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To investigate the impact of climate change on the growth period and yield of irrigated spring maize in arid region of Northwest China, the study was conducted based on located observational experiment and climatic data from 1984 to 2022. The results showed that the temperature increased significantly during the entire growth period with a climate trend rate of 0.76°C•10y-1 (P<0.01), and a significant rise in active accumulated temperature above 10°C, with a climate trend rate of 135.80°C•d•10y-1 (P<0.01). Although there was no significant change in precipitation during the entire growth period, it increased significantly during the milky-maturity stage, with a climate trend rate of 4.50mm•10y-1 (P<0.05). The sunshine duration increased significantly from 1984 to 2004, with a climate trend rate of 126.88h•10y-1 (P<0.01), but decreased significantly in the last 19 years, with a climate trend rate of -109.38h•10y-1 (P<0.01). The growth days of spring maize increased from 1984 to 2004, with a climatic trend rate of 9.86d•10y-1 (P<0.01), but decreased significantly in the last 19 years, with a climatic trend rate of 7.39d•10y-1 . The length of sowing-seedling and seventh leaf-jointing was significantly negatively correlated with temperature, respectively. The length of sowing-seeding, third leaf-seventh leaf and silking-milky was significantly positively correlated (P<0.05) with precipitation, respectively. The length of different growth periods was significantly positively correlated (P<0.01) with sunshine duration, respectively. The yield of spring maize fluctuated and climatic yield was significantly negatively correlated (P<0.05) with precipitation. In summary, climate change has been unfavorable to spring maize growth under current irrigation methods in arid region of northwest China. [ABSTRACT FROM AUTHOR]

The Yellow River Delta (YRD), known for its vast and diverse wetland ecosystem, is the largest estuarine delta in China. However, human activities and climate change have significantly degraded the wetland ecosystem in recent decades in the YRD. Therefore, an understanding of the land use modifications is essential for the efficient management and preservation of ecosystems in this region. This study utilized time series of remote sensing data and the extreme gradient boosting method to generate land use maps of the YRD from 2000 to 2020. Several methods, including transition matrix, land use dynamic degree, and standard deviation ellipse, were employed to explore the characteristics of land use transitions. The results underscore significant spatial variations in land use over the past two decades. The most rapid increase was observed in built-up area, followed by terrestrial water and tidal flats, while unutilized land experienced the fastest decrease, followed by forest–grassland. The spatial distribution patterns of agricultural land, built-up area, terrestrial water, and forest–grassland demonstrated stronger directionality compared to other land use types. The wetlands have expanded in size and improved in structure. Unutilized land has been converted into artificial wetlands comprising ponds, reservoirs, salt ponds, shrimp and crab ponds, and natural wetlands featuring mudflats and forest–grassland. The wetland conservation efforts after 2008 have proven very effective, playing a positive role in ecological and environmental preservation, as well as in regional sustainable development. [ABSTRACT FROM AUTHOR]

Improper processing of sensitive personal data concerning disabled people in government information disclosure not only violates their privacy rights but also leads to discrimination, stigmatization, and other serious secondary harm, that have long been overlooked. China's procurator-led public-interest litigation system is a powerful tool for protecting the privacy rights of vulnerable groups. This paper contends that procurator-led public-interest litigation, as a supplement to and support for private-interest litigation, assists the Chinese government in fulfilling its international obligations to protect the right to privacy of disabled people. [ABSTRACT FROM AUTHOR]

With the intensification of water pollution problems worldwide, constructed wetlands, as a green, efficient, and energy-saving wastewater treatment technology, have gradually attracted the wide attention of scholars at home and abroad. In order to better understand and master the research trends of constructed wetland treatment technology in China and promote its development, the literature from 2000 to 2023 in the CNKI database and the Web of Science (WoS) database (located in China) were selected as research objects. Then, CiteSpace software (6.2.R4) was used to visualize and analyze the literature, revealing the research trends and hot areas of constructed wetland treatment technology in China. Then, the optimized way of operation effect of constructed wetland was discussed to provide a theoretical and technical basis for the wide application of constructed wetland technology in our country. The results indicate that the annual publication volume of research on constructed wetlands in China is showing a rapid upward trend. Among them, the Chinese literature mainly focuses on how to improve the application effect of constructed wetlands on nitrogen and phosphorus removal of rural domestic wastewater by matching different wetland plants or developing combined processes. The English literature from the Web of Science (WoS) database mainly focuses on how to remove emerging pollutants, such as heavy metals and resistance genes in wastewater in China, by changing the filling matrix and microbial community structure or developing new processes, and the related mechanisms have been discussed. One of the hot spots for the future research of constructed wetlands in China is to vigorously develop microbial fuel cells, and try to overcome the problem of poor purification efficiency of constructed wetlands under complex conditions such as low temperature, low carbon-nitrogen ratio, and high pollution load. In order to strengthen its application, the specific optimization methods can be divided into two categories: self-optimization strategies such as increasing oxygen supply and transfer, providing electron donor matrix, preventing matrix blockage, and combination processes coupled with anaerobic treatment and other technologies. [ABSTRACT FROM AUTHOR]

This study investigates the decomposition process of algal blooms (ABs) in eutrophic lakes and its impact on the labile endogenous nitrogen (N) cycle. In situ techniques such as diffusive gradients in thin films (DGT) and high-resolution dialysis (HR-Peeper) were employed to decipher the vertical distribution of N fractions within the sediment–water interface (SWI) in Taihu, China. Additionally, an annular flume was used to simulate regional differences in lake conditions and understand labile nitrogen transformation during AB decomposition. This study reveals that the NH4+-N fraction exuded from algae is subsequently converted into NO3-N and NO2-N through nitrification, resulting in a significant increase in the concentrations of NO3−-N and NO2−-N at the SWI. The decomposition of algae also induces a significant increase in dissolved organic matter (DOM) concentration, referring to humic acid and humus-like components; a seven-millimeter decrease in dissolved oxygen (DO) penetration depth; as well as a significant decrease in the pH value near the SWI, which consequently promotes denitrification processes in the sediment. Moreover, the decomposition process influences nitrogen distribution patterns and the role conversion of sediments between a "source" and a "sink" of nitrogen. This investigation provides evidence on the migration and/or transformation of N fractions and offers insights into the dynamic processes across the SWI in eutrophic lakes. [ABSTRACT FROM AUTHOR]

In recent years, more and more technical tools have been introduced into various museums, bringing new opportunities and challenges for the research of museum learning. Whether the application of these technologies can effectively improve the effects of museum learning has become a major problem perplexing museum learning researchers. In this paper, a meta-analysis method is used to analyze and evaluate the 42 experimental or quasi-experimental studies on the technology application in the field of museum learning in the past decade. The results show that the technology application has a moderate or higher effect on museum learning, moreover, the age of learners, the type of technology, the type of museum and the visiting pattern of museum will significantly affect the effectiveness of technology on the museum learning. Therefore, the museum institutions can learn from excellent cases to accelerate the application of museum technology, give priority to the construction of digital resources, continue to promote the specialisation of museum technology application, and better play the role of technology in museum education. [ABSTRACT FROM AUTHOR]

The Marrakesh Treaty entered into force in China on May 5, 2022. To fulfill its obligations and guarantee basic education access for visually impaired people, China revised its copyright law and introduced supporting measures for Treaty implementation. This article discusses various issues in designing a legal system for achieving 'intangible accessible environments' for visually impaired people in China and the priorities and possible shortcomings in transforming the Marrakesh Treaty into domestic law. Legislation must carefully avoid using specialized over-protection designs that could exacerbate the marginalization and social isolation of visually impaired people. Furthermore, it is crucial to refine the supporting system for Treaty implementation and strengthen sectoral synergies and international cooperation. [ABSTRACT FROM AUTHOR]

Purpose: This national study aimed to investigate the lung ultrasound (LUS) training and practice of respiratory therapists (RTs) in mainland China.Methods: A cross-sectional multicenter survey was conducted from May 22, 2021 to August 12, 2021, through online platforms. This survey included RTs in mainland China. The survey was divided into four sections: (1) demographic characteristics and basic information; (2) basic information about LUS training and practice; (3) LUS practice details; and (4) Other ultrasound training and practice.Results: A total of 514 responses were received, and 494 valid responses were included in the analysis. 81.2% (401/494) participants' highest degree of education was a bachelor's degree, and 43.1% (213/494) participants were at level II in terms of job ranking. 99.2%(490/494) participants agreed that the RTs needed to learn lung ultrasound, but only 12.3% (61/494) participants had received a LUS training course. Further, 66.2% (327/494) experienced participants responded to Sect. 3. Most of RTs used LUS when the patient had hypoxia (265/327, 81%) or dyspnea (260/317, 79.5%); they also used it during spontaneous breathing trial(SBT) (191/327, 58.4%) or in prone position (177/327, 54.1%). The A-line (302/327, 92.4%), B-line (299/327, 91.4%), lung slide (263/327, 80.4%), and bat sign (259/327, 79.2%) were well known as LUS signs. Also, 30.6% (100/327) participants did not use the LUS protocol in their clinical practice, and only 25.4%(83/327) participants said they had used LUS scores. Moreover, 55.7% (182/327) participants frequently changed the respiratory therapy strategy according to LUS results.Conclusions: We should improve the number and workplace of RTs in mainland China in the future. We should also standardize the application of LUS practice and training for RTs in mainland China and establish corresponding certification pathways. [ABSTRACT FROM AUTHOR]

This paper presents a proposed static test and numerical study on the mechanical properties of steel-shell–concrete-structure-immersed tunnel nodes, which is used to investigate the seismic performance and damage mechanism of steel-shell–concrete-structure-immersed tunnel nodes. The test is based on the immersed tube tunnel project in the deep China channel, and the nodes representing the outermost and innermost vertical walls of the immersed tube tunnel, i.e., L-shaped and T-shaped node specimens, were designed and fabricated at a scale of 1:5, and the specimens were mainly subjected to the combined effect of vertical axial compression and lateral displacement loads. The test results show that the L-shaped node will exhibit brittle damage characteristics with high lateral load carrying capacity and energy dissipation capacity during the ultimate load phase, while the T-shaped node exhibits bending damage with better ductility, so the outermost vertical wall should be locally reinforced to ensure the necessary ductility of the structure in the actual project. In addition, by comparing the numerical calculation and experimental results, it is found that there is good agreement in terms of load–displacement curves and crack distribution, which shows that the modeling method proposed in this paper can accurately simulate the mechanical properties of immersed tunnel nodes and can guide the section design of immersed tunnels with steel shell–concrete structures. [ABSTRACT FROM AUTHOR]

Background: Attributed to the immunosuppression caused by malignancy itself and its treatments, cancer patients are vulnerable to developing nosocomial infections. This study aimed to develop a nomogram to predict the in-hospital death risk of these patients. Methods: This retrospective study was conducted at a medical center in Northwestern China. The univariate and multivariate logistic regression analyses were adopted to identify predictive factors for in-hospital mortality of nosocomial infections in cancer patients. A nomogram was developed to predict the in-hospital mortality of each patient, with receiver operating characteristic curves and calibration curves being generated to assess its predictive ability. Furthermore, decision curve analysis (DCA) was also performed to estimate the clinical utility of the nomogram. Results: A total of 1,008 nosocomial infection episodes were recognized from 14,695 cancer patients. Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (15.5%) was the most predominant causative pathogen. Besides, multidrug-resistant strains were discovered in 25.5% of cases. The multivariate analysis indicated that Eastern Cooperative Oncology Group Performance Status 3–4, mechanical ventilation, septic shock, hypoproteinemia, and length of antimicrobial treatment < 7 days were correlated with higher in-hospital mortality. Patients who received curative surgery were correlated with favorable survival outcomes. Ultimately, a nomogram was constructed to predict the in-hospital mortality of nosocomial infections in cancer patients. The area under the curve values of the nomogram were 0.811 and 0.795 in the training and validation cohorts. The calibration curve showed high consistency between the actual and predicted in-hospital mortality. DCA indicated that the nomogram was of good clinical utility and more credible net clinical benefits in predicting in-hospital mortality. Conclusions: Nosocomial infections stay conjoint in cancer patients, with gram-negative bacteria being the most frequent causative pathogens. We developed and verified a nomogram that could effectively predict the in-hospital death risk of nosocomial infections among these patients. Precise management of high-risk patients, early recognition of septic shock, rapid and adequate antimicrobial treatment, and dynamic monitoring of serum albumin levels may improve the prognosis of these individuals. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors (ICIs) are the standard treatment for advanced lung cancer, but immune‐related adverse events (irAEs) remain poorly understood, especially in a real‐world setting. Methods: A multicenter observational study was conducted. Medical records of lung cancer patients treated with ICIs at 26 hospitals from January 1, 2015, to February 28, 2021, were retrieved. Types of ICIs included antiprogrammed cell death 1 or antiprogrammed cell death ligand 1 (PD‐L1) monotherapy, anticytotoxic T‐lymphocyte antigen‐4 monotherapy, or combination therapy. Results: In total, 1905 patients with advanced lung cancer were evaluated. The median age was 63 (range 28–87) years, and the male/female ratio was 3.1:1 (1442/463). The primary histological subtype was adenocarcinoma (915). A total of 26.9% (512/1905) of the patients developed 671 irAEs, and 5.8% (110/1905) developed 120 grade 3–5 irAEs. Median duration from ICI initiation to irAEs onset was 56 (range 0–1160) days. The most common irAEs were thyroid dysfunction (7.2%, 138/1905), pneumonitis (6.5%, 124/1905), and dermatological toxicities (6.0%, 115/1905). A total of 162 irAEs were treated with steroids and 11 irAEs led to death. Patients with positive PD‐L1 expression (≥1%) and who received first‐line ICI treatment developed more irAEs. Patients who developed irAEs had a better disease control rate (DCR, 71.3% [365/512] vs. 56.0% [780/1145]; p < 0.001). Conclusions: The incidence rate of irAEs was 26.9% in a real‐world setting. IrAEs might be related to a better DCR, but clinicians should be more aware of irAE recognition and management in clinical practice. [ABSTRACT FROM AUTHOR]

China's newly issued genome-edited crop safety assessment guidelines do not entirely deviate from the existing genetically modified regulatory regimes. However, there is an urgent need to reform the genome-edited regulatory framework based on scientific values and a novel regulatory philosophy that balances diverse values to enhance public trust. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence and associated factors of psychological distress among patients with chronic hepatitis B receiving oral antiviral therapy and explore the association between psychological distress and self‐management behaviours among this population. Design: A cross‐sectional study. Methods: A convenience sample of 188 patients with chronic hepatitis B receiving oral antiviral therapy was recruited from March‐October 2018 to complete a self‐report questionnaire including the Chinese version of Depression Anxiety Stress Scale‐21 and Chronic Hepatitis B Self‐Management Scale. Logistic regression analysis and hierarchical multiple regression analysis were used to determine the factors associated with psychological distress and the association between psychological distress and self‐management behaviours respectively. Results: The prevalence of depression, anxiety, and stress symptoms were 33.0%, 38.3% and 17.6% respectively. Depression was associated with older age, female gender, lower education level and longer treatment duration; anxiety was associated with female gender and longer treatment duration; and stress was associated with age of 31–40 years, female gender and unmarried status. There were significant associations between depression and anxiety symptoms and self‐management behaviours. Conclusion: Psychological distress was prevalent among patients with chronic hepatitis B receiving oral antiviral therapy and had a negative impact on self‐management. Interventions targeting depression and anxiety symptoms may be beneficial to improve self‐management behaviours for this population. Impact: This study explored the factors associated with psychological distress in patients with chronic hepatitis B receiving oral antiviral therapy. The findings showed psychological distress was more common in patients who were with older age, female, less educated, unmarried and receiving longer duration of treatment and psychological distress was significantly associated with self‐management behaviours. Nurses and other healthcare providers should provide interventions to reduce the risk of psychological distress and improve self‐management behaviours for this population. [ABSTRACT FROM AUTHOR]

Background: Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate the characteristics, antibiotic resistance patterns, and prognosis of nosocomial infections due to multidrug-resistant (MDR) bacteria in cancer patients.Methods: This retrospective observational study analyzed cancer patients with nosocomial infections caused by MDR from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the survival status of the patients after infection and during hospitalization. The data were analyzed using independent samples t-test, Chi-square test, and binary logistic regression. P-values < 0.05 were considered significant.Results: One thousand eight patients developed nosocomial infections during hospitalization, with MDR strains detected in 257 patients. Urinary tract infection (38.1%), respiratory tract infection (26.8%), and bloodstream infection (BSI) (12.5%) were the most common infection types. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) (72.8%) members were the most frequently isolated MDR strains, followed by Acinetobacter baumannii (11.7%), and Stenotrophomonas maltophilia (6.2%). The results of multivariate regression analysis revealed that smoking history, intrapleural/abdominal infusion history within 30 days, the presence of an indwelling urinary catheter, length of hospitalization, and hemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria exhibited high rates of sensitivity to amikacin, meropenem, and imipenem.Conclusions: The burden of nosocomial infections due to MDR bacteria is considerably high in oncological patients, with ESBL-PE being the most predominant causative pathogen. Our findings suggest that amikacin and carbapenems actively against more than 89.7% of MDR isolates. The precise management of MDR bacterial infections in cancer patients may improve the prognosis of these individuals. [ABSTRACT FROM AUTHOR]

Maize is a major crop in the semiarid region of northwestern China, and, in recent years, severe drought events have often severely impacted local maize production. In this paper, an assessment model for maize drought vulnerability in the semiarid region of northwestern China was constructed after an in-depth analysis of factors linked to drought vulnerability. The model establishes an evaluation index system for drought vulnerability and assesses the level of environmental sensitivity, degree of exposure, crop sensitivity, and adaptability. An assessment and a regionalization analysis of maize drought vulnerability were then conducted for the semiarid region of northwestern China. The results showed the spatial distribution characteristics of environmental sensitivity, degree of exposure, crop sensitivity, and adaptability. The high and sub high vulnerable areas for maize were located mainly in the northern and southern parts of the warm temperate zone (District I A) and covered most of the central region of the middle temperature zone (District II A). The low and sub low vulnerable areas were in the central part of District I A, in the eastern and western part of District II A, and across the whole of the warm temperate zone (Districts I B), the middle temperature zone (Districts II B), and the plateau area of the sub temperate zone (District III). The main factors affecting high drought vulnerability varied across different areas. These results provide a theoretical basis for the risk management of maize production and will help prevent drought disasters in the semiarid region of northwestern China. [ABSTRACT FROM AUTHOR]

Glioma is the most common primary intracranial malignant tumor, and glioblastoma has the worst prognosis. In recent years, immunotherapy targeting immune checkpoints has shown promising results in various solid tumors, and has also become a potential breakthrough in the field of glioma treatment, which has attracted the attention of worldwide neurosurgeons and neuro-oncologists. This paper reviews the literature about immune checkpoint molecules and the clinical trials of immune checkpoint inhibitors, and briefly introduces the research status of immunotherapy in glioma. We hope to provide some references for the design and development of subsequent clinical studies of glioma immunotherapy in China. [ABSTRACT FROM AUTHOR]

Background: China is facing challenges of the shifting presentation of tuberculosis (TB) from younger to elderly due to an ageing population, longer life expectancy and reactivation disease. However, the burden of elderly TB and influence factors are not yet clear. To fill the gap, we generated a cohort study to measure the magnitude of TB incidence and associated factors among the elderly population aged 65 years and above in China. Methods: In this cohort established in 2013 through a prevalence survey conducted in selected sites, a total of 34 076 elderlies without TB were enrolled into two-year follow-up. We used both active and passive case findings to find out all TB patients among them. The person-year (PY) incidence rates for both bacteriologically positive TB and active TB were calculated. Cox proportional regression model was performed to test effect of risk factors, and the population attributable fraction (PAF) of each risk factor contributing to incident TB among elderlies was calculated. Results: Over the two-year follow-up period, a total of 215 incident active TB were identified, 62 of which were bacteriologically positive. The incidence rates for active TB and bacteriologically positive TB were 481.8 per 100 000 PY (95% CI: 417.4–546.2 per 100 000 PY) and 138.9 per 100 000 PY (95% CI: 104.4–173.5 per 100 000 PY), respectively. Incident cases detected by active case finding were significantly higher (P < 0.001). Male, non-Han nationality, previously treated TB, ex/current smoker and body mass index (BMI) < 18.5 presented as independent predictors for developing TB disease. For developing bacteriologically positive TB, the biggest contribution was from self-reported ex or current smoker (18.06%). And, for developing active TB, the biggest contribution was from non-Han nationality (35.40%), followed by male (26.80%) and age at 75 years and above (10.85%). Conclusions: Ageing population in China had a high TB incidence rate and risk to develop TB disease, implying that National TB Program (NTP) needs to prioritize for elderly. Active case finding should be applied capture more active TB cases among this particular population, especially for male, non-Han nationality, and those with identified risk factors. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess the self‐management activities among rural patients with chronic hepatitis B (CHB), and the influence of psychosocial and demographic factors on their self‐management activities. Background: Chronic hepatitis B is a serious public health concern. Rural patients may have limited access to healthcare services. Although self‐management is important for controlling chronic hepatitis B, few studies focus on the self‐management activities among rural patients with chronic hepatitis B. Understanding self‐management activities and related factors in this population are important to design and implement appropriate intervention strategies. Design: A cross‐sectional study. Methods: From June–December 2017, totally 236 rural patients with chronic hepatitis B were recruited from hepatology department in two hospitals in Chongqing, China. The questionnaire included demographic characteristics, Chronic Hepatitis B Self‐Management Scale, Self‐Efficacy for Managing Chronic Disease, and Social Support Rating Scale. The study followed the STROBE checklist. Results: Rural patients with chronic hepatitis B reported poor self‐management activities for the score indexes of symptom management (57.36%), lifestyle management (54.89%), psychosocial coping (54.84%) and disease information management (53.11%) were all below 60%. Self‐efficacy, objective support, subjective support, gender, education level and marital status showed significant effect on self‐management activities. Conclusion: Rural patients with chronic hepatitis B were found to perform insufficient self‐management activities. Self‐efficacy, social support, gender, education level and marital status were identified to influence their self‐management activities. Relevance to clinical practice: Self‐management activities should be promoted among rural patients with chronic hepatitis B. The factors that were identified in this study should be addressed when developing interventions to promote the performance of self‐management activities for rural patients with chronic hepatitis B. [ABSTRACT FROM AUTHOR]

Gansu Province is a high-incidence area for many meteorological disasters. In this research, using affected and covered risk indices for the main agro-meteorological disasters (drought, flood, wind hail, and frost), the variability characteristics of agro-meteorological disasters were analyzed and the risks calculated based on the information diffusion method against the background of climate change in Gansu Province. The results showed that of affected (crop yield reduced by >10%) and covered (crop yield reduced by >30%) areas for drought and frost tended to increase between 1978 and 2014, whereas those for flood and wind hail tended to decrease. The affected and covered risk indices for drought increased, those for flood and wind hail showed a slight decreasing trend, the frost affected risk index decreased, and the frost covered risk index increased. Comparing the four kinds of risk for agro-meteorological disasters, the estimated risk decreased as the affected and covered risk indices increased. The risk of drought was more serious than those for other agro-meteorological disasters for the same affected risk index, followed by frost, flood, and wind hail. The most serious disaster agro-meteorological covered risk was wind hail, followed by drought, flood, and frost. After a rapid change in temperature in 1994, the estimated affected risk values of drought and frost increased on average by 17.56 and 96.83%, respectively, whereas the estimated risks of flood and wind hail decreased on average by 15.59 and 5.90%, respectively. After the temperature jump, the estimated covered risk of drought increased on average by 19.57%, whereas those of flood, wind hail, and frost decreased on average by 3.02, 1.78, and 26.10%, respectively. These new scientific discoveries are significant for agro-meteorological disaster prevention in Gansu Province. [ABSTRACT FROM AUTHOR]

Background: Keratoconus normally presents as a sporadic disease. Although different studies have found sequence variants of the visual system homeobox 1 (VSX1) gene associated with keratoconus in humans, no research has detected such variants in sporadic keratoconus patients from China. To investigate the possibility of VSX1 being a candidate susceptibility gene for Chinese patients with sporadic keratoconus, we performed sequence screening of this gene in such patients.Methods: Whole DNA was obtained from the leukocytes in the peripheral venous blood of 50 patients with sporadic keratoconus and 50 control subjects without this ocular disorder. Polymerase chain reaction single-strand conformation polymorphism analysis and direct DNA sequencing technology were used to detect sequence variation in the five exons and splicing regions of the introns of the VSX1 gene. The sequencing results were analyzed using DNAstar software.Results: One novel missense heterozygous sequence variant (p.Arg131Pro) was found in the first exon of the VSX1 gene in one keratoconus patient. Another heterozygous sequence variant (p.Gly160Val) in the second exon was found in two keratoconus patients. These variants were not detected in the control subjects. In the third intron of the VSX1 gene, c.8326G > A nucleotide substitution (including heterozygous and homozygous change) was also discovered. The frequency of this variation did not differ significantly between patients and controls, it should belong to single-nucleotide polymorphism of the VSX1 gene. Bioinformatic analysis also predicted that one missense sequence variation (p.Arg131Pro) may not cause a pathogenic change.Conclusions: In this study, we added one novel missense sequence variation (p.Arg131Pro) in the coding region of the VSX1 gene to the range of VSX1 coding region variations observed in patients with sporadic keratoconus from China. Our work suggests that VSX1 sequence variants might be involved in the pathogenesis of sporadic keratoconus, but their precise role in disease causation requires further investigation. [ABSTRACT FROM AUTHOR]

Background: Delirium is a common complication in elderly patients after surgery and associated with increased morbidity and mortality. Studies suggest that deep anesthesia and intense pain are important precipitating factors of postoperative delirium. Neuraxial block is frequently used in combination with general anesthesia for patients undergoing major thoracic and abdominal surgery. Compared with general anesthesia alone and postoperative intravenous analgesia, combined epidural-general anesthesia and postoperative epidural analgesia decreases the requirement of general anesthetics during surgery and provided better pain relief after surgery. However, whether combined epidural-general anesthesia plus epidural analgesia is superior to general anesthesia plus intravenous analgesia in decreasing the incidence of postoperative delirium remains unknown. Methods/design: This is a multicenter, open-label, randomized, parallel-controlled clinical trial. One thousand eight hundred elderly patients (age range 60-90 years) who are scheduled to undergo major thoracic or abdominal surgery are randomized to receive either general anesthesia plus postoperative intravenous analgesia or combined epidural-general anesthesia plus postoperative epidural analgesia. The primary outcome is the 7-day incidence of postoperative delirium. Secondary outcomes include the duration of postoperative delirium, the intensity of pain during the first three days after surgery, the 30-day incidences of postoperative non-delirium complications, the length of stay in hospital after surgery and 30-day all-cause mortality. Discussion: Results of the present study will provide information to guide clinical practice in choosing appropriate anesthesia-analgesia method for elderly patients undergoing major thoracic and abdominal surgery. [ABSTRACT FROM AUTHOR]

Medulloblastoma (MB) is one of the most common primary central nervous system tumors in children. Data is lacking of a large cohort of medulloblastoma patients in China. Also, our knowledge on the sensitivity of different molecular subgroups of MB to adjuvant radiation therapy (RT) or chemotherapy (CHT) is still limited. The authors performed a retrospective study of 173 medulloblastoma patients treated at two institutions from 2002 to 2011. Formalin-fixed paraffin embedded (FFPE) tissues were available in all the cases and sections were stained to classify histological and molecular subgroups. Univariate and multivariate analyses were used to investigate prognostic factors. Of 173 patients, there were 118 children and 55 adults, 112 males and 61 females. Estimated 5-year overall survival (OS) rates for all patients, children and adults were 52%, 48% and 63%, respectively. After multivariate analysis, postoperative primary radiation therapy (RT) and chemotherapy (CHT) were revealed as favorable prognostic factors influencing OS and EFS. Postoperative primary chemotherapy (CHT) was found significantly improving the survival of children (p<0.001) while it was not a significant prognostic factor for adult patients. Moreover, patients in WNT subtype had better OS (p = 0.028) than others (SHH and Non-SHH/WNT subtypes) given postoperative adjuvant therapies. Postoperative primary RT was found to be a strong prognostic factor influencing the survival in all histological and molecular subgroups (p<0.001). Postoperative primary CHT was found significantly to influence the survival of classic medulloblastoma (CMB) (OS p<0.001, EFS p<0.001), SHH subgroup (OS p = 0.020, EFS p = 0.049) and WNT subgroup (OS p = 0.003, EFS p = 0.016) but not in desmoplastic/nodular medulloblastoma (DMB) (OS p = 0.361, EFS p = 0.834) and Non-SHH/WNT subgroup (OS p = 0.127, EFS p = 0.055). Our study showed postoperative primary CHT significantly influence the survival of CMB, SHH subgroup and WNT subgroup but not in DMB and Non-SHH/WNT subgroup of MB. [ABSTRACT FROM AUTHOR]

The deteriorating air quality in eastern China including the Yangtze River Delta is attracting growing public concern. In this study, we measured the ambient PM10and fine PM2.5in the mega-city, Nanjing at four different times. The 24-h average PM2.5and PM10mass concentrations were 0.033–0.234 and 0.042–0.328 mg/m3, respectively. The daily PM10and PM2.5concentrations were 2.9 (2.7–3.2, at 95% confidence interval) and 4.2 (3.8–4.6) times the WHO air quality guidelines of 0.025 mg/m3for PM2.5and 0.050 mg/m3for PM10, respectively, which indicated serious air pollution in the city. There was no obvious weekend effect. The highest PM10pollution occurred in the wintertime, with higher PM2.5loadings in the winter and summer. PM2.5was correlated significantly with PM10and the average mass fraction of PM2.5in PM10was about 72.5%. This fraction varied during different sampling periods, with the lowest PM2.5fraction in the spring but minor differences among the other three seasons. [ABSTRACT FROM AUTHOR]

Epimedium rhizomatosum is a rare endemic plant species inhabited in some high-elevation mountain area in the Sichuan province of China. In this study, we assembled the complete chloroplast genome of E. rhizomatosum from Illumina short-read sequencing data. The chloroplast genome of E. rhizomatosum was 159,151 bp in length, which comprises of a large single copy (LSC) region of 86,604 bp, a small single copy (SSC) region of 17,071 bp and two inverted repeat regions (IRa and IRb) of 27,737 bp for each. The total GC content of E. rhizomatosum chloroplast genome was 38.8%, while the corresponding values of LSC, SSC, and IR regions were 37.3%, 32.8%, and 43.0%, respectively. A total of 112 unique genes was identified from the chloroplast genome of E. rhizomatosum, including 78 protein-coding genes, four ribosomal RNA genes, and 30 tRNA genes. The phylogenetic analysis showed that E. rhizomatosum closely related to E. acuminatum. Our study will provide useful information on further clarifying the phylogenetic and evolutionary relationship in the genus Epimedium. [ABSTRACT FROM AUTHOR]

Based on the analysis of relevant literature studies on psychology and emotional labor, the paper develops a theoretical model of emotional labor of tour guides in East China itinerary by applying the theory and method of SEM, combining the characteristics of the management of tour guide human resources and makes an in-depth discussion and analysis of the essential connotation of emotional labor of tour guides, its moderating factors and consequence variables. The study results indicate that the relationship of different variables in SEM fully accords with the hypotheses. The study fills the gap in this area to a certain degree and also offers some practical suggestions regarding better integrating emotional labor management in the human resources management of tour guides. [ABSTRACT FROM AUTHOR]

We performed this study to reassess the prognostic factors of diffuse large B-cell lymphoma (DLBCL) in the era of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in Chinese population. One hundred and twenty-five consecutive patients with DLBCL were enrolled in this study from February 2000 to September 2006. They had received six courses of R-CHOP regimen consisting of rituximab 375 mg/m2, intravenously, D1; cyclophosphamide 750 mg/m2, bolus infusion, D2; doxorubicin 50 mg/m2, bolus infusion, D2; vincristine 1.4 mg/m2, bolus infusion, D2; and prednisone 60 mg, orally, D2-6. All the patients were evaluated and followed-up after the treatment. Eighty-six out of 125 enrolled patients (68.8%) achieved complete response (CR), 16 patients (12.8%) achieved partial response (PR), 11 patients (12.8%) achieved stable disease, and 12 patients (9.6%) experienced progressive disease (PD). In univariate analysis, IPI factors, except for age, was correlated with the treatment outcome of complete remission; however, only early clinical stages and absence of bulky disease was statistically significantly associated with the better CR rate. Lactate dehydrogenase (LDH), extranodal diseases, bulky disease, and obtaining CR after completion of four courses of treatment was correlated with TTF ( P = 0.038, 0.044, 0.034, and 0.000, respectively); performance status, LDH level, number of extranodal diseases, and obtaining CR after completion four courses of treatment significantly influenced OS ( P = 0.027, 0.000, 0.019, and 0.000, respectively); and presence of bulky disease and obtaining CR at the end of fourth cycle of treatment were significantly correlated with DFS in multivariate analysis ( P = 0.006 and 0.001, respectively) in Cox regression. IPI is still important in predicting the prognosis in the R-CHOP era in DLBCL; however, obtaining CR after four cycles of R-CHOP and presence of bulky disease should be considered together. [ABSTRACT FROM AUTHOR]

The concentrations and distributions of six polycyclic musks and two nitro musks in Suzhou Creek, influent/effluent of a sewage treatment plant (STP), and household commodities were investigated and discussed in this study. The levels of 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexa-methylcyclopenta(g)-2-benzopyran (HHCB) and 7-acetyl-1,1,3,4,4,6-hexamethyl-1,2,3,4-tetrahydronaphthalene (AHTN) in Suzhou Creek were 3–78ngg−1 (dry weight) and 2–31ngg−1 (dry weight) in sediments, while 20–93ngl−1 and 8–20ngl−1 in surface waters. The results indicated a low proportion of wastewater burden in this river. The concentrations of HHCB and AHTN in the effluent of the STP were 5- to 6-fold higher than those in Suzhou Creek. The amounts discharged into the aquatic environment from sewage in Shanghai are 1.26t (HHCB) and 0.38t (AHTN) in 2007, and the input into the STPs is estimated to be HHCB 0.2gy−1 and AHTN 0.06gy−1 per inhabitant, respectively. A broad concentration range of HHCB and AHTN could be observed in household commodities. The distributions are in accordance with the profiles of musks in aquatic environment, with HHCB and AHTN being the major components. [Copyright &y& Elsevier]

Epimedii Folium has been used as a common traditional Chinese medicine for more than 2000 years in China. In this study, we assembled the complete chloroplast (cp) genome of Epimedium brevicornu. The whole cp genome of E. brevicornu is 158,658 bp in length, comprising a pair of inverted repeat (IR) regions (27,699 bp) separated by a large single copy (LSC) region (86,558 bp) and a small single copy (SSC) region (16,702bp). The E. brevicornu cp genome contains 129 genes, of which 84 protein-coding genes, 37 tRNA genes, and eight rRNA genes. Phylogenetic analysis shows that E. brevicornu is closely clustered with E. wushanense, E. lishihchenii, and E. sagittatum. The published E. brevicornu chloroplast genome will provide useful information for the phylogenetic and evolutionary study on Epimedium family of Berberidaceae. [ABSTRACT FROM AUTHOR]

Epimedium wushanense is a well-known medicinal plant in Berberidaceae in China. In this study, we sequenced the complete chloroplast (cp) genome of E. wushanense. The results showed that the cp genome of E. wushanense was 157,283 bp in length, which is composed of a large single-copy region (LSC, 88,579 bp) and a small single-copy region (SSC, 17,082 bp) that were separated by a pair of inverted repeat regions (IRa and IRb, 25,811 bp). The chloroplast genome of E. wushanense contains 112 unique genes, of which are 78 protein-coding genes, 30 tRNA genes, and 4 rRNA genes. The overall GC content was 38.78%. The phylogenetic tree analysis showed that E. wushanense was closely related to E. pseudowushanense, E. lishihchenii, and E. sagittatum. [ABSTRACT FROM AUTHOR]

Epimedium davidii, which belongs to Berberidaceae, is mainly distributed in the southwest of China. In this study, the complete chloroplast genome of E. davidii was sequenced and assembled. The circular genome is 159,715 bp in length, which comprises a large single-copy region (LSC, 85,862 bp), a small single-copy region (SSC, 17,081 bp), and a pair of inverted repeat regions (IRa and IRb, 28,386 bp). The chloroplast genome of E. davidii contains 112 unique genes, of which 78 protein-coding genes, 30 tRNA genes, and 4 rRNA genes. Phylogenetic analysis indicated that E. davidii was closely related to Epimedium acuminatum. [ABSTRACT FROM AUTHOR]

The article discusses the study which investigates on the reasons behind the custom of overconfidence among Asians. The researchers anticipated that overconfidence would be less marked in persons educated in Singapore than those in China. It is provided that the education system in Singapore is more highly westernized in terms of medium of instruction used than in China. It was found that Chinese students exhibited higher degrees of overconfidence than Singaporean students.

Rapid urbanization has destroyed urban water systems and led to blackened and odorous rivers. The heavily polluted rivers are always facing eutrophication and heavy metal pollution, while the combined effects of these environmental factors on the microbial diversity and distribution of the river microbial communities have not been adequately reported, especially the archaeal communities. In this study, we investigated the community structure and microbial distribution of sediment archaeal communities from an urban blackened and odorous river basin of the Zhang river, in Nanling, China. Results showed that the archaeal community from the eight sediment sites have average values of Shannon and Chao1 at 3.4921 and 232.7202, respectively. The community diversity and richness were different among samples. Halobacterota and Euryarchaeota were the most abundant phylum and Crenarchaeota also took up a considerable amount of the archaeal community. To reveal the main environmental drivers of the distribution of archaeal communities in sediment, the environmental physicochemical factors (total nitrogen, total phosphorus, oxidation/reduction potential, nitrate nitrogen, ammonia nitrogen, pH and total organic carbon) and heavy metals (Cr, Ni, Cu, Zn, As, Cd, Pb and Hg) in sediment were determined. A redundancy analysis (RDA) revealed that Eh was the most prominent influencing factor, and As was the most influential heavy metal on the microbial distribution of archaeal communities. Furthermore, a variance partitioning analysis (VPA) was used to identify the impacts of physicochemical factors and heavy metals on the archaeal community distribution. Results showed that heavy metals have higher effects on archaeal community distribution than physicochemical factors. The present study suggested that the heavy metal pollution should be paid more attention in the microbial distribution in heavily polluted urban rivers, and also should be taken into consideration for improving the efficacies of ecological evaluation and remediation. [ABSTRACT FROM AUTHOR]

Approximately 500,000 new head and neck squamous cell carcinoma (HNSCC) cases are detected every year around the world, and its incidence ranks sixth among all cancer types globally. Among these cases, oral squamous cell carcinoma (OSCC) and laryngeal squamous cell carcinoma (LSCC) are HNSCC subtypes with high incidence rates, especially in China. The present study examines the association between the apolipoprotein L1 (APOL1) mRNA and protein expression and clinical parameters in HNSCC. The two most common types (oral and larynx) of HNSCC were selected for subgroup analyses. Immunohistochemistry (IHC) was used to detect APOL1 protein expression levels in HNSCC clinical specimens. It was demonstrated that APOL1 protein expression in 221 cases of HNSCC was higher compared with that in normal tissues. Consistent upregulation of APOL1 protein was also found in subgroups of OSCC and LSCC. Through mining the ArrayExpress, The Cancer Genome Atlas and the Gene Expression Omnibus databases, microarrays and RNA sequencing data for HNSCC were retrieved, which were used to analyze APOL1 mRNA expression levels. The results showed that APOL1 expression was higher in both OSCC and LSCC subtypes, as well as in HNSCC, compared with that in non-cancerous squamous epithelium. The summary receiver operating characteristic analysis showed that APOL1 had potential as a diagnostic biomarker for HNSCC, OSCC and LSCC. Thus, upregulation of APOL1 may contribute to the tumorigenesis of HNSCC. [ABSTRACT FROM AUTHOR]

Quality control of Chinese herbal tea remains a challenge due to our poor knowledge of their complex chemical profile. This study aims to investigate the chemical composition of one of the best-selling and famous brand of beverage in China, Wanglaoji Herbal Tea (WLJHT), via a full component quantitative analysis. In this paper, a total of thirty-four representative constituents were identified or tentatively characterized using ultra-high performance liquid chromatography coupled with quadrupole tandem time-of-flight mass spectrometry (UPLC-Q-TOF-MS). Moreover, the quantitative analyses of fourteen constituents were performed by high performance liquid chromatography with a triple quadruple tandem mass spectrometry (HPLC-MS/MS) method and saccharide compositions of WLJHT were also quantitatively determined by high performance liquid chromatography (HPLC) with evaporative light scattering detector (ELSD) on a Hilic column, separately. Using multiple chromatographic techniques presented a good precision, sensitivity, repeatability and stability, and was successfully applied to analyze 16 batches of WLJHT samples. Therefore, it would be a reliable and useful approach for the quality control of WLJHT. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors (ICIs) have improved the prognosis of patients with non-small cell lung cancer but rarely been explored in pulmonary sarcomatoid carcinoma (PSC). This multicenter study aimed to evaluate the effectiveness of ICIs for PSC and its underlying mechanism. Advanced PSC who received ICIs between August 2018 and May 2022 from 11 centers in China were included. Clinical characteristics and treatment information were collected. Whole-exome sequencing (WES) and whole transcriptome sequencing were conducted on pre-treatment samples to explore the mechanism. 113 patients with PSC were enrolled, the median PFS for patients receiving ICIs therapy was 8.77 months (95 % confidence interval, 4.21 to 13.32). Combining ICIs with anti-angiogenic agents significantly increased PFS (p = 0.04). Liver metastasis and combination therapy with anti-angiogenic agents were independent risk factors for PFS (Hazard Ratio [HR] = 3.652, p = 0.019 and HR = 0.435, p = 0.017, respectively). WES showed that PSC presented with a TMB of 6.3 mutations per million base pairs. High expression of TNFα signaling and glycolysis related gene showed a better prognosis. ICIs showed promising benefits for advanced PSC, and the addition of anti-angiogenic therapy might be a more effective treatment strategy for this disease. • The efficacy of ICIs in PSC was poorly explored. • The mPFS for PSC receiving ICIs was 8.77 m (95 % CI, 4.21-13.32). • The addition of anti-angiogenic therapy with ICIs increased PFS of PSC. • The median TMB of PSC was 6.3 mutations per million base pairs. [ABSTRACT FROM AUTHOR]

The Chinese Glioma Cooperative Group (CGCG) Guideline Panel for adult diffuse gliomas provided recommendations for diagnostic and therapeutic procedures. The Panel covered all fields of expertise in neuro-oncology, i.e. neurosurgeons, neurologists, neuropathologists, neuroradiologists, radiation and medical oncologists and clinical trial experts. The task made clearer and more transparent choices about outcomes considered most relevant through searching the references considered most relevant and evaluating their value. The scientific evidence of papers collected from the literature was evaluated and graded based on the Oxford Centre for Evidence-based Medicine Levels of Evidence and recommendations were given accordingly. The recommendations will provide a framework and assurance for the strategy of diagnostic and therapeutic measures to reduce complications from unnecessary treatment and cost. The guideline should serve as an application for all professionals involved in the management of patients with adult diffuse glioma and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in China. [ABSTRACT FROM AUTHOR]

Five new amide alkaloids, named delamide A-E (1 – 5), along with five known ones, methyl-N-(3-carboxy-2-methylpropanoyl) anthranilate (6), benzoic acid, 2-[(1-oxodecyl) amino]-methylester (7), puberline (8), benzoic acid, 2-[(4-methoxy-2-methyl-1, 4-dioxobutyl) amino]-methylester (9) and benzoic acid, 2-[(4-methoxy-3-methyl-1, 4-dioxobutyl) amino]-methylester (10) were isolated from the extract of Delphinium brunonianum. Their structures were elucidated by extensive spectroscopic analyses (including 1D-, 2D-NMR, and HR-ESI-MS). 1 – 10 were also evaluated for their acetylcholinesterase (AChE) inhibiting activity by the Ellman's method. Delamide A (1) showed highly selective AChE inhibition activity. The kinetic analysis revealed that 1 was a mixed-type reversible inhibitor of AChE. Unlabelled Image • Five new amide alkaloids, together with five known ones were isolated from the aerial parts of Delphinium brunonianum. • Their structures were elucidated by 2D-NMR and circular dichroism (CD) analysis. • 1 showed inhibitory activity against AChE with IC 50 of 9.7 μM by Ellman's method. [ABSTRACT FROM AUTHOR]

Two novel Gram-stain-negative, aerobic, and non-motile strains, designated FZY0004 T and YYF002 T , were isolated from an agar-degrading co-culture, which was obtained from seawater of the intertidal zone of Yancheng City, the Yellow Sea of China. Strain FZY0004 T optimally grew at 28 °C, pH 7.0, and 2-6% NaCl, while strain YYF002 T optimally grew at 28 °C, pH 7.5, and 2-4% NaCl. Strain FZY0004 T possessed Q-9 as the major respiratory quinone, and its major fatty acids (> 10%) were summed feature 8 (C 18:1 ω7c), C 16:0 , and summed feature 3 (C 16:1 ω7c/C 16:1 ω6c). The polar lipids identified in strain FZY0004 T were phosphatidylethanolamine (PE), phosphatidylglycerol (PG), and several unidentified phospholipids (PL) and lipids (L). On the other hand, strain YYF002 T had MK-6 as the predominant respiratory quinone and its major fatty acids consisted of iso-C 15:0 , iso-C 15:1 G, and iso-C 15:0 3-OH. The polar lipids identified in strain YYF002 T were aminolipid (AL), PE, and several unidentified lipids. Strain FZY0004 T shared 99.5% 16S rRNA gene sequence similarity and 90.1% average nucleotide identity (ANI) with T. povalilytica Zumi 95 T , and strain YYF002 T shared 99.2% 16S rRNA gene sequence similarity and 88.2% ANI with W. poriferorum JCM 12885 T . The genomic DNA G + C contents of strains FZY0004 T and YYF002 T were 54.5% and 33.5%, respectively. The phylogenetic, phenotypic, and physiological characteristics permitted the distinction of the two strains from their neighbors, and we thus propose the names Thalassospira aquimaris sp. nov. (type strain FZY0004 T  = JCM 35895 T  = MCCC 1K08380 T ) and Winogradskyella marincola sp. nov. (type strain YYF002 T  = JCM 35950 T  = MCCC 1K08382 T )., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: The health literacy of ethnic groups in remote areas of China is far from satisfactory. However, the health literacy of ethnic groups in China remains unclear. This study aimed to explore the health literacy of the "advancing directly" ethnic group and its influencing factors., Methods: A cross-sectional study was conducted using a staged sampling method among the Wa ethnic group, who have rapidly transitioned directly from the traditional lifestyle of slash-and-burn cultivation to modern societies. We used the Health Literacy Questionnaire (HLQ) to assess health literacy. We defined low health literacy as less than 60% of the total score and adequate health literacy as more than 80% of the total score., Results: A total of 668 individuals met the inclusion criteria and the mean age was 42.19 (SD 10.56) years. The mean HLQ total score was 29.9 (SD 10.56). The prevalence of adequate health literacy was 0.89%. There were significant differences between the low and the non-low health literacy groups in terms of gender, age, education, marital status, occupation, residing place, current smoking status, and waist circumference (all p  < 0.05). Multiple linear regression analysis showed that women ( t  = 9·418, p  < 0.001), older age ( B  = -0.0091, t  = -2.644, p  = 0.008), low educational level ( B  = 0.766, t  = 6.018, p  < 0.001), current smoking ( B  = -2.66, t  = -3.038, p  = 0.008), and residence far from township ( B  = -5.761, t  = -4.1, p  < 0.001) were associated with low HLQ total score., Conclusion: Our findings suggest that the health literacy of the Wa ethnic group is far from favorable. It indicates the need for increased efforts in improving the health literacy of "advancing directly" ethnic groups., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yang, Liu, Zhang, Yao, Wang, Leng, Li, Liu, Liu, Pu, Li, Yang, Zhang, Mu and Zhang.)

Background: Adolescent malignant-bone tumor patients' fear of cancer recurrence is a significant psychological issue, and exploring the influencing factors associated with fear of cancer recurrence in this population is important for developing effective interventions. This study is to investigate the current status and factors influencing fear of cancer recurrence (FCR) related to malignant bone-tumors in adolescent patients, providing evidence for future targeted mental health support and interventions., Design: A cross-sectional survey., Methods: In total, 269 adolescent malignant-bone tumor cases were treated at two hospitals in Zhejiang Province, China from January 2023 to December 2023. Patients completed a General Information Questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Family Hardiness Index (FHI), and a Simple Coping Style Questionnaire (SCSQ). Univariate and multivariable logistic regressions analysis were used to assess fear of cancer recurrence., Results: A total of 122 (45.4%) patients experienced FCR (FoP-Q-SF ≥ 34). Logistic regression analysis analyses showed that per capita-monthly family income, tumor stage, communication between the treating physician and the patient, patient's family relationships, family hardiness a positive coping score, and a negative coping score were the main factors influencing FCR in these patients (P < 0.05)., Conclusions: FCR in malignant-bone tumor adolescent patients is profound. Healthcare professionals should develop targeted interventional strategies based on the identified factors, which affect these patients; helping patients increase family hardiness, helping patients to positively adapt, and avoid negative coping styles., (© 2024. The Author(s).)

Background: Sunvozertinib is an oral, irreversible, and selective tyrosine kinase inhibitor that has a favourable safety profile and encouraging antitumour activity, as shown in phase 1 studies of patients with heavily pretreated non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutation (exon20ins). We aimed to assess the antitumour efficacy of sunvozertinib in patients with platinum-pretreated locally advanced or metastatic NSCLC with EGFR exon20ins., Methods: WU-KONG6 is a single-group, open-label, multicentre phase 2 trial of sunvozertinib monotherapy, conducted across 37 medical centres in China. We enrolled adult patients with pathologically or cytologically confirmed locally advanced or metastatic NSCLC whose tumour tissue carried an EGFR exon20ins mutation. All patients had received at least one line of previous systemic therapy, with at least one line containing platinum-based chemotherapy. The primary endpoint was objective response rate (ORR), as assessed by the independent review committee. The ORR was defined as the percentage of patients who achieved complete or partial response, confirmed by two separate assessments with at least 4-week time interval, until disease progression or initiation of any new anti-cancer therapy. Enrolled patients received sunvozertinib 300 mg once daily until meeting discontinuation criteria per the protocol. Patients who received at least one dose of treatment and were evaluable for efficacy analysis were included in the primary analysis, and all patients who received at least one dose of treatment were included in the safety analysis. This study is registered with ChinaDrugTrials.org, CTR20211009, and ClinicalTrials.gov, NCT05712902, and efficacy and safety follow-up are ongoing., Findings: Between July 19, 2021, and May 6, 2022, 104 patients were enrolled. At data cutoff (Oct 17, 2022), the last enrolled patient had been followed up for about 6 months. Among 97 patients evaluable for efficacy analysis, 59 (61%) patients achieved tumour response, with a confirmed ORR of 61% (95% CI 50-71). All tumour responses were partial responses. Tumour responses were observed irrespective of age, sex, smoking history, EGFR exon20ins subtypes, brain metastasis at baseline, previous lines of therapy, and history of onco-immunotherapy. In total, 19 death events occurred over a median follow-up period of 7·6 months (IQR 6·1-9·4). Sunvozertinib was well tolerated at 300 mg once daily. The most common grade 3 or worse treatment-related adverse events were blood creatine phosphokinase increased (18 [17%] of 104), diarrhoea (eight [8%]), and anaemia (six [6%]). The most common serious treatment-related adverse events were interstitial lung disease (five [5%] of 104), anaemia (three [3%]), vomiting (two [2%]), nausea (two [2%]) and pneumonia (two [2%])., Interpretation: In this phase 2 study, sunvozertinib demonstrated antitumour efficacy in patients with platinum-based chemotherapy pretreated NSCLC with EGFR exon20ins, with a manageable safety profile. A multinational randomised, phase 3 study of sunvozertinib versus platinum-doublet chemotherapy in EGFR exon20ins NSCLC is ongoing (NCT05668988)., Funding: Dizal Pharmaceutical., Competing Interests: Declaration of interests ZY reports employment by Dizal Pharmaceutical. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Toxicological studies have indicated that exposure to chlorinated paraffins (CPs) may disrupt intracellular glucose and energy metabolism. However, limited information exists regarding the impact of human CP exposure on glucose homeostasis and its potential association with an increased risk of developing gestational diabetes mellitus (GDM). Here, we conducted a prospective study with a nested case-control design to evaluate the link between short- and medium-chain CP (SCCPs and MCCPs) exposures during pregnancy and the risk of GDM. Serum samples from 102 GDM-diagnosed pregnant women and 204 healthy controls were collected in Hangzhou, Eastern China. The median (interquartile range, IQR) concentration of SCCPs was 161 (127, 236) ng/mL in the GDM group compared to 127 (96.9, 176) ng/mL in the non-GDM group ( p < 0.01). For MCCPs, the GDM group had a median concentration of 144 (117, 174) ng/mL, while the control group was 114 (78.1, 162) ng/mL ( p < 0.01). Compared to the lowest quartile as the reference, the adjusted odds ratios (ORs) of GDM were 7.07 (95% CI: 2.87, 17.40) and 3.34 (95% CI: 1.48, 7.53) in the highest quartile of ∑SCCP and ∑MCCP levels, respectively, with MCCPs demonstrating an inverted U-shaped association with GDM. Weighted quantile sum regression evaluated the joint effects of all CPs on GDM and glucose homeostasis. Among all CP congeners, C 13 H 23 Cl 5 and C 10 H 16 Cl 6 were the crucial variables driving the positive association with the GDM risk. Our results demonstrated a significant positive association between CP concentration in maternal serum and GDM risk, and exposure to SCCPs and MCCPs may disturb maternal glucose homeostasis. These findings contribute to a better understanding of the health risks of CP exposure and the role of environmental contaminants in the pathogenesis of GDM.

Purpose: Medulloblastoma is the most common childhood malignant brain tumor and is a leading cause of cancer-related death in children. Recent transcriptional studies have shown that medulloblastomas comprise at least four molecular subgroups, each with distinct demographics, genetics, and clinical outcomes. Medulloblastoma subtyping has become critical for subgroup-specific therapies. The use of gene expression assays to determine the molecular subgroup of clinical specimens is a long-awaited application of molecular biology for this pediatric cancer., Methods: In the current study, we established a medulloblastoma transcriptome database of 460 samples retrieved from three published datasets (GSE21140, GSE37382, and GSE37418). With this database, we identified a 23-gene signature that is significantly associated with the medulloblastoma subgroups and achieved a classification accuracy of 95.2%., Results: The 23-gene signature was further validated in a long-term cohort of 142 Chinese medulloblastoma patients. The 23-gene signature classified 21 patients as WNT (15%), 41 as SHH (29%), 16 as Group 3 (11%), and 64 as Group 4 (45%). For patients of WNT, SHH, Group 3, and Group 4, 5-year overall-survival rate reached 80%, 62%, 27%, and 47%, respectively (p < 0.0001), meanwhile 5-year progression-free survival reached 80%, 52%, 27%, and 45%, respectively (p < 0.0001). Besides, SHH/TP53-mutant tumors were associated with worse prognosis compared with SHH/TP53 wild-type tumors and other subgroups. We demonstrated that subgroup assignments by the 23-gene signature and Northcott's NanoString assay were highly comparable with a concordance rate of 96.4%., Conclusions: In conclusion, we present a novel gene signature that is capable of accurately and reliably assigning FFPE medulloblastoma samples to their molecular subgroup, which may serve as an auxiliary tool for medulloblastoma subtyping in the clinic. Future incorporation of this gene signature into prospective clinical trials is warranted to further evaluate its clinical., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

In the information age, real-world data-based evidence can help extrapolate and supplement data from randomized controlled trials, which can benefit clinical trials and drug development and improve public health decision-making. However, the legitimate use of real-world data in China is limited due to concerns over patient confidentiality. The use of personal information is a core element of data governance in public health. In China's public health data governance, practical problems exist, such as balancing personal information protection and public value conflict. In 2021, China adopted the Personal Information Protection Law (PIPL) to provide a consistent legal framework for protecting personal information, including sensitive medical health data. Despite the PIPL offering critical legal safeguards for processing health data, further clarification is needed regarding specific issues, including the meaning of "separate consent," cross-border data transfer requirements, and exceptions for scientific research. A shift in the law and regulatory framework is necessary to advance public health research further and realize the potential benefits of combining real-world evidence and digital health while respecting privacy in the technological and demographic change era., 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 Yao and Yang.)

The extremely serious urban runoff eutrophication and black odorous phenomenon pose a significant threat to the lake aquatic ecosystem, resulting in a significantly increased frequency, magnitude, and duration of algal blooms in lakes. However, few investigations focus on small tributaries of the lakes, despite the ubiquity and potential local importance of these runoffs. Thus, the labile sediments NH 4 + -N, NO 3 - -N, PO 4 3- , Fe 2+ , and S 2- in black odorous runoff at Wuxi were overall analyzed at high resolution using diffusive gradients in thin films (DGT). The variations in labile N, P, Fe, and S distribution profiles at different sampling sites indicated high heterogeneity in sediments. The concentrations of labile P, Fe, and S showed synchronous variation from the sediment-water interface (SWI) up to -20 mm along sediment profiles. Moreover, there existed a significant positive correlation among labile P, Fe, and S concentrations ( p < 0.05), which might represent typical odor compounds' FeS and H 2 S synchronous release process in urban runoff. Furthermore, the apparent diffusion fluxes of labile P, Fe, and S across the SWI were all released upward, while fluxes of NH 4 + -N and NO 3 - -N release downward, indicating the sediments act as source and sink of P and N, respectively. Sediments' potential for endogenous P and N fractions release results in the black-odorous water, and sediment finally abouchement the Taihu, which intensifies further lake eutrophication phenomenon.

The vertical labile arsenic (As) concentration and diffusion pattern variations in eutrophic lakes were investigated using in situ techniques of diffusive gradients in thin films (DGT) and high-resolution dialysis (HR-Peeper) in the typical eutrophic system of Lake Taihu in China. In addition, simulation experiments were used to reveal labile As distributions in sediment profiles under the influence of algae blooms and wind fluctuations. Our results indicated that eutrophication could lead to the migration and transformation of As fractions, including increased As bioavailability, as well as varied diffusion patterns. The sulfate released from algae decomposition reduced to H 2 S and formed FeS, which weak adsorbability contributed to the increased mobility of the As fractions. Meanwhile, further decomposition released a large quantity of algae-derived organic matter which competed with the adsorbed As, leading to more endogenous As migrating to the overlying water. Accordingly, the H 2 S production presented a likely explanation for the changed distribution of labile As and contributed to labile As concentrations in the sediment profiles significantly increasing at depths of -20 mm to -60 mm in the early stages of the simulation experiment. Moreover, the areas of enhanced diffusion patterns with high concentrations of As obviously expanded. However, following the complete decomposition of the algae, the organic matter component significantly changed, suggesting an explanation for the variations in distribution of labile As. All the diffusion pattern variations showed similar trends. Consequently, variation of labile As diffusion patterns could indicate the decomposition and eutrophication levels of freshwater ecosystems., Competing Interests: Declaration of competing interest We have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Urbanization has destroyed river ecosystems, leading to eutrophication. Heavy metals are frequently observed in urban rivers, and the joint effects of eutrophication and heavy metals on microbial communities, especially on fungal communities, have not been adequately explored. In this study, we explored the effect of sediment physicochemical factors and heavy metals on the microbial diversity, community structure, and functions of bacterial and fungal communities from a black-odorous river in Wuhu, China. Twenty-four samples were collected, and the diversity and structure of fungal and bacterial communities were determined by high-throughput sequencing. Proteobacteria and Rozellomycota were the main phyla in the bacterial and fungal communities, respectively. The results showed different distribution patterns of bacterial and fungal communities along the river. Physicochemical factors and heavy metals exhibited different effects on microbial variation. Specifically, pH and Cr negatively affected bacterial α-diversity, whereas total phosphorus and Cr significantly affected fungal α-diversity. Variance partitioning analysis revealed that physicochemical factors explained more of the bacterial community structure than heavy metals (49.5% vs. 36.6%), with pH and total phosphorus being the dominant factors. Opposite patterns were observed for fungal community structure, with heavy metals contributing the most (48.0%). A similar influence pattern was observed for the predicted functions of the two communities. This study suggests that heavy metals in eutrophication rivers are essential factors that shift the microbial variation and should be considered in urban river evaluation and remediation., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

What Is Known and Objectives: Ademetionine 1,4-Butanedisulfonate (SAMe) enteric-coated tablets are widely used for treatment of pre-cirrhotic and cirrhotic intrahepatic cholestasis, as well as intrahepatic cholestasis of pregnancy (ICP), but incomplete clinical data and interference from endogenous substances pose numerous challenges for clinical trial of ademetionine. The objective of this study was to evaluate the pharmacokinetic profile of SAMe enteric-coated tablets and to assess its food impact and safety in healthy Chinese subjects., Methods: A randomized, open-label, single-dose study was carried out to determine the pharmacokinetics of SAMe enteric-coated tablets administered in both fasted and postprandial conditions. Baseline collection and data adjustment were required to reduce the effect of endogenous substances. Relevant pharmacokinetic data from subjects administered the reference formulation will be disclosed and utilized in this thesis., Results: Twenty-four subjects with a body mass index (BMI) of 19-24 kg/m 2 were enrolled in the study and all completed the trial. The impact of food on the drug was noticeable, with faster absorption in the fasting group (T max , 4.50 ± 1.07 and 7.50 ± 1.58 for the fasting and postprandial groups, respectively) but higher exposure in the postprandial group (AUC 0-inf , 4021.02 ± 3377.13 and 5087.28 ± 3539.26 for the fasting and postprandial groups, respectively). No serious adverse effects were observed in the fasted and postprandial conditions., What Is New and Conclusions: The pharmacokinetic profile of SAMe enteric-coated tablets in healthy Chinese subjects was partially complemented in this study. SAMe enteric-coated tablets showed promising safety in fasted and postprandial conditions. However, the impact of food on the drug was significant and might access to the absorption site and affect biochemical reactions., (© 2022 John Wiley & Sons Ltd.)

Copy number variation (CNV) has been used as an important source of phenotypic and genetic diversity in recent years. Nicastrin ( NCSTN ) gene is usually attached to human diseases such as Alzheimer's disease, and Acne inversa. However, there are no essays about the NCSTN gene combining with cattle breeds. In our study, we discovered different distributions of NCSTN gene copy number and associated it with phenotypic traits in four Chinese yellow cattle breeds (XN, PN, QC and YL). The result turned out that the CNV of the NCSTN gene was associated with several growth traits, such as cannon circumference, chest girth and rump length ( p  < 0.05). In general, we revealed the eminence over CNV of NCSTN gene and economic traits, suggesting that the CNV of the NCSTN gene can be considered to be a promising molecular breeding marker of Chinese beef cattle.

As an important geographical boundary, the subalpine coniferous forests in the Qinling Mountains have critical effects on water conservation, biodiversity conservation and climate regulation at the regional and even larger scale. In recent decades, temperature significantly increased in the Qinling Mountains, with significant spatial heterogeneity. An understanding of the responses of the Qinling coniferous trees to climate change is important for the protection and management of mountain forests under climate change. In this study, we synthesized the relationships between the radial growth of coniferous trees and climate at different altitudes in the western, central, and eas-tern Qinling Mountains. The effects of climate change on coniferous trees were investigated from the aspects of radial growth, NDVI, phenology, and species distribution range. Furthermore, know-ledge gaps in the responses of tree growth to climate change and possible future directions in this field were discussed.