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The northern margin of the North China Craton (NNCC) hosts Mesozoic gold deposits of significant economic importance. The metal sources of these gold systems have long been debated with mainly magmatic‐hydrothermal versus metamorphic fluid models. Mercury (Hg) isotopes, which undergo unique mass‐independent fractionation, can provide important insights into the source of metals in gold deposits due to the close association between Hg and Au in such systems. Here, we investigated the Hg isotopic composition of six gold deposits of the Middle Jurassic to Early Cretaceous age and potential source rocks in the NNCC. Variable ∆199Hg values were observed in bulk ore and pyrite samples (−0.28‰ to 0.34‰, n = 51) and coeval granites (−0.21‰ to 0.13‰; n = 25). The negative ∆199Hg values of bulk ore and pyrite samples mostly agree with that observed for metamorphic basement rocks (−0.37‰ to 0.11‰; n = 32). The positive ∆199Hg values of bulk ore and pyrite samples agree with those reported in marine sediments (0‰–0.3‰). So the data suggest binary mixing of ocean‐recycled Hg originated from the subducted oceanic slab, and terrestrial‐recycled Hg from the Precambrian basement in Mesozoic gold deposits. The contribution of Hg (and Au, by analogy) from both reservoirs varies depending on active continental arc versus intracontinental setting and is ultimately controlled by translithospheric heat flow driven by paleo‐Pacific plate subduction. Plain Language Summary: Photoreduction of Hg(II) on Earth's surface system leads to mass‐independent fractionation of Hg isotopes, resulting in positive and negative Δ199Hg values in marine and terrestrial systems, respectively. Here, we observe negative to positive Δ199Hg values in the Mesozoic gold deposits in the northern margin of the North China Craton. These results suggest binary mixing of ocean‐recycled Hg from the fluids released by subducting oceanic slab or the mantle metasomatized by these fluids, and terrestrial‐recycled Hg from the Precambrian basement in Mesozoic gold deposits. Paleo‐Pacific plate subduction and translithospheric heat flow may have played a key role in the metallogenic metal enrichment of the Mesozoic gold deposits in the northern margin of the North China Craton. Key Points: Mass‐independent fraction of Hg isotopes is observed in Mesozoic gold deposits in the northern margin of the North China CratonPositive Δ199Hg values in Mesozoic gold deposits suggest Hg was sourced from lithospheric mantle modified by oceanic subductionNegative Δ199Hg values in Mesozoic gold deposits suggest that Hg was sourced from the Precambrian basement [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the effect of dapagliflozin (DAPA) on the rate of heart failure rehospitalization in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM). Methods: AMI patients with T2DM from CZ-AMI registry between January 2017 and January 2021 were enrolled in this study. Patients were stratified into DAPA users and non-DAPA users. The primary outcome was the incidence of heart failure rehospitalization. Kaplan–Meier analysis and Cox regressions were performed to evaluate the prognostic significance of DAPA. Propensity score matching (PSM) was performed to minimize the bias of confounding factors and facilitate the comparability between groups. The enrolled patients were matched with a propensity score of 1:1. Results: A total of 961 patients were included, and 132 (13.74%) heart failure rehospitalizations occurred during a median follow-up of 540 days. In the Kaplan–Meier analysis, DAPA users had a statistically significantly lower rate of heart failure rehospitalization than non-DAPA users (p < 0.0001). Multivariate Cox analysis showed that DAPA was an independent protective factor for heart failure rehospitalization risk after discharge (HR = 0.498, 95% CI = 0.296 ~ 0.831, p = 0.001). After 1:1 propensity score matching, survival analysis showed a lower cumulative risk of heart failure rehospitalization in DAPA users than in non-DAPA users (p = 0.0007). In-hospital and continued use of DAPA remained significantly associated with a reduced risk of heart failure rehospitalization (HR = 0.417, 95% CI = 0.417 ~ 0.838, p = 0.001). Results were consistent across sensitivity and subgroup analyses. Conclusion: In patients with diabetic AMI, in-hospital and continued use of DAPA after discharge were associated with a significant lower risk of heart failure rehospitalization. [ABSTRACT FROM AUTHOR]

Background: To explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years.Methods: A retrospective cohort study was performed. A total of 407 consecutive patients who were admitted with infective endocarditis were included. The clinical characteristics and the risk factors related to the prognosis of infective endocarditis during this period were analyzed.Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ± 16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 11.3%. Among patients with underlying heart disease, congenital heart disease was the most common (25.8%), followed by rheumatic heart disease (17.0%) which showed a decreased trend during this period (P < 0.001). There were 222(54.5%) patients with positive blood cultures results and Streptococci (24.6%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 235 patients (57.7%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P < 0.001, OR = 28.594, 95% CI 5.561-148.173) and vegetation length>30 mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality.Conclusions: There were no significant changes in the overall incidence of infective endocarditis, but the clinical features of infective endocarditis had slightly changed during the past ten years. Streptococci infective endocarditis was still the predominant. Patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length>30 mm had an worse in-hospital outcome. [ABSTRACT FROM AUTHOR]

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a major problem among nosocomial infections, and it is a serious threat to patients. The clinical characteristics and outcome of CRKP bloodstream infection (BSI) in nontransplant patients remains unelucidated. The aim of this study was as follows: identify the risk factors of CRKP infection; generate new ideas for prevention; and generate new ideas for the most effective therapeutic management in nontransplant patients.Methods: The study retrospectively analyzed the clinical and microbiological data of nontransplant patients with K pneumoniae (KP) bacteremia from January 2013 to December 2015 to identify risk factors, clinical features, and outcomes using multivariate logistic regression analysis.Results: Of the 371 patients with KP-BSI in nontransplant patients included in this study, 28.0% (N = 104) had CRKP. The 28-day mortality was higher in patients infected with CRKP (55.8%) than in those with carbapenem-susceptible KP (13.9%) (P < .001). Multivariate analysis showed previous gastric catheterization, previous use of carbapenems, hypoproteinemia, and high Acute Physiologic Assessment and Chronic Health Evaluation II scores as independent risk factors for CRKP-BSIs. Carbapenem-resistant KP infection, severe illness, and tigecycline therapy were independent risk factors for death from KP-BSIs. Taken together, inappropriate antibiotic treatment both in empirical and definitive therapy and imipenem minimum inhibitory concentrations (MICs) of >8 mg/L were associated with poor clinical outcome.Conclusions: Nontransplant patients with CRKP-BSI had higher mortality. Carbapenems exposure was an independent risk factor for CRKP infection. Imipenem MICs of >8 mg/L, tigecycline therapy, and inappropriate treatments increased the 28-day mortality of KP-BSI patients. [ABSTRACT FROM AUTHOR]

We aimed to clarify the epidemiologic and clinical importance of evolutionary events that occurred in carbapenem-resistant Klebsiella pneumoniae (CRKP). We collected 203 CRKP causing bloodstream infections in a tertiary hospital in China during 2013-2017. We detected a subclonal shift in the dominant clone sequence type (ST) 11 CRKP in which the previously prevalent capsular loci (KL) 47 had been replaced by KL64 since 2016. Patients infected with ST11-KL64 CRKP had a significantly higher 30-day mortality rate than other CRKP-infected patients. Enhanced virulence was further evidenced by phenotypic tests. Phylogenetic reconstruction demonstrated that ST11-KL64 is derived from an ST11-KL47-like ancestor through recombination. We identified a pLVPK-like virulence plasmid carrying rmpA and peg-344 in ST11-KL64 exclusively from 2016 onward. The pLVPK-like-positive ST11-KL64 isolates exhibited enhanced environmental survival. Retrospective screening of a national collection identified ST11-KL64 in multiple regions. Targeted surveillance of this high-risk CRKP clone is urgently needed. [ABSTRACT FROM AUTHOR]

Exploring species and their functional diversity is of fundamental importance in biology and ecology. Many earthworm species comprise a wide range of genetic lineages/cryptic species, but it remains unclear whether these lineages/cryptic species represent distinct ecological entities that differ in traits. We barcoded 280 individuals of the earthworm species Eisenia nordenskioldi from 42 forest plots across seven elevations (800–1700 m) on Changbai Mountain, northeast China, and found them to comprise two genetic lineages with a p-distance in the COI gene of 16.7%. We evaluated whether the two distinct lineages differ in morphological (body length, body with, body mass and length:width ratio) and stoichiometric traits (C, N and P concentrations and C:N, C:P and N:P ratios), and whether these traits vary with elevation. At elevations where lineages co-existed, we further evaluated their ecological niche overlap. When co-existing, the two lineages of E. nordenskioldi significantly differed in body length, body mass, length:width ratio, and C and N concentrations as well as C:N and N:P ratios. With increasing elevation, body length, body mass and the length:width ratio of the two lineages linearly increased, whereas body width and C:N ratio linearly decreased; while C and N concentrations as well as C:P and N:P ratios showed a hump-shaped relationship with elevation. Across elevations trait distribution overlapped by 29%–100%, but the overlap in body mass, body length and length:width ratio decreased to 0%–15% when the two lineages co-existed. The significant differences in multiple traits indicate that the two lineages have different physiologies, supporting their status as cryptic species. The documented variations in morphological and stoichiometric traits of the two lineages/cryptic species call for integration of genetics and ecology for understanding biodiversity and ecological functioning of soil animal species. [Display omitted] • DNA barcoding identified two cryptic species in earthworm Eisenia nordenskioldi. • These two cryptic species differ in three morphological and five stoichiometric traits. • Body mass of both cryptic species were negatively correlated with elevation. • Overlap of morphological and stoichiometric traits changed with elevation and depended on body mass and length. [ABSTRACT FROM AUTHOR]

Purpose: Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bacteria causes nosocomial infections worldwide. However, KPC-producing K. pneumoniae outbreak has never been reported in Shandong Province, China. The purpose of our study was to elucidate the epidemiological and drug resistance mechanisms of KPC-producing K. pneumoniae strains collected from a large teaching hospital in Shandong during the outbreak. Moreover, we attempted to characterize the genetic environment and phylogenetic analysis of blaKPC-2 in outbreak isolates. Methods: We monitored a 64-day outbreak of infection in a general hospital in Shandong Province, and the bacteria causing the infection were all ST11-type K. pneumoniae. The genotype correlation of KPC-producing K. pneumoniae isolates was assessed by whole-genome sequencing (WGS) phylogenetic analysis. Subsequent studies included antibiotic susceptibility testing, multilocus sequence typing (MLST) and S1-pulsed-field gel electrophoresis (S1-PFGE), Southern blot hybridization. Results: From February 1, 2018 to April 5, 2018, 14 KPC-producing K. pneumoniae isolates from different wards were collected. All 14 isolates were resistant to carbapenems and carried the extended-spectrum β-lactamase (ESBL) gene as well as fosA, and sul genes. Whole-genome analysis showed that all 14 the outbreak isolates were all ST11 type. The blaKPC-2 carrying plasmids were all belong to IncFIIK2 type, and the size ranged from 94 kb to 368 kb. Conclusion: As far as we know, this report first describes the genomics characterization of KPC-2-producing K. pneumoniae outbreak isolates from Shandong Province, China. In our study, these isolates appeared to be cloned, and ST11 K. pneumoniae was the major clone caused the outbreak. Therefore, routine surveillance of such strains in this region is urgently warranted. [ABSTRACT FROM AUTHOR]

Recently, a number of single nucleotide polymorphisms (SNPs) were identified to be associated with late-onset Alzheimer disease (LOAD) through genome-wide association study data. Identification of SNP-SNP interaction played an important role in better understanding genetic basis of LOAD. In this study, fifty-eight SNPs were screened in a cohort of 229 LOAD cases and 318 controls from mainland China, and their interaction was evaluated by a series of analysis methods. Seven risk SNPs and six protective SNPs were identified to be associated with LOAD. Risk SNPs included rs9331888 (CLU), rs6691117 (CR1), rs4938933 (MS4A), rs9349407 (CD2AP), rs1160985 (TOMM40), rs4945261 (GAB2) and rs5984894 (PCDH11X); Protective SNPs consisted of rs744373 (BIN1), rs1562990 (MS4A), rs597668 (EXOC3L2), rs9271192 (HLA-DRB5/DRB1), rs157581 and rs11556505 (TOMM40). Among positive SNPs presented above, we found the interaction between rs4938933 (risk) and rs1562990 (protective) in MS4A weakened their each effect for LOAD; for three significant SNPs in TOMM40, their cumulative interaction induced the two protective SNPs effects lost and made the risk SNP effect aggravate for LOAD. Finally, we found rs6656401-rs3865444 (CR1-CD33) pairs were significantly associated with decreasing LOAD risk, while rs28834970-rs6656401 (PTK2B-CR1), and rs28834970-rs6656401 (PTK2B-CD33) were associated with increasing LOAD risk. In a word, our study indicates that SNP-SNP interaction existed in the same gene or cross different genes, which could weaken or aggravate their initial single effects for LOAD. [ABSTRACT FROM AUTHOR]

Background: Infective endocarditis (IE) especially in the elderly is a serious disease, with a worse prognosis.Methods: A retrospective cohort study was conducted. A total of 405 patients with definite IE were divided into three groups: 205 patients under 50 years old, 141 patients between 50 and 64 years old and 59 patients over 65 years old.Results: For older patients, clinical symptoms such as fever, anemia, and heart murmur were as common as the younger patients. IE in old patients had more frequent nosocomial origin (P = 0.007) and tended to be more frequent with bad oral hygiene (p = 0.008). The most frequent isolated pathogens in the old groups was streptococci and coagulase-negative staphylococci. The old patients had a lower operation rate (40.7% vs 58.9% vs 62.4%, P = 0.012) and higher in-hospital mortality (20.3% vs 10.6% vs 8.8%, P = 0.044) compared with the younger patients. Surgical treatment was a significant predictor of one-year mortality even after adjusting for the confounders (HR = 2.45, 95% CI 1.027-10.598, P = 0.009). The one-year survival rate was higher for older patients with surgical intervention than those without (95.8% vs 68.6%, P = 0.007).Conclusions: Older patients with IE presented with more comorbidities, bad oral hygiene, more nosocomial origin and a more severe prognosis than younger patients. Streptococci was the most frequent micro-organisms in this group. Surgery were underused in old patients and those with surgical treatment had better prognosis. [ABSTRACT FROM AUTHOR]

Mercury isotopes display both mass-dependent and mass-independent fractionation and allow the tracing of pathways and storage of surface-derived Hg in the lithosphere. While the subduction-related orogenic recycling of Hg from marine reservoirs into hydrothermal systems in continental arc settings has been documented recently, the source of Hg in intracontinental hydrothermal systems remains unclear. We measured Hg isotopes in two intracontinental anorogenic/postorogenic Late Mesozoic hydrothermal gold deposits in the South China craton and the Central Asian orogenic belt of northern China, respectively. The ore and sulfide samples from the studied systems have positive δ 202 Hg (0.70 ± 0.39‰, 1SD, n = 49) and negative Δ 199 Hg values (−0.12 ± 0.05‰, 1SD, n = 49). These values are different from their country rocks and regional geological environment (volcanic arc granites, marine sedimentary rocks) which have positive Δ 199 Hg values, but similar to that of their Precambrian supracrustal basement rocks of largely non-marine continental materials. We conclude that Hg in the intracontinental hydrothermal systems was leached from basement rocks by upper crustal basinal fluid circulation driven by regional heat flow, likely due to lithospheric thinning and upwelling of the asthenosphere in the Late Mesozoic. The intracontinental hydrothermal systems and their continental sources with positive δ 202 Hg and negative Δ 199 Hg values are complementary to volcanic-arc and marine sedimentary rocks with opposite δ 202 Hg - Δ 199 Hg compositions. The distinct Hg isotopic features of hydrothermal systems in different tectonic settings, in particular the indelible Δ 199 Hg signature, allow the tracing of large-scale material cycling in the Earth. • Hydrothermal systems in arc and intracontinental settings show opposite Δ 199 Hg. • Intracontinental systems have negative Δ 199 Hg reflecting a terrestrial Hg source. • Mercury isotope can be a tracer of Hg cycling in hydrothermal systems. [ABSTRACT FROM AUTHOR]

Sewage sludge is considered to be an important sink for polycyclic aromatic hydrocarbons (PAHs) in wastewater treatment plants and the potential risks from sludge contaminated with PAHs during land application has attracted attention. To identify the priority PAHs for control and enhance their removal from sludge, the occurrence characteristics, removal efficiency, and risk assessment of PAHs in sewage sludges from across China were analyzed. Data collection was from 2001 to 2023. Results showed that 16 PAHs were widely detected in Chinese sewage sludge with total amounts (∑16PAHs) between 0.06 and 34.93 mg kg dw−1. Fossil fuel, coal, and biomass combustion are main anthropogenic sources of PAHs in China. In general, phenanthrene (PHE), anthracene (ANT), fluorescein (FL), chrysene (CHR), pyrene (PYR), and benzo[b]fluoranthene (BbF) are regarded as the main components and PAHs with 3–5 rings dominate (84.01%–91.53%) sewage sludge in China. Although aerobic composting and anaerobic treatment significantly improve ∑16PAHs removal, sludge stabilization treatment only reduced the risk by a small amount, especially for high-molecular-weight (HMW) PAHs. The benzo[a]anthracene (BaA), benzo[a]pyrene (BaP), and dibenzo[a,h]anthracene (DahA) are proposed as the priority control contaminants for sewage sludge in China because they have consistently high-risk quotient (RQ) values of 2.42–7.47, 1.28–3.16, 1.06–1.83 before and after sludge stabilization, respectively. More attention should be paid to BaA, BbF, benzo[k]fluoranthene (BkF), BaP, DahA, and indeno[1,2,3-cd]pyrene (IcdP) in Beijing; ANT, BaA, and BaP in Shanghai; and BaA and BaP in Guanghzou. Although the toxic equivalent quotient (TEQ) for PAHs met the limit concentration requirements of the national standard, the potential health risks due to long-term exposure to HMW PAHs cannot be ignored because the incremental lifetime cancer risk (ILCR) was consistently in the risk threshold range (>1 × 10−6). Some suggestions on enhanced treatment approaches and land use standards are proposed to further alleviate the risk from HMW PAHs. [Display omitted] • PHE, ANT, FL, CHR, PYR and BbF are main PAHs in sewage sludges from across China. • Digestion and composting respectively removed 40.56% and 65.76% ∑16PAHs from sludge. • Digestion and composting are limited in reducing risk level of HMW PAHs. • The ecological risks and health risks are mainly caused by HMW PAHs. • BaA, BaP and DahA are proposed for priority control in sewage sludges. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to explore the association between triglycerides (TGs) and the risk of atrial fibrillation (AF) recurrence., Methods and Results: Included were adult patients with AF who underwent radiofrequency catheter ablation in the Affiliated Changzhou Second People's Hospital of Nanjing Medical University. The enrolled patients were divided into the AF recurrence group and the sinus rhythm (SR) maintenance group. The univariate Cox regression analysis and Kaplan-Meier survival curve were performed estimate the association between TG and the risk of AF recurrence. Of the 402 patients, 79 (19.7%) experienced recurrence of AF after ablation. The TG level was significantly higher in the AF recurrence group than in the SR-maintaining group. Patients were grouped by quartile of TG levels, with Quartile 1 and Quartile 2 defined as the low concentration group, Quartile 3 as the moderate concentration group, and Quartile 4 as the high concentration group. Multivariate Cox regression analysis showed that the moderate concentration group (p = .02, hazard ratio [HR]: 2.331, 95% confidence interval [CI]: 1.141-4.762) and high concentration group (p = .007, HR: 2.873, 95% CI: 1.332-6.199) were associated with an increased risk of AF recurrence compared with the low concentration group. The median follow-up was 1.17 years, it is indicated that a higher risk of recurrent AF was observed in the moderate concentration and high concentration group (log-rank: χ 2  = 7.540, p = .023)., Conclusion: Our data suggest that an elevated TG level measured before catheter ablation is associated with an increased risk of AF recurrence., (© 2024 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.)

Desmin (DES) is an important intermediate filament protein associated with the extrasarcomeric cytoskeleton and cellular function that was first reported to be associated with cardiac conduction disease and cardiomyopathy in 1998. We generated an induced pluripotent stem cell (iPSC) line from the left bundle branch block (LBBB) patient's peripheral blood mononuclear cells using Sendai virus-mediated reprogramming. The iPSCs exhibited stable amplification, expressed pluripotent markers, and spontaneously differentiated into three layers in vitro. Additionally, it showed a normal diploid karyotype and maintained the pathogenic mutation in DES. Hence, the iPSC line provided a platform for exploring LBBB mechanisms associated with DES mutations., 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 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Inhibition of fatty acid synthase (FAS) plays a crucial protective role in pulmonary hypertension (PH). Our aim was to identify novel metabolites in mice with hypoxia-induced PH after treatment with C75 (FAS inhibitor) and to confirm the presence of these metabolites in paediatric patients with PH., Methods: The PH mouse model was built by chronic hypoxia and ovalbumin (OVA) assistance. Untargeted metabolomics was used to analyse mouse serum. Six children with PH and six relative controls (patients without lung and heart disease) were selected in Shanghai Children's Hospital and they all performed blood tandem mass spectrometry during hospitalization., Results: First, a total of 29 differential metabolites, including lipid metabolites, polyamine, and glutamine were identified as differential metabolites in the hypoxia group compared with the control group. After C75 treatment, symptoms were partially relieved in the PH mouse, and 15 differential metabolites, including lipid metabolites, polyamine, and glutamine were identified in the hypoxia + C75 group compared with the hypoxia group. These differential metabolites were enriched in arginine and glycerolipid metabolism through metabolite set enrichment analyses and were involved in excessive cell proliferation, which was a characteristic of PH. Second, glutamine and caproyl carnitine levels were increased in paediatric patients with PH., Conclusions: FAS may be a potential PH therapeutic target. Lipid metabolites, polyamine, and glutamine, are closely related to PH. Putrescine and glutamine might be biomarkers for PH., Competing Interests: The authors declare no conflict of interest., (© 2023 The Author(s). Published by IMR Press.)

Introduction: This study investigated the status of knowledge on hepatitis B among the residents in Qingdao and provided a reference for improving relevant public awareness strategies., Methodology: This cross-sectional study was conducted by an online questionnaire on the WeChat platform. Chi-square test was used to compare the hepatitis B influencing factors between subgroups. Binary logistic regression was used for multiple factor analysis to explore the influencing factors., Results: The total awareness rate of hepatitis B was 79.6% among the 3261 qualified online questionnaires. Logistic regression showed that females (OR = 1.843, 95% CI: 1.547- 2.196), aged between 51 and 60 (OR = 2.323, 95% CI: 1.409-3.829), married (OR = 1.699, 95% CI: 1.335-2.162), and worked in government-affiliated departments were the influencing factors for the knowledge about hepatitis B., Conclusions: The residents of Qingdao had incomplete knowledge about hepatitis B. Females, aged between 51 and 60, married, and those who worked in government-affiliated departments were found to have higher awareness rate than other subgroups. The government and related departments should pay more attention in educating the sub-groups that lack hepatitis B knowledge., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2023 Wenliang Fei, Tingting Xiao, Xiaofan Li, Feng Yang.)

Objective: The aim of this study was to examine the influencing pathways of the neighborhood built environment on children's outdoor leisure activities and obesity., Methods: A total of 378 elementary school students from 10 schools in central Shanghai were selected by a convenient sampling method for questionnaire survey and accelerometer tracking., Results: 1) The neighborhood built environment could affect children's obesity not only through direct effect ( β = 0.15, p < 0.05), but also through the mediating effect of outdoor leisure activities ( β = 0.19, p < 0.05). 2) For boys, the neighborhood built environment could affect children's obesity not only through direct effect ( β = 0.17, p < 0.05), but also through the mediating effect of outdoor leisure activities ( β = 0.26, p < 0.05). For girls, the neighborhood built environment could affect children's obesity only through the mediating effect of outdoor leisure activities ( β = 0.13, p < 0.05)., Conclusion: The neighborhood built environment and outdoor leisure activities are important influencing factors in children's obesity. The neighborhood built environment and outdoor leisure activities could have direct and indirect effects on children's obesity, while there are gender differences in the influencing pathways of the neighborhood built environment on children's obesity. This study suggests that improving the neighborhood built environment and promoting outdoor leisure activities in children have important value for influencing children's obesity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tan, Lu and Xiao.)

TECRL, first reported in a Sudanese family with catecholaminergic polymorphic ventricular tachycardia (CPVT) in 2016. TECRL, is an endoplasmic reticulum (ER) protein preferentially expressed in the heart, playing a role in cardiomyocyte calcium homeostasis. Using Sendaivirus-mediated reprogramming, we generated an induced pluripotent stem cell (iPSC) line from the CPVT patient's peripheral blood mononuclear cell. The iPSC exhibited stable amplification, expressed pluripotent markers, and differentiated spontaneously into three layers in vitro. Additionally, the iPSC line maintained a normal karyotype, retained the pathogenic TECRL mutation, and the cell resource facilitated a platform to explore the CPVT mechanisms related to TECRL mutations., (Copyright © 2022. Published by Elsevier B.V.)

To evaluate whether two-dose of varicella vaccine would provide a better protection to children from varicella than one-dose, we conducted a 1:3 matched case-control study in children in Qingdao, China. A total of 509 varicella cases aged 6-11 y were collected from the China Information System for Disease Control and Prevention (CISDCP). And 1,527 controls, who did not suffer from varicella, were selected and matched with cases by age and class. The varicella vaccine effectiveness (VE) and corresponding 95% confidence interval (95% CI) were calculated. The vaccination coverage rate of one-dose varicella vaccine in the cases was 52.9%, while for the controls was 59.1%. And the two-dose vaccination rate in the cases and controls were 4.3% and 14.5%, respectively. A statistically significant difference was found in the immunization history between the cases and controls ( P < .001).The overall varicella VE was 56.1% (95% CI: 45.0%-64.9%), and the VE of two-dose vaccination (81.6%, 95% CI: 70.5%-88.4%) was substantially higher than that of one-dose vaccination (44.7%, 95% CI: 31.6%-55.4%). For less than 2 y, 2-4 y, 4-6 y, and more than 6 y after only one-dose vaccination, the varicella VE were 96.6% (95% CI: 75.0%-99.5%), 81.2% (95% CI: 55.6%-92.0%), 60.8% (95% CI: 46.8%-70.2%), and 18.0% (95% CI: 4.3%-35.6%), respectively. The varicella VE gradually decreased over time (P for trend < 0.001). It is recommended that the coverage of varicella vaccine should be increased and two-dose of varicella vaccine should be included in the National Immunization Program of China.

Clostridioides difficile is the most common pathogen causing antibiotic-associated diarrhea. Previous studies showed that diverse sources, aside from C. difficile infection (CDI) patients, played a major role in C. difficile hospital transmission. This study aimed to investigate relationships and transmission potential of C. difficile strains from different sources. A prospective study was conducted both in the intensive care unit (ICU) and six livestock farms in China in 2018-2019. Ninety-eight strains from CDI patients (10 isolates), asymptomatic hospitalized carriers (55), the ICU environment (12), animals (14), soil (4), and farmers (3) were collected. Sequence type (ST) 3/ribotype (RT) 001, ST35/RT046, and ST48/RT596 were dominant types, distributed widely in multiple sources. Core-genome single-nucleotide polymorphism (cgSNP) analysis showed that hospital and farm strains shared several common clonal groups (CGs, strains separated by ≤ 2 cgSNPs) (CG4/ST3/RT001, CG7/ST35/RT046, CG11/ST48/RT596). CDI patients, asymptomatic carriers, and the ICU environment strains also shared several common CGs. The number of virulence genes was not statistically different between strains from different sources. Multi-source strains in the same CG carried identical virulence gene sequences, including pathogenicity genes at the pathogenicity locus and adhesion-related genes at S-layer cassette. Resistance genes ( ermB , tetM , etc.) were widespread in multiple sources, and multi-source strains in the same CG had similar resistance phenotypes and carried consistent transposons and plasmid types. The study indicated that interspecies and cross-regional transmission of C. difficile occurs between animals, the environment, and humans. Community-associated strains from both farms and asymptomatic hospitalized carriers were important reservoirs of CDI in hospitals.

Mercury is a global pollutant. The mercury exchanges between vegetation and the atmosphere are important for the global mercury cycle. Grassland ecosystems occupy more than 25% of the global land area and have different succession processes and ecological functions. The current research regarding mercury exchanges between forests and the atmosphere have attracted much attention, but the research regarding grasslands tends to be rare. To reveal the characteristics of mercury exchanges in grasslands, this study conducted field in-situ monitoring experiments in a Leymus meadow grassland regions of the Songnen Plains in northeastern China. The exchange flux values of the GEM (gaseous element mercury) between the plants and the atmosphere were measured using a dynamic flux bag method (DFB). The experiments were conducted for the purpose of assessing the mercury flux levels between the vegetation and the atmosphere in a typical Leymus chinensis meadow. The goal was to further the understanding of the change characteristics and influential factors and to describe the source and sink actions and dynamics between the grassland vegetation and the atmosphere. The diurnal variation characteristics were as follows: High during the day and low at night, with peaks generally appearing at noon. The growing period was characterized by absorption peaks of atmospheric mercury by the plants. The breeding period was characterized by the peak release of atmospheric mercury by the plants. The change characteristics were as follows: During the growing period, the duration of the plants in a mercury absorption state exceeded 96.5%, which was represented as the net sink of the atmospheric mercury. During the breeding period, the time of mercury release ranged between 46.4% and 66.8%, making the breeding period the net source of atmospheric mercury. The results of this study's analysis indicated that each environmental factor was correlated with the mercury flux, and the environmental factors had different effects on the mercury flux during the different stages of plant growth. The atmospheric mercury concentration levels were the main factor during the growing period. Atmospheric humidity was the main factor during the breeding period. Solar radiation was the decisive factor during the entire experimental period.

Objectives: Drug resistance in Pseudomonas aeruginosa (PAE) is a serious health threat. Additionally, it is important to understand the associated socioeconomic burden., Methods: Clinical information and hospital cost data for patients with PAE bloodstream infections (BSIs) in a tertiary teaching hospital (2011-2016) were collected retrospectively to estimate the direct economic burden. Socioeconomic loss incurred by patients was calculated using the human capital approach combined with estimating disability-adjusted life years (DALYs). Differences in socioeconomic burden between BSIs caused by carbapenem-resistant (CR) and carbapenem-susceptible (CS) PAE were compared., Results: This study included data for 220 patients, of which were 29.5% (65/220) CR-PAE BSIs. The median direct economic burden of patients following CR-PAE BSI was significantly higher than following CS-PAE BSI ($5005.94 vs. $1462.86; P < 0.001). The median DALY loss was significantly higher in the CR-PAE group compared with CS-PAE group (0.024 vs. 0.008; P = 0.001). The median indirect socioeconomic loss of patients in the CR-PAE group tended to be significantly higher than in the CS-PAE group ($64.06 vs. $29.71; P = 0.011). The annual economic burden of CR-PAE is higher (up to >1.5 times) than the Chinese annual per capita GDP., Conclusion: The economic burden of PAE BSIs is significant, irrespective of carbapenem resistance. The direct economic burden of CR-PAE BSI was at least three-fold that of CS-PAE BSI. The DALY loss caused by CR-PAE BSI is three-fold that caused by CS-PAE BSI. The indirect socioeconomic loss caused by CR-PAE BSI is more than twice that of CS-PAE BSI., (Copyright © 2021. Published by Elsevier Ltd.)

Floating-harbor syndrome, are mainly caused by heterozygous truncating mutations in SRCAP. To our best knowledge, the mutation (c.452&#95;453del) located in the fifth exon of SRCAP, has not been reported yet. Herein, an induced pluripotent stem cell (iPSC) line was generated from the peripheral blood mononuclear cells of an infant with floating-harbor syndrome accompanied with dilated cardiomyopathy through Sendaivirus-mediated reprogramming. These iPSCs have excellent cellular features, including stable amplification, pluripotent markers expression, and spontaneous differentiation into three germ layers, and a normal karyotype. These iPSCs provide a suitable cell model to study the mechanism of Floating-harbor syndrome., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

CTNNA3, first reported in association with arrhythmogenic right ventricular cardiomyopathy in 2003, is an unique component of both desmosomes and adherens junctions. Using Sendaivirus-mediated reprogramming, we generated an induced pluripotent stem cell (iPSC) line from the peripheral blood mononuclear cells of a child with arrhythmia. The iPSCs exhibited stable amplification, expressed pluripotent markers, and differentiated spontaneously into three germ layers in vitro. Additionally, this iPSC line was found to maintain a normal karyotype and retain the pathogenic mutation in CTNNA3, facilitating a platform to study the disease mechanisms of arrhythmia and dysfunctions related to CTNNA3 mutations., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

This study investigated the willingness of Qingdao residents to receive COVID-19 vaccination in 2020 and any factors that might influence them. All data were collected by telephone questionnaires and were utilized for analyzing the potential factors of willingness to be vaccinated through descriptive analysis and logistic regression analysis. Of the 2,802 respondents, 2,284 (81.5%) said they would agree to receive the vaccine against COVID-19. People who earned high incomes, who carefully followed media news on COVID-19 vaccine, who looked forward to successful vaccine research, and who closely followed vaccine protective efficacy expressed more interest in being vaccinated than other people did. In addition, people who paid attention to protective efficacy of vaccine, vaccine price, and expert opinion were more likely to accept COVID-19 vaccination than people who focused on vaccine safety. When vaccine price was ≥201 RMB, people were less likely to accept vaccination than ≤200 RMB. 1,842 respondents (65.7%) wished that government could provide COVID-19 vaccination for free. This study suggests that the government should increase vaccination compliance by strengthening publicity efforts and decreasing vaccine price.

Long-term exposure to high levels of arsenic has been documented to induce skin and liver damage, affecting hundreds of millions of people. While arsenic-induced skin and liver damage and trace element alterations have been studied, their correlations and risks have not been explained. Based on the above premise, this study included a total of 172 subjects from a coal-burning arsenic poisoning area. The levels of 18 trace elements in hair and six liver function indices in serum were detected, and the associations between and risks of trace elements related to skin and liver damage were analyzed. Finally, the receiver operating characteristic (ROC) curve and areas under the curve (AUC) were used to analyze the diagnostic values of certain trace elements for arsenic-induced skin and liver damage. The results found that a decrease in Se was a risk factor for arsenic-induced skin and liver damage (OR = 8.33 and 1.92, respectively). Furthermore, increases in Al and V were risk factors for arsenic-induced skin damage (OR = 1.05) and liver damage (OR = 13.16), respectively. In addition, the results found that Se and Al possessed certain diagnostic values for arsenic-induced skin damage (AUC = 0.93, 0.80), that Se possessed a diagnostic value for liver damage (AUC = 0.93), and that the combination of Se and Al increased the diagnostic value for skin damage (AUC = 0.96). This study provides an important research basis for further understanding the reasons for arsenic-induced skin and liver damage, for screening and identifying candidate diagnostic biomarkers, and for improving prevention and control strategies for arsenism., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Tigecycline is one of the last-resort antibiotics to treat severe infections. Recently, tigecycline resistance has sporadically emerged with an increasing trend, and Tet(X) family represents a new resistance mechanism of tigecycline. In this study, a novel chromosome-encoded tigecycline resistance gene, tet (X14), was identified in a tigecycline-resistant and colistin-resistant Empedobacter stercoris strain ES183 recovered from a pig fecal sample in China. Tet(X14) shows 67.14-96.39% sequence identity to the other variants [Tet(X) to Tet(X13)]. Overexpression of Tet(X14) in Escherichia coli confers 16-fold increase in tigecycline MIC (from 0.125 to 2 mg/L), which is lower than that of Tet(X3), Tet(X4) and Tet(X6). Structural modelling predicted that Tet(X14) shared a high homology with the other 12 variants with RMSD value from 0.003 to 0.055, and Tet(X14) can interact with tetracyclines by a similar pattern as the other Tet(X)s. tet (X14) and two copies of tet (X2) were identified on a genome island with abnormal GC content carried by the chromosome of ES183, and no mobile genetic elements were found surrounding, suggesting that tet (X14) might be heterologously obtained by ES183 via recombination. Blasting in Genbank revealed that Tet(X14) was exclusively detected on the chromosome of Riemerella anatipestifer , mainly encoded on antimicrobial resistance islands. E. stercoris and R. anatipestifer belong to the family Flavobacteriaceae , suggesting that the members of Flavobacteriaceae maybe the major reservoir of tet (X14). Our study reports a novel chromosome-encoded tigecycline resistance gene tet (X14). The expanded members of Tet(X) family warrants the potential large-scale dissemination and the necessity of continuous surveillance for tet (X)-mediated tigecycline resistance.

Few studies have investigated the association between essential trace elements and oxidative stress in environmental media and populations with endemic arsenism caused by coal burning. Element contents and oxidative stress indicators were measured. Moreover, the expression of genes related to the nuclear factor E2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1)-antioxidant response element (ARE) signaling pathway and Nrf2-ARE binding ability is detected. The results show that the contents of arsenic, copper, iron, and chromium were increased in environmental media from the arsenism area compared with the control area; however, the selenium content decreased. The arsenic, iron, chromium, and copper contents and the copper/zinc ratio were also increased in the arsenic-exposed population; however, the selenium content decreased. The results also show that the concentrations of arsenic, iron, and chromium and the copper/zinc ratio increased gradually with the severity of arsenism. However, selenium concentrations decreased gradually with the severity of arsenism. The contents of malondialdehyde, 8-hydroxyldeoxyguanosine, and protein carbonyl in plasma increased, while the levels of sulfhydryl, thioredoxin reductase (TrxR), glutathione peroxidase (Gpx), and superoxide dismutase 1 (SOD1) decreased. The mRNA expression of Keap1 and TrxR1 decreased in the blood, while the mRNA expression of Nrf2, GPx1, and SOD1 increased. Moreover, the Nrf2 protein content and Nrf2-ARE binding ability increased, and the Keap1 protein content decreased. In conclusion, our data suggest that the increased arsenic content in environmental media and populations was accompanied by abnormal levels of essential trace elements. Insufficient selenium intake, copper, and chromium overload and a high copper/zinc ratio might be some of the causes of arsenism, which might be related to the Nrf2/Keap1-ARE signaling pathway.

We aimed to clarify the epidemiologic and clinical importance of evolutionary events that occurred in carbapenem-resistant Klebsiella pneumoniae (CRKP). We collected 203 CRKP causing bloodstream infections in a tertiary hospital in China during 2013-2017. We detected a subclonal shift in the dominant clone sequence type (ST) 11 CRKP in which the previously prevalent capsular loci (KL) 47 had been replaced by KL64 since 2016. Patients infected with ST11-KL64 CRKP had a significantly higher 30-day mortality rate than other CRKP-infected patients. Enhanced virulence was further evidenced by phenotypic tests. Phylogenetic reconstruction demonstrated that ST11-KL64 is derived from an ST11-KL47-like ancestor through recombination. We identified a pLVPK-like virulence plasmid carrying rmpA and peg-344 in ST11-KL64 exclusively from 2016 onward. The pLVPK-like-positive ST11-KL64 isolates exhibited enhanced environmental survival. Retrospective screening of a national collection identified ST11-KL64 in multiple regions. Targeted surveillance of this high-risk CRKP clone is urgently needed.

Background: Escherichia coli is one of the most common strains of extended-spectrum β-lactam (ESBL)-producing bacteria, and the prevention and treatment of ESBL-producing E. coli infections is an ongoing challenge. The clinical characteristics and outcomes of ESBL-producing E. coli bacteremia in non-transplant patients remain to be elucidated., Methods: This retrospective study included 491 non-transplant patients with E. coli bloodstream infections (BSIs) from January 2013 to December 2016 and was conducted to investigate the risk factors, clinical features, and outcomes of these infections., Results: Of the 491 E. coli BSI patients, 57.6% suffered from infections with ESBL-producing strains. A multivariate analysis showed that urinary tract infection, prior use of cephalosporin, and treatment with β-lactam-β-lactamase inhibitor (BLBLI) combination antibiotics were independent risk factors for the development of ESBL-producing E. coli BSIs. The overall mortality rate in E. coli BSI patients was 14.46%, and there was no significant difference in the 28 day mortality rate between ESBL-producing E. coli and non-ESBL-producing E. coli BSI patients (14.8% vs. 14.0%, respectively; P  = 0.953). Similarly, there was no difference between the community-acquired infection group and the nosocomial infection group. Hepatobiliary disease, carbapenem exposure, high APACHE II score, and hypoproteinemia were independent risk factors for death in E. coli BSI patients. Multivariate analysis showed that hypoproteinemia and severe disease were independent risk factors for death from ESBL -producing E. coli BSIs. Furthermore, there was no significant difference in the 28 day mortality between patients with ESBL -producing E. coli BSIs treated with carbapenem monotherapy versus those treated with BLBLI combination antibiotics (12.8% vs. 17.9%, respectively; P  = 0.384)., Conclusions: Prior use of cephalosporin or BLBLI combination antibiotics increased the risk ratio for ESBL -producing E. coli infection. Hypoproteinemia and severe disease are independent risk factors for death in patients with E. coli BSIs. There was no significant difference in the 28 day prognosis of patients with ESBL-producing E. coli and those with non-ESBL-producing E. coli BSIs. These data do not support the conclusion that carbapenems might be more effective than BLBLI antibiotics for treatment of patients with BSIs caused by ESBL-producing E. coli ., Competing Interests: Competing interestsThe authors declare that they have no competing interests.

Background: Pseudomonas aeruginosa (PA) is a leading cause of nosocomial infections, and carbapenem non-susceptible strains are a major threat to patient safety., Methods: A single center, retrospective comparative analysis of carbapenem-non-susceptible PA (CnSPA) and carbapenem-susceptible PA (CSPA) bloodstream infections (BSIs) was conducted between January 1, 2007, and December 31, 2016. Prevalence and risk factors associated with CnSPA BSIs were examined., Results: The study enrolled 340 patients with PA BSIs; 30.0% ( N  = 101) of patients had CnSPA. High APACHE II scores (≥15), central venous catheterization, and delayed application of appropriate definitive therapy were independently associated with higher risk of mortality in PA BSIs. Multivariate analysis revealed that respiratory disease and exposure to carbapenems within the previous 90 days to onset of BSI were independent risk factors for acquisition of CnSPA BSIs. Overall all-cause 30-day mortality associated with PA BSIs was 26.8% (91/340). In addition, mortality was higher in patients with CnSPA than in those with CSPA (37.6% vs. 22.2%, respectively; P  = 0.003). Corticosteroid therapy and delayed receipt of effective definitive therapy were independent risk factors for death from CnSPA BSIs., Conclusion: Increased incidence of CnSPA BSIs was observed during the study period, with higher mortality seen in patients with these infections. Respiratory disease and exposure to carbapenems were independent risk factors for development of CnSPA BSIs. Appropriate definitive therapy reduced mortality rates. BLBLIs were as effective as carbapenems as a treatment for PA BSIs., Competing Interests: Ethics approval for this study was submitted and approved through Research Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University (Reference Number 1028).Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Recently, the coiled‑coil‑helix‑coiled‑coil‑helix domain 2 (CHCHD2) gene was identified as a possible causative gene for Parkinson's disease (PD). Three other neurodegenerative diseases, Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), share significant overlaps with PD in clinical phenotypes, pathological features and genetic heredities, and it is still unclear whether CHCHD2 variants could explain these three diseases. The present study screened all exons of the CHCHD2 gene in a total of 780 patients (511 AD, 181 ALS and 88 FTD) and 500 healthy controls from the Chinese Han population. Two missense variants, 5C>T (Pro2Leu) and 238A>G (Ile80Val), were identified in five unrelated patients with AD while no mutations were observed in patients with ALS or FTD. These mutations have been reported as low‑frequency variants in the ExAC database with frequencies of 0.0075 and 0.000025. Pro2 Leu, however, was also detected in controls and was confirmed to have no significant association with the risk for AD; Ile80Val was not detected in any normal controls, suggesting that the CHCHD2 gene may be associated with AD in the Chinese Han population.

Objective: Mutations of the cyclin F (CCNF) gene were recently identified to be associated with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) in Western and Japanese populations. The rare protein-altering variants frequency is 0.6 to 3.3% in ALS and FTD from these diverse geographic populations while no systematic analysis of CCNF variants were conducted in the Chinese population., Methods: We screened all exons of CCNF in a cohort of 269 cases (including 181 ALS and 88 FTD) from Mainland China using Sanger sequencing., Results: A rare heterozygous variant (c.481G > A, p.G161R) was detected in a sporadic ALS case with a frequency of 0.6%, while no mutation was identified in patients with FTD. The same variant was also found in a sporadic ALS patient from America., Conclusions: Our result indicates that the mutation of CCNF is rare in patients with ALS and FTD from Mainland China.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting motor neurons of the brain, brainstem and spinal cord. To date, mutations in more than 30 genes have been linked to the pathogenesis of ALS. Among them, SOD1, FUS and TARDBP are ranked as the three most common genes associated with ALS. However, no mutation analysis has been reported in central-southern China. In this study, we sequenced SOD1, FUS and TARDBP in a central-southern Chinese cohort of 173 patients with ALS (15 familial ALS and 158 sporadic ALS) to detect mutations. As a result, five missense mutations in SOD1, namely, p.D101N, p.D101G, p.C111Y, p.N86S and p.V87A, were identified in three unrelated familial probands and three sporadic cases; two mutations in FUS were found in two unrelated familial probands, including an insertion mutation (p.P525&#95;Y526insY) and a missense mutation (p.R521H); no variants of TARDBP were observed in patients. Therefore, SOD1 mutations were present in 20.0% of familial ALS patients and 1.9% of sporadic ALS patients, while FUS mutations were responsible for 13.3% of familial ALS cases, and TARDBP mutations were rare in either familial or sporadic ALS cases. This study broadens the known mutational spectrum in patients with ALS and further demonstrates the necessity for genetic screening in ALS patients from central-southern China.