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Using the Structure of Observed Learning Outcomes (SOLO) taxonomy as the analytic framework, this study examined the impact of the reasoning flow scaffold (RFS) on students' written arguments. Two classes with a total of 88 10th grade students in a school participated in this study. One class, set as the experimental group, was taught scientific argumentation with RFS whereas the control class received conventional argumentation teaching. They all experienced three argument assignments of writing scientific arguments and the measurement task before and after the teaching intervention. The results of data analysis showed that after teaching intervention, students in the experimental group performed significantly better than those in the control group on evidence and rebuttal while there were no significant differences on claim or reason between the two groups. Some implications and suggestions are provided in the last part of this paper.

Ramularia sphaeroidea was primarily identified based on the characteristics of its conidia and several sequences. The fungus causes severe leaf spot disease on hairy vetch (Vicia villosa var. glabrescens) in Yunnan Province in China. The growth, sporulation, fungicide efficacy, and host range of the pathogen were evaluated to aid in disease management. Different types of culture media and carbon and nitrogen sources were used to evaluate the growth of R. sphaeroidea. Oatmeal, maltose, and potassium nitrate agar had a higher amount of sporulation. Difenoconazole (10%) was the most effective fungicide against the leaf disease caused by R. sphaeroidea. In addition, foliar inoculation sprays were used to assess the host range of R. sphaeroidea in six different plant species, including alfalfa (Medicago sativa L.), sainfoin (Onobrychis viciifolia Scop.), erect milkvetch (Astragalus adsurgens Pall.), common vetch (Vicia sativa L.), red clover (Trifolium pratense L.), and white clover (Trifolium repens L.). R. sphaeroidea successfully infected these plants, indicating that it has a wider host range than hairy vetches. [ABSTRACT FROM AUTHOR]

Objectives: To explore the mediating role of self‐esteem in social anxiety and QoL during the COVID‐19 local epidemic in China. Design: A cross‐sectional survey. Methods: This study conveniently selected 344 hypertensive patients from a Grade‐A tertiary hospital in Wuhu, Anhui Province, as the study population. Participants completed the demographic questionnaire, the social phobia inventory, the self‐esteem scale and the 36‐item short‐form health survey. Results: Social anxiety, self‐esteem and QoL were significantly correlated with each other. Social anxiety showed no direct effect on QoL (β = 0.011, p > 0.05). Social anxiety showed an indirect effect on QoL (β = −0.248, p < 0.001). Self‐esteem fully mediated the association between social anxiety and QoL in hypertensive patients. Patient or Public Contribution: Hypertensive patients in this study were participants during the data collection process. Nursing staff from the cardiology department at the hospital of a hospital in Wuhu City, Anhui Province assisted in the recruitment phase of the data collection process. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the associations of lipid indicators and mortality in Beijing Elderly Comprehensive Health Cohort Study. METHODS: A prospective cohort was conducted based on Beijing Elderly Comprehensive Health Cohort Study with 4499 community older adults. After the baseline survey, the last follow-up was March 31, 2021 with an average 8.13 years of follow-up. Cox proportional hazard model was used to estimate the hazard ratios (HR) with 95% CI for cardiovascular disease (CVD) death and all-cause death in associations with baseline lipid indicators. RESULTS: A total of 4499 participants were recruited, and the mean levels of uric acid, body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol (TC), triglyceride, and low-density lipoprotein cholesterol (LDL-C) showed an upward trend with the increasing remnant cholesterol (RC) quarters (Ptrend < 0.05), while the downward trend was found in high-density lipoprotein cholesterol (HDL-C). During the total 36,596 person-years follow-up, the CVD mortality and all-cause mortality during an average 8.13 years of follow-up was 3.87% (95% CI: 3.30%-4.43%) and 14.83% (95% CI: 13.79%-15.86%) with 174 CVD death participants and 667 all-cause death participants. After adjusting for confounders, the higher level of TC (HR = 0.854, 95% CI: 0.730-0.997), LDL-C (HR = 0.817, 95% CI: 0.680-0.982) and HDL-C (HR = 0.443, 95% CI: 0.271-0.724) were associated with lower risk of CVD death, and the higher level of HDL-C (HR = 0.637, 95% CI: 0.501-0.810) were associated with lower risk of all-cause death. The higher level of RC (HR = 1.276, 95% CI: 1.010-1.613) increase the risk of CVD death. Compared with the normal lipid group, TC ≥ 6.20 mmol/L group and LDL-C ≥ 4.10 mmol/L group were no longer associated with lower risk of CVD death, while RC ≥ 0.80 mmol/L group was still associated with higher risk of CVD death. In normal lipid group, the higher levels of TC, LDL-C and HDL-C were related with lower CVD death. CONCLUSIONS: In community older adults, higher levels of TC and HDL-C were associated with lower CVD mortality in normal lipid reference range. Higher RC was associated with higher CVD mortality, which may be a better lipid indicator for estimating the CVD death risk in older adults. [ABSTRACT FROM AUTHOR]

Background: Studies exploring whether metastatic organotropism and risk in gastric cancer (GC) differ by primary anatomical site are scarce. Methods: This study included 15,260 and 1623 patients diagnosed with GC from the Surveillance, Epidemiology, and End Results (SEER) registry database and the Nanfang Hospital in China, respectively. Patients were stratified according to primary site of GC, and the incidence of metastasis to different organs was used to determine the metastatic organotropism for each GC subsite. Finally, the metastatic organotropism and risk were compared among the different subsite groups. Results: Liver metastasis was the most common metastasis site in cardia GC, whereas other‐site metastases were more common in the body, antrum, overlapping lesions, and unspecified GCs. Liver and other‐site metastases were also frequently observed in the fundus, pylorus, lesser curvature, and greater curvature GCs. Patients with GC with definite primary tumor sites in the SEER and validation Nanfang hospital cohorts were compared by grouping as proximal and distal GCs for further analysis. In the SEER cohort, the top three metastatic sites of proximal GC were liver (21.4%), distant lymph node (LN) (14.6%), and other‐site (mainly peritoneum, 11.9%), whereas those of distal GC were other‐site (mainly peritoneum, 19.5%), liver (11.8%), and distant LN (9.5%). The incidence of metastasis to the liver, distant LN, lung, and brain was significantly higher in patients with proximal GC than in those with distal GC in both the SEER and Nanfang cohorts (p < 0.05). However, metastasis to other‐site/peritoneum was significantly lower in patients with proximal GC compared to those with distal GC in the Nanfang Hospital and SEER cohorts, respectively (p < 0.05). Conclusion: Liver and distant LN are the preferred metastatic sites for proximal GC, whereas peritoneal metastasis is more common in distal GC. Proximal GC has a higher risk of lymphatic and hematogenous metastases, and a lower risk of transcoelomic metastasis than distal GC. Our findings highlight the need to stratify GC by its primary subsite to aid in planning and decision‐making related to metastatic management in clinical practice. [ABSTRACT FROM AUTHOR]

aimed to describe in detail the prevalence of anemia in patients with TBM in Southern China and its association with the clinical forms of TB, as well as other characteristics of these patients. Methods: We conducted a retrospective analysis of patients diagnosed with TBM at two tertiary hospitals in southern China. The demographic characteristics, clinical characteristics, and laboratory results of 114 patients with TBM were collected. Multivariate logistic regression analysis was performed to explore the risk factors for anemia in patients with TBM. Results: Electronic medical record data of adult patients diagnosed with TBM from January 2004 to December 2019 were reviewed. Among 134 patients with TBM, 20 were excluded and 114 were analyzed, of whom 33 had anemic, the prevalence rate of anemia was 28.9%. Among patients with anemia, 51.5% had hypochromic microcytic anemia, 33.3% had normochromic normocytic anemia, and 15.2% had macrocytic anemia. Fever duration, TBM grade III and ESR were found to be independent predictors of anemia. Conclusion: Anemia was highly prevalent in patients with TBM, mainly hypochromic microcytic anemia. Besides, Fever duration, TBM grade III and ESR are predictors of anemia in patients with TBM. [ABSTRACT FROM AUTHOR]

Anthracnose is a disease caused by Colletotrichum species. They are well known as major plant pathogens, and a black stem disease, specifically caused by Colletotrichum truncatum and primarily infecting sword bean (Canavalia gladiata), was observed in the Yunnan province, China. To aid disease management and to determine pathogenic characteristics, the species causing the leaf spot disease of hairy vetch was verified as C. truncatum. A sequence analysis of the ITS, ACT, GAPDH, and HIS3 genes was conducted, as well as morphological and cultural characteristics, to identify this Colletotrichum species, which has curved conidia. C. truncatum isolates from sword bean formed a distinctive group among Colletotrichum species, including those that infect other forage and field crops. Artificially inoculated sword bean seedlings showed typical symptoms of anthracnose, which were similar to field observations. To the best of our knowledge, this is the first report of C. truncatum causing black stem disease on sword beans in China. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) has shown promising results in gastric cancer (GC) with peritoneal metastasis. However, clinical practice experience of NIPS is still lacking in China. In this study, we investigate the efficacy and safety of NIPS in Chinese patients. Methods: Eligible patients received NIPS every 3 weeks. Gastrectomy was performed for patients who met the criteria of conversion surgery. The primary end point was 1-year overall survival (OS) rate. Secondary end points were the response rate, toxic effects, conversion surgery outcomes and median survival time (MST). Results: Sixty-seven patients were enrolled. The primary endpoint was achieved with 1-year OS rate reached 67.2% (95% CI, 56.8%-79.4%). Conversion surgery was performed in 42 patients (62.9%), and R0 resection was achieved in 23 patients (54.8%) with the MST of 31.3 months (95% CI, 24.3-38.3). And the MST was 19.3 months (95% CI, 16.4-22.2) for all patients. Toxicity and surgical complications were well-tolerated. Moreover, sex, R0 resection, pathological nodal stage and tumor regression grade (TRG) were independent prognostic factors for patients who underwent conversion surgery. Conclusion: The NIPS is effective and safe in treating GC patients with peritoneal metastasis. Male patients, patients who underwent R0 resection, patients with ypN0-1 or TRG 1 after conversion surgery are more likely to benefit from the NIPS. Clinical Trial Registration: http://www.chictr.org.cn/ , identifier https://clinicaltrials.gov/ (). [ABSTRACT FROM AUTHOR]

Background: Tuberculous meningitis (TBM) is the most serious form of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis , and is characterized by high morbidity and mortality. Unfortunately, it is difficult to distinguish TBM from bacterial meningitis (BM) based on clinical features alone. The latest diagnostic tests and neuroimaging methods are still not available in many developing countries. This study aimed to develop a simple diagnostic algorithm based on clinical and laboratory test results as an early predictor of TBM in South China. Methods: A retrospective study was conducted to compare the clinical and laboratory characteristics of 114 patients with TBM and 47 with BM. Multivariate logistic regression analysis was performed on the characteristics of independently predicted TBM to develop a new diagnostic rule. Results: Five characteristics were predictive of a diagnosis of TBM: duration of symptoms before admission; tuberculous symptoms; white blood cell (WBC) count, total cerebrospinal fluid WBC count, and cerebrospinal fluid chloride concentration. The sensitivity and specificity of the new scoring system developed in this study were 81.6 and 93.6%, respectively. Conclusion: The new scoring system proposed in this study can help physicians empirically diagnose TBM and can be used in countries and regions with limited microbial and radiological resources. [ABSTRACT FROM AUTHOR]

Background: This meta-analysis aimed to assess the efficacy and safety of ginkgo terpene lactone preparations including ginkgo diterpene lactone meglumine injection, ginkgolide injection, and ginkgolide B injection for ischemic stroke (IS). Methods: We searched the randomized controlled trials (RCTs) with publication date earlier than 31 August 2021 in PubMed, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journals Database (VIP), Chinese Biomedical Literature Database (CBM), Wanfang Database, Embase, and the Cochrane Library. RevMan 5.3 software was applied to analyze the data and generate the forest plot and funnel plot. Meanwhile, publication bias was also assessed by Egger's test with STATA 12 software. Results: A total of 28 RCTs were eligible for inclusion. Among them, 23 RCTs were used to evaluate the efficacy of ginkgo terpene lactone preparations as the main treatment intervention for IS. To be specific, ginkgo diterpene lactone meglumine injection was superior to control drug in improving clinical efficacy [RR = 1.18, 95% CI (1.12, 1.24), Z = 6.36, p < 0.001] and neurological function [MD = −1.42, 95% CI (−1.91, −0.93), Z = 5.66, p < 0.001]. However, the effectiveness of the ginkgolide B injection group was equivalent to that of the control group. Additionally, ginkgolide injection achieved better clinical efficacy [RR = 1.10, 95% CI (1.02, 1.18), Z = 2.36, p = 0.02], but the changes of neurological function deficit was not obviously different between two groups [MD = −0.43, 95% CI (−4.32, 3.46), Z = 0.22, p = 0.83]. Furthermore, meta-analysis of five trials on ginkgo diterpene lactone meglumine injection combined with recombinant tissue plasminogen activator (rt-PA) thrombolytic therapy for acute IS showed that combination therapy was better in improving clinical efficacy [OR = 1.91, 95% CI (1.13, 3.22), Z = 2.41, p = 0.02] and neurological function [MD = −3.31, 95% Cl (−3.64,−2.98), Z = 19.63, p < 0.001]. Importantly, no serious adverse drug reactions/adverse drug events (ADRs/ADEs) were reported. Conclusion: Ginkgo terpene lactone preparations have good therapeutic effects on patients with IS. For acute IS, ginkgo diterpene lactone meglumine injection can be used as a complementary therapy to improve the clinical efficacy of rt-PA. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to identify the prevalence and factors associated with atrial fibrillation (AF) in older patients with obstructive sleep apnea (OSA) in China.  METHODS: This was an explorative cross-sectional study. Between January 2015 and October 2017, we continuously recruited 1285 older patients with OSA who underwent overnight polysomnography from sleep centers of multiple hospitals. They were assessed using 12-lead ECG or 24-h dynamic ECG, and their baseline demographics, clinical characteristics, sleep parameters, and medical history were determined. Multivariate binary logistic regression analysis was used to investigate the factors related to AF in these older patients with OSA.Results: The clinician classified 122 (9.5%) patients as having AF. The prevalence of AF significantly increased with age (P < 0.05) but did not significantly differ between the mild, moderate, and severe OSA groups. Additionally, the prevalence of paroxysmal AF was 7.2% among the overall study population, and it increased with OSA severity or advanced age (P < 0.05). Persistent AF was noted in 2.3% participants, and the prevalence also increased with age. The logistic regression analysis showed that age (OR = 1.054, 95%CI: 1.027-1.018, P < 0.001), history of drinking (OR = 1.752, 95%CI: 1.070-2.867, P < 0.05), chronic heart disease (OR = 1.778, 95%CI: 1.156-2.736, P < 0.01), diabetes mellitus (OR = 1.792, 95%CI: 1.183-2.713, P < 0.01), and reduced diastolic function (OR = 2.373, 95%CI = 1.298-4.337, P < 0.01) were relevant to AF among participants with OSA.Conclusion: The prevalence of AF is significantly common in older patients with OSA. Age, history of drinking, chronic heart disease, diabetes mellitus, and reduced diastolic function are independently related to AF in these patients. [ABSTRACT FROM AUTHOR]

Objective To observe the dynamic changes of free CD147 and its induced product matrix metalloproteinase-9 (MMP-9) of patients with traumatic brain injury (TBI) in peripheral blood, and to explore the relationship between its expression changes and short-term prognosis. Methods Thirty-nine patients with TBI admitted to the Second Hospital of Tianjin Medical University from May 2014 to December 2016 were included in the study. The expression changes of free CD147 and MMP - 9 in peripheral blood were determined by enzyme-linked immunosorbent assay (ELISA), and the activity of MMP-9 was determined through gelatin zymography. The prognosis was evaluated via Glasgow Outcome Scale (GOS) at discharge. Results There was no significant difference in GOS score between male and female patients at discharge (2.63 ± 1.28 vs. 2.57 ± 1.14; t = 0.161, P = 0.873). There was a statistically significant difference in GOS score between different age groups at discharge (t = 2.191, P = 0.038). The GOS scores of patients over 60 years old were lower than those of patients under 40 years old (t = 2.645, P = 0.014) and those between 40 and 60 years old (t = 2.320, P = 0.029). According to the GOS score, they were divided into a good prognosis group (GOS score ≥ 3, n = 25) and a poor prognosis group (GOS score < 3, n = 14). Free CD147 in peripheral blood of patients with poor prognosis [(5.07 ± 1.89) ng/ml vs. (10.37 ± 1.69) ng/ml; t = 2.080, P = 0.048] and MMP-9 [(41.55 ± 4.67) ng/ml vs. (75.23 ± 5.18) ng/ml; t = 2.512, P = 0.019] were higher than the good prognosis group. Correlation analysis showed that the GOS score at discharge was negatively correlated with free CD147 (r = - 0.473, P = 0.000) and MMP - 9 (r = - 0.435, P = 0.036) in peripheral blood. Conclusions The higher the level of free CD147 and its induced product MMP-9 in peripheral blood of patients with TBI, the worse the prognosis, which indicated that free CD147 and MMP-9 can be used as important indicators for poor prognosis of patients with TBI. [ABSTRACT FROM AUTHOR]

Previous experimental studies have regarded distraction, an emotional regulation strategy, as an attentional disengagement strategy and considered it to be maladaptive in the long term. This study intends to further examine the relationship between distraction and negative emotions by using a questionnaire and a multiple mediation model. A total of 723 college students completed the distraction, cognitive reappraisal and problem-solving subscales of the Measurement of Affect Regulation Styles, the Needs Satisfaction Questionnaire, the Meaningful Life Measure, and the Emotional Experience Questionnaire of Well-being. Structural equation modeling (SEM) was performed, and mediation effects were tested. The results showed that (1) distraction was used significantly more frequently than problem-solving and cognitive reappraisal, with a large effect size (partial η2 = 0.321 > 0.138), and (2) distraction had an effect on negative emotions through two multiple mediation paths, i.e., positive emotion—cognitive reappraisal—meaning in life, and positive emotion—problem-solving—needs satisfaction. Distraction reduces negative emotions by enhancing positive emotions and facilitating cognitive reappraisal, problem-solving, meaning in life and needs satisfaction. It is not a kind of avoidance but a temporary rest to strive for a better life. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to demonstrate that capecitabine metronomic chemotherapy is non-inferior to capecitabine conventional chemotherapy as maintenance treatment, in patients who have responded to 16-18 weeks first-line chemotherapy in metastatic colorectal cancer (mCRC).Methods: The study design is a prospective, randomized, open label, phase II clinical trial. Those patients with mCRC who respond well after 16-18 weeks of standard doublet chemotherapy as induction may be enrolled into this study, and randomly assigned to the capecitabine metronomic group or standard dosage group. The duration of disease control after randomization and progression-free survival after enrollment are the primary endpoints. Overall survival, safety, and quality of life are the secondary endpoints. The sample size required to achieve the research objectives of this project is 79 patients in each group. The study recently started on 1 January 2018, and will last for 36 months.Discussion: This project is intended to study the efficacy and safety of capecitabine metronomic chemotherapy in the maintenance treatment of advanced colorectal cancer, and to explore the strategy of "low toxicity, high efficiency, economy, and individualization", which is suitable for China's national conditions and pharmacoeconomics. It has great prospects for clinical application and a clear socioeconomic value.Trial Registration: ClinicalTrials.gov: NCT03158610. Registered on 15 May 2017. [ABSTRACT FROM AUTHOR]

The relationship between normal thyroid function and type 2 diabetes mellitus (T2DM) has been a particular focus for concern. The present study determined the relationship between thyroid hormone levels and the prevalence of diabetic retinopathy (DR) in T2DM patients. A cross-sectional study (n = 633) was performed in Xi'an, Shaanxi Province, China. Subjects were evaluated for anthropometric measurements, thyroid function, and diabetic retinopathy. Logistic regression models were used to assess the relationships between thyroid hormones and DR. Of 633 patients, 243 (38.4%) patients suffered from DR. The prevalence of DR showed a significantly decreasing trend across the quartiles based on free triiodothyronine (FT3) (FT3 quartile 1 group [FT3-Q1] <4.35 pmol/L, FT3 quartile 2 group [FT3-Q2] 4.35–4.70 pmol/L, FT3 quartile 3 group [FT3-Q3] 4.70–5.08 pmol/L, and FT3 quartile 4 group [FT3-Q4] ≥5.08 pmol/L) (56.7%, 42.5%, 33.1%, 23.8%, P < 0.001). In comparison with all participants categorized in FT3-Q1, the multivariable adjusted odds ratios (95% confidence interval) of DR in FT3-Q2, FT3-Q3, and FT3-Q4 were 0.587 (0.340–1.012), 0.458 (0.258–0.813), and 0.368 (0.201–0.673), (P = 0.055 , P = 0.008 , P = 0.001), respectively. FT3 levels within the normal range are negatively associated with DR in euthyroid patients with type 2 diabetes. Further studies should be aimed at clarifying the relationship between thyroid hormones and T2DM. [ABSTRACT FROM AUTHOR]

Recurrent stroke is becoming an increasingly important public health issue owing to the increased risk of disability and death. However, population-based studies investigating the rate of recurrent stroke in China are rare. We explored the rate and determinants of recurrent stroke within 1 and 5 years after the initial stroke in a rural population in China. Data for stroke events were obtained from the Tianjin Brain Study, conducted between 1992 and 2016. The age-standardized rates of recurrent stroke within the first year and the first 5 years after the initial stroke were calculated for this period. Determinants of recurrent stroke were assessed using Cox regression analyses. The overall age-standardized rate of recurrent stroke within 1 year was 5.7% (men, 6.9%; women, 4.6%); within 5 years, the overall recurrent stroke rate was 22.5% (men, 24.0%; women, 20.2%). The recurrence rate increased with advancing age and decreased with increased educational attainment. Age ≥65 years and a history of alcohol consumption were independent risk factors for recurrent stroke within 1 year after the incident stroke, after adjusting for age, sex, education, hypertension, diabetes, smoking, and alcohol consumption. However, the risk of recurrent stroke within 5 years after the incident stroke was positively associated with male sex, age ≥65 years, a lower level of education, known diabetes, and alcohol consumption, after adjusting for the previously indicated covariates. These findings suggest a crucial need to address risk factor management among stroke patients to reduce the burden of stroke, especially among low-income populations. Furthermore, a multicenter, large sample, nationwide study is urgently needed. [ABSTRACT FROM AUTHOR]

Mythimna separata (Walker) moths captured in light traps were monitored in Luohe, central‐northern China, from 1980 to 2016. Annual average temperature recorded an increase of 0.298°C/10 years in this region in the period. Our results indicate that a rising April and May average temperature and earlier occurrences of days recording the highest day temperature (30°C) caused an advanced peak and increasing proportion of high ovarian development levels of first‐generation females in earlier summers. Results using Johnson's formulation of "oogenesis‐flight syndrome" indicate that increasing sexual maturity proportion has resulted in more emigrant individuals in the local first‐generation moth becoming residents, and then increased individuals rapidly in the local second‐generation moth since 2006. Consequences of this action have a boom in corn damage since 2007 in this region. Advanced peak dates of the first and second‐generation moth revealed the same response to increasing average monthly temperatures in the monitoring period. Increasing temperatures, the average May temperature exceeds or equal to 22°C, during the early 2000's may represent a physiological threshold for M. separata development. Our results suggest that climate warming may impact M. separata migratory status and cause a problem of crop production in this region. [ABSTRACT FROM AUTHOR]

Background: Hitherto, a population-based analysis of the cause of death in urban areas of Western China has not been undertaken over an extended period. The aims of this study were to calculate the overall and annual cause-specific mortality rates by age and sex in urban areas of Western China from 2003 to 2012 and to evaluate the quality of the data.Methods: We used Excel software, cause-of-death registrations, and International Classification of Diseases, 10th revision, codes to calculate the overall and yearly cause-specific crude mortality rates by age and sex, the Chinese age-standardized mortality rate, and life expectancies.Results: In the Jiulongpo District from 2003 to 2012, there was an increase in the number of death case reports in the census-registered population, a decrease in the number of omitted deaths, and rise in the crude mortality rate. Except for 2003, the Chinese age-standardized mortality rate was the lowest in 2012 (330.83/100,000) and highest in 2005 (390.08/100,000). Life expectancy increased from 78.36 years in 2005 to 81.67 years in 2012.Conclusions: With the development of its social economy, the Chinese government and public attach greater importance to cause-of-death surveillance. The quality of cause-of-death registrations has gradually increased, crude mortality rates have risen, the Chinese age-standardized mortality rate has fallen, and life expectancies have increased. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the prevalence of cognitive impairment and the distribution of its risk factors among residents aged ≥60 years without cardiovascular and cerebrovascular diseases in rural areas of northern China screened with the Chinese version of the Mini-Mental State Examination (MMSE). Between 2012 and 2013, a questionnaire survey was conducted to collect basic information from participants. Cognitive function was assessed using the MMSE. In the univariate analysis, risk factors for cognitive disorders were female sex, low education and central obesity, while drinking was found to be a protective factor. In the multivariate analysis, risk factors were old age (odds ratio [OR], 1.888; 95% confidence interval [CI]: 1.256-2.838; P = 0.002 for the 70-year-old group compared with the 60-year-old group; OR, 3.593; 95% CI, 2.468-5.230; P < 0.001 for the ≥75-year-old group compared with the 60-year-old group), low education (OR, 3.779; 95% CI: 2.218-6.440; P < 0.001 for the illiterate group compared with the group with ≥9 years of education; OR, 1.667; 95% CI, 1.001-2.775; P = 0.05 for the group with less than primary school compared with the group with ≥9 years of education), and higher blood pressure (BP; OR, 1.655; 95% CI: 1.076-2.544; P = 0.002 for individuals with stage III hypertension compared with those with normal BP). These findings suggest that it is crucial to manage and control level of BP, and improve educational attainment in order to reduce the prevalence and burden of cognitive impairment among low-income residents in rural China. [ABSTRACT FROM AUTHOR]

In recent years, microplastics (MPs) as emerging carriers for environmental pollutants have attracted increasing worldwide attention. However, the adsorption of heavy metals on MPs, especially for biodegradable MPs, has been still poorly understood in estuarine environments. In this study, we investigated the aging of biodegradable and conventional MPs in the Pearl River Estuary after long-term exposure and their impacts on the adsorption of heavy metals from seawater. The results showed that the changes in surface characteristics were more prominent on biodegradable MPs than on conventional MPs after aging. Both biodegradable and conventional MPs could adsorb heavy metals, and their adsorption capacities fluctuated greatly on different MPs and different exposure times. The adsorption capacities of Cu, Pb, and As on biodegradable MPs were higher than those on conventional MPs, whereas Mn, Cr, and Co had lower adsorption on biodegradable MPs after 9–12 months by inductively coupled plasma-mass spectrometry (ICP-MS). The aging characteristics (CI, O/C, and X c) of MPs accounted for a contribution of 51.0% on heavy metal adsorption, while the environmental factors (temperature, salinity, pH, and heavy metal concentration) only contributed to 13.2%. Therefore, the present study can provide important evidence on the environmental behaviors and ecological risks of biodegradable and conventional MPs in estuarine systems. [Display omitted] • Adsorption of heavy metals on biodegradable MPs was first reported in the Pearl River Estuary. • The changes in the physicochemical property of biodegradable MPs were distinct. • Biodegradable MPs tend to particularly adsorb Cu, Pb, and As. • The aging properties of MPs had a strong relationship with heavy metal adsorption. [ABSTRACT FROM AUTHOR]

Crateva unilocularis is naturally distributed in Southern China, which is an elite natural tree with high edible and medicinal value. In this study, whole chloroplast (cp) genome of Crateva unilocularis was assembled and characterized on the basis of Illumina pair-end sequencing data. The complete cp genome was 156,417 bp in length, containing a large single-copy region (LSC) of 85,607 bp and a small single-copy region (SSC) of 18,164 bp, which were separated by a pair of 26,323 bp inverted repeat regions (IRs). The genome contained 128 genes, including 85 protein-coding genes, 35 tRNA genes, and 8 rRNA genes. The overall GC content is 36.32%, while the corresponding values of the LSC, SSC, and IR regions were 33.98, 29.45, and 42.48%, respectively. The maximum-likelihood phylogenetic analysis showed a strong sister relationship with Crateva tapia. These findings provide a foundation for further investigation of cp genome evolution in Crateva unilocularis and other higher plants. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis transmission is typically focal. Understanding spatial variations of Schistosoma infections and their associated factors is important to help to invent site-specific intervention strategies. Methods: A five-year longitudinal study was carried out prospectively in 12 natural villages, Guichi district of Anhui province. A GIS-based spatial analysis was conducted to identify geographic distribution patterns of schistosomiasis infections at the household scale. Results: The results of the spatial autocorrelation analysis for 2005 showed that there were significant spatial clusters of human infections at the household level, and these results were in agreement with that of the spatial scan statistic. As prevalence of infections in humans decreased over the course of control, the spatial distribution of these infections became less heterogeneous. Conclusions: The findings imply that it may be necessary to re-assess risk factors of S. japonicum transmission over the course of control and to adjust accordingly control measures in the communities. [ABSTRACT FROM AUTHOR]

A new kind of marattialean raches are reported from the coal balls in Coal Seam No.7 in the upper part of the Taiyuan Formation (early Early Permian) from Taiyuan, Shanxi, China and are assigned to the genus Stipitopteris Grand'Eury (Psaroniaceae). The present specimens are different from all six reported species of the genus, and are therefore proposed as a new species: Stipitopteris shanxiensis. The raches of the new species are generally dorsi-ventrally flattened. The main raches usually exhibit scales of different forms on their surface. Beneath the epidermis is a zone of parenchymatous cells, some of which contain tannin-like contents. Inside this is a zone of small sclerenchymatous cells. Inward are the ground tissue and vascular bundles. The vascular bundles are continuous and are in two circles: the outer circle assumes a transversely elliptical shape with the gap and pinna trace, and the inner circle assumes a shallow C-shape with inrolled ends. The ground tissue located at the inner side of the vascular bundle is composed of thicker-walled parenchymatous cells. The cells of the ground tissue are vertically elongated in longitudinal sections. Subordered raches are smaller and have simpler structures than the main raches. The parenchyma zone beneath the epidermis is thinner, usually one to two cells wide and the sclerenchyma zone is usually absent. The scales are poorly developed and there is only one C-shaped vascular bundle. The new species is comparable to the crosiers of Psaroniaceae of the Euramerican Flora in some aspects, for example, it has a dorsi-ventrally flattened rachis and scales on the surface of the rachis. However, the other features and the preservative conditions of the present specimens indicate that they are not crosiers, but fully developed or mature raches. The new species is the first well-studied anatomically-preserved rachis of Psaroniaceae from the Cathaysian Flora and bears significance not only in understanding the anatomy and taxonomy of Psaroniaceae in the Cathaysian Flora, but also in the relationship between the Euramerican Flora and the Cathaysian Flora. [ABSTRACT FROM AUTHOR]

Surface displacement is an common environmental geological phenomenon in the Beijing Plain. Research on surface displacement in the Beijing Plain has mainly focused on vertical surface displacement, whereas the horizontal displacement has scarcely been studied. To investigate the 3-D surface displacement in the Beijing Plain, we construct a leveling-constrained multidirectional PS-InSAR 3-D surface displacement estimation method to obtain the 3-D surface displacement information. The results show that the surface displacement in the study area during 2016–2018 was mainly vertical displacement with two main northern and southern subsidence centers; the vertical displacement ranged from −150 mm/year (down) to 5 mm/year (up), and the east–west horizontal displacement ranged from 20 mm/year (east) to 22 mm/year (west). Validation results show that the 3-D surface displacement estimation results agree well with leveling data and GPS data, indicating the reliability of the 3-D surface displacement datasets. The 3-D surface displacement results show that horizontal displacement is obvious in the areas with a large vertical displacement in the eastern Beijing Plain. Additionally, the horizontal displacement is directed toward the center of vertical displacement. The compressive strain is observed close to the centers of vertical displacement, whereas tensile strain occurs far from the centers of vertical displacement. The main cause of the 3-D surface displacement in the study area is the long-term groundwater overexploitation, especially deep groundwater exploitation. The spatial and temporal extents of displacement do not exactly match the locations of the groundwater sinks in different aquifers; instead, geological structures and stratigraphic/lithological conditions may have a combined effect. Moreover, the spatial and temporal distributions of surface displacement are closely related to ground fissure activity, and both influence each other. [ABSTRACT FROM AUTHOR]

With Graph: Figure 3 (a) Mean vertical displacement velocities throughout the NCP derived from the Sentinel-1A (S1A) data by using persistent scatterer interferometric synthetic aperture radar (PS-InSAR), (b) statistics of the subsidence rates at persistent scatterer (PS) points, (c) changes in the area with subsidence over 50 mm from 2016 to 2018, and (d) changes in the maximum subsidence rates from 2016 to 2018: PP, CP, and LP represent the piedmont alluvial-proluvial plain, central alluvial-lacustrine plain, and littoral plain, respectively. Replace Graph: Figure 3 (a) Mean vertical displacement velocities throughout the NCP derived from the Sentinel-1A (S1A) data by using persistent scatterer interferometric synthetic aperture radar (PS-InSAR), (b) statistics of the subsidence rates at persistent scatterer (PS) points, (c) changes in the area with subsidence over 50 mm from 2016 to 2018, and (d) changes in the maximum subsidence rates from 2016 to 2018: PP, CP, and LP represent the piedmont alluvial-proluvial plain, central alluvial-lacustrine plain, and littoral plain, respectively. Recent Ground Subsidence in the North China Plain, China, Revealed by Sentinel-1A Datasets. [Extracted from the article]

Groundwater resources have been exploited and utilized on a large scale in the North China Plain (NCP) since the 1970s. As a result of extensive groundwater depletion, the NCP has experienced significant land subsidence, which threatens geological stability and infrastructure health and exacerbates the risks of other geohazards. In this study, we employed multi-track Synthetic Aperture Radar (SAR) datasets acquired by the Sentinel-1A (S1A) satellite to detect spatial and temporal distributions of surface deformation in the NCP from 2016 to 2018 based on multi-temporal interferometric synthetic aperture radar (MT-InSAR). The results show that the overall ground displacement ranged from −165.4 mm/yr (subsidence) to 9.9 mm/yr (uplift) with a standard variance of 28.8 mm/yr. During the InSAR monitoring period, the temporal pattern of land subsidence was dominated by a decreasing tendency and the spatial pattern of land subsidence in the coastal plain exhibited an expansion trend. Validation results show that the S1A datasets agree well with levelling data, indicating the reliability of the InSAR results. With groundwater level data, we found that the distribution of subsidence in the NCP is spatially consistent with that of deep groundwater depression cones. A comparison with land use data shows that the agricultural usage of groundwater is the dominant mechanism responsible for land subsidence in the whole study area. Through an integrated analysis of land subsidence distribution characteristics, geological data, and previous research results, we found that other triggering factors, such as active faults, precipitation recharge, urbanization, and oil/gas extraction, have also impacted land subsidence in the NCP to different degrees. [ABSTRACT FROM AUTHOR]

Background: Fertility desire for a second child has been a lively topic since the implementation of the two-child policy in China. Chinese researchers have explored various factors influencing the fertility desire for a second child. However, there have not been studies on the individual differences in the relative fertility costs and fertility benefits and their effects on fertility desire for a second child. Methods: A total of 396 participants rated four kinds of relative fertility costs, four kinds of fertility benefits and their fertility desire for a second child. Latent profile analysis (LPA) was used to explore the individual differences in the relative fertility costs and fertility benefits and their effects on fertility desire for a second child. Results: Stepwise regression analysis showed that parenting joy, health risks, mutual care among siblings, the flourishing of family, and time pressure and opportunity cost significantly predicted the fertility desire for the second child. According to the latent profile analysis, the participants were classified into four classes. Participants in the lowest-cost/lowest-benefit and high-cost/medium-benefit classes had low fertility desire for a second child, while those in the low-cost/high-benefit and highest-cost/highest-benefit classes had high fertility desire. Conclusion: Fertility benefits have a stronger effect on the fertility desire for a second child than relative fertility costs. Fertility benefits should be paid more attention to than relative fertility costs. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is a universal chronic disease in China. The balance of the gut microbiome is highly crucial for a healthy human body, especially for the immune system. However, the relationship between the gut microbiome and CKD has not yet been clarified.Methods: A total of 122 patients were recruited for this study. Among them, 24 patients were diagnosed with CKD5 but did not receive hemodialysis therapy, 29 patients were diagnosed with CKD5 and received hemodialysis therapy and 69 were matched healthy controls. The gut microbiome composition was analyzed by a 16S rRNA (16S ribosomal RNA) gene-based sequencing protocol. High-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC/ESI-MS/MS) technology was used to evaluate the levels of microbiome-related protein-binding uremic toxins level, indoxyl sulfate (IS) and p-cresyl sulfate (PCS), in the patients.Results: We compared the gut microbiome results of 122 subjects and established a correlation between the gut microbiome and IS and PCS levels. The results indicated that alpha and beta diversity were different in patients with CKD5 than in the healthy controls (p < 0.01). In comparison to healthy controls, CKD5 patients exhibited a significantly higher relative abundance of Neisseria (p < 0.001), Lachnoclostridium (p < 0.001) and Bifidobacterium (p < 0.001). Faecalibacterium (p < 0.001) displayed a notably lower relative abundance for CKD5 patients both with and without hemodialysis than for controls. It was also found that the concentrations of IS and PCS were correlated with the gut microbiome.Conclusions: Our results indicate that CKD5 patients both with and without hemodialysis had dysbiosis of the gut microbiome and that this dysbiosis was associated with an accumulation of IS and PCS. These results may support further clinical diagnosis to a great extent and help in developing potential probiotics to facilitate the treatment of CKD5. [ABSTRACT FROM AUTHOR]

Land subsidence is a global environmental geological hazard caused by natural or human activities. The high spatial resolution and continuous time coverage of interferometric synthetic aperture radar (InSAR) time series analysis techniques provide data and a basis for the development of methods for the investigation and evolution mechanism study of regional land subsidence. Beijing, the capital city of China, has suffered from land subsidence for decades since it was first recorded in the 1950s. It was reported that uneven ground subsidence and fractures have seriously affected the normal operation of the Beijing Capital International Airport (BCIA) in recent years before the overhaul of the middle runway in April 2017. In this study, InSAR time series analysis was successfully used to detect the uneven local subsidence and ground fissure activity that has been gradually increasing in BCIA since 2010. A multi-temporal InSAR (MT-InSAR) technique was performed on 63 TerraSAR-X/TanDem-X (TSX/TDX) images acquired between 2010 and 2017, then deformation rate maps and time series for the airport area were generated. Comparisons of deformation rate and displacement time series from InSAR and ground-leveling were carried out in order to evaluate the accuracy of the InSAR-derived measurements. After an integrated analysis of the distribution characteristics of land subsidence, previous research results, and geological data was carried out, we found and located an active ground fissure. Then main cause of the ground fissures was preliminarily discussed. Finally, it can be conducted that InSAR technology can be used to identify and monitor geological processes, such as land subsidence and ground fissure activities, and can provide a scientific approach to better explore and study the cause and formation mechanism of regional subsidence and ground fissures. [ABSTRACT FROM AUTHOR]

• A review to summarize the studies of chemical constituents, pharmacological activities and clinical studies et al. of Ixeris sonchifolia. • Traditional uses of IS, covering 19 TCM classics and 19 traditional uses containing IS, were presented in the form of Table. • All known chemical constituents isolated from IS and their chemical structures were enumerated in this review. • So far there are 11 methods used for analysis of IS, but the development of more advanced analysis methods is indispensable. • The assistant therapy action and curative effect evaluation of IS were discussed in detail. The assistant therapy action and curative effect evaluation of IS were discussed in detail. Ixeris sonchifolia (IS), principally its dried form, is widely used as traditional and folk medicines in some Asian countries, especially China. In this review, we summarized its traditional uses, chemical constituents, quality control measures, pharmacological activities, therapeutic evaluation, toxicity evaluation and clinical applications. 130 chemical constituents isolated from IS have been reported, including flavones, sesquiterpenes, triterpenes, phenylpropanoids, organic acids and others. They showed various pharmacological activities, such as protecting cardiocerebral vascular system, anticancer effect and antiviral etc. The quality control evaluation studies, clinical applications, other possible applications and suggestions for future research also were discussed. The aim of this review is to critically appraise the available literature and suggest directions for further development of IS to improve its medical value and use. [ABSTRACT FROM AUTHOR]

Land subsidence is the ground surface response to underground space development, utilization and evolution. Presently, land subsidence has developed into a global, comprehensive and interdisciplinary complex systems problem. More than half a century has passed since the discovery of subsidence in the Beijing Plain in the 1960s. In this study, we investigate the land subsidence in the Beijing Plain over the period of 2003–2015 using ENVISAT ASAR and RADARSAT-2 interferometric datasets and the small baseline subset interferometric synthetic aperture radar (SBAS-InSAR) technique. Furthermore, we introduced the data field model and index-based built-up index (IBI) to obtain the dynamic and static load information of the Beijing Plain. Then, based on a machine learning method, we selected the gradient lifting decision tree (GBDT) model to quantitatively analyze the contributions of groundwater level change, compressible deposit thickness and dynamic and static loads to land subsidence. The results showed that the maximum land subsidence rate was 122 and 141 mm/year in 2003–2010 and 2010–2015, respectively. Comparisons between the SBAS-InSAR results and leveling measurements showed that the minimum absolute error achieved was only 0.2 mm/year. We suggest that the groundwater exploitation in the third confined aquifer has greater impacts on land subsidence in the Beijing Plain than the other factors. The land subsidence likely occurred in compressible deposit thicknesses exceeding 90 m. Moreover, we found that the compressible thickness and groundwater level contributions to land subsidence exceeded 60%. Our results provide a scientific basis for the regulation and control of regional land subsidence. Unlabelled Image • The causes of land subsidence in Beijing Plain are complex. • The maximum land subsidence rate is 122 and 141 mm/year in 2003–2010 and 2010–2015. • The dynamic load by using a spatial data mining method of data field model. • The third confined aquifer groundwater has greater impacts on land subsidence. • Compressible thickness and groundwater contribution to land subsidence exceed 60%. [ABSTRACT FROM AUTHOR]

[Display omitted] • Discrete structural styles and mineral assemblages from auriferous quartz-ankerite-pyrite-arsenopyrite veins (Q2 and Q3) suggest superimposing gold mineralization at Tuanshanbei. • Comprehensive geological and H-O-Nd isotopic composition evidences are features that better adhere to metamorphic devolatilization models, indicating that the two-staged gold mineralization events both formed from metamorphic hydrothermal fluids originated from Cangxiyan Group metamorphic rocks. The Jiangnan Orogen is China's third largest gold province, and has undergone complex orogenic processes and tectonic overprinting, forming multistage magmatism, deformation, metamorphism, and gold mineralization. Our field studies indicate that the Tuanshanbei gold ores (central Jiangnan Orogen) have two generations of auriferous quartz-ankerite-pyrite-arsenopyrite veins (Q2 and Q3), with the latter containing abundant ankerite and base metal sulfides. Both Q2 and Q3 veins are younger than the emplacement of the Tuanshanbei granodiorite vein-ore host, and cut by post-ore diabase dikes. Q2 veins were likely associated with the Early Devonian near N-S-directed shortening, along sub-horizontal EW-/WNW-striking transpressive faults, whereas Q3 veins (hosting ∼ 70% of the total Au resource), were primarily hosted in the Early Triassic moderately-/steeply-dipping NW-striking tensional/transtensional faults and moderately-dipping NE-/NNE-striking transpressive faults, associated with NW-SE-directed shortening. Discrete structural styles and mineral assemblages from Q2 and Q3 suggest superimposing gold mineralization at Tuanshanbei. To determine the source(s) of the ore-forming aqueous-carbonic fluids, we conducted mineralogical and in-situ LA-(MC)-ICP-MS Nd-isotope analyses on two generations of hydrothermal monazite, and H-O isotope analyses on the quartz from Q2 and Q3 veins. The results suggest that the Tuanshanbei ore fluids have δD = −66.7 to −57.6‰ (Q2) and −66.8 to −66.2‰ (Q3), and calculated δ18O H2O = 4.5–9.7‰ (Q2) and 6.1–7.8‰ (Q3). The H-O isotopic data suggest a metamorphic and/or magmatic water source for the ore fluids. Hydrothermal monazite (coexists with native gold and auriferous sulfides) from Q2 and Q3 veins displays subtle heterogeneous BSE response along cracks and grain margin, suggesting alteration there. The 147Sm/144Nd and 143Nd/144Nd ratios of altered parts of Q2 and Q3 monazite grain are significantly perturbed via dissolution–recrystallization by the hydrothermal fluids, whereas their initial Nd isotope compositions seem to be less affected. The unaltered Q2 and Q3 monazite samples have similar initial εNd values (Q2: −8.07 to −7.36, Q3: −10.87 to −9.99) to the Neoproterozoic Cangxiyan Group greenschist–amphibolite-facies metamorphic rocks. Geological and structural evidence suggest both Q2 and Q3 ore-forming events were related to metamorphism, typical of orogenic gold deposits. We interpreted that various parts of the basement were metamorphosed (to near the greenschist-amphibolite-facies boundary) at different times, during which the gold-bearing metamorphic fluids produced migrated into the same structural conduits and deposited the ores there in two ore-forming episodes. [ABSTRACT FROM AUTHOR]

Background: Folate deficiency is an independent risk factor for congenital heart disease (CHD); however, the maternal plasma folate level is paradoxically not a good diagnostic marker. Genome-wide surveys have identified variants of nonfolate metabolic genes associated with the plasma folate level, suggesting that these genetic polymorphisms are potential risk factors for CHD.Methods: To examine the effects of folate concentration-related variations on CHD risk in the Han Chinese population, we performed 3 independent case-control studies including a total of 1489 patients with CHD and 1745 control subjects. The expression of the Fidgetin (FIGN) was detected in human cardiovascular and decidua tissue specimens with quantitative real-time polymerase chain reaction and Western blotting. The molecular mechanisms were investigated by luciferase reporter assays, surface plasmon resonance, and chromatin immunoprecipitation. FIGN-interacting proteins were confirmed by tandem affinity purification and coimmunoprecipitation. Proteasome activity and metabolite concentrations in the folate pathway were quantified with a commercial proteasome activity assay and immunoassays, respectively.Results: The +94762G>C (rs2119289) variant in intron 4 of the FIGN gene was associated with significant reduction in CHD susceptibility (P=5.1×10-14 for the allele, P=8.5×10--13 for the genotype). Analysis of combined samples indicated that CHD risks in individuals carrying heterozygous (GC) or homozygous (CC) genotypes were reduced by 44% (odds ratio [OR]=0.56; 95% confidence interval [CI]=0.47-0.67) and 66% (OR=0.34; 95% CI=0.23-0.50), respectively, compared with those with the major GG genotype. Minor C allele carriers who had decreased plasma folate levels exhibited significantly increased FIGN expression because the transcription suppressor CREB1 did not bind the alternative promoter of FIGN isoform X3. Mechanistically, increased FIGN expression led to the accumulation of both reduced folate carrier 1 and dihydrofolate reductase via inhibition of their proteasomal degradation, which promoted folate absorption and metabolism.Conclusions: We report a previously undocumented finding that decreased circulating folate levels induced by increased folate transmembrane transport and utilization, as determined by the FIGN intronic variant, serves as a protective mechanism against CHD. Our results may explain why circulating folate levels do not have a good diagnostic value. [ABSTRACT FROM AUTHOR]

Sediment dredging is an effective means to control the endogenous pollution of lakes, which could significantly change the concentration and composition of organic matter, especially dissolved organic matter (DOM) in the lake. DOM is particularly important for the release of endogenous pollutants, which will inevitably bring an impact on aquatic biodiversity. Nevertheless, in recent research little attention has been paid to the desorption mechanism of DOM on pollutants and the change of biodiversity during dredging. This study investigated the physicochemical properties of DOM in the sediment by taking a sediment dredging project in Dianchi Lake in China for example. The correlations of DOM properties with the desorption behavior of nitrogen (N), phosphorus (P), cadmium (Cd), lead (Pb) and the biodiversity of aquatic organisms were analyzed. The results show that the aromaticity and humification of DOM were improved after dredging, and the high molecular weight DOM was degraded into low molecular weight substance. The desorption amount of N, P and heavy metals (Cd, Pb) were decreased as the pH values increased. Moreover, NH 4 +-N promoted the release of Pb2+ from DOM, while the release of PO 4 3--P was inhibited. Correlation analysis shows that the physicochemical properties of DOM exactly affected the release of N, P, Cd and Pb. It was easier to desorb pollutants with low aromaticity and humification of DOM, leading to a decrease in the diversity of aquatic organisms. This study identified the desorption mechanism of endogenous pollutants in DOM and the ecological risk to aquatic organisms, providing a theoretical basis for the prevention and control of water pollution. [Display omitted] • Possible desorption mechanism of N, P and heavy metals from DOM are proposed. • Correlations of DOM properties and desorption behavior of pollutants was analyzed. • The relationship between DOM and biodiversity of aquatic organisms were explored. • The effects of dredging on pollutant release and biodiversity were evaluated. [ABSTRACT FROM AUTHOR]

[Display omitted] • We provided more evidence on associations between legacy PFASs and PFAS alternatives and glucose-homeostasis. • We explored the joint associations of legacy PFASs and PFAS alternatives. • 6:2 Cl-PFESA contributed the most in the joint associations. • Sex-specific associations were observed. Epidemiological studies on the associations of legacy per- and polyfluoroalkyl substances (PFASs) and glucose homeostasis remain discordant. Understanding of PFAS alternatives is limited, and few studies have reported joint associations of PFASs and PFAS alternatives. To investigate associations of novel PFAS alternatives (chlorinated perfluoroalkyl ether sulfonic acids, Cl-PFESAs and perfluorobutanoic acid, PFBA) and two legacy PFASs (Perfluorooctanoic acid, PFOA and perfluorooctane sulfonate, PFOS) with glucose-homeostasis markers and explore joint associations of 13 legacy and alternative PFASs with the selected outcomes. We used cross-sectional data of 1,038 adults from the Isomers of C8 Health Project in China. Associations of PFASs and PFAS alternatives with glucose-homeostasis were explored in single-pollutant models using generalized linear models with natural cubic splines for PFASs. Bayesian Kernel Machine Regression (BKMR) models were applied to assess joint associations of exposures and outcomes. Sex-specific analyses were also conducted to evaluate effect modification. After adjusting for confounders, both legacy (PFOA, PFOS) and alternative (Cl-PFESAs and PFBA) PFASs were positively associated with glucose-homeostasis markers in single-pollutant models. For example, in the total study population, estimated changes with 95% confidence intervals (CI) of fasting glucose at the 95th percentile of 6:2Cl-PFESA and PFOS against the thresholds were 0.90 (95% CI: 0.59, 1.21) and 0.44 (95% CI: 0.26, 0.62). Positive joint associations were found in BKMR models with 6:2Cl-PFESA contributing most. Sex-specific associations existed in both single- and multi-pollutant models. Legacy and alternative PFASs were positively associated with glucose-homeostasis markers. 6:2Cl-PFESA was the primary contributor. Sex-specific associations were also identified. These results indicate that joint associations and effect modification should be considered in risk assessment. However, further studies are recommended to strengthen our findings and to elucidate the mechanisms of action of legacy and alternative PFASs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the caregiving behaviours and supportive needs of caregivers of patients with HIV/AIDS and provide a basis for healthcare institutions to carry out caregiver interventions., Design: A purposive sampling method was used to select 11 caregivers of patients with HIV/AIDS in the Infectious Disease Department of a tertiary hospital in Nanjing, China, to conduct semistructured interviews. Colaizzi analysis was used to collate and analyse the interview data., Setting: All interviews were conducted at a tertiary hospital specialising in infectious diseases in Nanjing, Jiangsu Province., Participants: We purposively sampled 11 caregivers of people with HIV/AIDS, including nine women and two men., Results: Analysing the results from the perspective of iceberg theory, three thematic layers were identified: behavioural, value and belief. The behavioural layer includes a lack of awareness of the disease, physical and mental coping disorders, and an increased sense of stigma; the values layer includes a heightened sense of responsibility, the constraints of traditional gender norms, the influence of strong family values and the oppression of public opinion and morality and the belief layer includes the faith of standing together through storms and stress., Conclusion: Healthcare professionals should value the experiences of caregivers of patients with HIV/AIDS and provide professional support to improve their quality of life., 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: Creativity is an essential cognitive ability that plays a crucial role in advanced thinking. While previous research has demonstrated the impact of insomnia on cognitive function, its effects on creativity in Chinese adolescents remain unclear. This study explored the relationship between insomnia (specifically, daytime and nighttime disturbances) and creativity in adolescents. Additionally, it examined the potential mediating effect of the need for cognition on this relationship., Methods: Questionnaires were administered to 302 adolescents to measure their creativity, need for cognition, and insomnia levels using the Williams Creative Tendencies Scale, Need for Cognition Scale, and Bergen Insomnia Scale, respectively. Regression analysis was conducted to examine the direct impact of insomnia on creativity. Furthermore, a mediation model was constructed to investigate the role of the need for cognition in mediating the relationship between insomnia and creativity., Results: The findings of the present study indicated that insomnia had a direct impact on the creativity of adolescents, demonstrating a time-of-day effect. Daytime disturbances were found to have a positive correlation with overall creativity and imagination, whereas no significant direct effect was found between nighttime disturbances and creativity. Further analysis revealed that insomnia, specifically daytime disturbances, might influence creativity by affecting the individual's need for cognition. However, no similar indirect effects were observed for the relationship between nighttime disturbances and creativity., Conclusions: Our findings indicate that adolescents might experience improved creativity as a result of daytime disruptions, and the level of need for cognition could play a crucial role in understanding the link between insomnia and creativity in adolescents., (© 2024. The Author(s).)

Baccaurea ramiflora Lour., an evergreen tree of the Baccaurea genus of the Phyllanthaceae family, is primarily distributed in South Asia, Southeast Asia, and southern China, including southern Yunnan Province. It is a wild or semi-cultivated tree species with ornamental, edible, and medicinal value, exhibiting significant development potential. In this study, we present the whole-genome sequencing of B. ramiflora, employing a combination of PacBio SMRT and Illumina HiSeq 2500 sequencing techniques. The assembled genome size was 975.8 Mb, with a contig N50 of 509.33 kb and the longest contig measuring 7.74 Mb. The genome comprises approximately 73.47% highly repetitive sequences, of which 52.1% are long terminal repeat-retrotransposon sequences. A total of 29,172 protein-coding genes were predicted, of which 25,980 (89.06%) have been annotated, Additionally, 3452 non-coding RNAs were identified. Comparative genomic analysis revealed a close relationship between B. ramiflora and the Euphorbiaceae family, with both being sister groups that diverged approximately 59.9 million years ago. During the evolutionary process, B. ramiflora exhibited positive selection in 278 candidate genes. Synonymous substitution rate and collinearity analysis demonstrated that B. ramiflora underwent a single ancient genome-wide triploidization event, without recent genome-wide duplication events. This high-quality B. ramiflora genome provides a valuable resource for basic research and tree improvement programs focusing on the Phyllanthaceae family., (© 2024. The Author(s).)

Tropane alkaloids (TAs), which are anticholinergic agents, are an essential class of natural compounds, and there is a growing demand for TAs with anesthetic, analgesic, and spasmolytic effects. Anisodus acutangulus (Solanaceae) is a TA-producing plant that was used as an anesthetic in ancient China. In this study, we assembled a high-quality, chromosome-scale genome of A. acutangulus with a contig N50 of 7.4 Mb. A recent whole-genome duplication occurred in A. acutangulus after its divergence from other Solanaceae species, which resulted in the duplication of ADC1 and UGT genes involved in TA biosynthesis. The catalytic activities of H6H enzymes were determined for three Solanaceae plants. On the basis of evolution and co-expressed genes, AaWRKY11 was selected for further analyses, which revealed that its encoded transcription factor promotes TA biosynthesis by activating AaH6H1 expression. These findings provide useful insights into genome evolution related to TA biosynthesis and have potential implications for genetic manipulation of TA-producing plants., (Copyright © 2023. Published by Elsevier Inc.)

Objective: To develop and validate a risk assessment model for the prediction of the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) in patients with idiopathic pulmonary fibrosis (IPF)., Methods: We enrolled a total of 110 patients with IPF, hospitalized or treated as outpatients at Xuzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from July 2012 to July 2020. Of these, 78 and 32 patients were randomly assigned to training and test groups, respectively. The risk factors for AE-IPF were analyzed using logistic regression analysis, and a nomographic model was constructed. The accuracy, degree of calibration, and clinical usefulness of the model were assessed with the consistency index (C-index), calibration diagram, and decision curve analysis (DCA). Finally, the stability of the model was tested using internal validation., Results: The results of logistic regression analysis showed that a history of occupational exposure, diabetes mellitus (DM), essential hypertension (EH), and diffusion capacity for carbon monoxide (DLCO)% predicted were independent risk factors for AE-IPF prediction. The nomographic model was constructed based on these independent risk factors, and the C-index was 0.80. The C-index for the internal validation was 0.75, suggesting that the model had good accuracy. The decision curve indicated that for a threshold value of 0.04-0.66, greater clinical benefit was obtained with the AE-IPF risk prediction model., Conclusion: A customized AE-IPF prediction model based on a history of occupational exposure, DM, EH, and DLCO% predicted provided a reference for the clinical prediction of AE-IPF., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2020 Qi Wu et al.)

Neoadjuvant chemotherapy with docetaxel, oxaliplatin, fluorouracil, and leucovorin (FLOT regimen) has shown promising results in terms of pathological response and survival rate in patients with locally advanced resectable gastric cancer (LAGC). However, tegafur gimeracil oteracil potassium capsule (S-1) plus oxaliplatin (SOX regimen) is the preferred chemotherapy regimen in Eastern countries. Here, we conduct an open label, two-arm, phase II randomized interventional clinical trial (Dragon III; ClinicalTrials.gov: NCT03636893) to evaluate the safety and efficacy of both regimens. Patients with LAGC are randomly assigned to receive either 4 cycles of the neoadjuvant FLOT regimen (40 patients) or 3 cycles of the SOX regimen (34 patients) before gastrectomy. The primary endpoint is the comparison of complete (TRG1a) or subtotal (TRG1b) tumor regression grading in the primary tumor. There are no significant differences in adverse effects or postoperative morbidity and mortality between the two groups. No significant differences in the proportion of tumor regression grading between the FLOT group and the SOX group are found. Complete or subtotal TRG is 20.0% in the FLOT group versus 32.4% in the SOX group. Therefore, our study does not find statistically significant differences between neoadjuvant FLOT and SOX regimens for the primary outcomes reported here in locally advanced gastric cancer.

Purpose: The present study focused on the long-term prognostic value of dynamic body mass index (BMI) change in gastric cancer patients who underwent gastrectomy. Methods : Clinical data from a total of 576 gastric cancer patients who underwent radical gastrectomy were collected. Univariate and multivariate analyses were performed to demonstrate the association between dynamic BMI variables (BMI before surgery, 1 month, 6 months or 12 months after surgery) and prognosis (DFS and OS). The correlation between BMI loss after surgery and survival outcomes was also evaluated. Results : Post-operative BMI, especially BMI at one year after surgery ( p <0.001), was an independent risk factor of recurrence and mortality, wherein patients with high-BMI (≥23) showed significantly better outcomes than patients with normal-BMI (18.5-23) (DFS, HR:0.49; 95% CI:0.31-0.78; OS, HR:0.30; 95% CI: 0.15-0.59). On the contrary, low-BMI (<18.5) patients presented with worse outcomes (DFS, HR: 1.34; 95% CI: 1.00-1.80; OS, HR: 1.68; 95% CI: 1.20-2.34). In addition, compared with moderate BMI loss (≤10%), severe postoperative BMI loss (>10%) at one year was independently associated with substantially worse prognosis for DFS (HR: 1.54; 95% CI: 1.15-2.08) and OS (HR: 1.45; 95% CI: 1.02-2.06). Subgroup analysis indicated that gender ( p =0.03), extent of resection ( p <0.001), tumor site ( p =0.001) and perineural invasion ( p =0.007) were associated with postoperative BMI loss at one year. The prognostic value of postoperative BMI loss at one year was consistent among most clinicopathological subgroups, except for tumor site (interaction p =0.025 for OS). Conclusion : In Chinese gastric cancer patients who underwent gastrectomy, higher postoperative BMI (≥ 23) was significantly associated with longer survival time, whereas severe BMI loss (>10%) at one year after surgery was associated with worse outcomes. Thus, body weight maintenance after treatment is important, and dynamic monitoring of body weight and nutritional status should be emphasized in clinical practice., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Background: Subclinical hypothyroidism is a common condition in patients with heart failure and is defined as elevated serum thyroid hormone (TSH) with normal circulating free thyroxine (FT4). Evidence on the effect of thyroid hormone treatment is lacking. We designed a randomized controlled trial to compare the efficacy and safety of thyroid hormone supplementation in patients with chronic heart failure complicated with subclinical hypothyroidism., Methods/design: Eligible participants were identified from the cardiology units of five study centers based on the following criteria: 18 years or older, systolic heart failure with NewYork Heart Association (NYHA) class II-III, left ventricular ejection fraction ≤ 40%, and subclinical hypothyroidism (TSH > 4.78μIU/ml, < 10 μIU/ml + FT4 level within reference range). Eligible patients will be randomly assigned in a 1:1 manner to receive thyroxine replacement therapy plus standard chronic heart failure (CHF) treatment or only standard CHF therapy. Levothyroxine will be administered at an initial dose of 12.5 μg once daily and will be titrated until TSH is within the normal range. The primary endpoints include the difference in distance of the six-minute walk test between 24 weeks and baseline. The secondary endpoints include differences in plasma NT-proBNP levels and serum lipid profiles, changes in the NYHA classification, cardiovascular death, re-hospitalization, differences in echocardiographic and cardiac magnetic resonance imaging measures, and Minnesota Living With Heart Failure Questionnaire (MLHFQ) results between 24 weeks and baseline., Discussion: ThyroHeart-CHF is designed as a prospective, multi-center, randomized, controlled clinical trial to study the efficacy and safety of thyroid hormone supplementation in patients with chronic heart failure complicated with subclinical hypothyroidism. The study findings will have significant implications for discovering the new therapeutic targets and methods of heart failure., Trail Registration: ClinicalTrials.gov, NCT03096613 . Registered on 30 March 2017.

This study aimed to investigate the impact of timing interval to start AED withdraw (TIW) after surgery on the seizure outcome in non-neoplastic drug resistant epilepsy (DRE). TIW were divided into three groups (respectively,<1 year, 1-<2 years, and ≥2 years). The seizure outcome at the different time points after starting AED withdrawal were compared among three groups. Other factors that related to seizure recurrence and TIW were included into the multiple analysis to investigate the predictors of seizure-free. Altogether, 205 patients were involved in the study. 102 individuals (50%) had seizure recurrence and 127 (62%) had seizure-free at the final follow up. 115 of them have attempted AED reduction and had not seizure recurrence before AED reduction. The rate of seizure-free had no significant difference among people with different TIW. Multiple analysis indicated that temporal surgery is a favorable predictor of seizure-free at the first year after starting AED withdrawal, and preoperative secondary generalized seizures is an unfavorable predictor of seizure-free at the final follow up. In patients with non-neoplastic DRE, TIW is not the mainly influence factor on seizure outcome, however, preoperative secondary generalized seizures and extra-temporal surgery are negatively associated with seizure-free.

We aimed to explore the impact of blood pressure (BP) levels on atherosclerosis in a rural Chinese population with a low-education level, low income, high incidence of stroke, and high prevalence of hypertension. B-mode ultrasonography was used to measure carotid intima-media thickness (CIMT) in adults aged ≥ 45 years with no history of stroke or cardiovascular disease. A total of 5403 eligible subjects were included in this study. The mean CIMT was 0.57 mm overall, 0.58 mm for men and 0.56 mm for women. Systolic blood pressure (SBP) and hypertension were significantly associated with increased CIMT. CIMT increased by 0.42 μm for every 1 mm Hg-increase in SBP (P < 0.001). The mean CIMT in participants with a history of hypertension was 17.42 μm greater than that in participants with no history of hypertension (P < 0.001). Diastolic blood pressure (DBP) was a protective factor, as CIMT decreased by 0.44 μm with every 1 mm Hg-increase in DBP (P = 0.011).

The association between normal thyroid function and diabetic kidney disease (DKD) has gained increasing attention. The present study evaluated the relationship between normal thyroid hormone levels and DKD in type 2 diabetes mellitus (T2DM) patients. A total of 862 type 2 diabetes patients were enrolled in this cross-sectional study in Xi ' an, Shaanxi Province, China. The subjects were evaluated for anthropometric measurements, thyroid function and DKD. Of 862 patients, 246 (28.5%) suffered from DKD, and the prevalence of DKD did not differ between men and women. The prevalence of DKD showed a significantly decreasing trend across the quartiles based on free triiodothyronine (FT3) levels (41.1%, 30.6%, 23.8%, and 18.9%, P < 0.001). In comparison with all participants categorized in the first FT3 quartile group (FT3-Q1) (<4.380), the adjusted odds ratio of DKD in the second FT3 quartile group (FT3-Q2), the third FT3 quartile group (FT3-Q3), and the fourth FT3 quartile group (FT3-Q4) were 0.655(95%CI: 0.406-1.057), 0.493(95%CI: 0.299-0.813), 0.406(0.237-0.697) (P < 0.05). Also, similar results were observed in men. Conversely, none of the FT3 groups was associated with DKD in women. The present study showed that FT3 within normal range was negatively correlated with DKD in T2DM patients.

Air pollution may increase cardiovascular and respiratory risk through inflammatory pathways, but evidence for acute effects has been weak and indirect. Between December 2014 and July 2015, we enrolled 36 healthy, nonsmoking college students for a panel study in Shanghai, China, a city with highly variable levels of air pollution. We measured personal exposure to particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) continuously for 72 hours preceding each of 4 clinical visits that included phlebotomy. We measured 4 inflammation proteins and DNA methylation at nearby regulatory cytosine-phosphate-guanine (CpG) loci. We applied linear mixed-effect models to examine associations over various lag times. When results suggested mediation, we evaluated methylation as mediator. Increased PM2.5 concentration was positively associated with all 4 inflammation proteins and negatively associated with DNA methylation at regulatory loci for tumor necrosis factor alpha (TNF-α) and soluble intercellular adhesion molecule-1. A 10-μg/m3 increase in average PM2.5 during the 24 hours preceding blood draw corresponded to a 4.4% increase in TNF-α and a statistically significant decrease in methylation at one of the two studied candidate CpG loci for TNF-α. Epigenetics may play an important role in mediating effects of PM2.5 on inflammatory pathways.

Few studies have been conducted which evaluate the prevalence of contamination of medical uniforms in China. The present study was designed to explore the characteristics of uniform contamination and associated factors. A total of 120 participants were enrolled in the study and 122 uniforms were sampled. Each uniform was sampled at three different sites to determine the colonisation of microorganisms. A total of 366 swab samples were cultured; 294 (80.3%) samples yielded various microorganisms and 75(61.5%) uniforms were contaminated with bacteria. The uniforms of medical students had the highest prevalence of contamination. The cuffs of uniforms were the most easily infected with bacteria. Participants who wiped their hands at the back of uniforms had higher contamination rate in the hanging part of uniforms. Our study demonstrated that medical uniforms can harbour microorganisms. Proper handling of medical uniforms and adequate education to medical staffs are required to decrease healthcare-associated infections.

Background: Folate deficiency is an independent risk factor for congenital heart disease (CHD); however, the maternal plasma folate level is paradoxically not a good diagnostic marker. Genome-wide surveys have identified variants of nonfolate metabolic genes associated with the plasma folate level, suggesting that these genetic polymorphisms are potential risk factors for CHD., Methods: To examine the effects of folate concentration-related variations on CHD risk in the Han Chinese population, we performed 3 independent case-control studies including a total of 1489 patients with CHD and 1745 control subjects. The expression of the Fidgetin (FIGN) was detected in human cardiovascular and decidua tissue specimens with quantitative real-time polymerase chain reaction and Western blotting. The molecular mechanisms were investigated by luciferase reporter assays, surface plasmon resonance, and chromatin immunoprecipitation. FIGN-interacting proteins were confirmed by tandem affinity purification and coimmunoprecipitation. Proteasome activity and metabolite concentrations in the folate pathway were quantified with a commercial proteasome activity assay and immunoassays, respectively., Results: The +94762G>C (rs2119289) variant in intron 4 of the FIGN gene was associated with significant reduction in CHD susceptibility ( P =5.1×10 -14 for the allele, P =8.5×10 --13 for the genotype). Analysis of combined samples indicated that CHD risks in individuals carrying heterozygous (GC) or homozygous (CC) genotypes were reduced by 44% (odds ratio [OR]=0.56; 95% confidence interval [CI]=0.47-0.67) and 66% (OR=0.34; 95% CI=0.23-0.50), respectively, compared with those with the major GG genotype. Minor C allele carriers who had decreased plasma folate levels exhibited significantly increased FIGN expression because the transcription suppressor CREB1 did not bind the alternative promoter of FIGN isoform X3. Mechanistically, increased FIGN expression led to the accumulation of both reduced folate carrier 1 and dihydrofolate reductase via inhibition of their proteasomal degradation, which promoted folate absorption and metabolism., Conclusions: We report a previously undocumented finding that decreased circulating folate levels induced by increased folate transmembrane transport and utilization, as determined by the FIGN intronic variant, serves as a protective mechanism against CHD. Our results may explain why circulating folate levels do not have a good diagnostic value., (© 2017 American Heart Association, Inc.)