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The current study investigated the link between social competence with peers (SCWP) and theory of mind (ToM) skills among Chinese preschool children. Using a sample of 363 Chinese children aged 3-5 (Mage = 4.54 years, SD = 0.84, 183 boys), this cross-sectional study demonstrates that children's SCWP, as reported by teachers, was significantly related to their ToM. Notably, this link was found to be significant even after controlling for children's age, sex, sibling presence or absence, parental education level, family possessions, family size and language skills. The current research provides empirical evidence for the association between SCWP and social understanding. Furthermore, beyond links with scores on the false-belief tests used in most past studies, the current result showed a clear independent link between teachers' ratings of social competence and the total score on a reliable developmentally sequenced ToM scale.

BACKGROUND: Providing effective health education is essential for patients with cancer-related pain. One solution is leveraging instant messaging tools for teach-back health education. OBJECTIVES: This study investigated the effects of WeChat-based teach-back health education on patients with advanced cancer who underwent patient-controlled intrathecal analgesia implantation and used hydromorphone. METHODS: This retrospective study evaluated 150 hospitalized patients with advanced cancer pain. Patients were classified into a conventional health education group (N = 50) and a teach-back group (N = 100) based on whether they received WeChatbased teach-back health education. Pain was rated using a numeric rating scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index at one, two, and three months postdischarge. FINDINGS: Patients who received remote teachback health education better managed their pain. Data also demonstrated improvements in patients' sleep quality and caregiver satisfaction, and reductions in the occurrence of adverse reactions. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is an infectious disease caused by a bacterium called Mycobacterium tuberculosis (Mtb). Previous studies have primarily focused on the transmissibility of multidrug-resistant (MDR) or extensively drug-resistant (XDR) Mtb. However, variations in virulence across Mtb lineages may also account for differences in transmissibility. In Mtb, polyketide synthase (PKS) genes encode large multifunctional proteins which have been shown to be major mycobacterial virulence factors. Therefore, this study aimed to identify the role of PKS mutations in TB transmission and assess its risk and characteristics. Methods: Whole genome sequences (WGSs) data from 3,204 Mtb isolates was collected from 2011 to 2019 in China. Whole genome single nucleotide polymorphism (SNP) profiles were used for phylogenetic tree analysis. Putative transmission clusters (≤10 SNPs) were identified. To identify the role of PKS mutations in TB transmission, we compared SNPs in the PKS gene region between "clustered isolates" and "non-clustered isolates" in different lineages. Results: Cluster-associated mutations in ppsA, pks12, and pks13 were identified among different lineage isolates. They were statistically significant among clustered strains, indicating that they may enhance the transmissibility of Mtb. Conclusion: Overall, this study provides new insights into the function of PKS and its localization in M. tuberculosis. The study found that ppsA, pks12, and pks13 may contribute to disease progression and higher transmission of certain strains. We also discussed the prospective use of mutant ppsA, pks12, and pks13 genes as drug targets. [ABSTRACT FROM AUTHOR]

Background: Clusterin, a glycoprotein implicated in Alzheimer's disease (AD), remains unclear. The objective of this study was to analyze the effect of cerebrospinal fluid (CSF) clusterin in relation to AD biomarkers using a longitudinal cohort of non-demented individuals. Methods: We gathered a sample comprising 86 individuals under cognition normal (CN) and 134 patients diagnosed with MCI via the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. To investigate the correlation of CSF clusterin with cognitive function and markers of key physiological changes, we employed multiple linear regression and mixed-effect models. We undertook a causal mediation analysis to inspect the mediating influence of CSF clusterin on cognitive abilities. Results: Pathological characteristics associated with baseline Aß42, Tau, brain volume, exhibited a correlation with initial CSF clusterin in the general population, Specifically, these correlations were especially prominent in the MCI population; CSF Aß42 (PCN = 0.001; PMCI = 0.007), T-tau (PCN < 0.001; PMCI < 0.001), and Mid temporal (PCN = 0.033; PMCI = 0.005). Baseline CSF clusterin level was predictive of measurable cognitive shifts in the MCI population, as indicated by MMSE (ß = 0.202, p = 0.029), MEM (ß = 0.186, p = 0.036), RAVLT immediate recall (ß = 0.182, p = 0.038), and EF scores (ß = 0.221, p = 0.013). In MCI population, the alterations in brain regions (17.87% of the total effect) mediated the effect of clusterin on cognition. It was found that variables such as age, gender, and presence of APOE e4 carrier status, influenced some of these connections. Conclusion: Our investigation underscored a correlation between CSF clusterin concentrations and pivotal AD indicators, while also highlighting clusterin's potential role as a protective factor for cognitive abilities in MCI patients. [ABSTRACT FROM AUTHOR]

Objective: The ASTRUM-005 trial demonstrated that adding serplulimab to chemotherapy significantly prolonged the survival of patients with extensivestage small cell lung cancer (SCLC), but also increased the risk of adverse events. Given the high cost of serplulimab compared to chemotherapy, this study aimed to evaluate the cost-effectiveness of serplulimab plus chemotherapy as a firstline treatment for extensive-stage SCLC from the perspective of China’s healthcare system. Methods: A Markov model was developed to simulate the disease process of extensive-stage SCLC and estimate the health outcomes and direct medical costs of patients. Scenario analyses, univariate sensitivity analyses, and probabilistic sensitivity analyses were conducted to explore the impact of different parameters on model uncertainty. The primary model outcomes included costs, life-years (LYs), quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). Results: Compared to placebo plus chemotherapy, serplulimab plus chemotherapy resulted in an additional 0.25 life-years and 0.15 QALYs, but also increased costs by $26,402, resulting in an ICER of 179,161 USD/QALY. Sensitivity analysis showed that the ICER was most sensitive to the cost of serplulimab, and the probability that serplulimab was cost-effective when added to chemotherapy was only 0 at the willingness-to-pay threshold of 37,423 USD/ QALY. Scenario analysis revealed that price discounts on serplulimab could increase its probability of being cost-effective. Conclusion: Serplulimab plus chemotherapy is not a cost-effective strategy for first-line treatment of extensive-stage SCLC in China. Price discounts on serplulimab can enhance its cost-effectiveness. [ABSTRACT FROM AUTHOR]

Herbal medicine has been widely applied for a range of diseases in China since antiquity. Cassia obtusifolia L. and Cassia tora L. are plants whose seeds have high reported medicinal values and have been documented to function as a laxative, to lower lipid level and to lower blood pressure. The main active ingredient in Cassia seeds is aurantio-obtusin (AO), which is an anthraquinone monomer compound. Currently, AO is listed in China as a quality control index component of Cassia seeds. In clinical practice in China, AO is typically used to treat obesity, diabetes and its complications, non-alcoholic fatty liver disease and allergic reactions. In addition, AO has been reported to confer insecticidal activities and antimalarial effects. Previous studies have even suggested that AO is a potential therapeutic candidate for a variety of diseases with research value. Therefore, the present review summarizes and discuss the existing literature on AO to provide a review of its pharmacological activity and mechanism of action, with the aim of providing a basis for its development and utilization in a clinical setting. [ABSTRACT FROM AUTHOR]

China's urban commercial banks are more likely to face risks with the rapid development of Internet finance. However, few studies unfold the impact of Internet finance on the risk-taking level of urban commercial banks and explore their role path in depth. To study the relationship between the two and their path of action, this paper takes 62 city commercial banks in China from 2011 to 2020 as research objects and makes empirical tests by Stata. The intermediary effect model is used to study its impact path from the perspectives of assets, liabilities, and intermediate services. The conclusions are as follows: (1) Internet finance aggravates the risk-taking of urban commercial banks; (2) This effect shows heterogeneity in listed and nonlisted, trans-region and non-trans-region urban commercial banks; (3) Net interest margin, debt structure, and non-interest income show the mediating effect when Internet finance affects the risk-taking of urban commercial banks. The results are beneficial for urban commercial banks to change their business strategies with their characteristics and achieve sustainable and healthy development. [ABSTRACT FROM AUTHOR]

The artiopodans, consisting of trilobites and their relatives, were a major euarthropod group in the Paleozoic. Since the first discovery of Naraoia from the Chengjiang fauna, a significant number of artiopodans have been subsequently found in China. Here we describe three new artiopodan species from the lower Cambrian Chengjiang fauna (Cambrian Series 2, Stage 3) at Malong, Yunnan, China. Zhugeia acuticaudata gen. et sp. nov. is defined by a semielliptical cephalon with long genal spines, nine overlapping thoracic tergites, and a pygidium with an elongated needle-like median spine. Its cephalic shield covers multiple anterior thoracic tergites. Tonglaiia bispinosa gen. et sp. nov. is defined by a suboval cephalon, seven thoracic tergites, and a micropygous pygidium with a pair of parallel posteriormost spines. Sidneyia malongensis sp. nov., a new occurrence of Sidneyia from South China, is defined by a crescent-shaped cephalon, eight imbricated tergites, and an abdomen consisting of two cylindrical segments and a tail fluke. The evolutionary affinities of these new taxa are reconstructed and discussed in a phylogenetic context. Phylogenetic analyses resolve Z. acuticaudata among the xandarellids and T. bispinosa gen. et sp. nov. as a trilobitomorph with an uncertain placement, The discovery of three new species improves the biodiversity of artiopodans from the Cambrian and the Chengjiang fauna. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about the first line induction chemotherapy cycles for HIV-associated diffuse large B-cell lymphoma (DLBCL) as these are less common than HIV-negative lymphoma. Currently, the optimal treatment cycles option remains undefined. Therefore, we performed a multi-center study to analyze the clinical characteristics and outcomes of HIV-associated DLBCL patients in different treatment modes in China. Methods: Totally 273 newly diagnosed HIV-associated DLBCL patients at eleven large academic centers from October 2008 to October 2021, were analyzed. Results: In the entire cohort, the median age was 47 years (range, 21-90) at lymphoma diagnosis, and 223 patients were male (81.7%). One hundred and ninety-four (71.1%) patients were germinal center B-cell-like lymphoma (GCB) subtype. Most patients (65.2%, 178/273) had elevated lactate dehydrogenase (LDH), and advanced Ann Arbor stage (78.9% 213/273) at diagnosis. High international prognostic index (IPI) score (3-5) at diagnosis was found in 65.2% (178/273) of patients. One hundred and fifty-five patients (56.8%) had extranodal involvement. The median CD4 cell count was 168/ml (range, 2-1067), of whom 174 (63.7%) had a CD4 cell count below 200/ml. The median follow-up of our cohort was 10.1 (0.1-160) months. The overall 2-year OS rates 58.0%. Median OS times in the 0, 1-3, 4-6, and >6 cycles chemotherapy cohort were 7.1 months, 20.0 months, not reached, and not reached, respectively (Hazard Ratio (HR) =0.549, 95% Confidence interval (CI) 0.451-0.667; p<0.001). Cox multivariate analysis showed that age ≥60 (HR=2.207, 95%CI 1.321-3.690; p=0.003), high IPI score (3-5) (HR=2.926, 95% CI 1.716-4.988; p<0.001), B symptoms (HR=1.928, 95%CI 1.192-3.119; p=0.007), elevated LDH (HR=1.696, 95%CI 1.031-2.791; p=0.038) and received less than 4 cycles chemotherapy (HR=0.520, 95%CI 0.424-0.637; p<0.001) were independent risk factor for adverse prognosis based on overall survival (OS). Discussion: These results demonstrated that 4-6 cycles chemotherapy were significantly associated with improved outcomes in HIV-associated DLBCL patients. However, >6 cycles chemotherapy did not further improve the survival of patients. [ABSTRACT FROM AUTHOR]

Accurate predictions of wheat yields are essential to farmers'production plans and to the international trade in wheat. However, only poor approximations of the productivity of wheat crops in China can be obtained using traditional linear regression models based on vegetation indices and observations of the yield. In this study, Sentinel-2 (multispectral data) and ZY-1 02D (hyperspectral data) were used together with 15709 gridded yield data (with a resolution of 5 m × 5 m) to predict the winter wheat yield. These estimates were based on four mainstream data-driven approaches: Long Short-Term Memory (LSTM), Random Forest (RF), Gradient Boosting Decision Tree (GBDT), and Support Vector Regression (SVR). The method that gave the best estimate of the winter wheat yield was determined, and the accuracy of the estimates based on multispectral and hyperspectral data were compared. The results showed that the LSTM model, for which the RMSE of the estimates was 0.201 t/ha, performed better than the RF (RMSE = 0.260 t/ha), GBDT (RMSE = 0.306 t/ha), and SVR (RMSE = 0.489 t/ha) methods. The estimates based on the ZY-1 02D hyperspectral data were more accurate than those based on the 30-m Sentinel-2 data: RMSE = 0.237 t/ha for the ZY-1 02D data, which is about a 5% improvement on the RSME of 0.307 t/ha for the 30-m Sentinel-2 data. However, the 10-m Sentinel-2 data performed even better, giving an RMSE of 0.219 t/ha. In addition, it was found that the greenness vegetation index SR (simple ratio index) outperformed the traditional vegetation indices. The results highlight the potential of the shortwave infrared bands to replace the visible and near-infrared bands for predicting crop yields Our study demonstrates the advantages of the deep learning method LSTM over machine learning methods in terms of its ability to make accurate estimates of the winter wheat yield. [ABSTRACT FROM AUTHOR]

Objectives: To assess the benefit of a bariatric surgery in four artificial intelligence-identified metabolic (AIM) subtypes of obesity with respect to the improvement of glucometabolism and the remission of diabetes and hyperinsulinemia. Methods: This multicenter retrospective study prospectively collected data from five hospitals in China from 2010 to 2021. At baseline 1008 patients who underwent a bariatric surgery were enrolled (median age 31 years; median BMI 38.1kg/m2 ; 57.40% women) and grouped into the four AIM subtypes. Baseline and follow-up data (506 and 359 patients at 3- and 12-month post-surgery) were collected for longitudinal effect analysis. Results: Out of the four AIM subgroups, hypometabolic obesity (LMO) group was characterized by decompensated insulin secretion and high incidence of diabetes (99.2%) pre-surgery. After surgery, 62.1% of LMO patients with diabetes achieved remission, lower than the other three subgroups. Still, the bariatric surgery significantly reduced their blood glucose (median HbA1c decreased by 27.2%). The hypermetabolic obesity-hyperinsulinemia (HMO-I) group was characterized by severe insulin resistance and high incidence of hyperinsulinemia (87.8%) pre-surgery, which had been greatly alleviated postsurgery. For both metabolic healthy obesity (MHO) and hypermetabolic obesity-hyperuricemia (HMO-U) groups who showed a relatively healthy glucometabolism pre-surgery, rate of glucometabolic comorbidities improved moderately post-surgery. Conclusion: In terms of glucometabolism, the four AIM subtypes of patients benefited differently from a bariatric surgery, which significantly relieved hyperglycemia and hyperinsulinemia for the LMO and HMO-I patients, respectively. The AIM-based subtypes may help better inform clinical decisions on bariatric surgery and patient counseling pertaining to postsurgery outcomes. [ABSTRACT FROM AUTHOR]

Starting from the effects of diseases and pests on tea quality, tea industry and export trade, the status quo and control of tea diseases and pests, assurance and traceability of tea quality safety, tea industry and export trade development are analyzed in detail, and green prevention and control measures against tea diseases and pests are put forward combined with the status quo of tea in China. [ABSTRACT FROM AUTHOR]

The global pandemic, COVID-19, has dealt a heavy blow to the tourism industry. Therefore, exploring the mechanisms influencing travel intention in the post-epidemic era can help provide management insights for the recovery of the travel market. Relying on the logic of social cognition theory, we conducted an empirical analysis from the perspective of trust and found that institutional trust and interpersonal trust can positively predict travel intention in the context of the epidemic, while travelers' health risk perception and safety self-efficacy mediate the relationship between trust and travel intention. Moreover, we verified the moderating role of tourists' psychological resilience. Further, the study confirms that China's active prevention policy not only reduces the physical health harm caused by the epidemic, but also effectively increases individuals' institutional trust in a proactive government. Through China's active anti-epidemic policy, individuals were able to counteract the negative impact of the COVID 19 epidemic on their travel intention. Further, theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

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The Polio Endgame Strategy 2019-2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance. [ABSTRACT FROM AUTHOR]

Revealing public preferences regarding the ecological restoration of a river basin and evaluating the associated social benefits provide important references for the development of related policies. Taking the Shiyang River Basin as an example, this study quantified and analyzed the difference in public preferences regarding the ecological restoration of the river basin by the choice experiments method and the random parameters logit (RPL) model. It also evaluated the social benefits of river basin ecological restoration. The results showed that (1) The residents all hoped to improve the ecological environment of the Shiyang River Basin and were willing to bear certain restoration costs. (2) There were significant differences in public preferences for ecological restoration of the river basin. These differences existed between the upper, middle, and lower reaches of the river and between urban and rural residents. (3) The average annual cost of ecological restoration that the basin residents were willing to pay was between 505.833 ∼ 948.571 RMB yuan, and the total annual benefits of ecological restoration were 381.2 million RMB yuan. Based on these conclusions, the following recommendations were made. First, future ecological and environmental policies should be further combined with public preferences; and even cross-regional ecological compensation can be introduced to balance the interests of different social groups, to win public support. Second, increased water-saving technology in industries and agriculture, residents' awareness of water conservation, and the management of water pollution measures should be promoted in order to improve the ecological environment of the river basin. Third, the budget for the ecological restoration of the Shiyang River Basin should be 381.2 million yuan per year. Costs should be controlled while meeting the restoration goals. [ABSTRACT FROM AUTHOR]

The genus-level recognition of monophyletic shortlegged toads (Brachytarsophrys) has been recently implicated in the taxonomic debate of Megophrys sensu lato. In the present study, Brachytarsophrys is reasonably regarded as a distinct genus based on significant morphological differentiations and recent molecular analyses. Furthermore, a comprehensive review of this genus is performed, with two species groups proposed based on morphological differences and phylogenetic relationships. Particularly, Brachytarsophrys platyparietus is removed as a synonym of Brachytarsophrys carinense and considered a valid species due to significant genetic divergence and distinct morphological differences. In addition, a new species, Brachytarsophrys orientalis sp. nov., is described based on a series of specimens collected from southeastern China. This work takes the member species of the genus Brachytarsophrys to seven, suggesting that the diversity of Brachytarsophrys is underestimated. In addition, the genus levels of other monophyletic groups within the subfamily Megophryinae are discussed. [ABSTRACT FROM AUTHOR]

The diversity of the subgenus Panophrys within the genus Megophrys has been revealed to be extremely underestimated from southeastern China. Herpetological surveys coupled with extensive sampling in a longitudinal mountain belt located in southeastern China resulted in the discoveries of six new species of the subgenus Panophrys. Furthermore, the new discoveries support the findings of "micro-endemism", "sympatric phenomenon" and "sympatric but distant phylogenetically" which appear to be common among Panophrys species, and also indicates that the Asian horned toads would be good candidates for studies on speciation and biogeography, and additionally emphasizes the conservation difficulties of these toads. [ABSTRACT FROM AUTHOR]

With the aim to examine variations in the migration phenology and population of N. lugens along with the advance/retreat of the Asian summer monsoon (ASM) and lay the foundation for further study on predicting the timing and location of N. lugens outbreak, correlation analysis and spatial analysis were applied for estimating the impact of the ASM and its related meteorological factors on the migration phenology and population of N. lugens in China in this paper. The ASM had a positive effect on the occurrence and outbreak of N. lugens. First, the first appearance date of N. lugens was consistent with seasonal advances of the northernmost location of the ASM, and the ASM provided the dynamic condition for the northward migration of N. lugens. Second, outbreak of N. lugens occurred in the area under the control of the ASM, and the ASM provided the survival condition for the population of N. lugens. Third, the population was positively related to the northernmost location of the ASM, θE (850hPa) and wind speed (850hPa). Particularly, the stronger southwest wind caused the date of the first, peak and last catches of N. lugens to turn up earlier than in the extremely years. [ABSTRACT FROM AUTHOR]

Microbial drug resistance has become a major public health concern worldwide. To acquire epidemiologic data on drug-resistant tuberculosis (DR TB) among children, a major cause of illness and death for this population, we conducted a retrospective study of 2006-2015 data from 36 TB prevention and control institutions in Shandong Province, China. A total of 14,223 new TB cases, among which children (<18 years of age) accounted for only 5.5%, were caused by culture-confirmed Mycobacterium tuberculosis. Among children with TB, 18.9% had DR TB and 6.9% had multidrug-resistant TB. Over the past decade, the percentage of DR TB; multidrug-resistant TB; and overall first-line drug resistance for isoniazid, rifampin, ethambutol, and streptomycin among children increased significantly (at least 12%). Understanding the long-term trends of DR TB among children can shed light on the performance of TB control programs, thereby contributing to global TB control. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to develop an effective nomogram capable of estimating the individual survival outcomes of patients with hepatocellular carcinoma (HCC), and compare the predictive accuracy and discriminative ability with other staging systems.Methods: The nomogram was established based on a retrospective study of 661 patients newly diagnosed with HCC at the Beijing Ditan Hospital (Beijing, China), Capital Medical University, between October 2008 and July 2012. The predictive accuracy and discriminative ability of the previously developed nomogram were assessed by C-index and calibration curves, and were compared to seven current commonly used staging systems. The results were validated, using a bootstrap approach to correct for bias, in a prospective study of 220 patients consecutively enrolled between August 2012 and March 2013.Results: Multivariate analysis of the primary cohort for survival analysis identified the independent factors to be aspartate aminotransferase, ɣ-glutamyl transpeptidase, white blood cell count, neutrophil-to-lymphocyte ratio, prothrombin activity, α-fetoprotein, tumor number and size, lymph node metastasis, and portal vein involvement, which were all included to build the nomogram. The calibration curve for predicting the probability of survival showed consistency between the nomogram and the actual observation. The C-index of the nomogram was 0.81 (95% confidence interval, 0.79-0.82), which was statistically better than that of the Tumor, Node, Metastasis staging (0.71), Barcelona Clinic Liver Cancer staging (0.77), Okuda (0.62), Japan Integrated Staging (0.73), Cancer of the Liver Italian Program score (0.76), Chinese University Prognostic Index (0.68), and the Groupe d' Etude et de Traitement du Carcinome Hepatocellulaire Prognostic classification (0.65) (p < 0.001 for all). The results were validated in the prospective validation cohort.Conclusions: The prognostic nomogram resulted in more accurate individualized risk estimates for overall survival in HCC patients. [ABSTRACT FROM AUTHOR]

Background: The emergence and spread of Carbapenem-resistant Escherichia coli (CREC) is becoming a serious problem in Chinese hospitals, however, the data on this is scarce. Therefore, we investigate the risk factors for healthcare-associated CREC infection and study the incidence, antibiotic resistance and medical costs of CREC infections in our hospital.Methods: We conducted a retrospective, matched case-control-control, parallel study in a tertiary teaching hospital. Patients admitted between January 2012 and December 2015 were included in this study. For patients with healthcare-associated CREC infection, two matched subject groups were created; one group with healthcare-associated CSEC infection and the other group without infection.Results: Multivariate conditional logistic regression analysis demonstrated that prior hospital stay (<6 months) (OR:3.96; 95%CI:1.26-12.42), tracheostomy (OR:2.24; 95%CI: 1.14-4.38), central venous catheter insertion (OR: 8.15; 95%CI: 2.31-28.72), carbapenem exposure (OR: 12.02; 95%CI: 1.52-95.4), urinary system disease (OR: 16.69; 95%CI: 3.01-89.76), low hemoglobin (OR: 2.83; 95%CI: 1.46-5.50), and high blood glucose are associated (OR: 7.01; 95%CI: 1.89-26.02) with CREC infection. Total costs (p = 0.00), medical examination costs (p = 0.00), medical test costs (p = 0.00), total drug costs (p = 0.00) and ant-infective drug costs (p = 0.00) for the CREC group were significantly higher than those for the no infection group. Medical examination costs (p = 0.03), total drug costs (p = 0.03), and anti-infective drug costs (p = 0.01) for the CREC group were significantly higher than for the CSEC group. Mortality in CREC group was significantly higher than the CSEC group (p = 0.01) and no infection group (p = 0.01).Conclusion: Many factors were discovered for acquisition of healthcare-associated CREC infection. CREC isolates were resistant to most antibiotics, and had some association with high financial burden and increased mortality. [ABSTRACT FROM AUTHOR]

Background: Rapid urbanization of China has resulted in significant domestic migration. The purpose of the present study was to survey the sexual behavior of migrant workers in Shanghai and determine the risk factors for unprotected sex.Methods: A cross-sectional study of the sexual behavior of 5996 migrant workers was conducted in 7 administrative regions of Shanghai in 2012 from August to October. A self-administered questionnaire was used to collect data.Results: Five thousand seven hundred seventy two out of the 5996 migrants enrolled into the present study were primarily young adults aged 34.3 ± 10.6 years. Of them, 73.5 % were married, 51.1 % graduated from junior high school, 46.0 % earned 1500-2500 yuan (RMB) monthly. The majority (82.3 %) of the migrants engaged in sexual behavior, and 58.0 % did not use condoms in sexual intercourse. Some of the participants (15.2 %) had casual extramarital partners within the previous 12 months; among them, 76.2 % never or only occasionally used condoms. The results of the multivariate logistic regression analysis suggested that condom use was associated with age, occupation, monthly income, education, and housing conditions. Having temporary sexual partners was significantly associated with several factors such as unmarried (OR: 0.47, 95 % CI: 0.38-0.57), working at domestic (OR: 1.65,95 % CI: 1.17-2.34), working at wholesale/retail(OR: 1.65, 95 % CI: 1.13-2.13), and male migrants (OR: 2.37, 95 % CI: 1.96-2.85), but not with other factors such as age, monthly income, or education. Having casual extramarital partners was significantly associated with female migrants working at domestic (OR: 1.89, 95 % CI: 1.09-3.28), unmarried male migrants (OR: 0.51, 95 % CI: 0.36-0.74).Conclusion: Closer attention should be paid to sexual health education among migrant workers, especially women and those working in domestic and wholesale/retail occupations. The use of condoms should be promoted for older (>35 y), low-income, and less-educated individuals. [ABSTRACT FROM AUTHOR]

Ganoderma, also known as Lingzhi or Reishi, has been used for medicinal purposes in Asian countries for centuries. It is a medicinal fungus with a variety of biological properties including immunomodulatory and antitumor activities. In this study, we investigated the molecular mechanisms by which Ganoderma tsugae (GT), one of the most common species of Ganoderma, inhibits the proliferation of HER2-overexpressing cancer cells. Here, we show that a quality assured extract of GT (GTE) inhibited the growth of HER2-overexpressing cancer cells in vitro and in vivo and enhanced the growth-inhibitory effect of antitumor drugs (e.g., taxol and cisplatin) in these cells. We also demonstrate that GTE induced cell cycle arrest by interfering with the HER2/PI3K/Akt signaling pathway. Furthermore, GTE curtailed the expression of the HER2 protein by modulating the transcriptional activity of the HER2 gene and the stability/degradation of the HER2 protein. In conclusion, this study suggests that GTE may be a useful adjuvant therapeutic agent in the treatment of cancer cells that highly express HER2. [ABSTRACT FROM AUTHOR]

Evergreen broad-leaved forest is now gradually degraded and fragmented, and there is an increase in the amount of habitat edges as a result of long-term human activity. However, the role of edges in the regeneration of primary forest species is poorly understood. After 20 years of the edge creation, we analyzed primary forest species distribution and abundance, and changes in floristic composition, vegetation structure across forest-field gradients in Ailao Mountain, SW China. Our results revealed that there was a higher abundance and richness of primary species, late secondary species and thorny lianas at the distances 0-50 m than at the distances more than 50 m from the edge into the forest exterior. At the distances >50 m, no individuals of dominant canopy trees Lithocarpus xylocarpus, Castanopsis wattii, and L. jingdongensis were found, whereas the abundance of early pioneer shrub species and herbaceous cover was significantly greater. The richness of primary species showed a decrease with increasing distances from the forest edge to the exterior, particularly of medium-seeded primary species showing a drastic decrease. Moreover, no large-seeded primary species occurred at the distances >60 m. This study indicates that the forest edge as a buffer zone may be in favor of primary species regeneration. A dense shrub and herb layer, and seed dispersal may be the major factors limiting the forest regeneration farther from the forest edge. Therefore, to facilitate forest recovery processes, management should give priority to the protection of buffer zones of this forest edge. [ABSTRACT FROM AUTHOR]

Canopy organic matter (COM) composed of epiphyte community exists as a complex subsystem in the montane cloud forest (MCF). We estimated the biomass and nutrient pools of COM in a subtropical MCF in the Ailao Mountain National Nature Reserve (NNR). The diameter at breast height (DBH) of host trees was the best parameter in the estimation of epiphytic biomass, compared to the height ( H) of host trees and the combination of both parameters. The effect of host tree species was negligible in the estimation. Therefore, it was concluded that the DBH data of all trees of a forest regardless of species was a suitable index for the non-destructive estimation of epiphytic biomass in field surveys, especially for investigations of larger study areas. According to species-specific equations, the total COM biomass was estimated to be 2,261 ± 537 (SD) kg ha−1, which was dominated by bryophytes (73.6%) and canopy humus (13.9%). The greatest proportion of COM was located on the inner branches (52.2%), followed by outer branches, trunks, the understory, and branch junctions. The nutrient pools (mean ± SD, kg ha−1) of the COM were: N = 37.9 ± 9.0, P = 1.97 ± 0.47, K = 9.6 ± 2.3, Ca = 9.6 ± 2.3, Mg = 2.64 ± 0.63 and Na = 0.25 ± 0.06. Assessments of epiphytic biomass and nutrient capital supported the idea that the canopy subsystem holds a substantial pool of nutrients, especially when compared to the labile components of the forest ecosystem. [ABSTRACT FROM AUTHOR]

The species composition, diversity, and abundance of lianas were studied in four secondary forests (a 100-year-old forest, a middle-aged forest, and two younger secondary forests), and compared with an undisturbed primary forest in the Ailao Mountains of subtropical SW China. The results showed that the species composition of lianas differed greatly from the secondary forests to the primary forest, which exhibit early and late-successional species. The abundance of lianas was relatively higher in the two younger and middle-aged secondary forests than in the old-growth secondary and primary forests. However, liana species richness was very limited in the four secondary forests as compared to the primary forest. Root climbers mainly grew in the primary forest, whereas tendril and hook climbers predominated in the four secondary forests, while stem twiners were common in both. The majority of lianas recorded in this study reproduced by animal dispersal, and there was no variation in dispersal modes across the five forest types. A step-wise regression showed that the abundance of small lianas (dbh <4 cm) was positively correlated with the abundance of small- and medium-sized tree stems and negatively correlated with the abundance of large-sized tree stems, whereas there is a strong positive correlation between the abundance of large lianas (dbh ≥4 cm) and large tree stems. Results from the CCA indicate that canopy openness, soil moisture, and average canopy height were the most important factors that influenced the abundance and distribution of lianas. [ABSTRACT FROM AUTHOR]

The tropical rain forest in Xishuangbanna, SW China has a high floristic diversity and is closely related to Malaysian rain forests in flora. This forest would not normally be established in such a climatic region as Xishuangbanna (less precipitation and lower air temperature) compared to those of the lowland moist tropics. The mean annual rainfall is 1487 mm, which is considerably lower than rain forests in other parts of the world. It is believed that the frequent occurrence of radiation fog might play an important role in the water relations of plants and in the hydrological cycle of this type of rain forest. However, the multiple hydrological and ecological effects of radiation fog are not well understood. In this paper, we describe and analyze the significance of radiation fog to this forest, and develop a hypothesis that fog plays an important role in the presence of the tropical rain forest in Xishuangbanna. Suggestions for further research on the significance of fog are offered. [ABSTRACT FROM AUTHOR]

DNA typing for human leukocyte antigen (HLA)-A, -B and -DRB1 was performed using polymerase chain reaction–sequence-based typing method on 618 randomly selected healthy individuals of the Han population in Northern China. Allele frequencies and haplotypes were statistically analyzed. A total of 84 HLA-A alleles, 143 B alleles, and 122 DRB1 alleles were detected, and 853 A-B-DRB1 haplotypes, 473 A-B haplotypes, and 551 B-DRB1 haplotypes were statistically inferred. Statistical analysis of three-locus haplotypes showed that A*0207-B*4601-DRB1*0901 (3.06%) was the most predominant. Gene frequencies and haplotypic associations within HLA-A, -B, and -DRB1 loci were determined at a high-resolution (four digit) allelic level and should provide useful information in anthropology, bone marrow donor registry, legal medicine, and disease association studies. [ABSTRACT FROM AUTHOR]

To determine the cause of a 2008 outbreak of aseptic meningitis in Shandong Province, China, we analyzed samples from outbreak patients and coxsackievirus B3 samples collected during 1990-2010 surveillance. The cause of the outbreak was coxsackievirus B3, genogroup D. Frequent travel might increase importation of other coxsackievirus B3 genogroups. [ABSTRACT FROM AUTHOR]

Presents population data of STR loci in Chinese Han population from north of Guangdong Sheng, China. Sufficiency of the size of the study population for the purpose of the study; Reasons behind the selection of the Chelex-100 protocol during extraction of genomic DNA; Sensitivity and reliability of the PCR system provided by Applied Biosystems.

Presents a genetic analysis of short tandem repeat (STR) loci of individuals in the Yili Uigar ethnic autonomous region in China. Blood samples from unrelated individuals; DNA extraction method; Equipment and software used; Compliance with the Hardy-Weinberg equilibrium; Absence of any significant difference in the 15 STR loci.

Background and Objectives: Cow's milk allergy (CMA) is the most common food allergy in young children. Previous studies have reported that single-nucleotide polymorphisms (SNPs) are associated with CMA. The extent to which SNPs contribute to the occurrence of CMA is unknown. The purpose of this study was to investigate the independent relevance of genetic predisposition to CMA in Chinese children.Methods and Study Design: 200 infants with CMA and 799 healthy controls aged 0-12 months were included. Five previously identified genetic variants (rs17616434, rs2069772, rs1800896, rs855791 and rs20541) were genotyped. Logistic regression was used to analyze the genetic associations or their interactions with a family history of allergy on CMA.Results: Among the five SNPs, only IL10 rs1800896 was significantly associated with CMA (odds ratio (OR) 1.60, p=0.042). Each 1-risk allele increase in the genetic risk score (GRS) was suggestively associated with an 11% higher risk of CMA (1.11: 0.99-1.27, p=0.069) and a 45% increased risk of CMA in the GRS high-risk group compared to the GRS low-risk group (1.45: 1.02-2.06, p=0.037). Furthermore, parental allergy also increased the risk of CMA among children (1.87: 1.46-2.39, p<0.001). Importantly, parental allergy exacerbated the genetic effect on the risk of CMA.Conclusions: The rs1800896 variant in the IL-10 gene is associated with CMA in Chinese children. In addition, the GRS had an interaction with parental history of allergy, implying that genetic risk for CMA was exacerbated among those with parental history of allergy. [ABSTRACT FROM AUTHOR]

Biological foaming (or biofoaming) is a frequently occurring problem in wastewater treatment plants (WWTPs) and is attributed to the overwhelming growth of filamentous bulking and foaming bacteria (BFB). Biological foaming has been intensively investigated, with BFB like Microthrix and Skermania having been identified from WWTPs and implicated in foaming. Nevertheless, studies are still needed to improve our understanding of the microbial diversity of WWTP biofoams and how microbial activities contribute to foaming. In this study, sludge foaming at the Qinghe WWTP of China was monitored, and sludge foams were investigated using culture-dependent and culture-independent microbiological methods. The foam microbiomes exhibited high abundances of Skermania, Mycobacterium, Flavobacteriales, and Kaistella. A previously unknown bacterium, Candidatus Kaistella beijingensis, was cultivated from foams, its genome was sequenced, and it was phenotypically characterized. Ca. K. beijingensis exhibits hydrophobic cell surfaces, produces extracellular polymeric substances (EPS), and metabolizes lipids. Ca. K. beijingensis abundances were proportional to EPS levels in foams. Several proteins encoded by the Ca. K. beijingensis genome were identified from EPS that was extracted from sludge foams. Ca. K. beijingensis populations accounted for 4 to 6% of the total bacterial populations in sludge foam samples within the Qinghe WWTP, although their abundances were higher in spring than in other seasons. Cooccurrence analysis indicated that Ca. K. beijingensis was not a core node among the WWTP community network, but its abundances were negatively correlated with those of the well-studied BFB Skermania piniformis among cross-season Qinghe WWTP communities. [ABSTRACT FROM AUTHOR]

Background: Corticosteroid therapy followed by splenectomy for immune thrombocytopenic purpura (ITP) is the standard practice. Rituximab is mostly used in patients with chronic refractory ITP who have failed multiple previous treatments, including splenectomy.Objective: We explored the potential role of rituximab as an early therapeutic option for patients with corticosteroid-resistant ITP who preferred to avoid splenectomy in favor of other treatment. Methods: Twenty-five patients with corticosteroid- resistant ITP were treated with rituximab between May 1, 2009, and June 30, 2012, at a single center. Rituximab was administered at 100 mg/m2 on days 7, 14, 21, and 28. The response to rituximab therapy and adverse effects were observed. Results: Complete remission was achieved in 19 patients (76%), partial remission in 3 patients (12%), and minimal response in none of the patients; 1 patient was considered a treatment failure (4%). Two patients (8%) were lost to follow-up. Twenty- two patients (88%) achieved a platelet count > 50x109/L. The median time from administration of the first rituximab dose to partial remission was 2 months (range, 0.7-3 months) for all the patients. Response classified as sustained was achieved in 21 patients (84%). No serious adverse effects were observed during rituximab therapy. Conclusions: Rituximab therapy is effective and safe for patients with corticosteroid-resistant ITP before splenectomy, resulting in high complete remission and overall response rates. A multicenter study with a larger sample should be performed to further explore the role of rituximab therapy. [ABSTRACT FROM AUTHOR]

Environmental surveillance is an effective approach in investigating circulating enteroviruses and had been conducted in the cities of Jinan and Linyi since February 2008 and April 2010, respectively. This study analyzed 46 sewage samples collected in the two cities in 2011 and found that echovirus 6 (E6) was the predominant serotype, with 134 isolates (65 in Jinan and 69 in Linyi) from 23 (50%) samples. This differs from the 2010 data that found 29 E6 isolates in Jinan and only 3 in Linyi. Phylogenetic analysis of the VP1 coding region showed that all environmental E6 samples from 2008 to 2011 (n = 167) segregated into two lineages and revealed an increase in VP1 gene diversity in 2011, suggesting that the increased number of E6 detections reflects a real epidemic in the two cities. Most Linyi isolates (n = 61, or 88%) in 2011 segregated into sublineage la, together with 18 Jinan isolates in 2011. Interestingly, the ancestral VP1 sequence of sublineage la inferred using the maximum-likelihood method had 100% identity with the sequence of one environmental isolate from Jinan in August 2010, suggesting an intercity spread from Jinan to Linyi. By Bayesian phylodynamic methods, the most recent common ancestor of Linyi isolates in sublineage la dated back to 24 December 2010, revealing that this sublineage was likely imported into Linyi from August to December in 2010. This study demonstrates that environmental surveillance is a sensitive method in tracing transmission pathways of circulating enteroviruses among different regions and reveals that E6-associated aseptic meningitis is an emerging concern in China. [ABSTRACT FROM AUTHOR]

Enterovirus environmental surveillance on sewage from the city of Jinan, Shandong Province, China, was initiated in 2008. Thirty echovirus 6 (E6) strains--1 in 2008 and 29 in 2010--were isolated and identified. Most E6 isolates (n = 21) came from the sewage collected on August 2010, revealing high local E6 activity at that time. Interestingly, the VP1 sequences of most isolates, even from the same sewage, were not identical. Phylogenetic analysis of VP1 sequences revealed two lineages for these isolates, with 78.0 to 80.0% nucleotide identities with one another, 94.8 to 100.0% identity within the major lineage, and 92.7 to 98.5% identity within the minor one. The VP1 sequences of environmental isolates, clinical isolates from 1998 to 2010, and global E6 were subjected to evolutionary analysis using Bayesian phylodynamic methods. The inferred E6 VP1 ancestral sequence dated back to 1901 (range, 1873 to 1928) and evolved with 7.047 x 10-3 substitutions per site per year. Shandong E6 segregated into three clusters, and the two environmental lineages belonged to clusters A and C, which originated in 2003 and 1992, respectively. The antigenicity analysis via neutralization assay confirmed great antigenic differences between Shandong isolates and a prototype strain. These findings underscore the value of continuous environmental surveillance and genetic analysis to monitor circulating enteroviruses in the population and give further insight into E6 evolution. [ABSTRACT FROM AUTHOR]

This study aimed to characterize molecular mechanism of 3 Salmonella enterica strains and novel mobile genetic elements identified in them. The strains, designated SW1, SW39, and SW109084, were obtained from diarrhea patients. The results of susceptibility testing showed SW39 was nonsusceptible to imipenem and cefotaxime. Whole genome sequencing was performed on Illumina HiSeq platform. Multilocus-sequence typing revealed SW1 belonged to ST2529 which was first confirmed in S. enterica, SW109084 was ST34 which was first reported in Enteritidis and SW39 was ST19. Resistome analysis showed SW1, SW109084, and SW39 carried 14, 19, and 17 antibiotic resistance genes. Seven transposons and 4 integrons were confirmed in these strains. Notably, a novel In6- and In7-like class 1 integron designated InSW39 and a novel transposon Tn5393k were identified in plasmid pSW39. The study of genomics and resistance in S. enterica plays a significant role in prevention and treatment of Salmonella infections., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Few epidemiological studies have explored the effects of air pollution on the risk of drug-resistant tuberculosis (DR-TB)., Objective: To investigate the short and long term residential concentrations of ambient air pollutants (particulate matter <10 μm in diameter (PM 10 ) and particulate matter≤2.5 μm in diameter (PM 2.5 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), ozone (O 3 ), and carbon monoxide (CO)) in relation to the risk of DR-TB in a typical air pollution city, Jinan city, China., Methods: A total of 752 new culture-confirmed TB cases reported in TB prevention and control institutions of Jinan from January 1, 2014 to December 31, 2015 were included. Average individual-level concentrations of air pollution for 5 different exposure windows, vary from 90 days to 720 days to diagnosis were estimated using measurements from monitor closest to the patient home addresses. Logistic regression model adjusted for potential confounders was employed to evaluate correlation between air pollution and DR-TB risk at different five exposure windows individually., Results: There were substantially increased mono-drug resistance and poly-drug resistance risks for ambient PM 2.5 , PM 10 , O 3 , and CO exposures. High exposure to PM 2.5 , PM 10 , and CO was also significantly associated with increased incidence of multi-drug resistance (MDR) both in the single- and multi-pollutants regression models. The dominant positive associations for PM 2.5 was observed at 540 days exposure, for O 3 was observed at 180 days exposure, and for PM 10 and CO was observed from 90 days to 540 days exposures., Conclusions: Our finding suggest that exposure to ambient air pollution (PM 2.5 , PM 10 , O 3 , and CO) are associated with increased risk of DR-TB. We provided epidemiological evidence of association between pollution exposure and mono-, poly- and multi-drug resistance., (Copyright © 2019. Published by Elsevier Ltd.)

Aim: To establish a clinical scoring model to predict risk of acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB) patients., Methods: This was a retrospective study of 1457 patients hospitalized for CHB between October 2008 and October 2013 at the Beijing Ditan Hospital, Capital Medical University, China. The patients were divided into two groups: severe acute exacerbation (SAE) group (n = 382) and non-SAE group (n = 1075). The SAE group was classified as the high-risk group based on the higher incidence of ACLF in this group than in the non-SAE group (13.6% vs 0.4%). Two-thirds of SAE patients were randomly assigned to risk-model derivation and the other one-third to model validation. Univariate risk factors associated with the outcome were entered into a multivariate logistic regression model for screening independent risk factors. Each variable was assigned an integer value based on the regression coefficients, and the final score was the sum of these values in the derivation set. Model discrimination and calibration were assessed using area under the receiver operating characteristic curve and the Hosmer-Lemeshow test., Results: The risk prediction scoring model included the following four factors: age ≥ 40 years, total bilirubin ≥ 171 μmol/L, prothrombin activity 40%-60%, and hepatitis B virus DNA > 10(7) copies/mL. The sum risk score ranged from 0 to 7; 0-3 identified patients with lower risk of ACLF, whereas 4-7 identified patients with higher risk. The Kaplan-Meier analysis showed the cumulative risk for ACLF and ACLF-related death in the two risk groups (0-3 and 4-7 scores) of the primary cohort over 56 d, and log-rank test revealed a significant difference (2.0% vs 33.8% and 0.8% vs 9.4%, respectively; both P < 0.0001). In the derivation and validation data sets, the model had good discrimination (C index = 0.857, 95% confidence interval: 0.800-0.913 and C index = 0.889, 95% confidence interval: 0.820-0.957, respectively) and calibration demonstrated by the Hosmer-Lemeshow test (χ (2) = 4.516, P = 0.808 and χ (2) = 1.959, P = 0.923, respectively)., Conclusion: Using the scoring model, clinicians can easily identify patients (total score ≥ 4) at high risk of ACLF and ACLF-related death early during SAE.

Background: Lymph nodes posterior to right recurrent laryngeal nerve (PRRLN) may be frequently overlooked during central compartment dissection (CCD) for papillary thyroid carcinoma (PTC). The purpose of this study was to investigate risk factors of lymph node PRRLN metastasis in right-sided PTC, thereby to identify the indications for lymph node PRRLN dissection., Methods: We conducted a retrospective study of patients with right-sided PTC who underwent a thyroidectomy plus lymph node PRRLN dissection during ipsilateral CCD., Results: Overall, 108 patients (26.7%) had lymph node PRRLN metastases, including 26 (6.4%) who presented with solely lymph node PRRLN positivity. Factors of extrathyroidal extension, multifocality, larger tumor (≥1 cm), level VIa positivity (p < .0001 for each), and lateral compartments positivity (p = .0002) significantly predicted lymph node PRRLN metastasis in right-sided PTC., Conclusion: Lymph node PRRLN should be routinely explored during CCD because of the possibility of only involvement in PTC. Factors of tumors larger than 1 cm, multifocality, and extrathyroidal extension were independent predictors of lymph node PRRLN metastasis in right-sided PTC, and suggested the clinical indications of lymph node PRRLN dissection., (Copyright © 2013 Wiley Periodicals, Inc.)