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Objective: The role of the Hospital Pharmacy Preceptor (HPP) is pivotal in upholding the excellence of experiential training and fostering the professional growth of pharmacy interns. However, there is a lack of studies that provide an overview of pharmacy internships from the perspective of HPP. This study explores the experience and expectations of HPPs regarding existing problems and possible coping strategies in intern teaching. Methods: This is a qualitative study that was conducted through individual interviews and focus group discussions. HPPs were invited as participants from large-scale tertiary hospitals in representative provinces of mainland China. Interview and focus group discussion data were analyzed using thematic analysis to see emerging themes from the data. Nvivo 12 was utilized for data management and processing. Results: Eight individual interviews and two focus group discussions were conducted, involving 14 HPPs as participants. Upon the examination of the interviews and focus group data, four themes were summarized regarding HPPs' perceptions: 1) current presenting problems; 2) possible coping strategies; 3) something HPPs should do; 4) something interns should do. Conclusion: This study found that from the HPPs' perspective, the hospital-based pharmacy internship still has some problems from policy to practice, which need to be addressed by the joint efforts of the state, schools, internship bases, pharmacy preceptors, and students. [ABSTRACT FROM AUTHOR]

The causes of the decreased intensity of the East Asian summer monsoon (EASM) over the past 150 years are still not fully understood, although several studies have linked the monsoon weakening to the warming of tropical oceans. Here, we use pine tree‐rings to reconstruct the precipitation total for April–August from 1810 to 2018, in south‐central Shandong Province, in the EASM region. The reconstruction accounts for 41.8% of the instrumental precipitation variance during 1965–2018. The EASM precipitation reconstruction shows extreme pluvial conditions in 1832, 1833, 1886, and 1998, and extreme droughts in 1878, 1901, and 1910, which correspond precisely to extreme climatic events recorded in historical documents. The reconstructed precipitation reveals a drying trend since the 1870s, which matches well with the decreasing trend of the EASM inferred from stalagmite oxygen isotope (δ18O) records and climate simulations. The trend of decreasing precipitation since the 1870s, indicated by our reconstruction, is significantly correlated with the spring sea surface temperature (SST) of the North Atlantic Ocean, which suggests that the EASM weakening was linked to North Atlantic SST variations during the past 150 years. This potential role of North Atlantic SST variability is supported by climate sensitivity simulations of the Community Earth System Model. North Atlantic SST variability induces two teleconnections of Rossby‐like wave propagation from the North Atlantic into East Asia, resulting in anomalous precipitation in this region. Key Points: A 209‐year precipitation reconstruction was established from the south‐central Shandong, the monsoonal eastern China used pine tree ringsSeveral historical severe droughts are captured by the reconstructed precipitation, and 20th century was dominated by dry conditionsThe trend of decreasing precipitation since the 1870s correlates significantly with spring sea surface temperature in the North Atlantic [ABSTRACT FROM AUTHOR]

Paleoclimatic records reveal spatially asynchronous changes of East Asian summer monsoon (EASM) precipitation during the Holocene, but the underlying mechanisms are not fully understood. This study explores the role of the zonal shift of the Asian westerly jet (AWJ) core on the spatial‐temporal variability of EASM precipitation based on Holocene climate simulations using the KCM and CESM forced by orbital variations. We analyzed the composite differences of summer precipitation and associated atmospheric circulations between the early (middle) and middle (late) Holocene. Simulations suggest a dipole pattern of summer precipitation with increasing (decreasing) precipitation in central (southern) China from the early to late Holocene, which was shaped by the eastward shift of the AWJ core. The eastward shift of the AWJ core and the accompanied eastward movement of the upper‐level convergence over the AWJ's right exit region weakened the low‐level downward motions over central China. Meanwhile, the low‐level upward motions over southern China were weakened by the concurrent eastward (westward) migration of the South Asian High (western Pacific subtropical High) during the Holocene. Consequently, summer precipitation increased (decreased) in central (southern) China from the early to late Holocene. The eastward shift of the AWJ core was primarily driven by amplified meridional insolation gradient at middle latitudes via strengthening upper‐level westerly intensity during the Holocene. In addition, land cover difference between East Asia and central Asia caused a greater enhancement of westerlies intensity in East Asia, further modulating the eastward movement of the AWJ core during the Holocene. Key Points: Our simulations reveal a dipole pattern of summer precipitation between central and southern China during the HoloceneThe dipole precipitation pattern was strongly modulated by zonal shift of the Asian westerly jet coreInsolation variation and land cover caused the eastward shift of the Asian westerly jet core during the Holocene [ABSTRACT FROM AUTHOR]

Periodic wetting is an inherent feature of many monsoon marginal region deserts. Previous studies consistently demonstrate desert wetting during times of Earth's high orbital eccentricity and strong summer monsoon. Here we report the first evidence demonstrating desert wetting during Earth's low orbital eccentricity from the late Miocene strata of the northwestern Tarim Basin of northern China, which is commonly thought to be beyond the range of Asian monsoon precipitation. Using mechanisms for modern Tarim wetting as analogs, we propose that East Asian summer monsoon weakening enhanced westward moisture transport and caused opposite desert wetting pattern to that observed in monsoon marginal region deserts. This inference is supported by our model simulations. This result has far-reaching implications for understanding environmental variations in non-monsoonal deserts in the next few thousands of years under high atmospheric CO2 content and low eccentricity. The late Miocene Tarim desert experienced periodic wetting and greening in eccentricity minimum and East Asian summer monsoon weakening [ABSTRACT FROM AUTHOR]

Background: Hospital-based pharmacy internship (HBPI) is critical for the transition from "pharmacy students" to "professional pharmacists". This study explores the pharmacist interns' experiences and expectations for HBPI from their personal experiences intending to provide references for future hospital pharmacy education reform and policy development. Methods: This is a multicenter qualitative study applying focus group discussions. Pharmacist interns were invited as participants from large teaching hospitals in Henan, China. A thematic analysis was conducted to qualitatively analyze this data. Nvivo 12 was utilized for data management and processing. Results: Three focus group discussions were conducted, involving 16 interns as participants. Three themes were summarized regarding interns' expectations and experiences: (1) positive experiences of the HBPI; (2) negative experiences of the HBPI; (3) expectations and suggestions for the HBPI. Conclusion: This study finds that the HBPI improves the professional knowledge, professional skills, and core competencies of interns. Therefore, the HBPI is an important preparation and transition stage for pharmacy students. However, the current pharmacy internship in China still has imperfections such as the insufficient ability of clinical teachers, unreasonable internship models, and unscientific internship content. [ABSTRACT FROM AUTHOR]

Background: Pegylated recombinant human granulocyte colony-stimulating factors (PEG-rhG-CSFs) are more commonly and widely used than recombinant human granulocyte colony-stimulating factors (rhG-CSFs) in preventing chemotherapy-induced neutropenia in patients with stage II-IV breast cancer. To reduce the financial burden on these patients, the corresponding medical insurance directory needs to be revised. Objectives: To evaluate the cost-effectiveness of PEG-rhG-CSF versus rhG-CSF in patients with stage II-IV breast cancer in central China. Methods: Two Markov models, a chemotherapy model and a post-chemotherapy model, were developed to study the effects and costs, with a time horizon of 12 weeks and 35 years, respectively. Cost and probability input data were primarily obtained from a retrospective real-world study conducted in five tertiary hospitals. Propensity score matching was adopted to overcome retrospective bias. Other parameters were extracted from literature as well as advice from clinical experts. Univariate and probabilistic sensitivity analyses were conducted. Results: In the first chemotherapy model, PEG-rhG-CSF was associated with fewer episodes of febrile neutropenia (FN) (N = 19 per 1000 patients treated), infections (N = 24 per 1000 patients treated) and deaths (N = 2 per 1000 patients treated), but higher costs (¥36 more per patient treated). The post-chemotherapy model indicated that PEG-rhG-CSF led to higher gains in quality-adjusted life years (QALYs) (11.695 versus 11.516) in comparison to rhG-CSF. Sensitivity analysis showed that the cost of PEG-rhG-CSF had the greatest impact on the incremental costs, and incremental QALYs were very sensitive to the risk of RDI <85%. The probability of PEG-rhG-CSF being cost-effective compared to rhG-CSF was 66% at the willingness to pay (WTP) thresholds of ¥72,371 per QALY gained. Conclusion: According to this economic evaluation based on real-world data, PEG-rhG-CSF may be considered as a more cost-effective strategy relative to rhG-CSF for stage II-IV breast cancer patients in central China. However, to reflect a national perspective, further evidence is needed using data from larger-scale studies. [ABSTRACT FROM AUTHOR]

Juglandis Mandshuricae Cortex is the bark of Juglans mandshurica Maxim., which has been used as a folk medicine plant in China and India. In this study, an ultra‐high performance liquid chromatography–quadrupole/orbitrap high‐resolution mass spectrometry method was developed to clarify and quantify the chemical profiling of Juglandis Mandshuricae Cortex rapidly. A total of 113 compounds were characterized. Among them, seven flavonoids were simultaneously quantified in 15 min, including myricetin, myricetrin, taxifolin, kaempferol, quercetin, quercitrin, and naringenin. The method was validated for accuracy, precision, and the limits of detection and quantification. All calibration curves showed a good linear relationship (r > 0.9990) within test ranges. The intra‐ and inter‐day relative standard deviations were less than 2.16%. Accuracy validation showed that the recovery was between 95.6 and 101.3% with relative standard deviation values below 2.85%. The validated method was successfully applied to determine the contents of seven flavones in Juglandis Mandshuricae Cortex from seven sources and the contents of these places were calculated respectively. This method provides a theoretical basis for further developing the medicinal value of Juglandis Mandshuricae Cortex. [ABSTRACT FROM AUTHOR]

Tebipenem pivoxil (TBPM-PI), an oral carbapenem antibiotic, has shown special advantages in pediatric infections and was in urgent need in China. Although pharmacokinetics, urinary excretion, and metabolite information of its active form tebipenem (TBPM) has been reported, ethnic differences may exist among the Chinese and Japanese population. By now, no systematic pharmacokinetics, urinary excretion, metabolites, or safety information has been revealed to the Chinese population. The purpose of the present work was to investigate abovementioned information of TBPM-PI granules after oral single ascending doses of 100, 200, and 400 mg in Chinese volunteers. Based on the pharmacokinetic study, the urine pharmaco-metabolomic analysis was conducted to reveal metabolomic interruptions and metabolite information. The study design was a single-center, open-label, randomized, single-dose pharmacokinetic study of 36 healthy volunteers (with half of them being male and the other half female). Time to maximum concentration (T max) was reached at 0.50, 0.50, or 0.67 h for 100, 200, or 400 mg, respectively. The linear pharmacokinetic characteristic of maximum plasma concentration (C max) was detected over 100–200 mg. The area under the concentration time curve (AUC) was proportional to the dose in the range of 100–400 mg. The maximum urinary excretion rate was detected at 0–1 or 1–2 h for dose of 100 or 200–400 mg. Cumulative amount of TBPM excreted in urine by 24 h accounted up to 90, 95, and 80% of dose administered for three groups, respectively. The pharmaco-metabolomic analysis revealed urine metabolic trajectory of deviation at 0–1 or 1–2 h and gradually regressing back to the pre-dose group at the following time periods. Urine metabolites from M1 to M4 were identified, indicating ethnic difference in metabolites among the Chinese or Japanese population. The current work proved safety and tolerance of single-dose administration of oral TBPM-PI in Chinese healthy volunteers over doses of 100–400 mg. All these results provide pharmacokinetics, urine excretion, urine metabolomics, urine metabolites, and safety information in healthy Chinese volunteers after oral single ascending doses of TBPM-PI, benefitting further development and clinical utilities. [ABSTRACT FROM AUTHOR]

Purpose: Primary ciliary dyskinesia (PCD), which commonly causes male infertility, is an inherited autosomal recessive disorder. This study aimed to investigate the clinical manifestations and screen mutations associated with the dynein axonemal assembly factor 2 (DNAAF2) gene in a Han Chinese family with PCD. Methods: A three-generation family with PCD was recruited in this study. Eight family members underwent comprehensive medical examinations. Genomic DNA was extracted from the participants' peripheral blood, and targeted next-generation sequencing technology was used to perform the mutation screening. The DNAAF2 expression was analyzed by immunostaining and Western blot. Results: The proband exhibited the typical clinical features of PCD. Spermatozoa from the proband showed complete immotility but relatively high viability. Two novel compound heterozygous mutations in the DNAAF2 gene, c.C156A [p.Y52X] and c.C26A [p.S9X], were identified. Both nonsense mutations were detected in the proband, whereas the other unaffected family members carried either none or only one of the two mutations. The two nonsense heterozygous mutations were not detected in the 600 ethnically matched normal controls or in the Genome Aggregation Database. The defect of the DNAAF2 and the outer dynein arms and inner dynein arms were notably observed in the spermatozoa from the proband by immunostaining. Conclusion: This study identified two novel compound heterozygous mutations of DNAAF2 leading to male infertility as a result of PCD in a Han Chinese family. The findings may enhance the understanding of the pathogenesis of PCD and improve reproductive genetic counseling in China. [ABSTRACT FROM AUTHOR]

Kang‐Ai injection, which is composed of Astragali Radix, Ginseng Radix et Rhizoma, and kushenin, is extensively used in China as an adjuvant therapy for many types of cancer and chronic hepatitis B. In the present study, 47 herbal compounds (11 alkaloids, 8 astragalosides, and 28 ginsenosides), were detected in Kang‐Ai injection by ultra‐high‐performance liquid chromatography coupled to quadrupole time‐of‐flight tandem mass spectrometry, of which 31 were identified using authentic standards. Additionally, a practical ultra‐high‐performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry method was employed for simultaneous quantitative detection (31 available compounds), and relative quantitative detection (16 unavailable compounds) within 10 min. The limit of detection and limit of quantification was 0.11‐2.22 and 0.53‐11.08 ng/mL, respectively. Altogether, content levels of each compound ranged from 0.03 to 9835.57 μg/mL. Furthermore, chemometric analysis indicated oxymatrine, astragaloside IV, ginsenosides Rg1 and Re, and matrine had the greatest effect on concentration fluctuation. Therefore, we suggested these five compounds should be monitored during the manufacturing process. This method can be applied to provide crucial chemical profiles and quality assessments for Kang‐Ai injection, guaranteeing the safety, effectiveness, and controllability of the drug in clinics. [ABSTRACT FROM AUTHOR]

Garcinia multiflora is a kind of evergreen tree which is widely distributed in the south of China. However, few researches focused on the constituents in different parts of G. multiflora as well as their potential targets and pathways in vivo. To clarify the chemical constituents of G. multiflora rapidly and predict the potential targets as well as pathways in vivo that this plant may have effects on, a feasible and accurate strategy was developed to identify the chemical constituents in fruits, leaves, and branches of G. multiflora by ultra‐high performance liquid chromatography with Q‐Exactive hybrid quadrupole‐orbitrap high‐resolution accurate mass spectrometry. Network pharmacology was then employed and a "compounds‐targets‐diseases" network was established. Sixty‐one compounds including polycyclic polyprenylated acylphloroglucinols, xanthones, and flavonoids were finally identified in different parts of G. multiflora, and the contents of seven constituents were quantified, respectively. On the basis of the network pharmacology analysis results, compounds in this plant were speculated to have potential pharmacodynamic effect on cancer, inflammatory, respiratory diseases, cardiovascular diseases, and metabolic diseases. This research will provide a new method for the advanced study on the pharmacodynamic materials basis of G. multiflora, and offer valuable evidences for medicinal purpose of this plant. [ABSTRACT FROM AUTHOR]

Climatic instability, especially on decadal to multi-decadal time scales, has a profound impact on societal development and human welfare in semi-arid and arid regions. Previous work suggested that arid northwestern China was characterized by a dry Medieval Warm Period (MWP, from ca. 1000 to 1300 AD) and a wet Little Ice Age (LIA, from ca. 1400 to 1850 AD), but there is a lack of studies addressing the issue of climatic variability during the last millennium. Here, we present results from a diverse range of proxy records from northwestern China with the aim of evaluating the time variation of hydroclimatic variability during the MWP and LIA. Within the context of an overall cold climate, we detected a pattern of higher moisture variability during the LIA compared to the MWP. A comparison of the proxy records of climatic instability during the LIA from northwestern China with the major modes of SST and atmospheric variability, which affect moisture/precipitation in Asia, suggests that the instability of the North Atlantic Oscillation (NAO) from middle- to high-latitude regions during the LIA was a major driving factor. The westerlies may play an important role in linking the unstable climatic conditions observed in the above-mentioned regions. Our results support the concept that climatic instability was above the norm during cold periods, in contrast with present observations that demonstrate the occurrence of increasingly extreme climatic events with ongoing global warming. [ABSTRACT FROM AUTHOR]

The stems and roots of Marsdenia tenacissima (Roxb.) Wight et Arn., a traditional Chinese medicine and Dai herbal medicine, have been widely used for the treatment of asthma, trachitis, tonsillitis, pharyngitis, cystitis, pneumonia and drug or food poisoning. Nowadays, the extract of Marsdenia tenacissima, under the trademark of "Xiao-ai-ping", is widely used in clinic for the treatment of different cancers in China. To date, approximately 196 chemical ingredients covering steroids, triterpenes and organic acids have been identified from different parts of this plant. Steroids are the major characteristic and bioactive constituents of this plant. Modern pharmacology has demonstrated that the crude extracts and steroids have various in vitro and in vivo pharmacological activities, such as multidrug resistance reversal, antitumor, anti-angiogenic, immunomodulation and anti-HIV activities. The multidrug resistance reversal of steroids provided evidence for the use of this herb in clinic. However, despite wide clinical application, clinical trials, quality control method, pharmacokinetic and toxicity research on Marsdenia tenacissima were seldom reported and deserved further efforts. The present review aimed to achieve a comprehensive and up-to-date investigation in ethnopharmacology, phytochemistry, pharmacology, clinical study, pharmacokinetics, toxicology and quality control of Marsdenia tenacissima. In addition, the possible perspectives and trends for future studies of Marsdenia tenacissima have also been put forward. It is believed that this review would provide a theoretical basis and valuable data for future in-depth studies and applications. [ABSTRACT FROM AUTHOR]

Background: Ticagrelor, the first reversible P2Y12 receptor antagonist, exhibits faster onset and offset of antiplatelet effects and more consistent platelet inhibition than clopidogrel in both healthy subjects and patients with stable coronary artery disease.Objective: The objectives of this study were to establish a population pharmacokinetics (PK) and pharmacodynamics (PD) model of ticagrelor and to provide a theoretical basis for the optimization of ticagrelor treatment in clinic.Methods: A single oral dose of 180 mg ticagrelor was administered to 14 healthy male subjects in a randomized study. Common single-nucleotide polymorphisms (SNPs) in biotransformation enzymes CYP3A4 and CYP3A5 (CYP3A4*1G and CYP3A5*3) were genotyped by PCR-direct sequencing. Blood samples were collected to measure plasma concentrations of ticagrelor and its active metabolite AR-C124910XX and maximal platelet inhibition. Various models were evaluated to characterize the pharmacokinetics of ticagrelor and AR-C124910XX as well as their PK-PD relationship. Covariates that may potentially affect PK or PD of ticagrelor and AR-C124910XX were included and assessed. Simulation for dosage regimen was performed based on the final PK-PD model.Results: Ticagrelor and AR-C124910XX PK were best described by a two-compartment model with first-order transit absorption model. CYP3A4*1G increased clearance for AR-C124910XX, but had no significant effect on ticagrelor clearance. The relationship between concentration and platelet response of ticagrelor was best described by a turnover model. Simulation results indicated that a lower dosage regimen of 30 mg maintenance dose (MD) could produce an anticipated anti-platelet response in comparison to the routine clinical dosage regimen (180 mg loading dose (LD), 90 mg MD).Conclusion: Our study developed a population PK-PD model for ticagrelor and further simulation for dosage regimen was performed based on the final model. Compared to the current recommended dosage regimen (180 mg LD, 90 mg MD), our simulation result of a relatively lower dose (30 mg MD) could also obtain an acceptable anti-platelet response, which may provide a reference for further dosage regimen design in Chinese population. [ABSTRACT FROM AUTHOR]

Xuebijing (XBJ) injection is an ethnomedicinal formula that has been widely used in the therapy of sepsis in China. However, the underlying theraputic mechanisms remain uninvestigated. In this research, a metabolomic method based on UHPLC-Q-Orbitrap HRMS was applied tomake a holistic evaluation of XBJ on septic rats which were induced by the classical cecal ligation and puncture (CLP) operation. The plasma metabolic changes were profiled and evaluated by multivariate analytical (MVA) methods. In the results, a total of 41 differential metabolites were identified between CLP-operated group and sham-operated group, which were mainly involved in amino acid metabolism and lipid metabolism. After pathway analysis, it was finally discovered that the majority of the influenced metabolic pathways caused by sepsis mainly involved in energy metabolism, oxidative stress, and inflammation metabolism. When intervened by XBJ injection, 32 of the 41 disordered metabolites had been adjusted in reverse, which suggested that XBJ could mediate the abnormal metabolic pathways synergistically. In conclusion, the present study systematically investigated the efficacy and its underlying therapeutic mechanisms of XBJ on sepsis, while offering a new insight for the subsequent relevant exploration of other Chinese medicine at the same time. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives Spontaneous reporting of adverse drug reactions (ADRs) in hospitals is often under-reported, which may lead to problems in patient management. This study was aimed to assess the effectiveness of a financial intervention based on a fine and a bonus for improving spontaneous reporting of ADRs by physicians in a hospital setting. Methods This study was conducted at the First Affiliated Hospital of Zhengzhou University (China). Starting in 2009, a bonus of 20 RMB (Chinese currency) was given for each spontaneous ADR report, and a fine of 50 RMB was given for any withheld ADR report. A time series analysis using autoregressive integrated moving average models was performed to assess the changes in the total number of spontaneous ADR reports between the preintervention period (2006-2008) and during the first (2009-2011) and second (2012-2014) intervention periods. Results The median number of reported ADRs per year increased from 29 (range 27-72) in the preintervention period to 277 (range 199-284) in the first intervention period and to 666 in the second (range 644-691). The monthly number of reported ADRs was stable during the 3 periods: 3.56 ± 3.60/month (95% confidence interval (CI), 2.42-4.75) during the preintervention period, 21 ± 13/month (95% CI, 16.97-25.80) in the first intervention period, and 56 ± 20/month (95% CI, 48.81-62.17) in the second intervention period. Conclusion A financial incentive and ADR management regulations had a significant effect on the increase of reported ADRs. [ABSTRACT FROM AUTHOR]

Gentiana macrophylla Radix, commonly known as Qin-Jiao (QJ), was recorded alone to treat jaundice in Compendium of Materia Medica and has been frequently prescribed for treatment of liver disease in China. However, the underlying mechanism remains unknown. In the present work, QJ of 1,2 g/kg or silybin of 40 mg/kg (positive control) was orally given to rats for 7 days to verify the protective effect on acute liver damage induced by tetrachloride (CCl4). Together with serum biochemistry and histopathological examination, 1H-NMR based metabolomics work was carried out to investigate the efficacy. It turned out that QJ of 2 g/kg exerted comparable protective effect with positive control and partially recovered disturbed metabolism by CCl4. Multivariate analysis was conducted and metabolites altered significantly among groups were assigned and discussed, including betaine, glucose, lactate, creatine, and LDL/VLDL. Metabolic regulations involved in QJ or silybin treatment were as follows: tricarboxylic acid (TCA) cycle, synthesis of LDL/VLDL, and gluconeogenesis were enhanced, while betaine metabolism, glycolysis, creatine metabolism, synthesis of ketone bodies, amino acids metabolism, and β-oxidation of fatty acids were suppressed. For the first time hepatoprotective effect of QJ on acute liver damage was revealed by 1H-NMR based metabolomics, prompting understanding of the underlying mechanism. [ABSTRACT FROM AUTHOR]

ABSTRACT We present a pollen-based precipitation reconstruction and multi-proxy records from a 485-cm-long sequence from a sediment core from Xingyun Lake, Yunnan Plateau, south-west China, which depicts the evolution of the Indian Summer Monsoon (ISM) during the last 8500 years. Pollen and other palaeoenvironmental records document several stages of vegetation history and climate change. The warmest and wettest climate in the Xingyun Lake catchment occurred before 5500 cal a BP, and subsequently the climate became gradually drier. After 2000 cal a BP the regional environmental conditions became unstable, and a wet Medieval Warm Period is probably recorded. Our reconstruction of the ISM is similar to that portrayed by Holocene speleothem δ18O records from southern China, but is distinctly different from the East Asian Summer Monsoon (EASM) evolution, which features a mid-Holocene maximum. Our results support the hypothesis that the ISM and EASM evolved asynchronously during the Holocene, and imply that the Chinese speleothem δ18O records from southern China may principally reflect changes in moisture source from the Indian monsoon domain, and thus record the history of the ISM rather than the EASM. [ABSTRACT FROM AUTHOR]

This study investigated the bacterial regrowth in drinking water distribution systems receiving finished water from an advanced drinking water treatment plant in one city in southern China. Thirteen nodes in two water supply zones with different aged pipelines were selected to monitor water temperature, dissolved oxygen (DO), chloramine residual, assimilable organic carbon (AOC), and heterotrophic plate counts (HPC). Regression and principal component analyses indicated that HPC had a strong correlation with chloramine residual. Based on Chick-Watson's Law and the Monod equation, biostability curves under different conditions were developed to achieve the goal of HPC ⩽ 100 CFU/mL. The biostability curves could interpret the scenario under various AOC concentrations and predict the required chloramine residual concentration under the condition of high AOC level. The simulation was also carried out to predict the scenario with a stricter HPC goal (⩽ 50 CFU/mL) and determine the required chloramine residual. The biological regrowth control strategy was assessed using biostability curve analysis. The results indicated that maintaining high chloramine residual concentration was the most practical way to achieve the goal of HPC ⩽ 100 CFU/mL. Biostability curves could be a very useful tool for biostability control in distribution systems. This work could provide some new insights towards biostability control in real distribution systems. [ABSTRACT FROM AUTHOR]

Transition protein 2 (TNP2) participates in removing nucleohistones and the initial condensation of spermatid nucleus during spermiogenesis. This study investigated the relationship between the variants of the bovine TNP2 gene and the semen quality traits of Chinese Holstein bulls. We detected three single nucleotide polymorphisms (SNPs) of the TNP2 gene in 392 Chinese Holstein bulls, namely, g.269 G>A (exon 1), g.480 C>T (intron 1), and g.1536 C>T (3′-UTR). Association analysis showed that the semen quality traits of the Chinese Holstein bulls was significantly affected by the three SNPs. The bulls with the haplotypic combinations H6H4, H6H6, and H6H8 had higher initial semen motility than those with the H7H8 and H8H4 haplotypic combinations (P<0.05). SNPs in the microRNA (miRNA) binding region of the TNP2 gene 3′-UTR may have contributed to the phenotypic differences. The phenotypic differences are caused by the altered expression of the miRNAs and their targets. Bioinformatics analysis predicted that the g.1536 C>T site in the TNP2 3′-UTR is located in the bta-miR-154 binding region. The quantitative real-time polymerase chain reaction results showed that the TNP2 mRNA relative expression in bulls with the CT and CC genotypes was significantly higher than those with the TT genotype (P<0.05) in the g.1536 C>T site. The luciferase assay also indicated that bta-miR-154 directly targets TNP2 in a murine Leydig cell tumor cell line. The SNP g.1536 C>T in the TNP2 3′-UTR, which altered the binding of TNP2 with bta-miR-154, was found to be associated with the semen quality traits of Chinese Holstein bulls. [ABSTRACT FROM AUTHOR]

Abstract: Organic matter in source water has presented many challenges in the field of water purification, especially for conventional treatment. A two-year-long pilot test comparing water treatment processes was conducted to enhance organic matter removal. The tested process combinations included the conventional process, conventional plus advanced treatment, pre-oxidation plus conventional process and pre-oxidation plus conventional plus advanced treatment. The efficiency of each kind of process was assayed with the comprehensive indices of CODMn, TOC, UV254, AOC, BDOC, THMs, and HAAs and their formation potential. The results showed that the combination of the conventional process and O3-BAC provides integrated removal of organic matter and meets the required standards. It is the best performing treatment tested in this investigation for treating polluted source water in China. Moreover, much attention should be paid to organic removal before disinfection to control DBP formation and preserve biostability. This paper also reports the range of efficiency of each unit process to calculate the total efficiency of different process combinations in order to help choose the appropriate water treatment process. [Copyright &y& Elsevier]

Monsoon precipitation over China exhibits large spatial differences. It has been found that a significantly enhanced East Asian summer monsoon (EASM) is characterized by increased rainfall in northern China and by reduced rainfall in southern China, and this relationship occurs on different time scales during the Holocene. This study presents results from a diverse range of proxy paleoclimatic records from northern China where precipitation variability is traditionally considered as an EASM proxy. Our aim is to evaluate the evolution of the EASM during the Holocene and to compare it with all of the published stalagmite δ 18 O records from the Asian monsoon region in order to explore the potential mechanism(s) controlling the Chinese stalagmite δ 18 O. We found that the intensity of the EASM during the Holocene recorded by the traditional EASM proxy of moisture (or precipitation) records from northern China is significantly different from the Chinese stalagmite δ 18 O records. The EASM maximum occurred during the mid-Holocene, challenging the prevailing view of an early Holocene EASM maximum mainly inferred from stalagmite δ 18 O records in eastern China. In addition, all of the well-dated Holocene stalagmite δ 18 O records, covering a broad geographical region, exhibit a remarkably similar trend of variation and are statistically well-correlated on different time scales, thus indicating a common signal. However, in contrast with the clear consistency in the δ 18 O values in all of the cave records, both instrumental and paleoclimatic records exhibit significant spatial variations in rainfall on decadal-to-centennial time scales over eastern China. In addition, both paleoclimatic records and modeling results suggest that Holocene East Asian summer monsoon precipitation reached a maximum at different periods in different regions of China. Thus the stalagmite δ 18 O records from the EASM region should not be regarded as a reliable indicator of the strength of the East Asian summer monsoon. Furthermore, modern observations indicate that the moisture for precipitation in the East Asian monsoon region is mainly derived from the Indian Ocean. The moisture transport route from the Indian Ocean to the East Asian monsoon region during the Holocene is almost identical to that of modern precipitation. Therefore the strong correlation of δ 18 O records in the EASM and Indian summer monsoon (ISM) regions, and the similarity of the pattern of latitudinal changes in δ 18 O values in stalagmites and in modern meteoric precipitation along the water vapor transport route, further suggests that the stalagmite δ 18 O records from the EASM region are essentially a signal of the isotopic composition of precipitation, which is determined mainly by changes in the δ 18 O of atmospheric vapor in the upstream source region over the Indian Ocean and Indian Monsoon region via the upstream depletion mechanism. Finally, the main trends of the stalagmite δ 18 O records are strongly correlated with the known evolution of the ISM, and therefore these records reflect the history of the ISM rather than that of the EASM. Our findings support the conclusion that EASM variability is mainly controlled by Northern Hemisphere summer insolation and was strongly modulated by ice volume during the last deglaciation and early Holocene, which delayed the response of the EASM maximum to peak insolation forcing. [ABSTRACT FROM AUTHOR]

The short and scare record limits to understand the history of the hydroclimate change in east-central China. In this study, we developed a 225-year tree-ring width chronology (STD) for Chinese pine originating from the Shiren Mountain in Henan Province, east-central China. We analysed the correlation between the STD and different climatic factors and then reconstructed the May–June moisture variation, which is one of the longest moisture variation reconstruction based on tree-ring width in this region. Further, the results of the spatial analysis between our reconstruction and actual moisture variation revealed that our reconstruction is representative of large-scale May–June self-calibrating Palmer Drought Severity Index (scPDSI) in east-central China. Additionally, the reconstruction showed five relatively dry and five relatively wet epochs over the past 225 years. It also showed that the moisture variation in the study area is similar to those corresponding to other nearby sites and could be validated by historical documents; these findings demonstrate the reliability of our reconstruction back in time. Furthermore, we detected the reason for the coherent May–June moisture change in east-central China. It showed that the actual scPDSI showed significantly positive correlations with concurrent precipitation. Additionally, regression analyses showed that precipitation is largely determined by the frontal system, which is also responsible for the coherent May–June moisture pattern observed in east-central China. In addition, the result of spectral analysis and correlation patterns of the reconstructed scPDSI with global sea surface temperatures indicated that the El Niño-Southern Oscillations might be the forcing mechanism for regional moisture variability. [ABSTRACT FROM AUTHOR]

Understanding the factors behind past vegetation changes is instructive to anticipate how vegetation will react to future climate change and human activities. The factors that contribute to the changes in vegetation during the Holocene in the topographically diverse southeast China are still not well understood. This study presents a recently acquired subalpine pollen record and combines it with pollen records from low-lying areas and mountains in southeast China. We utilized a Rate of Change (RoC) analysis on the pollen sequences to detect shifts in vegetation composition. Our findings indicate a significant increase in vegetation rate of change in southeast China over the past 3000 years, comparable to or exceeding maximum levels seen during the early Holocene, a period characterized by greater climate variability. By analyzing available paleorecords of climate, fire, and human activity, it becomes clear that vegetation in southeast China was significantly affected by climate before c. 3 ka BP. However, after this time, human impacts began to play a prominent role, first in the lowlands and later in the mountains, in addition to the influence of climate variations. Our study emphasizes the significance of taking into account the rate of vegetation compositional change when examining the factors that influence long-term vegetation changes. • A new subalpine pollen and charcoal record from southeast China. • Rate of change analysis in synthesized pollen records reveals vegetation turnover. • Climate is the main factor driving regional vegetation changes before 3 ka BP. • Humans played a prominent role, first in the lowlands and later in the mountains. [ABSTRACT FROM AUTHOR]

Aims: Tacrolimus has extensive pharmacokinetic variability among patients and a narrow therapeutic window. The U.S. Clinical Pharmacogenetics Implementation Consortium recommends a starting dose for tacrolimus of 0.15–0.3 mg/kg/day, which is much higher compared with 0.05–0.15 mg/kg/day used in China. The purpose of this study was to investigate the influence of clinical factors and single nucleotide polymorphisms (SNPs) on tacrolimus concentrations in Chinese renal transplant recipients. Methods: This study enrolled 406 tacrolimus-treated patients. After renal transplantation, the first tacrolimus trough concentration and corresponding clinical information were collected from all patients. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to genotype 15 SNPs. The relationship between the genetic and clinical factors and dose-adjusted tacrolimus trough concentration was examined. The tacrolimus starting dose was predicted using a classification and regression tree analysis. Results: Examination of the 15 SNPs and several clinical factors identified the CYP3A5 genotype (p = 5.6 × 10−11) and hemoglobin (p = 8.4 × 10−10) as the most significant determinants of tacrolimus C0/D. Accordingly, a concise tacrolimus recommendation dosage model, a classification scheme, and a regression tree were developed. Conclusion: A new classification and regression tree model was developed for establishing the starting dose of tacrolimus based on the CYP3A5 genotype and hemoglobin values. This result may help clinicians prescribe an appropriate initial tacrolimus dose. ClinicalTrials.gov ID: 2020-KY-147. [ABSTRACT FROM AUTHOR]

Four sampling campaigns were conducted in two years to understand the fluctuation of N -Nitrosamines (NAs) and their precursors in one drinking water treatment plant (DWTP) in East China in different seasons. This water supply system has been facing several nitrosamine challenges related with source water, including the switch of water source, high concentration of ammonium, formed NAs and NA formation potential (FP) in source water. Besides, the use of ozonation in the DWTP and chloramination in networks will increase the NDMA concentration in tap water. To address these challenges, the bio-pretreatment was applied in this DWTP to decrease the concentration of ammonium and NAs. The following biological activated carbon (BAC) will neutralize the nitrosamine increase brought by ozonation. The use of free chlorine in disinfection process will also decrease the NDMA formation compared with chloramination. The results will benefit other cities in China and other countries with similar impacted water sources. Unlabelled Image [ABSTRACT FROM AUTHOR]

Investigating long-term natural precipitation variability in Northwest China is crucial for our understanding of the recent wetting trend in this region. This study explores the mechanisms of precipitation variations in Northwest China during the mid-Holocene (MH) using the Community Earth System Model (CESM). We emphasize the role of ocean feedbacks in the response of precipitation changes in the summer half-year (April–September; the rainy season of Northwest China) to orbital forcing, via comparing simulation results from the single atmosphere general circulation model (AGCM) and fully coupled atmosphere–ocean general circulation model (AOGCM) of the CESM. The AOGCM simulations reveal a decrease of precipitation in Northwest China during the MH compared to the pre-Industrial (PI) era, matching well with proxy records. The drier MH is reproduced by the AGCM with orbital forcing when the tropical Indian Ocean cooling is taken into account. The tropical Indian Ocean cooling is affected by the decrease of spring insolation, contrasting to Eurasian warming caused by the increase of summer insolation during the MH. The tropical Indian Ocean cooling contributes to a reduction of the upper-level westerlies to the south of the westerly jet axis and hence a northward shift of the westerly jet during the MH relative to the PI, via amplifying the decrease of meridional thermal gradient from the tropical Indian Ocean to northern Eurasia and weakening the strength of the South Asian high. The northward migration of the westerly jet benefits anomalous downward motion and ultimately weakens precipitation in Northwest China during the MH. Therefore, the tropical Indian Ocean plays an important role in orbital forcing of MH precipitation variations in Northwest China. We further infer that abnormal warming of the tropical Indian Ocean is probably a key factor for the recent wetting trend in Northwest China. • Model–proxy comparison reveals a wetting trend in Northwest China since the mid-Holocene. • Tropical Indian Ocean is key to orbital forcing of precipitation changes in Northwest China. • Tropical Indian Ocean warming triggers the recent wetting trend in Northwest China. [ABSTRACT FROM AUTHOR]

The variability and interaction of the East Asian summer monsoon (EASM), East Asian winter monsoon (EAWM) and Westerlies dominate mid-latitude Asian hydroclimate and influence over a billion lives in Asia. However, how variation in the EASM, EAWM and Westerlies influences climate change in their transition zones in NW China remain unclear. Specifically, how these atmospheric systems interact during strong-weak phases variation over different timescales is still hotly debated. This study investigates four loess-paleosol sequences in the transition zone between EASM and Westerlies-influenced areas along the central Hexi Corridor of NW China, and presents 63 quartz optically stimulated luminescence (OSL) ages to generate the most detailed chronology for any loess record within the Hexi Corridor. In combination with sedimentology, proxy indexes of magnetic parameters (χ lf , χ fd , χ ARM /SIRM) and grain size of these loess-paleosol sequences, and TraCE-21 ka climatic modelling, the loess deposition and climatic changes at central Hexi Corridor regions over the past 25 ka are reconstructed. Our results indicate that: (1) loess deposition initiated by at least 25 ka at Hexi Corridor. Loess depositional rates decrease from late last glacial into the Holocene, with maximum accumulation rates (140–180 g/cm3/ka) occurring during the Last Glacial Maximum. Depositional hiatuses up to 8 ka are recognized in late Quaternary Hexi Corridor loess, which suggests that high-resolution chronologies are necessary for robust paleoclimatic reconstructions from loess records in the region. (2) Over glacial-interglacial cycles, climate in the Hexi Corridor demonstrates a cold-dry glacial and a warm-moist interglacial, consistent with moisture changes observed in the monsoonal Chinese Central Loess Plateau and Westerlies-dominated Central Asia. However, moisture in central Hexi Corridor increased from the early Holocene to mid-Holocene, with a wettest period at 8–7 ka, and followed by a relatively wet late Holocene. These changes are most consistent with the EASM-dominated Chinese Central Loess Plateau and suggests that Westerlies influence in the central Hexi Corridor is minor over at least the past 25 kyr. (3) EAWM intensities demonstrate an anti-phase relationship to EASM intensities over the past 25 kyr in the Hexi Corridor, with decreasing EAWM intensity into the early-mid Holocene and an increase into the late Holocene. (4). EASM precipitation variability in the Hexi Corridor appears to not to be a direct nor singular response to changes in 30°N summer insolation. EASM lags insolation by 3 kyr during the Holocene, supporting the idea that high-latitude forcing through changes in ice volume, greenhouse gases, and/or meltwater input to North Atlantic and Southern oceans can effectively modulate EASM intensity and critically influence Hexi Corridor paleoclimatic conditions. • Loess depositional hiatuses up to 8 kyr occur in the Hexi Corridor. • Over the past 25 kyr, the wettest period occurs at 8–7 ka in the Hexi Corridor. • East Asian Summer Monsoon controls central Hexi Corridor precipitation since 25 ka. • East Asian Winter Monsoon is anti-phase to East Asian Summer Monsoon since 25 ka. • High-latitude forcing modulates EASM intensity and Hexi Corridor climatic changes. [ABSTRACT FROM AUTHOR]

Paleoclimatic changes in arid central Asia (ACA), one of the largest arid regions in the world, are complex and the nature of these changes on orbital cycles remains unclear. Widely distributed loess records in ACA potentially provide records of paleoclimatic variation, but these records are difficult to interpret due to a lack of robust high resolution chronologies. K-feldspar pIRIR dating was employed to date 37 samples from a 13 m loess-paleosol sequence (section KS15) in an intermontane basin of the Tianshan Mountains, central ACA, NW China. The reliability of the pIRIR ages was determined by using internal checks of luminescence characteristics of the pIR 50 IR 290 and pIR 200 IR 290 signals, and by comparing pIR 50 IR 290 and pIR 200 IR 290 ages. A high resolution chronology for the loess-paleosol sequence, spanning 130–45 ka, was established using Bacon age/depth modeling. In combination with climate proxy indexes of magnetic susceptibility, total organic material, and δ 13 C of organic remains from the sequence, our results suggest: (1) the pIRIR ages utilizing pIR 50 IR 290 and pIR 200 IR 290 signals are consistent for loess samples <150 ka; (2) eolian loess was deposited in intermontane basins of the Tianshan Mountains by at least ∼150 ka, with a steadily increasing rate of loess deposition from the last interglacial to the last glacial period; (3) ACA had a moist climate, characterized by paleosol development, during periods at 117–109, 97–85, 77–70 and 58–50 ka, corresponding to MIS 5d, MIS 5b, MIS 5–4 and MIS 3c; (4) ACA had dry climates, characterized by loess deposition, at 131–117, 109–97, 85–76, 70–58 and 50–46 ka, corresponding to MIS 5e, MIS 5c, MIS a and MIS 3b; and (5) during sub-stages of MIS 5 the ACA climate was characterized by cold-moist to warm-dry shifts which appear to be related to ∼21 ka precession cycles, but inversely related to Northern Hemisphere summer insolation patterns. Moisture variation in ACA thus has an anti-phase relationship to that in monsoonal East Asia. Orbital forcing may be responsible for this moisture variation in ACA. [ABSTRACT FROM AUTHOR]

Our understanding on the spatial-temporal patterns of climatic variability over the last few millennia in the East Asian monsoon-dominated northern China (NC), and its role at a macro-scale in affecting the prosperity and depression of Chinese dynasties is limited. Quantitative high-resolution, regionally-synthesized palaeoclimatic reconstructions as well as simulations, and numerical analyses of their relationships with various fine-scale, numerical agro-ecological, social-economic, and geo-political historical records during the period of China's history, are presented here for NC. We utilize pollen data together with climate modeling to reconstruct and simulate decadal- to centennial-scale variations in precipitation or temperature for NC during the last 2200 years (-200–2000 AD). We find an overall cyclic-pattern (wet/warm or dry/cold) in the precipitation and temperature anomalies on centennial- to millennial-scale that can be likely considered as a representative for the entire NC by comparison with other related climatic records. We suggest that solar activity may play a key role in driving the climatic fluctuations in NC during the last 22 centuries, with its quasi ∼100, 50, 23, or 22-year periodicity clearly identified in our climatic reconstructions. We employ variation partitioning and redundancy analysis to quantify the independent effects of climatic factors on accounting for the total variation of 17 fine-grained numerical Chinese historical records. We quantitatively illustrate that precipitation (67.4%) may have been more important than temperature (32.5%) in causing the overall agro-ecological and macro-geopolitical shifts in imperial China with NC as the central ruling region and an agricultural heartland over the last 2200 years. [ABSTRACT FROM AUTHOR]

The drinking water sources of many cities in southern China are frequently contaminated by upstream urban drainage during storm events, which brings high concentrations of N -nitrosamine (NA) precursors and poses a threat to the safety of drinking water. We conducted two sampling campaigns during the heavy rain season in 2015 in one representative city in southern China. We detected that the concentration of N -nitrosodimethylamine formation potential (NDMA FP) in urban drainage during two storm events was 80–115 ng/L and the total formation potential concentration of nine nitrosamines (TNA 9 FP) was 145–165 ng/L. To address the deteriorated water quality, 30 mg/L of powdered activated carbon (PAC) was fed into the water intake. PAC adsorption alone could remove 52% of NDMA FP and 52% of TNA FP, while the subsequent conventional process only removed 8% of TNA FP. We isolated six chemicals ( N,N -benzyldimethylamine, 5-[(dimethylamino)methyl]-2-furanmethanol, N,N -dimethyl-3-aminophenol, N,N -dimethylethylamine, Ziram, and N,N -dimethylaniline) and confirmed them to be NA precursors. Among these NA precursors, Ziram was identified for the first time as a NA precursor that is formed via chloramination; its molar yield for NDMA was 6.73 ± 0.40%. [ABSTRACT FROM AUTHOR]

N -Nitrosamines (NAs) in drinking water have attracted considerable attention in recent years due to their high carcinogenicity, frequent occurrence, and their potential regulation. During the past three years, we have collected about 164 water samples of finished water, tap water, and source water from 23 provinces, 44 cities from large cities to small towns, and 155 sampling points all over China. The occurrence of NAs in the finished and tap water was much higher in China than that in the U.S. Nine NAs were measured and NDMA had the highest concentration. The occurrence of NDMA was in 33% of the finished waters of water treatment plants and in 41% of the tap waters. The average NDMA concentration in finished and tap waters was 11 and 13 ng/L, respectively. Formation potentials (FPs) of source waters were examined with an average NDMA FP of 66 ng/L. Large variations in NA occurrence were observed geographically in China and temporally in different seasons. The Yangtze River Delta area, one sub-area in East China, had the highest concentrations of NAs, where the average NDMA concentrations in the finished and tap water were 27 and 28.5 ng/L, respectively, and the average NDMA FP in the source water was 204 ng/L. NA control may be achieved by applying breakpoint free chlorination and/or advanced treatment of ozone – granular activated carbon process to remove the NA precursors before disinfection. [ABSTRACT FROM AUTHOR]

A sampling campaign was conducted monthly to investigate the occurrence of N -nitrosamines at a conventional water treatment plant in one city in North China. The yield of N -nitrosamines in the treated water indicated precursors changed greatly after the source water switching. Average concentrations of N -nitrosodimethylamine (NDMA), N -nitrosomorpholine (NMOR), and N -nitrosopyrrolidine (NPYR) in the finished water were 6.9, 3.3, and 3.1 ng/L, respectively, from June to October when the Luan River water was used as source water, while those of NDMA, N -nitrosomethylethylamine (NMEA), and NPYR in the finished water were 10.1, 4.9, and 4.7 ng/L, respectively, from November to next April when the Yellow River was used. NDMA concentration in the finished water was frequently over the 10 ng/L, i.e. , the notification level of California, USA, which indicated a considerable threat to public health. Weak correlations were observed between N -nitrosamine yield and typical water quality parameters except for the dissolved organic nitrogen. [ABSTRACT FROM AUTHOR]

The lower reaches of the Yangtze River have a long history of human occupation and rice cultivation, but our understanding of human activities in the mountainous region south of the lower Yangtze is still limited. In this study, we present a high-resolution vegetation record spanning the past 2900 years from the Southeast Hills of China by analyzing loss-on-ignition, pollen, charcoal, and non-pollen-palynomorphs from a lake sediment core. Combining our data with historical records, results suggest the study region was covered by dense broadleaved forests dominated by evergreen Cyclobalanopsis / Quercus from the start of the pollen record at 890 BCE until 850 CE. During this early period, colonization of the mountainous region was limited by rugged relief, closed forests, and lack of suitable land for farming. Later between 850 CE and 1180 CE, a slight decrease of evergreen trees, small rises in cereals and the ruderal herb Artemisia , and more frequent fire events point to the development of small-scale agricultural practices related to increased population. This change may reflect the shift of the economic center of China towards the lower Yangtze reaches, which happened during the Tang Dynasty (618–907 CE) and the influx of war refugees from the north especially during the Song Dynasty (960–1279 CE). From 1180 CE, a sharp decline of evergreen broadleaved trees and a peak in fire frequency was closely linked to a wave of deforestation resulting from the abrupt expansion of cereal cultivation. These changes were accompanied by the remarkable spread of pioneer secondary plants such as Pinus , Artemisia , and Dicranopteris -type ferns, which are typical indicators of human-induced deforestation in the region. It is probable that the population boom spread to the mountains and intensive agricultural activities took place involving terraced fields. Additionally, the coeval mining, smelting, and porcelain production in the mountains enlarged the scale of deforestation. Our study provides valuable information for landscape management and biodiversity conservation in the mountainous hinterland of subtropical southeast China. • Dense broadleaved forest covered the Southeast Hills of China before ~1000 CE. • Primitive conditions no longer existed due to strong human activity from ~1000 CE. • War refugee influx since Song Dynasty spread cereal cultivation in the mountains. • Extensive deforestation radically changed vegetation landscape in the mountains. [ABSTRACT FROM AUTHOR]

Abstract: Earthquakes can be devastating to built infrastructure and the natural environment, as evidenced by the March 2011, M=9.0 earthquake, and subsequent tsunami, in Japan. As seen in the Japanese event, environmental damage caused by secondary disasters (tsunami, leakage from a nuclear reactor) can equal or exceed the impacts of the primary event. In order to develop an environmental assessment system to examine secondary disasters, a comprehensive environmental impact evaluation was conducted after the Wenchuan earthquake that occurred on 12 May 2008 in the Sichuan Province, China. This evaluation focused on several key environmental elements such as wastewater, drinking water, soil, solid waste, radiation, and ecosystem-level effects. As part of this assessment, an analysis of root causes and potential solutions was conducted for key issues such as population relocation and resettlement in temporary dwellings, recovery of environmental protection functions, industrial development strategies and production recovery. Methods for post-quake environmental assessment were developed, utilizing GIS-based techniques for spatial evaluation of primary and secondary disaster patterns. The goal of this exercise was the development of effective assessment methods that can be rapidly applied in a post-disaster situation to reduce and mitigate damage caused by secondary disasters, and facilitate the recovery of impaired environmental management structure and function. [Copyright &y& Elsevier]

The source and fate of N -nitrosamines and their precursors in terms of formation potential (FP) was investigated quantitatively in the city level for the first time. Different sources of nitrosamines and their precursors were investigated in one city in the Yangtze River delta, China. The source water located downstream of the city contained 8.4 ng/L of N -nitrosodimethyamine (NDMA) and 153 ng/L of NDMA FP. The contribution of each discharge source was evaluated based on the concentration, the river water flux, and the amount of wastewater discharges. Textile printing and dyeing wastewater, and electroplating industrial wastewater contained high concentration of nitrosamines and were important discharge sources. Taking NDMA and NDMA FP attenuation by photolysis and biodegradation into consideration, the mass load calculation showed upstream surface water brought about 13 ± 4% of NDMA and 21 ± 3% of NDMA FP to downstream source water. Local wastewater discharges contributed 30 ± 8% of NDMA and 17 ± 2% of NDMA FP to downstream source water. Endogenous formation via amino acids metabolism could contribute 36% of NDMA FP (maximum) to downstream source water. Overall, this study provides a protocol for quantitative evaluation of the nitrosamine contribution to urban water supply from different contamination sources. [Display omitted] • Fate of nitrosamines and precursors in an urban water system were investigated. • Nitrosamines and precursors of various wastewater discharges were characterized. • Upstream input and local wastewater discharges were important nitrosamine sources. • Upstream input, wastewaters and endogenous generation were major NDMA FP sources. [ABSTRACT FROM AUTHOR]

N-nitrosodimethylamine (NDMA) as one emerging disinfection by-product has been investigated globally since 1990s. However, its main precursors are still unclear. We found that NDMA formation potential (NDMAFP) of various water samples increased firstly and then decreased gradually during incubation with microorganism. We hypothesized that NDMA precursors could be produced through metabolism of nitrogenous components and then gradually be biodegraded. To verify this hypothesis, six amino acids (AAs), peptone and ammonium were separately incubated with microorganism and NDMAFP was measured regularly. The average molar yield of the substrates to NDMAFP were 60–200 × 10−6 for the AAs, 350 × 10−6 for peptone under aerobic condition. The extracellular fraction with molecular weight (MW) less than 1 k Dalton contributed the majority to NDMAFP in the peptone experiment, followed by that with MW between 10 k and 0.22 μm and the intracellular materials. Dimethylamine and methylamine were detected during the experiments but their contribution to NDMAFP is quite limited. The results indicate that the nitrosamine precursors may not be the direct metabolite of AAs or peptones but the excretion of living bacteria or the components in dead bacteria body. Our results inferred that AA metabolism may give an NDMAFP of 0.12 nmol/L (maximum) or 0.09 nmol/L (average) in water under aerobic condition. This estimation of NDMAFP from AA metabolism can account for 38% (maximum) or 27% (average) of the median NDMAFP in waters of China (0.32 nmol/L) reported before. Image 1 • Hypothesis of NDMA precursors formation via microbial metabolism was raised firstly. • Hypothesis of NDMA precursors formation via microbial metabolism was verified firstly. • Dynamics of NDMA precursors in source waters were observed during incubation. • Microbial metabolism of total amino acids contributes NDMA precursor greatly in waters of China. [ABSTRACT FROM AUTHOR]

Objectives: Intensive care unit (ICU) dying patients are the most important source of organ donation. This study explores the reasons affecting organ donation in the Chinese sociocultural context from the perspectives of coordinators and physicians, and further seeks countermeasures to alleviate the shortage of organs., Design and Setting: Semistructured interviews conducted in a large tertiary hospital in China., Participants and Method: 15 respondents (including 8 organ coordinators and 7 ICU physicians) were interviewed. Participants were invited to describe the factors that influence organ donation and the underlying reasons behind it. Bronfenbrenner's socioecological system model was used as theoretical support to construct a theoretical model of the factors influencing organ donation. Respondents participated in semistructured qualitative interviews that were audio-recorded and transcribed. The relevant data were analysed using thematic analysis., Results: Four themes that influenced organ donation were identified including the influence of the deceased person's attributes, immediate family members, surrounding people and the environment, and the social-level factors. In addition, we obtained four strategies from the interviews to improve the organ shortage to ameliorate the current supply-demand imbalance in organ donation. These include multilevel publicity, relevant policy support, increasing other forms of supply and reducing organ demand., Conclusions: Factors affecting organ donation after the death of a Chinese citizen include the personal characteristics of the donor, the decisions of family members such as immediate family members and the indirect influence of surrounding people such as collateral family members, in addition to factors related to the humanistic environment, religious beliefs and social opinion., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aims: The risk of ticagrelor-related bleeding events remains a major clinical concern, especially in East Asian populations. Previous studies have reported higher ticagrelor exposure in Asian patients than in Caucasians. This prompted us to investigate the correlation between ticagrelor concentrations and bleeding events., Methods: Patients diagnosed with acute coronary syndrome and receiving dual antiplatelet therapy (aspirin and ticagrelor) were enrolled and followed up for 12 months. Trough plasma concentrations of ticagrelor and a major active metabolite were assayed, and 10 single nucleotide polymorphisms associated with ticagrelor pharmacokinetics and safety were also identified., Results: A total of 631 patients were included and 133 patients had bleeding academic research consortium type 1 or 2 bleeding event. The median ticagrelor concentration (interquartile range) was significantly higher in patients with bleeding events than that in patients without bleeding events (322.6 ng/mL [196.2-458.0 ng/mL] vs. 222.1 ng/mL [140.4-341.9 ng/mL], P < .001). According to the receiver operating characteristic curve, the cut-off value for ticagrelor levels predicting bleeding events was 363.3 ng/mL (area under the curve = 0.65; P < .001, 95% Cl: 0.595-0.700). Pharmacogenomics results showed that P2Y12 (rs6787801, P = .024) and P2Y12 (rs6785930, P = .048) were statistically associated with ticagrelor levels and bleeding events, respectively., Conclusion: Ticagrelor plasma concentrations were associated with bleeding events in Chinese patients with acute coronary syndrome., (© 2022 British Pharmacological Society.)

Objective: The rapid spread of COVID-19 has overwhelmed healthcare systems across the world. During the early stage of the pandemic, frontline healthcare workers (FHWs) caring for patients at intensive care units (ICUs) faced extreme pressure and challenges. This qualitative study aimed to describe the different phases of psychological distress of FHWs during the early stage of the COVID-19 pandemic., Design: Qualitative study., Setting: The First Affiliated Hospital of Zhengzhou University, a designated hospital for patients with COVID-19 in central China., Participants: Eight physicians and six nurses working in the ICU who provided direct patient care for COVID-19 patients., Methods: A descriptive phenomenological study using thematic analysis was applied. Semi-structured one-on-one interviews over telephone or Wechat (a social platform in China) rather than face-to-face interviews were conducted due to quarantine. Interviews were audio-recorded and transcribed verbatim and then were analysed thematically., Findings: A total of 14 interviews were conducted, and each interview lasted 20-60 min. Five thematic categories were identified, and the participants' psychological experiences were classified into five stages (1) the mobilisation period: a sense of responsibility with worries; (2) the preparation period: worries, fears and doubts about the epidemic; (3) the transitional period: complex and diverse psychological feelings; (4) the adaptation period: self-adjustment and help from external support and (5) the reflection period: a reflection on life and nature., Conclusion: The study showed that the COVID-19 pandemic had significant psychological impacts on FHWs. Self-regulation and external support help FHWs to overcome challenges to a certain extent. More attention should be paid to the psychological wellbeing of ICU FHWs in COVID-19-designated hospitals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: There are insufficient educational resources and opportunities available to nurses at county-level medical institutions in China to receive pharmacy knowledge education. Video conference pharmacy education (VCPE) has become a solution. However, a few studies have explored the perceptions of nurses participating in VCPE. The study was aimed to explore the perceptions of nurses participating in VCPE at county-level medical institutions in remote areas in China. The barriers and suggestions to improve the VCPE were also assessed., Setting: The study was conducted in two county-level hospitals in Henan, China., Design and Participants: This qualitative study comprises two focus group discussions. Twenty-three nurses from two county-level hospitals in Henan province participated in the interview in May 2019., Results: The average age of our participants was 34.83±6.24 years old (from 26 to 55 years old). By deeply analysing the data, the following four domains were extracted: Four themes were extracted on VCPE from this qualitative study: (1) the pharmacy knowledge gains from VCPE, (2) the shortcomings VCPE, (3) the advantages of the VCPE and (4) the expectations and suggestions for the VCPE., Conclusion: The results of this study indicate VCPE is a valuable tool to provide education to nurses working at remote area county-level institutions. The results contribute to improvements in future VCPE deliveries., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Pharmacists are one of the coronavirus disease-2019 (COVID-19) treatment team members in China, yet only a few single-center studies have described the work experience of pharmacists during the pandemic., Purpose: This study aimed to explore in-depth experiences of hospital pharmacists providing pharmacy services during the COVID-19 pandemic in China on a national scale., Methods: This is a nationwide multicenter qualitative study that used the purposive sampling method. Semi-structured interviews were conducted with 11 pharmacists from large-scale tertiary hospitals in representative provinces of mainland China. The Colaizzi seven-step method was applied to analyze the interview data., Results: Eleven semi-structured interviews were conducted. Each interview lasted 25-70 min. By analyzing the work experiences of pharmacists in COVID-19 designated treatment hospitals, five descriptive themes were categorized: (1) drug supply service; (2) routine clinical pharmacy services; (3) expanded pharmacy services during the epidemic; (4) drug management loopholes; (5) areas of improvements of pharmacy services during a pandemic., Conclusion: During the COVID-19 epidemic, Chinese hospital pharmacists played various vital roles. However, there were loopholes in managing narcotic drugs, psychotropic drugs, and donated drugs. The study uncovered areas of improvement in pharmacy services during the pandemic. The emergency response capacity of hospital pharmacists should be continuously improved in the future., 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 © 2022 Wang, Yin, Zhang, Jia, Du, Li and Zhang.)

In this study, we developed a sensitive and efficient analytical approach combining a 96-well plate-based protein precipitation strategy with ultra-performance liquid chromatography electrospray ionization tandem mass spectrometry (UPLC-MS/MS) in order to assess the pharmacokinetic (PK) properties of sivelestat and its metabolite XW-IMP-A in samples of plasma from ALI/ARDS patients with SIRS. The samples were separated via gradient elution with a C18 column (Phenomenex Kinetex, C18, 2.6 μm, 100 Å, 50 × 2.1 mm) using 0.1 % formic acid aqueous solution (A) and acetonitrile-methanol (1:1, V:V) (B) as a mobile phase at a 0.6 mL/min flow rate. UPLC-MS/MS spectra were generated in positive ion mode, and multiple reaction monitoring (MRM) was used to detect the following transitions: m/z 435.1 → 360.0 for sivelestat, m/z 469.0 → 394.0 for sivelestat-IS, m/z 351.0 → 276.0 for XW-IMP-A, and m/z 384.9 → 310.0 for XW-IMP-A-IS. This assay was run for 2.5 min in total, and achieved lowest limit of quantitation values of 2.0 ng/mL and 0.5 ng/mL for sivelestat and XW-IMP-A, respectively, while remaining highly linear from 2-500 ng/mL for sivelestat (r 2 ≥ 0.9900) and from 0.5-125 ng/mL for XW-IMP-A (r 2 ≥ 0.9900). These validated data were consistent with US Food and Drug Administration (FDA) and European Medicines Agency (EMA) acceptance criteria. In addition, this method was successfully applied to the steady-state PK evaluation of ALI/ARDS patients with SIRS., Competing Interests: Declaration of Competing Interest Appropriate Ethics Committee approval has been obtained for the data reported. This work has not been submitted for publication elsewhere either in print or electronically, including on a web site, nor has it been accepted for publication elsewhere or is under consideration by another journal. All of the authors listed on the title page have read and agreed to its submission to Journal of Pharmaceutical and Biomedical Analysis, have met the criteria for authorship as established by the International Committee of Medical Journal Editors, believe that the paper represents honest work, and are able to verify the validity of the results reported. The authors declare no financial support or compensation has been received from any individual or corporate entity over the past three years for research or professional service and that there are no personal financial holdings that could be perceived as constituting a potential conflict of interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)

N-nitrosamines are potent carcinogens, particularly N-nitrosodimethylamine (NDMA) and N-nitrosodiethylamine (NDEA), which are commonly found in a variety of foods and drinking water. We calculated the food and drinking water intakes of NDMA, NDEA, and total volatile nitrosamines (TVNA) by Chinese residents in different provinces by multiplying the reported total diet study results by the nitrosamine contents in food and drinking water. The weighted content of nitrosamines in each category of foods and the concentration of nitrosamines in drinking water was obtained through literature review. The exogenous NDMA, NDEA and TVNA intakes of adult residents in 20 provinces ranged from 171 to 425 ng/d, 41 to 140 ng/d and 373 to 1028 ng/d, respectively. The main contributors to NDMA and TVNA intakes were vegetables, cereals, aquatic products, and meats while the main sources of NDEA intake were vegetables and cereals. The average total NDMA intake per capita in China (251 ng/d) was similar to that in Germany in 1991 (231 ng/d) but higher than that in the United States (136 ng/d), Canada (87.6 ng/d) and France (188 ng/d). Large differences in nitrosamine intakes were observed between the coastal provinces and inland provinces. Drinking water was estimated to contribute 13.1%, 1.3% and 10.8% of the exogenous intakes of NDMA, NDEA and TVNA, respectively. Based on our results, we recommend setting the NDMA drinking water criterion of 40 ng/L. Overall, this study presents basic information regarding nitrosamines intake via food and drinking water in China that will facilitate risk assessment, generation of health advisories and policy making., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Despite excellent bactericidal effect, dosing adjustment of polymyxin B for patients with renal insufficiency and polymyxin B-related nephrotoxicity is still a major concern to clinicians. The aim of this study was to compare the population pharmacokinetics (PK) properties of polymyxin B in Chinese patients with different renal functions and to investigate the relationship between PK parameters and polymyxin B-related acute kidney injury (AKI). A total of 37 patients with normal renal function (creatinine clearance ≥ 80 ml/min) and 33 with renal insufficiency (creatinine clearance < 80 ml/min) were included. In the two-compartment population PK models, the central compartment clearance (CL) (2.19 liters/h versus 1.58 liters/h; P <  0.001) and intercompartmental clearance ( Q ) (13.83 liters/h versus 10.28 liters/h; P <  0.001) values were significantly different between the two groups. The simulated values for AUC across 24 h at steady state (AUC ss,24h ) for patients with normal renal function were higher than those for patients with renal insufficiency. However, renal dosing adjustment of polymyxin B seemed not to be necessary. In addition, during the treatment, AKI occurred in 23 (32.86%) patients. The polymyxin B AUC ss,24h in patients with AKI was significantly higher than that in patients without AKI (108.66 ± 70.10 mg · h/liter versus 66.18 ± 34.79 mg · h/liter; P =  0.001). Both the receiver operating characteristic (ROC) curve and logistic regression analysis showed that an AUC ss,24h of >100 mg · h/liter was a good predictor for the probability of nephrotoxicity., (Copyright © 2021 American Society for Microbiology.)

Pharmacists with long experience and low personal satisfaction from work are at higher risk of burnout, but the role of specific personality traits is less well understood. In addition, the medical system in China is different from that of other countries, and the characteristics of pharmacist burnout might be different from that of other countries. This study evaluated the roles played by personality, working environment, and work characteristics on burnout and job satisfaction among Chinese hospital pharmacists.This was a cross-sectional study undertaken between April 28 and 30, 2017. The questionnaires were completed at the "National Academic Conference of the Chinese Society of Clinical Pharmacy". Questionnaires were handed out to 1786 pharmacists, and 1394 valid questionnaires were analyzed using structural equation modeling techniques.The final structural model showed that, as expected, personality and working environment factors directly or indirectly predicted burnout dimensions (emotional exhaustion, depersonalization, and reduction of personal accomplishment) and job satisfaction variables. The analyses were consistent with the features of pharmacists' work characteristics, including job demands, job control, and workload playing mediating roles between antecedent variables (personality and working environment) and emotional outcomes (burnout and job satisfaction). On the other hand, job control and workload did not predict emotional exhaustion.This study indicates that personality is a negative predictor of 2 dimensions of burnout (emotional exhaustion and depersonalization), while the working environment, especially job demand, is a predictor of burnout and greater emotional exhaustion. Work characteristics are positively related to job satisfaction and play a protective role against burnout.

Meat is a rich source of protein, fatty acids and carbohydrates for human needs. In addition to necessary nutrients, high fat contents in pork increase the tenderness and juiciness of the meat, featuring diverse application in various dishes. This study investigated the transcriptomic profiles of intramuscular adipose tissues in Jinhua and Landrace pigs by employing advanced RNA sequencing. Results showed significant interesting to note that there were significant differences in the expression of genes. 1,632 genes showed significant differential expression, 837 genes were up-regulated and 195 genes were down-regulated. Variations in genes responsible for cell aggregation, extracellular matrix formation, cellular lipid catabolic process, and fatty acid binding strongly supported that both pig breeds feature variable fat and muscle metabolism. Certain differentially expressed genes are included in the pathway of mitogen-activated protein kinase signaling pathway, Ras signaling pathway and insulin pathway. Results from real-time quantitative polymerase chain reaction also validated the differential expression of 17 mRNAs between meats of the two pig breeds. Overall, these findings reveal significant differences in fat and protein metabolism of intramuscular adipose tissues of two pig breeds at the transcriptomic level and suggest diversification at the genetic level between breeds of the same species.

The source water in one forest region of the Northeast China had very high natural organic matter (NOM) concentration and heavy color during snowmelt period. The efficiency of five combined treatment processes was compared to address the high concentration of NOM and the mechanisms were also analyzed. Conventional treatment can hardly remove dissolved organic carbon (DOC) in the source water. KMnO4 pre-oxidization could improve the DOC removal to 22.0%. Post activated carbon adsorption improved the DOC removal of conventional treatment to 28.8%. The non-sufficient NOM removal could be attributed to the dominance of large molecular weight organic matters in raw water, which cannot be adsorbed by the micropore upon activated carbon. O3+activated carbon treatment are another available technology for eliminating the color and UV254 in water. However, its performance of DOC removal was only 36.4%, which could not satisfy the requirement for organic matter. The limited ozone dosage is not sufficient to mineralize the high concentration of NOM. Magnetic ion-exchange resin combined with conventional treatment could remove 96.2% of color, 96.0% of UV254 and 87.1% of DOC, enabling effluents to meet the drinking water quality standard. The high removal efficiency could be explained by the negative charge on the surface of NOM which benefits the static adsorption of NOM on the anion exchange resin. The results indicated that magnetic ion-exchange resin combined with conventional treatment is the best available technology to remove high concentration of NOM., (Copyright © 2014. Published by Elsevier B.V.)

The nitrogen loss and DO paradox in full-scale biofiltration for drinking water treatment and the possible pathway responsible for them were investigated. A highly contaminated source water was treated at Pinghu Surface Water Plant using four biofilters, which resulted in a steady removal of NH(4)(+)-N (2.67mg/L), a great DO consumption (8.86 mg/L) and an increase in the concentration of NO(3)(-)-N (1.77mg/L). The nitrogen and DO balances indicated that about 13 NH(4)(+)-N was lost and the actual DO consumption was about 30% lower than the theoretical DO demand if nitrification was regarded as the only pathway to remove NH(4)(+)-N. The analysis of correlation coefficients analysis between several factors and the nitrogen loss suggested that "Aerobic deammonification", the coupling of shortcut nitrification and the anaerobic ammonia oxidation (Anammox) in an aerobic environment, might be the most probable pathways to explain the occurrence of these phenomena. According to this mechanism, about 57% NH(4)(+)-N was removed through complete nitrification and about 21.5% NH(4)(+)-N was incompletely nitrified into NO(2)(-)-N. The latter then involved in Anammox as the electron acceptor with the remaining NH(4)(+)-N as the electron donor. Since the Anammox reaction is anaerobic, the nitrogen loss and DO paradox can be justified.