PFAS in the maternal circulation declined during pregnancy. There were negative associations between several PFAS and birth length. The sensitive window of exposure appeared to be the first trimester. The association was stronger for female fetuses., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: The objective of this study was to investigate the current status of fertility quality of life (QoL) and explore the influencing factors for infertile women with repeated implantation failure (RIF)., Methods: The sample consisted of 137 infertile women with RIF who were under treatment from January 2019 to December 2019 in the Reproductive Medical Center of Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine in China. A general information questionnaire, FertiQoL scale, perceived social support scale (PSSS), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were used to analyse the fertility QoL and related factors of RIF patients., Results: The total fertility QoL score of RIF patients was 60.44 ± 11.60. The results of multivariate regression analysis showed that residence, financial difficulties, male infertility, BMI index, depression, and family social support were the main factors that influenced the fertility QoL of RIF patients (adjusted R 2  = 0.762)., Conclusion: Based on the results of this study, RIF patients' psychological status must be addressed. Corresponding interventions such as building a sound family and social support system, creating a good medical environment and offering diverse health education should be provided to improve the fertility QoL of RIF patients.

It is important to forecast the risk of COVID-19 symptom onset and thereby evaluate how effectively the city lockdown measure could reduce this risk. This study is a first comprehensive, high-resolution investigation of spatiotemporal heterogeneities on the effect of the Wuhan lockdown on the risk of COVID-19 symptom onset in all 347 Chinese cities. An extended Weight Kernel Density Estimation model was developed to predict the COVID-19 onset risk under two scenarios (i.e., with and without the Wuhan lockdown). The Wuhan lockdown, compared with the scenario without lockdown implementation, in general, delayed the arrival of the COVID-19 onset risk peak for 1-2 days and lowered risk peak values among all cities. The decrease of the onset risk attributed to the lockdown was more than 8% in over 40% of Chinese cities, and up to 21.3% in some cities. Lockdown was the most effective in areas with medium risk before lockdown.

Aims: To evaluate the influence of gestational diabetes mellitus (GDM) on the perinatal outcomes of twin pregnancies and its impact on fetal growth profiles of twin offspring from 6 weeks to 12 months of corrected age., Methods: A longitudinal cohort study was conducted among pregnant women with twins and their twin offspring. All information on perinatal outcomes and child growth trajectories from 6 weeks to 12 months of corrected age were obtained and analyzed using a general linear model and logistic regression models., Results: GDM was not correlated with adverse perinatal outcomes of twin pregnancies; however, in monochorionic diamniotic (MCDA), but not dichorionic diamniotic (DCDA) twin pregnancies, GDM was correlated with gestational hypertension disorder and a fetus being small for gestational age (OR, 2.68; 95% CI 1.16-6.04 and OR, 0.35; 95% CI 0.16-0.76, respectively). In both MCDA and DCDA groups, GDM was positively associated with a higher risk of childhood overweight at 6 months of corrected age (2.32 [1.05, 5.09] and 2.00 [1.13, 3.53])., Conclusions: GDM had a greater impact on MCDA twin pregnancies in terms of maternal gestational hypertension disease and small for gestational age of newborns. Additionally, twin offspring exposed to GDM had a higher risk of being overweight at 6 months of corrected age irrespective of chorionicity., Clinical Trial Registration: ChiCTR-OOC-16008203., 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 © 2020 Elsevier B.V. All rights reserved.)

Coastal reservoirs are potentially CH 4 emission hotspots owing to their biogeochemical role as the sinks of anthropogenic carbon and nutrients. Yet, the fine-scale spatial variations in CH 4 concentrations and fluxes in coastal reservoirs remain poorly understood, hampering an accurate determination of reservoir CH 4 budgets. In this study, we examined the spatial variability of diffusive CH 4 fluxes and their drivers at a subtropical coastal reservoir in southeast China using high spatial resolution measurements of dissolved CH 4 concentrations and physicochemical properties of the surface water. Overall, this reservoir acted as a consistent source of atmospheric CH 4 , with a mean diffusive flux of 16.1 μmol m -2 h -1 . The diffusive CH 4 flux at the reservoir demonstrated considerable spatial variations, with the coefficients of variation ranging between 199 and 426% over the three seasons. The shallow water zone (comprising 23% of the reservoir area) had a disproportionately high contribution (56%) to the whole-reservoir diffusive CH 4 emissions. Moreover, the mean CH 4 flux in the sewage-affected sectors was significantly higher than that in the nonsewage-affected sectors. The results of bootstrap analysis further showed that increasing the sample size from 10 to 100 significantly reduced the relative standard deviation of mean diffusive CH 4 flux from 73.7 to 3.4%. Our findings highlighted the role of sewage in governing the spatial variations in reservoir CH 4 emissions and the importance of high spatial resolution data to improve the reliability of flux estimates for assessing the contribution of reservoirs to the regional and global CH 4 budgets.