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Background: The involvement of quality of life as the UNAIDS fourth 90 target to monitor the global HIV response highlighted the development of patient-reported outcome (PRO) measures to help address the holistic needs of people living with HIV/AIDS (PLWHA) beyond viral suppression. This study developed and tested preliminary measurement properties of a new patient-reported outcome (PROHIV-OLD) measure designed specifically to capture influences of HIV on patients aged 50 and older in China. Methods: Ninety-three older people living with HIV/AIDS (PLWHA) were interviewed to solicit items and two rounds of patient cognitive interviews were conducted to modify the content and wording of the initial items. A validation study was then conducted to refine the initial instrument and evaluate measurement properties. Patients were recruited between February 2021 and November 2021, and followed six months later after the first investigation. Classical test theory (CTT) and item response theory (IRT) were used to select items using the baseline data. The follow-up data were used to evaluate the measurement properties of the final instrument. Results: A total of 600 patients were recruited at the baseline. Of the 485 patients who completed the follow-up investigation, 483 were included in the validation sample. The final scale of PROHIV-OLD contained 25 items describing five dimensions (physical symptoms, mental status, illness perception, family relationship, and treatment). All the PROHIV-OLD dimensions had satisfactory reliability with Cronbach's alpha coefficient, McDonald's ω, and composite reliability of each dimension being all higher than 0.85. Most dimensions met the test-retest reliability standard except for the physical symptoms dimension (ICC = 0.64). Confirmatory factor analysis supported the structural validity of the final scale, and the model fit index satisfied the criterion. The correlations between dimensions of PROHIV-OLD and MOS-HIV met hypotheses in general. Significant differences on scores of the PROHIV-OLD were found between demographic and clinical subgroups, supporting known-groups validity. Conclusions: The PROHIV-OLD was found to have good feasibility, reliability and validity for evaluating health outcome of Chinese older PLWHA. Other measurement properties such as responsiveness and interpretability will be further examined. [ABSTRACT FROM AUTHOR]

The West Liaohe River Basin (WRLB) is a typical agro-pastoral interlaced zone in Northeast China where excessive economic development activities brought great pressure on the ecosystem and caused a series of ecological problems, having a negative effect on regional ecological carrying capacity (ECC). The rational construction of ecological security pattern (ESP) is an effective way to improve regional ECC and alleviate the contradiction between ecological protection and economic development. In this study, taking the WLRB as an example, spatiotemporal changes of ECC in the WLRB from 2000 to 2020 were explored by using spatial principal component analysis (SPCA). Furthermore, ecological sources were determined by coupling ECC evaluation results with important ecological patches such as natural protected areas, and the minimum cumulative resistance (MCR) model combined with the circuit theory method were employed to identify ecological security zoning, ecological corridors and key ecological nodes. Then a comprehensive ESP of the basin was constructed. The results show as follows: 1) The ECC of the overall WLRB was at medium carrying level, yet was spatially differentiated, which decreased from the periphery to the center of the basin in general. ECC showed a fluctuating upward trend from 2000 to 2020. 2) The ecological source area of the WLRB was 21926.91 km2, accounting for 17.33% of the total study area. The ecological sources were seriously fragmentated and mainly distributed in the mountain area. The area of ecological conservation zone, optimized buffer zone, ecological transition zone, ecological prevention and control zone were 55672.69 km2, 32662.24 km2, 23862.84 km2 and 12021.04 km2, accounting for 44.82%, 26.29%, 19.21% and 9.68%, respectively. We also extracted 95 ecological corridors (with a total length of 3130.97 km), 49 ecological pinch points (with a total area of 200.33 km2) and 30 ecological barrier points (with a total area of 318.30 km2), constituting a "pointslines-planes" comprehensive ecological security pattern. This research can provide scientific reference for the protection and restoration of ecological environment and regional sustainable development. [ABSTRACT FROM AUTHOR]

Background and purpose: Follow-up data of 6 737 patients undergoing surgery for gastric cancer were collected based on hospital registration, and the 1-, 3- and 5-years observed overall survival (OS) rates and disease-free survival (DFS) rates were analyzed to provide real-world research evidence for the prevention and control of gastric cancer and policy making in China. Methods: A total of 6 737 gastric cancer patients who underwent surgical treatment at Fudan University Shanghai Cancer center from 2015 to 2020 were included in this study. Clinical information and the follow-up endpoint data were collected through medical records review, telephone visits and death registry data linkage. The last follow-up date was November 30, 2023. Kaplan-Meier method was applied in evaluating the 1-, 3- and 5-year OS rate and DFS rate, and survival data were described by different subgroups including age group, gender, treatment period, tumor staging, and pathological characteristics. Results: With a median follow-up time of 50.99 months, the 5-year OS rate of surgically resected gastric cancer patients was 70.37%, and 5-year DFS rate in I-III stage cases was 69.46%. The 5-year OS rates of stage I, II, III and IV were 94.32%, 82.56%, 51.01% and 23.97%, respectively. The differences in survival among patients with different age, tumor location, gross classification, Borrmann classification and Lauren classification were significant. Conclusion: Staging is an important factor directly affecting the survival of gastric cancer patients. Screening and early diagnosis and treatment in large population, especially high-risk group, should be strengthened to further improve the patients' survival. [ABSTRACT FROM AUTHOR]

Background: This is a sub‐analysis of the Personalized Antithrombotic Therapy for Coronary Heart Disease after PCI (PATH‐PCI) trial in China to explore the relationship between smoking and outcomes following personalized antiplatelet therapy (PAT) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI). Methods: As a single‐center, prospective, randomized controlled and open‐label trial, the PATH‐PCI trial randomized CCS patients undergoing PCI into standard group or personalized group guided by a novel platelet function test (PFT), from December 2016 to February 2018. All patients were divided into smokers and nonsmokers according to their smoking status. Subsequently, we underwent a 180‐day follow‐up evaluation. The primary endpoint was the net adverse clinical events (NACE). Results: Regardless of smoking status, in the incidence of NACE, there was a reduction with PAT but that the reductions are not statistically significant. In the incidence of bleeding events, we found no statistically significant difference between two groups (smokers: 2.0% vs. 1.4%, HR = 1.455, 95% confidence interval [CI]: 0.595−3.559, p =.412; nonsmokers: 2.2% vs. 1.8%, HR = 1.228, 95% CI: 0.530−2.842, p =.632). In smokers, PAT reduced major adverse cardiac and cerebrovascular events (MACCE) by 48.7% (3.0% vs. 5.9%, HR = 0.513, 95% CI: 0.290−0.908, p =.022), compared with standard antiplatelet therapy (SAT). PAT also reduced the major adverse cardiovascular events (MACE) but there was no statistically difference in the reductions (p >.05). In nonsmokers, PAT reduced MACCE and MACE by 51.5% (3.3% vs. 6.7%, HR = 0.485, 95% CI: 0.277−0.849, p =.011) and 63.5% (1.8% vs. 4.9%, HR = 0.365, 95% CI: 0.178−0.752, p =.006), respectively. When testing p‐values for interaction, we found there was no significant interaction of smoking status with treatment effects of PAT (pint‐NACE =.184, pint‐bleeding =.660). Conclusion: Regardless of smoking, PAT reduced the MACE and MACCE, with no significant difference in bleeding. This suggests that PAT was an recommendable regimen to CCS patients after PCI, taking into consideration both ischemic and bleeding risk. [ABSTRACT FROM AUTHOR]

Natural bioactive compounds (NBCs) are widely used in clinical treatment. For example, Tripterygium wilfordii Hook f. is commonly known in China as Lei-Gong-Teng which means thunder god vine. This herb is widely distributed in Eastern and Southern China, Korea, and Japan. The natural bioactive compounds of this herb can be extracted and made into tripterygium glycoside tablets. It is one of the most commonly used and effective traditional Chinese herbal medicines against rheumatoid arthritis (RA), nephrotic syndrome (NS), autoimmune hepatis (AIH), and so on. However, many NBCs are difficult to reliably quantify in the serum due to the effects of matrix and RSD. In addition, the targeted compound's internal standard (IS) is rarely sold due to the complex isotope internal standard synthesis pathway. In this study, a new quantitation method for 18O labeling combined with off-line SPE was formulated. We contrasted the recoveries and matrix effects of various separation methods in order to choose the best method. Furthermore, we optimized the conditions for SPE loading and washing. An isotopic internal standard was prepared by the 16O/18O exchanging reaction in order to eliminate the matrix effects. The method's accuracy and precision met the requirements for method validation. The recovery of this method was close to 60%. The relative standard deviation (RSD) of the high-concentration sample was 2%, and the limit of detection (LOD) was 1 ng/mL. This method could be used to analyze the clinical serum concentration of demethylzeylasteral. Sixty samples were collected from 10 patients with diabetes nephropathy. The quantitation results of demethylzeylasteral in patients' serum obtained using this method exhibited a correlation between therapeutic drug monitoring (TDM) and decreased urinary protein. This work may have broad implications for the study of drug metabolism in vivo and the clinical application of low-abundance and difficult-to-quantify NBCs. [ABSTRACT FROM AUTHOR]

Elaeagnus oldhamii Maximowicz 1870 is an important medicinal plant mainly distributing in the southeastern coastal region of China. However, the complete chloroplast genome of E. oldhamii has never been studied at present. We obtained the complete chloroplast genome of E. oldhamii, which was 152,283 bp in length, with a typical quadripartite structure that includes a large single-copy region of 82,229 bp, a small single-copy region of 18,256 bp, and 2 inverted repeat (IR) regions of 25,899 bp. The genome contained 128 unique genes with a GC content of 37%, including 83 protein-coding genes, 37 tRNAs, and 8 rRNAs. Phylogenetic analysis suggested that E. oldhamii was closely related to E. glabra and E. macrophylla. [ABSTRACT FROM AUTHOR]

Critical Zone Science (CZS) explores the deep evolution of landscapes from the base of the groundwater or the saprolite‐rock interface to the top of vegetation, the zone that supports all terrestrial life. Here we propose a framework for CZS to evolve further as a discipline, building on 1st generation CZOs in natural systems and 2nd generation CZOs in human‐modified systems, to incorporate human behaviour for more holistic understanding in a 3rd generation of CZOs. This concept was tested in the China‐UK CZO programme (2016–2020) that established four CZOs across China on different lithologies. Beyond conventional CZO insights into soil resources, biogeochemical cycling and hydrology across scales, surveys of farmers and local government officials led to insights into human‐environment interactions and key pressures affecting the socio‐economic livelihoods of local farmers. These learnings combined with the CZS data identified knowledge exchange (KE) opportunities to unravel diverse factors within the Land‐Water‐Food Nexus, that could directly improve local livelihoods and environmental conditions, such as reduction in fertilizer use, contributing toward Sustainable Development Goals (SDGs) and environmental policies. Through two‐way local KE, the local cultural context and socio‐economic considerations were more readily apparent alongside the environmental rationale for policy and local action to improve the sustainability of farming practices. Seeking solutions to understand and remediate CZ degradation caused by human‐decision making requires the co‐design of CZS that foregrounds human behavior and the opinions of those living in human modified CZOs. We show how a new transdisciplinary CZO approach for sustainable Earth futures can improve alignment of research with the practical needs of communities in stressed environments and their governments, supporting social‐ecological and planetary health research agendas and improving capacity to achieve SDGs. Plain Language Summary: Critical Zone Science (CZS) explores how landscapes evolve from below the Earth's surface to the top of trees, supporting life on Earth. CZS was established by studying pristine landscapes, with little or no human modification of the land, water and soil. These pristine natural systems are rare in our modern world. In this paper, we have proposed a new approach to CZS for studying the human‐modified landscapes that dominate our world. To help explain why this is needed, we have re‐drawn a diagram explaining how the critical zone works to show the role of humans. We also give examples of research in three regions of China where we learned from local farmers living in our study areas, to improve our scientific understanding and to try to align our research process to address the biggest pressures affecting their lives. This new approach to CZS can help focus research to directly support local people and improve our ability to achieve the United Nations Sustainable Development Goals. Key Points: Integrating local knowledge with critical zone science can improve interpretation of scientific findings and delivery of Sustainable Development GoalsThird generation science can improve alignment of research with the practical needs of communities and governmentsA new conceptual diagram for human‐modified critical zones is produced to illustrate transdisciplinary Critical Zone Observatories for sustainable Earth futures [ABSTRACT FROM AUTHOR]

There is a growing global emphasis on sustainable agriculture to reduce human impacts and improve delivery of Sustainable Development Goals (SDGs). With increasing investment in critical zone observatories (CZOs), it becomes important to understand how sustainable agricultural knowledge is produced, shared and used between different groups including farmers, scientists and government. To explore these issues, scientists leading the knowledge exchange (KE) component of a China‐UK CZO program studied three farming regions with contrasting geologies and varying economic levels, using a practice‐based research method. We demonstrate how additional funding for social science research allowed us to understand how farmers access and share farming knowledge through bonding, bridging and linking networks, and how this varies spatially, using interviews and survey questionnaires. Knowledge flows, barriers and opportunities for designing locally suited two‐way KE activities were identified. First, we highlight the need for a more locally, socially embedded and reflexive approach to build trust and better address pressing local environmental challenges. Second, we show how social science can usefully inform KE for collaborative, international development science, to draw on local knowledge, promote research impacts and capacity building while avoiding knowledge mismatches. Lastly, a blueprint for the design and funding of future CZOs, social‐ecological and planetary health research agendas that combine science, social science, local knowledge and KE is presented, including the need for substantive social science research to take place in addition to science research in human‐modified landscapes—enabling the CZ science to be better grounded in, informed by and useful to local communities. Plain Language Summary: There is a growing global need for sustainable agriculture to reduce human impacts on the environment. To do this, we need to have a better understanding of how sustainable agricultural knowledge is produced, shared and used between different groups including farmers, scientists and government. In this paper, we explored these issues in three farming regions in China, using a practice‐based research method where we interviewed and surveyed several 100 farmers. We found that in two of the three regions, farmers access and share farming knowledge through family networks, whilst in the third region farmers learned from a broader range of groups including scientists and government. We recommend that future science studies in stressed agricultural landscapes use a more local approach to build trust and carry out science that better addresses pressing local environmental challenges. This requires us to study people, the residents in these landscapes, using social science, alongside understanding how the landscape is functioning ecologically. Lastly, we propose a new "blueprint" for funding of future science, social‐ecological and planetary health research agendas that combine science, social science, local knowledge and knowledge exchange. This will enable environmental science to be better grounded in, informed by and useful to local communities. Key Points: A blueprint for future critical zone observatories and planetary health research is presented that combines science, social science and local knowledgeWe show how social science can usefully inform knowledge exchange (KE) for collaborative science, to build capacity while avoiding knowledge mismatchesSpatial variations in how farmers learn through bonding, bridging and linking networks exist, showing the need for a local approach to KE [ABSTRACT FROM AUTHOR]

Background: Several studies have explored the connection between follicle-stimulating hormone (FSH) and nonalcoholic fatty liver disease (NAFLD). However, the impact of FSH elevation on NAFLD remains a topic of debate. Hence, this investigation aimed to evaluate the potential correlation between FSH levels and NAFLD in the aging population. Methods: This was a retrospective observational cross-sectional study between July 2017 and August 2018 in our hospital. We used data obtained from 455 patients over 60 years old. Anthropometrics and laboratory tests were performed for each patient. NAFLD was diagnosed by sonographic features and the fatty liver index (LFI). Results: Of the 455 patients, 200 (43.96%) had NAFLD on their ultrasound and 169 (37.14%) had NAFLD according to the LFI. An intraclass correlation coefficient of the two methods was 80.4% (P < 0.001). People with NAFLD on their ultrasound showed lower FSH levels (52.68 vs. 61.39 IU/L) and more unfavorable metabolic profiles. FSH was negatively correlated with age, alanine aminotransferase, estradiol, testosterone, systolic blood pressure, waist, body mass index, fasting blood glucose, postload plasma glucose and positive associated with total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol by Spearman correlation analysis (all P < 0.05). By controlling for all confounding factors, the odds ratios (OR) of FSH for NAFLD were determined in elderly individuals, both men and women, aged 60–70 years and over 70 years. These ORs were found to be 0.937, 0.982, 0.983, and 0.973, respectively, with corresponding 95% confidence intervals (CI) of 0.892–0.984 (P = 0.009), 0.971–0.993 (P = 0.002), 0.967–0.999 (P = 0.033), and 0.958–0.989 (P = 0.001). In addition, our findings demonstrated no significant correlation between FSH and advanced fibrosis when adjusting for potential covariates. The OR for advanced fibrosis was 0.979 (95% CI, 0.938–1.022, P = 0.339). Additionally, ROC curve analysis showed an optimal cut-off value of 66.91 for women and 15.25 for men for NAFLD diagnosis. Conclusions: There was an inverse relationship observed between levels of FSH in the blood serum and NAFLD in the elderly population. These findings suggest that reduced FSH levels might serve as a potential risk factor or biomarker for NAFLD in the elderly. [ABSTRACT FROM AUTHOR]

Fructus Aurantii (FA) is the dry and immature fruit of Citrus aurantium L. and its rutaceous cultivars. FA has been widely used to treat digestive system diseases since ancient China, and it promotes gastrointestinal (GI) motility in functional dyspepsia (FD), but its potential therapeutic mechanisms remain unclear. We examined the effects of FA ethanol extracts in an iodoacetamide (IA)-induced FD rat model. Firstly, key FA therapy targets for FD were gathered using systematic pharmacology. Combined with systemic pharmacological analyses, plasma metabolomics based on UPLC-QTOF-MS were conducted. Then, MetaboAnalyst was used to jointly analyze systemic pharmacology targets and metabolomic metabolites to select key metabolic pathways. Finally, the key path is verified by experiments. FA exerted distinct therapeutic effects in anti-inflammation and promoting gastrointestinal motility in our IA-induced FD rat model. When compared with the model group, FA down-regulated the inflammatory factors interleukin 1β and tumor necrosis factor-α. At the same time, FA up-regulated tight junction proteins in the intestinal epithelial barrier. Through the integrated analysis of metabolomics and systemic pharmacology, we conducted experimental verification on Fc epsilon RI signaling pathway. When compared with the model group, FA down-regulatedphospho-mitogen activated protein kinase, phospho-extracellular signal regulated kinase1/2, myosin light chain kinase, and phospho-myosin regulatory light chain protein levels. Thus, FA ameliorated FD by regulating the Fc epsilon RI signaling pathway. Our integrated strategy identified underlying FA mechanisms toward FD treatment and provided a foundation for FA development as a clinical agent for FD. [ABSTRACT FROM AUTHOR]

In the year 2023, 1 958 310 new cancer cases and 609 820 cancer deaths are projected to occur in the United States, estimated by Cancer Statistics, published by American Cancer Society. An accelerated decline in mortality rate of cancer continues since it reached the peak in 1991. The treatment advance brought survival benefit to patients which mainly contribute to the decline along with tobacco control and screening. COVID-19 pandemic caused 350 831 mortality and ranked 3rd in cause of death in 2020, and the mortality had a significant increase in multiple causes of death including cancer. By comparing the data of China and the United States released by GLOBOCAN database in 2020, it is found that, although the influence of the pandemic on cancer has not been evaluated. Although the incidence and mortality of cancer differ between US and China, the experiences are worth learning. Improving the standardization of diagnosis and treatment, enhancing the accessibility of cancer health care, upgrading the coverage of screening and increasing the human papillomavirus (HPV) vaccination rate are proven to be effective ways to reduce the mortality of cancer. [ABSTRACT FROM AUTHOR]

Tropical mountain ecosystems are usually colonized by numerous invasive plant species and represent an ideal 'natural laboratory' to study the effects of altitude on plant invasion. The aim of this study was to investigate the soil chemical and microbiological properties along an altitudinal gradient on a mountain colonized by the invader Ageratina adenophora. Rhizosphere soil of A. adenophora was collected over an altitudinal gradient (1400–2400 m) in Ailao Shan, China. We determined soil organic carbon (C), nutrient contents, enzyme activities, bacterial community composition as well as C and nitrogen (N) contents of the plant roots. Ecoenzymatic stoichiometric indices were calculated to estimate the relative C, N or P limitations of the microbial community. There was a significant effect of altitude on soil organic C in the rhizosphere, and a turning point in these measured variables was detected at an altitude of 2000 m. At low elevations, the rapid growth of invasive plants depleted the deficient phosphorus (P) in tropical soils, leading to microbial P limitation; at high elevations, microbes invested more energy to obtain C from resistant litter, leading to microbial C limitation. Bacterial beta diversity and soil pH contributed most to the altitudinal differences in ecoenzymatic stoichiometry, and Proteobacteria and Acidobacteria were the dominant bacterial phyla that determined the nutrient uptake status of microorganisms. These results demonstrate how microbial nutrient acquisition belowground of A. adenophora along an altitudinal gradient, which could contribute to further knowledge about the effects of altitude on biological invasion. [ABSTRACT FROM AUTHOR]

Background and Objectives: Poor nutritional status is a common finding in pulmonary tuberculosis (TB) patients with and without type 2 diabetes mellitus (T2DM), thiamin (VB-1) and riboflavin (VB-2) are coenzymes important for the activation of many enzymes involved in improving nutritional status. We aimed to investigate enzymatic activities and the associations between VB-1 and VB-2, and their relations to nutritional status in TB and TB+T2DM patients.Methods and Study Design: This was a cross-sectional study that prospectively enrolled TB 40 patients with or without T2DM respectively from the Chest Hospital of Qingdao and 76 healthy controls with similar age and gender distributions were recruited from the medical center of the affiliated hospital of Qingdao Medical College. The erythrocyte transketolase activation coefficient (ETKac, for VB-1 deficiency), the glutathione reductase activation coefficient (EGRac, for VB-2 deficiency), and metabolic enzyme activities were analyzed.Results: VB-1 and VB-2 deficiency rates were higher, and enzyme activities were lower in TB and TB+T2DM relative to control group. ETKac and EGRac were negatively correlated with enzyme activities, either with body mass index (BMI), while enzyme activities were positively associated with BMI.Conclusions: VB-1 and VB-2 concentrations were lower in TB patients with or without T2DM relative to controls, with concomitant reductions in the activity levels of key metabolic enzymes. Significant correlations were observed between VB-1 and VB-2 concentrations and the activity of these metabolic enzymes, they all correlated with nutrition status. VB-1 and VB-2 concentrations may thus impact metabolic enzyme activity and thereby influence nutritional status. [ABSTRACT FROM AUTHOR]

[Display omitted] • We firstly reported the ore ages of the newly discovered Li-rich pegmatite in the NQT. • The newly discovered pegmatites have similar ages to the pegmatite in the MYK. • The pegmatites in the NQT may be formed in a continental collision setting. Lithium–(beryllium) are important strategic metals in modern industries. The Markam–Yajiang–Karakoram (MYK) giant Li ore belt (>14 Mt Li 2 O) is located in the central Qinghai–Tibetan Plateau, and is a world-class Li deposit belt. The reported pegmatite deposits in the belt are mainly found in the Tianshuihai–Songpan–Garzê Terrane (TSGT) and are generally considered to be related to Late Triassic S-type granites and flysch sedimentary rocks. Recently, abundant pegmatite veins have also been discovered in an adjacent terrane (i.e., the North Qaidam Terrane) to the north of the MYK belt, but it is unclear whether these newly discovered pegmatites are genetic related to the MYK belt. Here, we report high-precision columbite–tantalite (i.e., coltan) U–Pb ages and muscovite–lepidolite 40Ar/39Ar ages for the Li–(Be) rare-element pegmatites from the North Qaidam Terrane (NQT) in the Chakabeishan area of the Zongwulong orogenic belt. Coltan grains from three spodumene-bearing pegmatite samples yielded weighted-mean 207Pb-corrected U–Pb ages of 214.9 ± 1.7, 217.0 ± 2.3, and 215.0 ± 1.5 Ma. Muscovite 40Ar/39Ar dating of two spodumene-bearing pegmatite samples and one barren pegmatite sample yielded plateau ages of 213.00 ± 0.97, 211.67 ± 0.35, and 211.78 ± 0.29 Ma, respectively. A lepidolite 40Ar/39Ar age for a lepidolite-bearing pegmatite is 216.62 ± 0.88 Ma. The subtle age differences obtained by the different methods are within reasonable error estimates or may be due to different closure temperatures. The ore-forming ages of the Chakabeishan Li–(Be) rare-element pegmatites are similar to those of Li–(Be) pegmatite deposits in the MYK belt. This and data from previous studies suggest that the Chakabeishan Li–(Be) rare-element pegmatites were also formed in a post-collisional setting after the closure of the Paleo-Tethys (Anyemaqen) Ocean. This study has important implications for understanding the origins of the MYK Li ore belt, indicating that the formation of these Li deposits was not solely associated with the Late Triassic S-type granites and flysch sedimentary rocks. Our results may also have implications for exploration, which extends the potential area of Li deposits from the Tianshuihai–Songpan–Garzê Terrane to the North Qaidam Terrane. [ABSTRACT FROM AUTHOR]

Land Use/ Cover Change (LUCC) plays a crucial role in influencing hydrological processes, nutrient cycling, and sediment transport in watersheds, ultimately impacting water quality on both spatial and temporal scales. Accurately predicting changes in watershed water quality is beneficial for the sustainable management of water resources. Current models often lack the ability to effectively predict water quality changes in a dynamic spatio-temporal context, particularly in complex watershed environments. The overall purpose of the study is to establish a comprehensive and dynamic modeling framework that links LUCC with water quality, allowing for accurate predictions of future water quality under varying land use scenarios. The model, which uses water quality as the dependent variable and LUCC as the independent variable, was developed to quantitatively predict changes in watershed water quality. To achieve this, annual multi-period remote sensing images from Landsat-5, Landsat-8 or Sentinel-2 satellites spanning from 1992 to 2022 were analyzed. Random Forest (achieving a Kappa coefficient of 0.9468) were employed to classify land use within the watershed. Based on classification results, a Cellular Automata-Markov chain model (CA-Markov) was constructed to simulate and predict the spatio-temporal patterns of land use, incorporating driving factors such as proximity to water systems, roads, elevation, and slope. Validation of the model using LUCC data from 2020 yielded a high prediction accuracy with a Kappa coefficient of 0.9505. The CA-Markov model was further utilized to project LUCC under three different scenarios-natural development, ecological protection, and arable land protection-between 2023 and 2033. Based on these projections, the coupled water quality and LUCC model was employed to predict water quality changes in the watershed over the same period. Key findings indicate that water quality is likely to improve under ecological protection scenario, while deterioration is expected under natural development scenario and cropland protection scenario due to urban expansion, agricultural practices, and water diversion for irrigation. This study provides a robust framework for watershed management, offering scientific guidance for source management and water purification efforts, thereby contributing significantly to the sustainable development of water resources., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Xiaoming Li reports financial support was provided by China Hunan Provincial Science and Technology Department. If there are other authors, they 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 Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: The impact of coronavirus disease 2019 (COVID-19) on diabetic kidney disease (DKD) patients in China is not fully understood. This study aimed to investigate infection status in a DKD cohort post-renal biopsy and analyze vaccination and infection rates, as well as symptom severity, across various renal pathologies in DKD patients., Methods: This epidemiological survey, centered on COVID-19, employed a Chinese DKD and renal puncture follow-up cohort. A customized questionnaire enabled standardized data gathering. It collected data on clinical characteristics, vaccination and infection statuses, and diverse pathological types. The study analyzed the relationship between vaccination and infection statuses across various pathological types, evaluating characteristics and treatment outcomes in patients with infections., Results: In total, 437 patients with DKD from 26 Chinese provinces were followed up for a median of 44.6 ± 20 months. COVID-19 infection, vaccination, and novel coronavirus pneumonia (NCP) rates were 73.68%, 59.3%, and 6.63%, respectively. Ten patients with NCP had severe pneumonia or died of COVID-19. Renal pathology revealed that 167 (38.22%) patients had diabetic nephropathy (DN), 171 (39.13%) had non-diabetic renal disease (NDRD), and 99 had DN and NDRD (22.65%). The DN group had the lowest vaccination (54.5%), highest all-cause mortality (3.6%), and highest endpoint rates (34.10%). Compared to patients who were not vaccinated pre-infection (117 cases), vaccinated patients (198 cases) had reduced NCP (6.6% vs. 13.7%), severity (1.0% vs. 3.4%), and endpoint (9.10% vs. 31.60%) rates., Conclusion: Vaccination can prevent infection and diminish COVID-19 severity in patients with DKD; therefore, increasing vaccination rates is particularly important., Clinical Trial Registration: ClinicalTrails.gov, NCT05888909., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wang, Dong, Zhang, Zheng, Lyu, Zhang, Huang, Liu, Wang, Zhang, Cao, Wu, Zhou, Cai and Chen.)

Objectives: Decreased prognostic nutritional index (PNI) was associated with adverse outcomes in many clinical diseases. This study aimed to evaluate the relationship between baseline PNI value and adverse clinical outcomes in patients with coronary artery disease (CAD)., Design: The Personalized Antiplatelet Therapy According to CYP2C19 Genotype in Coronary Artery Disease (PRACTICE) study, a prospective cohort study of 15 250 patients with CAD, was performed from December 2016 to October 2021. The longest follow-up period was 5 years. This study was a secondary analysis of the PRACTICE study., Setting: The study setting was Xinjiang Medical University Affiliated First Hospital in China., Participants: Using the 50th and 90th percentiles of the PNI in the total cohort as two cut-off limits, we divided all participants into three groups: Q1 (PNI <51.35, n = 7515), Q2 (51.35 ≤ PNI < 59.80, n = 5958) and Q3 (PNI ≥ 59.80, n = 1510). The PNI value was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm 3 )., Primary Outcome: The primary outcome measure was mortality, including all-cause mortality (ACM) and cardiac mortality (CM)., Results: In 14 983 participants followed for a median of 24 months, a total of 448 ACM, 333 CM, 1162 major adverse cardiovascular events (MACE) and 1276 major adverse cardiovascular and cerebrovascular events (MACCE) were recorded. The incidence of adverse outcomes was significantly different among the three groups (p <0.001). There were 338 (4.5%), 77 (1.3%) and 33 (2.2%) ACM events in the three groups, respectively. A restricted cubic spline displayed a J-shaped relationship between the PNI and worse 5-year outcomes, including ACM, CM, MACE and MACCE. After adjusting for traditional cardiovascular risk factors, we found that only patients with extremely high PNI values in the Q3 subgroup or low PNI values in the Q1 subgroup had a greater risk of ACM (Q3 vs Q2, HR: 1.617, 95% CI 1.012 to 2.585, p=0.045; Q1 vs Q2, HR=1.995, 95% CI 1.532 to 2.598, p <0.001)., Conclusion: This study revealed a J-shaped relationship between the baseline PNI and ACM in patients with CAD, with a greater risk of ACM at extremely high PNI values., Trial Registration Number: NCT05174143., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Previous studies suggested protective associations of vegetables and fruits (VF) intake with cognitive function, but evidence on specific types of VF was insufficient., Methods: The current study included 4066 participants from 1997 to 2006 in the China Health and Nutrition Survey (CHNS) and 6170 participants from 2013 to 2020 in the Health and Retirement Study (HRS). Dietary intake (using 3-day 24-h dietary recalls in CHNS and food frequency questionnaire in HRS) and cognitive function (using the Telephone Interview for Cognitive Status-Modified, TICS-m) were measured. Linear mixed-effects models were used to estimate the beta coefficients (β) and the 95% confidence intervals (CI) to evaluate the association of VF with cognitive function (z-score) and its decline., Results: Highest intake of total VF was associated with better cognitive function and slower cognitive decline. Differences in cognitive function z-score between the highest and lowest tertiles of VF consumption were 0.039 (95% CI: 0.002, 0.076) for CHNS and 0.063 (95% CI: 0.026, 0.100) for HRS. The corresponding differences in annual cognitive decline were 0.011 (95% CI: 0.002, 0.021) and 0.012 (95% CI: 0.003, 0.020) units respectively. Vegetables and fruits showed independent associations with cognitive function and its decline. In specific VF subgroups, when comparing the highest to the lowest tertile intake, cruciferous vegetables (β = 0.058, 95% CI: 0.017, 0.100 in CHNS and β = 0.067, 95% CI: 0.032, 0.101 in HRS) and green leafy vegetables (β = 0.036, 95% CI: -0.001, 0.073 in CHNS and β = 0.082, 95% CI: 0.046, 0.117 in HRS) was associated with better cognitive function in both cohorts. Similarly, higher intake of dark-colored vegetables (β = 0.019, 95% CI: 0.008, 0.030 for red/yellow vegetables in CHNS and β = 0.004, 95% CI: 0.001, 0.007 for green leafy vegetables in HRS) were associated with slower cognitive decline in subsequent years. Moreover, rigorous sensitivity analyses confirmed the stability of the results., Conclusions: Our findings support the potential beneficial roles of VF, especially cruciferous vegetables, green leafy vegetables, and red/yellow vegetables, in maintaining cognitive function and slowing cognitive decline in middle-aged and older adults., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Introduction: Hysterectomy is the most common surgical procedure in the field of gynaecology. The traditional multiport laparoscopy, transumbilical laparoendoscopic single-site surgery (TU-LESS) and transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy approaches have been implemented to varying degrees in clinical practice. At present, although their feasibility has been proven, there are no large randomised controlled studies on postoperative rehabilitation. This study aims to evaluate postoperative recovery and assess the safety and effectiveness of these three surgical approaches for total laparoscopic hysterectomy., Method and Analysis: This is a multicentre, randomised, single-blind, three-arm, parallel-group, interventional clinical trial. Recruitment will be carried out in five tertiary hospitals in China. Patients diagnosed with benign uterine disease or precancerous lesions will be assigned to the vNOTES group, TU-LESS group and conventional laparoscopy group at a 1:1:1 ratio. The achievement rate of comprehensive indices of enhanced recovery after surgery (ERAS) within 24 hours postoperatively will be considered the primary outcome (the comprehensive indicators of ERAS include fluid intake, passing flatus, urination after catheter removal, ambulation and a Visual Analogue Scale score ≤3.) This study will use a non-inferiority test, with a power (1-ß) of 80% and a margin of -0.15, at a one-sided α of 0.0125. The sample size will be 480 patients (including an assumed 15% dropout rate), calculated according to the primary outcome., Ethics and Dissemination: This study was approved on 25 April 2022 by the Medical Ethics Committee of West China Second University Hospital (2022(057)), Sichuan University, Chengdu, China. All participants will be required to provide informed consent before their participation in the study. The results of the trial will be submitted for publication in a peer-reviewed journal and presented at international conferences., Protocol Version: V.3.0, 31 August 2023., Trial Registration Number: ChiCTR2200057405., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The cancer screening rate in the working population is very low in China. Information-motivation-behavioral skills (IMB) model has been applied to elucidate screening behavior for various chronic diseases but has not been investigated in analyzing cancer screening behavior. This study aimed to examine factors influencing cancer screening behavior and their linkages based on the IMB model., Methods: A cross-sectional study was conducted in Shanghai, China from August to October 2021. Data were obtained through an anonymous questionnaire. Predictive relationships between variables in the IMB model and cancer screening behavior were evaluated. Structural equation modeling (SEM) was constructed to demonstrate the utility of the IMB model., Results: Among the 556 participants included in the analysis, 34.4% of participants had ever done a cancer screening. The construct validation analysis supported that the measure items included were acceptable. SEM found that knowledge of cancer warning signs and symptoms (β = 0.563, p < 0.001) and cancer screening behavioral skills (β = 0.264, p = 0.003) were related to participation in cancer screening, whereas cancer screening motivation was not directly influenced the participation in cancer screening (β = - 0.075, p = 0.372)., Conclusion: The cancer screening rate was found to be lower than expected in the working population. The IMB model could be used to make decisions in implementing behavioral interventions to participate in cancer screening among the Chinese working population. Enhancing the knowledge of cancer warning signs and symptoms and strengthening behavioral skills should be focused on to improve participation in cancer screening., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wang, Zhou, Zhang, Shen, Mo, He and Zheng.)

Background: The management of prediabetes has great clinical significance, and primary care providers (PCPs) play important roles in the management and prevention of diabetes in China. Nevertheless, little is known about PCPs' knowledge, attitudes, and practices (KAP) regarding prediabetes. This cross-sectional study aimed to assess the KAP regarding prediabetes among PCPs in the Central China region., Methods: This cross-sectional study was conducted using self-administered KAP questionnaires among PCPs from Central China region., Results: In total, 720 PCPs completed the survey. Most physicians (85.8%) claimed to be aware of the adverse effects of prediabetes and reported positive attitudes toward prediabetes prevention, but the PCPs' knowledge of prediabetes and management practices showed substantial gaps. The prediabetes knowledge level and practice subscale scores of the PCPs were only 54.7% and 32.6%, respectively, of the corresponding optimal scores. Female PCPs showed higher prediabetes knowledge level scores ( p = 0.04) and better practice scores ( p = 0.038). Knowledge and attitude scores were inversely correlated with participants' age and duration of practice ( p < 0.001). The PCPs who served in township hospitals had significantly higher knowledge and attitude scores than those who served in village clinics ( p < 0.001). Furthermore, knowledge and practice scores increased with increasing professional titles. Recent continuing medical education (CME) attendance had a significant positive influence on knowledge of prediabetes ( p = 0.029), but more than four-fifths of the surveyed PCPs did not participate in diabetes-related CME in the past year., Conclusions: Substantial gaps were observed in PCPs' knowledge and practices regarding prediabetes in the Central China region. CME programmes were under-utilized by PCPs. Structured programmes are required to improve PCPs' prediabetes-related knowledge and practices in China., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Pi, Yan, Fei, Zheng, Shi, Wang and Zhou.)

Background: The disease pathology for diabetes mellitus patients with chronic kidney disease (CKD) may be diabetic nephropathy (DN), non-diabetic renal disease (NDRD), or DN combined with NDRD. Considering that the prognosis and treatment of DN and NDRD differ, their differential diagnosis is of significance. Renal pathological biopsy is the gold standard for diagnosing DN and NDRD. However, it is invasive and cannot be implemented in many patients due to contraindications. This article constructed a new noninvasive evaluation model for differentiating DN and NDRD., Methods: We retrospectively screened 1,030 patients with type 2 diabetes who has undergone kidney biopsy from January 2005 to March 2017 in a single center. Variables were ranked according to importance, and the machine learning methods (random forest, RF, and support vector machine, SVM) were then used to construct the model. The final model was validated with an external group (338 patients, April 2017-April 2019)., Results: In total, 929 patients were assigned. Ten variables were selected for model development. The areas under the receiver operating characteristic curves (AUCROCs) for the RF and SVM methods were 0.953 and 0.947, respectively. Additionally, 329 patients were analyzed for external validation. The AUCROCs for the external validation of the RF and SVM methods were 0.920 and 0.911, respectively., Conclusion: We successfully constructed a predictive model for DN and NDRD using machine learning methods, which were better than our regression methods., Clinical Trial Registration: ClinicalTrial.gov, NCT03865914., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Liu, Dong, Wang, Pei, Chen, Zheng, Wang, Chen, Feng, Sun, Cai and Chen.)

Objective: To investigate the factors that influence the length of stay (LOS) in a neonatal intensive care unit (NICU)., Methods: This retrospective study analysed clinical data from all newborns hospitalized in the NICU of a tertiary hospital in the Western Hunan area of China over a 9-year period (2012-2020). Factors associated with the LOS were analysed using univariate analysis and Cox regression analysis., Results: A total of 16 094 newborns were included in the study: of which 9615 were inborn and 6479 were outborn newborns. There were 9482 males and 6612 females. Over the 9-year period, the mean LOS was 11.08 days (median LOS, 9.00 days; range, 1-141 days); and the LOS first increased, then decreased and stabilized. A LOS of 8-28 days was the most common duration (8849 of 16 094; 54.98%). Cox regression analysis demonstrated that sex, patient source, delivery method, gestational age, birth weight and comorbidities were significantly associated with LOS., Conclusion: Being male, low gestational age and low birth weight increased the LOS. Reducing preterm and post-term infants, as well as eliminating comorbidities, could effectively shorten the LOS of newborns.

To explore a new marker which can detect bacterial vaginosis (BV) with high sensitivity and specificity quantitatively. According to the Nugent Score, vaginal secretions from study participants were divided into BV, healthy, and BV-intermediate groups. First, we compared the obvious differences and high abundance of bacteria in the three groups using 16S rRNA-sequencing, and screened out candidate markers. Then, quantitative detection of these candidate markers from the three groups was done using real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR), followed by evaluation of the sensitivity and specificity. Finally, we verified the new markers using clinical cases. Gardnerella vaginalis, Atopobium vaginae, Lactobacillus, Megasphaera were screened out by 16S rRNA-sequencing. RT-qPCR data were transformed and analyzed through ROC curves. PCR results for these bacteria were log-transformed using Lactobacillus crispatus as the numerator and other BV-related bacteria as the denominator. Four new indicators were found. Of these, log L. crispatus / G. vaginalis (L/G) <0 was the best indicator. The sensitivity, specificity, positive predictive value, and negative predictive value of our system were 93.5%, 97.2%, 96.6 and 94.6%, respectively. Combination of data for 16S rRNA-sequencing and RT-qPCR revealed four indicators for BV detection. Of these, log L/G < 0 was the best indicator. Creating a molecular-diagnostic system independent of the Nugent Score for BV could have an important impact on the clinical management of BV. Abbreviation : log L. crispatus / G. vaginalis (logL/G); Bacterial vaginosis (BV); vaginal secretions (VSs); polymerase chain reaction (PCR); rRNA-sequencing (rRNA-seq); real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR); operational taxonomic unit (OTU); non-metric multidimensional scaling (NMDS); receiver operating characteristic (ROC).

The aim of this study is to assess the impacts of urban green space on depressive symptoms among Chinese urban residents aged 45 and older. In total, 7397 urban respondents were included in this study. Each respondent participated in the China Health and Retirement Longitudinal Study Wave 3 (2015). Environmental-level variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were used in the multilevel regression analysis. Almost one-third of the sample population suffered from depressive symptoms (31.20%). The multilevel logistic regression model showed that green coverage ratio of city-built districts is negatively associated with the prevalence of depressive symptoms among urban mid-aged (OR = 0.79, p < 0.05) and elderly (OR = 0.75, p < 0.05) residents, and the public recreational green space helps to reduce elderly people's depressive symptoms (OR = 0.77, p < 0.05). This study adds insights about the impact of green space and other environmental factors on depressive symptoms among mid-aged and elderly urban dwellers. It is important to provide enough and accessible overall urban green spaces; additionally, attention should also be paid to specific green space forms such as public recreational green space.

Background and Objectives: Poor nutritional status is a common finding in pulmonary tuberculosis (TB) patients with and without type 2 diabetes mellitus (T2DM), thiamin (VB-1) and riboflavin (VB-2) are coenzymes important for the activation of many enzymes involved in improving nutritional status. We aimed to investigate enzymatic activities and the associations between VB-1 and VB-2, and their relations to nutritional status in TB and TB+T2DM patients., Methods and Study Design: This was a cross-sectional study that prospectively enrolled TB 40 patients with or without T2DM respectively from the Chest Hospital of Qingdao and 76 healthy controls with similar age and gender distributions were recruited from the medical center of the affiliated hospital of Qingdao Medical College. The erythrocyte transketolase activation coefficient (ETKac, for VB-1 deficiency), the glutathione reductase activation coefficient (EGRac, for VB-2 deficiency), and metabolic enzyme activities were analyzed., Results: VB-1 and VB-2 deficiency rates were higher, and enzyme activities were lower in TB and TB+T2DM relative to control group. ETKac and EGRac were negatively correlated with enzyme activities, either with body mass index (BMI), while enzyme activities were positively associated with BMI., Conclusions: VB-1 and VB-2 concentrations were lower in TB patients with or without T2DM relative to controls, with concomitant reductions in the activity levels of key metabolic enzymes. Significant correlations were observed between VB-1 and VB-2 concentrations and the activity of these metabolic enzymes, they all correlated with nutrition status. VB-1 and VB-2 concentrations may thus impact metabolic enzyme activity and thereby influence nutritional status.

Background: Women with advanced-stage high-grade serous ovarian cancer (HGSOC) are likely to have a bad prognosis. Relapses are common in patients even with no evidence of disease after primary treatment. We aimed to identify the prognostic factors for disease recurrence in these patients., Methods: A nested case-control study was conducted in a large medical center in Southwest China. The primary outcome was recurrence of disease within 3 years after clinical remission (CR). Cox regression was used to calculate the time to event analysis in different groups., Results: Ninety-seven patients were finally included. Fifty-seven patients (58.8%) relapsed within 3 years after CR. Among all the variables, the difference in posttreatment CA-125 level was statistically significant (P <0.05) between the recurrent group and the progression-free group in both univariate and multivariable analysis. A cutoff value was set at the median level in the recurrent group (10 U/ml) to categorize patients into two arms. In Cox regression, the posttreatment CA-125 level was identified as a prognostic factor for recurrence with an OR of 1.05 (95% CI: 1.02-1.10, P = 0.033). The median time (from initiation of treatment) until relapse was 25 months for patients whose posttreatment CA-125 levels were higher than 10 U/ml, while it was undefined for patients whose posttreatment CA-125 level were ≤ 10 U/ml. Patients with a higher posttreatment CA-125 level showed an increased risk for OC relapse compared to those with a lower posttreatment CA-125 level. Furthermore, as shown in line graphs recording serum CA-125 levels during follow-up in each recurrent case, the increments of serum CA-125 levels were delayed in recurrent OC patients who had a posttreatment CA125 level ≤ 10 U/ml compared with those with a higher CA-125 level., Conclusion: A low serum CA-125 level after primary treatment was a potential prognostic factor in women with advanced HGSOC., (© 2021. The Author(s).)