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Abstract Objectives To explore the association between tea, coffee, and caffeine consumption and the risk of female infertility. Methods We analyzed data from 2099 females aged 18 to 44 years, participating in the National Health and Nutrition Examination Survey (NHANES) 2013–2018. We used generalized linear models (GLM) and generalized additive model (GAM) to investigate the dose-response relationship between the tea, coffee, and caffeine consumption and infertility, adjusting for potential confounders. Results A non-linear relationship was detected between tea consumption and infertility and the inflection point was 2 cups/day. On the right side of the inflection point, we did not detect a significant association. However, on the left side, we found a negative relationship between tea consumption and infertility (OR: 0.73; 95% CI: 0.57 to 0.93; P = 0.0122). Meanwhile, our study found no significant association between coffee (0.96, 0.81 to 1.13, P = 0.6189) or caffeine consumption (1.15, 0.93 to 1.42, P = 0.2148) and female infertility. Conclusions Tea consumption was non-linearly associated with infertility, whereas no significant associations were found between coffee, caffeine consumption and infertility.

The changes in lipid and microbial during beef storage exert a substantial impact on the overall quality of beef. In this study, lipidomics and microbiomics were used to evaluate the effects of chilled storage (at 4 °C, CS) and superchilled storage (at −2 °C, SS) on the quality of yak tenderloin. The data revealed that TG, PS, PI, PE, and Car are the key factors contributing to the generation of undesirable odor during the storage of tenderloin. Macrococcus, Lactobacillus, Myroides, and Proteobacteria directly affect the storage quality of yak tenderloin. Integrated analysis revealed that microbial metabolites interact with lipids, resulting in a deterioration of meat quality. These changes are mediated by Myroides, Pseudomonas, and Lactobacillus, which regulate fatty oxidation and metabolism of PE, PI, PS, Cer, and SM. These findings have important implications for understanding the changes in quality and microbial activity of refrigerated meat and meat products.

T cell engagers (TCEs) are becoming an integral class of biological therapeutic owing to their highly potent ability to eradicate cancer cells. Nevertheless, the widespread utility of classical CD3-targeted TCEs has been limited by narrow therapeutic index (TI) linked to systemic CD4+ T cell activation and aberrant cytokine release. One attractive approach to circumvent the systemic activation of pan CD3+ T cells and reduce the risk of cytokine release syndrome is to redirect specific subsets of T cells. A promising strategy is the use of peptide-major histocompatibility class I bispecific antibodies (pMHC-IgGs), which have emerged as an intriguing modality of TCE, based on their ability to selectively redirect highly reactive viral-specific effector memory cytotoxic CD8+ T cells to eliminate cancer cells. However, the relatively low frequency of these effector memory cells in human peripheral blood mononuclear cells (PBMCs) may hamper their redirection as effector cells for clinical applications. To mitigate this potential limitation, we report here the generation of a pMHC-IgG derivative known as guided-pMHC-staging (GPS) carrying a covalent fusion of a monovalent interleukin-2 (IL-2) mutein (H16A, F42A). Using an anti-epidermal growth factor receptor (EGFR) arm as a proof-of-concept, tumor-associated antigen paired with a single-chain HLA-A *02:01/CMVpp65 pMHC fusion moiety, we demonstrate in vitro that the IL-2-armored GPS modality robustly expands CMVpp65-specific CD8+ effector memory T cells and induces potent cytotoxic activity against target cancer cells. Similar to GPS, IL-2-armored GPS molecules induce modulated T cell activation and reduced cytokine release profile compared to an analogous CD3-targeted TCE. In vivo we show that IL-2-armored GPS, but not the corresponding GPS, effectively expands grafted CMVpp65 CD8+ T cells from unstimulated human PBMCs in an NSG mouse model. Lastly, we demonstrate that the IL-2-armored GPS modality exhibits a favorable developability profile and monoclonal antibody-like pharmacokinetic properties in human neonatal Fc receptor transgenic mice. Overall, IL-2-armored GPS represents an attractive approach for treating cancer with the potential for inducing vaccine-like antiviral T cell expansion, immune cell redirection as a TCE, and significantly widened TI due to reduced cytokine release.

Abstract Objectives To explore the relationship between different types of physical activity and female infertility. Methods This study analyzed data from 2,796 female participants aged 18–44 years in the United States, obtained from the National Health and Nutrition Examination Survey (NHANES) database spanning the years 2013 to 2020. Multiple logistic regression analyses and generalized linear models were used to explore the relationship between different types of physical activity and infertility after adjusting for potential confounding factors. Results We found a non-linear relationship between recreational activities and infertility with an inflection point of 5.83 h/week (moderate intensity), while work activities and traffic-related activities did not. On the left side of the inflection point, there was no significant association between recreational activity time and infertility (OR = 0.93, 95% CI: 0.86 to 1.02, P = 0.1146), but on the right side of the inflection point, there was a positive association between recreational activity time and the risk of infertility (OR = 1.04, 95% CI: 1.02 to 1.06, P = 0.0008). Conclusions The relationship between different types of physical activity and female infertility varies. We acknowledge the potential influence of confounding variables on this relationship. However, we have already adjusted for these potential variables in our analysis. Therefore, our findings suggest that appropriate recreational activity programs are essential for promoting reproductive health in women of reproductive age. Nevertheless, it is important to note that the observed association does not imply causality. Given the limitations of cross-sectional studies, further prospective cohort studies are needed to explore the causal relationship while accounting for additional confounding factors.

Abstract Background The Tibetan area is one of China’s minority regions with a shortage of general practice personnel, which requires further training and staffing. This research helps to understand the current condition and demand for general practitioner (GP) training in Tibetan areas and to provide a reference for promoting GP education and training. Methods We conducted a cross-sectional survey using stratified sampling targeting 854 GPs in seven cities within the Tibetan Autonomous Region, utilizing an online questionnaire. Achieving a high response rate of 95.1%, 812 GPs provided invaluable insights. Our meticulously developed self-designed questionnaire, available in both Chinese and Tibetan versions, aimed to capture a wide array of data encompassing basic demographics, clinical skills, and specific training needs of GPs in the Tibetan areas. Prior to deployment, the questionnaire underwent rigorous development and refinement processes, including expert consultation and pilot testing, to ensure its content validity and reliability. In our analysis, we employed descriptive statistics to present the characteristics and current training needs of GPs in the Tibetan areas. Additionally, chi-square tests were utilized to examine discrepancies in training needs across various demographic groups, such as age, job positions, and educational backgrounds of the participating GPs. Results The study was completed by 812 (812/854, 95.1%) GPs, of whom 62.4% (507/812) were female. The top three training needs were hypertension (81.4%, 661/812), pregnancy management (80.7%, 655/812), and treatment of related patient conditions and events (80.5%, 654/812). Further research shows that the training required by GPs of different ages in “puncturing, catheterization, and indwelling gastric tube use” (64.6% vs. 54.8%, p = 9.5 × 10− 6) varies statistically. GPs in various positions have different training needs in “community-based chronic disease prevention and management” (76.6% vs. 63.9%, p = 0.009). The training needs of GPs with different educational backgrounds in “debridement, suturing, and fracture fixation” (65.6% vs. 73.2%, p = 0.027) were also statistically significant. Conclusions This study suggests the need for targeted continuing medical education activities and for updating training topics and content. Course developers must consider the needs of GPs, as well as the age, job positions, and educational backgrounds of GPs practicing in the Tibetan Plateau region. Trial registration Not applicable.

Abstract This study delves into the influence of green financing within the cultural industry on the green growth trajectories of China’s 32 provinces spanning the years 2010 to 2021. Employing the Common Correlated Effects Mean Group (CCEMG) estimator, the research comprehensively assesses the impact of various independent variables on green growth. The findings indicate that a 1% rise in cultural sustainability investment correlates with a 0.63% upswing in green growth, whereas a 1% increase in carbon dioxide emissions corresponds to a 0.14% decline in green growth. Additionally, the study posits that shifts in the scale of the financial market do not exert a significant influence on green growth. Moreover, the negative coefficient of −0.25% for the variable “ICT diffusion index” suggests that heightened use of ICT devices is associated with a reduction in green growth. Given these insights, proposed strategies involve advancing the digitalization of the cultural industry through fintech and big data, establishing supportive regulatory frameworks, and fostering collaborations between financial institutions and cultural organizations.

ObjectiveTo evaluate the association between bedtime and infertility and to identify the optimal bedtime for women of reproductive age.MethodsWe conducted a cross-sectional study using data from 3,903 female participants in the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2020. The effect of bedtime on female infertility was assessed using the binary logistic regression in different models, including crude model and adjusted models. To identify the non-linear correlation between bedtime and infertility, generalized additive models (GAM) were utilized. Subgroup analyses were conducted by age, body mass index (BMI), waist circumference, physical activity total time, marital status, smoking status, drinking status and sleep duration.ResultsAfter adjusting for potential confounders (age, race, sleep duration, waist circumference, marital status, education, BMI, smoking status, drinking status and physical activity total time), a non-linear relationship was observed between bedtime and infertility, with the inflection point at 22:45. To the left side of the inflection point, no significant association was detected. However, to the right of it, bedtime was positively related to the infertility (OR: 1.22; 95% CI: 1.06 to 1.39; P = 0.0049). Subgroup analyses showed that late sleepers with higher BMI were more prone to infertility than those with a lower BMI (BMI: 25–30 kg/m2: OR: 1.26; 95% CI: 1.06 to 1.51; P = 0.0136; BMI ≥ 30 kg/m²: OR: 1.21, 95% CI: 1.09 to 1.34; P = 0.0014).ConclusionBedtime was non-linearly associated with infertility, which may provide guidance for sleep behavior in women of childbearing age.

The purpose of this study was to compare the structural and functional of protein from yak milk residue, which collected from different elevations (MRP1 and MRP2) in Tibet, as well as their potential for enhancing the quality of non-fat yogurt. The results showed that MRP1 exhibited higher levels of β-sheet, turbidity, particle size, and gel properties. MRP2 had better flexibility, emulsification, foaming, water/oil absorption capacity. The addition of MRP1 (3%) could improve texture and sensory properties of yogurt. Although MRP2 yogurt had higher hardness, gumminess, chewiness and water holding capacity, poor mouthfeel. Rheological test showed that MRPs yogurt exhibited typical gel-like and shear-thinning behavior. Moreover, the fortification of non-fat yogurts with MRP1 brought the formation of larger protein clusters with a more tightly knit network of smaller pores. These results indicate that MRP1 can be used as a fat substitute to improve the quality of non-fat yogurt.

Objective Instability of the dorsal radioulnar ligament (DRUL) is caused by multiple factors from bony and soft tissue structures. Studies of DRUJ instability based on MRI have rarely been reported. This study aims to investigate related instability factors in the distal radioulnar joint (DRUJ) after trauma based on MRI imaging. Methods The MRI imaging was performed on 121 post‐traumatic patients with or without DRUJ instability from April 2021 to April 2022. All patients demonstrated pain or attenuated wrist ligamentous tissue quality with physical examination. The interesting variables, including age, sex, the distal radioulnar transverse shape, the triangular fibrocartilage complex (TFCC), DRUL, the volar radioulnar ligament (VRUL), distal interosseus membrane (DIOM), the extensor carpi ulnaris (ECU), and pronator quadratus (PQ), were analyzed using univariable and multivariable logistic regression model. The different variables were compared in radar plots and bar chart. Results An average age of 121 patients was 42.16 ± 16.07 years. The 50.4% DRUJ instability existed in all patients and the distal oblique bundle (DOB) presented in 20.7% of patients. The TFCC (p = 0.03), present DIOM (p = 0.001), and PQ (p = 0.006) were identified to be significant in final multivariable logistic model. The percentage of patients with ligament injuries were general higher in DRUJ instability group. The patients with absent DIOM had a higher rate in DRUJ instability, TFCC, and ECU injury. There was higher stability in shape of C‐type, intact TFCC, and present DIOM. Conclusion DRUJ instability is closely associated with TFCC, DIOM, and PQ. It could provide a potential for early detection of potential instability risk and taking necessary preventive measures.

T cell engagers, a category of T cell-retargeting immunotherapy, are rapidly transforming clinical cancer care. However, the lack of tumor-specific targets poses a significant roadblock for broad adaptation of this therapeutic modality in many indications, often resulting in systemic on-target off-tumor toxicity. Though various tumor-derived intracellular mutations provide a massive pool of potential tumor-specific antigens, targeting them is extremely challenging, partly due to the low copy number of tumor associated antigen (TAA)-derived pMHC on tumor cell surface. Further, the interplay of binding geometry and format valency in relation to the capacity of a T cell engager to efficiently target low density cell-surface pMHC is not well understood. Using the Wilms’ tumor 1 (WT1) oncoprotein as a proof-of-principle TAA, combined with an array of IgG-like T cell engager modalities that differ in their anti-TAA valency and binding geometry, we show that the ability to induce an immunological synapse formation, resulting in potent killing of WT1 positive cancer cell lines is primarily dependent on the distinct geometrical conformations between the Fab arms of anti-WT1-HLA-A*02:01 and anti-CD3. The augmented avidity conferred by the binding of two anti-WT1-HLA-A*02:01 Fab arms has only minimal influence on cell killing potency. These findings demonstrate the need for careful examination of key design parameters for the development of next-generation T cell engagers targeting low density TAA-pMHCs on tumor cells.

Abstract There are various surgical methods for tracheoesophageal fistula; however, there is presently no unified standard. Based on the magnetic compression technique, we designed a novel method for the treatment of tracheoesophageal fistula. The purpose of this study was to verify its feasibility in an animal experiment. Six beagle dogs underwent surgical repair after constructing a tracheoesophageal fistula model. After the tracheal and esophageal spaces were freed during the operation, two magnets were used to clamp the fistula. The operation time, intraoperative blood loss, postoperative complications, and wound healing were monitored. Samples were obtained 14 days after the operation, and fistula repair was observed. The tracheoesophageal fistula repair operation was successfully completed for all six beagles. The average operation time was 23.67 ± 4.50 min. The average intraoperative blood loss was less than 10 mL. One dog had a postoperative wound infection, and the rest had no postoperative complications. The wound healed well. In all dogs, after specimen collection, it was observed that the fistula was successfully closed and the mucosal layer was smooth and flat. Histological observation showed that the anastomosis was slightly inflamed, the mucosal layer and surrounding tissues were arranged neatly, and the structure was slightly disordered. Magnetic compression technique can be effectively used to repair tracheoesophageal fistula, shorten the operation time, and simplify the operation procedure, and thus, it has the potential for clinical application.

Naoluoxintong (NLXT) has been used to treat ischemic stroke (IS) in China for more than two hundred years. However, the pharmacodynamic material basis of NLXT has not been fully studied. Under the guidance of the former network pharmacological analysis, a rapid and reliable method combining UPLC-Q-TOF-MSE with the novel informatics UNIFI™ platform was established which was used to study the composition of NLXT and its prototype components and metabolites in vivo. A total of 102 compounds were identified. 13 compounds were sourced from “Monarch herb”, mainly involving flavonoids and their glycosides. 54 compounds were sourced from “Minister herb”, mainly involving triterpenoid saponins, organic acids and lactones. 11 compounds were from the “Assistant herb”, mostly containing citric acid and esters of citric acid. 24 compounds were from the “Guide herb”, mostly including flavonoids and their glycosides, organic acids and lactones. Moreover, 24 prototype components and 30 metabolites were detected, and in vivo transformation pathways for different types of chemical components were provided. This is a comprehensive report on the identification of major chemical components in NLXT and metabolic components in rats by UPLC-Q-TOF-MS combined with UNIFI platform under the guidance of network pharmacology, which is helpful for the quality control of NLXT and the study of quality markers.

Abstract In single-port thoracoscopic lobectomy, surgical instruments are likely to collide and interfere with each other. We used magnetic anchor technique to design an anchoring device suitable for thoracoscopic surgery, and verified the safety and feasibility of its use in animal experiments. Ten Beagles were used as models, and magnetic anchor technology was used to assist thoracoscopic lobectomy. During the operation, a self-designed magnetic anchored internal grasper was used in place of the traditional laparoscopic grasping forceps. The operation time, intraoperative blood loss, incidence of postoperative complications, and the effect of intraoperative use of the device were analyzed. All 10 beagles were successfully operated; the mean operation time was 19.7 ± 3.53 min (range 15–26 min), and the postoperative blood loss was

Objective Caring for patients with multimorbidity is an important part of primary care. It has become increasingly relevant that understanding the spectrum of multimorbidity will help general practitioners (GPs) acquire working knowledge and improve management skills. However, there was little research on characteristics of multimorbidity in primary care in China. This study aimed to identify the spectrum of frequency, proportion and ranking of multimorbidity patterns in adult patients seen at community health centres (CHCs) in Shanghai, China.Design and setting This was an observational, retrospective, cross-sectional study analysis of outpatient data of 244 CHCs in Shanghai, China.Participants Adult patients with chronic disease who visited Shanghai CHCs during 2014–2018 were selected from Shanghai CHC electronic medical records database using the International Classification of Diseases 10th Revision codes matched to the Second Version of International Classification of Primary Care codes.Primary and secondary outcome measures A number of adult patients with chronic disease were counted. Then frequency, proportion and rank of disease patterns of multimorbidity were analysed.Results Analysis of 301 651 158 electronic health records of 5 909 280 adult patients (54.2% females) found the multimorbidity proportion to be 81.2%. The prevalence of multimorbidity increased with age, which climbed from 43.7% among those aged 19–34 to 94.9% among those more than 80 years of age. The proportion of multimorbidity was higher in females (83.2%) than males (79.7%). Vascular and metabolic diseases were the most frequent diseases for patients over 45 years old.Conclusions Multimorbidity has brought huge challenges to primary care practice in Shanghai. The Shanghai government should strengthen its support for the multitargeted prevention of chronic diseases and the improvement of GPs’ management capabilities.

Zhang et al. present the cryo-EM structure of ATP-binding cassette transporters ABCG5/G8 in complex with the Fab fragments from two monoclonal antibodies at 3.3 Å resolution. This study provides structural insights into the transport cycle and potential epitopes for therapeutic interventions that control cholesterol homeostasis.

Unpaired single-image dehazing has become a challenging research hotspot due to its wide application in modern transportation, remote sensing, and intelligent surveillance, among other applications. Recently, CycleGAN-based approaches have been popularly adopted in single-image dehazing as the foundations of unpaired unsupervised training. However, there are still deficiencies with these approaches, such as obvious artificial recovery traces and the distortion of image processing results. This paper proposes a novel enhanced CycleGAN network with an adaptive dark channel prior for unpaired single-image dehazing. First, a Wave-Vit semantic segmentation model is utilized to achieve the adaption of the dark channel prior (DCP) to accurately recover the transmittance and atmospheric light. Then, the scattering coefficient derived from both physical calculations and random sampling means is utilized to optimize the rehazing process. Bridged by the atmospheric scattering model, the dehazing/rehazing cycle branches are successfully combined to form an enhanced CycleGAN framework. Finally, experiments are conducted on reference/no-reference datasets. The proposed model achieved an SSIM of 94.9% and a PSNR of 26.95 on the SOTS-outdoor dataset and obtained an SSIM of 84.71% and a PSNR of 22.72 on the O-HAZE dataset. The proposed model significantly outperforms typical existing algorithms in both objective quantitative evaluation and subjective visual effect.

A new crown ether–polyoxometalate assembly [K(H24C12O6)]3[K(H24C12O6)(CH3CN)][SiMo12O40] (1) based on the Keggin-type polyanion [SiMo12O40]4− was successfully synthesized through one-pot strategy in acetonitrile solution. The polyanion is coordinated to two [K([18]-crown-6)]+ supramolecular cations via crown–K–O(POM) coordinate-covalent bonds, leading to the formation of a spindle-shaped discrete structure. Complex 1 exhibited good hydrogen evolution reaction (HER) activity in an acidic medium. Moreover, a small overpotential η10 of 120 mV and a Tafel slope of 112 mV dec−1 were obtained. This crown ether–polyoxometalate hybrid electrocatalyst also presented excellent HER stability even after 2000 cycles of operation.

Plant metabolic regulation is an important strategy for dealing with abiotic stress, which can initiate dramatic changes in metabolite profiles. Metabolomic studies have been extensively used to reveal the responses of plants to abiotic stress, but research concerning how shade growth conditions impact the physiological responses of purple Perilla under Cd stress is still rare. Therefore, the research was designed to observe the important metabolites of purple Perilla under shaded conditions and Cd stress. In this study, we compared the metabolite profiles of purple Perilla exposed to shade and Cd stresses. The results showed that the metabolite profiles of purple Perilla under these stresses could be classified separately. Compared with the normal sunlight treatment, important energy metabolic pathways, including the citrate cycle, and glyoxylate and dicarboxylate metabolism, were inhibited under shade stress. Metabolite analysis revealed that pyruvate was involved in numerous metabolic pathways under Cd stress, and decreased pyruvate was regarded as a metabolite marker for physiological changes. The results show that increased thiamine is an important intermediate that is beneficial for enhancement of Cd stress tolerance.

Ferroportin is an iron exporter essential for releasing cellular iron into circulation and is inhibited by a peptide hormone, hepcidin. Here authors present cryo-EM structures of the ferroportin from the primate Philippine tarsier (TsFpn) with and without hepcidin and show that TsFpn is an electroneutral H+ /Fe2+ antiporter.

Abstract Objective Following World Health Organization’s initiatives to advance primary care, China put forth forceful policies including the Personal Family Doctor Contract to ensure that every family sign up with a qualified doctor in a community health center (CHC) ever since its 2009 New Health Reform. We used the Johns Hopkins-designed Primary Care Assessment Tool (PCAT) to assess primary care quality experienced by the contracted residents and compare this across different socioeconomic regions. Methods Using a multistage sampling method, four CHCs each were randomly selected from urban, suburban and rural districts of Shanghai, a metropolitan with 24 million residents. ANOVA and Multivariate analyses were used to assess the association between location of CHC and the quality of primary care experience. Findings A total of 2404 CHC users completed our survey. Except for the domain of coordination (information systems), users from suburban CHCs reported best primary care experiences in all other domains, followed by users of rural CHCs. After controlling for covariates, suburban CHC users were more likely to report higher total PCAT scores (ß = 1.57, P

With the growing amount of chronic patients, consistent monitoring for health care professionals has been a major concern and a direct incentive to develop mobile health systems that are adaptive and energy-efficient. The data collected from these devices is extremely important and may be affected by wireless communication environments encouraging a preliminary stage that adapts transmission of data to network dynamics. The paper provides compression and classification schemes for data based on a Hybrid Deep Learning Model (HDLM) that represents data characteristics, acquired data, and energy efficiency data delivery dynamics. Further, the EEG and EMG signals are compressed and classified based on Hybrid Deep Learning Model (HDLM) has been mathematically analyzed. Hence, The system is specifically based on the Stacked Auto-Encoder (SAE) architecture which extracts discrimination in the multimodal representation of data; it reconstructs data from the latent description with the help of encoder-decoder layers for data analysis. Furthermore, Multi-Modality Adaptive Compression shows its performance, computational complexity and response to different network states has been experimentally analyzed at lab scale numerical analysis. This method is therefore appropriate for mHealth applications, which can improve energy efficiency, minimize capacity, and minimize transmission latency in the mHealth cloud with intelligent preprocessing.

TrkH is a bacterial ion channel that is regulated by nucleotides and its associated protein TrkA. Here the authors present ADP and ATP bound TrkH-TrkA structures, which reveal the mechanism for the transmission of nucleotide-induced conformational changes in TrkA to the opening of the TrkH channel and further support the proposed gating mechanism with functional studies.

Improving crop nitrogen use efficiency can facilitate sustainable production, however, the genetic mechanisms have not been fully revealed. Here, the authors discover the NAC42-NPF6.1 signaling cascade mainly derives from indica and wild rice and demonstrate the potential of using the allele for cultivar improvement.

Cultural diversity is disappearing quickly. Whilst a phylogenetic approach makes explicit the continuous extinction of cultures, and the generation of new ones, cultural evolutionary changes such as the rise of agriculture or more recently colonisation can cause periods of mass cultural extinction. At the current rate, 90% of languages will become extinct or moribund by the end of this century. Unlike biological extinction, cultural extinction does not necessarily involve genetic extinction or even deaths, but results from the disintegration of a social entity and discontinuation of culture-specific behaviours. Here we propose an analytical framework to examine the phenomenon of cultural extinction. When examined over millennia, extinctions of cultural traits or institutions can be studied in a phylogenetic comparative framework that incorporates archaeological data on ancestral states. Over decades or centuries, cultural extinction can be studied in a behavioural ecology framework to investigate how the fitness consequences of cultural behaviours and population dynamics shift individual behaviours away from the traditional norms. Frequency-dependent costs and benefits are key to understanding both the origin and the loss of cultural diversity. We review recent evolutionary studies that have informed cultural extinction processes and discuss avenues of future studies.

The National Health and Family Planning Commission of the People's Republic of China has proposed to improve the medical capacity of general practitioners and the establishment of general practice in recent health reform. For the first time, the ability to conduct scientific research was included in this reform, which demands community healthcare centres (CHCs) to strengthen their research capacity. The evaluation of community scientific research capacity has become an important endeavour to promote the implementation of research in CHCs. Since 2016, our research team has been working on an evaluation system and has published the scientific research capacity ranking for the top 100 CHCs in China. The latest released ranking of scientific research capacities of China CHCs has aroused great attention in the country.

Background: Mental disorders endanger people’s health and lives. General practitioners (GPs) play a valuable role in identifying and treating mental disorders in outpatient clinical settings. However, there are obstacles for GPs’ identification in developing countries. Objective: This study’s aim was to identify the related obstacles and to propose optimized strategies. Methods: We conducted qualitative interviews with 26 GPs from seven randomly sampled community healthcare centers in Shanghai, China. The interview guide was based primarily on the items from mental status evaluation. After transcribing, coding, condensing, and categorizing talking content, we summarized the theme structure and results. Findings: GPs lacked the confidence and skills to conduct psychiatric evaluation and seldom conducted it. Patients’ behaviors also influenced whether evaluations were conducted. The GPs expressed that they were short of strategies and wished to be well trained and have sufficient practice. We found that two major reasons impeded GPs’ identification. First, the GPs had difficulty making a diagnosis: they lacked diagnostic ability and confidence, they had misunderstandings about diagnoses, and they had unclear qualifications for making psychiatric diagnoses. Second, the GPs lacked skills for evaluation and reevaluation: their evaluation had inadequacies of contents and subjects; they lacked mental state examination evaluation, communication, and severity assessment skills and knowledge. Conclusions: This study found that it is difficult for GPs in developing countries to become competent in the diagnosis and systematic evaluation of mental disorders without external help. Unclear qualification also limited GPs’ diagnoses of mental disorders. We proposed that optimized strategies to overcome these challenges lie in support of changes in policy, programs, and utilizing effective tools, such as the mhGAP, GMHAT/PC, BVC, Grille’s assessment tool, and telemedicine.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The non-axisymmetric geometry structure of the volute leads to the uneven circumferential distribution of the flow field inside centrifugal compressors. It is difficult to describe the whole flow field for few measuring points installed around the centrifugal compressor casing wall. In this paper, seventy-two static pressure measuring probes including the six circumferential position and the twelve meridional position were installed around the casing wall, and the circumferential distribution of the static pressure was compared under the different speeds at the full flow rate. Some especial circumferential distributions of the static pressure were founded through analyzing the experimental results. At the small flow rate, the circumferential distribution of the static pressure not only has the peak static pressure point induced by the volute tongue but also has the bulge phenomenon, which also appears near the design flow rate. The stall inception most likely occurs at the static pressure peak or the static pressure bulge region. In each speed, there is a flow rate corresponding to the lowest circumferential variation of the static pressure and the peak efficiency. The amplitude of the circumferential static pressure variation does not decrease with the reducing flow rate, on the contrary, the amplitude has the increasing tendency along the meridional direction. The circumferential static pressure distribution at the leading edge of the splitter blade is almost the same at different small flow rates. Meanwhile, the circumferential static pressure distribution has the two peaks phenomenon, which has the approximately 180° circumferential difference between the two peaks points.