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Background: Autism spectrum disorder (ASD) is a multifactorial, pervasive, neurodevelopmental disorder, of which intestinal symptoms collectively represent one of the most common comorbidities. Methods: In this study, 1,222 children with ASD and 1,206 typically developing (TD) children aged 2-7 years were enrolled from 13 cities in China. Physical measurement and basic information questionnaires were conducted in ASD and TD children. The Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Behavior Checklist (ABC) were used to evaluate the clinical symptoms of children with ASD. The six-item Gastrointestinal Severity Index (6-GSI) was used to evaluate the prevalence of intestinal symptoms in two groups. Results: The detection rates of constipation, stool odor, and total intestinal symptoms in ASD children were significantly higher than those in TD children (40.098% vs. 25.622%, 17.021% vs. 9.287%, and 53.601% vs. 41.294%, respectively). Autistic children presenting with intestinal comorbidity had significantly higher scores on the ABC, SRS, CARS, and multiple subscales than autistic children without intestinal symptoms, suggesting that intestinal comorbidity may exacerbates the core symptoms of ASD children. Conclusion: Intestinal dysfunction was significantly more common in autistic than in TD children. This dysfunction may aggravate the core symptoms of children with ASD.

The present research examined the perceived teachers' charismatic leadership and entrepreneurial intentions of college students. Based on the theory of emotional contagion, this study proposes a mediating model of entrepreneurial passion between college students' perception of teachers' charismatic leadership and entrepreneurial intentions. A questionnaire survey was conducted in 420 college students in Jiangsu Province, China. The results showed that college students' perceived teachers' charismatic leadership had a significant positive effect on entrepreneurial passion. Moreover, perceived teachers' charismatic leadership of college students was found to have a significant positive predictive effect on entrepreneurial intentions, and entrepreneurial passion had a significant positive effect on entrepreneurial intentions. The mediation model analysis indicated that entrepreneurial passion played a partial mediating role between college students' perception of teachers' charismatic leadership and entrepreneurial intentions. The study results deepened our understanding of the inner influence mechanism of college students' perception of teachers' charismatic leadership and entrepreneurial intentions, in addition to providing a practical basis for college educators.

Background: Autism spectrum disorder (ASD) is a multifactorial, pervasive, neurodevelopmental disorder, of which intestinal symptoms collectively represent one of the most common comorbidities. Methods: In this study, 1,222 children with ASD and 1,206 typically developing (TD) children aged 2-7 years were enrolled from 13 cities in China. Physical measurement and basic information questionnaires were conducted in ASD and TD children. The Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Behavior Checklist (ABC) were used to evaluate the clinical symptoms of children with ASD. The six-item Gastrointestinal Severity Index (6-GSI) was used to evaluate the prevalence of intestinal symptoms in two groups. Results: The detection rates of constipation, stool odor, and total intestinal symptoms in ASD children were significantly higher than those in TD children (40.098% vs. 25.622%, 17.021% vs. 9.287%, and 53.601% vs. 41.294%, respectively). Autistic children presenting with intestinal comorbidity had significantly higher scores on the ABC, SRS, CARS, and multiple subscales than autistic children without intestinal symptoms, suggesting that intestinal comorbidity may exacerbates the core symptoms of ASD children. Conclusion: Intestinal dysfunction was significantly more common in autistic than in TD children. This dysfunction may aggravate the core symptoms of children with ASD. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the correlation between thyroid function and urinary iodine/creatinine ratio (UI/Cr) in pregnant women during different trimesters and explored potential influencing factors. Methods: In this cross-sectional study, serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and UI/Cr were measured in 450 pregnant women. Correlations were analyzed using Pearson's correlation coefficient and multiple linear regression. Subgroup analyses were performed based on age, body mass index (BMI), parity, gestational age, education, occupation, and family history of thyroid disorders. Results: UI/Cr was positively correlated with FT4 levels in the first and second trimesters, particularly in women with older age, higher BMI, multiparity, higher education, and employment. No significant correlations were found between UI/Cr and TSH or FT3 levels. Conclusion: UI/Cr is positively correlated with FT4 levels in early pregnancy, especially in women with certain risk factors. Regular monitoring of iodine status and thyroid function is recommended for pregnant women to ensure optimal maternal and fetal health. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Can exposure to palmitic acid (PA), a common saturated fatty acid, modulate autophagy in both human and mouse trophoblast cells through the regulation of acyl-coenzyme A-binding protein (ACBP)? SUMMARY ANSWER PA exposure before and during pregnancy impairs placental development through mechanisms involving placental autophagy and ACBP expression. WHAT IS KNOWN ALREADY High-fat diets, including PA, have been implicated in adverse effects on human placental and fetal development. Despite this recognition, the precise molecular mechanisms underlying these effects are not fully understood. STUDY DESIGN, SIZE, DURATION Extravillous trophoblast (EVT) cell line HTR-8/SVneo and human trophoblast stem cell (hTSC)-derived EVT (hTSCs-EVT) were exposed to PA or vehicle control for 24 h. Female wild-type C57BL/6 mice were divided into PA and control groups (n = 10 per group) and subjected to a 12-week dietary intervention. Afterward, they were mated with male wild-type C57BL/6 mice and euthanized on Day 14 of gestation. Female ACBPflox/flox mice were also randomly assigned to control and PA-exposed groups (each with 10 mice), undergoing the same dietary intervention and mating with ACBPflox/floxELF5-Cre male mice, followed by euthanasia on Day 14 of gestation. The study assessed the effects of PA on mouse embryonic development and placental autophagy. Additionally, the role of ACBP in the pathogenesis of PA-induced placental toxicity was investigated. PARTICIPANTS/MATERIALS, SETTING, METHODS The findings were validated using real-time PCR, Western blot, immunofluorescence, transmission electron microscopy, and shRNA knockdown approaches. MAIN RESULTS AND THE ROLE OF CHANCE Exposure to PA-upregulated ACBP expression in both human HTR-8/SVneo cells and hTSCs-EVT, as well as in mouse placenta. PA exposure also induced autophagic dysfunction in HTR-8/SVneo cells, hTSCs-EVT, and mouse placenta. Through studies on ACBP placental conditional knockout mice and ACBP knockdown human trophoblast cells, it was revealed that reduced ACBP expression led to trophoblast malfunction and affected the expression of autophagy-related proteins LC3B-II and P62, thereby impacting embryonic development. Conversely, ACBP knockdown partially mitigated PA-induced impairment of placental trophoblast autophagy, observed both in vitro in human trophoblast cells and in vivo in mice. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Primary EVT cells from early pregnancy are fragile, limiting research use. Maintaining their viability is tough, affecting data reliability. The study lacks depth to explore PA diet cessation effects after 12 weeks. Without follow-up, understanding postdiet impacts on pregnancy stages is incomplete. Placental abnormalities linked to elevated PA diet in embryos lack confirmation due to absence of control groups. Clarifying if issues stem solely from PA exposure is difficult without proper controls. WIDER IMPLICATIONS OF THE FINDINGS Consuming a high-fat diet before and during pregnancy may result in complications or challenges in successfully carrying the pregnancy to term. It suggests that such dietary habits can have detrimental effects on the health of both the mother and the developing fetus. STUDY FUNDING/COMPETING INTEREST(S) This work was supported in part by the National Natural Science Foundation of China (82171664, 82301909) and the Natural Science Foundation of Chongqing Municipality of China (CSTB2022NS·CQ-LZX0062, cstc2019jcyj-msxmX0749, and cstc2021jcyj-msxmX0236). The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Basic military training consists of highly regimented training in the context of fairly extreme psychosocial stressors, and some recruits suffered from rigorous disturbance in mind. Even if practical measures which include instructive psychological intervention have been taken to ameliorate the disturbance, some questions still have not been settled in our practical work for recruits. For example, what are the manifestations of psychological problems for recruits? What is the difference of the psychological problems at different stages during the training? A perspective investigation was found that emotion disturbances before the training and somatic symptoms at the end of the 1st month of training are remarkable, which can be viewed as, if needed, target symptoms in the psychological intervention. While recruits got more objective social supports in the later training and their sleep status had not shown significant change during the military training. Based on the investigations, we also submitted our suggestion to mental health intervention for recruits, and this may be helpful for health education in the army.

Aims: This two-wave, longitudinal study aimed to examine the potential moderating and mediating effects of resilience on the association between perceived school bullying and psychotic-like experiences among Chinese sexual minority adolescents. Methods: A total of 4192 senior high students were included and 984 (23.5%) of them were identified as a sexual minority (mean age = 16.68 years, SD = 0.71). Participants completed two online surveys during April 21 to May 12, 2021 and December 17 to 26, 2021, respectively, as well as completed self-report measures of sample characteristics, perceived school bullying, resilience, and psychotic-like experiences (including two dimensions: delusional experiences and hallucinatory experiences). Results: Perceived school bullying and resilience were associated with psychotic-like experiences in sexual minority adolescents. Resilience mediated the relationship between perceived school bullying and subsequent psychotic-like experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ delusional experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ hallucinatory experiences (b = 0.02, 95% CI = 0.01 ~ 0.03). Additionally, resilience only moderated the associations of perceived school bullying with hallucinatory experiences (b = −0.06, 95% CI = −0.12 ~ −0.01). Conclusions: These findings indicated that resilience plays a crucial role in mediating or moderating the relationship between perceived school bullying and psychotic-like experiences. Assessing and reducing school bullying, as well as promoting resilience, may have important clinical implications for reducing the risk of psychotic-like experiences in sexual minority adolescents. [ABSTRACT FROM AUTHOR]

Due to the increased frequency of extreme weather events and the implementation of the China's dual-carbon target, thermal power companies have been under pressure to construct green infrastructure and to actively pursue low-carbon transformation in response to stricter environmental regulations. This research thus selects 30 listed thermal power enterprises in China as study objects and assesses their green investment efficiency in the low-carbon transition process using three-stage DEA evaluation model with environmental regulation as an exogenous variable. Based on this, a benchmark regression model is used to corroborate the relationship between environmental regulation and green investment. Simultaneously, we carry out analysis to compare the correlation between thermal power firms' green investment efficiency and their focus on green investments. The results show in terms of total efficiency that environmental regulation significantly improves the total efficiency of 80% of thermal power enterprises compared to the absence of this exogenous variable. With the addition of environmental regulation, firms' total efficiency declines gradually in general from 2018 to 2022, with the mean value of efficiency falling by 0.068. In terms of stage-specific efficiency, the efficiency of the green investment stage of the majority of firms is between 0.3 and 0.6, which is much lower than that of the operational stage and the market performance stage. In terms of sub-indicator efficiency, both green investment efficiency and social donation efficiency among thermal power enterprises show obvious polarization, with 30% of them having an efficiency of 1 and 30% less than 0.1. In terms of green investment focus, thermal power unit renovation has a more obvious role in boosting the green investment efficiency of thermal power enterprises than do wind power and photovoltaic projects. Therefore, both governmental departments and thermal power enterprises need to take active measures in order to achieve green transformation from the perspective of green investment efficiency. Through the segmentation of important projects of green investment, this paper provides a reasonable investment direction reference for the sustainable transformation of China's thermal power industry. It also provides a rich and novel theoretical basis for the Chinese government to further improve the relevant environmental protection laws and regulations of thermal power industry. [ABSTRACT FROM AUTHOR]

Objective To investigate the age-related changes of the mandibular third molar root pulp visibility in individuals in East China, and to explore the feasibility of applying this method to determine whether an individual is 18 years or older. Methods A total of 1 280 oral panoramic images were collected from the 15-30 years old East China population, and the mandibular third molar root pulp visibility in all oral panoramic images was evaluated using OLZE 0-3 four-stage method, and the age distribution of the samples at each stage was analyzed using descriptive statistics. Results Stages 0, 1, 2 and 3 first appeared in 16.88, 19.18, 21.91 and 25.44 years for males and in 17.47, 20.91, 22.01 and 26.01 years for females. In all samples, individuals at stages 1 to 3 were over 18 years old. Conclusion It is feasible to determine whether an individual in East China is 18 years or older based on the mandibular third molar root pulp visibility on oral panoramic images. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical features of infection-associated autoimmune encephalitis (IAE) with different antibodies in Xinjiang region, and to explore the diagnostic value of relevant laboratory indicators for IAE. Methods A total of 47 patients with IAE diagnosed and treated in People's Hospital of Xinjiang Uiger Autonomous Region from January 2018 to October 2023 were enrolled, including 18 cases (38.30%) of anti-leucine-rich glioma-inactivated 1 (LGI1) antibody-associated encephalitis, 16 cases (34.04%) of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, 8 cases (17.02%) of anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated encephalitis, and 5 cases (10.64%) of anti-γ-aminobutyric acid receptor type B (GABABR) encephalitis. Social demographic data, clinical manifestations, laboratory and other examinations were collected, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of relevant laboratory indicators for IAE. Results The age of onset (χ² = 9.500, P = 0.023), myasthenia (χ² = 9.967, P = 0.019), vision loss (χ² = 9.967, P = 0.019) and seizures (χ² = 8.046, P = 0.045), cerebrospinal fluid (CSF) white blood cell count (χ² = 15.237, P = 0.002) and chloride (F = 4.156, P = 0.011) in patients with anti-LGI1 antibody-associated encephalitis, anti-NMDAR encephalitis, anti-MOG antibody-associated encephalitis and anti-GABABR encephalitis were statistically significant. The age of onset in patients with anti-LGI1 antibody-associated encephalitis was larger than that in patients with anti-NMDAR encephalitis (Z =-2.384, P = 0.017) and anti-MOG antibody-associated encephalitis (Z =-2.420, P = 0.016). The CSF white blood cell count in patients with anti-NMDAR encephalitis was higher than that in patients with anti-LGI1 antibody-associated encephalitis (Z =-3.307, P = 0.001) and anti-MOG antibody-associated encephalitis (Z =-2.835, P = 0.005). CSF chloride was higher in patients with anti-NMDAR encephalitis (t = 3.159, P = 0.007) and anti-GABABR encephalitis (t =-4.592, P = 0.007) than in patients with anti-LGI1 antibody-associated encephalitis. ROC curve showed that the area under the curve (AUC) of age of onset for diagnosis of anti-LGI1 antibody-associated encephalitis was 0.722 (95%CI: 0.569-0.875, P = 0.012), the sensitivity was 0.556, the specificity was 0.821, and the cut-off value was 54.50 years old. The AUC of CSF white blood cell count in the diagnosis of anti-LGI1 antibody-associated encephalitis was 0.706 (95%CI: 0.558-0.855, P = 0.019), the sensitivity was 0.889, the specificity was 0.571, and the cut-off value was 4.50 x 106/L. The AUC in the diagnosis of anti-NMDAR encephalitis was 0.790 (95%CI: 0.643-0.937, P = 0.002), the sensitivity was 0.600, the specificity was 0.967, and the cut-off value was 13.50 x 106/L. The AUC of CSF chloride for the diagnosis of anti-LGI1 antibody-associated encephalitis was 0.748 (95%CI: 0.598-0.898, P = 0.005), with a sensitivity of 0.722 and a specificity of 0.714, and a cut-off value of 122.70 mmol/L. Conclusions IAE with different antibodies in Xinjiang region has specific clinical features. Age of onset, CSF white blood cell count and chloride have important value in the diagnosis of anti-LGI1 antibody-associated encephalitis, and CSF white blood cell count has important value in the diagnosis of anti-NMDAR encephalitis. [ABSTRACT FROM AUTHOR]

Toona ciliata var. pubescens, known as "Chinese mahogany", has high commercial value and is classified as a level II priority protected wild plant in China. However, due to overexploitation and its poor natural regeneration capacity, natural T. ciliata var. pubescens forests show varying degrees of decline in habitat adaptability. Arbuscular mycorrhizal fungi (AMF) symbiosis presents a potential strategy to enhance its regeneration. In this study, T. ciliata var. pubescens seedlings were inoculated with Septoglomus viscosum, followed by RNA-Seq analysis to compare gene expression differences between AMF-inoculated (AMI) and non-mycorrhizal (NM) treatments three months post-inoculation. A total of 16,163 differentially expressed genes (DEGs) were upregulated by AMF colonization, constituting 96.46% of the total DEGs. Specifically, 14,420 DEGs were exclusively expressed in the AMI treatment, while 35 DEGs were completely silenced. Most of the upregulated DEGs were located on the cell membrane, nucleus, and cytoskeleton and functioned in protein binding, S-adenosylmethionine-dependent methyltransferase activity, and lipid binding during cellular/macromolecule/protein localization, intracellular/protein transport, the cell cycle, and signal transduction. Additionally, lots of key genes related to oxidative stress responses, nutrient transport, and small GTPase-mediated signal transduction were found to be upregulated. These results suggest that AMF inoculation may enhance root cell growth by activating genes involved in nutrient uptake, stress responses, signal transduction, and substance transportation. This study elucidates the molecular mechanisms underlying the growth promotion of T. ciliata var. pubescens through AMF symbiosis, laying a foundation for the future application of AMF in its natural forest regeneration. [ABSTRACT FROM AUTHOR]

Background: Advanced schistosomiasis is the most serious outcome of infection and has a negative impact on both physical fitness and mental health of patients, the latter of which has long been overlooked. Therefore, we performed this systematic review and meta-analysis to estimate the overall prevalence of depressive symptoms, one of the most common mental problems, in patients with advanced schistosomiasis in China. Methods: Six electronic databases were searched for studies reporting the prevalence of depressive symptoms in the targeted patients. Assessments were pooled using a fixed- or random-effects model based on heterogeneity test. Subgroup analyses were further performed and differences between/among groups were examined using the chi-squared test. The protocol had previously been registered in PROSPERO (CRD42023406708). Results: A total of 11 studies with 1,673 participants were included. The pooled prevalence of depressive symptoms in advanced schistosomiasis in China was 62.01% (95% CI: 51.30% - 72.72%), with a significant heterogeneity among studies. Depressive symptoms were more prevalent in patients with complications and more than half of the patients suffered a mild- or moderate-level of depression. No publication bias was found, and sensitivity analysis showed a stable result. Conclusions: The overall prevalence of depressive symptoms in advanced schistosomiasis in China was high enough to warrant psychotherapeutic interventions, especially for patients with complications. This would greatly prevent or/and reduce depression and improve their quality of life. Author summary: Schistosomiasis is a neglected tropical disease (NTD) which affects more than 250 million people across 78 countries worldwide. The three major schistosomes infecting humans are Schistosoma mansoni, S. japonicum, and S. haematobium. In China, after 70 years of control efforts, tremendous progress has been made, and now the number of schistosomiasis japonica infections is at its lowest historical level. However, advanced schistosomiasis, which is the most serious outcome of schistosome infection, poses a great threat as an increasing number of the patients have been diagnosed. Depression is a frequently occurring mental health issue caused by the disease that has long been overlooked. Therefore, we performed this meta-analysis to estimate the overall prevalence of depressive symptoms in patients with advanced schistosomiasis in China and its possible influential factors. We found that the pooled prevalence was 62.01% (95% CI: 51.30% - 72.72%) in the targeted patients and the estimate was associated with complications of the disease. Our study would call for psychological interventions to improve quality of life for patients with advanced schistosomiasis. [ABSTRACT FROM AUTHOR]

Background: Previous studies of maternal iron and birth outcomes have been limited to single indicators that do not reflect the comprehensive relationship with birth outcomes. We aimed to investigate the relationship between maternal iron metabolism and neonatal anthropometric indicators using comprehensive iron-related indicators. Methods: A total of 914 Chinese mother-child dyads were enrolled in this prospective study. Subjects' blood samples were collected at ≤ 14 weeks of gestation. Serum concentrations of iron-related indicators were measured by enzyme-linked immunosorbent assay (ELISA). Femur length was measured by B-ultrasound nearest delivery. Neonatal anthropometric indicators were collected from medical records. Results: After adjustment for potential covariates, higher iron (per one standard deviation, SD increase) was detrimentally associated with − 0.22 mm lower femur length, whereas higher transferrin (per one SD increase) was associated with 0.20 mm higher femur length. Compared with normal subjects (10th-90th percentiles), subjects with extremely high (> 90th percentile) iron concentration were detrimentally associated with lower femur length, birth weight, and chest circumference, and a higher risk of low birth weight, LBW (HR: 3.92, 95%CI: 1.28, 12.0). Subjects with high concentration of soluble transferrin receptor, sTFR and transferrin (> 90th percentile) were associated with higher femur length. Subjects with low concentration of iron and ferritin concentrations (< 10th percentile) were associated with a higher risk of LBW (HR: 4.10, 95%CI: 1.17, 14.3) and macrosomia (HR: 2.79, 95%CI: 1.06, 7.35), respectively. Conclusions: Maternal iron overload in early pregnancy may be detrimentally associated with neonatal anthropometric indicators and adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to translate and culturally adapt the standardized outcomes in nephrology–hemodialysis fatigue (SONG–HD fatigue) scale and to assess the psychometric properties of the Chinese version of the SONG–HD fatigue (C-SONG–HD fatigue) scale. Methods: Forward and back translations were used to translate the SONG–HD fatigue scale into Chinese. We used the C-SONG–HD fatigue scale to survey Chinese patients undergoing hemodialysis (HD) in China. We examined the distribution of responses and floor and ceiling effects. Cronbach's alpha and McDonald's omega coefficient, intraclass coefficients, and Spearman correlations were used to assess internal consistency reliability, test–retest reliability, and convergent validity, respectively. Responsiveness was also evaluated. Results: In total, 489 participants across southeast China, northwest China, and central China completed the study. The C-SONG–HD fatigue scale had good internal consistency (Cronbach's alpha coefficient 0.861, omega coefficient 0.916), test–retest reliability (intraclass correlation coefficient 0.695), and convergent validity (Spearman correlation 0.691). The analysis of all first-time HD patients did not show notable responsiveness, and only patients with temporary vascular access had good responsiveness with an effect size (ES) of 0.54, a standardized response mean (SRM) of 0.85, and a standard error of measurement (SEM) of 0.77. Conclusion: The Chinese version of the SONG–HD fatigue scale showed satisfactory reliability and validity in patients undergoing hemodialysis (HD) in China. It could be used as a tool to measure the fatigue of Chinese HD patients. [ABSTRACT FROM AUTHOR]

Background: Treating persistent, recurrent, or metastatic cervical cancer remains challenging. Although pembrolizumab, combined with chemotherapy and bevacizumab, offers a promising first-line option, its cost-effectiveness within the Chinese healthcare system has not been established. Methods: A partitioned survival model was constructed using patient data from the KEYNOTE-826 trial. Efficacy, safety, and economic data from both trial and real-world practices were utilized to determine the costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER) of the treatment strategies. Comprehensive insights were gained through the sensitivity and subgroup analyses. Results: Over five years, the combination of pembrolizumab, chemotherapy, and bevacizumab offered an additional 1.18 QALYs compared to that provided by standard treatments. This regimen increased the costs by US$ 134,502.57, resulting in an ICER of US$ 114,275.67 per QALY, relative to traditional treatment costs. The ICER for the pembrolizumab regimen was further calibrated to be US$ 52,765.69 per QALY. Both ICER values surpassed China's established willingness-to-pay threshold. Importantly, subgroup analysis revealed enhanced cost-effectiveness in patients presenting with a programmed death-ligand 1 combined positive score (PD-L1 CPS) =10. Conclusion: Introducing pembrolizumab alongside chemotherapy and bevacizumab may not be a cost-effective primary strategy for advanced cervical cancer against current standards. However, for patients with a PD-L1 CPS =10, the therapeutic and economic outcomes could be improved by adjusting the pembrolizumab price. [ABSTRACT FROM AUTHOR]

Liquidambar L. is a significant constituent of the Cenozoic flora in the Northern Hemisphere. Currently, this genus exhibits a discontinuous distribution across Asia and North America, with the center of diversity being in southeastern Asia. This study presents the first occurrence of Liquidambar in the Oligocene of South China. Fossil sweetgum infructescences, associated pollen, and leaves have been found in the Nanning Basin, Guangxi. A new species, Liquidambar nanningensis sp. nov., is described based on the morphological and anatomical characteristics of three-dimensionally preserved infructescences. The Liquidambar fossils from the Nanning Basin show a combination of features indicative of the former genera of Altingiaceae, Altingia, Liquidambar s. str., and Semiliquidambar. The new occurrence expands the taxonomic and morphological diversity of the Paleogene Liquidambar species in South China. [ABSTRACT FROM AUTHOR]

A unique petrified tree fern displaying distinct patterns was recently discovered in northeast China, attracting considerable interest. This study provides a comprehensive set of data for this material obtained through standard gemological testing, petrographic observation, scanning electron microscopy, energy-dispersive spectroscopy, electron probe microanalysis, and Raman spectroscopy. The petrified tree fern exhibits colors ranging from golden yellow to brown, with additional variations caused by iron oxides. Chalcedony is the primary mineral component, while the presence of metastable moganite gives chalcedony its fibrous nature, contributing to the delicate structure of the samples. The surface pattern originates from plant structures preserved during silicification, further confirming the samples belong to the extinct Cretaceous period tree fern Tempskya sp. [ABSTRACT FROM AUTHOR]

Our previous study has revealed that EphA7 was upregulated in patient-derived esophageal squamous cell carcinoma (ESCC) xenografts with hyper-activated STAT3, but its mechanism was still unclear. To assess the association between EphA7 and STAT3, western blotting, immunofluorescence, ChIP assay, and qRT-PCR were conducted. Truncated mutation and luciferase assay were performed to examine the promoter activity of EphA7. CCK-8 assay and colony formation were performed to assess the proliferation of ESCC. Cell-derived xenograft models were established to evaluate the effects of EphA7 on ESCC tumor growth. RNA-seq analyses were used to assess the effects of EphA7 on related signals. In this study, EphA7 was found upregulated in ESCC cell lines with high STAT3 activation, and immunofluorescence also showed that EphA7 was co-localized with phospho-STAT3 in ESCC cells. Interestingly, suppressing STAT3 activation by the STAT3 inhibitor Stattic markedly inhibited the protein expression of EphA7 in ESCC cells, in contrast, activation of STAT3 by IL-6 obviously upregulated the protein expression of EphA7. Moreover, the transcription of EphA7 was also mediated by the activation of STAT3 in ESCC cells, and the −2000∼−1500 region was identified as the key promoter of EphA7. Our results also indicated that EphA7 enhanced the cell proliferation of ESCC, and silence of EphA7 significantly suppressed ESCC tumor growth. Moreover, EphA7 silence markedly abolished STAT3 activation-derived cell proliferation of ESCC. Additionally, RNA-seq analyses indicated that several tumor-related signaling pathways were significantly changed after EphA7 downregulation in ESCC cells. Our results showed that the transcriptional expression of EphA7 was increased by activated STAT3, and the STAT3 signaling may act through EphA7 to promote the development of ESCC. [ABSTRACT FROM AUTHOR]

This aim of this study was to investigate women's knowledge about HPV along with their experience and acceptability of self-sampling in Jiangsu province, China. A total of 862 women aged 25–63 years old from Jiangsu province who purchased an HPV self-sampling test kit were invited to complete a questionnaire designed by the authors. Participants had high acceptability for HPV self-sampling with a mean score of 4.2 (95% [CI], 4.1–4.22) out of 5 points. 27% of participants preferred clinician-sampling, 33% preferred self-sampling, other 40% expressed no preference. Women with good knowledge about HPV and with a good experience with HPV self-sampling were more acceptable for self-sampling (P < 0.05). The biggest concern about HPV self-sampling of the participants includes 'specimens' spoilage', 'incorrect sampling', 'can't get results in time', and so on. HPV self-sampling can be used to improve cervical cancer screening coverage and participation rates in China. Cancer screening and can be an alternative primary screening for cervical cancer. •What the results of this study add? This study adds new findings about Chinese women's experience and acceptability of HPV self-sampling. We found that most women had high acceptability for HPV self-sampling in Jiangsu province, China, and high knowledge about HPV as well as good •What is already known on this subject? HPV self-sampling testing was proven to be useful for improving the uptake rate of cervical experience of self-sampling can improve the acceptability for self-sampling in women. •What the implications are of these findings for clinical practice and/or further research? Further research should assess the acceptability of women with less education or who never screened. [ABSTRACT FROM AUTHOR]

Objective of the current study was to explore the gene polymorphism and expression of NRG1, DAOA, and DISC1 genes in a Han population with UHR for psychosis in China.Methods: Eighteen UHR individuals, 61 first-degree relatives of patients with schizophrenia (FDR), 55 first-episode psychosis individuals (FEP), and 61 healthy controls (HC) were enrolled in the study. The genotypes at four loci of the NRG1 gene, four loci of the DAOA gene, and two loci of the DISC1 gene were tested for all subjects, and mRNAs of NRG1 and DISC1 were examined and analyzed in a pairwise comparison among the four groups. Statistical analysis of genetics was performed using snpStats software. For the case-control association analysis, a single site association study, epistatic effect analysis, and haplotype analysis were used to explore the association of the above genes.Results: This study found that rs3918341 in the DAOA gene was associated with susceptibility to UHR by single site association analysis. Epistatic effect analysis results showed that the NRG1 gene interacted with the DAOA gene and DISC1 gene in the susceptibility to UHR. Haplotype association analysis showed that all haplotypes were not significantly associated with UHR. NRG1 mRNA was significantly downregulated in the UHR group compared with the HC group as well as the FEP group.Conclusion: Our preliminary results show that NRG1, DAOA, and DISC1 genes may play a role in psychosis onset, opening the way to the identification of prognostic biomarkers. [ABSTRACT FROM AUTHOR]

Extant species of Liquidambar L. exhibit a disjunct distribution between western and eastern Asia and eastern North America to Central America, with the highest species diversity being in China. In this study, two new species of Liquidambar are described from the Eocene of Hainan Island, South China: L. hainanensis on basis of the leaf fossils, and L. ovoidea based on compressions of infructescences. The co‐occurrences of L. hainanensis leaves, associated infructescences of L. ovoidea and dispersed pantoporate pollen grains have the combination of morphological features peculiar to the genera Liquidambar and former Semiliquidambar and Altingia. This is considered further palaeobotanical justification for the placement of these three genera into a single genus, Liquidambar, proposed earlier based on molecular markers. Our data provide evidence for the occurrence of an ancestral polymorphic group of Liquidambar species (L. maomingensis with associated capitate infructescences, L. bella, L. hainanensis and L. ovoidea) during the Eocene in South China, and corroborate the view that South China could have been a centre of Liquidambar speciation during the Eocene. The morphological similarity of L. hainanensis leaves to those of the extant species L. orientalis from Western Asia and the North American L. styraciflua may support the importance of both the North Atlantic Land Bridge and the Bering Land Bridge for the dispersal of Liquidambar. Analysis of fossil species of Liquidambar from eastern Asia also contributes to further understanding of patterns in the taxonomic diversity and evolutionary history of this genus. [ABSTRACT FROM AUTHOR]

Background: Clonorchissinensis, one of the most important food-borne zoonotic trematodes, remains prevalent in China. Understanding its infection status in animals is crucial for controlling human clonorchiasis. Here we conducted a systematic review and meta-analysis to focus on the spatio-temporal disparities of C.sinensis infection in animals in China. Methods: Data on C.sinensis prevalence in snails, the second intermediate hosts, or animal reservoirs in China were extracted from electronic databases including PubMed, Embase, Web of Science, Chinese Wanfang database, CNKI, VIP, and China Biomedical Literature database. A random-effects meta-analysis model was utilized to estimate the pooled prevalence in each of the above animal hosts. Subgroup analysis and multivariable meta-regression were performed to explore potential sources of heterogeneity across studies and compare the temporal disparity of infection rates between high and low epidemic areas. Scatter plots were used to depict the biogeographical characteristics of regions reporting C.sinensis infection in animals. Results: The overall pooled prevalence of C.sinensis was 0.9% (95% CI: 0.6–1.2%) in snails, 14.2% (12.7–15.7%) in the second intermediate host, and 14.3% (11.4–17.6%) in animal reservoirs. Prevalence in low epidemic areas (with human prevalence < 1%) decreased from 0.6% (0.2–1.2%) before 1990 to 0.0% (0.0–3.6%) after 2010 in snails (P = 0.0499), from 20.3% (15.6–25.3%) to 8.8% (5.6–12.6%) in the second intermediate hosts (P = 0.0002), and from 18.3% (12.7–24.7%) to 4.7% (1.0–10.4%) in animal reservoirs. However, no similar decrease in prevalence was observed in high epidemic areas (with human prevalence ≥ 1.0%). C.sinensis infections were predominantly reported in areas with altitudes below 2346 m and annual cumulative precipitation above 345 mm and were mostly concentrated in eastern China. Conclusions: There are spatio-temporal disparities in the animal infections of C.sinensis in different areas of China. Animal infections are primarily concentrated in regions with low altitude and high precipitation. The results suggest that implementing One Health-based comprehensive measures targeting both humans and animals, especially in high epidemic areas, is essential for successful eradication of C.sinensis in China. [ABSTRACT FROM AUTHOR]

Phytoplasmas are phloem-limited plant pathogens, such as sugarcane white leaf (SCWL) phytoplasma, which are responsible for heavy economic losses to the sugarcane industry. Characterization of phytoplasmas has been limited because they cannot be cultured in vitro. However, with the advent of genome sequencing, dierent aspects of phytoplasmas are being investigated. In this study, we developed a DNA enrichment method for sugarcane white leaf (SCWL) phytoplasma, evaluated the eect of DNA enrichment via Illumina sequencing technologies, and utilized Illumina and Nanopore sequencing technologies to obtain the complete genome sequence of the “Candidatus Phytoplasma sacchari” isolate SCWL1 that is associated with sugarcane white leaf in China. Illumina sequencing analysis elucidated that only 1.21% of the sequencing reads from total leaf DNA were mapped to the SCWL1 genome, whereas 40.97% of the sequencing reads from the enriched DNA were mapped to the SCWL1 genome. The genome of isolate SCWL1 consists of a 538,951 bp and 2976 bp long circular chromosome and plasmid, respectively. We identified 459 protein-encoding genes, 2 complete 5S-23S-16S rRNA gene operons, 27 tRNA genes, and an incomplete potential mobile unit (PMU) in the circular chromosome. Phylogenetic analyses and average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) values based on the sequenced genome revealed that SCWL phytoplasma and sugarcane grassy shoot (SCGS) phytoplasma belonged to the same phytoplasma species. This study provides a genomic DNA enrichment method for phytoplasma sequencing. Moreover, we report the first complete genome of a “Ca. Phytoplasma sacchari” isolate, thus contributing to future studies on the evolutionary relationships and pathogenic mechanisms of “Ca. Phytoplasma sacchari” isolates. [ABSTRACT FROM AUTHOR]

Background: Cow's milk protein allergy (CMPA) is one of the most common types of food allergy in infants. Faecal pathogen cultures showed that the positive rate of Clostridium perfringens was more than 30%, which was significantly higher than that for other bacteria. Therefore, it is speculated that Clostridium perfringens colonization may be one of the pathogenetic factors for CMPA in infants. We conducted a real-world evidence study. Infants aged 0–6 months with diarrhoea and mucoid and/or bloody stools were recruited from a large tertiary hospital in China. Faecal pathogen cultures for the detection of Clostridium perfringens were confirmed by flight mass spectrometry, and potential toxin genes were identified using PCR. After 12 months of follow-up, the diagnoses of CMPA and food allergy were recorded. The correlation was assessed by Pearson correlation analysis. Results: In this study, 358 infants aged 0–6 months with gastrointestinal symptoms and faecal pathogen cultures were recruited. A total of 270 (44.07% girls; mean age, 2.78 ± 2.84 months) infants were followed up for 12 months. Overall, the rate of positivity for Clostridium perfringens in faecal pathogen cultures was 35.75% (128/358) in infants aged ≤ 6 months. The earliest Clostridium perfringens colonization was detected within 2 days after birth. The majority of Clostridium perfringens isolates were classified as type C in 85 stool samples. In the Clostridium perfringens-positive group, 48.21% (54/112) of infants were clinically diagnosed with food allergies after 12 months, including 37.5% (42/112) with CMPA, which was significantly higher than that of the negative group, with 7.59% (12/158) exhibiting food allergies and 5.06% (8/158) presenting CMPA (P < 0.0001). Faecal Clostridium perfringens positivity was significantly correlated with CMPA, food allergy, faecal occult blood, faecal white blood cells, antibiotic use, increased peripheral blood platelet counts, and decreased haemoglobin levels (P < 0.0001). Conclusions: This study demonstrates that intestinal colonization by Clostridium perfringens is common in infants. The majority of Clostridium perfringens isolates are classified as type C. Colonization of the intestine by Clostridium perfringens is associated with the development of CMPA and food allergy in infants. [ABSTRACT FROM AUTHOR]

This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100–149 μg/L, compared with those with a median urinary iodine concentration of 150–249 μg/L maintained through sustainable universal salt iodization. This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt, urine, and blood during their routine antenatal care in the 18 counties in Fujian Province, China. The levels of salt iodine concentration, urinary iodine concentration (UIC), free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid-stimulating hormone (TSH), thyroglobulin (Tg), thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits. The median UIC (mUIC) in pregnant women was 130.8 μg/L (interquartile range = 91.5–198.1 μg/L) in the counties with an mUIC of 100–149 μg/L (Group I), and 172.0 μg/L (interquartile range = 123.5–244.4 μg/L) in the counties with an mUIC of 150–249 μg/L (Group II). Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II (P > 0.05). Except for FT4 values, the TSH, FT4, FT3, Tg and Tg values > 40 (μg/L) and the thyroid diseases prevalence rate (TDR) showed no significant differences between Group I and Group II (P > 0.05), whether or not iodine supplementation measures were taken. Compared with an mUIC of 150–249 μg/L, not only there was no difference in thyroid morphology, but also the Tg value, rate of Tg values > 40 μg/L, and TDR were not higher in pregnant women in the counties with an mUIC of 100–149 μg/L achieved through sustainable universal salt iodization in Fujian Province, China. [ABSTRACT FROM AUTHOR]

Cross-laminated timber (CLT) is increasingly being utilized in Europe, North America and elsewhere due to its superior mechanical properties and environmental-friendly performance. Considering regions and countries, such as China, those are scarce in structural wood resource but rich in bamboo forest, an idea of introducing bamboo into CLT system has been proposed to form a novel composite material, named as cross-laminated bamboo and timber (CLBT). This paper focuses on the comparison of thermal insulation performance of CLBT and CLT panels. The thermal resistance and transmittance of CLT and CLBT wall specimens were measured by the Guarded Hot Box test. A calculation method provided by ISO standard and a finite element (FE) model were also used to evaluate the thermal resistance of CLT and CLBT panels. Based on the proposed FE model, some parametric analysis was performed through 11 CLBT panels with different compositions, including the layer number of glubam and timber, the thickness of extruded polystyrene and the use of gypsum board and screws. Moreover, the feasibilities of these CLBT panels were evaluated for the application in different climate regions of China and the United States in accordance with the corresponding Chinese and American building energy efficiency standards, respectively. It can be finally concluded that, the development and application of CLBT contributes to achieving the low carbon sustainable features of structures, which is due to the good carbon sequestration ability of its component materials (i.e., timber and bamboo) as well as the good insulation performance of CLBT panels. [ABSTRACT FROM AUTHOR]

Background: Fear of disease progression (FoP) is among the most prevalent and major psychological burdens breast cancer patients encounter. Excessive FoP may result in serious adverse effects for patients. FoP in breast cancer patients has gained attention recently; however, its prevalence in China is unknown. Objectives: This meta-analysis and systematic review aimed to assess the overall FoP among Chinese breast cancer patients to make recommendations for treatment and care. Methods: Systematic search databases included PubMed, EMbase, The Cohrane Library, Web of Science, CINAHL, PsycINFO and 4 Chinese databases (Wan Fang Data, CBM, VIP and CNKI). The retrieval time ranged from the database's establishment to March 20, 2023. After two researchers independently evaluated the literature, retrieved information, and assessed the risk of bias for the included literature, Stata 15.1 software was used to conduct a meta-analysis. Results: A total of 37 moderate or high-quality studies involving 9,689 breast cancer patients were included. Meta-analysis showed that the pooled mean score of FoP for Chinese breast cancer patients was 33.84 [95% CI (31.91, 35.77)], prediction interval (21.57 ~ 46.11). The subgroup study found that FoP levels varied among breast cancer patients of different regions, ages, educational levels, marital statuses, residences, illness stages, and disease statuses. Conclusion: Breast cancer patients have higher FoP scores. Healthcare workers should be concerned. We expect that more relevant research will be undertaken and more effective interventions will be developed. Patients can manage their illness and improve their quality of life by reducing their fears. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: PROSPERO CRD42023408914. [ABSTRACT FROM AUTHOR]

This paper proposes new perspective on the nexus between transportation and urbanization in China to test the search-matching theory. We find that the linkage between transportation and urbanization has both frequency and time-varying features. We find that transportation improves urbanization in the short term, while urbanization plays the importation role in transportation during the period 1969–1996. This result obviously supports search-matching theory that in the subsample periods, the transportation infrastructure exerts positive effects on urbanization in the short term but not in the long term. In the long term, urbanization will promote the development of transportation, while short-term traffic infrastructure investment can effectively improve the transfer of population to urban regions. It would be beneficial for the government to formulate the scientific traffic planning policy and adjust the transport structure to improve urbanization. [ABSTRACT FROM AUTHOR]

Currently, sharp contradiction exists between edible oil supply and demand in China. Developing edible oil production largely depends on the development of rapeseed production. For less land competition between cereal crops and rapeseed, the Yangtze River Basin is the main rapeseed producing area in China. But, problems (such as a large amount of labor, high labor cost and low efficiency) seriously restrict the development of rapeseed industry. The whole-process mechanization (including sowing, management, and harvesting) is the key to boosting rapeseed production. Thus we reviewed the research on rapeseed biological characteristics, planting habits, and rotation systems, to focus on high yield loss rate during harvesting. We expected to improve mechanized harvesting of rapeseed in China. The research processes on breeding ideotype rapeseed suitable for mechanized harvesting as resistance to lodging, pod cracking, and sclerotinia disease were also discussed. The aim was to provide an insight on breeding and cultivation management of rapeseed suitable for high efficient mechanized harvesting. [ABSTRACT FROM AUTHOR]

Objective: To assess the clinical efficacy of fucoidan‐assisted standard quadruple therapy (SQT) in Helicobacter pylori (H. pylori) eradication and the improvement of gut microbiota. Methods: An open‐label randomized controlled trial was conducted at the Affiliated Hospital of Qingdao University in Shandong Province, China. Ninety patients who tested positive for H. pylori were randomized to the standard quadruple therapy (SQT) group (SQ), SQT + fucoidan combination group (SF), and fucoidan + sequential SQT group (FS), respectively. Stool samples were collected for gut microbiota composition at baseline and after treatment. Results: After H. pylori eradication, the relative abundances of most conditional pathogens in the SQ decreased, while those of several beneficial bacteria increased or decreased (P < 0.05). In FS, the abundances of most beneficial bacteria increased gradually from baseline to week 12, while those of the conditional pathogens decreased (P < 0.05). The abundance of Bifidobacterium had a decreasing trend in SQ, but remained unchanged in SF and increased in FS (P < 0.05). The abundances of most beneficial bacteria were significantly higher in FS than in SQ and SF (P < 0.05). Addition of fucoidan enhanced symptom improvement during H. pylori eradication compared with SQT alone. Conclusions: Fucoidan considerably improved gut dysbiosis during SQT for H. pylori eradication. Gut microbiota can be maintained by the addition of fucoidan before eradication therapy with SQT rather than by concomitant addition with therapy. Fucoidan‐assisted SQT could relieve gastrointestinal symptoms during H. pylori eradication. [ABSTRACT FROM AUTHOR]

Background: POD places a heavy burden on the healthcare system as the number of elderly people undergoing surgery is increasing annually because of the aging population. As a large country with a severely aging population, China’s elderly population has reached 267 million. There has been no summary analysis of the pooled incidence of POD in the elderly Chinese population. Methods: Systematic search databases included PubMed, Web of Science, EMBASE, Cochrane Library Databases, China Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database (CBM), WanFang Database, and Chinese Science and Technology Periodicals (VIP). The retrieval time ranged from the database’s establishment to February 8, 2023. The pooled incidence of delirium after non-cardiac surgery was calculated using a random eects model. Meta-regression, subgroup, and sensitivity analyses were used to explore the source of heterogeneity. Results: A total of 52 studies met the inclusion criteria, involving 18,410 participants. The pooled incidence of delirium after non-cardiac surgery in the elderly Chinese population was 18.6% (95% CI: 16.4–20.8%). The meta-regression results revealed anesthesia method and year of publication as a source of heterogeneity. In the subgroup analysis, the gender subgroup revealed a POD incidence of 19.6% (95% CI: 16.9–22.3%) in males and 18.3% (95% CI: 15.7–20.9%) in females. The year of publication subgroup analysis revealed a POD incidence of 20.3% (95% CI: 17.4–23.3%) after 2018 and 14.6 (95% CI: 11.6–17.6%) in 2018 and before. In the subgroup of surgical types, the incidence of hip fracture surgery POD was 20.7% (95% CI: 17.6–24.3%), the incidence of non-cardiac surgery POD was 18.4% (95% CI: 11.8–25.1%), the incidence of orthopedic surgery POD was 16.6% (95% CI: 11.8–21.5%), the incidence of abdominal neoplasms surgery POD was 14.3% (95% CI: 7.6–21.1%); the incidence of abdominal surgery POD was 13.9% (95% CI: 6.4–21.4%). The anesthesia methods subgroup revealed a POD incidence of 21.5% (95% CI: 17.9–25.1%) for general anesthesia, 15.0% (95% CI: 10.6–19.3%) for intraspinal anesthesia, and 8.3% (95% CI: 10.6–19.3%) for regional anesthesia. The measurement tool subgroup revealed a POD incidence of 19.3% (95% CI: 16.7–21.9%) with CAM and 16.8% (95% CI: 12.6–21.0%) with DSM. The sample size subgroup revealed a POD incidence of 19.4% (95% CI: 16.8–22.1%) for patients ≤ 500 and 15.3% (95% CI: 11.0–19.7%) for patients > 500. The sensitivity analysis suggested that the pooled incidence of postoperative delirium in this study was stable. Conclusion: Our systematic review of the incidence of delirium after non-cardiac surgery in elderly Chinese patients revealed a high incidence of postoperative delirium. Except for cardiac surgery, the incidence of postoperative delirium was higher for hip fracture surgery than for other types of surgery. However, this finding must be further explored in future large-sample studies. [ABSTRACT FROM AUTHOR]

Background: Drug-resistant Pseudomonas aeruginosa infections rapidly increased and contributed to life-threatening nosocomial infections; however, the distribution, species, drug susceptibility and dynamic trends of P. aeruginosa infection in China remained unclear. This study was conducted to better understand the epidemiological data of increased P. aeruginosa infections from 2016 to 2022 in a hospital in China. Methods: This study involved 3301 patients infected with P. aeruginosa, diagnosed using a nosocomial infection surveillance system in a tertiary hospital between 2016 and 2022. The P. aeruginosa infections from 2016 to 2022 were assessed according to the hospital department and species, and the drug susceptibility was evaluated using 16 antimicrobial agents. Results: The P. aeruginosa infection prevalence in the hospital department was: Neurosurgery (14.30%), Emergency (13.30%), and Critical Care Medicine (11.69%). Samples for P. aeruginosa infection identification were from sputum (72.52%) and other secreta (9.91%). The P. aeruginosa infections demonstrated a greater sensitivity to amikacin (AMK, 91.82%), tobramycin (TOB, 82.79%), and gentamycin (GEN, 82.01%); however, P. aeruginosa infection demonstrated greater resistance to ticarcillin (22.57%), levofloxacin (21.63%), and ciprofloxacin (18.00%). Conclusion: The P. aeruginosa infections were commonly observed in the Neurosurgery, Emergency, and Critical Care Medicine departments and demonstrated greater sensitivity to AMK, TOB, and GEN than the other drugs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the epidemiological and clinical characteristics of measles in Jinan, Shandong, China, over a 32-year stage to facilitate measles prevention in the future. Methods: Data on measles cases from 1991 to 2022 were obtained from the public health department and medical records of patients at Shandong Public Health Clinical Center. Retrospective analysis was conducted on the distribution of measles cases in different years, months, and age groups, and observation of the differences in clinical manifestations and complications among different age groups. Results: From January 1991 to December 2022, 7531 measles cases were recorded at Shandong Public Health Clinical Center. During the 32-year period, there were two outbreaks of measles in 2008 and 2016, respectively. During the COVID-19 pandemic period from 2020 to 2022, the number of cases reached the lowest point in the past 30 years. The number and percentage of cases in the 0– 1y groups was significantly higher than in other age groups, and 97.75% patients in this group did not receive measles vaccine. Complications such as pneumonia and myocarditis appeared more frequent in patients under 12 years of age, but liver function damage is more common in adult patients. Conclusion: Although the measles epidemic has been greatly controlled since the use of measles vaccine, intermittent outbreaks still exist, so there is still a long way to go to eliminate measles. The proportion of infants under the age of 1 without measles vaccine and adults over 24 years old accounts for nearly 80% of the total. This group of people should be of concern, and feasible measures should be designated to protect these susceptible populations. [ABSTRACT FROM AUTHOR]

Background: Platelet parameters during pregnancy were associated with the risk of preeclampsia (PE), but the predictive value of these parameters for PE remained unclear. Our aim was to clarify the individual and incremental predictive value of platelet parameters, including platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) for PE. Methods: This study was based on the Born in Guangzhou Cohort Study in China. Data on platelet parameters were extracted from medical records of routine prenatal examinations. Receiver operating characteristic (ROC) curve was performed to analyze the predictive ability of platelet parameters for PE. Maternal characteristic factors proposed by NICE and ACOG were used to develop the base model. Detection rate (DR), integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI) were calculated compared with the base model to assess the incremental predictive value of platelet parameters. Results: A total of 30,401 pregnancies were included in this study, of which 376 (1.24%) were diagnosed with PE. Higher levels of PC and PCT were observed at 12–19 gestational weeks in women who developed PE later. However, no platelet parameters before 20 weeks of gestation reliably distinguished between PE complicated pregnancy and non-PE complicated pregnancy, with all values of the areas under the ROC curves (AUC) below 0.70. The addition of platelet parameters at 16–19 gestational weeks to the base model increased the DR for preterm PE from 22.9 to 31.4% at a fixed false positive rate of 5%, improved the AUC from 0.775 to 0.849 (p = 0.015), and yielded a NRI of 0.793 (p < 0.001), and an IDI of 0.0069 (p = 0.035). Less but significant improvement in prediction performance was also observed for term PE and total PE when all the four platelet parameters were added to the base model. Conclusions: Although no single platelet parameter at the early stage of pregnancy identified PE with high accuracy, the addition of platelet parameters to known independent risk factors could improve the prediction of PE. [ABSTRACT FROM AUTHOR]

Based on the panel data of 30 provinces in China from 2011 to 2019, this paper uses a two-stage DEA model to measure regional innovation efficiency, then non-parametric test is used to examine the impact of innovation network structure and government R&D investment on regional innovation efficiency. The results show that, at the provincial level, innovation efficiency of regional R&D is not necessarily in direct proportion to the innovation efficiency in the commercialization stage. Commercialization efficiency is not necessarily high in provinces with high technical R&D efficiency. At the national level, the innovation efficiency gap between our country's R&D and commercialization stage is small, indicating that the development of the national innovation efficiency is more and more balanced. Innovation network structure can promote the R&D efficiency, but has no significant effect on the commercialization efficiency. Government R&D investment helps to improve the R&D efficiency, but it is not conducive to the improvement of commercialization efficiency. The interaction between innovation network structure and government R&D investment will have compound effects on regional innovation efficiency; the region with underdeveloped innovation network structure can increase the government R&D investment to make it have a higher level of R&D. This paper provides insights into how to improve innovation efficiency in different social networks and policy environments. [ABSTRACT FROM AUTHOR]

Objectives: Weight perceptions have been implicated in weight control related behaviors among children and adolescents, yet studies in mainland China are scarce. We examined the associations of self-perceived weight status and weight misperception with weight control related behaviors in Chinese middle and high school students. Methods: We used cross-sectional data from the 2017 Zhejiang Youth Risk Behavior Survey which that included 17,359 Chinese students, with 8,616 boys and 8,743 girls. Perceived weight status, as well as height, weight and weight control related behaviors information was collected via a self-reported questionnaire. Odds ratios (ORs) with 95% confidence intervals (CIs) calculated by multinomial logistic regression were used to assess the relationships between weight perceptions and weight control related behaviors. Results: Among the 17,359 students aged 9 to 18 years, the mean (SD) age was 15.72 (1.64) years. Overall, 34.19% of children and adolescents perceived themselves as overweight and the prevalence of weight misperception was 45.44%, with 35.54% overestimation and 9.90% underestimation. Children and adolescents perceiving themselves as overweight were more likely to have weight control behaviors, with OR was 2.60 (95% CI: 2.39–2.83) for weight control attempt, 2.48 (2.28–2.70) for exercising, 2.85 (2.60–3.11) for dieting, 2.01 (1.51–2.68) for taking laxatives, 2.09 (1.67–2.02) for taking diet pills, and 2.39 (1.94–2.94) for fasting, respectively, compared to those with right weight status. Among children and adolescents with overestimating weight status, the OR was 2.40 (2.22–2.59), 2.50 (2.31–2.70), 2.85 (2.61–3.11), 1.81 (1.39–2.37), 2.20 (1.77–2.74), and 2.16 (1.77–2.63) for weight control attempt, exercising, dieting, taking laxatives, taking diet pills, and fasting, relative to those with accurate weight perception. Conclusions: Self-perceived overweight and weight misperception are prevalent in Chinese children and adolescents, and positively associated with weight control related behaviors. [ABSTRACT FROM AUTHOR]

The Jehol and Yanliao biotas of northern China, two world‐class Lagerstätten with abundant biomass and biodiversity, provide critical clues to Mesozoic terrestrial ecosystems. Their evolution is a response to the destruction of the North China craton. However, the impetus for the rapid bloom of the biotas remains a mystery. Mesozoic large‐scale volcanic‐sedimentary strata in northern China are rich in terrestrial organisms. Statistical analyses show that volcanic nutrient element delivery, biomass, and biodiversity in these stratigraphic sequences increase synchronously, while harmful elements have the opposite change with them. These observations reveal the coevolutionary relationship between volcanism and terrestrial biotas. The increased nutrient element supply and inhibited harmful element delivery to terrestrial ecosystems from the voluminous volcanic products, produced under the geodynamic regime of paleo‐Pacific subduction and cratonic destruction, could create a conducive environment for the biodiversity and high prosperity of Mesozoic terrestrial biotas. Plain Language Summary: The weathering of volcanic products can quickly provide material supply for ecosystems, including nutrient and harmful elements. The availability of these elements in volcanic‐sedimentary sequences can provide key evidence for the intrinsic relations between volcanism and terrestrial biological evolution. Through statistically‐based big data analyses, we determine the changes in nutrient/harmful element delivery, biomass, and vertebrate and entomic diversity of the Mesozoic fossil‐bearing volcanic‐sedimentary strata in northern China. Excluding the interference of pyroclastic flows on the fossil records, the results reveal the significant contributions of elevated volcanic nutrient supply to the flourishing of the Jehol and Yanliao biotas. Meanwhile, the inhibited release of harmful elements has limited impacts on the biotas. This study opens a new path for multidisciplinary investigations to explore the feedback relationship among regional tectonics, volcanism, and terrestrial biotas. Key Points: Mesozoic terrestrial biotas in northern China coevolved with volcanism during the paleo‐Pacific subduction and cratonic destructionThe increasing supply of volcanic nutrients promoted the flourishing of the Jehol and Yanliao biotasInhibited volcanic toxic delivery facilitated the rapid bloom of the terrestrial biotas [ABSTRACT FROM AUTHOR]

Car use restrictions have been adopted in some mega cities that experience rapid car ownership increase and worsening traffic congestion. Although easy to implement and considered fair, most implementations of this travel demand management policy do not offer travelers the flexibility to choose the days that they cannot use their cars. In this paper, we study a flexible car use restriction policy under which a private car cannot be driven on a certain day of a week, but the day can be chosen by its owner. Under this flexible policy, individuals face a dilemma between driving in congestion and traveling without a car, each incurring a cost of its own. The resulting equilibrium solutions under these two competing choices were derived, and a series of laboratory experiments were carried out to validate the theoretical results. The experimental results are found to be in agreement with the theoretical results. Moreover, our analysis shows that the flexible car use restriction policy reduces the average travel cost with a lesser increase in average driving cost when compared with the traditional car use restriction policy. Funding: Z.-Y. Gao was supported by the National Natural Science Foundation of China [Grant 71621001]. W.-X. Wang was supported by the National Natural Science Foundation of China [Grant 71631002]. R. Jiang was supported by the National Natural Science Foundation of China [Grant 71931002]. X.-Y. Sun was supported by the National Natural Science Foundation of China [Grant 71961002]. B.-Y. Zhang was supported by the National Natural Science Foundation of China [Grants 71922004 and 72131003]. X. Han was supported by the National Natural Science Foundation of China [Grant 71801011] and by the China Postdoctoral Science Foundation [Grant 2018M631331]. Supplemental Material: The e-companion is available at https://doi.org/10.1287/trsc.2023.1200. [ABSTRACT FROM AUTHOR]

Background: Community-acquired pneumonia (CAP) is a major public health challenge worldwide. However, the aetiological and disease severity-related pathogens associated with CAP in adults in China are not well established based on the detection of both viral and bacterial agents. Methods: A multicentre, prospective study was conducted involving 10 hospitals located in nine geographical regions in China from 2014 to 2019. Sputum or bronchoalveolar lavage fluid (BALF) samples were collected from each recruited CAP patient. Multiplex real-time PCR and bacteria culture methods were used to detect respiratory pathogens. The association between detected pathogens and CAP severity was evaluated. Results: Among the 3,403 recruited eligible patients, 462 (13.58%) had severe CAP, and the in-hospital mortality rate was 1.94% (66/3,403). At least one pathogen was detected in 2,054 (60.36%) patients, with two or more pathogens were co-detected in 725 patients. The ten major pathogens detected were Mycoplasma pneumoniae (11.05%), Haemophilus influenzae (10.67%), Klebsiella pneumoniae (10.43%), influenza A virus (9.49%), human rhinovirus (9.02%), Streptococcus pneumoniae (7.43%), Staphylococcus aureus (4.50%), adenovirus (2.94%), respiratory syncytial viruses (2.35%), and Legionella pneumophila (1.03%), which accounted for 76.06–92.52% of all positive detection results across sampling sites. Klebsiella pneumoniae (p < 0.001) and influenza viruses (p = 0.005) were more frequently detected in older patients, whereas Mycoplasma pneumoniae was more frequently detected in younger patients (p < 0.001). Infections with Klebsiella pneumoniae, Staphylococcus aureus, influenza viruses and respiratory syncytial viruses were risk factors for severe CAP. Conclusions: The major respiratory pathogens causing CAP in adults in China were different from those in USA and European countries, which were consistent across different geographical regions over study years. Given the detection rate of pathogens and their association with severe CAP, we propose to include the ten major pathogens as priorities for clinical pathogen screening in China. [ABSTRACT FROM AUTHOR]

Many hemiparasites attach to a range of different host species, resulting in complex parasite–host interactions. Comprehensive molecular phylogenies allow the investigation of evolutionary relationships between these host plants. We surveyed the hosts of the laurel dodder (Cassytha filiformis, Lauraceae) in China, representing 184 species from 146 genera, 67 families, and spanning flowering plants, conifers, and ferns, using host phylogenetic relationships to investigate the susceptibility to attack by this hemiparasitic plant among the vascular plants. The process of produced well-formed haustoria by C. filiformis was also observed in detail for six different hosts. Our results show that C. filiformis grows mainly on trees and shrubs from phylogenetically divergent members of the rosid and asterid eudicot clades, often attacking multiple adjacent hosts simultaneously, and forming extensive colonies. However, whether and to what extent transitions between C. filiformis and host plants occur remain unclear. Physiological evidence for the complex parasite–host species interactions need to be studied in the future. [ABSTRACT FROM AUTHOR]

Summary: Buckwheat is an important crop which originated in China and spread widely across Eurasia. However, exactly where in China domestication took place remains controversial. Archaeological and palynological records suggest a longer cultivation history of buckwheat in northern China than in southwestern China, but this conflicts with phylogenetic evidence implicating southwestern China as the centre of origin and diversity of buckwheat.We investigate alternative methodologies for inferring the occurrence of buckwheat cultivation and suggest that relative abundance could provide a reliable measure for distinguishing between wild and cultivated buckwheat in both present‐day and fossil samples.Approximately 12 800‐yr palaeoecological record shows that Fagopyrum pollen occurred only infrequently before the early Holocene. As southwestern China entered the early agricultural period, c. 8000–7000 yr ago, a slight increase in abundance of Fagopyrum pollen was observed. Approximately 4000 yr ago, concurrent with the Pu minority beginning to develop dry‐land agriculture, the abundance of Fagopyrum pollen increased significantly, suggesting the cultivation of this crop. Fagopyrum pollen rose to a maximum value c. 1270 yr ago, suggesting an intensification of agricultural activity.These findings fill a gap in the Fagopyrum pollen record in southwestern China and provide new indications that early cultivation may have occurred in this region. [ABSTRACT FROM AUTHOR]

This study aimed to develop and evaluate a population pharmacokinetic (PPK) combined machine learning approach to predict tacrolimus trough concentrations for Chinese adult liver transplant recipients in the early posttransplant period. Tacrolimus trough concentrations were retrospectively collected from routine monitoring records of liver transplant recipients and divided into the training data set (1287 concentrations in 145 recipients) and the test data set (296 concentrations in 36 recipients). A PPK model was first established using NONMEM. Then a machine learning model of Xgboost was adapted to fit the estimated individual pharmacokinetic parameters obtained from the PPK model with Bayesian forecasting. The performance of the final PPK model and Xgboost model was compared in the test data set. In the final PPK model, tacrolimus daily dose, postoperative days, hematocrit, aspartate aminotransferase, and concomitant voriconazole, were identified to significantly influence the clearance. The postoperative days along with hematocrit significantly influence the volume of distribution. In the Xgboost model, the first 5 predictors for predicting the clearance were concomitant with voriconazole, sex, single nucleotide polymorphisms of CYP3A4*1G and CYP3A5*3 in recipients, and tacrolimus daily dose, for the volume of distribution were postoperative days, age, weight, total bilirubin and graft : recipient weight ratio. In the test data set, the Xgboost model showed the minimum median prediction error of tacrolimus concentrations, less than the PPK model with or without Bayesian forecasting. In conclusion, a PPK combined machine learning approach could improve the prediction of tacrolimus concentrations for Chinese adult liver transplant recipients in the early posttransplant period. [ABSTRACT FROM AUTHOR]

Fungal communities related to invasive plants may change with an elevational gradient, which may affect the performance and invasiveness of invasive plants. Our recent study revealed that root arbuscular mycorrhizal fungi colonization rate of invasive plant Galinsoga quadriradiata decreased with elevation. However, it is unclear whether it is caused by the changes in the fungal community along elevation. To address this issue, we used high-throughput sequencing techniques, functional groupings and linear statistics to examine how fungal communities in the rhizosphere and roots of G. quadriradiata are changed across the elevation in Qinling and Bashan Mountains, China. Our results revealed that species diversity and composition of the rhizosphere and root fungal communities changed along the elevation. The Shannon–Wiener diversity index in the rhizosphere and roots increased and decreased with elevation, respectively. In contrast, the relative abundance of pathotroph in the rhizosphere decreased while it increased in the roots with elevation. These suggest that, when the invasive plant colonizes into high altitudes, it may not suffer from limited rhizosphere fungal symbionts, but rather the ability of the plant to create and maintain these associations decreases. The invader tends to accumulate more pathogenic fungi in the roots, while the dependence on symbiotic fungi is reduced during expansion into higher elevations. These results highlight that the interactions between invasive plants and fungal community substantially change along elevation, and that belowground interactions may be key in our understanding of how invasive plants derive success in stressful, high-elevation environments. [ABSTRACT FROM AUTHOR]

Gentle slopes with large amounts of granite blocks are widespread in granitic areas with warm and humid climate. These blocks pose a potential risk to the existing and planned infrastructure. The instability type and geometry of these blocks will influence their motility and destructive power to some extent. This study aims at creating a classification system that can indicate both the shape and the instability type of these blocks and then developing a block removal scheme. The classification system was constructed based on the mechanical stability analysis of blocks on an inclined surface. This analysis identified key factors affecting stability, including block shape, block weathering roundness, the existing state of a block on a slope, and the friction between the block and the slope. The achieved work allowed the establishment of a direct correlation between block geometry and their instability types. The availability of this classification system was validated by field data and experimental data in the literature. The proposal to remove blocks identified as the toppling types, such as cylindrical-toppling types, cuboid-toppling types, cube-toppling types, was put forward to avoid the uneconomical problem of a complete clearance. Meanwhile, this classification provides a foundation for further research on the instability probability of each type of block and the development of a more refined blocks' removal scheme. The classification approach adopted in this paper can provide a reference for the classification of other lithological blocks under similar engineering geological conditions. [ABSTRACT FROM AUTHOR]

Objective: The consequences and impact of violent behavior in schizophrenia are often serious, and identification of risk factors is of great importance to achieve early identification and effective management. Methods: This follow-up study sampled adult patients with schizophrenia in primary mental health care in a rural area of southern China, in which 491 participants completed a comprehensive questionnaire at baseline and the 2-year follow-up. Sociodemographic, clinical and psychological assessment data were collected from all participants. Paired sample T-Tests and the McNemar Test were performed to examine changes over the follow-up period. Generalized Estimating Equations (GEE) were used to analyze the risk factors for violent behavior. Results: The results showed that about two in five community-dwelling patients with schizophrenia reported violent behavior in the past year. At follow-up, participants were significantly less employed, had more times of hospitalization, more psychotropic medication, and severer depressive symptoms, but had better health-related quality of life than at baseline. Use of clozapine and better insight into medication decreased the possibility of violent behavior, while more severe positive symptoms, insomnia, as well as use of second-generation antipsychotics other than clozapine, antidepressants and mood stabilizers increased the possibility of violent behavior. Conclusions: Risk evaluation, prevention and management of violence in patients with schizophrenia are demanded in primary mental health care. [ABSTRACT FROM AUTHOR]

Purpose: Rock desertification is the most serious ecological problem in karst areas and can easily cause soil structure instability. The aim of this work was to analyze the influences of organic carbon, carbon components and pore structural differences on the stability of aggregates in rocky desertification areas. Materials and methods: Soil samples were collected from the karst peak-cluster depression area in Southwest China. Soil aggregate stability was determined by the Le Bissonnais (LB) method. The relationship between variables was analyzed via the structural equation model (SEM). Results and discussion: There were significant differences in the stability of aggregates among different land uses in the study area: secondary forest (SF) > coppice forest (CF) > plantation forest (PF) > citrus plantation (CP) > cultivated land (CL). The main crushing mechanisms of aggregates were slaking and mechanical failure. Aggregate pores were mainly < 30 μm storage pores, with pore throat diameters concentrated in the 0–20 μm range, which was associated with the cohesive soil texture of the study area. The pore connectivity of aggregates was better in SF and CF, followed by PF, while CP and CL had lower colloidal material contents, isolated pore structure and poor connectivity due to the heavy application of inorganic fertilizers and influences from human disturbances. Conclusions: SEM analysis showed that SOC and POC determined aggregate stability, mainly by directly or indirectly influencing aggregate porosity and the number of storage pores. The POC was the main variable in organic carbon composition to determine the pore characteristics and stability of aggregates. To meet the bidirectional demand of production and improvement of soil structure, it is necessary to rationally distribute fertilizer and reduce disturbance frequency in agricultural production land. [ABSTRACT FROM AUTHOR]

Background: Plasmablastic lymphoma (PBL) is a rare but aggressive B-cell lymphoma subtype with poor prognosis. Knowledge about the etiology, clinicopathologic and molecular features, and outcomes of PBL is limited. This study aimed to examine the clinicopathologic characteristics, therapeutic approaches, and clinical outcomes of PBL patients in a Chinese population. Methods: A total of 102 PBL patients were recruited from three cancer centers. The pathologic features and clinical outcomes of 56 patients with available treatment details and follow-up data were reviewed and analyzed. RNA sequencing was performed in 6 PBL and 11 diffuse large B-cell lymphoma (DLBCL) patients. Results: Most patients in our cohort were male (n = 36, 64.3%), and 35 patients presented with Ann Arbor stage I/II disease at diagnosis. All these patients showed negative findings for human immunodeficiency virus, and the vast majority of patients in our cohort were immunocompetent. Lymph nodes (n = 13, 23.2%) and gastrointestinal tract (n = 10, 17.9%) were the most commonly involved site at presentation. Post-treatment complete remission (CR) was the only prognostic factor affecting overall survival (OS) and progression-free survival (PFS) in the multivariate analysis. RNA-seq demonstrated that B-cell receptor (BCR), T-cell receptor (TCR), P53, calcium signaling, and Wnt signaling pathways were significantly downregulated in PBLs compared with GCB (or non-GCB) DLBCLs. Conclusions: In this multicenter study in the Chinese population, PBL mainly occurred in immunocompetent individuals and most patients present with early-stage disease at diagnosis. Post-treatment CR was an important prognostic factor affecting OS and PFS. RNA-seq showed that the B-cell receptor (BCR), P53, calcium signaling, cell adhesion molecules, and Wnt signaling pathways significantly differed between PBL and GCB (or non-GCB) DLBCL, which provided theoretical basis for its pathogenesis and future treatment. [ABSTRACT FROM AUTHOR]

The thrombopoietin mimetic peptide for injection is a second-generation thrombopoietin receptor agonist (TPO-RA) used in the treatment of patients with immune thrombocytopenia. The aim of the present study was to assess the safety, tolerance, pharmacokinetic and pharmacodynamic properties of thrombopoietin mimetic peptide for injection in Chinese healthy volunteers. A randomized, placebo-controlled, double-blind, dose-escalation study was conducted in healthy Chinese subjects aged 18–50 years. Thirty subjects received single subcutaneous injection of 0.3 μg/kg, 1.0 μg/kg, 2.0 μg/kg thrombopoietin mimetic peptide or placebo. Thrombopoietin mimetic peptide was safe and well tolerated at doses of 0.3–2.0 μg/kg. There was no significant change in mean platelet count (PLT) from baseline at the 0.3 μg/kg or placebo groups. The mean PLT of subjects in the 1.0 μg/kg and 2.0 μg/kg groups peaked at day 12 (± 1), began to decline around day 17, and returned to the baseline level at day 28 (± 1). Platelet aggregation rates of the three dose groups showed no significant change before and after administration. Serum concentrations of thrombopoietin mimetic peptide in all subjects were below the quantization limit. This was the first study to demonstrate that subcutaneous injection of thrombopoietin mimetic peptide at doses of 0.3–2.0 μg/kg was safe and well tolerated in Chinese healthy subjects. As a second-generation TPO-RA, thrombopoietin mimetic peptide is effective at improving PLT after single subcutaneous injection at dose of ≥1 μg/kg. P lain l anguage s ummary What is the context? ● Immune thrombocytopenia (ITP) is a rare, serious autoimmune disorder characterized by low platelet count (PLT) without an alternate cause. The treatment goal of ITP is to increase the platelet count to a safe level that can stop active bleeding and reduce the risks of future bleeding. ● Thrombopoietin receptor agonists (TPO-RAs, e.g. eltrombopag, avatrombopag, hetrombopag, and romiplostim) have shown high response rates in stimulating platelet production and reducing the risk of bleeding. TPO-RAs provide ITP patients with well-tolerated, long-term treatment choices. What is new? ● The thrombopoietin mimetic peptide for injection is a new TPO-RAs developed by Shandong Quangang Pharmaceutical Co., Ltd. (China). ● This study showed that thrombopoietin mimetic peptide is effective at improving PLT after a single subcutaneous injection. ● The thrombopoietin mimetic peptide is safe and well-tolerated in Chinese healthy subjects. What is the impact? ● This study provides evidence for the further development potential of the thrombopoietin mimetic peptide. [ABSTRACT FROM AUTHOR]

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Highly penetrant copy number variants (CNVs) and genes related to the etiology of TOF likely exist with differences among populations. We aimed to identify CNV contributions to sporadic TOF cases in Han Chinese. Genomic DNA was extracted from peripheral blood in 605 subjects (303 sporadic TOF and 302 unaffected Han Chinese [Control] from cardiac centers in China) and analyzed by genome‐wide association study (GWAS). The GWAS results were compared with existing Database of Genetic Variants. These CNVs were further validated by qPCR. Bioinformatics analyses were performed with protein–protein interaction (PPI) network and KEGG pathway enrichment. Across all chromosomes 119 novel "TOF‐specific CNVs" were identified with prevalence of CNVs of 21.5% in chromosomes 1‐20 and 37.0% including Chr21/22. In chromosomes 1‐20, CNVs on 11q25 (encompasses genes ACAD8, B3GAT1, GLB1L2, GLB1L3, IGSF9B, JAM3, LOC100128239, LOC283177, MIR4697, MIR4697HG, NCAPD3, OPCML, SPATA19, THYN1, and VPS26B) and 14q32.33 (encompasses genes THYN1, OPCML, and NCAPD3) encompass genes most likely to be associated with TOF. Specific CNVs found on the chromosome 21 (6.3%) and 22(11.9%) were also identified in details. PPI network analysis identified the genes covering the specific CNVs related to TOF and the signaling pathways. This study for first time identified novel TOF‐specific CNVs in the Han Chinese with higher frequency than in Caucasians and with 11q25 and 14q32.33 not reported in TOF of Caucasians. These novel CNVs identify new candidate genes for TOF and provide new insights into genetic basis of TOF. [ABSTRACT FROM AUTHOR]