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Background: Moral distress seriously affects professional nurses, and a number of instruments have been developed to measure the level of moral distress. The moral distress thermometer (MDT) is one of the commonly used instruments that can rapidly measure real-time moral distress; however, it remains unclear whether it is still useful in the Chinese cultural context. Aim: This study aimed to adapt and validate the MDT among Chinese registered nurses. Research design: An online, cross-sectional, survey study of adapting and validating Chinese version of MDT. Participants and research context: A total of 182 registered nurses effectively finished this survey. The correlation between MDT score and the score of the moral distress scale-revised version (MDS-R) was used for evaluating convergent validity, and MDT scores of registered nurses who working in different departments and who made different actions to the final question of the MDS-R were compared by using one-way ANOVA to evaluate construct validity. Ethical considerations: The Ethics Committee of Chongqing Traditional Chinese Medicine Hospital approved this study. Results: The Chinese version of MDT was described as relevant to measure moral distress, with a reported item-level content validity index (I-CVI) and scale-level CVI (S-CVI) of 1. The mean MDT score and mean MDS-R score were 2.54 and 38.66, respectively, and the correlation between these two scores was significantly moderate (r = 0.41). Nurses working different departments reported different levels of moral distress, and those working in intensive care unit reported the highest level of moral distress than those working in other departments (p = 0.04). The MDT scores between nurses who presented different actions to their position were also significantly different, and those who had ever left and those who had considered leaving but did not leave reported significantly higher moral distress. Conclusion: The MDT is a reliable, valid, and easy-to-use instrument to rapidly measure the real-time moral distress of registered nurses in China. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been present globally for more than three years, and cross-border transmission has played an important role in its spread. Currently, most predictions of COVID-19 spread are limited to a country (or a region), and models for cross-border transmission risk assessment remain lacking. Information on imported COVID-19 cases reported from March 2020 to June 2022 was collected from the National Health Commission of China, and COVID-19 epidemic data of the countries of origin of the imported cases were collected on data websites such as WHO and Our World in Data. It is proposed to establish a prediction model suitable for the prevention and control of overseas importation of COVID-19. Firstly, the SIR model was used to fit the epidemic infection status of the countries where the cases were exported, and most of the r2 values of the fitted curves obtained were above 0.75, which indicated that the SIR model could well fit different countries and the infection status of the region. After fitting the epidemic infection status data of overseas exporting countries, on this basis, a SIR-multiple linear regression overseas import risk prediction combination model was established, which can predict the risk of overseas case importation, and the established overseas import risk model overall P <0.05, the adjusted R2 = 0.7, indicating that the SIR-multivariate linear regression overseas import risk prediction combination model can obtain better prediction results. Our model effectively estimates the risk of imported cases of COVID-19 from abroad. [ABSTRACT FROM AUTHOR]

The occurrence of slope instability disasters seriously endangers the safety of people's lives and property in China. Therefore, it is essential to study the slope instability process and the interaction between soil and retaining walls. In this paper, the smoothed-particle hydrodynamics (SPH) method, based on the elastoplastic constitutive model of rock and soil, was used to simulate the entire process of slope instability and the interaction between soil and retaining walls. The model, based on the classical elastic–plastic theory, includes linear elastic deformation and plastic deformation following the non-associated flow rule under the Drucker–Prager (DP) yield criterion. By considering the plastic characteristics of geotechnical materials, this method can accurately simulate the slope movement process. The model was established, calculated, and compared with a slope example, thus verifying its feasibility. Furthermore, the motion response of the retaining wall under different conditions was studied, which provides a new numerical simulation platform for the stability checking of the retaining wall and motion analysis after the interaction between the retaining wall and slope soil. [ABSTRACT FROM AUTHOR]

• The LCPCP has significantly reduced the carbon intensity of pilot cities. • Secondary-industry-heavy locations reduced carbon more effectively. • The LCPCP achieved carbon emission reductions through technological innovation. • The mechanism of technological innovation was mainly concentrated in the eastern region. • Our findings assist policymakers create better climate governance and low-carbon economic development. The low-carbon pilot cities policy (LCPCP) aims to stimulate economic growth and ensure the attainment of greenhouse gas emission reduction targets to address climate change. China issued the LCPCP in 2010 and steadily expanded the size of its pilot zones. This study builds a quasi-natural experiment based on China's LCPCP and a difference-in-difference model employing urban carbon intensity data over a 10-year period beginning in 2007 to examine the implementation repercussions of the LCPCP. According to the findings, the LCPCP has significantly reduced the carbon intensity of pilot cities. Additionally, an analysis of heterogeneity suggests that the LCPCP is more prevalent in regions with higher concentrations of secondary industries. Moreover, the mechanism reveals that the decarbonization program reduces carbon intensity through technological innovation, particularly in eastern China. In conclusion, our findings provide strong support for the operation and promotion of China's LCPCP as well as guidance and support for China's goal of reducing carbon emissions. [ABSTRACT FROM AUTHOR]

The Yellow River Basin (YRB) is an important region for both ecological and economic growth in China, and a healthy and stable ecological environment is fundamental to achieving high-quality development. Investigating the spatio-temporal changs of vegetation carbon sinks in the YRB is necessary to improve understanding of the regional carbon cycle. This study analyzed the YRB using the Google Earth Engine (GEE) platform. The basin was divided into sections based on ecological function regionalization schemes. We applied Theil-Sen median trend analysis and Spearman correlation analysis, along with the lasso regression model, to examine the NPP's temporal and spatial patterns and its driving factors in these regions. The objective was to examine the NPP' s temporal and spatial patterns and its driving factors in these regions, identifying commonalities within regions and differences between regions, while analyzing in a targeted manner the lack of vegetation carbon sequestration in ecological areas. This study highlighted the importance of ecological engineering in ecological civilization and carbon neutrality, providing scientific theoretical support and a decision-making basis for the realization of carbon neutrality. The research results indicate significant upward trends (p <0.001) in both the average annual NPP (AANPP) growth rate (57.98%) and the total annual NPP (TANPP) growth rate (41.9%) in the YRB from 2001 to 2020. The multi-year average NPP (MYANPP) exhibit a spatial distribution with high values in the south and low values in the north. The spatial distribution of NPP exhibits notable spatial aggregation and heterogeneity, where regions demonstrating improvement trends constitute 93.01% of the area, and approximately 79.73% of this region displays low volatility. A high-value area is concentrated in the Agroecological Zone of the Fenwei Basin (I-11), the Loess Plateau Agriculture and Grassland Ecological Zone (I-12), and the Qinba Mountains Deciduous and Evergreen Broad-leaved Forest Ecological Zone (I-15), with significant spatial differences. Temperature, precipitation, and forests are the foremost elements affecting NPP in the YRB, exhibiting positive correlations. Conversely, farmland displays negative correlations. Overall, NPP shows an increasing trend in all ecological function areas, and the NPP of the YRB shows a trend of improvement as a whole, as the ecological environment of the YRB has improved significantly. • Significant differences in NPP were observed among ecological functional zones. • The vegetation condition of the Yellow River Basin has been improved continuously. • Population, temperature, precipitation, forest were the main driving factor of NPP. • The average annual NPP and the total annual NPP increased significantly. [ABSTRACT FROM AUTHOR]

Background: Posterior spinal fusion (PSF) for the correction of idiopathic scoliosis is associated with severe postoperative pain. Erector spinae plane block (ESPB) has been proposed to provide analgesia and reduce opioid consumption. We aimed to investigate the effect of bilateral ultrasound-guided single-shot ESPB on postoperative analgesia in pediatric patients undergoing PSF., Methods: This double-blinded, randomized controlled trial will enroll 74 AIS patients undergoing elective PSF. Participants will be assigned to the ESPB group or control group at a 1:1 ratio. Patients in the ESPB group will receive ultrasound-guided bilateral ESPB preoperatively, and patients in the control group received sham ESPB using normal saline. The primary joint endpoints are the area under the curve (AUC) of numerical rating scale (NRS) score and opioid consumption in postoperative 24 h. The secondary endpoints are numerical rating scale (NRS) score and opioid consumption at postoperative 0.5, 3, 6, 9, 12, 24, 36, and 48 h, rescue analgesia, recovery outcomes, and adverse events., Discussion: At present, studies investigating the effect of ESPB on pediatric patients are still needed. This study focuses on the effect of ESPB on pediatric patients undergoing PSF on postoperative pain control and intends to provide a new strategy of multimodal analgesia management for major spine surgery., Trial Registration: Chinese Clinical Trial Registry ChiCTR2300074505. Registered on August 8, 2023., (© 2024. The Author(s).)

Diarrhea and constipation are common health concerns in children. Numerous studies have identified strong association between gut microbiota and digestive-related diseases. But little is known about the gut microbiota that simultaneously affects both diarrhea and constipation or their potential regulatory mechanisms. Stool samples from 618 children (66 diarrhea, 138 constipation, 414 healthy controls) aged 0-3 years were collected to investigate gut microbiota changes using 16S rRNA sequencing. Compared with healthy, children with diarrhea exhibited a significant decrease in microbial diversity, while those with constipation showed a marked increase (p < 0.05). Significantly, our results firstly Ruminococcus increased in constipation (p = 0.03) and decreased in diarrhea (p < 0.01) compared to healthy controls. Pathway analysis revealed that Ruminococcus highly involved in the regulation of five common pathways (membrane transport, nervous system, energy metabolism, signal transduction and endocrine system pathways) between diarrhea and constipation, suggesting a potential shared regulatory mechanism. Our finding firstly reveals one core microorganisms that may affect the steady balance of the gut in children with diarrhea or constipation, providing an important reference for potential diagnosis and treatment of constipation and diarrhea., (© 2024. The Author(s).)

Purpose: The primary objective of this study was to evaluate how the utilization of virtual surgical planning (VSP) and the epidemiological profile of patients undergoing orthognathic surgery (OGS) have changed in the past decade., Methods: The records of patients who had undergone orthognathic surgery at a national dental hospital were reviewed. Trends in VSP, epidemiological data, presentation of dentofacial deformity, and management details were recorded., Results: A total of 1184 patients were included in this study. The majority of the patients seeking treatment in this dental hospital were young Chinese adults with dentofacial deformities requiring bimaxillary surgeries. Most patients presented with a skeletal Class III pattern (79.0%), and asymmetry was diagnosed in 80.8% of all cases., Conclusion: There was an initial slow pick-up rate for VSP, but this rapidly increased to a high adoption rate of 98.7-100% between 2019 and 2021. Together with an increasing body of evidence suggesting greater accuracy in VSP, utilization in this technology can be enhanced with greater familiarity with the technology and improvements in the VSP services., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: The long-term effect of neighborhood poverty on internalizing symptoms in adolescents and the biological mechanisms underlying this association remain unclear. We defined neighborhood poverty at the village level in two dimensions: intensity (i.e., poverty rate) and duration. This study investigated how the poverty rate and duration of exposure to neighborhood poverty interact to predict internalizing symptoms in adolescents through biological mechanisms (i.e., allostatic load and early pubertal timing)., Methods: A total of 418 adolescents (50.2% girls; 11-14 years old; mean age = 12.57 years) living in rural China participated in two waves of data collection. Path analysis was conducted to examine the mediating role of allostatic load and pubertal timing in the relationship between the duration of exposure to neighborhood poverty and internalizing symptoms. Moreover, the interactive effect between the poverty rate and duration of neighborhood poverty on the allostatic load was tested., Results: The positive association between the duration of exposure to neighborhood poverty and internalizing symptoms of adolescents was explained by elevated allostatic load and early pubertal timing after adjusting for gender, age, prior family socioeconomic states and internalizing symptoms. The duration in neighborhood poverty was a stronger predictor of allostatic load for adolescents living in high poverty rate neighborhoods than for those living in low poverty rate neighborhoods., Discussion: Neighborhood poverty gets "under the skin" through biological pathways and affects internalizing symptoms among adolescents. The findings highlight the importance of considering different dimensions of neighborhood poverty (e.g., intensity and duration) on adolescents' health., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Malignant cerebral edema (MCE) is a severe condition characterized by rapid neurological deterioration and a potentially poor prognosis. Scoring systems including the malignant brain edema (MBE) score, Enhanced Detection of Edema in Malignant Anterior Circulation Stroke score (EDEMA), and modified EDEMA score, have been developed to predict MCE in patients with large hemispheric infarction (LHI). We aimed to externally validate and comparethe predictive efficacy of these scores in LHI patients within 48 h of onset and not undergoing reperfusion therapy., Methods: Demographic, clinical and radiological data were retrospectively collected from LHI patients within 48 h of onset and not receiving reperfusion therapy. Patients were divided into MCE and non-MCE group. The calibration, discrimination, and clinical practicability of the three scores were verified using Hosmer-Lemeshow goodness-of-fit test, receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA), respectively. Finally, continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were applied to determine the discrimination performance of the three scores., Results: A total of 314 patients were included in the study, with 122 cases being MCE patients. The Hosmer-Lemeshow goodness-of-fit test showed excellent fitting ability across the MBE (p = 0.36), EDEMA (p = 0.61), and modified EDEMA scores (p = 0.62) in our patients. The MBE, EDEMA, and modified EDEMA scores had the AUCs of 0.855 (95 % CI 0.818-0.898), 0.782 (95 % CI 0.727-0.837) and 0.878 (95 % CI 0.844-0.919) respectively. The MBE (NRI, 0.33; 95 % CI, 0.11-0.56, p = 0.003 and IDI, 0.11; 95 % CI, 0.03-0.18; p = 0.004) and modified EDEMA scores (NRI, 1.10; 95 % CI, 0.94-1.26; p < 0.001 and IDI, 0.17; 95 % CI, 0.13-0.20, p < 0.001) showed better performance than the EDEMA score. DCA demonstrated that the modified EDEMA score outperformed the other two scores, possessing heightened clinical usefulness., Conclusions: The MBE, EDEMA, and modified EDEMA scores for predicting MCE are also applicable in non-revascularization LHI patients within 48 h of onset. Both the MBE and modified EDEMA scores demonstrated higher predictive validity as predictive tools for MCE in LHI patients than the EDEMA score. Furthermore, the modified EDEMA score could be a suitable prediction tool in Chinese patients for its excellent clinical utility., 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 © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The mechanisms underlying the distribution of many toxic metal(loid)s in shoots and metal(loid) transport to grains have been well documented in the quest for food safety but there remains a lack of knowledge on thallium (Tl) accumulation in food crops. Here, field investigations combined with a glasshouse pot experiment were conducted to investigate the characteristics of Tl distribution and accumulation in coix, a major food crop in south Guizhou province, China, and the role of node I in restricting Tl transport to the seed. Fourteen percent of coix seed samples collected from the Lanmuchang Tl-As-Hg mine contained higher Tl concentrations than the recommended limit for foods and feedstuffs in Germany (0.5 mg kg -1 ), with the highest exceedance rate of the metal(loid)s determined, when grown in soils surrounding the mine with a very high Tl concentration of 0.07-89.5 mg kg -1 and a general low pH of 4.19-6.48. Thallium concentrations were higher in coix nodes than in internodes, followed by roots and grains. The Tl translocation factors from node I to grains were 0.01-0.21 and were the lowest of any translocation factors between different tissues. Node I is therefore the key tissue restricting Tl transport to coix grains. Thallium was localized mainly in the diffuse vascular bundles (DVBs) in node I. The co-localization of Tl and sulfur in the DVBs and Tl contamination-induced phytochelatin (PC) accumulation indicate that Tl storage in the DVBs involving complexation with PCs in node I is an important process in Tl accumulation in coix grains. Moreover, the area of DVBs in node I increased with increasing soil Tl pollution level, providing more channels for Tl transport to the panicles and grains and thereby acting as a key factor restricting Tl transport to the grains. These results provide new insights into the key role of node I in Tl accumulation in coix grains and indicate key points to minimize Tl accumulation in grains for food safety., 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 © 2023. Published by Elsevier B.V.)

Ticks act as vectors and hosts of numerous arboviruses. Examples of medically important arboviruses include the tick-borne encephalitis virus, Crimean Congo hemorrhagic fever, and severe fever with thrombocytopenia syndrome. Recently, some novel arboviruses have been identified in blood specimens of patients with unexplained fever and a history of tick bites in Inner Mongolia. Consequently, tick-borne viruses are a major focus of infectious disease research. However, the spectrum of tick-borne viruses in subtropical areas of China has yet to be sufficiently characterized. In this study, we collected 855 ticks from canine and bovine hosts in four locations in Hainan Province. The ticks were combined into 18 pools according to genus and location. Viral RNA-sequence libraries were subjected to transcriptome sequencing analysis. Molecular clues from metagenomic analyses were used to classify sequence reads into virus species, genera, or families. The diverse viral reads closely associated with mammals were assigned to 12 viral families and important tick-borne viruses, such as Jingmen, Beiji nairovirus, and Colorado tick fever. Our virome and phylogenetic analyses of the arbovirus strains provide basic data for preventing and controlling human infectious diseases caused by tick-borne viruses in the subtropical areas of China., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)