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Himalayas and Tibetan Plateau (HTP) is important for global biodiversity and regional sustainable development. While numerous studies have revealed that the ecosystem in this unique and pristine region is changing, their exact causes are still poorly understood. Here, we present a year-round (23 March 2017 to 19 March 2018) ground- and satellite-based atmospheric observation at the Qomolangma monitoring station (QOMS, 4276 m a.s.l.). Based on a comprehensive chemical and stable isotope ( 15 N) analysis of nitrogen compounds and satellite observations, we provide unequivocal evidence that wildfire emissions in South Asia can come across the Himalayas and threaten the HTP's ecosystem. Such wildfire episodes, mostly occurring in spring (March-April), not only substantially enhanced the aerosol nitrogen concentration but also altered its composition (i.e., rendering it more bioavailable). We estimated a nitrogen deposition flux at QOMS of ∼10 kg N ha -1 yr -1 , which is approximately twice the lower value of the critical load range reported for the Alpine ecosystem. Such adverse impact is particularly concerning, given the anticipated increase of wildfire activities in the future under climate change.

Formation pathways and sources of atmosphere nitrate (NO 3 - ) have attracted much attention as NO 3 - had detrimental effects on Earth's ecosystem and climate change. Here, we measured nitrogen (δ 15 N-NO 3 - ) and oxygen (δ 18 O-NO 3 - and Δ 17 O-NO 3 - ) isotope compositions in nitrate aerosols at the Qomolangma station (QOMS) over the Himalayan-Tibetan Plateau (HTP) to quantify the formation mechanisms and emission sources of nitrate at the background site. At QOMS, the enhanced NO 3 - concentrations were observed in the springtime. The average δ 15 N-NO 3 - , δ 18 O-NO 3 - , and Δ 17 O-NO 3 - values were 0.4 ± 4.9, 64.7 ± 11.5 and 27.6 ± 6.9‰, respectively. Seasonal variations of isotope ratios at QOMS can be explained by the different emissions and formation pathways to nitrate. The average fractions of NO 2 + OH and N 2 O 5 + H 2 O to nitrate production were estimated to be 43 and 52%, respectively, when the NO 3 + hydrocarbon (HC)/dimethyl sulfide (DMS) (NO 3 + HC/DMS) pathway was assumed to be 5%. Using stable isotope analysis in the R (SIAR) model, the relative contributions of biomass burning (BB), biogenic soil emission, traffic, and coal combustion to nitrate were estimated to be 28, 25, 24, and 23%, respectively, on yearly basis. By FLEXible PARTicle (FLEXPART) dispersion model, we highlighted that NO x from BB emission over South Asia that had undergone N 2 O 5 + H 2 O processes enhanced the nitrate concentrations in the springtime over the HTP region.

Ethnopharmacological Relevance: Tibetan traditional medicine CheeZheng Pain-Relieving Plaster (CZPRP) is frequently used as an over-the-counter external analgesic for musculoskeletal pain; however, its evidence for low back pain (LBP) has not been evaluated., Aim of the Study: This study aims to assess the efficacy and safety of CZPRP for both acute, subacute and chronic LBP through a systematic review and meta-analysis of clinical trials., Materials and Methods: PubMed, CENTRAL, CNKI, CQVIP, and Wanfang databases were searched through April 20, 2020 for randomized controlled trials of CZPRP for LBP. Eligible comparators were placebo, active treatment, or usual care. Clinical outcomes included pain severity, lower back function score, pain-free rate, and adverse events (AEs). Qualitative evaluations were conducted using the Cochrane risk of bias assessment tools. Quantitative analyses were conducted using a random-effects model., Results: This study includes 1674 LBP patients from nine clinical studies. Pooled analyses among subjects with acute LBP show 1) significant pain reductions (mean difference -0.84, 95% confidence interval[CI] -1.31, -0.37) in CZPRP plus diclofenac versus diclofenac, 2) significant improvements in lower back function (standard mean difference -1.50, 95% CI -2.16, -0.85) in CZPRP versus diclofenac, and 3) a higher pain-free rate in CZPRP alone (risk ratio 1.48, 95% CI 1.16, 1.89; I 2 = 61%) or CZPRP plus nonsteroidal anti-inflammatory drugs (NSAIDs) (risk ratio 1.66, 95% CI 1.14, 2.40; I 2 = 0%) versus NSAIDs. However, in a heterogeneous population with mixed LBP subtypes, there was no significant difference in pain outcomes between CZPRP and diclofenac. Additionally, CZPRP use did not increase AEs compared with no CZPRP (p = 0.40). All nine studies are associated with moderate to high risk of bias., Conclusions: The use of CZPRP is associated with improved acute LBP outcomes compared to diclofenac. However, due to the moderate to high risk of bias of the studies, future rigorous randomized controlled trials are needed to evaluate the effects of CZPRP for acute and chronic LBP., (Copyright © 2021 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Objective Burnout is a triad of emotional exhaustion, depersonalization, and reduced personal accomplishment resulting from job stress. Although with distinct regional and cultural characteristics, burnout among anesthesiologists in the Tibet has not been described. This study aimed to explore the prevalence of burnout among anesthesiologists in Tibet and its associated factors. Methods A cross-sectional survey was conducted in Tibet, China, with an anonymous questionnaire. Social-demographic characteristics, work status, three dimensions of burnout assessed by the Maslach Burnout Inventory-Human Service Survey were collected and analyzed. Results A total of 133 individuals from 17 hospitals completed the survey from March to June 2018. The prevalence of moderate- to high-level of emotional exhaustion, depersonalization, and burnout in personal accomplishment was 65.4% (95% CI , 57.0%-72.9%), 66.9% (95% CI , 58.5%-74.3%), and 83.5% (95% CI , 76.2%-88.8%), respectively. An annual caseload ≥500, frequent overtime work and fair to poor sleep quality were significantly associated with a higher level of emotional exhaustion ( P <0.001, P =0.001, and P <0.0001, respectively). 5-9 years in anesthesiology experience was significantly associated with a high level of emotional exhaustion and depersonalization ( P =0.002 and P =0.003, respectively). Conclusions More than half of anesthesiologists working in Tibet experience a moderate- to high- level of burnout in at least one dimensional scale. Anesthesiologists having 5-9 years of experience are more prone to emotional exhaustion and depersonalization. Efforts to decrease burnout through reducing the working load and raising the social recognition of anesthesiologists in Tibet should be considered.

Nitrogenous aerosols are ubiquitous in the environment and thus play a vital role in the nutrient balance as well as the Earth's climate system. However, their abundance, sources, and deposition are poorly understood, particularly in the fragile and ecosensitive Himalayan and Tibetan Plateau (HTP) region. Here, we report concentrations of nitrogen species and isotopic composition (δ 15 N) in aerosol samples collected from a forest site in the HTP (i.e., Southeast Tibet). Our results revealed that both organic and inorganic nitrogen contribute almost equally with high abundance of ammonium nitrogen (NH 4 + -N) and water-insoluble organic nitrogen (WION), contributing ∼40% each to aerosol total nitrogen (TN). The concentrations and δ 15 N exhibit a significant seasonality with ∼2 times higher in winter than in summer with no significant diurnal variations for any species. Moreover, winter aerosols mainly originated from biomass burning emissions from North India and East Pakistan and reached the HTP through a long-range atmospheric transport. The TN dry deposition and total deposition fluxes were 2.04 kg ha -1 yr -1 and 6.12 kg ha -1 yr -1 respectively. Our results demonstrate that the air contamination from South Asia reach the HTP and is most likely impacting the high altitude ecosystems in an accepted scenario of increasing emissions over South Asia.

The genetic resources and the mechanism of miniaturization in the Tibet Mini-pig have not been comprehensively studied. Polymorphisms in genes related to the insulin-like growth factor (IGF) axis have been investigated for years, but few on the polymorphism of IGF-binding protein-5 (IGFBP-5) in the Tibetan pig. In this study, allele-specific polymerase chain reaction (AS-PCR) was used to analyze polymorphisms in exon 1 of the IGFBP-5 gene in two pig breeds, Tibet Mini-pigs and Junmu No. 1 White pigs. A BLAST analysis of the expressed sequence tags in the porcine IGFBP-5 gene revealed that exon 1 of this gene has two single nucleotide polymorphisms (SNPs), G188T and G503A. The AS-PCR results demonstrated that in both pig breeds examined, the TT, GT, and GG genotypes existed at the G188T locus, with GT as the most common genotype. At the G503A locus, GG, GA, and AA genotypes existed in Junmu No. 1 White pigs, with the GA genotype as the most frequently occurring. By contrast, at this locus, only the GA and AA genotypes were observed in the Tibetan pigs, and AA was more common than GA. There was a significant difference (P < 0.01) in allele distribution between the two breeds at the G503A locus but not the G188T locus, and there was a lower polymorphism information content for the two polymorphic loci in Tibet Mini-pigs than in Junmu No. 1 White pigs. The present study revealed SNPs in exon 1 of IGFBP-5 gene in the Tibet Mini-pig, possibly providing more understanding of the mechanism of miniaturization.

Interspecies competition is the main factor determining the trophic niche width of sympatric species on both ecological and evolutionary levels. In August 2004, a microscopic analysis of feces was made to analyze the diet compositions of Pantholops hodgsoni, Procapra picticaudata and Equus kiang under free-living circumstances between Chuma River and Wudaoliang in the Kekexili National Nature Reserve. The trophic niche widths and overlaps of these herbivorous ungulates were calculated based on the diet compositions, and the results showed that these three ungulates had similar foods, but the proportions of their diet compositions were different. Gramineous plants were the main food sources for P. hodgsoni, P. picticaudata and E. kiang, accounting for 58.7%, 44.57% and 92.28% of the diet, respectively. The trophic niche widths of P. hodgsoni, P. picticaudata and E. kianthese were 0.878, 0.735 and 0.695, and the niche overlaps of P. hodgsoni and E. kiang, P. hodgsoni and P. picticaudata, and E. kiang and P. picticaudata were 0.869, 0.985 and 0.785, respectively, which suggested that there was a potential intense competition among them, especially for P. hodgsoni and P. picticaudata. The relations between competition and coexistence among P. hodgsoni, P. picticaudata and E. kiang were discussed from the viewpoints of their ecological characteristics and trophic ecology.