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IMPORTANCE: Infectious conjunctivitis can lead to corneal involvement and result in ocular morbidity. The identification of biomarkers associated with corneal involvement has the potential to improve patient care. OBJECTIVE: To identify biomarkers in patients with acute infectious conjunctivitis. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study took place from December 2016 to March 2024. Analyses were performed in 3 phases. First, logistic regression and machine learning algorithms were used to predict the probability of demonstrating corneal involvement in patients with presumed infectious conjunctivitis. Second, quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used to confirm the most important biomarker gene identified by the algorithm. Third, the biomarker gene was validated in prospectively collected conjunctival samples of adult patients from 3 outpatient centers in Thailand and 1 in India. Patients with signs and symptoms of infectious conjunctivitis and onset within less than 14 days were eligible. Exclusion criteria were the inability to consent, presumed toxicity, or allergic conjunctivitis. EXPOSURES: Acute infectious conjunctivitis. MAIN OUTCOMES AND MEASURES: The identification and validation of ocular surface gene expression associated with corneal findings on slitlamp examination. RESULTS: Thirteen genes exhibited a 1.5–log2 fold change in expression in patients with corneal involvement compared to patients without corneal involvement. Using the 13 genes to train and cross validate, logistic regression produced the highest mean area under the receiver operating characteristic curve (AUROC; 0.85; 95% CI, 0.84-0.86) for corneal involvement. The removal of apolipoprotein E (APOE) from the gene ensemble led to a decline in predictive performance of the logistic regression classifier (from mean AUROC 0.85 [95% CI, 0.84-0.86] to 0.74 [95% CI, 0.73-0.75]; adjusted P = .001 [Tukey test]). Orthogonal testing of APOE expression level with RT-qPCR showed that APOE expression was higher in patients with corneal involvement compared to patients without (median [IQR], 0.23 [0.04-0.47] vs 0.04 [0.02-0.06]; P = .004 [Mann-Whitney U test]). Using a Youden index of 0.23 Δ threshold cycle, APOE had a sensitivity of 56% (95% CI, 33-77) and a specificity of 88% (95% CI, 79-93) in 106 samples with conjunctivitis at Aravind, India (P < .001 [Fisher exact test]). When applied to a different patient population in Thailand, the same criteria could discriminate between disease states (58 samples; sensitivity, 47%; 95% CI, 30-64 and specificity, 93%; 95% CI, 77-99; P = .001 [Fisher exact test]). CONCLUSIONS AND RELEVANCE: The results from this study suggest that the host conjunctival immune response can be meaningfully interrogated to identify biomarkers for ocular surface diseases.

IMPORTANCE: Acute infectious conjunctivitis is a common ocular condition with major public health consequences. OBJECTIVE: To assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, patients with presumed acute infectious conjunctivitis were enrolled in the study at 5 sites (Honolulu, Hawaii; Los Angeles, San Francisco, and San Diego, California; and Petah-Tikva, Israel) from March 2021 to March 2023. Patients with allergic or toxic conjunctivitis were excluded. MAIN OUTCOMES AND MEASURES: Pathogens were identified by unbiased RNA deep sequencing. RESULTS: In all, 52 patients (mean [range] age, 48 [7-80] years; 31 females [60%]) were enrolled at 5 sites (6 patients from Honolulu, 9 from San Diego, 11 from Los Angeles, 13 from San Francisco, and 13 from Petah-Tikva). RNA deep sequencing detected human adenovirus species D in one-quarter of patients (13 of 52). A wide range of pathogens, including human coronavirus 229E, SARS-CoV-2, and herpes simplex virus type 1, was also identified, as well as several bacteria and fungi. Moreover, 62% (32 of 52) of patients presented with purulent discharge, while only 8% (4 of 52) of patients had confirmed bacterial pathogens. CONCLUSION AND RELEVANCE: In this cross-sectional study, pathogens associated with acute infectious conjunctivitis varied between all 5 sites in the US and Israel. Purulent discharge was a common presenting sign in this study, with a low specificity for bacteria-associated conjunctivitis, suggesting that further diagnostic workup may be necessary to inform antibiotic stewardship. Additional research on cost-effectiveness of using RNA deep sequencing is needed to ascertain whether it is better to monitor patients clinically until resolution of disease.

Purpose: The purpose of this paper is to explore the changes of the scale of urban tourists in mainland China under the impact of COVID-19 and, specifically, the following questions: how did the scale of domestic tourists change nationwide and in the seven geographic regions? What are the differences in the changes among the seven geographic regions? What are the changes in the hot spot areas and spatial clustering of domestic tourists across the country? Design/methodology/approach: Using the data of domestic tourist arrivals in 337 cities in mainland China from 2018 to 2021, this research analyzes the absolute differences and relative differences in the scale of domestic tourists nationwide and in seven geographic divisions with the help of indicators such as range analysis, standard deviation, coefficient of variation and Herfindahl–Hirschman Index and explores the changes in the hot spot areas and spatial concentration degree of the spatial scale of domestic tourists nationwide under the influence of the epidemic using kernel density analysis and spatial auto-correlation analysis. Findings: The absolute differences in all seven geographical divisions continue to increase during 2018–2021. The domestic tourism in southwest China is extremely uneven. Absolute differences in the northwest and northeast regions are relatively small, and the development in attracting domestic tourists is more balanced. Relative differences in southwest China are comparatively large, with the trend of uneven development being obvious. The northeast, northwest and eastern regions of China are small, and the development is more balanced. The popularity of domestic tourism in the Beijing–Tianjin–Hebei region, as well as the Yangtze River Delta region, continues to decline and then pick up in 2021. The inland southwest region became a new domestic tourism hot spot in 2021. The size of domestic tourists from 2018 to 2021 in mainland China cities shows a significant positive spatial correlation, and there is a spatial agglomeration phenomenon, but some regional agglomeration types change from 2018 to 2021. Research limitations/implications: The impact of the epidemic on the number and spatial scale of domestic tourism in China has been clarified, which makes up for the comparison of domestic tourism changes before and after the epidemic. A clear understanding of the changes in the number and spatial scale of domestic tourists in different regions after the epidemic is conducive to the development of domestic tourism revitalization strategies in accordance with the actual situation of each province and promotes the internal circulation of Chinese tourism. Practical implications: This paper tries to clarify the quantitative scale of domestic tourism in different regions after the epidemic, which is conducive to the development of domestic tourism revitalization strategies in cities in different regions according to regional characteristics and the actual situation of each province and to promote the healthy operation of the internal circulation of tourism in China. This paper also tries to show the changes of domestic tourism market hot spots, agglomeration conditions changes before and after the outbreak and the clarity of tourists’ preference space changes. Originality/value: Scale of domestic tourists; Absolute difference; Relative difference; Spatial hot spot distribution; Spatial agglomeration change 本文旨在探寻疫情影响下中国大陆城市游客规模演化规律, 具体而言, 疫情影响下, 全国及七大地理分区的国内游客量规模变化如何？七大地理地区的变化有何差异？以及疫情影响下, 全国国内游客空间规模的热点区域和空间集聚程度有何变化？ 利用2018-2021年中国大陆337各城市的国内游客量数据, 借助极差、标准差、变异系数、赫芬达尔指等指标分析全国及七大地理分区国内游客规模的绝对差异和相对差异; 借助核密度分析、空间自相关分析等ArcGIS分析工具, 探寻疫情影响下全国国内游客空间规模的热点区域和空间集聚程度的变化情况。 ①绝对差异方面, 七大地理分区的绝对差异均持续增大。西南地区的游客量的绝对差异巨大, 国内游发展极不均衡。西北地区、东北地区绝对差异相对较小, 在吸引国内游客方面发展较为均衡。②相对差异方面, 西南地区的国内游发展相对差异较大, 发展不均衡趋势明显; 东北地区、西北地区、华东地区的国内游发展相对差异较小, 发展较为均衡。③热点区域变化方面, 京津冀地区、长三角地区的国内旅游热度持续下降, 在2021年有所回升; 内陆西南地区在2021年成为新的国内游热点区域。④2018年至2021年城市国内游客量规模均呈现出显著的空间正相关的关系, 存在着空间集聚现象, 但部分区域集聚类型在2018到2021年间发生变化。 ①理论意义：明晰了疫情对中国国内旅游人次的数量规模和空间规模的影响, 弥补了当前疫情前后国内旅游业变化对比的研究; 阐明了疫情前后中国城市国内游客空间格局的变化, 拓展了研究情景, 丰富了中国旅游业时空变化的相关研究。②实践意义：明晰了疫后不同地区国内旅游人次的数量规模和空间规模变化情况, 以及国内旅游市场热点变化和游客空间偏好变化, 有利于各地区城市对症下药, 制定符合各省份实际情况的国内旅游业振兴策略, 促进中国旅游业内循环。

Feelings about local foods are thought to affect visitor perceptions of destination images. This research used content and statistical analysis of 2887 reviews of food posted on Tripadvisor by international tourists to Beijing. A conceptual model was constructed of the process of food perceptions. Country of origin influenced overall perceptions of food and dining in China's capital. Subsequently, international tourists from 45 countries were divided into groups based on economic levels, cultures, and geographic regions, and differences in food perceptions were further analyzed. The economic levels of countries significantly influenced taste preferences, service perceptions, and negative emotions, and cultural backgrounds affected dining reasons, flavor and restaurant location perceptions. However, it was found that the geographical regions of visitors did not significantly impact food perceptions. The research findings have reference value for destination food marketing strategies.

Technology has been gradually and widely applied to the hotel industry. Nevertheless, even though the impact of cultural values on technology adoption has been explored by previous studies, how individual-level cultural values affect hotel technology adoption was overlooked by prior studies. Hence, to bridge the aforementioned gap, the present study identifies the effects of cultural values on the acceptance of hotel technology adoption from the perspective of hotel employees. A questionnaire survey was adopted to collect data from employees currently working in the hotel industry in the U.S. To investigate the impacts of individual-level cultural values (i.e., collectivism, power distance, long-term orientation, uncertainty avoidance, and masculinity) on the technology acceptance model (i.e., perceived usefulness, perceived ease of use), structural equation modeling was applied to test and validate the seven-factor construct. The main practical implication of the present study is the consideration of cultural values on the implementation of new hotel technologies to accelerate their successful adoption.

ABSTRACTAlthough stakeholder theory has been advocated as an ideal concept for heritage tourism development, conflicts among different parties always exist. Nonetheless, a limited number of studies have addressed this issue. Hence, the present study analyses different stakeholders’ perception of the attributes regarding the development of heritage tourism sites in China and their satisfaction level. Findings discover the conflicts occurring in such development by investigating the dominating stakeholders (i.e. tourists, local residents and tourism-related service personnel) in five selected heritage tourism sites. This study suggests the coordination mechanism to solve the conflict of interest among stakeholders. The coordination mechanism includes multi-party coordination, improving the training and compensation system and encouraging participation in the development of heritage tourism sites.

IMPORTANCE: Metagenomic deep sequencing (MDS) demonstrates that persistent and active rubella virus (RV) infection is associated with Fuchs heterochromic iridocyclitis (FHI). OBJECTIVE: To assess the utility of MDS in identifying RV infection in patients with uveitis. DESIGN, SETTING, AND PARTICIPANTS: This case series assessed 6 patients diagnosed by MDS with RV-associated uveitis at a tertiary uveitis referral center in the United States. EXPOSURES: Prior RV infection. MAIN OUTCOMES AND MEASURES: Clinical examination findings, slitlamp photography, corneal confocal imaging, and infectious pathogen genome obtained from RNA sequencing. RESULTS: Six white men (age range, 36-61 years) were diagnosed with RV-associated uveitis by MDS. Three patients exhibited iris heterochromia associated with their uveitis in classic FHI fashion. The other 3 patients had less classic FHI features and exhibited anterior vitritis. Three patients had in vivo corneal confocal microscopy, with 2 demonstrating stellate keratic precipitates in addition to endothelial infiltration, spotlike holes, and enlarged intercellular boundaries. Of these 3 patients, 1 patient exhibited polymorphism and polymegathism of the endothelial cells. CONCLUSIONS AND RELEVANCE: These findings suggest that persistent RV infection is associated with recurrent or chronic anterior or anterior-intermediate uveitis as well as corneal endothelial cell damage. Ophthalmologists should consider RV infection as a potential cause of hypertensive anterior and intermediate uveitis.

BackgroundToxoplasma gondiiis the most common infectious cause of posterior uveitis worldwide. Two multicopy targets (B1 and Rep529) are commonly used in T. gondiiPCR assays, but studies evaluating these targets in ocular fluid samples are limited. Herein, we determine the analytical characteristics of a single-reaction, internally controlled, dual-target, real-time T. gondiiPCR and evaluate the clinical performance of this assay in intraocular fluid samples obtained at a reference ophthalmologic centre in the USA.MethodsLower limits of detection for the B1 and Rep529 components of the dual-target assay were determined using serial dilutions of cultured T. gondiistrain Z185. The dual-target assay was then used to test 148 archived intraocular samples (132 vitreous,16 aqueous humour) collected at the Francis I. Proctor Foundation between January 2010 and December 2015 for testing by a nested, conventional PCR targeting the B1 gene.ResultsThe 95% lower limits of detection for the dual-target assay was determined to be 1.05 tachyzoites/mL for B1 and 0.83 tachyzoites/mL for Rep529. Using archived clinical intraocular specimens, the dual-target assay demonstrated 97.2% positive per cent agreement (n=35/36; 95% CI 83.7% to 99.9%) and 99.1% negative per cent agreement (n=111/112; 95% CI 94.4% to 100%) compared with the nested, conventional B1 PCR.ConclusionThis single-reaction, internally controlled, dual-target (B1, Rep529) real-time PCR for the detection of T. gondiiDNA in intraocular specimens demonstrated excellent agreement with nested, conventional, B1 PCR. The dual-target design may ensure T. gondiidetection when variation is present in one of two target regions.

Soil erosion has become a major global environmental problem and is particularly acute on the Loess Plateau (LP), China. It is therefore highly important to control this process in order to improve ecosystems, protect ecological security, and maintain the harmonious relationship between humans and nature. We compared the effects of rainfall and land use (LU) patterns on soil erosion in different LP watersheds in this study in order to augment and improve soil erosion models. As most research on this theme has so far been focused on individual study areas, limited analyses of rainfall and LU patterns on soil erosion within different- scale watersheds has so far been performed, a discrepancy which might influence the simulation accuracies of soil erosion models. We therefore developed rainfall and LU pattern indices in this study using the soil erosion evaluation index as a reference and applied them to predict the extent of this process in different-scale watersheds, an approach which is likely to play a crucial role in enabling the comprehensive management of this phenomenon as well as the optimized design of LU patterns. The areas considered in this study included the Qingjian, Fenchuan, Yanhe, and Dali river watersheds. Results showed that the rainfall erosivity factor (R) tended to increase in these areas from 2006 to 2012, while the vegetation cover and management factor (C) tended to decrease. Results showed that as watershed area increased, the effect of rainfall pattern on soil erosion gradually decreased while patterns in LU trended in the opposite direction, as the relative proportion of woodland decreased and the different forms of steep slope vegetation cover became more homogenous. As watershed area increased, loose soil and craggy terrain properties led to additional gravitational erosion and enhanced the effects of both soil and topography.

Tomato (Solanum lycopersicum) plants are susceptible to infection by root-knot nematodes, which cause severe economic losses. Planting resistant tomato plants can reduce nematode damage; however, the effects of resistant tomato root exudates in suppressing Meloidogyne incognitaremain insufficiently understood. Here, we determined that the resistant tomato plant Lycopersicon esculentumcv. Xianke-8 (XK8) alleviates nematode damage by downregulating the expression of the essential parasitic nematode gene Mi-flp-18to reduce the infection and reproduction of M. incognita. Using gas chromatography–mass spectrometry, we identified vanillin as a unique compound (compared to susceptible tomato cultivars) in XK8 root exudates that acts as a lethal trap and inhibitor of egg hatching. Moreover, the soil application of 0.4–4.0 mmol/kg vanillin significantly reduced galls and egg masses. The parasite gene Mi-flp-18was downregulated upon treatment with vanillin, both in vitroand in pot experiments. Collectively, our results reveal an effective nematicidal compound that can use in feasible and economical strategies to control RKNs.

The Loess Plateau, which is located in the arid and semi-arid areas of China, experiences significant soil erosion due to intense human activities and soil erodibility. It is necessary to explore and identify the land-use types or land-use patterns that can control soil erosion and achieve certain agricultural production capabilities. This study established runoff plots with two slope gradients (5° and 15°) in north of Yan'an, one area of the Loess Plateau, with 3 single land-use types (cultivated land, CL; switchgrass, SG; and abandoned land, AL) and 2 composite land-use types (CL-SG and CL-AL). From 2006 to 2012, we continuously monitored the rainfall characteristics, runoff depth, soil loss, vegetation coverage, and soil physical properties. The results indicated a general trend in the number of runoff and soil loss events for the 5 land-use types: CL = CL-SG > CL-AL > SG> AL. The general trend for runoff depth, soil loss, their magnitudes of variation, and the slopes of rainfall-runoff regression equation was CL > CL-SG > CL-AL > SG > AL, whereas the rainfall threshold for runoff generation exhibited the opposite trend. Results of nonparametric test regarding runoff depth/EI30and soil loss/EI30, where EI30is the product of rainfall kinetic energy and the maximum rainfall intensity over 30 min, and the runoff depth-soil loss relationship regression indicated that the effect of CL-AL was similar to that of SG; SG was similar to AL; and CL-AL, SG, and AL were superior to CL with regard to soil and water conservation. Runoff depth and soil loss significantly increased as the slope gradient increased. Runoff depth and soil loss were significantly correlated with the soil particle size composition and bulk density, respectively. The strongest significant correlations were found between runoff depth and vegetation coverage as well as between soil loss and vegetation coverage, which showed that vegetation coverage was the primary factor controlling soil erosion. Therefore, the composite land-use type CL-AL and the artificial grassland (SG) are appropriate options because both soil conservation and a certain degree of agricultural production are necessary in the study area.

An aspartic acid-functionalized water-soluble perylene bisimide, N,N′-di(2-succinic acid)-perylene-3,4,9,10-tetracarboxylic bisimide (PASP) was synthesized and characterized. It has absorbance maximum A0–0and A0–1at 527 and 498 nm (ε ≈ 1.7 × 104L cm–1mol–1) respectively in pH 7.20 HEPES buffer. Two quasi-reversible redox processes with E1/2at −0.17 and −0.71 V (vs Ag/AgCl) respectively in pH 7–12.5 aqueous solutions. PASP can react with Na2S in pure aqueous solution to form monoanion radical and dianion species consecutively. PASP–•has EPR signal with g= 1.998 in aqueous solution, whereas PASP2-is EPR silent. The monoanion radical formation is a first-order reaction with k= 8.9 × 10–2s–1. Dianion species formation is a zero-order reaction and the rate constant is 4.3 × 10–8mol L–1s–1. The presence of H2O2greatly increases the radical formation rate constant. PASP as a two-electron transfer reagent is expected to be used in the water photolysis.

A heart of gold: Au@polymer nanostructures with hydrophobic mesoporous shells show tunable permeability and Au cores with adjustable diameters. This nanocomposite exhibits selective catalytic activity for hydrophobic molecules.

Herz aus Gold: In Au@Polymer‐Nanostrukturen können die Permeabilität der hydrophoben mesoporösen Schale und der Durchmesser des Goldkerns eingestellt werden. Die Nanokomposite wirken als selektive Katalysatoren für hydrophobe Moleküle.

A highly adaptable polycarboxylate superplasticizer (PCE-2) was synthesized by free radical copolymerization in aqueous solution with isoprenol polyoxyethylene ether as macromonomer, acrylic acid and hydroxyethyl acrylate and 2-methacryloyloxyethyl phosphate as unsaturated monomers, mercaptopropionic acid as chain transfer agent, hydrogen peroxide - Bruggolite FF6/ferrous sulfate heptahydrate as redox initiator. The structure of the copolymer was characterized by IR and GPC. The adaptability of the copolymer to concrete was studied from four aspects, such as dosage, water consumption, temperature and clay content. The results show that adaptability of the PCE-2 is better than those of the commercially available Polycarboxylate Superplasticizer (PCE-1).