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The threat of microplastics to marine animals and habitats is increasing, which may affect sea turtle nesting grounds. The Qilianyu Islands are the largest remaining green turtle (Chelonia mydas) nesting grounds in China. Despite being far from the mainland, microplastic pollution cannot be ignored. In this study, the level of microplastic pollution in surface sediments from three different zones, namely, the bottom, intertidal, and supratidal zone, was investigated on North Island, Qilianyu Islands. The results showed that the abundance of microplastics in the supratidal zone was significantly higher than that in the bottom zone and intertidal zone (r = 3.65, p = 0.011), with the highest average abundance of microplastics located on the southwest coast of North Island. In the bottom zone, only plastic blocks (88%) and fibers (12%) were found. The main types of microplastics in the intertidal and supratidal zones were plastic blocks (48%) and foam (42%), with polyethylene (PE) (40%) and polystyrene (PS) (34%) being the predominant components. These types and components of microplastics differed from those in the surrounding seawater, but corresponding types and components were found in the plastic debris on the beach. Meanwhile, it was also observed that there were multiple instances of fragmented plastic on the beach. Thus, we suggest that the microplastics on the beach in North Island were mainly derived from the fragmentation of microplastic debris, indicating secondary microplastics. It is recommended to further strengthen the regular cleaning of plastic debris on the beach, especially the removal of small plastic debris, in order to reduce the pollution from secondary microplastics generated by the fragmentation of beach plastic debris and to better protect China's most important sea turtle nesting site in the South China Sea. [ABSTRACT FROM AUTHOR]

Introduction: Streptococcus pneumoniae is an important human pathogen that may cause severe invasive pneumococcal diseases (IPDs) in young children and the elderly. A comprehensive comparative whole-genome analysis of invasive and non-invasive serotype strains offers great insights that are applicable to vaccine development and disease control. Methods: In this study, 58 invasive (strains isolated from sterile sites) and 71 non-invasive (serotypes that have not been identified as invasive in our study) pneumococcal isolates were identified among the 756 pneumococcal isolates obtained from seven hospitals in Zhejiang, China (2010-2022). Serotyping, antimicrobial resistance tests, and genomic analyses were conducted to characterize these strains. Results and discussion: The three most invasive serotypes were 23F, 14, and 6B. The invasive pneumococcal isolates' respective resistance rates against penicillin, ceftriaxone, tetracycline, and erythromycin were 34.5%, 15.5%, 98.3%, and 94.7%. Whole-genome sequencing indicated that the predominant invasive clonal complexes were CC271, CC876, and CC81. The high rate of penicillin non-susceptible Streptococcus pneumoniae (PNSP) is related to the clonal distribution of resistance-conferring penicillin-binding proteins (PBP). Interestingly, we found a negative correlation between invasiveness and resistance in the invasive pneumococcal serotype strains, which might be due to the proclivity of certain serotypes to retain their β-lactam resistance. Moreover, the mutually exclusive nature of zmpC and rrgC+srtBCD suggests their intricate and potentially redundant roles in promoting the development of IPD. These findings reveal significant implications for pneumococcal vaccine development in China, potentially informing treatment strategies and measures to mitigate disease transmission. [ABSTRACT FROM AUTHOR]

Background: Female nurses have been considered as a vulnerable population in the context of mental health, due to the nature of their work, which can be stressful and emotionally taxing. Understanding the relationship between depressive symptoms and quality of work life (QWL) can contribute to improving mental health and job performance. However, limited studies have focused on the effect of depressive symptoms on QWL in female nurses. Objectives: The present study aimed to assess the effect of depressive symptoms on female nurses’ QWL using propensity score matching (PSM). Methods: A cross-sectional, online study using convenience sampling was conducted among 1,401 female nurses in China. PSM was used to minimize the impact of potential confounders between no depressive symptoms and depressive symptoms. Stepwise multiple linear regression analyses were performed on the PSM samples to explore the effects of depressive symptoms on the QWL. Results: The results revealed there were 33.5% of the female nurses reported depressive symptoms before PSM. And female nurses in this study had a moderate level of QWL before PSM (122.11  ±  18.15), which remained steady after PSM (118.33  ±  18.04). After PSM, the final sample contained 864 female nurses. Stepwise multiple linear regression results indicated that depressive symptoms were the most strongly associated with QWL (β   = −0.454, p  <  0.001). Conclusion: This study highlights the importance of developing mental health plans and psychological interventions for female nurses to maintain mental health and QWL, which is critical to the nursing workforce’s sustainability. [ABSTRACT FROM AUTHOR]

Modern geodetic technologies, including high-precision ground-based gravity measurements, satellite gravimetry, satellite altimetry, Global Navigation Satellite Systems (GNSS), and Interferometric Synthetic Aperture Radar(InSAR), offer a wealth of observations for monitoring global hydrological processes with exceptional accuracy and spatio-temporal resolutions. Mass redistribution and Earth's surface deformation over land related to global and regional water cycling can be inferred from modern gravimetry, altimetry, GNSS, and InSAR techniques. Hydrogeodesy becomes an emerging field of geodesy aiming to analyze the changes of water in the Earth system. The paper introduces the China's advances in hydrogeodesy in recent years. It brings together multiple geodetic teams' work from China, showcasing the application of modern geodetic technologies in the field of hydrology, including research on terrestrial water storage, groundwater storage, glaciers/ice sheets, and reservoir water storage. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of whole-body vibration training (WBVT) with different frequencies on the balance ability of older adults. Methods: Randomized controlled trials (RCTs) on the WBVT interventions on balance ability in older adults were searched through PubMed, Web of Science, The Cochrane Library, ProQuest, Embase, Opengrey, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (CSTJ) databases from the establishment of the database to August 2022, and all literature that met the PICOS (Participants, Intervention, Comparison, Outcomes, Study design) criteria were enrolled. Two reviewers screened and assessed the methodological quality of the included literature according to the physiotherapy evidence database (PEDro) scale criteria. Statistical analysis was performed using Stata 14.0 software after data extraction.Results: Twenty-five RCTs with a total of 1267 subjects were finally included. The results of the pairwise comparison of the Network Meta-analysis showed that the Timed Up and Go Test (TUGT) values of Low-frequency whole-body vibration training (LF-WBVT) was lower than the placebo and traditional rehabilitation groups, and the difference was statistically significant [WMD = −1.37, 95% CI (−2.53, −0.20)] [WMD = −1.84, 95% CI(-3.17,-0.51)]. The Five-repetition Sit-to-Stand Test (5STS) values of LF-WBVT, Medium-frequency whole-body vibration training (MF-WBVT), and High-frequency whole-body vibration training (HF-WBVT) were lower than the placebo and traditional rehabilitation groups, but none of them were statistically significant. In addition, the TUGT and 5STS values of HF-WBVT had a tendency to be lower than those of LF-WBVT and MF-WBVT, but neither of them was statistically different. The cumulative probability ranking results of both TUGT and 5STS showed that HF-WBVT was the best protocol.Conclusion: Current evidence shows that HF-WBVT may be the best protocol for improving balance in older adults. Due to the study’s limitations, the conclusion obtained in this study still needs to be further confirmed by more high-quality studies. [ABSTRACT FROM AUTHOR]

Objectives: Patient-reported outcomes (PROs) provide a global perspective of patient health status which plays an enormous role in evaluating clinical efficacy. However, the application of PROs in traditional Chinese medicine (TCM) was still insufficiently studied in mainland China. Methods: This cross-sectional study was performed based on interventional clinical trials of TCM that were conducted in mainland China from 1 January 2010, to 15 July 2022. Data was retrieved from the ClinicalTrials.gov and Chinese Clinical Trial Registry. We included interventional clinical trials of TCM for which the country of the primary sponsors or recruitment settings in mainland China. For each included trial, data including clinical trial phases, study settings, participant's age, sex, diseases, and the patient-reported outcome measures (PROMs) were extracted. Trials were categorized into four categories according to 1) listed PROs as primary endpoints, 2) listed PROs as secondary endpoints, 3) listed PROs as coprimary outcomes (both primary and secondary endpoints), and 4) did not mention any PROMs. Results: Among a total of 3,797 trials, 680 (17.9%) trials listed PROs as primary endpoints, 692 (18.2%) trials listed PROs as secondary endpoints, and 760 (20.0%) trials listed PROs as coprimary endpoints. Among 675,787 participants included in the registered trials, 448,359 (66.3%) patients' data were scientifically collected by PRO instruments. Neurological diseases (11.8%), musculoskeletal symptoms (11.5%), mental health conditions (9.1%) were the most common conditions evaluated by PROMs. Disease-specific symptoms related concepts were used most frequently (51.3%), followed by health-related quality of life concepts. Visual analog scale, 36-item Short-Form Health Questionnaire, and TCM symptom score were the most common PROMs in these trials. Conclusion: In this cross-sectional study, the use of PROs increased in the past decades according to clinical trials of TCM conducted in mainland China. Considering that the application of PROs in clinical trials of TCM has some existing issues including uneven distribution and lack of normalized PROs of TCM, further study should be focused on the standardization and normalization of TCM-specific scales. [ABSTRACT FROM AUTHOR]

Background: The risk factors of progestational anxiety, depression, and sleep disturbance in women with a history of recurrent pregnancy loss (RPL) remain controversial, additional study is needed to investigate the incidence and risk factors of progestational anxiety, depression, and sleep quality in RPL women. Methods: A cross-sectional study was conducted among 663 non-pregnant RPL women in Northeast China from October 2019 to July 2022. We assessed the state of anxiety, depression, and sleep quality before pregnancy using structured questionnaires, including sociodemographic characteristics, statetrait anxiety scale (STAI), center for epidemiological survey, depression scale (CES-D), Pittsburgh sleep quality index (PSQI), and symptom self-rating scale (SCL-90). Logistic regression was used to evaluate the association between sleep quality and anxiety, depression. Pearson's correlation was used to evaluate the correlation between anxiety and depression. Multivariate logistic regression analysis was used to find the risk factors of depression symptoms. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of the model. Results: The incidence of state anxiety, trait anxiety, depression, and sleep disturbance in RPL women were 60.3, 51.7, 33.9, and 31.2%, respectively. The level of anxiety and depression in RPL women varied at different stages of treatment. In a longitudinal study (25 pairs), we found the level of state anxiety and trait anxiety were significantly lower after the cause was identified. Sleep disturbance is positively correlated with anxiety and depression. Logistic regression showed that the number of miscarriages =4 (Odds ratio (OR) = 2.268, 95%CI 1.300-3.956), Low household family income (OR = 1.613, 95%CI 1.036-2.513/OR = 2.361, 95%CI 1.095-5.092), interval since last miscarriage <6 months (OR = 2.154, 95%CI 1.246-3.726) and sleep disturbance (OR = 5.523, 95%CI 3.542-8.614) were associated with the occurrence of depressive symptoms. At the same time, anxiety can be used as a predictor of depression. Conclusion: Recurrent pregnancy loss women have a certain degree of anxiety, depression, and sleep disturbance. Education level, interval since the last miscarriage <6 months, and sleep disturbance are risk factors for anxiety and depression. A history of pregnancy loss after 14 weeks and no living birth are also closely related to anxiety. Therefore, it is necessary to pay close attention to the psychological state of RPL women and provide appropriate psychosocial support to reduce the occurrence of negative emotions. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to characterize the genomic epidemiology of human adenoviruses (HAdVs) in Hubei, China, using metagenomic next-generation sequencing (mNGS). Methods: In total, 25 HAdV-positive samples collected from 21 pediatric patients were sequenced and subjected to mNGS using the NextSeq 550 and GenoLab M sequencing platforms. The metagenomic data were assembled de novo for molecular typing, phylogenetic and recombination analyzes. Results: We assembled 50 HAdV genomes, 88% (22/25) genomes from GenoLab M, and 84% (21/25) genomes from NextSeq 550 have perfect alignments to reference genomes with greater than 90%. The most fully assembled 25 genomes were categorized into 7 HAdV genotypes, the most abundant of which were HAdV-B3 (9/25) and HAdV-C2 (6/25). Phylogenetic analyzes revealed that the newly isolated HAdV-B3 strains diverged into separate clusters according to their genotypes. Vigilance is needed that HAdV-B3 isolates have begun to form new distinct clusters. High nucleotide identity was observed in the whole genome level within the same HAdV genotypes, while marked differences of three capsid genes across HAdV genotypes were noted. The high nucleotide diversity regions were concordant with the reported hypervariable regions. Further, three recombinant strains were identified: S64 and S71 originated from the parental strains HAdV-B14 and HAdV-B11, and S28 originated from HAdV-C1, HAdV-C5, and HAdV-CBJ113. GenoLab M and NextSeq 550 showed comparable performance with respect to data yield, duplication rate, human ratio, and assembly completeness. Conclusion: The sequencing quality and assembly accuracy showed that mNGS assembled genomes can be used for subsequently HAdV genotyping and genomic characterization. The high nucleotide diversity of capsid genes and high frequency of recombination events has highlighted the necessity for HAdV epidemiological surveillance in China. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the relationship between carotid stenosis with variants in genes referred to inflammation and endothelial function. Methods: There was a multi-center, cross sectional survey in southwestern China. The eight communities were selected at random in southwestern China. The residents aged >40 years volunteered to participate in face-to-face survey. Subjects with at least three of the aforementioned eight stroke related risk factors or a history of stroke were classified as high-risk population for stroke. A total of 2,377 subjects were the high-risk population for stroke in the eight communities, and degree of carotid stenosis was assessed by carotid ultrasound. Genotypes of 6 variants in 3 genes related to inflammation and endothelial function were examined. Gene-gene interaction was analyzed by generalized multifactor dimensionality reduction (GMDR). Results: Carotid stenosis were found in 295 (12.41%) subjects, of whom 51 (17.29%) had moderate or severe stenosis. According to multivariate logistic regression analysis, we found that HABP2rs7923349TT was independent risk factor for carotid stenosis (OR, 1.96, 95% CI: 1.22-3.13, P = 0.005) and ITGA2rs1991013AG and HABP2rs7923349TT were independent risk factors for moderate to severe carotid stenosis (OR, 2.28, 95% CI: 1.28-4.07, P = 0.005; OR, 2.90, 95% CI: 1.19-7.08, P = 0.019). GMDR analysis showed that there was a significant gene-gene interaction between ITGA2 rs4865756 and HABP2 rs7923349, and the high-risk interactive genotype in the two variants was independently associated with a higher risk for carotid stenosis after adjusting the covariates (OR, 1. 42, 95% CI 1.10-1.84, P = 0.008). Conclusions: Prevalence of carotid stenosis was very high in the high-risk stroke population in southwestern China. Variants in genes referred in endothelial function were associated with the carotid stenosis. The high-- risk interactive genotype in ITGA2 rs4865756 and HABP2 rs7923349 was independently associated with a higher risk for carotid stenosis. [ABSTRACT FROM AUTHOR]

The herpetofauna of the Indomalayan bioregion of Asia suffers from severe habitat loss, unsustainable harvesting, and lack of research and conservation. Here, we investigated the range‐wide phylogeography of the endangered "eyed" turtles (genus Sacalia, including the Beale's Eyed Turtle S. bealei and the Four‐eyed Turtle S. quadriocellata) and discovered a natural interspecific hybrid turtle population in China. Based on phylogeny of the mitochondrial Cytochrome b gene of 101 samples in this study and public data, three major clades and six subclades were identified: S. bealei (SBE) in eastern‐southern China, east S. quadriocellata in South China (northern east [SQUen] and southern east [SQUes] subclades), and west S. quadriocellata mainly in Vietnam (northern west [SQUwn], central west [SQUwc], and southern west [SQUws] subclades). We sequenced 16 nuclear DNA loci of 87 samples from SBE, SQUen, SQUes, and SQUwn subclades. Population genetic clustering analysis suggested a structure similar to the mitochondrial phylogeny, where most samples were classified into four genetic clusters corresponding to the four mtDNA subclades. However, a proportion of samples carrying SQUen mtDNA haplotypes formed an additional distinct cluster SHY. Those samples are found in the contact zone of the two species bearing mosaic and intermediate morphological characteristics. We detected an admixed ancestry in SHY from SBE and SQUen that conformed to an intrapopulation breeding scenario for at least hundreds of generations after the initial hybrid event, leading to a conclusion that SHY is a distinct and near‐panmictic population derived from natural interspecific hybridization. In addition, SQUes (Hainan Island endemic) is of special concern due to significant isolation and low genetic diversity. We suggest that seven evolutionarily significant units should be recognized to facilitate appropriate conservation actions. These findings also highlight the urgent need for further herpetological research and conservation in this region. [ABSTRACT FROM AUTHOR]

Background and purpose: Abdominal obesity (AO) is a well-known independent risk factor for stroke in the general population although it remains unclear in the case of the elderly, especially in Chinese older patients with obstructive sleep apnea (OSA), considering the obesity paradox. This study aimed to investigate the association between AO and stroke among Chinese older patients with OSA. Methods: Data were collected from January 2015 to October 2017, and 1,290 older patients (age 60-96 years) with OSA (apnea-hypopnea index ≥ 5 events/h on polysomnography) were consecutively enrolled from sleep centers at six hospitals, evaluated for AO defined as waist circumference (WC) using the standardized criteria for the Chinese population, and followed up prospectively for a median period of 42 months. Logistic regression and Cox regression analyses were used to determine the cross-sectional and longitudinal associations between AO and stroke risk in these participants and different groups of the severity of OSA. Results: Participants with AO had a higher prevalence of stroke at baseline. A higher incidence of stroke during a median follow-up period of 42 months in participants with AO than in participants without AO (12.4% vs. 6.8% and 8.3% vs. 2.4%, respectively; both P < 0.05) was predicted. Cross-sectional analysis revealed an association between AO and stroke (odds ratio [OR]1.96, 95% confidence interval [CI] 1.31-2.91), which was stronger among participants with moderate OSA only (OR 2.16, 95%CI 1.05-4.43). Cox regression analysis showed that, compared to participants without AO, participants with AO had a higher cumulative incidence of stroke (hazard ratio [HR] 2.16, 95% CI 1.12-4.04) during a median follow-up of 42 months, and this association was observed in patients with severe OSA only (HR 3.67, 95% CI 1.41-9.87) but not for individuals with mild OSA (HR = 1.84, 95% CI 0.43-6.23) and moderate OSA (HR = 1.98, 95% CI 0.73-6.45). Conclusion: The risk of stroke is associated with AO among Chinese older patients who have OSA, both at baseline and during follow-up, and the strength of the association varied by OSA severity. Active surveillance for early detection of AO could facilitate the implementation of stroke-preventive interventions in the Chinese older OSA population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the efficacy of acupuncture, an alternative medicine therapy, as a preventive treatment for menstruationrelated migraine (MRM). Patients and methods: This was a prospective, multicenter, double-dummy, participant-blinded, randomized controlled clinical trial conducted in China between 1 April 2013, and 30 April 2014. The participants were enrolled from four study centers and randomized to into either the acupuncture group, which received 24 sessions of acupuncture at traditional acupoints plus placebo, or the medication group, which received sham acupuncture plus naproxen. The primary endpoint was change from the baseline average number of migraine days per perimenstrual period over cycles 1-3. The secondary endpoints included changes from the baseline average number of migraine days outside the perimenstrual period, mean number of migraine hours during and outside the perimenstrual period, mean visual analog scale score during and outside the perimenstrual period, ≥50% migraine responder rate, and the proportion of participants who used acute pain medication over cycles 1-3 and 4-6. Results: A total of 172 women with MRM were enrolled; 170 in the intentionto-treat analyses. Our primary outcome reported a significant between-group difference that favored the acupuncture group (95% CI, 0.17-0.50; P < 0.001), with the average reduction of migraine days per perimenstrual period from the baseline was 0.94 (95% CI, 0.82-1.07) in the acupuncture group and 0.61 (95% CI, 0.50-0.71) in the medication group over cycles 1-3. Conclusion: This study showed that compared to medication, acupuncture reduces the number of migraine days experienced by patients with MRM. For patients who received the acupuncture treatment over three cycles, the preventive effect of the therapy was sustained for six cycles. [ABSTRACT FROM AUTHOR]

Purpose: Mutation in the USH2A gene is the most common cause of inherited retinal dystrophy (IRD), including non-syndromic retinitis pigmentosa (RP) and Usher syndrome II (USH2). Gene editing and therapy targeting USH2A, especially the hotspot region, would benefit a large proportion of IRD patients. In this study, we comprehensively analyzed the genetic spectrum of the USH2A gene, aiming to identify global hot spot mutations in USH2A-related IRDs and differences in hot spot regions across continents. Materials and methods: A retrospective USH2A-related IRD study was conducted, including our IRD cohort, and reported USH2A studies worldwide. Results: A total of 3,972 mutated USH2A alleles of approximately 1,935 patients were collected from 33 cohort studies worldwide, containing 102 alleles of 51 patients in our IRD cohort. Mutations in exon 13 were the most common, reaching 18.4% globally and a higher frequency of 22% in America, 19.2% in Europe, and a lower 12% in East Asia. Pathogenic mutations that affected 10 of the 72 exons of USH2A, exon 2, exon 13, exon 41-43, exon 50, exon 54, exon 57, exon 61, and exon 63 in total were responsible for half of global USH2A mutant alleles. With base editors including adenine base editor (ABE), cytidine base editor (CBE), and glycosylase base editor (GBE), 76.3% of single nucleotide variations (SNVs) and 58% of all mutations in USH2A are correctable. Meantime, four novel pathogenic mutations were revealed in our IRD cohort, p. (Val1130Cysfs-72), p. (Ala2139fs-14), p. (Gly4139Arg), and p. (Val4166Cysfs-7). Conclusion: In this study, we revealed four novel mutations, expanding the spectrum of USH2A mutations, and importantly presented global hotspot exons and mutations of USH2A as well as the proportion of SNVs that can be restored by different base editors, providing a perspective for exploring high-efficiency and broader-reaching gene editing and gene therapies. [ABSTRACT FROM AUTHOR]

Selection of a representative sampling area for accurate and reliable yield evaluation of wheat (Triticum aestivum L.) is important for optimizing straw retention in soils and its removal as biofuel feedstock. A field experiment was conducted at four wheat fields in the North China in 2020. Wheat straw and grain yields varied from 359.2-682.8 and 338.5-640.4 g m-2, respectively, and plant height varied from 51.3-59.7 cm across all plots in the four sites. Variation in either relative deviation (RD) or standard error (SE) of straw and grain yield and plant height estimates decreased with the increase in random sampling square (RSS) (one square = approximately 1 m) and random sampling plant (RSP) numbers, respectively. Minimum RSS numbers of 3-10 and 1-10 m² were needed to satisfy RD less than 5% in two-third of the plots for straw and grain yield estimates, respectively. This suggests that 10 m² could be recommended as the minimum RSS number per plot. However, the incidence frequency of RD was 63.75% and 60.00% within the RD interval of 0%-5% for straw and grain yield estimates, respectively, from the RSS number of 10 m², indicating that yields from RSSs in field trials are prone to large variations. Therefore, it is strongly recommended to design a large plot as possible and to harvest the whole plot for estimating yields. The threshold RSP number ranged from 14-18 to satisfy RD less than 1.5% and a minimum RSP of 20 plants (including mains and tillers) per plot could be recommended for wheat field experiments. [ABSTRACT FROM AUTHOR]

Background: Freshwater fungi are highly diverse and ecologically important in freshwater systems. In China, more than 1000 species of freshwater fungi are known. Here, we present a brownspored hyphomycetes that was collected on a submerged decaying bamboo culm in a forest stream in China. New information: Phylogenetic analyses of combined LSU, ITS and TUB2 sequences confirm the placement of our new strain in Veronaea (Herpotrichiellaceae), sister to V. japonica. Veronaea aquatica sp. nov. differs from related taxa V. compacta and V. japonica in having longer conidiophores and cylindrical to pyriform or subclavate conidia with 0–2 septa. Veronaea aquatica also has darker brown hyphae compared to V. japonica. A morphological description and detailed illustrations of V. aquatica are provided. [ABSTRACT FROM AUTHOR]

Urban areas demonstrate great influence on precipitation, yet the spatial clustering features of precipitation are still unclear over urban areas. This study quantitatively examines the spatial clustering of precipitation intensity in 130 urban-affected regions over mainland China during 2008-15 using a high-resolution merged precipitation product. Results show that the spatial heterogeneity patterns display diverse distribution and vary with precipitation intensity and urban sizes. Extreme and heavy precipitation has higher spatial heterogeneity than light precipitation over the urban-affected regions of grade 1 cities, and their mean Moran's I are 0.49, 0.47, and 0.37 for the intensity percentiles of ≥95%, 75%-95%, and < 75%, respectively. The urban signatures in the spatial clustering of precipitation extremes are observed in 37 cities (28%),mainly occurring in the Haihe River basin, the Yangtze River basin, and the Pearl River basin. The spatial clustering patterns of precipitation extremes are affected by the local dominant synoptic conditions, such as the heavy storms of convective precipitation in Beijing (Moran's I = 0.47) and the cold frontal system in the Pearl River delta (Moran's I = 0.78), resulting in large regional variability. The role of urban environments for the spatial clustering is more evident in wetter conditions [e.g., relative humidity (RH) > 75% over Beijing and RH > 85% over the Pearl River delta] and warmer conditions (T > 258C over Beijing and T > 288C over the Pearl River delta). This study highlights the urban modification on the spatial clustering of some precipitation extremes, and calls for precautions and adaptation strategies to mitigate the adverse effect of the highly clustered extreme rainfall events. [ABSTRACT FROM AUTHOR]

Background. The coronavirus disease 2019 (COVID-19) pandemic is a major threat to the public. However, the comprehensive profile of suicidal ideation among the general population has not been systematically investigated in a large sample in the age of COVID-19. Methods. A national online cross-sectional survey was conducted between February 28, 2020 and March 11, 2020 in a representative sample of Chinese adults aged 18 years and older. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9. The prevalence of suicidal ideation and its risk factors was evaluated. Results. A total of 56,679 participants (27,149 males and 29,530 females) were included. The overall prevalence of suicidal ideation was 16.4%, including 10.9% seldom, 4.1% often, and 1.4% always suicidal ideation. The prevalence of suicidal ideation was higher inmales (19.1%) and individuals aged 18-24 years (24.7%) than in females (14.0%) and those aged 45 years and older (11.9%). Suicidal ideation was more prevalent in individuals with suspected or confirmed infection (63.0%), frontline workers (19.2%), and people with pre-existing mental disorders (41.6%). Experience of quarantine, unemployed, and increased psychological stress during the pandemic were associated with an increased risk of suicidal ideation and its severity. However, paying more attention to and gaining a better understanding of COVID-19-related knowledge, especially information about psychological interventions, could reduce the risk. Conclusions. The estimated prevalence of suicidal ideation among the general population in China during COVID-19 was significant. The findings will be important for improving suicide prevention strategies during COVID-19. [ABSTRACT FROM AUTHOR]

The variability of the lower tropospheric temperature inversion (TI) across China remains poorly understood. Using seven years' worth of high-resolution radiosonde measurements at 120 sites, we compile the climatology of lower tropospheric TI in terms of frequency, intensity, and depth during the period from 2011 to 2017. The TI generally exhibits strong seasonal and geographic dependencies. Particularly, the TI frequency is found to be high in winter and low in summer, likely due to the strong aerosol radiative effect in winter. The frequency of the surface-based inversion (SBI) exhibits a ''west low, east high'' pattern at 0800 Beijing time (BJT), which then switches to ''west high, east low'' at 2000 BJT. Both the summertime SBI and elevated inversion (EI) reach a peak at 0800 BJT and a trough at 1400 BJT. Interestingly, the maximum wintertime EI frequency occurs over Southeast China (SEC) rather than over the North China Plain (NCP), likely attributable to the combination of the heating effect of black carbon (BC) originating from the NCP, along with the strong subsidence and trade inversion in SEC. Correlation analyses between local meteorology and TI indicate that larger lower tropospheric stability (LTS) favors more frequent and stronger TIs, whereas the stronger EI under smaller LTS conditions (unstable atmosphere) is more associated with subsidence rather than BC. Overall, the spatial pattern of the lower tropospheric TI and its variability in China are mainly controlled by three factors: local meteorology, large-scale subsidence, and BC-induced heating. These findings help shed some light on the magnitude, spatial distribution, and underlying mechanisms of the lower tropospheric TI variation in China. [ABSTRACT FROM AUTHOR]

High-income countries often outsource material demands to poorer countries along with the associated environmental damage. This phenomenon can also occur within (large) countries, such as China, which was responsible for 24 to 30% of the global material footprint (MF) between 2007 and 2010. Understanding the distribution and development of China's MF is hence critical for resource efficiency and circular economy ambitions globally. Here we present a comprehensive analysis of China's MF at the provincial and sectoral levels. We combine provincial-level input-output data with sector- and province-specific trade data, detailed material extraction data, and the global input-output database EXIOBASE. We find that some provinces haveMFs equivalent to medium-sized, highincome countries and limited evidence of material decoupling. Lower-income regions with high levels of material extraction can have an MF per capita as large as developed provinces due to much higher material intensities. The higher-income south-coastal provinces have lower MF per capita than equally developed provinces. This finding relates partly to differences in economic structure but indicates the potential for improvement across provinces. Investment via capital formation is up to 4 times more resource-intensive than consumption and drives 49 to 86% of provincial-level MFs (the Organisation for Economic Co-operation and Development average is 37%). Resource-efficient production, efficient use of capital goods/infrastructure, and circular design are essential for reductions in China's MF. Policy efforts to shift to a high-quality development model may reduce material intensities, preferably while avoiding the further outsourcing of high-intensity activities to other provinces or lower-income countries. [ABSTRACT FROM AUTHOR]

The bamboo snout beetle Cyrtotrachelus buqueti is a widely distributed wood-boring pest found in China, and its larvae cause significant economic losses because this beetle targets a wide range of host plants. A potential pest management measure of this beetle involves regulating olfactory chemoreceptors. In the process of olfactory recognition, pheromone-binding proteins (PBPs) play an important role. Homology modeling and molecular docking were conducted in this study for the interaction between CbuqPBP1 and dibutyl phthalate to better understand the relationship between PBP structures and their ligands. Site-directed mutagenesis and binding experiments were combined to identify the binding sites of CbuqPBP1 and to explore its ligand-binding mechanism. The 3D structural model of CbuqPBP1 has six a-helices. Five of these a-helices adopt an antiparallel arrangement to form an internal ligand-binding pocket. When docking dibutyl phthalate within the active site of CbuqPBP1, a CH-π interaction between the benzene ring of dibutyl phthalate and Phe69 was observed, and a weak hydrogen bond formed between the ester carbonyl oxygen and His53. Thus, Phe69 and His53 are predicted to be important residues of CbuqPBP1 involved in ligand recognition. Site-directed mutagenesis and fluorescence assays with a His53Ala CbuqPBP1 mutant showed no affinity toward ligands. Mutation of Phe69 only affected binding of CbuqPBP1 to cedar camphor. Thus, His53 (Between α2 and α3) of CbuqPBP1 appears to be a key binding site residue, and Phe69 (Located at α3) is a very important binding site for particular ligand interactions. [ABSTRACT FROM AUTHOR]

Background: A large number (n = 460) of A(H7N9) human infections have been reported in China from March 2013 through December 2014, and H7N9 outbreaks in humans became an emerging issue for China health, which have caused numerous disease outbreaks in domestic poultry and wild bird populations, and threatened human health severely. The aims of this study were to investigate the directional trend of the epidemic and to identify the significant presence of spatial-temporal clustering of influenza A(H7N9) human cases between March 2013 and December 2014.Methods: Three distinct epidemic phases of A(H7N9) human infections were identified in this study. In each phase, standard deviational ellipse analysis was conducted to examine the directional trend of disease spreading, and retrospective space-time permutation scan statistic was then used to identify the spatio-temporal cluster patterns of H7N9 outbreaks in humans.Results: The ever-changing location and the increasing size of the three identified standard deviational ellipses showed that the epidemic moved from east to southeast coast, and hence to some central regions, with a future epidemiological trend of continue dispersing to more central regions of China, and a few new human cases might also appear in parts of the western China. Furthermore, A(H7N9) human infections were clustering in space and time in the first two phases with five significant spatio-temporal clusters (p < 0.05), but there was no significant cluster identified in phase III.Conclusions: There was a new epidemiologic pattern that the decrease in significant spatio-temporal cluster of A(H7N9) human infections was accompanied with an obvious spatial expansion of the outbreaks during the study period, and identification of the spatio-temporal patterns of the epidemic can provide valuable insights for better understanding the spreading dynamics of the disease in China. [ABSTRACT FROM AUTHOR]

With the rapid development of China's economy, the demand for labor in the coastal cities continues to grow. Due to restrictions imposed by China's household registration system, a large number of floating populations have subsequently appeared. The relationship between floating populations and crime, however, is not well understood. This paper investigates the impact of a floating population on residential burglary on a fine spatial scale. The floating population was divided into the floating population from other provinces (FPFOP) and the floating population from the same province as ZG city (FPFSP), because of the high heterogeneity. Univariate spatial patterns in residential burglary and the floating population in ZG were explored using Moran's I and LISA (local indicators of spatial association) models. Furthermore, a geographically weighted Poisson regression model, which addressed the spatial effects in the data, was employed to explore the relationship between the floating population and residential burglary. The results revealed that the impact of the floating population on residential burglary is complex. The floating population from the same province did not have a significant impact on residential burglary in most parts of the city, while the floating population from other provinces had a significantly positive impact on residential burglary in most of the study areas and the magnitude of this impact varied across the study area. [ABSTRACT FROM AUTHOR]

Rehmannia is a non-parasitic genus in Orobanchaceae including six species mainly distributed in central and north China. Its phylogenetic position and infrageneric relationships remain uncertain due to potential hybridization and polyploidization. In this study, we sequenced and compared the complete chloroplast genomes of six Rehmannia species using Illumina sequencing technology to elucidate the interspecific variations. Rehmannia plastomes exhibited typical quadripartite and circular structures with good synteny of gene order. The complete genomes ranged from 153,622 bp to 154,055 bp in length, including 133 genes encoding 88 proteins, 37 tRNAs, and 8 rRNAs. Three genes (rpoA, rpoC2, accD) have potentially experienced positive selection. Plastome size variation of Rehmannia was mainly ascribed to the expansion and contraction of the border regions between the inverted repeat (IR) region and the single-copy (SC) regions. Despite of the conserved structure in Rehmannia plastomes, sequence variations provide useful phylogenetic information. Phylogenetic trees of 23 Lamiales species reconstructed with the complete plastomes suggested that Rehmannia was monophyletic and sister to the clade of Lindenbergia and the parasitic taxa in Orobanchaceae. The interspecific relationships within Rehmannia were completely different with the previous studies. In future, population phylogenomic works based on plastomes are urgently needed to clarify the evolutionary history of Rehmannia. [ABSTRACT FROM AUTHOR]

Background: No systemic evaluation of asthma control in Jilin Province has been reported. Asthma control might provide the basis for asthma management in this region. A multicenter hospital-based cross-sectional study was performed to investigate the asthma control and related factors for severe asthma exacerbations in patients with moderate or severe asthma in Jilin Province, China.Methods: The study enrolled 1546 patients in five grade one general hospitals from January to December 2013. Asthma medication, patient self-management, asthma control test (ACT) scores and frequency of severe asthma exacerbations during the follow-up (12 months) were collected via a follow-up questionnaire.Results: In the study, 889 patients provided a complete follow-up questionnaire. Severe asthma exacerbations occurred in 54.89 % of patients. ACT score ≤15, asthma medication ≤ 3 months, severe asthma, income level lower than average Per Capita Disposable Income (PCDI) and a lower educational level were risk factors of a severe exacerbation.Conclusions: Poor adherence to asthma medication, poor asthma symptom control, lower income, a low educational level might be possible reasons for the high incidence of severe asthma exacerbations and poor asthma control in Jilin Province of China. [ABSTRACT FROM AUTHOR]

We monitored the last remaining Asian elephant populations in China over the past decade. Using DNA tools and repeat genotyping, we estimated the population sizes from 654 dung samples collected from various areas. Combined with morphological individual identifications from over 6,300 elephant photographs taken in the wild, we estimated that the total Asian elephant population size in China is between 221 and 245. Population genetic structure and diversity were examined using a 556-bp fragment of mitochondrial DNA, and 24 unique haplotypes were detected from DNA analysis of 178 individuals. A phylogenetic analysis revealed two highly divergent clades of Asian elephants, α and β, present in Chinese populations. Four populations (Mengla, Shangyong, Mengyang, and Pu’Er) carried mtDNA from the α clade, and only one population (Nangunhe) carried mtDNA belonging to the β clade. Moreover, high genetic divergence was observed between the Nangunhe population and the other four populations; however, genetic diversity among the five populations was low, possibly due to limited gene flow because of habitat fragmentation. The expansion of rubber plantations, crop cultivation, and villages along rivers and roads had caused extensive degradation of natural forest in these areas. This had resulted in the loss and fragmentation of elephant habitats and had formed artificial barriers that inhibited elephant migration. Using Geographic Information System, Global Positioning System, and Remote Sensing technology, we found that the area occupied by rubber plantations, tea farms, and urban settlements had dramatically increased over the past 40 years, resulting in the loss and fragmentation of elephant habitats and forming artificial barriers that inhibit elephant migration. The restoration of ecological corridors to facilitate gene exchange among isolated elephant populations and the establishment of cross-boundary protected areas between China and Laos to secure their natural habitats are critical for the survival of Asian elephants in this region. [ABSTRACT FROM AUTHOR]

Background: The relationship between cardiac output and septic acute kidney injury (AKI) remains unclear. The purpose of this study was to assess the association between the cardiac index (CI) and the renal outcomes in patients with septic shock. Methods: A one-year prospective cohort study was performed in the surgical and medical ICU of a teaching hospital in Nanjing, China. Twenty-nine septic shock patients who required early goal-directed fluid resuscitation were consecutively included. Pulse indicator continuous cardiac output (PiCCO) device was used to measure hemodynamic parameters before and after early goal-directed therapy (EGDT). Based on CI changes after EGDT, patients were assign to the CI increased group or the CI constant group, respectively. The incidence of poor renal outcome, which was defined as AKI on admission without recovery in following three days or new onset AKI within 28 days, was recorded. We investigated whether an increased CI was associated with a better renal outcome. Results: After EGDT, there were 16 patients in the CI increased group and 13 patients in the CI constant group. The incidence of poor renal outcome was lower in CI increased group than in the CI constant group (6% vs. 62%; P = 0.003) with a relative risk of 0.10. The logistic regression showed that the CI percent change was associated with renal outcome, with an odd ratio of 0.003 (P = 0.056) after adjustment of possible confounding factors. The CI percent change would predict a good renal outcome (AU ROC 0.739, P = 0.012) with moderate accuracy (sensitivity 75% and specificity 89%) when using a 10% cut-off value from Youden index. The CI percent change was also positively correlated with creatinine clearance (CCr) after EGDT (ρ = 0.548; P = 0.002). Conclusions: The increased CI after EGDT was a protective factor for kidney in patients with septic shock. A CI increased above 10% could be potentially used to predict development and reversibility of AKI in septic shock patients. Trial registration: Clinicaltrials.gov:NCT01862588 (May 13, 2013). [ABSTRACT FROM AUTHOR]

Immunomodulatory effect has been found to be an important therapeutic measure for immune responses against cancer. In this study, we evaluated the inhibition of Scutellaria barbata D. Don (SB), an anti-inflammatory and an antitumor Chinese herb, including flavonoids and scutebarbatines on tumor growth and its immunomodulatory effects in vivo. HPLC and LC/MS/MS methods were conducted for the analysis of flavonoids and scutebarbatines in SB. Lewis-bearing C57BL/6 mice model was established and tumor volume was evaluated by high frequency color ultrasound experiment. ELISA and western blot analysis were performed for the determination of immunomodulatory factors. SB treatment at the dose of 10, 6.67, and 3.33 g crude drug/kg/d significantly inhibited tumor growth of Lewis-bearing C57BL/6 mice with the inhibition rates of 44.41 ± 5.44%, 33.56 ± 4.85%, and 27.57 ± 4.96%, respectively. More importantly, the spleen and thymus indexes were increased remarkably by SB treatment. SB could decrease IL-17, IL-10, FOXP3, TGF-β1, RORγt, and IL-6 levels whereas it could increase remarkably IL-2 and IFN-γ levels. Our results demonstrated that SB could inhibit tumor growth in vivo through regulating immune function in tumor-bearing mice and suggested that the immunomodulatory function of SB had a potential therapeutic effect in lung cancer. [ABSTRACT FROM AUTHOR]

In China, the psychological health problems of children and adolescents have been more and more serious recently. The psychological disorders not only have a lot of adverse effects for children and adolescents, but also were an important source of mental disease in adulthood. In order to make more people understand this serious problem, this paper summarized the current situation of child and adolescent mental health problems in China and the risk factors for child and adolescent mental health problems; additionally, the interventions of child and adolescent psychological problems were also reviewed in this paper. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the pedagogical skills of third-year nursing students at Yangzhou University (China)., Methods: A multisite quasi-experimental design was used in this study. Fifty-five participants were selected by convenience sampling. The Objective Structured Teaching Evaluation (OSTE) scale was used to assess teaching skills. The evaluation included four different stages: Teaching Background Analysis (E1), Lesson Plan Presentation (E2), Mock Class (E3) and Teaching Reflection (E4). Prior to the assessment, the teachers assigned homework to the students to complete at the four stations., Results: Fifty-five nursing students with an average age of 21.3±0.7 years participated in the study, with a predominance of female students (78.2%). The highest mean score was achieved in E1 (83.1), followed by E2 and E3 (82.5 and 82.3 respectively), while the lowest mean score was found in E4 (79.6). In E3, instructors gave lower scores for class organisation, class characteristics and overall performance compared to the self-reported scores of the standardised students (p<0.05). More than 80% of the students strongly agreed and recommended the OSTE as the primary method for assessing teaching skills in the classroom., Conclusion: Deficits in teaching skills were identified in the participating students; this information will allow specific interventions to improve the situation. The OSTE instrument was a useful method for assessing the pedagogical skills of undergraduate nursing students., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

Objective: Whether uric acid (UA) has an effect on renal function remains controversial. We aimed to investigate the association between serum UA with the decline in estimated glomerular filtration rate (eGFR) in middle-aged and elderly populations in the China Health and Retirement Longitudinal Study (CHARLS)., Design: Longitudinal cohort study., Setting: This was a second analysis of a public dataset (CHARLS)., Participants: In this study, 4538 middle-aged and elderly individuals were screened after removing individuals younger than 45 years old, with kidney disease, malignant tumour and missing values., Outcome Measures: Blood tests were performed both in 2011 and 2015. Decline in eGFR was defined as an eGFR decrease of more than 25% or deterioration of the eGFR stage during the 4-year follow-up period. Logistic models corrected for multiple covariables were used to analyse the association of UA with the decline in eGFR., Results: The median (IQR) concentrations of serum UA grouped by quartiles were 3.1 (0.6), 3.9 (0.3), 4.6 (0.4) and 5.7 (1.0) mg/dL, respectively. After multivariable adjustment, the OR of the decline in eGFR was higher for quartile 2 (3.5-<4.2 mg/dL: OR 1.44; 95% CI 1.07 to 1.64; p<0.01), quartile 3 (4.2-<5.0 mg/dL: OR 1.72; 95% CI 1.36 to 2.18; p<0.001) and quartile 4 (≥5.0 mg/dL: OR 2.04; 95% CI 1.58 to 2.63; p<0.001) when compared with quartile 1 (<3.5 mg/dL), and the p value for the trend was <0.001., Conclusions: Over a 4-year follow-up period, we found that elevated UA was associated with a decline in eGFR in the middle-aged and elderly individuals with normal renal function., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Some studies have reported using ultrasonic evaluations to assess diaphragm function in patients with chronic obstructive pulmonary disease (COPD). However, they have limitations and thus cannot provide strong evidence to support ultrasound evaluations for diaphragm function and dysfunction severity assessments in this patient population. Additionally, quantitative studies on the relationship between ultrasound evaluations and diaphragm function do not exist. Therefore, we performed a systematic review and meta-analysis to explore the usefulness of ultrasonography for evaluating diaphragm function in patients with COPD., Methods: The Cochrane Library, PubMed, Embase, Web of Science, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Network, and Chinese Scientific Journal Database (i.e., VIP) databases were searched for literature about ultrasonic evaluations of diaphragm function in patients with COPD for systematic review. We extracted patient demographic, diaphragm mobility, diaphragm thickness, diaphragm thickening score, and other related parameter data using RevMan 5.3 software for the meta-analysis., Results: We included 13 articles in the systematic review, 8 of which (494 participants) were included in the meta-analysis. The degree of diaphragm offset in patients with COPD was significantly lower than that in healthy controls (weighted mean difference [WMD] = -1.34; 95% confidence interval [CI]: -2.15, 0.53; P < .05). The diaphragm deviation was lower in the severe COPD group than in the mild-to-moderate COPD group (WMD = 0.50; 95% CI: -0.01, 1.01; P = .06), but the difference was not significant., Conclusion: Ultrasonography effectively evaluates diaphragm function in patients with COPD. The diaphragm offset can be used as an auxiliary diagnostic index for COPD, which is also related to disease severity., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Microplastics, new persistent pollutants, have recently attracted considerable attention. When present in beach sediments, microplastics may adversely affect the nesting and hatching of sea turtles on beaches. In this study, we investigate microplastic pollution at Qilianyu (northeastern Xisha Islands), the largest known nesting ground for green sea turtles ( Chelonia mydas ) in China. We found that the average abundance of microplastics in the beach surface sediments was 338.44 ± 315.69 thousand pieces·m -3 or 1,353.78 ± 853.68 pieces·m -2 , with foam and fragments as the main microplastic type identified. The microplastic particles were categorised as small and were predominantly within the 0.05-1 mm size category. Most microplastic particles were white (71.31%). Polystyrene and polyethylene were found to be the most common forms of plastic present. Microplastic pollution was not only observed on the beach surface but also at the bottom of nests approximately 60 cm may be harmful to the incubation of sea turtle eggs. We suggest removing plastic litter, especially small pieces of plastic, on beaches to reduce the threat of microplastic pollution to marine life, including sea turtles. Furthermore, the foam used in aquaculture should be recovered and replaced before it becomes fragmented due to age. In addition, regional cooperation between stakeholders in the South China Sea should be strengthened to collectively promote the reduction and cleanup of marine litter., Competing Interests: The authors declare that they have no competing interests., (© 2022 Zhang et al.)

Background: Since April 2021, the SARS-CoV-2 (B.1.167) Delta variant has been rampant worldwide. Recently, this variant has spread in Guangzhou, China. Our objective was to characterize the clinical features and risk factors of severe cases of the Delta variant in Guangzhou., Methods: A total of 144 patients with the Delta variant were enrolled, and the data between the severe and non-severe groups were compared. Logistic regression methods and Cox multivariate regression analysis were used to investigate the risk factors of severe cases., Results: The severity of the Delta variant was 11.1%. Each 1-year increase in age (OR, 1.089; 95% CI, 1.035-1.147; P = 0.001) and each 1-μmol/L increase in total bilirubin (OR, 1.198; 95% CI, 1.021-1.406; P = 0.039) were risk factors for severe cases. Moreover, the risk of progression to severe cases increased 13.444-fold and 3.922-fold when the age was greater than 58.5 years (HR, 13.444; 95% CI, 2.989-60.480; P = 0.001) or the total bilirubin level was greater than 7.23 μmol/L (HR, 3.922; 95% CI, 1.260-12.207; P = 0.018), respectively., Conclusion: Older age and elevated total bilirubin were independent risk factors for severe cases of the Delta variant in Guangzhou, especially if the age was greater than 58.5 years or the total bilirubin level was greater than 7.23 μmol/L.

Human settlement environment is space places closely related to human production and life, and also surface spaces inseparable from human activities. As a coastal city in the east of China, Qingdao has a relatively high level of urbanization. However, it also along with many urban problems at the same time, among which the problem of human settlement environment has attracted more and more general attention from people. According to the characteristics of human settlement environment in Qingdao, the research constructs an index system with 10 index factors from natural factors and humanity factors, and proposes a comprehensive evaluation model. Evaluate and grade suitability of human settlement environment in Qingdao, explore the spatial aggregation and differentiation of the quality of human settlement environment, and reveal the internal connection of spatial evolution. The results indicate that the overall livability of Qingdao is relatively good, showing a multi-center and radial driving development. The distribution of livability is uneven, showing a decreasing spatial distribution law from the coast to the inland, and the quality of human settlement environment in Jiaozhou Bay and the coastal areas is relatively high. Qingdao is mainly based on natural livability, supplemented by humanity livability, compared with natural suitability, the spatio-temporal evolution characteristics of humanity livability have experienced three stages: rising-contradictory rising-harmonious rising. The quality of human settlement environment has obvious spatial correlation and is positively correlated with the degree of agglomeration, and the agglomeration of blocks with a higher quality of human settlement environment is higher than that of blocks with a lower level. The rule of human settlement environment changing over time is that areas with high quality of human settlement environment begin to shift from the city center to the north and the south, transforming into multi-point development, and overall environmental suitability has been improved. According to the results of the comprehensive evaluation, combined with its local development status and policies, the research puts forward developmental suggestions for the construction of human settlement environment in Qingdao, and provides decision-making basis for relevant departments to solve the problem of deterioration of human settlement environment., Competing Interests: The authors have declared that no competing interests exist.

Aim: To assess disease-specific circulating microRNAs (miRNAs) in non-alcoholic steatohepatitis (NASH) patients., Methods: A total of 111 biopsy-proven non-alcoholic fatty liver disease (NAFLD) or chronic hepatitis B (CHB) patients and healthy controls from mainland China were enrolled to measure their serum levels of miR-122, -125b, -146b, -16, -21, -192, -27b and -34a. The correlations between serum miRNAs and histological features of NAFLD were determined. The diagnostic value of miRNA in NASH and significant fibrosis was analyzed and compared with that of cytokeratin-18 (CK-18), fibrosis-4 (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI), respectively., Results: Circulating miR-122, -16, -192 and -34a showed differential expression levels between NAFLD and CHB patients, and miR-34a had an approximately 2-fold increase in NAFLD samples compared with that of CHB samples ( P < 0.01). Serum miR-122, -192 and -34a levels were correlated with steatosis (R = 0.302, 0.323 and 0.470, respectively, P < 0.05) and inflammatory activity (R = 0.445, 0.447 and 0.517, respectively, P < 0.01); only serum miR-16 levels were associated with fibrosis (R = 0.350, P < 0.05) in patients with NAFLD. The diagnostic value of miR-34a for NASH (area under the receiver operating characteristic, 0.811, 95%CI: 0.670-0.953) was superior to that of alanine aminotransferase, CK-18, FIB-4 and APRI in NAFLD, but miR-16 showed a limited performance in the diagnosis of significant fibrosis in NASH., Conclusion: Circulating miR-34a may serve as a disease-specific noninvasive biomarker for the diagnosis of NASH., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest.