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To 1) determine the prevalence and types of disrespectful maternity care witnessed by students; 2) describe students' perceptions of respectful maternity care and associated factors; and 3) investigate whether witnessing disrespectful care influences their perceptions of respectful maternity care. Limited evidence exists about nursing and midwifery students' perceptions of respectful maternity care and prevalence of disrespectful maternity care in China. Understanding students' perceptions can inform pre-registration curricula and clinical practice programs, promoting the implementation of respectful maternity care. An exploratory national online survey was conducted. Data were analysed using bivariate analysis and multi-factor analysis of variance. Among 733 students, positive perceptions towards respectful maternity care were common. Approximately one-fifth witnessed disrespect, with physical violence, lack of communication and untimely care most frequently reported. A better understanding of respectful maternity care was associated with female students of Han ethnicity, majoring in midwifery, undertaking a longer internship/practicum and reporting fewer instances of observed disrespect. Although students reported positive perceptions of respectful maternity care, inadequate understanding was evident. Incorporating relevant content about respectful care into the curriculum is suggested. Reducing students' exposure to disrespectful maternity care may ensure that certain forms of disrespect or abuse do not become normalized among students. This requires system-level efforts to create a safe and supportive working environment for maternity health providers. To promote respectful maternity care in China, system-level changes are warranted. Respectful maternity care needs to be essential content in pre-registration midwifery and nursing curricula. Encouraging students to identify poor practice and discuss good practice in a safe learning environment is warranted. [ABSTRACT FROM AUTHOR]

To ensure water security, it is crucial to understand the characteristics of nitrogen (N) and phosphorus (P) in water and to reduce their inputs. We conducted a 2-year trial (2021–2022) in tobacco fields across three sites in the Erhai Lake basin, China, to comprehensively measure and summarize N and P loss through runoff and leaching for four fertilizer treatments: no fertilizer (CK); farmers' traditional organic fertilizer (FP); chemical fertilizer (CF); and a combination of organic and inorganic fertilizer (OIC). The highest N concentrations were detected in leachate in the early tobacco growth stage, whereas the highest P concentrations occurred in runoff in the middle growth stage. Compared to FP, the OIC treatment improved nutrient uptake in flue-cured tobacco, while also reducing N loss through runoff and leaching by 45.37% and 19.34%, and reducing P loss by 7.22% and 8.26%, respectively. Correlation analyses revealed positive relationships of nutrient loss with soil organic matter content and nutrient inputs; elevation and soil water content exhibited varying correlations with different nutrients. These findings provide a theoretical foundation for the effective management of agricultural non-point source pollution in the Erhai Lake basin and shed light on water pollution pressures worldwide. [Display omitted] • The characteristics of nutrient loss under different fertilization treatments and geographical conditions were explored. • The combination of organic and inorganic fertilizer increased the yield of tobacco field and reduced the nutrient loss. • Nitrogen and Phosphorus were mainly lost in the form of nitrate N and dissolved P. • Soil organic matter content and nutrient input had a positive effect on nutrient loss. [ABSTRACT FROM AUTHOR]

There are no data validating the performance of spleen stiffness measurement in ruling out high-risk varices in patients with HBV-related cirrhosis under maintained viral suppression. Thus, we aimed to prospectively validate the performance of spleen stiffness measurement (cut-off 46 kPa) combined with Baveno VI criteria in ruling out high-risk varices in these patients. Patients with cirrhosis were enrolled from April to December 2019 at the hepatology unit of the Nanfang Hospital, China. Liver and spleen transient elastography and esophagogastroduodenoscopy were performed at enrollment. Antiviral regimen(s) and virological responses, evaluated every 3-6 months, were recorded. Overall 341 patients with HBV-related cirrhosis under maintained viral suppression were enrolled, and the prevalence of high-risk varices was 20.5% (70/341). Baveno VI criteria spared 37.0% (126/341) esophagogastroduodenoscopies and no high-risk varices were missed (0/70). Eight cases of high-risk varices (8/70, 11.4%) were misclassified in patients (208/341, 61.0%) within the expanded Baveno VI criteria. The spleen stiffness measurement cut-off (≤46.0 kPa) was shown to safely rule out high-risk varices in these patients (the percentage of missed high-risk varices was 4.3%). Over half (61.6%, 210/341) of patients met the combined model (Baveno VI criteria and spleen stiffness measurement cut-off ≤46 kPa) and 4.3% (3/70) of high-risk varices cases were misclassified. This combined model exhibited a sensitivity of 95.71%, specificity of 76.38%, negative predictive value of 98.57%, and negative likelihood ratio of 0.06 for ruling out high-risk varices. We validated the excellent performance of Baveno VI criteria combined with spleen stiffness measurement (cut-off 46 kPa) for safely ruling out high-risk varices in patients with HBV-related cirrhosis under viral suppression; more than half of esophagogastroduodenoscopy procedures were spared using this combination. NCT04123509 Esophageal varices have important prognostic implications in patients with cirrhosis. Thus, their timely identification is important so that treatment can be initiated early. Herein, we validated the excellent performance of the combination of Baveno VI criteria with spleen stiffness measurement (cut-off 46 kPa) for ruling out high-risk esophageal varices in patients with HBV-related cirrhosis under maintained viral suppression (with antiviral treatment). This combined model was able to safely rule out high-risk varices (missed/total <5%) and over half (61.6%) of esophagogastroduodenoscopy procedures were spared. • Largest prospective study validating the performance of Baveno VI criteria in patients with cirrhosis under HBV suppression. • SSM (≤46 kPa) for ruling out high-risk varices was well validated in patients with cirrhosis under viral suppression. • More unnecessary endoscopies (>50%) can be safely avoided by combining Baveno VI criteria and SSM model. [ABSTRACT FROM AUTHOR]

• Coal gangue filling reclamation led to increases in bulk density, decreases in nutrients, and accumulation of heavy metals. • Reclamation and reconstruction activities changed the relationship strength and cooperation efficiency among soil properties. • The reduction in bulk density due to soil aggregates restoration was essential for reclaimed mine soil recovery. • Under high-groundwater-level conditions, the filled coal gangue became a new source of heavy metals for reclaimed mine soils. • Water-dissolved colloids acted as carriers of the heavy metals. Coal gangue filling reclamation is an important means to restore coal mining subsided cultivated land. However, coal gangue can release heavy metals, threatening the overlying soil environment. During the reconstruction of reclaimed mine soils (RMSs), soil properties evolve in a complex manner and influence the distribution of heavy metals, forming complex network relationships that differ from those of non-subsided cultivated soils (NCSs). It is difficult to determine the mechanism of RMS reconstruction and heavy metal accumulation and distribution by studying the trends of only a few variables. Complex network theory (CNT), however, can reveal the original internal characteristics and mechanisms of the system in a comprehensive and effective way. This study aimed at revealing the characteristics and mechanisms of soil reconstruction and heavy metal distribution in RMSs from a holistic perspective. Reclaimed cultivated land with coal gangue filling in high-groundwater-level mining areas in Jining City, Shandong Province, China, was selected for the study. First, soil samples were collected from depths of 0–20, 20–40, and 40–60 cm, and a total of 21 soil indicators were determined. Then, CNT was applied to explore the special soil property relationships and key factors in the RMS reconstruction process. Finally, the intrinsic mechanism of RMS reconstruction and heavy metal distribution was revealed by comparison with NCSs. The results showed that coal gangue filling reclamation and reconstruction activities led to increases in bulk density (BD), decreases in nutrients, and the accumulation of heavy metals. These activities also changed the relationship strength and cooperation efficiency among soil properties. BD reduction due to soil aggregate recovery increased microbial activity and accumulated organic carbon and nutrients, which became essential for RMS recovery. The filled coal gangue became a new source of heavy metals for the RMSs, with water-dissolved colloids acting as carriers of the heavy metals. [ABSTRACT FROM AUTHOR]

• The concept of cultivated land quality (CLQ) was deduced from the concept of "quality". • CLQ emphasizes the satisfaction of cultivated land conditions to human well-being. • The elements, connotations, and dimensions of CLQ were clarified from the perspective of farmland ecosystems. • An CLQ evaluation analysis framework was proposed. Historically, the cognition and management of cultivated land quality (CLQ) have been fragmented, leading to an inability to meet contemporary scenarios and requirements of China's agricultural development and cultivated land protection. This study aimed to systematically recognize the concepts, elements, connotations, and dimensions of CLQ and build a new cultivated land quality evaluation (CQE) system. Initially, we deduced the concept of CLQ through the clear concept of "quality" in line with international standards. Next, we connected CLQ with the framework of farmland ecosystem service cascades and clarified the element structure of CLQ based on the structure of farmland ecosystems. Then, based on the multi-level human well-being that farmland ecosystems can provide, the connotations and dimensions of CLQ was determined. Using Wen County within Henan Province as a case study site, we constructed a CQE system for empirical analysis and comparative verification, showing that the new system was better than the existing one. This study helped to clarify the CLQ and provided a theoretical basis and technical reference for sustainable intensification (SI) and multi-directional protection and supervision of cultivated land. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and has caused traumatic experience for nurses worldwide. However, the prevalence of depression and anxiety symptoms in nurses, and how psychosocial factors influence nurses in this public crisis are unknown. To determine the effect of COVID-19 on the mental health of nurses and the prevalence of anxiety and depression symptoms among nurses in China during the outbreak. A cross-sectional study. A total of 3,228 nurses in Sichuan Province and Wuhan City were selected by convenience sampling. All participants were invited to complete the questionnaire through WeChat from January 27 to February 3, 2020. A self-reported questionnaire combining depression and anxiety scale was used to collect data anonymously. Binary and multivariate logistic regression was applied to measure the odds of psychosocial factors of anxiety and depression and perceived health, respectively. The total incidence of depression (34.3%) and anxiety (18.1%) during the COVID-19 outbreak was lower than that during the SARS outbreak; however, the rate of depression in our study (47.1%) was high and similar in a recent study (50.4%) about the health care workers exposed to COVID-19 in China. The results indicated that COVID-19-related stress, relationship quality with family, and demographic characteristics were associated with depression, anxiety, and perceived health status. Furthermore, the prevalence of depression was similar between nurses working in low-risk COVID-19 wards was as high as working in high-risk COVID-19 wards (OR, 1.078; 95% CI, 0.784–1.481). Our study revealed the high prevalence of depression and anxiety among nurses during the outbreak of COVID-19. COVID-19 factors and psychosocial factors were associated with mental health of nurses. The results suggest that hospitals should implement effective mental health promotion programs focused on occupational safety and family support to improve the well-being of nurses. [ABSTRACT FROM AUTHOR]

Although early-onset Parkinson's disease (EOPD) has a more penetrant genetic etiology, the genetic architecture of EOPD remains unclear. The objectives of this study were to assess the genetic and clinical features of EOPD among ethnic Chinese from mainland China. Using whole-exome sequencing, we performed genetic analyses of 240 participants including 193 with sporadic and 47 with familial EOPD (age of onset <50 years). In total, 18 patients (7.5%) harbored pathogenic or likely pathogenic variants in known PD genes. Among these variants, biallelic variants in Parkin and PINK1 were responsible for 4.2% of cases, and rare likely pathogenic variants in LRRK2 (1.7%) also appeared to be a relatively common cause of EOPD. Notably, 7.5% of patients carried risk variants in either LRRK2 or GBA , which should also be considered for EOPD. Nevertheless, 41 patients (17.1%) had rare variants of unknown significance. In conclusion, our findings provide a better understanding of the genetic architecture of PD among ethnic Chinese, and the pathogenicity of numerous rare variants should be further investigated. • 18 patients (7.5%) carried pathogenic or likely pathogenic variants in known PD genes. • (Likely) pathogenic variants in Parkin and PINK1 were responsible for 4.2% of the patients. • Rare likely pathogenic variants in LRRK2 (1.7%) also appeared to be a relatively common cause of EOPD. • 7.5% of patients carried risk variants in either LRRK2 or GBA. [ABSTRACT FROM AUTHOR]