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Given the intricate and competitive global academic landscape and Chinese female PhDs' critical situation of being marginalized and otherized, this study aims to examine the academic career decision-making experiences of three unmarried and childless Chinese female PhD graduates. Collaborative autoethnography is employed to delve into the three authors' experiences and reflections regarding the influential factors impacting their job-seeking and decision-making process as recent graduates, who earned their PhD degrees in 2022 from three popular destinations for international students in East Asia, namely Hong Kong, South Korea and Japan. Research findings indicate that various contextual and individual factors have shaped the authors' decision-making and diverse career options were adopted to strike a 'happy medium' between long-term career aspirations and increased competition for academic positions. This study provides implications for policymakers and university administrators to attract highly skilled female international professionals and overseas-educated Chinese female PhDs considering a professional career in academia.

We advocate the in-depth integration of information technology and education in the digital age, and we also encourage teachers of all disciplines to actively carry out online and offline blended learning. This study attempts to use an empirical research to apply the Blended Learning to the oral English teaching in the first year of senior high school. A one-semester teaching experiment is conducted to explore whether there is a significant difference in the students' oral English proficiency between the experimental class and the controlled class. The major findings of the study are as follows: (1) There are significant differences of students' oral English proficiency before and after the experiment in the experimental class and the controlled class; (2) Blended learning can improve students' oral English proficiency, among which pronunciation and intonation, range and accuracy of vocabulary and fluency of language are the most significant ones, while the accuracy and complexity of grammatical structure are insignificant.

Introduction: Oligomeric alpha-synuclein in red blood cells (RBC-o-α-Syn) has been shown to be increased in patients with Parkinson's disease (PD). However, factors that affect RBC-o-α-Syn levels remain to be elucidated. The aim of this study is to analyze the correlations between RBC-o-α-Syn levels and the age, sex and different clinical variables of patients with PD. Methods: 167 patients with PD and 119 healthy controls (HC) were enrolled in this study. The patients with PD were diagnosed based on the MDS clinical diagnostic criteria for PD. All participants were evaluated for their clinical characteristics. Western blot analysis was used to examine the molecular sizes of RBC-o-α-Syn. A newly established chemiluminescent immunoassay was used to measure RBC-o-α-Syn levels. Results: Higher RBC-o-α-Syn levels were detected in PD patients than in HC subjects. The receiver operating characteristic (ROC) curve indicated that a cut off value of 55.29 ng/mg discriminated well between PD patients and HC subjects, with a sensitivity of 67.66% (95% CI: 60.24-74.29%), a specificity of 88.24% (95% CI: 81.22-92.86%), and an area under the curve (AUC) of 0.857. The levels of RBC-o-α-Syn were higher in female than male patients (p = 0.033). For different subtypes, the levels of RBC-o-α-Syn were higher in the MIX subtype than the tremor-dominant (TD) PD. In addition, the levels of RBC-o-α-Syn were higher in patients with than without cognitive impairment (p = 0.016), and negatively correlated with Mini-Mental State Examination (MMSE) scores (r = -0.156, p = 0.044). Conclusion: Our study demonstrates that RBC-o-α-Syn levels in patients with PD are higher than those in HC subjects and affected by the sex and the severity of cognitive impairment. [ABSTRACT FROM AUTHOR]

Objective: This study evaluates the research developments concerning Rehmanniae Radix in ovarian hypofunction diseases. It explores the processing methods of Rehmanniae Radix, the variations in its compounds before and after processing, the mechanism of Rehmanniae Radix and its active compounds in improving ovarian function, and the advancements in clinical applications of traditional Chinese medicine (TCM) compound that include Rehmanniae Radix. Methods: Comprehensive literature search was conducted using databases such as China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, National Science and Technology Library, the Pharmacopoeia of the People's Republic of China, Pubmed, and the Web of Science Database. The search utilized the following Medical Subject Headings (MeSH) and keywords: "Rehmanniae Radix," "Drying Rehmannia Root," "Rehmannia glutinosa," "Rehmanniae Radix Praeparata," "Traditional Chinese Medicine Processing," "Pharmacological Effects," "Ovarian Aging," "Diminished ovarian reserve," "Premature ovarian insufficiency," "Premature Ovarian Failure," "Ovarian hypofunction diseases". Results: The ancient Chinese medical books document various processing techniques for Rehmanniae Radix. Contemporary research has identified changes in its compounds processing and the resultant diverse therapeutic effects. When processed into Rehmanniae Radix Praeparata, it is noted for its ability to invigorate the kidney. TCM compound containing Rehmanniae Radix is frequently used to treat ovarian hypofunction diseases, demonstrating significant clinical effectiveness. The key changes in its compounds processing include cyclic dilute ether terpene glycosides, phenylethanol glycosides, sugars, and 5-hydroxymethylfurfural. Its pharmacological action is primarily linked to the improvement of granulosa cell proliferation, antioxidative and anti-aging properties, and modulation of the immune and inflammatory microenvironment. Furthermore, Rehmanniae Radix also offers therapeutic benefits for cardiovascular and cerebrovascular diseases, osteoporosis and cognitive dysfunction caused by low estrogen levels. Thereby Rehmanniae Radix mitigates both the short-term and long-term health risks associated with ovarian hypofunction diseases. Conclusion: Processed Rehmanniae Radix has shown potential to improve ovarian function, and its compound prescriptions have a definite effect on ovarian dysfunction diseases. Therefore Rehmanniae Radix was garnering interest for both basic and clinical research, with promising application prospects as a future therapeutic agent for ovarian hypofunction diseases. However, further studies on its toxicology and the design of standardized clinical trials are necessary to fully establish its efficacy and safety. [ABSTRACT FROM AUTHOR]

Background: Generic substitution policies have been widely implemented worldwide to enhance the accessibility of medications. Nevertheless, certain patients have voiced discontent with these policies. This study aimed to evaluate the patient preferences for generic substitution policies and explore the potential for optimization to enhance patient acceptance. Methods: A discrete choice experiment (DCE) was conducted to estimate the relative importance (RI) of five attributes, including generic consistency evaluation (GCE), reimbursement rate, medication use control, information disclosure, and post-marketing surveillance. Respondents were recruited among inpatients and outpatients in three cities and surveys were conducted face-to-face. Preference coefficients, RI of attributes, and the uptake rate of various policies were computed using a mixed logit model. The interaction effects were also included to examine preference heterogeneity. Results: A total of 302 patients completed the survey. All five attributes significantly impacted policy acceptance. GCE held the highest RI value at 56.64%, followed by reimbursement rate (RI = 12.62%), information disclosure (RI = 12.41%), post-marketing surveillance (RI = 9.54%), and medication use control (RI = 8.80%). Patient preferences varied depending on their gender and income. The patient uptake rate of China's current policy was only 68.56%. If all generics were to pass GCE without altering the other attributes, the uptake rate of policies would rise to 82.63%. Similarly, implementing information disclosure without changing other attributes would result in a 78.67% uptake rate, which is comparable to the effect of a 10% increase in reimbursement rate for generics (78.81%). Combining these policies could mitigate the adverse effects of mandatory substitution on patient. Conclusion: Chinese patient preferences for generic substitution policies were mainly influenced by GCE. China's current generic substitution policy has room for further optimization to enhance patient acceptance. [ABSTRACT FROM AUTHOR]

The coupling coordination between the development of the digital economy and the construction of an ecological civilization is an important topic for the high-quality coordinated development of China’s economy and society. This study is based on panel data from 31 provinces and cities in China from 2013 to 2020. It utilizes the entropy method, coupling coordination degree model, and panel Tobit model to calculate the coupling coordination degree between the development of the digital economy and the construction of an ecological civilization, and to analyze the influencing factors. The results indicate that the overall coupling coordination degree of the two systems has been increasing year by year at the national level, with the development status transitioning from a mildly imbalanced state to a state on the brink of imbalance. The eastern region of China has the highest coupling coordination degree between the two systems, while the central and western regions both lag behind the national average, demonstrating a gradient decline in coupling coordination development across the eastern, central, and western regions. Urbanization, human capital, industrial structure, technological innovation, and government management have a significant positive impact on the coupling coordination degree of the two systems at the national level, while openness to the outside world has a significant negative impact. The impact of these influencing factors on the development of coupling coordination between the two systems exhibits significant heterogeneity across the eastern, central, and western regions, and each region should promote the development of coupling coordination based on local conditions, timing, and circumstances. [ABSTRACT FROM AUTHOR]

Background: We aimed to characterize the relationship between the serum 25-hydroxyvitamin D concentration and the circulating lipid concentrations of patients with NAFLD in the Hulunbuir region of China. Methods: One hundred fifty-six patients, who were diagnosed with NAFLD in the Physical Examination Department of the Second Clinical College of Inner Mongolia University for the Nationalities between January 2021 and March 2023, were recruited as NAFLD group, and 160 healthy people were recruited as a control group during the same period. The serum 25(OH)VitD, TBIL, TG, TC, LDL-C, HDL-C, AST, ALT, GGT, and FPG activities of the participants were measured, and hepatic ultrasonography was performed. Results: The BMI of the NAFLD group was higher than of the control group (p < 0.05). The serum 25(OH)VitD3 (p < 0.05) and the HDL-C concentrations of the NAFLD group were lower than those of the normal control group. However, the AST (p < 0.05), ALT (p < 0.05), and GGT (p < 0.05) activities, and the serum TG (p < 0.05), TC (p < 0.05), LDL-C (p < 0.05), and the fasting glucose (p < 0.05) concentrations of the NAFLD group were higher than those of the normal control group. The serum 25(OH)VitD3 concentrations of the NAFLD group significantly correlated negatively with BMI (r = -0.302, p < 0.01), TG (r = -0.221, p < 0.05), and fasting glucose (r = -0.236, p < 0.05). The BMI, TG, and fasting glucose of vitamin D-deficient participants were higher than of the participants with adequate or insufficient levels of vitamin D (p < 0.05). Finally, the BMI of vitamin D-deficient participants was higher than of those with an adequate vitamin D status (p < 0.05). Conclusions: A deficiency of 25(OH)VitD is more common in people from the Hulunbuir region of China than elsewhere. In addition, the vitamin D status is significantly associated with NAFLD; as the serum vitamin D concentration decreases, patients with NAFLD show greater dyslipidemia and hyperglycemia and a higher BMI. [ABSTRACT FROM AUTHOR]

BACKGROUND Previous studies have demonstrated the benefits of ideal cardiovascular health (CVH) in reducing cardiovascular risk. However, its role in subclinical atherosclerosis (SA) progression remains unclear. We aim to examine the association of CVH, estimated by the American Heart Association's new Life's Essential 8 (LE8), with the progression of SA. METHODS This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for 5.7 years. The LE8 score (range, 0–100) consisted of blood pressure, lipids, glucose, body mass index, smoking status, diet health, physical activity and sleep health was evaluated in 1998 and 2008–2009. Progression of SA was determined by carotid plaque and coronary artery calcification (CAC) in 2008–2009 and 2013–2014. Log-binomial regression model was used to estimate the association of LE8 score with SA progression. RESULTS Each 10 points increment in LE8 score was associated with 15.2% (RR: 0.848, 95% CI: 0.797–0.902), 17.7% (RR: 0.823, 95% CI: 0.766–0.884) and 12.0% (RR: 0.880, 95% CI: 0.845–0.916) lower risks of carotid plaque, CAC and overall SA progression, respectively. Compared with participants with non-ideal CVH at both visits, the participants with ideal CVH at both visits had 39.1% (RR: 0.609, 95% CI: 0.494–0.752), 41.0% (RR: 0.590, 95% CI: 0.456–0.764) and 29.7% (RR: 0.703, 95% CI: 0.598–0.825) lower risks of carotid plaque, CAC and overall SA progression, respectively. CONCLUSIONS Higher LE8 scores were associated with lower risks of SA progression. Besides, long-term maintenance of optimal CVH was more beneficial to prevent SA progression. [ABSTRACT FROM AUTHOR]

Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is a serious disease that affects wheat worldwide. There is a great need to develop cultivars with combinations of all-stage resistance (ASR) and adult-plant resistance (APR) genes for sustainable control of the disease. QYrsv.swust-1BL in the Italian durum wheat (Triticum turgidum ssp. durum) cultivar Svevo is effective against Pst races in China and Israel, and the gene has been previously mapped to the long arm of chromosome 1B. The gene is flanked by SNP (single nucleotide polymorphism) markers IWB5732 and IWB4839 (0.75 cM). In the present study, we used high-density 660K SNP array genotyping and the phenotypes of 137 recombinant inbred lines (RILs) to fine map the QYrsv.swust-1BL locus within a 1.066 Mb region in durum wheat Svevo (RefSeq Rel. 1.0) on chromosome arm 1BL. The identified 1.066 Mb region overlaps with a previously described map of Yr29/QYr.ucw-1BL, a stripe rust APR gene. Twenty-five candidate genes for QYrsv.swut-1BL were identified through comparing polymorphic genes within the 1.066 Mb region in the resistant cultivar. SNP markers were selected and converted to Kompetitive allele-specific polymerase chain reaction (KASP) markers. Five KASP markers based on SNP were validated in a F2 and F2:3 breeding population, providing further compelling evidence for the significant effects of QYrsv.swut-1BL. These markers should be useful in marker-assisted selection for incorporating Yr29/QYrsv.swust-1BL into new durum and common wheat cultivars for resistance to stripe rust. [ABSTRACT FROM AUTHOR]

Objective: To explore the perception of good death of patients with end-stage cancer by nurses in the oncology department. Method: In the study we used a phenomenological approach and semi-structured interviews. A total of 11 nurses from the oncology department of a Grade A hospital in Taizhou were interviewed on the cognition of good death from July 1 to September 30, 2022. Colaizzi's analysis method was used to analyse the interview data. This study followed the consolidated criteria for reporting qualitative research (COREQ). Result: Four themes were identified: a strong sense of responsibility and mission; To sustain hope and faith; The important role of family members; Improve patients' quality of life. Conclusion: The nurses in the department of oncology have a low level of knowledge about the "good death", and the correct understanding and view of the "good death" is the premise of the realization of " good death". The ability of nursing staff to improve the "good death", attention, and meet the needs and wishes of individuals and families, is the guarantee of the realization of "good death". [ABSTRACT FROM AUTHOR]

Exhumed (ultra)high-pressure ([U]HP) metamorphic rocks are markers of paleosubduction zones and can provide crucial implications for the geodynamic evolution of subduction-exhumation. A variety of (U)HP metamorphic rocks from many collisional orogens have commonly documented a lowpressure high-temperature overprint, which appears to indicate a pervasive geodynamic process behind (U)HP metamorphic rock exhumation. A good case study of garnet amphibolite and associated garnet-biotite gneiss with an unambiguous low-pressure high-temperature overprint in the Xixia-Xiaguan area of the North Qinling Orogen, central China, provides a significant opportunity to uncover this geodynamic process. A detailed study of petrography, mineral chemistry, and phase equilibria modeling suggests that the investigated garnet amphibolite and garnet-biotite gneiss have jointly experienced multistage exhumation processes with near-isothermal decompression from the (U)HP eclogite facies (26.8-29.0 kbar/740-775 °C) to the mediumpressure (MP) amphibolite facies (8.7-10.0 kbar/740-775 °C), subsequent remarkable near-isobaric heating to the low-pressure (LP) granulite facies (6.8-8.2 kbar/832-835 °C), followed by final decompression and cooling to the LP amphibolite facies (5.8-6.8 kbar/740-757 °C). U-Pb age dating of zircons from the garnet amphibolite and garnetbiotite gneiss yielded metamorphic ages of ca. 500 Ma, 450 Ma, and 400 Ma, which we consider to represent (U)HP eclogite-facies, LP granulite-facies, and late LP amphibolite-facies metamorphism, respectively. According to the regional geology and the metamorphic history we have determined, this multistage exhumation process of twostep exhumation stages delimited by a phase of LP near-isobaric heating was associated with slab rollback. Accordingly, we propose a tectonic model of exhumation driven by slab rollback for the geodynamic evolution of (U)HP metamorphic rock exhumation in the North Qinling Orogen. Additionally, a combination of previous studies and our new results suggests that exhumation driven by slab rollback appears to be a fundamental mechanism for the (U)HP metamorphic rock exhumation within collisional orogens. [ABSTRACT FROM AUTHOR]

Background: Kidney transplantation is considered the most effective treatment for end-stage renal failure. Recent studies have shown that the significance of the immune microenvironment after kidney transplantation in determining prognosis of patients. Therefore, this study aimed to conduct a bibliometric analysis to provide an overview of the knowledge structure and research trends regarding the immune microenvironment and survival in kidney transplantation. Methods: Our search included relevant publications from 2013 to 2023 retrieved from the Web of Science core repository and finally included 865 articles. To perform the bibliometric analysis, we utilized tools such as VOSviewer, CiteSpace, and the R package "bibliometrix". The analysis focused on various aspects, including country, author, year, topic, reference, and keyword clustering. Results: Based on the inclusion criteria, a total of 865 articles were found, with a trend of steady increase. China and the United States were the countries with the most publications. Nanjing Medical University was the most productive institution. High-frequency keywords were clustered into 6 areas, including kidney transplantation, transforming growth factor β, macrophage, antibodymediated rejection, necrosis factor alpha, and dysfunction. Antibody mediated rejection (2019-2023) was the main area of research in recent years. Conclusion: This groundbreaking bibliometric study comprehensively summarizes the research trends and advances related to the immune microenvironment and survival after kidney transplantation. It identifies recent frontiers of research and highlights promising directions for future studies, potentially offering fresh perspectives to scholars in the field. [ABSTRACT FROM AUTHOR]

Aim: With the implementation of China's three‐child policy in 2021, the nurse population faces an increase in the number of breastfeeding nurses returning to work after maternity leave. This study aims to describe the work experience of breastfeeding nurses returning to work after maternity leave. Design: A qualitative descriptive design. Methods: The data were collected through semi‐structured interviews with eight nurses and analysed through Braun and Clarke's thematic analysis. Results: Three themes and nine sub‐themes emerged from the analysis of the interviews: changes in nurses (emotional changes, physical changes and changes in work); needs for an improving work environment (needs for a supportive workplace and nurse shortage); support for breastfeeding nurses (support from coworkers, support from the manager, support from the organisation and own need for work). Public Contribution: This study highlighted that breastfeeding nurses need an adjustment period when they return to work after maternity leave. Successful breastfeeding requires support from coworkers, managers and the organisation. In addition, workplace support for breastfeeding and management for nurses needs to be improved. [ABSTRACT FROM AUTHOR]

In China's rapid industrial development, the adoption and impact of green supply chain practices (GSCP) have become pivotal. This research employs a non-radial, non-angle SBM-DEA model to examine the intricate relationship between environmental sustainability and economic advancement. The observation suggests that companies adopting the global sustainable consumption and production (GSCP) framework demonstrate a more substantial alignment with China's sustainable goals. However, this alignment is accompanied by a fundamental conflict between the need for economic growth and the need for environmental caution. This study highlights China's sincere efforts to adhere to global ecological norms, as the environmental outcomes (ENVO) demonstrated. The findings on organizational culture (O.C.) present a complex depiction of China's direction, highlighting the intersection between its longstanding traditions with the pressing demands of modern environmentally sustainable corporate practices. The presence of regulatory variations across provinces highlights the regional differences within the nation, thus causing organizations to adopt adaptable environmental policies. The complex network of supply chains in China and the careful management of financial resources underscore the diverse range of difficulties and opportunities that firms face. This research ultimately provides a comprehensive understanding of the crucial balancing process that characterizes China's path toward environmental sustainability. It highlights the importance of effectively managing these factors, since it is essential for enterprises to achieve enduring and sustainable success. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) poses a severe threat to global health. The wide distribution of environmental antibiotic resistance genes (ARGs), which can be transferred between microbiota, especially clinical pathogens and human commensals, contributed significantly to AMR. However, few databases on the spatiotemporal distribution, abundance, and health risk of ARGs from multiple environments have been developed, especially on the absolute level. In this study, we compiled the ARG occurrence data generated by a high-throughput quantitative PCR platform from 1,403 samples in 653 sampling sites across 18 provinces in China. The database possessed 291,870 records from five types of habitats on the abundance of 290 ARGs, as well as 8,057 records on the abundance of 30 mobile genetic elements (MGEs) from 2013 to 2020. These ARGs conferred resistance to major common types of antibiotics (a total of 15 types) and represented five major resistance mechanisms, as well as four risk ranks. The database can provide information for studies on the dynamics of ARGs and is useful for the health risk assessment of AMR. [ABSTRACT FROM AUTHOR]

Rich and diverse fungal species occur in different habitats on the earth. Many new taxa are being reported and described in increasing numbers with the advent of molecular phylogenetics. However, there are still a number of unknown fungi that have not yet been discovered and described. During a survey of fungal diversity in different habitats in China, we identified and proposed two new species, based on the morphology and multi-gene phylogenetic analyses. Herein, we report the descriptions, illustrations and molecular phylogeny of the two new species, Bisifusarium keratinophilum sp. nov. and Ovatospora sinensis sp. nov. [ABSTRACT FROM AUTHOR]

Sanghuangporus, also known as "Sanghuang" in China, is a well-known genus of traditional Chinese medicinal macrofungi. To make more effective use of Sanghuangporus resources, we completed the first genome assembly and annotation of a monokaryon strain of S. weigelae in the present study. A 33.96-Mb genome sequence was assembled as 13 contigs, leading to prediction of 9377 protein-coding genes. Phylogenetic and average nucleotide identity analyses indicated that the S. weigelae genome is closely related to those of other Sanghuangporus species in evolutionary tree, which clustered in one clade. Collinearity analysis revealed a high level of collinearity of S. weigelae with S. baumii, S. vaninii, and S. sanghuang. Biosynthesis pathways potentially involved in medicinal properties, including terpenoid and polysaccharide synthesis, were identified in S. weigelae, while polysaccharides were identified as the main medicinal metabolites in S. weigelae, with flavonoids more important in Sanghuangporus than other medicinal mushroom groups. Genes encoding 332 carbohydrate-active enzymes were identified in the S. weigelae genome, including major glycoside hydrolases and glycosyltransferases predicted, revealing the robust lignocellulose degradation capacity of S. weigelae. Further, 130 genes, clustered in seven classes were annotated to encode cytochromes P450 in the S. weigelae genome. Overall, our results reveal the remarkably medicinal capacity of S. weigelae and provide new insights that will inform the study of evolution and medicinal application of S. weigelae. The data are a reference resource for the formulation of scientific and rational ecological protection policies for Sanghuangporus species. [ABSTRACT FROM AUTHOR]

Simple Summary: In subtropical shallow lakes, large-scale changes in water temperature lead to seasonal succession of some cryptic rotifer species, and the temporal overlap of other cryptic rotifer species is a common phenomenon. However, in tropical shallow lakes, relatively stable water temperatures throughout the year may not lead to a seasonal succession of cryptic rotifer species, but evidence is scarce. Studies on the temporal distribution patterns of the cryptic Brachionus calyciflorus species in three lakes in China revealed that in the warm-temperate Lake Yunlong, B. fernandoi and B. calyciflorus s.s. underwent a seasonal succession, which was largely attributed to their differential adaptation to water temperature. In the subtropical Lake Jinghu, B. fernandoi, B. calyciflorus s.s., and B. dorcas exhibited both seasonal succession and temporal overlap. Seasonal successions were largely attributed to their differential adaptation to temperature, and temporal overlap resulted from their differential responses to algal food concentration. In the tropical Lake Jinniu, B. calyciflorus s.s. persisted throughout the year and overlapped with B. dorcas for 5 months. The temporal overlap resulted from their differential responses to copepod predation. These results indicated that the temporal distribution pattern of the cryptic B. calyciforus species and the mechanism that allows competitor coexistence vary with different climate zones. Sympatric distribution and temporal overlap of cryptic zooplankton species pose a challenge to the framework of the niche differentiation theory and the mechanisms allowing competitor coexistence. We applied the methods of phylogenetic analysis, DNA taxonomy, and statistical analysis to study the temporal distribution patterns of the cryptic B. calyciflorus species, an excellent model, in three lakes, and to explore the putative mechanisms for their seasonal succession and temporal overlap. The results showed that in the warm-temperate Lake Yunlong, B. fernandoi and B. calyciflorus s.s. underwent a seasonal succession, which was largely attributed to their differential adaptation to water temperature. In the subtropical Lake Jinghu, B. fernandoi, B. calyciflorus s.s., and B. dorcas exhibited both seasonal succession and temporal overlap. Seasonal successions were largely attributed to their differential adaptation to temperature, and temporal overlap resulted from their differential responses to algal food concentration. In the tropical Lake Jinniu, B. calyciflorus s.s. persisted throughout the year and overlapped with B. dorcas for 5 months. The temporal overlap resulted from their differential responses to copepod predation. These results indicated that the temporal distribution pattern of the cryptic B. calyciforus species and the mechanism that allows competitor coexistence vary with different climate zones. [ABSTRACT FROM AUTHOR]

This paper aims to explore whether the development of competitive computer gaming (eSports) industries is sustained in China. In doing so, we apply the Generalized Supremum Augmented Dickey-Fuller (GSADF) method to investigate when the bubbles originated and crashed in the Chinese eSports market from 2014 to 2021. Utilizing the data of the Chinese Electronic Sports Thematic Index (CESI), the empirical outcomes show that the Chinese eSports industry may deviate from its market value and that the industry witnesses bubble behaviors. The latent reasons might be attributed to government policies, economic growth, stock market crises, and venture capital investments. Therefore, to promote the stabilized and sustained development of the eSports industry in China, regulators and authorities should pay attention to the evolution of bubbles. Moreover, maintaining policy consistency and continuity may be beneficial in stabilizing investors' expectations and reducing speculative investment behaviors. [ABSTRACT FROM AUTHOR]

China has an exceptional diversity in Begonia, holding the second largest number of described species in this genus at the national level. Many new taxa need to be explored and described. This paper reports two new species, Begonia ruchengensis (B. sect. Reichenheimia) and B. auritalata (B. sect. Platycentrum), from Hunan province and Guizhou province, respectively. Besides the detailed morphology description, color illustrations, and line drawings, the diagnoses of these two species distinguished from their allied taxa are provided. Their conservation statuses are evaluated according to The Guidelines for Using the IUCN Red List Categories. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to explore the coping strategies of depression sufferers that have worked for them based on the study of an online depression community. Methods: We conducted a thematic narrative analysis of 120 stories posted by the members in the largest online depression community in China. MaxQDA version 18 was used to code the data, and the analytic approach was consistent with the category-centred approach of grounded theory. Results: The study found that the coping strategies mainly include self-reconciliation (e.g., perceiving/accepting feelings, accepting the present self, and holding hope for the future), actions (recreational activities, physical exercise, and engaging in volunteer work), addressing the stressors and symptoms (e.g., staying away from stressors, seeing the doctor), and seeking interpersonal support (e.g., seeking support from family, friends, and peers). Conclusion: The findings revealed the coping strategies that were helpful and examined how they functioned for the affected members, which make up for the lack of attention to the individual experiences of depression sufferers in coping research. The findings also have practical implications for the related education and consultation, providing useful insights for doctors and patients. These ways of coping are based on depression sufferer' anonymous narratives, which can be convincing to clients. [ABSTRACT FROM AUTHOR]

Objective: Real-word data on long-acting luteinizing hormone-releasing hormone (LHRH) agonists in Chinese patients with prostate cancer are limited. This study aimed to determine the real-world effectiveness and safety of the LHRH agonist, goserelin, particularly the long-acting 10.8-mg depot formulation, and the follow-up patterns among Chinese prostate cancer patients. Methods: This was a multicenter, prospective, observational study in hormone treatment-naïve patients with localized or locally advanced prostate cancer who were prescribed goserelin 10.8-mg depot every 12 weeks or 3.6-mg depot every 4 weeks with or without an anti-androgen. The patients had follow-up evaluations for 26 weeks. The primary outcome was the effectiveness of goserelin in reducing serum testosterone and prostate-specific antigen (PSA) levels. The secondary outcomes included testosterone and PSA levels, attainment of chemical castration (serum testosterone <50 ng/dL), and goserelin safety. The exploratory outcome was the monitoring pattern for serum testosterone and PSA. All analyses were descriptive. Results: Between September 2017 and December 2019, a total of 294 eligible patients received = 1 dose of goserelin; 287 patients (97.6%) were treated with goserelin 10.8-mg depot. At week 24 ± 2, the changes from baseline [standard deviation (95% confidence interval)] in serum testosterone (n = 99) and PSA (n = 131) were -401.0 ng/dL [308.4 ng/dL (-462.5, -339.5 ng/dL)] and -35.4 ng/mL [104.4 ng/mL (-53.5, -17.4 ng/mL)], respectively. Of 112 evaluable patients, 100 (90.2%) achieved a serum testosterone level < 50 ng/dL. Treatment-emergent adverse events (TEAEs) and severe TEAEs occurred in 37.1% and 10.2% of patients, respectively. The mean testing frequency (standard deviation) was 1.6 (1.5) for testosterone and 2.2 (1.6) for PSA. Conclusions: Goserelin 10.8-mg depot effectively achieved and maintained castration and was well-tolerated in Chinese patients with localized and locally advanced prostate cancer. [ABSTRACT FROM AUTHOR]

Background: Timely diagnosis and treatment of silent cerebrovascular disease (SCD) are critical for future cerebrovascular disease prevention, whereas asymptomatic specificity of SCD can lead to a lack of reasonable healthcare utilization. In China, access barriers to care for SCD patients is rarely studied. This study aimed to estimate the access barriers to care for SCD patients in rural China and explored associated factors. Methods: We constructed a demand-side questionnaire using the six-dimensional model of access barriers to care, and collected survey data in Guizhou province, China. Data from SCD patients were collected including demographics, health status, and self-perceived access barriers to care. Linear regression was used to estimate the association between access barriers to care and self-reported health status. Results: A total of 162 SCD patients were included in the analysis. The questionnaire's measures are adoptable with reliability (Cronbach's α = 0.86) and validity (KMO = 0.774, Bartlett's test pvalue < 0.05). The average score of access barriers to care for SCD patients in Guizhou was 13.41 (SD = 4.08). Average scores vary across the six dimensions, and affordability has the highest score of 3.07 (SD = 0.13), indicating the highest level of access barriers in terms of affordability. The lowest scored dimension is acceptability which score is 1.62 (SD = 0.33), indicating SCD patients had a relatively high willingness in receiving healthcare services. Regression outcome reported that self-reported worse health status was significantly associated with higher level of access barriers (p-value < 0.01). Conclusion: This study estimated overall and by-dimension access barriers to care for patients with SCD in rural China and investigated the association between health status and access barriers to care. The varied level of different dimensions of access barriers to care suggested that interventions designed to facilitate healthcare utilization should be specific and target those SCD patients who are in poorer health status and have difficulty affording healthcare expenses. [ABSTRACT FROM AUTHOR]

BACKGROUND The benefits of healthy lifestyles are well recognized. However, the extent to which improving unhealthy lifestyles reduces cardiovascular disease (CVD) risk needs to be discussed. We evaluated the impact of lifestyle improvement on CVD incidence using data from the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China). METHODS A total of 12,588 participants free of CVD were followed up for three visits after the baseline examination. Changes in four lifestyle factors (LFs) (smoking, diet, physical activity, and alcohol consumption) were assessed through questionnaires from the baseline to the first follow-up visit. Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). The risk advancement periods (RAPs: the age difference between exposed and unexposed participants reaching the same incident CVD risk) and population-attributable risk percentage (PAR%) were also calculated. RESULTS A total of 909 incident CVD cases occurred over a median follow-up of 11.14 years. Compared with maintaining 0-1 healthy LFs, maintaining 3–4 healthy LFs was associated with a 40% risk reduction of incident CVD (HR = 0.60, 95% CI: 0.45–0.79) and delayed CVD risk by 6.31 years (RAP: −6.31 [−9.92, −2.70] years). The PAR% of maintaining 3–4 unhealthy LFs was 22.0% compared to maintaining 0-1 unhealthy LFs. Besides, compared with maintaining two healthy LFs, improving healthy LFs from 2 to 3–4 was associated with a 23% lower risk of CVD (HR = 0.77, 95% CI: 0.60–0.98). CONCLUSIONS Long-term sustenance of healthy lifestyles or improving unhealthy lifestyles can reduce and delay CVD risk. [ABSTRACT FROM AUTHOR]

Background: As the standard treatment for pseudomyxoma peritonei (PMP), cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) can significantly prolong the survival of PMP patients, and some patients can even achieve long-term survival (LTS) or clinical cure. The purpose of this study was to analyze the clinicopathological and treatment features of PMP patients with LTS and to explore the survival benefit factors of PMP patients. Methods: The clinicopathological and prognostic data of PMP patients who received CRS + HIPEC at our center from December 2004 to May 2023 were retrospectively analyzed. PMP patients were divided into LTS group (≥ 10 years) and short-term survival (STS) group (< 5 years) according to the length of natural history. Univariate and multivariate analyses were performed to explore the beneficial factors of PMP patients with LTS. Results: A total of 609 patients with PMP received CRS + HIPEC treatment at our center. Two-hundred one patients with PMP were included in the study after screening, including 39 patients (19.4%) in the LTS group and 162 patients (80.6%) in the STS group. In STS group and LTS group, median overall survival based on natural history was 29.2 (2.4–59.9) vs. 138.9 (120.3–416.7) months. Univariate analysis revealed 8 factors (P < 0.05) with statistically significant differences between the two groups: gender, chemotherapy history, previous surgical score, Karnofsky Performance Status score, pathological diagnosis, lymphatic metastasis, peritoneal cancer index, and completeness of cytoreduction (CC). Multivariate analysis identified only two factors independently associated with LTS of PMP patients: CC and pathological diagnosis. Conclusion: Complete CRS and pathological features are two key factors affecting LTS in PMP patients. [ABSTRACT FROM AUTHOR]

The quality of care provided to patients with cancer at the end of their lives remains unsatisfactory, especially during their last days and hours of life. This study aimed to investigate knowledge and practice behaviors of oncology nurses in relation to the care of the dying and to analyze the influencing factors. A convenience sample of 222 oncology nurses was recruited from 14 hospitals in Beijing, China, in January 2022. These nurses completed an online survey that included a demographic and work characteristics questionnaire and knowledge and practice behavior questionnaires regarding the care needs of dying cancer patients. The self-perceived knowledge and practice behavior of oncology nurses toward the care of the dying were found to be moderate. However, their understanding of airway management, restlessness, and delirium management was insufficient. In addition, their ability to effectively communicate recommendations for discontinuing unnecessary procedures, medications, treatments, and monitoring was inadequate. Nurses' previous end-of-life care education and experience of caring for dying patients influenced their knowledge. Nurses' practice settings, experience of caring for dying patients, and their knowledge were key factors in shaping their behaviors. Providing targeted continuing education for nurses in hospital settings and exploring the nursing pathway may be important ways to bridge their knowledge gap and enhance their practice behaviors toward caring for dying patients. [ABSTRACT FROM AUTHOR]

Global Navigation Satellite System (GNSS) can provide all-weather, all-time, high-precision positioning, navigation and timing services, which plays an important role in national security, national economy, public life and other aspects. However, in environments with limited satellite signals such as urban canyons, tunnels, and indoor spaces, it is difficult to provide accurate and reliable positioning services only by satellite navigation. Multi-source sensor integrated navigation can effectively overcome the limitations of single-sensor navigation through the fusion of different types of sensor data such as Inertial Measurement Unit (IMU), vision sensor, and LiDAR, and provide more accurate, stable and robust navigation information in complex environments. We summarizes the research status of multi-source sensor integrated navigation technology, and focuses on the representative innovations and applications of integrated navigation and positioning technology by major domestic scientific research institutions in China during 2019--2023. [ABSTRACT FROM AUTHOR]

Traffic flow prediction plays an important role in intelligent transportation systems and is of great significance in the applications of traffic control and urban planning. Due to the complexity of road traffic flow data, traffic flow prediction has been one of the challenging tasks to fully exploit the spatiotemporal characteristics of roads to improve prediction accuracy. In this study, a combined flow direction level traffic flow prediction graph convolutional network (GCN) and long short-term memory (LSTM) model based on spatiotemporal characteristics is proposed. First, a GCN model is employed to capture the topological structure of the data graph and extract the spatial features of road networks. Additionally, due to the capability to handle long-term dependencies, the longterm memory is used to predict the time series of traffic flow and extract the time features. The proposed model is evaluated using real-world data, which are obtained from the intersection of Liuquan Road and Zhongrun Avenue in the Zibo High-Tech Zone of China. The results show that the developed combined GCNLSTM flow direction level traffic flow prediction model can perform better than the single models of the LSTM model and GCN model, and the combined ARIMA- LSTM model in traffic flow has a strong spatiotemporal correlation. [ABSTRACT FROM AUTHOR]

Diabetic nephropathy (DN) is a kidney disorder secondary to diabetes and is one of the main diabetic microvascular complications. As the number of diabetic patients grows, DN has become the leading cause of chronic kidney disease in China. Unfortunately, no definitive cure currently exists for DN. Cornus officinalis (CO), frequently utilized in clinical settings for diabetes mellitus treatment, has proven vital in both preventing and treating DN. This article explores the pathogenesis of DN and how CO and its active compounds regulate glucose and lipid metabolism, exhibit anti-inflammatory properties, inhibit oxidative stress, regulate podocytes, and manage autophagy. The mechanism and role of and its activecompounds in the treatment of DN are discussed. [ABSTRACT FROM AUTHOR]

Due to the many factors that affect commodity prices, price forecasting has become a problematic research point. With the development of machine learning and artificial in-telligence, some advanced ensemble algorithms and deep learning prediction methods based on time series have high accuracy and robustness. These algorithms have gradually become the inevitable choice for solving price prediction problems. Based on the National Bureau of Statistics of China data from January 2012 to December 2021, this study pro-poses deep learning combined forecasting model based on neural networks to predict wheat prices and fill the research gap in agricultural product price forecasting. Researchers utilize Python and Selenium to realize the automatic data acquisition of web pages to achieve the purpose of data collection and calculation. The final price result curve pre-dicted by the price prediction model based on LSTM deep learning agrees with the actual price curve, and the mean square error MSE is only 0.00026. It shows that this prediction model based on time series influenced by multiple factors has an excellent application prospect in price prediction. [ABSTRACT FROM AUTHOR]

The known species of the genus Norellisoma from China are reviewed and two new species from Yintiaoling Nature Reserve in Chongqing City, where no other Norellisoma species are recorded, are described: Norellisoma wuxiense sp. nov., Norellisoma yintiaoense sp. nov. A key to the species of Norellisoma from China is provided. [ABSTRACT FROM AUTHOR]

Background: Toripalimab is the first domestic anti-tumor programmed death 1 antibody marketed in China. The CHOICE-01 trial (identifier: NCT 03856411) demonstrated that toripalimab plus chemotherapy can significantly improve the clinical outcomes of advanced non-small cell lung cancer (NSCLC) patients. However, whether it is cost-effective remains unknown. Given the high cost of combination therapy, a cost-effectiveness analysis of toripalimab plus chemotherapy (TC) versus chemotherapy alone (PC) for the first-line treatment of patients with advanced NSCLC is required. Methods: A partitioned survival model was adopted to predict the course of disease in advanced NSCLC patients on TC or PC from the perspective of the Chinese healthcare system over a 10-year horizon. The survival data were obtained from the CHOICE-01 clinical trial. Cost and utility values were obtained from local hospitals and kinds of literature. Based on these parameters, the incremental costeffectiveness ratio (ICER) of TC vs. PC was measured, and one-way sensitivity analyses, probabilistic sensitivity analyses (PSA), and scenario analyses were performed to assess the robustness of the model. Results: In the base case, TC was associated with an incremental cost of $18510 and an incremental quality-adjusted life year (QALY) of 0.57 compared with PC, resulting in an ICER of $32237/QALY which was lower than the willingness to pay (WTP) threshold ($37654/QALY), TC was cost-effective. The health utility value of progression-free survival, the price of toripalimab, and the cost of best supportive care were factors that significantly influenced the ICER, but no change in any of them could change the model result. TC showed a 90% probability of being a cost-effective option at a WTP threshold of $37,654/QALY. In the 20 and 30-year time horizons, the results remained unchanged and TC remained cost-effective when the second-line treatment was switched to docetaxel. Conclusion: At a WTP threshold of $37,654 per QALY, TC was cost-effective compared to PC for patients with advanced NSCLC in China. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has greatly affected treatment-seeking behaviors of psychiatric patients and their guardians. Barriers to access of mental health services may contribute to adverse mental health consequences, not only for psychiatric patients, but also for their guardians. This study explored the prevalence of depression and its association with quality of life among guardians of hospitalized psychiatric patients during the COVID-19 pandemic. Methods: This multi-center, cross-sectional study was conducted in China. Symptoms of depression and anxiety, fatigue level and quality of life (QOL) of guardians were measured with validated Chinese versions of the Patient Health Questionnaire - 9 (PHQ-9), Generalized Anxiety Disorder Scale - 7 (GAD-7), fatigue numeric rating scale (FNRS), and the first two items of the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. Independent correlates of depression were evaluated using multiple logistic regression analysis. Analysis of covariance (ANCOVA) was used to compare global QOL of depressed versus non-depressed guardians. The network structure of depressive symptoms among guardians was constructed using an extended Bayesian Information Criterion (EBIC) model. Results: The prevalence of depression among guardians of hospitalized psychiatric patients was 32.4% (95% CI: 29.7-35.2%). GAD-7 total scores (OR=1.9, 95% CI: 1.8-2.1) and fatigue (OR=1.2, 95% CI: 1.1-1.4) were positively correlated with depression among guardians. After controlling for significant correlates of depression, depressed guardians had lower QOL than non-depressed peers did [F(1, 1,101)=29.24, p < 0.001]. "Loss of energy" (item 4 of the PHQ-9), "concentration difficulties" (item 7 of the PHQ-9) and "sad mood" (item 2 of the PHQ-9) were the most central symptoms in the network model of depression for guardians. Conclusion: About one third of guardians of hospitalized psychiatric patients reported depression during the COVID-19 pandemic. Poorer QOL was related to having depression in this sample. In light of their emergence as key central symptoms, "loss of energy," "concentration problems," and "sad mood" are potentially useful targets for mental health services designed to support caregivers of psychiatric patients. [ABSTRACT FROM AUTHOR]

The effects of the moon on mental activities remain contentious. Few studies have investigated associations between lunar phases and different types of bipolar disorder (BD) episodes. In the current study, 7,452 patients with BD from three hospitals were enrolled. Patients were divided into two groups on the basis of episode types, and the effects of lunar phase were examined for each type. The cosinor analysis revealed moon-related rhythmicity in admissions for BD in a period of 14.75 days. There were fewer admissions around the new moon and the full moon. There was no significant difference between different groups in acrophase. There was possibly a temporal lag between the onset of BD and hospitalization. Thus, it is too early to draw firm conclusions about the impact of lunar phases on BD. Sleep might be a middle way from moon effect to admissions of BD. These results have implications for future disease prevention strategies and research. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the relationship between sleep quality, snoring symptoms, night shift and risk of stroke in Chinese population over 40 years old. Methods: Based on the national screening and intervention program for high-risk population of stroke in 2016, 15,016 people completed the study of "the association between sleep and stroke," 58,696 people completed the snoring questionnaire, and 58,637 people completed the night shift questionnaire. Results: The proportion of coronary heart disease, hypertension, hyperlipidemia, diabetes, snoring, atrial fibrillation, stroke and high-risk group of stroke risk rating were higher in the group with poor sleep quality (p < 0.05). The proportion of high blood pressure, hyperlipidemia, diabetes, atrial fibrillation, transient ischemic attack (TIA), or high-risk group of stroke risk rating was higher in snoring group (p < 0.05). The body mass index (BMI), waist circumference, neck circumference, fasting blood glucose, triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and homocysteine (Hey) levels in snoring group were higher than the non-snoring group, and high density lipoprotein (HDL) levels were lower (p < 0.05). People with TIA, high risk for stroke, and high blood pressure were higher in night shift workers than non-night shift workers (p < 0.05). The levels of BMI, fasting blood glucose, 2h postprandial blood glucose, glycated hemoglobin, TG, TC, LDL, HDL and Hey in night shift group were lower than the non-night shift group (p < 0.05). Conclusion: Sleep quality, snoring and night shift might be related to the risk factors of stroke. [ABSTRACT FROM AUTHOR]

Aim: This study sought to compare treatment persistence, adherence, and risk of exacerbation among patients with COPD treated with single-inhaler triple therapy (SITT) and multiple-inhaler triple therapy (MITT) in the Chinese population. Methods: This was a multicenter, prospective observational study. Patients with COPD from ten hospitals in Hunan and Guangxi provinces in China were recruited from 1 January 2020 to 31 November 2021 for the study and were followed up for one year. Treatment persistence, adherence, and exacerbation rates during the 12-month follow-up were analyzed in COPD patients treated with SITT and MITT. Results: A total of 1,328 patients were enrolled for final analysis, including 535 (40.3%) patients treated with SITT and 793 (59.7%) treated with MITT. Of these patients, the mean age was 64.9 years and most patients were men. The mean CAT score was 15.2 ± 7.1, and the median (IQR) FEV1% was 54.4 (31.2). The SITT group had a higher mean CAT score, more patients with mMRC >1, and lower mean FEV1% and FEV1/FVC than the MITT patients. Moreover, the proportion of patients with ≥1 exacerbation in the previous year was higher in the SITT cohort. SITT patients had, compared to MITT patients, a higher proportion of adherence (proportion of days covered, PDC) ≥0.8 (86.5% vs. 79.8%; p = 0.006), higher treatment persistence [HR: 1.676 (1.356–2.071), p < 0.001], lower risk of moderateto-severe exacerbation [HR: 0.729 (0.593–0.898), p = 0.003], and severe exacerbation [HR: 0.675 (0.515–0.875), p = 0.003], as well as reduced all-cause mortality risk [HR: 0.475 (0.237-0.952), p = 0.036] during the 12-month follow-up. Persistence was related to fewer future exacerbations and mortality than nonpersistence in the SITT and MITT groups. Conclusion: Patients with COPD treated with SITT showed improved treatment persistence and adherence, as well as a reduction in the risk of moderate-to-severe exacerbation, severe exacerbation, and mortality compared to patients treated with MITT in the Chinese population. [ABSTRACT FROM AUTHOR]

Chimonanthus salicifolius S. Y. Hu (C. salicifolius) is a unique medicinal plant of Magnolia in China, it could inhibit pathogens and prevent flu, which has been extensively applied for drinking tea. The purpose of this study was to analyze the main components of ethyl acetate extract of C. salicifolius (EAECS) and explore the effect of extract on loperamide-induced constipation in mice. The mice with constipation induced by loperamide were given different concentrations of C. salicifolius extract once a day for 14 days. The constipation-related parameters, stool particles, the time of the first black stool defecation and gastrointestinal (GI) transit rate were determined. In addition, the change of abundance and diversity in intestinal microbiota were analyzed. The results indicated that the main components in EAECS were rutin, nicotiflorin, quercetin and kaempferol. After administration, EAECS treatment relieved loperamideinduced constipation in mice, as evidenced by reduced defecation time and significantly increased GI transit rate, fecal particles and water content. At genus level, the extract also remarkably reduced Ruminococcus and increased the abundance of Lactobacillus and Bifidobacterium in intestinal tract of mice (all p < 0.05). These findings indicated that EAECS effectively improved loperamide-induced constipation in mice and could be considered as a candidate treatment for constipation. [ABSTRACT FROM AUTHOR]

Background Education levels play a critical role in the development of chronic obstructive pulmonary disease (COPD), which mainly affects the elderly, who generally have a low level of education in China. We aimed to investigate the association between education level and COPD clinical characteristics and outcomes, especially the effects of education level on the all-cause mortality of COPD in the Chinese population. Methods We retrieved data collected between December 2016 and June 2020 in the RealDTC, an ongoing multicenter, real-world study on the status of diagnosis and treatment of COPD. The patients were classified into low- and high-education groups. We extracted data on demographics, pulmonary function, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, modified Medical Research Council (mMRC) scores, COPD Assessment Test (CAT) scores, exacerbation history, therapy, and comorbidities, and on mortality during three years of follow-up. Results We included 4098 patients with COPD, of whom 3258 (79.5%) were of low education. This group had higher ages, CAT scores, mMRC scores, and numbers of exacerbations, as well as a greater proportion of females, never smokers, biofuel exposure, and GOLD grade 3. Logistic regression showed that being aged ≥65 years, being female, having biofuel exposure, having CAT scores of 20-29, and having ≥2 exacerbations were independently associated with having low education (P < 0.05). Furthermore, low-education COPD patients had a higher cumulative mortality risk during three years of follow-up than their high-education counterparts (hazard ratio (HR) = 1.75; 95% confidence interval (CI) = 1.17-2.61, P = 0.006). Conclusions Low-education COPD patients, who accounted for most of our sample, had a higher symptom burden, risk of exacerbation, and risk of all-cause mortality. Clinicians attending COPD patients should be more attentive of individuals with low education levels. [ABSTRACT FROM AUTHOR]

Background The high costs of novel anticancer drugs have caused concern among healthcare stakeholders. To address the knowledge gap on the proportion of survival benefit with the related economic expenditure, we aimed to assess the correlation between the costs and value of innovative drugs targeted to specific tumours, before and after price negotiation policy implementation. Methods We identified new drugs for lung and breast cancer that entered the National Reimbursement Drug List (NRDL) through price negotiation from 2016 to 2023. Therapeutic value consisted of traditional clinical endpoints, like the percentage improvement of overall survival (≥OS%) and progression-free survival (≥PFS%), and the quantified gains of the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). We calculated monthly drug costs and used Spearman's correlation coefficient and Cohen's kappa statistics for statistical analysis. Results Twenty-nine innovative price-negotiated drugs were collected between 2016 and 2023. The median monthly costs were US$3381.31 out of NRDL and US$1095.88 within NRDL, with an ≥OS% of 22.24% (IQR = 6.45-29.48) and a ≥PFS% of 83.82% (IQR = 50.41-104.05). The median ASCO-VF score was 40.98, and 17 drugs scored the meaningful benefit of ESMO-MCBS. We found no association between clinical benefits and their costs before and after NRDL, either overall or for specific cancers. The agreement between the two frameworks was stable. Conclusions The negotiation policy decreased medication costs, but did not generate the expected correlation between the value and costs of anticancer drugs. Comprehensive value assessments need to be performed in the future to explore more in-depth findings and promote the affordability and availability of effective anticancer drugs. [ABSTRACT FROM AUTHOR]

Two new species of the lichenized genus Lasioloma are described from Asia: Lasioloma longiramosum W. C. Wang & A. Abas (collected from Malaysia), is characterized by a distinct woolly prothallus between dispersed thallus patches, comparatively small, muriform ascospores, long filiform conidia (main branch 22–28 μm in length, the other three branches 65–80 μm) and a foliicolous habitat; L. verrucosum W. C. Wang & X. L. Wei (collected from China), is characterized by a warted thallus, filiform conidia (main branch 22–32 μm in length, the other three branches 50–65 μm) and a corticolous habitat. The placement of both new species was confirmed by a molecular phylogenetic approach based on combined ITS, mtSSU and mtLSU sequences, and both are compared in detail to other similar species of the genus. Our study also revealed that the length of the conidial branches, which has not been explored in previous studies, should be regarded as an important feature for species delimitation in Lasioloma. [ABSTRACT FROM AUTHOR]

BACKGROUND: To investigate the most appropriate dual antiplatelet therapy (DAPT) duration for patients with acute coronary syndrome (ACS) after drug-eluting stent (DES) implantation in the largest cardiovascular center of China. METHODS: We enrolled 5,187 consecutive patients with ACS who received DES from January to December 2013. Patients were divided into four groups based on DAPT duration: standard DAPT group (11-13 months, n=1,568) and prolonged DAPT groups (13-18 months [n=308], 18-24 months [n=2,125], and >24 months [n=1,186]). Baseline characteristics and 5-year clinical outcomes were recorded. RESULTS: Baseline characteristics were similar across the four groups. Among the four groups, those with prolonged DAPT (18-24 months) had the lowest incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) (14.1% vs. 11.7% vs. 9.6% vs. 24.2%, P<0.001), all-cause death (4.8% vs. 3.9% vs. 2.1% vs. 2.6%, P<0.001), cardiac death (3.1% vs. 2.6% vs. 1.4% vs. 1.9%, P=0.004), and myocardial infarction (MI) (3.8% vs. 4.2% vs. 2.5% vs. 5.8%, P<0.001). The incidence of bleeding was not different among the four groups (9.9% vs. 9.4% vs. 11.0% vs. 9.4%, P=0.449). Cox multivariable analysis showed that prolonged DAPT (18-24 months) was an independent protective factor for MACCEs (hazard ratio [HR] 0.802, 95% confidence interval [CI] 0.729-0.882, P<0.001), all-cause death (HR 0.660, 95% CI 0.547-0.795, P<0.001), cardiac death (HR 0.663, 95% CI 0.526-0.835, P<0.001), MI (HR 0.796, 95% CI 0.662-0.957, P=0.015), and target vessel revascularization (HR 0.867, 95% CI 0.755-0.996, P=0.044). Subgroup analysis for high bleeding risk showed that prolonged DAPT remained an independent protective factor for all-cause death and MACCEs. CONCLUSION: For patients with ACS after DES, appropriately prolonging the DAPT duration may be associated with a reduced risk of adverse ischemic events without increasing the bleeding risk. [ABSTRACT FROM AUTHOR]

The emergence of pathogens is conferring resistance to last-resort therapies such as tigecycline, colistin, and carbapenems, limiting the therapeutic options, and raising concerns about the emergence of new "superbugs." This study reports the first incident of a blaNDM􀀀5 and tet(X4) co-harboring Escherichia coli with resistance to carbapenem and tigecycline recovered as the causative agent of a urinary tract infection in a 94-year-old patient. The E. coli strain ECCL209 carries multiple resistance genes [i.e., blaTEM􀀀1B, blaNDM􀀀5, blaCMY􀀀2, aadA22, florR, erm(B), mph(A), erm(42), lnuG, qnrS1, and sul2] and exhibits resistance to almost all clinically used antibiotics. MLST analysis found that the strain belongs to ST648, considered a worldwide highrisk pandemic clone. Moreover, multiple plasmid incompatibility types were detected, i.e., IncHI1A, IncHI1B, IncFII, IncFIA, IncFIB, IncQ1, Col, and IncX4. Genetic analysis revealed that blaNDM􀀀5 and tet(X4) genes were localized on two hybrid plasmids with multiple replicons. Continuous monitoring studies are suggested to quantify the antimicrobial resistance and assess the dissemination of such superbugs into a human healthcare setting. [ABSTRACT FROM AUTHOR]

Soil microenvironments and plant varieties could largely affect rhizosphere microbial community structure and functions. However, their specific effects on the tea rhizosphere microbial community are yet not clear. Beneficial microorganisms are important groups of microbial communities that hold ecological functionalities by playing critical roles in plant disease resistance, and environmental stress tolerance. Longjing43 and Zhongcha108 are two widely planted tea varieties in China. Although Zhongcha108 shows higher disease resistance than Longjing43, the potential role of beneficial tea rhizosphere microbes in disease resistance is largely unknown. In this study, the structure and function of rhizosphere microbial communities of these two tea varieties were compared by using the Illumina MiSeq sequencing (16S rRNA gene and ITS) technologies. Rhizosphere soil was collected from four independent tea gardens distributed at two locations in Hangzhou and Shengzhou cities in eastern China, Longjing43 and Zhongcha108 are planted at both locations in separate gardens. Significant differences in soil physicochemical properties as demonstrated by ANOVA and PCA, and distinct rhizosphere microbial communities by multiple-biotech analyses (PCoA, LEfSe, Co-occurrence network analyses) between both locations and tea varieties (p < 0.01) were found. Functions of bacteria were annotated by the FAPROTAX database, and a higher abundance of Nitrososphaeraceae relating to soil ecological function was found in rhizosphere soil in Hangzhou. LDA effect size showed that the abundance of arbuscular mycorrhizal fungi (AMF) was higher in Zhongcha108 than that in Longjing43. Field experiments further confirmed that the colonization rate of AMF was higher in Zhongcha108. This finding testified that AMF could be the major beneficial tea rhizosphere microbes that potentially function in enhanced disease resistance. Overall, our results confirmed that locations affected the microbial community greater than that of tea varieties, and fungi might be more sensitive to the change in microenvironments. Furthermore, we found several beneficial microorganisms, which are of great significance in improving the ecological environment of tea gardens and the disease resistance of tea plants. These beneficial microbial communities may also help to further reveal the mechanism of disease resistance in tea and potentially be useful for mitigating climate change-associated challenges to tea gardens in the future. [ABSTRACT FROM AUTHOR]

To achieve near-continuous vertical observations of volatile organic compounds (VOCs) in the planetary boundary layer (PBL), multi-channel whole-air sampling equipment onboard an unmanned aerial vehicle (UAV) platform was developed in this study. The equipment consists of a multi-position solenoid valve and specially designed lightweight quartz sampling canisters. The canisters have little adsorption loss of VOCs and good inter-canister reproducibility. The 7-day recovery test shows that most VOC species (97%) had a one-week decay within 20%. Online instruments for measuring O3, NO2, CO, SO2, and meteorological parameters are also integrated into the UAV platform. During one take-off and landing, the UAV platform can reach 800 m above the ground within 40 min and take whole-air samples at six heights. Vertical profiles of VOCs and trace gases during the evolution of the PBL in southwest China are successfully obtained by deploying the newly developed UAV system. [ABSTRACT FROM AUTHOR]

Background: Small-cell lung cancer (SCLC) is a recalcitrant tumor with a poor prognosis. With the rise of SCLC research in the past decade, this study aims to analyze the foundation and frontiers of SCLC research through bibliometric analysis. Methods: Relevant publications from the Web of Science Core Collection were retrieved on January 3, 2022. R package bibliometrix and EXCEL2019 were used to analyze quantitative variables. Bibliometric mapping was constructed by VOS viewer and CiteSpace software to visualize citation, co-authorship, cooccurrence, and co-citation analysis of countries/regions, organizations, authors, references, and keywords. Results: A total of 2,361 publications related to SCLC were identified with the total amount of articles steadily increasing, where China is the most productive country with 859 papers. Scholars and organizations from the United States, China, and Europe are primary sources of this research, among which the University of Texas MD Anderson Cancer Center made the most contribution to the field with 122 papers. Lung Cancer published the highest number of SCLC-related articles with a total of 121, while the Journal of Thoracic Oncology received the most citations totaling 3,098. Rudin, Charles M., and Sage, Julien are the most creative author. Leora, Horn, 2018, New Engl J Med and Rudin, Charles M., Nat Genet, 2012 can be categorized as classic literature owing to their high citations or strong sigma value. “Heterogeneity & Subtypes” and “Immunotherapy” may be the new frontiers in the SCLC domain. Conclusion: Research on SCLC showed an upward trend based on the current global situation. Moreover, the current scope of collaboration in SCLC research is chiefly regional, which should further focus on transnational cooperation in the future. More attention should be devoted to “Heterogeneity & Subtypes” and “Immunotherapy”, which will be the hotspots in future research. [ABSTRACT FROM AUTHOR]

Objective: It is very important to identify individuals who are at greatest risk for mild cognitive impairment (MCI) to potentially mitigate or minimize risk factors early in its course. We created a practical MCI risk scoring system and provided individualized estimates of MCI risk. Methods: Using data from 9,000 older adults recruited for the Beijing Ageing Brain Rejuvenation Initiative, we investigated the association of the baseline demographic, medical history, lifestyle and cognitive data with MCI status based on logistic modeling and established risk score (RS) models 1 and 2 for MCI. We evaluated model performance by computing the area under the receiver operating characteristic (ROC) curve (AUC). Finally, RS model 3 was further confirmed and improved based on longitudinal outcome data from the progression of MCI in a sub-cohort who had an average 3-year follow-up. Results: A total of 1,174 subjects (19.8%) were diagnosed with MCI at baseline, and 72 (7.8%) of 849 developed MCI in the follow-up. The AUC values of RS models 1 and 2 were between 0.64 and 0.70 based on baseline age, education, cerebrovascular disease, intelligence and physical activities. Adding baseline memory and language performance, the AUC of RS model 3 more accurately predicted MCI conversion (AUC = 0.785). Conclusion: A combination of risk factors is predictive of the likelihood of MCI. Identifying the RSs may be useful to clinicians as they evaluate their patients and to researchers as they design trials to study possible early non-pharmaceutical interventions to reduce the risk of MCI and dementia. [ABSTRACT FROM AUTHOR]

Background: The use of Chinese herbal medicine (CHM) for the treatment of atopic dermatitis (AD) has gained attention. This quantitative study systematically evaluated the efficacy and safety of CHM for the treatment of AD in eight high-level clinical trials, resulting in a high level of clinical evidence. Methods: Several databases were searched, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chongqing VIP Chinese Science (VIP), and Wanfang Database. High-quality randomized controlled trials (RCTs) comparing CHM with placebo were included. The 95% confidence interval (CI) of the risk ratio (RR) was calculated using software (RevMan 5.3) and a meta-analysis was performed. Evidence level evaluation using GRADE Profiler 3.6. Results: In total, 662 patients (322 in the experimental group and 340 in the control group) were included. The response rate of the Eczema Area and Severity Index (EASI) -90 was higher in the CHM group than in the placebo group (RR, 3.72; 95% CI, 1.76 to7.83; p = 0.01). Furthermore, the scoring of atopic dermatitis (SCORAD) (RR, -10.20), body surface area (BSA) (RR, -2.01), surface damage score (RR, -2.25), visual analog scale (VAS) (RR, -1.90), and sleep score (RR, -2.16), improvement of investigator's global assessment (IGA) (RR, 2.94) improved in the CHM group. The results showed no statistical difference between CHM and placebo (MD, -0.47; 95% CI, -1.30, 0.37; p = 0.27) in improving the Dermatology Life Quality Index (DLQI) or children's DLQI (CDLQI). There was also no significant difference in the IgE level between the two groups (MD, -62.76; 95% CI, -809.58, 684.05; p = 0.87). However, the adverse events (AEs) rate was slightly higher in patients treated with CHM than in those treated with placebo (RR, 1.42; 95% CI, 1.06-1.90; p = 0.02). Conclusion: CHM improved the size and severity of the skin lesions and sleep quality in patients with AD. Comparing the adverse effects between the two groups, CHM is safe. However, CHM does not improve the quality of life or the patient's IgE levels. [ABSTRACT FROM AUTHOR]