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Objective: We aimed to investigate the prevalence of covert hepatic encephalopathy (CHE) in cirrhotic patients in China and its risk factors. Methods: A multicenter prospective observational study was conducted from January 2021 to March 2022 at 16 medical centers across China to investigate the risk factors of CHE and establish a prediction model for CHE episodes. Results: A total of 528 patients were enrolled in the study. Based on both the psychometric hepatic encephalopathy score and Stroop test results, the prevalence of CHE was 50.4% (266/528), and the consistency between these two tests was 68.9%. Multivariate analysis showed that age (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.022–1.063, P < 0.001), duration of education (OR 0.891, 95% CI 0.832–0.954, P = 0.001), comorbidities of cardiovascular diseases, hypertension, cerebral apoplexy or diabetes mellitus (OR 2.072, 95% CI 1.370–3.133, P < 0.001), Child–Pugh score (OR 1.142, 95% CI 1.029–1.465, P = 0.025), and blood urea nitrogen concentration (OR 1.126, 95% CI 1.038–1.221, P = 0.004) were associated with CHE episodes. According to the Chronic Liver Disease Questionnaire, CHE patients had lower scores for abdominal symptoms and systemic symptoms (P < 0.001), indicating a poor health‐related quality of life. Based on a stepwise Cox regression hazard model, we established a nomogram for determining the probabilities of CHE episodes, and the area under the receiver operating characteristic curve was 0.733 (95% CI 0.679–0.788) and 0.713 (95% CI 0.628–0.797) in the training and validation cohorts. Conclusions: CHE is a common complication of cirrhosis in China. Large‐scale studies with long‐term follow‐up are needed to determine the natural history of Chinese CHE patients. [ABSTRACT FROM AUTHOR]

Accurate estimation of regional and global patterns of ecosystem respiration (ER) is crucial to improve the understanding of terrestrial carbon cycles and the predictive ability of the global carbon budget. However, large uncertainties still exist in regional and global ER estimation due to the drawbacks of modeling methods. Based on eddy covariance ER data from 132 sites in China from 2002 to 2020, we established Intelligent Random Forest (IRF) models that integrated ecological understanding with machine learning techniques to estimate ER. The results showed that the IRF models performed better than semiempirical models and machine learning algorithms. The observed data revealed that gross primary productivity (GPP), living plant biomass, and soil organic carbon (SOC) were of great importance in controlling the spatiotemporal variability of ER across China. An optimal model governed by annual GPP, living plant biomass, SOC, and air temperature (IRF‐04 model) matched 93% of the spatiotemporal variation in site‐level ER, and was adopted to evaluate the spatiotemporal pattern of ER in China. Using the optimal model, we obtained that the annual value of ER in China ranged from 5.05 to 5.84 Pg C yr−1 between 2000 and 2020, with an average value of 5.53 ± 0.22 Pg C yr−1. In this study, we suggest that future models should integrate process‐based and data‐driven approaches for understanding and evaluating regional and global carbon budgets. Plain Language Summary: With China already committing to achieve carbon neutrality before 2060, an accurate assessment of land carbon sink and its flux rate in China is an increasingly important area in global change ecology. In this essay, a high‐efficiency and accurate simulation method was introduced in this field; This method is particularly useful in the assessment of carbon sink and its flux rate in China by combining with reliable observation flux data. Using this new method, a reliable and reasonable value of carbon flux (ecosystem respiration) was obtained. Meanwhile, that method provides a better understanding of the mechanism governing the spatiotemporal variability of carbon flux. Therefore, this present study has gone some way toward enhancing our understanding of a comprehensive assessment and analysis of land carbon sink in China. Key Points: A model integrating ecological knowledge and machine learning was established to estimate ecosystem respiration (ER) in ChinaThe spatiotemporal patterns of ER are significantly affected by productivity, plant biomass, soil organic carbon, and air temperatureChina's ER was estimated to be 5.53 ± 0.22 petagrams of carbon per year (Pg C yr−1) on average for the years 2000–2020 [ABSTRACT FROM AUTHOR]

Climate warming-induced rangeland degradation in arid and semiarid steppe imposes substantial threats to the livelihoods of people. But this dilemma can be solved by combining all sectors of agriculture, animal husbandry and tourism through their complementarity, i.e. by adopting integrated landscape ecosystem-based approaches. A number of experiences and lessons have been achieved in a specific sector for its successful development, but not in the multiple social, economic, and ecological systems. In this study, we uses the perspective of integrated ecosystem management to strengthen crop-livestock integration and innovative livelihoods, and propose a multifunctional Kailash Landscape to activate the inter-linkage among agriculture, animal husbandry, and heritage pilgrimage/tourism in order to achieve multifunction of the socio-ecological system. A case study of Kailash Sacred Landscape Conservation and Development Initiative in China was quantitatively and qualitatively analyzed by land use and land cover change and its consequence on multiple ecosystem services. Integrated landscape management was found to be effective in building resilience of socio-ecosystems by reducing the vulnerability of traditional agriculture in terms of improving crop production and animal husbandry. A multifunctional landscape is expected to be integrated and build a resilient sector complementarity including farming, pastorism, environmental and socioeconomic function. The analyses show that integrated landscape approaches provide an effective perspective for sustainable socio-economic development in this sacred landscape. The findings highlight the importance of landscape-scale ecosystem-based adaptation to environment change. [ABSTRACT FROM AUTHOR]

Background: Diagnostic criteria for sarcopenia have not been established in Chinese. This study established criteria based on the L3‐skeletal muscle index (L3‐SMI) and assessed its value for outcomes predicting in cirrhotic Chinese patients. Methods: Totally 911 subjects who underwent a CT scan at two centres were enrolled in Cohort 1 (394 male and 417 female subjects, aged 20–80 years). The data of those subjects younger than 60 years (365 male and 296 female subjects) were used to determine the reference intervals of the L3‐SMI and its influencing factors. Cohort 2 consisted of 480 patients (286 male and 184 female patients) from three centres, and their data were used to investigate the prevalence of sarcopenia and evaluate the value of L3‐SMI for predicting the prognosis and complications of cirrhosis. Results: Age and sex had the greatest effects on the L3‐SMI (P < 0.001). The L3‐SMI scores were clearly higher in male patients than in female patients (52.94 ± 8.41 vs. 38.91 ± 5.65 cm2/m2, P < 0.001) and sharply declined in subjects aged ≥ 60 years. Based on the mean −1.28 × SD among adults aged < 60 years, the L3‐SMI cut‐off value for sarcopenia was 44.77 cm2/m2 in male patients and 32.50 cm2/m2 in female patients. Using these values, 22.5% of the cirrhotic patients (28.7% of male patients and 11.9% of female patients) were diagnosed with sarcopenia. Compared with non‐sarcopenia individuals, sarcopenia patients had lower body mass index (21.28 ± 3.01 vs. 24.09 ± 3.39 kg/m2, P < 0.001) and serum albumin levels (31.54 ± 5.93 vs. 32.93 ± 5.95 g/L, P = 0.032), longer prothrombin times (16.39 ± 3.05 vs. 15.71 ± 3.20 s, P = 0.049), higher total bilirubin concentrations (41.33 ± 57.38 vs. 32.52 ± 31.48 μmol/L, P = 0.039), worse liver function (Child–Pugh score, 8.05 ± 2.11 vs. 7.32 ± 2.05, P = 0.001), higher prevalence of cirrhosis‐related complications (81.82% vs. 62.24%, P < 0.001) and mortality (30.68% vs. 11.22%, P < 0.001). Overall survival was significantly lower in the sarcopenia group [risk ratio (RR) = 2.643, 95% confidence interval (CI) 1.646–4.244, P < 0.001], accompanied with an increased cumulative incidence of ascites (RR = 1.827, 95% CI 1.259–2.651, P = 0.002), spontaneous bacterial peritonitis (RR = 3.331, 95% CI 1.404–7.903, P = 0.006), hepatic encephalopathy (RR = 1.962, 95% CI 1.070–3.600, P = 0.029), and upper gastrointestinal varices (RR = 2.138, 95% CI 1.319–3.466, P = 0.002). Subgroup analysis showed sarcopenia shortened the survival of the patients with Model For End‐Stage Liver Disease score > 14 (RR = 4.310, 95% CI 2.091–8.882, P < 0.001) or Child–Pugh C (RR = 3.081, 95% CI 1.516–6.260, P = 0.002). Conclusions: Sarcopenia is a common comorbidity of cirrhosis and can be used to predict cirrhosis‐related complications and the prognosis. [ABSTRACT FROM AUTHOR]

Using the Surface waterproofing to solve moisture expansion which leads to the acceleration of surface weathering of sandstone relics is a hot topic. This study focuses on surface coating protection because of the special status of cultural relics. The fluorinated ZnO/SiO 2 nano-coating was applied on the sandstone matrix in this work. The loading of the fluorinated ZnO/SiO 2 in the nano-coating, the penetration depth of the nano-coating in the sandstone matrix, and the waterproofing effect of the sandstone surface were investigated within the limitation of the color difference systematically. The freeze-thaw cycles, light exposure, water absorption, and aging tests were carried out to evaluate the environmental durability of the nano-coating in a simulated humid environment of southwestern of China. All the tests meet the criteria for the heritage protection color difference. When the loading of fluorinated ZnO/SiO 2 nano-coating is 0.4%, the water contact angle (WCA) and oil contact angle (OCA) are significantly improved, which are larger than 160° and 140°, respectively. The WCA and OCA have little changed after freeze-thaw cycle for three weeks, and the WCA only decreases only 7% after 300 h UV aging treatment. This significantly enhanced stability is due to the good penetration depth of the fluorinated ZnO/SiO 2 nano-coating on the sandstone matrix. Moreover, the excellent air permeability is achieved as well to ensure substrate breathing. This work would provide a new idea for the long-term protection of sandstone heritage in practical environment. [ABSTRACT FROM AUTHOR]

Mosquito transmitted viruses are responsible for an increasing burden of human disease. Despite this, little is known about the diversity and ecology of viruses within individual mosquito hosts. Here, using a meta-transcriptomic approach, we determined the viromes of 2,438 individual mosquitoes (81 species), spanning ~4,000 km along latitudes and longitudes in China. From these data we identified 393 viral species associated with mosquitoes, including 7 (putative) species of arthropod-borne viruses (that is, arboviruses). We identified potential mosquito species and geographic hotspots of viral diversity and arbovirus occurrence, and demonstrated that the composition of individual mosquito viromes was strongly associated with host phylogeny. Our data revealed a large number of viruses shared among mosquito species or genera, enhancing our understanding of the host specificity of insect-associated viruses. We also detected multiple virus species that were widespread throughout the country, perhaps reflecting long-distance mosquito dispersal. Together, these results greatly expand the known mosquito virome, linked viral diversity at the scale of individual insects to that at a country-wide scale, and offered unique insights into the biogeography and diversity of viruses in insect vectors., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Building a scientific and reasonable ecological network is the key for optimizing the pattern of territorial development and protection, and is of great significance for ensuring regional ecological security and promoting the virtuous cycle of ecosystems. In previous studies, nodal attack method (destruction of ecological source area) was often used in the "robustness" evaluation of ecological networks. Actually, the ecological corridor is more fragile than the source area, and thus the nodal attack method is not reasonable. In this study, taking Jiuquan City as the research area, based on the circuit model to construct the ecological network, we carried out the topology optimization of ecological network by using three strategies (random edge increase, node degree and priority edge increase with low node intermedium number) in complex network theory. We compared and analyzed the "robustness" of ecological network before and after optimization by constructing edge attack strategy, and selected the best network optimization strategy. The results showed that 65 ecological source areas were identified in Jiuquan City, with a total area of 20275.15 km 2 , and that grassland accounted for 89.5% of the source area. We identified 179 ecological corridors with a total length of 6387.16 km, 158 ecological barrier points with a total area of 1385.5 km 2 . The unused land accounted for 92.2% of the total barrier points area. We identified 63 ecological pinch points, mainly concentrated in the source edge and corridor intersection. Among them, the spatial distribution of 11 barrier points and pinch points was consistent, which was the key area to be repaired in ecological network optimization. The three optimization strategies had significantly improved the stability of ecological network in Jiuquan City. The relative size of the maximum connected subgraph and the edge connected rate of the ecological network of the optimization strategy of adding edges according to degree were all the most stable under random attack mode and deliberate attack mode, which was the best optimization scheme for ecological network in Jiuquan City.

Based on the PSR model, we built an evaluation system for resource and environment carrying capacity. We used the entropy weight method, the comprehensive index model and the spatial analysis function of GIS to explore the spatial-temporal dynamic of the resource and environment carrying capacity of the Lanzhou-Xining urban agglomeration, and used the obstacle degree model to identify the obstacle factors. The results showed that resource and environment carrying capacity of the Lanzhou-Xining urban agglomeration from 2005 to 2018 showed a fluctuating upward trend, which was generally at good condition. The coefficient of variation of resource and environment carrying capacity had a fluctuating upward trend, while regional differences were gradually expanding. Spatially, resource and environment carrying capacity presented a "dual-core" structure centered on the main urban areas of Lanzhou and Xining. The high-level areas were mainly concentrated in the Hehuang Valley with Lanzhou and Xining as the center and some surrounding counties, while the low-level areas were distributed in the central and southern regions of the urban agglomeration. Among them, there were spatiotemporal variations of the subsystem index. The pressure index showed a fluctuating and decreasing trend, and spatially showed a decreasing distribution characteristic from Lanzhou and Xining urban areas to the peripheral areas. The state index showed a fluctuating upward trend, and spatially showed the evolution characteristics of high in the east and west wings and low in the middle. The response index showed an upward trend, and spatially showed distribution patterns high in the east and middle, and low in the west and outside. The urbanization rate, per capita industrial wastewater discharge, domestic waste harmless treatment rate, water consumption index, and the proportion of environmental protection investment in GDP are the main obstacles restricting the improvement of resource and environment carrying capacity of Lanhzhou-Xining urban agglomeration.

Objective: To evaluate the reliability and validity of the Chinese version of the eight-item Morisky Medication Adherence Scale (MMAS-8) in Chinese patients with systemic lupus erythematosus (SLE)., Methods: The survey was conducted with a consecutive sampling of 158 Chinese SLE patients attending public hospitals from January to March 2021. We used the translated Chinese version of the MMAS-8 to collect related data. Reliability, item, and factor analyses were used to test the reliability and validity of the MMAS-8 scale in the selected patients. The internal consistency reliability was evaluated using Cronbach's α coefficient. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs) in a subset of 30 participants. Construct validity was evaluated using confirmatory factor analysis and correlations between the Self-efficacy for Appropriate Medication Use Scale (SEAMS) and related measures., Results: The internal consistency reliability of the Chinese version of the MMAS-8 was high (Cronbach's α = 0.817), and the test-retest reliability was excellent (intraclass correlation = 0.947; P < 0.001). There were significant differences in the F test and t test between the two extreme groups before and after the ranking of 27% of the questionnaire scores (P < 0.001). The Kaiser-Meyer-Olkin (KMO) value of construct validity was 0.860. The spherical test value of Bartlettgers was 417.8822. Factor analysis yielded three components that accounted for 69.375% of the total variance. Exploratory factor analysis identified three dimensions of the Chinese version of the MMAS-8. In terms of criterion validity, the correlation of the MMAS-8 score in SEAMS indicated that the convergent validity was good (r = 0.926; P < 0.001)., Conclusions: This study shows that the Chinese version of the Medication Adherence Scale-8 is a reliable and valid tool for assessing medication adherence in Chinese SLE patients. Key Points • Many factors affect medication adherence in SLE patients. • Many questionnaires measure medication adherence levels. • There is a lack of reliable validation of medication adherence questionnaires specifically for SLE patients., (© 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

To explore the hydrogen and oxygen stable isotopes and vapor sources of atmospheric precipitation in the loess region of north Shaanxi, we collected 107 samples of precipitation during 2018 to 2020 in the Dingbian County, Shaanxi Province. After measuring δ 18 O and δ 2 H of precipitation, we analyzed the isotopic characteristics and vapor sources of precipitation in different seasons. There was obvious seasonal variability in δ 18 O and δ 2 H, in that they were more depleted in the wet season (June-September) but more enriched in the dry season (April-May, October-November). In addition, the deuterium excess values were high in the dry season but low in the wet season. The local meteoric water line was regressed as δ 2 H=7.35δ 18 O+4.19 ( R 2 =0.96, P <0.01) with slope and intercept lower than that of the global meteoric water line, indicating an impact of evaporation on isotope fractionation. There was temperature effect in the precipitation isotopes for the whole year and for the dry season, while the precipitation isotopes in the wet season were affected by the combined effects of temperature and rainfall amount. The HYSPLIT model showed that the dry season water vapor mainly came from the Atlantic Ocean and the polar Arctic Ocean, while the wet season vapor mainly came from the Indian Ocean and Pacific subject to the Westerly.

Background: Recent studies have demonstrated the presence of associations between metabolic syndrome and the onset of nonalcoholic fatty liver disease (NAFLD). Metabolic syndrome, in turn, has been found to be linked to high serum uric acid to HDL-cholesterol ratios (UHR). However, the relationship between UHR values and the occurrence of NAFLD in non-obese individuals remains unknown. The present study aimed to examine the possible correlation between UHR values and NAFLD onset among a non-obese Chinese population without dyslipidemia, as well as comparing the predictive value of UHR versus other NAFLD onset predictors., Methods: A total of 9837 non-obese patients, with normal blood lipid levels, were included in a 5-year retrospective cohort study, and the onset of NAFLD in these patients was diagnosed by liver ultrasound., Results: Out of the 9837 patients, 855 were diagnosed with NAFLD during the 5-year follow-up period, for an overall total prevalence of 8.7% at the end of the study period. Across quintiles 1, 2, 3, 4 and 5 of UHR (respectively, ratios of ≤ 120.88, 120.89-154.01, 154.02-189.91, 189.92-240.46, and ≥ 240.47), the prevalence of NAFLD among the patients increased from 2.4%, 5%, 7.9%, 10.3%, and 17.8%, respectively. After adjustments for age, gender, liver and kidney functional markers, as well as metabolic indicators, multivariate Cox proportional hazard regression analysis demonstrated that the hazard ratio (HR) was the highest in quintile 5, at 1.76 (1.12-2.75), and the lowest in quintile 1. The area under the curve (AUC) for UHR (0.690) was higher than that for serum uric acid (UA, 0.666) and HDL-C (0.636), suggesting the predictive ability of UHR for NAFLD onset was better than either alone. This finding was further supported by the presence of an independent association between UHR and NAFLD, even within the normal range of UA and HDL-C; the HR (95% confidence interval, CI) for NAFLD was 1.002 (1.000-1.004). Compared with other significant predictors, AUC for UHR (0.67) was similar to that of low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C, 0.68), non-high-density lipoprotein cholesterol (NHDL-C)/HDL-C (0.68) and alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratios (0.7), and was higher than that of LDL-C (0.63), remnant cholesterol (RC,0.59), and albumin (ALB)/alkaline phosphatase (ALP) ratio (0.61). The sensitivity of UHR (71%) was the highest among all indicators. In the subgroup with ALT < 40U/L, the AUC for UHR was 0.70, which was the highest among all predictors; among ALT > 40U/L, UHR was able to predict the occurrence of NAFLD (AUC = 0.61, p = 0.007), which was not the case for RC (P = 0.441), ALB/ALP (P = 0.419), and ALT/AST (P = 0.159)., Conclusions: UHR serve as an inexpensive and reliable predictor of NAFLD onset in non-obese Chinese people with normal blood lipid levels, allowing for identification of individuals at high risk for NAFLD., (© 2022. The Author(s).)