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Purpose: This study aimed to examine the KAP of physicians regarding targeted drug therapy for lung cancer in China. Methods: This cross-sectional study enrolled physicians working in hospitals in Nanyang. A self-administered questionnaire was developed (Cronbach's α=0.912) to collect the demographic information and KAP. Results: This study included 191 valid questionnaires. Most participants were male (70.2%) and aged 36– 50 (55.5%). The median knowledge score was 29 (24– 31) (/36, 80.6%), the mean attitude score was 42 (39– 44) (/50, 84.0%), and the mean practice score was 28 (26– 29) (/30, 93.3%), indicating sufficient knowledge, positive attitudes, and proactive practice. The female gender (OR=5.291, 95% CI: 1.426– 19.634, P=0.013), working in non-public tertiary hospitals (OR=0.053, 95% CI: 0.008– 0.360, P=0.003), and working in medical oncology (OR=10.764, 95% CI: 2.638– 43.922, P=0.001) were independently associated with adequate knowledge. Only the knowledge scores (OR=1.121, 95% CI: 1.036– 1.212, P=0.004) were independently associated with a positive attitude. Only the attitude scores (OR=1.895, 95% CI: 1.333– 2.694, P< 0.001) were independently associated with proactive practice. Conclusion: Physicians working in thoracic surgery, respiratory medicine, or medical oncology displayed sufficient knowledge, positive attitude, and proactive practice toward targeted therapy for lung cancer. [ABSTRACT FROM AUTHOR]

The emergence of alternative stable states in forest systems has significant implications for the functioning and structure of the terrestrial biosphere, yet empirical evidence remains scarce. Here, we combine global forest biodiversity observations and simulations to test for alternative stable states in the presence of evergreen and deciduous forest types. We reveal a bimodal distribution of forest leaf types across temperate regions of the Northern Hemisphere that cannot be explained by the environment alone, suggesting signatures of alternative forest states. Moreover, we empirically demonstrate the existence of positive feedbacks in tree growth, recruitment and mortality, with trees having 4–43% higher growth rates, 14–17% higher survival rates and 4–7 times higher recruitment rates when they are surrounded by trees of their own leaf type. Simulations show that the observed positive feedbacks are necessary and sufficient to generate alternative forest states, which also lead to dependency on history (hysteresis) during ecosystem transition from evergreen to deciduous forests and vice versa. We identify hotspots of bistable forest types in evergreen-deciduous ecotones, which are likely driven by soil-related positive feedbacks. These findings are integral to predicting the distribution of forest biomes, and aid to our understanding of biodiversity, carbon turnover, and terrestrial climate feedbacks. Alternative stable states in forests have implications for the biosphere. Here, the authors combine forest biodiversity observations and simulations revealing that leaf types across temperate regions of the NH follow a bimodal distribution suggesting signatures of alternative forest states. [ABSTRACT FROM AUTHOR]

Purpose: To compare the impact of burr hole drainage and craniotomy for acute liquid epidural hematoma (LEDH) in pediatric patients. Methods: This retrospective study enrolled pediatric patients with LEDH who underwent surgery in the Affiliated Hospital of Nanyang Medical College, China, between October 2011 and December 2019. According to the surgical procedure, patients were divided into the craniotomy group and the burr hole drainage group. Results: A total of 21 pediatric patients were enrolled (14 males, aged 7.19 ± 2.77 years), including 13 cases in the burr hole drainage group and 8 patients in the craniotomy group. The operation time and hospitalization period in the burr hole drainage group were 33.38 ± 6.99 min and 9.85 ± 1.07 days, respectively, which were significantly shorter than that in the craniotomy group (74.25 ± 9.68 min and 13.38 ± 1.71 days, respectively; all p < 0.05). The Glasgow Coma Scale (GCS) score after burr hole drainage was significantly improved than before (median: 15 vs 13, p < 0.05). No serious complications were observed in either group; one patient in the craniotomy group developed an infection at the incision point. All patients were conscious (GCS score was 15) at discharge. Conclusion: Compared with craniotomy, burr hole drainage was associated with better clinical outcomes and early recovery in patients with LEDH. [ABSTRACT FROM AUTHOR]

The article explores the use of large language models (LLMs) in scientific research, highlighting their potential benefits and limitations. It provides examples of how LLMs can assist in various scientific tasks, such as summarizing documents and improving writing. However, it also acknowledges the need for fact-checking and the potential biases in training data. The authors emphasize the importance of adhering to ethical guidelines and journal policies when using LLMs. While LLMs can be valuable tools, caution should be exercised in their use. [Extracted from the article]

Forests are a substantial terrestrial carbon sink, but anthropogenic changes in land use and climate have considerably reduced the scale of this system1. Remote-sensing estimates to quantify carbon losses from global forests2–5 are characterized by considerable uncertainty and we lack a comprehensive ground-sourced evaluation to benchmark these estimates. Here we combine several ground-sourced6 and satellite-derived approaches2,7,8 to evaluate the scale of the global forest carbon potential outside agricultural and urban lands. Despite regional variation, the predictions demonstrated remarkable consistency at a global scale, with only a 12% difference between the ground-sourced and satellite-derived estimates. At present, global forest carbon storage is markedly under the natural potential, with a total deficit of 226 Gt (model range = 151–363 Gt) in areas with low human footprint. Most (61%, 139 Gt C) of this potential is in areas with existing forests, in which ecosystem protection can allow forests to recover to maturity. The remaining 39% (87 Gt C) of potential lies in regions in which forests have been removed or fragmented. Although forests cannot be a substitute for emissions reductions, our results support the idea2,3,9 that the conservation, restoration and sustainable management of diverse forests offer valuable contributions to meeting global climate and biodiversity targets.Analysis of ground-sourced and satellite-derived models reveals a global forest carbon potential of 226 Gt outside agricultural and urban lands, with a difference of only 12% across these modelling approaches. [ABSTRACT FROM AUTHOR]

To quantify the ecological consequences of recent nationwide restoration efforts in China, spatially explicit information on forest biomass carbon stock changes over the past 20 years is critical. However, long-term biomass tracking at the national scale remains challenging as it requires continuous and high-resolution monitoring. Here, we characterize the changes in the above- and belowground biomass carbon (AGBC and BGBC) of forests in China between 2002 and 2021 at 1 km spatial resolution by integrating multiple types of remote sensing observations with intensive field measurements through regression and machine learning approaches. On average, 8.6 ± 0.6 and 2.2 ± 0.1 PgC were stored in above- and belowground live forests in China. Over the last 20 years, the total forest biomass carbon pool in China has increased at a rate of 114.5 ± 16.3 TgC yr -1 (approximately 1.1 % yr -1). The most pronounced forest biomass carbon stock gains occurred in central to southern China, including the southern Loess Plateau, Qinling mountains, southwestern karsts and southeastern forests. While the combined use of multi-source remote sensing data provides a powerful tool to assess the forest biomass carbon changes, future research is also needed to explore the drivers of the observed woody biomass trends and to evaluate the degree to which biomass gains will translate into biodiverse, healthy ecosystems that are sustainable. Annual forest above- and belowground biomass maps for China are now available at 10.6084/m9.figshare.21931161.v1 (Chen, 2023). [ABSTRACT FROM AUTHOR]

Due to massive energetic investments in woody support structures, trees are subject to unique physiological, mechanical, and ecological pressures not experienced by herbaceous plants. Despite a wealth of studies exploring trait relationships across the entire plant kingdom, the dominant traits underpinning these unique aspects of tree form and function remain unclear. Here, by considering 18 functional traits, encompassing leaf, seed, bark, wood, crown, and root characteristics, we quantify the multidimensional relationships in tree trait expression. We find that nearly half of trait variation is captured by two axes: one reflecting leaf economics, the other reflecting tree size and competition for light. Yet these orthogonal axes reveal strong environmental convergence, exhibiting correlated responses to temperature, moisture, and elevation. By subsequently exploring multidimensional trait relationships, we show that the full dimensionality of trait space is captured by eight distinct clusters, each reflecting a unique aspect of tree form and function. Collectively, this work identifies a core set of traits needed to quantify global patterns in functional biodiversity, and it contributes to our fundamental understanding of the functioning of forests worldwide. Understanding patterns in woody plant trait relationships and trade-offs is challenging. Here, by applying machine learning and data imputation methods to a global database of georeferenced trait measurements, the authors unravel key relationships in tree functional traits at the global scale. [ABSTRACT FROM AUTHOR]

Combating climate change requires unified action across all sectors of society. However, this collective action is precluded by the ‘consensus gap’ between scientific knowledge and public opinion. Here, we test the extent to which the iconic cities around the world are likely to shift in response to climate change. By analyzing city pairs for 520 major cities of the world, we test if their climate in 2050 will resemble more closely to their own current climate conditions or to the current conditions of other cities in different bioclimatic regions. Even under an optimistic climate scenario (RCP 4.5), we found that 77% of future cities are very likely to experience a climate that is closer to that of another existing city than to its own current climate. In addition, 22% of cities will experience climate conditions that are not currently experienced by any existing major cities. As a general trend, we found that all the cities tend to shift towards the sub-tropics, with cities from the Northern hemisphere shifting to warmer conditions, on average ~1000 km south (velocity ~20 km.year-1), and cities from the tropics shifting to drier conditions. We notably predict that Madrid’s climate in 2050 will resemble Marrakech’s climate today, Stockholm will resemble Budapest, London to Barcelona, Moscow to Sofia, Seattle to San Francisco, Tokyo to Changsha. Our approach illustrates how complex climate data can be packaged to provide tangible information. The global assessment of city analogues can facilitate the understanding of climate change at a global level but also help land managers and city planners to visualize the climate futures of their respective cities, which can facilitate effective decision-making in response to on-going climate change. [ABSTRACT FROM AUTHOR]

Aim: The aim was to assess whether and to what extent the role of local landscape attributes in shaping macroscopic biodiversity patterns is sensitive to spatial and thematic resolutions of land cover data. Location: Sub‐Saharan Africa and continental China. Time period: Early 21st century. Taxa studied: Terrestrial mammals. Methods: We conducted spatial and thematic scaling analyses to generate land cover datasets of different spatial (0.3, 0.5, 1.0 and 9.0 km) and thematic (two, three and five classes) resolutions. We calculated landscape metrics based on the resulting land cover maps and examined the power of landscape metrics for explaining species richness patterns, using non‐spatial (OLS) and spatial (SAR) linear models and random forest (RF) models. We systematically assessed the resolution dependence of explanatory power for different geographical regions, different scaling approaches and different model types. We also compared the explanatory power of landscape attributes with that of macroclimate. Results: Collectively, local landscape attributes generally had strong explanatory power for species richness. For the African system, the largest explanatory power was c. 60% based on the OLS models and random forest models and c. 30% based on the non‐spatial components of the SAR models. For the Chinese system, the largest explanatory power was c. 35% based on the OLS models and c. 40% based on the SAR and random forest models. We observed a linear scaling relationship, which is robust to studied systems, scaling approaches and model types. In contrast, the scaling relationship varies substantially among single landscape metrics. At coarse resolutions, the addition of landscape attributes collectively would not improve climate‐envelope models significantly, whereas at finer resolutions, landscape attributes collectively have explanatory power that is close to or even exceeds climate. Main conclusions: Local landscape attributes play an important role in shaping macroscopic biodiversity patterns. However, their strength is highly sensitive to both spatial and thematic resolutions of land cover data, with stronger explanatory power detected at finer resolutions. Strong sensitivity to spatial and thematic resolutions makes landscape attributes highly plastic determinants, leading to contrasting conclusions if based on greatly different resolutions of land cover data. Scaling analyses are needed to examine such cross‐scale effects of macroecological determinants systematically. [ABSTRACT FROM AUTHOR]

NAND Flash memories present inevitable decline in reliability due to scaling down and multilevel cell (MLC) technology. High retention error rate in highly program/erase (P/E) cycled blocks induces stronger ECC requirement in system, causing higher spare bits cost and hardware overhead. In this paper, a least significant bit (LSB) page refresh based retention recovery scheme is proposed to improve the retention reliability of highly scaled MLC NAND Flash. As in the scheme, LSB page refresh operation induces floating gate electron re-injection to compensate charge leakage during long retention time, and realizes retention error rate reduction. Experiment result on 2x-nm MLC NAND Flash exhibits more than 78% retention error rate reduction. Comparing with reported retention error recovery scheme, the proposed scheme presents 2.5 times recovery efficiency promotion and 60% latency reduction. [ABSTRACT FROM AUTHOR]

In this paper, we have studied the total ionizing dose (TID) radiation response up to 2 Mrad(Si) of silicon-oxide-nitride-oxide-silicon (SONOS) memory cells and memory circuits, fabricated in a 130 nm complimentary metal-oxide-semiconductor (CMOS) SONOS technology. We explored the threshold voltage ( V) degradation mechanism and found that the V shifts of SONOS cells depend on the charge state; simply programming the cell to a higher V cannot compensate for the radiation induced V loss. The off-state current ( I) increase in the SONOS cell is also studied in this paper. Both V and I degradation would affect the memory system. Read data failures are mainly caused by V shifts under irradiation, and program and erase failures are mainly caused by increased I, which overloads the charge pumping circuit. By varying the reference current, our 4 Mb NOR flash chip has the potential to survive a radiation dose of 1 Mrad(Si) in read mode. [ABSTRACT FROM AUTHOR]