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Intensified strategic competition between China and the US and the outbreak of the Russia–Ukraine conflict have polarised international attention on the promotion and prospects for European strategic autonomy (ESA). This change in the international and regional environment raises an important question: How does ESA affect China–EU relations? Answering it requires clarification of the main impacts of ESA promotion on China–EU relations. These include: the EU's reduced dependence on key materials and technologies from certain countries, and the formulation and expression, in line with core EU interests, of an independent stance and policies on China; China's adjustment of its European Strategy; and persistent external pressure from the United States. Starting from its particular interests, the EU has, to some extent, independently assessed and accordingly refined its relations with China, having pursued cooperation in global public welfare governance and other areas of similarly low ideological significance, and pragmatically explored ways of moderating competition and enhancing cooperation with China. Fields highly sensitive to geopolitical influence, or which involve key technologies and globally important supply chains, are those wherein China is treated as a competitor. Upon analysis, it can be concluded that the EU's most consistent approach to its goals of strategic autonomy is that of maintaining an alliance with the United States while avoiding full dependence on it, and competing with China in key areas that allow leeway for practical cooperation. [ABSTRACT FROM AUTHOR]

Steel sheeting is usually provided at the upper flange of purlin in steel roof with screw connections. The resulting diaphragm effect provided by the sheeting enhances the buckling resistance of the purlin. However, this diaphragm effect will be reduced due to any abnormality in the screw connection caused by wind-induced fatigue particularly from typhoon. This would reduce the buckling resistance of the purlin with sheeting (the purlin-sheeting system), and it would affect subsequent condition evaluation during their service life. This problem is addressed in this paper with a framework of time-dependent reliability evaluation of the buckling limit state of the purlin-sheeting system. The buckling resistance reduction due to the degradation of the diaphragm effect from typhoon is taken into account in the resistance model. The randomness of wind intensity and landfall occurrence of typhoon during the service life of purlin are also accounted for in the wind load effect model. The time-dependent reliability of the purlin at different positions of a roof is studied. Then the variation of reliability of the system due to the effect of climatic changes in the design service life is discussed. The proposed strategy is then applied to the evaluation of a purlin-sheeting system in eleven cities in China with typhoon occurrences with some useful results for future studies in the provisions of the design code. [ABSTRACT FROM AUTHOR]

This study investigated the interdecadal characteristics of the frequency of the winter single station extreme cold events (SSECEs) in North China and their relationship with sea surface temperature (SST). The results showed the following: (a) The SSECEs occurred frequently before 1991, but less thereafter, with an increase after 2018. The first two interdecadal modes of the SSECE frequency were east–west inverse and "n" patterns. (b) The interdecadal abrupt change of the "n" pattern occurred around 1997/1998. Before 1997/1998, the synergistic effects between the positive Interdecadal Pacific Oscillation (+IPO) and the negative North Atlantic Multidecadal Oscillation (−AMO) triggered the "two troughs and one ridge" anomalous circulation in Eurasia. The Rossby wave energy propagated downstream from the Atlantic, strengthening the Lake Baikal ridge. Furthermore, the Siberian High (SH) became weaker in the north and stronger in the south. With the favorable jet conditions, the cold air invaded North China along the northerly airflow in front of the Lake Baikal ridge, resulting in the frequent SSECE occurrence in central North China. Afterwards, the opposite occurred. (c) The cooperation of SST anomalies (SSTAs) led to the east–west inverse anomaly of the SSECE frequency. Before 1991, the high SSTAs in the central North Atlantic and low SSTAs in the equatorial Indian Ocean and the southwest Pacific triggered "+", "−", "+", and "−" wave trains at mid-latitudes from the Atlantic to the North Pacific. The Rossby wave energy propagated eastward from the Atlantic, resulting in the SH and Urals ridge strengthening, and the Aleutian Low and East Asian trough deepening. The northwestern airflow in front of the Urals ridge guided the cold air into North China, leading to frequent SSECEs in central and eastern North China before 1991. The opposite occurred between 1992 and 2018. [ABSTRACT FROM AUTHOR]

Background The evidence for the comparative effectiveness and safety of ticagrelor versus clopidogrel in older patients with acute coronary syndrome (ACS) is limited, especially in the acute phase of ACS. This study aimed to compare the in-hospital outcomes of ticagrelor versus clopidogrel in older patients with ACS. Methods Hospitalised ACS patients aged ≥75 years who were recruited to the Improving Care for Cardiovascular Disease in China-ACS project between November 2014 and December 2019 and received aspirin and P2Y12 receptor inhibitors within 24 h after first medical contact were included. The primary outcomes were in-hospital major adverse cardiovascular events (MACE) and major bleeding. Multivariable Cox regression was performed to evaluate the comparative effectiveness and safety of ticagrelor and clopidogrel. Inverse probability of treatment weighting (IPTW) and propensity score matching analyses were performed to evaluate the robustness of the results. Results Of 18,244 ACS patients, 18.5% received ticagrelor. Multivariable-adjusted analysis revealed comparable risks of in-hospital MACE between patients receiving ticagrelor and clopidogrel (hazard ratio [HR] 1.12, 95% confidence interval [CI] 0.92–1.35). However, ticagrelor use was associated with 45% higher risk of in-hospital major bleeding compared with clopidogrel use (HR 1.45, 95% CI 1.09–1.91). Similar results were found in the IPTW analysis. Conclusions ACS patients aged ≥75 years receiving ticagrelor during the acute phase had similar risk of in-hospital MACE, but higher risk of in-hospital major bleeding compared with those receiving clopidogrel. More evidence is needed to guide the use of P2Y12 receptor inhibitors during hospitalisation in older patients with ACS. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02306616. [ABSTRACT FROM AUTHOR]

In this study, Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks–Climate Data Record (PERSIANN-CDR) was evaluated for the assessment of long-term drought monitoring in Huaihe River Basin using daily gauge observation data for the period from 1983 to 2017. The evaluation results show that the PERSIANN-CDR algorithm has a good detection ability for small precipitation events over the whole basin, but a poor ability for extreme precipitation events (>50 mm/day). Daily PERSIANN-CDR estimates perform relatively better in areas with abundant precipitation, while the monthly and yearly PERSIANN-CDR estimates are highly consistent with gauge observations both in magnitude and space. The Standardized Precipitation Index (SPI) at various time scales (3, 6, and 12 months) was calculated based on PERSIANN-CDR and gauge observation, respectively. Grid-based values of statistics derived from those SPI values demonstrate that PERSIANN-CDR has a good ability to capture drought events of each time scale across the basin. However, caution should be applied when using PERSIANN-CDR estimates for basin-scale drought trend analysis. Furthermore, three drought events with long duration and large extent were selected to test the applicability of PERSIANN-CDR in drought monitoring. The results show that it has a good ability to capture when and where droughts occur and how far they spread. Due to the overestimation of small precipitation events, PERSIANN-CDR tends to overestimate the number of extreme droughts and their extents. This needs to be considered in future algorithm improvement. [ABSTRACT FROM AUTHOR]

Despite the known influence of continuous cropping on soil microorganisms, little is known about the associated difference in the effects of continuous cropping on the community compositions of soil bacteria and fungi. Here, we assessed soil physicochemical property, as well as bacterial and fungal compositions across different years (Uncropped control, 1, 6, 11, 16, and 21 years) and in the watermelon system of a gravel mulch field in the Loess Plateau of China. Our results showed that long-term continuous cropping led to substantial shifts in soil bacterial and fungal compositions. The relative abundances of dominant bacterial and fungal genera (average relative abundance > 1.0%) significantly varied among different continuous cropping years (P < 0.05). Structural equation models demonstrated that continuous cropping alter soil bacterial and fungal compositions mainly by causing substantial variations in soil attributes. Variations in soil pH, nutrient, salinity, and moisture content jointly explained 73% and 64% of the variation in soil bacterial and fungal compositions, respectively. Variations in soil moisture content and pH caused by continuous cropping drove the shifts in soil bacterial and fungal compositions, respectively (Mantel R = 0.74 and 0.54, P < 0.01). Furthermore, the variation in soil bacterial and fungal composition showed significant correlation with watermelon yield reduction (P < 0.01). Together, long-term continuous cropping can alter soil microbial composition, and thereby influencing watermelon yield. Our findings are useful for alleviating continuous cropping obstacles and guiding agricultural production. [ABSTRACT FROM AUTHOR]

The optimal P2Y 12 inhibitor in high bleeding risk (HBR) patients with acute coronary syndrome (ACS) remains unclear. We compared the in-hospital efficacy and safety of ticagrelor versus clopidogrel in ACS patients at HBR. We identified 22,120 hospitalized ACS patients with HBR treated with aspirin combined with either clopidogrel (n = 17,420) or ticagrelor (n = 4700) in the Improving Care for Cardiovascular Disease in China-ACS (CCC-ACS) project between November 2014 and December 2019. The median length of hospital stay was 10 days (interquartile range, 7–14 days). Compared with clopidogrel, ticagrelor was associated with a higher risk of in-hospital TIMI major or minor bleeding (4.8% vs 3.8%; adjusted OR 1.20; 95% CI 1.03–1.41; P = 0.022). The incidence of TIMI major bleeding (1.7% vs 1.1%, P = 0.005) and intracranial bleeding (0.8% vs 0.5%, P = 0.005) were also higher in the ticagrelor group than in the clopidogrel group. There was no significant difference in the rate of in-hospital major adverse cardiovascular and cerebrovascular event (MACCE) (a composite of all-cause death, myocardial infarction, stent thrombosis, or ischemic stroke) with ticagrelor compared with clopidogrel therapy (4.2% vs 4.3%; adjusted OR 1.08; 95% CI 0.90–1.28; P = 0.411). Outcomes in the propensity-matched cohorts and in sensitivity analyses were consistent with the those of the main analysis. Among ACS patients with HBR, ticagrelor as compared with clopidogrel was associated with an increased risk of in-hospital major bleeding without a significant reduction in in-hospital MACCE. https://www.clinicaltrials.gov. Unique identifier: NCT02306616. [ABSTRACT FROM AUTHOR]

Bark is an essential component of tree branches, yet its role in controlling branch-leached dissolved organic matter (DOM) characteristics remains unknown in forests. Here, we collected branches (about 1.5 cm in diameter) of two evergreen coniferous trees, two deciduous broadleaf trees, and three evergreen broadleaf trees from a subtropical forest in southern China, and subsequently used a bark removal experiment to determine the effects of bark on branch-derived DOM quantity and bioavailability. Regardless of tree type, the presence of bark reduced tree branch-leached dissolved organic carbon (DOC), dissolved total nitrogen (DTN), and dissolved total phosphorus (DTP) productions. Moreover, DOC, DTN, and DTP productions leached from the branches containing bark were always much lower than the expected values summed from barks and the branches without bark. The presence of bark increased DOM aromaticity in the broadleaf tree branch leachates but reduced DOM aromaticity in the coniferous tree branch leachates. During 42 days of incubation, the presence of bark decreased broadleaf tree branch-leached DOM bioavailability and the relative increments of aromaticity, whereas the opposite trends were observed for the coniferous tree branch-leached DOM. Tree branch-derived DOM bioavailability correlated negatively with SUVA254 values, but exhibited no relationship with either DOC:DTN ratio or DOC:DTP ratio. These observations highlight that tree bark can prevent DOM leaching from branches and regulate branch-leached DOM bioavailability via its effect on DOM aromaticity in subtropical forests. [ABSTRACT FROM AUTHOR]

China's Mars exploration mission has stimulated tremendous interest in planetary science exploration recently. To propose potential scientific research projects, this study presents a concept simulation for the measurement of Martian atmospheric winds using the Doppler Michelson interferometry technique. The simulation is based on the satellite instrument initially designed for the Dynamic Atmosphere Mars Observer (DYNAMO) project to measure vertical profiles of winds from the 1.27 μm airglow observations in the Martian atmosphere. A comprehensive DYNAMO measurement simulation forward model based on an orbit submodel, an atmospheric background field submodel, and an instrument submodel is developed using the Michelson equation. The simulated interferogram signal over the field of view (FOV) calculated by the forward model is associated with the filter transmittance function, column emission rate of airglow, wind velocity, temperature, and the Michelson phase. The agreement between the derived atmospheric signals from the simulated interferogram without altitude inversion and the input parameters used to initiate the forward model confirms the validity of the forward model. [ABSTRACT FROM AUTHOR]

Many Tibetan heritage buildings in China are opened to tourists recently. The crowd load has become a significantly concern to the structural safety of the structures. The beams of these wooden structures are easily deformed or cracked under the crowd load. The condition assessment of the timber beam in a Tibetan heritage building under crowd load has become a new challenge. Convention statistical evaluation method making use of monitored strain data require a threshold value which is determined with no physical meaning. This paper separates the monitored strain into temperature-induced strain and crowd-induced strain. An analytical model of the timber beam including the semi-rigid connections at its ends is formulated for the calculation of different material stresses under crowd load. The condition of the beam is then quantitatively evaluated against the residual strength of material. The shear stress at any point of the beam can then be calculated from limited number of sensors for evaluating the more popular shear crack damage which is not monitored in most existing ancient structures. [ABSTRACT FROM AUTHOR]

Wind shear has important implications for Kelvin–Helmholtz instability (KHI) and gravity waves (GWs) in the mesosphere–lower thermosphere (MLT) region where its momentum transport process is dominated by short-period (<1 h) GWs. However, the sub-hourly variation in wind shear is still not well quantified. This study aims to improve current understanding of vertical wind shear by analyzing multi-year meteor radar measurements at the Mohe (MH, 53.5°N, 122.3°E), Beijing (BJ, 40.3 ° N , 116.2 ° E ), Wuhan (WH, 30.5 ° N , 114.6 ° E ), and Fuke (FK, 19.5°N, 109.1°E) stations in China. The wind field is estimated by a new algorithm, e.g., the damped least squares fitting. Taking the wind shear estimated by normal products as a criterion, the shear produced by the new algorithm has more statistical convergence as compared to the traditional algorithm, e.g., the least squares fitting. Therefore, we argue that the 10 min DLSA wind probably produces a more reasonable vertical shear. Both intensive wind shears and GW kinetic energy can be simultaneously captured during the 0600–1600 UTs of May at MH and during the 1300–2400 UTs of March at FK, possibly implying that the up-propagation of GWs could contribute to the production of large wind shears. The sub-hourly variation in wind shears is potentially valuable for understanding the interrelationship between shear (or KHI) and GWs. [ABSTRACT FROM AUTHOR]

Simultaneous measurements of atmospheric volatile organic compounds (VOCs), conventional gases and meteorological parameters were performed at an urban site in Jinan, East China, in June 2021 to explore the formation and evolution mechanisms of summertime ozone (O3) pollution events. O3 Episode Ⅰ, O3 Episode II, and non-O3 episodes were identified based on the China Ambient Air Quality Standards and the differences in precursor concentrations. The O3 concentrations in Episode I and Episode II were 145.4 μg/m3 and 166.4 μg/m3, respectively, which were significantly higher than that in non-O3 episode (90 μg/m3). For O3 precursors, VOCs and NOx concentrations increased by 48% and 34% in Episode I, and decreased by 21% and 27% in Episode II compared to non-O3 episode days. The analysis of the m,p-xylene to ethylbenzene ratio (X/E) and OH exposure demonstrated that the aging of the air masses in Episode II was significantly higher than the other two episodes, and the differences could not be explained by localized photochemical consumption. Therefore, we speculate that the high O3 concentrations in Episode II were driven by the regional transport of O3 and its precursors. Backward trajectory simulations indicated that the air masses during Episode II were concentrated from the south. In contrast, the combination of high precursor concentrations and favorable meteorological conditions (high temperatures and low humidity) led to an excess of O3 in Episode I. Positive matrix factorization (PMF) model results indicated that increased emissions from combustion and gasoline vehicle exhausts contributed to the elevated concentrations of VOCs in Episode I, and solvent usage may be an important contributor to O3 formation. The results of this study emphasize the importance of strengthening regional joint control of O3 and its precursors with neighboring cities, especially in the south, which is crucial for Jinan to mitigate O3 pollution. [ABSTRACT FROM AUTHOR]

Introduction: We investigated the epidemiology of Cytochrome P450 (CYP) 3A4 genotype and the relationship between CYP3A4 genotype and alcohol drinking habits. Materials and methods: A single-centered retrospective study was conducted on 630 patients who underwent CYP3A4*1G genetic testing. Their relevant information on epidemiology and etiology was collected. Laboratory testing, including CYP3A4*1G genotype, liver function tests, and serum lipid measurements were performed. Bi-variate logistic regressions were used to examine the relationship between variables. The relationship between alcohol drinking and CYP3A4*1G genotype was estimated. Demographic and clinical features were analyzed. Participants with drinking history were divided into non-heavy drinking and heavy drinking groups. Liver function and dyslipidemia of participants with drinking histories were compared between CYP3A4*1G mutation (GA+AA) and wild-type (GG) groups. Results: Participants with CYP3A4*1G mutation(GA+AA) had an increased adjusted odds ratio (AOR) of 2.56 (95% CI, 1.4–4.65; P = 0.00) for alcohol abuse when compared with participants without CYP3A4 mutation (GG). In the subgroup of participants with alcohol abuse, there are no significant differences in liver injury levels and serum lipid levels between CYP3A4*1G mutant and wild-type groups. Patients with CYP3A4*1G mutation had an increased AOR of cardiac-vascular diseases and malignant diseases compared with patients without CYP3A4*1G mutation. The epidemiology had no difference between GA and AA group. Conclusion: The study indicated that there was association between alcohol drinking and CYP3A4*1G genetic mutation. In the subgroup of participants with alcohol abuse, there are no significant differences in liver injury and dyslipidemia between CYP3A4*1G mutant and wild-type groups. CYP3A4*1G mutation was also related to cardiac-vascular diseases and malignant diseases. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are frequently coexisted mental illness. The lack of solid objective diagnostic criteria has led to a high rate of suicide. The brain-gut axis bridges the gastrointestinal system with neuropsychiatric disorders. However, it is still not possible to reflect mental disease with gastrointestinal information. The study aimed to explore the auxiliary diagnostic value of gastrointestinal myoelectrical activity in anxiety-depression disorders (ADD) without gastrointestinal disturbance. Methods: A natural population cohort from 3 districts in Western China were established. The Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 were used to assess ADD. Gastrointestinal myoelectrical activity of ADD were measured by multi-channel cutaneous electrogastroenterogram (EGEG). Then the parameters of EGEG between ADD and healthy controls were analyzed. Results: The average amplitude and response area of intestinal channel in ADD were significantly lower than those of controls (153.49 ± 78.69 vs. 179.83 ± 103.90, 57.27 ± 29.05 vs. 67.70 ± 38.32), which were shown to be protective factors for ADD (OR = 0.944 and 0.844, respectively). Further, the scale item scores related to the core symptoms of anxiety and depression were also associated with these two channels (p < 0.05), and the gastrointestinal electrical signals of ADD are significantly changed in the elderly compared to the young adults. Conclusions: The intestinal myoelectrical activity has a certain auxiliary diagnostic value in psychiatric disorders and is expected to provide objective reference for the diagnosis of anxiety and depression. [ABSTRACT FROM AUTHOR]

While air quality in China has improved significantly in recent years, the population is becoming increasingly vulnerable to air pollution due to the aging population. In this study, we assessed premature deaths attributable to long- and short-term exposures to PM2.5 and O3, as well as their driving forces in Shandong from 2014 to 2060 based on county-level near-real-time air pollutant concentration datasets and projected concentrations of PM2.5 and O3. We found that the concentrations of PM2.5 and O3 in most districts and counties from Shandong are still higher than the corresponding concentration limit of Grade II. Premature mortality caused by long- and short-term exposures to PM2.5 decreased by 13,045 and 8092 in 2020 compared with those in 2014, respectively. Furthermore, premature mortality attributable to short-term exposure to O3 was 36.08% higher than that due to short-term exposure to PM2.5 in 2020. The results of the driving force analysis indicate that the health benefits brought about by the improvement in air quality have been offset by the changes in population age structure. In the future, the increase in O3 concentration and population aging are the top two driving forces having adverse effects on the health burden. This study provides support for controlling the health risks of PM2.5 and O3 pollution, especially for the development of dual-pollutant concentration targets and synergistic control strategies. [ABSTRACT FROM AUTHOR]

Atmospheric gravity waves (GWs) in the mesosphere-lower thermosphere (MLT) are crucial for the understanding of general circulation. However, their dynamical characteristics are hardly retrieved due to the difficulty in the high-resolution observation of wind. Therefore, this paper uses eight years (2013–2020) of meteor radar measurements in the MLT region at Mohe station (53.5°N, 122.3°E), China, to retrieve high-temporal-resolution mesospheric wind data and further evaluate the temporal variation of GW kinetic energy. As the detected meteor trails exceed 6, the wind velocity is recalculated using the least square algorithm method, significantly increasing the temporal resolution of wind from 1 h up to 5 min. This resolution is sufficiently high for the investigation of GW kinetic energy, which exhibits a high spatial-temporal variability. For instance, it is enhanced in the winter season during the period of 0200–1400 UT and in the spring season during the period of 0800–1300 UT. The similarity between the climatological characteristics of GWs in MLT and the seasonal variation of GW total energy in the troposphere, determined from high-resolution radiosondes near to Mohe station, suggests that the meteorology in the lower atmosphere could be an important source of GWs in the MLT region. [ABSTRACT FROM AUTHOR]

Methotrexate (MTX) and iguratimod (IGU) are conventional synthetic disease modifying antirheumatic drugs widely used in the treatment of Rheumatoid arthritis (RA) in China. Although MTX combined with IGU can significantly inhibit the progression of RA, some patients do not respond to the treatment. The purpose of this study is to explore the difference of serum protein expression between RA patients with good and poor response to the combined therapy by label-free quantitative proteomic approach. From the proteomics data, a total of 782 proteins in the serum of RA patients were detected, and of which 9 were upregulated and 18 were downregulated in the good response group compared to poor response group. Among them, four significantly differentially expressed proteins (RELN, LDHA, MRC1 and TKT) were further validated by multiple reaction monitoring (MRM)-based quantification approach, and three of them (RELN, LDHA and MRC1) were confirmed to be correlated with the response to MTX/IGU therapy. Logistic regression and ROC analysis indicated that the combination of RELN, LDHA and MRC1 had good performance in evaluating the response. This result proved the different serum proteins signature fingerprint between response group and non-response group; and highlighted the potential of the label-free and mass spectrometry-based quantitative proteomic approach in screening biomarkers for evaluating clinical response to MTX/IGU therapy in RA. • The expression of serum proteins is different between R and NR group after treating by MTX combined with IGU. • 9 upregulated and 18 downregulated proteins were detected in two groups, respectively. • Combination of RELN, LDHA and MRC1 was validated to be the candidate biomarker to evaluate the efficacy. • Several dysregulated serum proteins are involved in the anti-inflammatory progress of MTX and IGU. • The study provides a new option for further research on the mechanism of MTX and IGU. [ABSTRACT FROM AUTHOR]

Background: Desertification is one of the main obstacles to global sustainable development. Monitoring, evaluating and mastering its driving factors are very important for the prevention and control of desertification. As one of the largest deserts in China, the development of desertification in Otindag Sandy Land (OSL) resulted in the reduction in land productivity and serious ecological/environmental consequences. Although many ecological restoration projects have been carried out, the vegetation restoration of OSL and the impact mechanism of climate and human activities on desertification remain unclear. Methods: Taking OSL as the research area, this paper constructs the desertification index by using the remote sensing images and meteorological and socio-economic data, between 1986 and 2016, and analyzes the spatio-temporal evolution process and driving factors of desertification by using trend analysis and spearman rank correlation. Results: The results showed that: (1) Desertification in the OSL has fluctuated greatly during the past 30 years. Desertification recovered between 1986 and 1990, expanded and increased between 1990 and 2000, reduced between 2000 and 2004, developed rapidly between 2004 and 2007, and recovered again between 2007 and 2016; (2) The desertification of OSL is dominated by a non-significant change trend, accounting for 73.27%. In the significant change trend, the area of desertification rising trend is 20.32%, which is mainly located in the north and east, and the area of declining trend is 6.41%, which is mainly located in the southwest; (3) Desertification is the result of the superposition of climate and human activities. Climate change is the main influencing factor, followed by human activities, and the superposition effects of the two are spatio-temporal differences. Conclusions: These results shed light on the development of desertification in OSL and the relative importance and complex interrelationship between human activities and climate in regulating the process of desertification. Based on this, we suggest continuing to implement the ecological restoration policy and avoid the destruction of vegetation by large-scale animal husbandry in order to improve the situation of desertification. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment (MCI) is the prodromal stage and an important risk factor of Alzheimer's disease (AD). Interventions at the MCI stage are significant in reducing the occurrence of AD. However, there are still many obstacles to the screening of MCI, resulting in a large number of patients going undetected. Given the strong correlation between gastrointestinal function and neuropsychiatric disorders, the aim of this study is to develop a risk prediction model for MCI based on gastrointestinal myoelectrical activity. The Mini-Mental State Examination and electrogastroenterography were applied to 886 participants in western China. All participants were randomly assigned to the training and validation sets in a ratio of 7:3. In the training set, risk variables were screened using LASSO regression and logistic regression, and risk prediction models were built based on nomogram and decision curve analysis, then validation was performed. Eight predictors were selected in the training set, including four electrogastroenterography parameters (rhythm disturbance, dominant frequency and dominant power ratio of gastric channel after meal, and time difference of intestinal channel after meal). The area under the ROC curve for the prediction model was 0.74 in the training set and 0.75 in the validation set, both of which exhibited great prediction ability. Furthermore, decision curve analysis displayed that the net benefit was more desirable when the risk thresholds ranged from 15% to 35%, indicating that the nomogram was clinically usable. The model based on gastrointestinal myoelectrical activity has great significance in predicting the risk of MCI and is expected to be an alternative to scales assessment. [ABSTRACT FROM AUTHOR]

Chukrasia tabularis is an economically important tree and widely cultured in the southeast of China. Its barks, leaves, and fruits are consumed as a traditional medicine and perceived as a valuable source for bioactive limonin compounds. The extracts from root barks of C. tabularis showed significant anti‐inflammatory effect. The aim of this research was to explore the material basis of C. tabularis anti‐inflammatory activity, and to purify and identify anti‐inflammatory active ingredients. By a bioassay‐guided isolation of dichloromethane fraction obtained two novel phragmalin limonins, Chukrasitin D and E (1 and 2), together with 12 known limonins (3–14). The chemical structure of these compounds is determined on the basis of extensive spectral analysis and chemical reactivity. In addition, the activities of these isolated limonins on the production of nitric oxide (NO), tumor necrosis factor alpha (TNF‐α), and nuclear factor kappa B (NF‐κB) in RAW264.7 cells induced by lipopolysaccharide (LPS) were evaluated. Limonins 1 and 2 indicated significant anti‐inflammatory activity with IC50 values of 6.24 and 6.13 μM. Compound 1 notably inhibited the production of NF‐κB, TNF‐α and interleukin 6 (IL‐6) in macrophages. The present results suggest that the root barks of C. tabularis exhibited anti‐inflammatory effect and the limonins may be responsible for this activity. [ABSTRACT FROM AUTHOR]

Previous studies reported regional variations in in-hospital acute coronary syndrome (ACS) mortality, but the reasons for that were not clearly defined. We explored whether differences in patient characteristics could explain regional variation. The Improving Care for Cardiovascular Disease in China (CCC)-ACS project is an ongoing national registry and quality improvement project, involving 150 tertiary hospitals from 30 provinces across China. We applied a prediction model that included patient-specific variables to calculate the expected in-hospital mortality. For each province, we reported the observed, expected in-hospital mortality and the risk-adjusted ratio which is based on the observed divided by the expected mortality. From 2014 to 2018, 79 585 ACS patients were enrolled. The average in-hospital mortality was 1.8%. There was a wide variation in the in-hospital mortality among different provinces (0.2-3.9%). Patient characteristics explained part of this variation because of differences in the expected in-hospital mortality (0.7-2.8%). There was a substantial variation in the risk-adjusted ratio among provinces (0.2-3.5), which suggests that the variations in the mortality cannot be completely explained by the differences in patient characteristics. In conclusion, we observed a wide regional variation in mortality for ACS, part of which could be explained by the difference in patient characteristics. [ABSTRACT FROM AUTHOR]

Background: Nursing care service is an important part of the healthcare system; however, patients' favorite type of nursing care remains unknown. This study aims to investigate inpatients' and nurses' favorite types of nursing care and identify nurses' learning needs. Method: The study selected a province-representative sample of inpatients and nurses using a stratified random sampling method from 18 selected hospitals, including 9 Level Ⅱ hospitals and 9 Level Ⅲ hospitals in 9 cities of Hebei province. All participants were personally interviewed about their favorite type of nursing care. Multinomial logistic regression analysis was applied to analyze the potential associations between favorite nursing care and factors about inpatients and nurses. Results: Data from 3,642 inpatients and 371 nurses were included for the final analysis during this survey. Among inpatients, the proportions who selected good attitude-centered, good nursing skill-centered, good environment-centered and good health education guidance-centered as their favorite types of nursing care were 49.9%, 31.8%, 5.8%, and 12.5%, respectively. Concurrently, among nurses, the proportions were 49.9%, 29.6%, 19.1%, and 1.3%, respectively. Multivariate analysis showed that most patients selected good attitude-centered nursing care as their favorite type of nursing care. However, patients who did not live with guardians and had more than one hospitalization per year were more likely to select other nursing care types. Conclusion: Attitude-centered nursing care service was the favorite type of nursing care for most inpatients and nurses. Health education guidance was another main concern of inpatients. The main factors affecting the patients' choice of favorite nursing care included patients' living status and the number of hospitalization events per year. Nursing education should focus on nurse attitude as well as on health education guidance. [ABSTRACT FROM AUTHOR]

The incidence and the risk factors of in-hospitalized acute kidney injury (AKI) in patients hospitalized for atrial fibrillation (AF) were unclear. The Improving Care for Cardiovascular Disease in China-AF (CCC-AF) project is an ongoing registry and quality improvement project, with 240 hospitals recruited across China. We selected 4527 patients hospitalized for AF registered in the CCC-AF from January 2015 to January 2019. Patients were divided into the AKI and non-AKI groups according to the changes in serum creatinine levels during hospitalization. Among the 4527 patients, the incidence of AKI was 8.0% (361/4527). Multivariate logistic analysis results indicated that the incidence of in-hospital AKI in patients with AF on admission was 2.6 times higher than that in patients with sinus rhythm (OR 2.60, 95% CI 1.77–3.81). Age (per 10-year increase, OR 1.22, 95% CI 1.07–1.38), atrial flutter/atrial tachycardia on admission (OR 2.16, 95% CI 1.12–4.15), diuretics therapy before admission (OR 1.48, 95% CI 1.07–2.04) and baseline hemoglobin (per 20 g/L decrease, OR 1.21, 95% CI 1.10–1.32) were independent risk factors for in-hospital AKI. β blockers therapy given before admission (OR 0.67, 95% CI 0.51–0.87) and non-warfarin therapy during hospitalization (OR 0.71, 95% CI 0.53–0.96) were associated with a decreased risk of in-hospital AKI. After adjustment for confounders, in-hospital AKI was associated with a 34% increase in risk of major adverse cardiovascular (OR 1.34, 95% CI 1.02–1.90, p = 0.023). Clinicians should pay attention to the monitoring and prevention of in-hospital AKI to improve the prognosis of patients with AF. [ABSTRACT FROM AUTHOR]

Based on the continuous online measurements of volatile organic compounds (VOCs) at a suburban site in Jinan, Shandong province in the wintertime of 2021, characteristics, chemical transformations and sources of VOCs were analyzed. The total mixing ratio of VOCs was 30.35 ± 19.9 ppbv, with alkanes being the most abundant species. Alkenes and aromatics were the major contributors to the hydroxyl radical loss rate (L OH) and the ozone formation potential (OFP), accounting for 44.9% and 32.7% to L OH , and 43.2% and 33.4% to OFP, respectively. Aromatics had the primary contribution (98.1%) to the secondary organic aerosol potential (SOAP), and the high correlation between SOAP and PM 2.5 concentrations (R = 0.70) suggested that VOCs were critical precursors of PM 2.5. Coal/biomass burning and motor vehicle emissions were the main sources of VOCs (24.6% and 23.8%, respectively), followed by petrochemical and fuel evaporation (19.9%), industrial sources (16.9%), and liquefied petroleum gas/natural gas use (14.8%). Backward trajectories and the potential source contribution function (PSCF) analysis results suggested that short-range transport from the southeast was the primary potential source of VOC concentrations in suburban Jinan. The results can provide theoretical support for local governments to develop VOC emission control strategies in suburban areas. • Daytime VOCs were significantly influenced by strong localized emissions. • SOAP of VOCs and PM 2.5 were highly correlated. • Coal/biomass burning and vehicle emissions were the most significant sources of VOCs. • Short-distance transport from the southeast was important for VOCs control. [ABSTRACT FROM AUTHOR]

Objective: The aim is to assess the relationship between the hemoglobin glycation index(HGI) and dietary patterns, and investigates whether inflammation and oxidative stress mediate the relationship.Methods: Cross-sectional data were collected from 453 dwellers in a Chinese rural community. Diet was assessed using 24 h food recalls. Based on the energy intake ratio from three macronutrients, dietary patterns were identified by cluster analysis. The HGI was defined as the observed HbA1c minus predicted HbA1c. Indicators of inflammation and oxidative stress were assessed.Result: 3 dietary patterns were clustered, namely "fat(n = 100)", "balance(n = 186)" and "carbohydrate(n = 167)". The fat dietary patterns had lower HGI than the other two dietary patterns. TNFα was higher in the carbohydrate dietary pattern. Linear regression analysis suggested that the carbohydrate dietary pattern was correlated with higher HGI levels(β = 0.204,95 %CI(0.071,0.338)), compared with the fat dietary pattern. The relationship disappeared after accounting for biomarkers of inflammation and oxidative stress. Mediation analyses indicated that TNFα might explain for 19.15 % effects of the carbohydrate dietary pattern on HGI, compared with the fat dietary pattern.Conclusion: The carbohydrate dietary pattern had positive associations with HGI and TNFα. TNFα partly mediated the relationship between dietary patterns and HGI. [ABSTRACT FROM AUTHOR]

• Single-dose dupilumab pharmacokinetics (PK) were studied in 30 Chinese subjects. • Repeated-dose PK were studied in 82 Chinese adults with atopic dermatitis. • PK were comparable to non-Asians after accounting for body weight. Dupilumab, a fully human monoclonal antibody targeting IL-4Rα, has demonstrated rapid and sustained improvements in clinical outcomes in patients with atopic dermatitis (AD), asthma, and chronic rhinosinusitis with nasal polyps. In a phase 1, double-blind, ascending-dose study, 30 healthy Chinese adults were randomized to single subcutaneous doses of dupilumab 200, 300, 600 mg, or placebo. In a phase 3, double-blind study, 165 Chinese adults with AD were randomized to dupilumab 300 mg or placebo every 2 weeks. Following single doses of dupilumab 200, 300, and 600 mg in the phase 1 study, mean serum maximum concentrations (C max) were 25.4 ± 4.0, 37.2 ± 14.5, and 77.3 ± 19.0 mg/L, respectively. For a 1.5-fold increase in dupilumab dose, 1.31-, 1.73-, and 1.66-fold increases in C max , area under the curve to real time (AUC last), and extrapolated to infinity (AUC) were observed, respectively, while a 2-fold dose increase resulted in 2.17-, 2.81-, and 2.80-fold increases, respectively. In the phase 3 study, mean dupilumab trough concentrations were 78.8 ± 32.0 and 86.4 ± 33.6 mg/L at weeks 12 and 16, respectively. C max increased approximately proportionally to dose, while AUC and AUC last increased greater than proportionally. Dupilumab pharmacokinetics were generally comparable between Chinese and non-Asian healthy subjects (single dose) and between Chinese and non-Asian AD patients (repeated doses), with differences accounted for by body weight. As differences in exposure by weight are unlikely to be clinically relevant based on late-stage study results, no dose adjustment by ethnic origin or weight is required. [ABSTRACT FROM AUTHOR]