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In order to investigate the changes in soil enzyme activity and their influencing factors in coal mining subsidence areas with high underground water levels, in this study, we collected soil samples at different depths (SL: 0–20 cm; ML: 20–40 cm; DL: 40–60 cm) in a deep coal seam subsidence area (T1), a shallow coal seam subsidence area (T2), and control non-subsidence areas (W1 and W2) in eastern China. Soil physicochemical properties and enzyme activities were determined, and the mechanism of the latter's response to coal mining subsidence was investigated based on correlation analysis, redundancy analysis, and structural equation modeling. The results show the following: (1) In the coal mining subsidence areas, the soil pH value (pH), soil available nitrogen (AN), available phosphorus (AP), available potassium (AK), and soil organic matter (SOM) contents were lower than those in the non-subsidence areas, while the soil water content (SWC) and bulk density (BD) were higher than those in the non-subsidence areas and increased with depth. (2) The activities of soil urease (URE), sucrase (SUC), alkaline phosphatase (ALP), and catalase (CAT) gradually decreased with depth and were all lower than those in the non-subsidence areas; the largest decreases with respect to the latter were 24.33%, 18.73%, 38.89%, and 5.88%, respectively. (3) The soil nutrient environment had a highly significant and direct positive effect on enzyme activity, with AN, AP, and SOM contents having the greatest impact. (4) Soil BD had a highly significant and direct negative effect and an indirect negative effect (by affecting nutrients) on enzyme activity. The results of this study on the effects of soil physicochemical properties on enzyme activity provide a basis for the ecological restoration of mines. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is one of the most common and severe complications of multiple myeloma (MM). The aim of this study was to learn about the current awareness regarding MM-associated VTE among Chinese hematologists. A nationwide, online, questionnaire-based survey was sent to the specialized hematologists in mainland China. The questionnaire investigated respondents' demographic and occupational characteristics, their ability to identify VTE risk factors, and their thromboprophylaxis decisions for different anti-MM regimens. Six clinical vignettes were used to evaluate hematologists' awareness of stratified thromboprophylaxis. The data were analyzed using SPSS software. A total of 518 valid questionnaires were received. Of the 518 hematologists investigated, only 23.7% of them could identify VTE-related risk factors correctly. Most hematologists could select appropriate thromboprophylaxis for common anti-MM regimens such as VCd (bortezomib, cyclophosphamide, and dexamethasone) and VRd (bortezomib, lenalidomide, and dexamethasone), but not for uncommon ones such as VTD-PACE (bortezomib, thalidomide, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, and etoposide) and KRd (carfilzomib, lenalidomide, and dexamethasone). The results from the vignettes suggested that only 19.5% of the hematologists could be defined as the 'stratified thromboprophylaxis' group, and the awareness of stratified thromboprophylaxis depended significantly on physicians' age and working seniority. The results of our study showed that a large proportion of Chinese hematologists failed to recognize the VTE risk factors, most of them cannot select appropriate thromboprophylaxis for different MM therapeutic regimens and lack awareness of stratified thromboprophylaxis for MM-associated VTE. A standard VTE prevention guideline is urgently needed for the Chinese myeloma group. Continuous education for new professionals should be encouraged. A VTE collaborative group is supposed to be established in each hospital to enhance the overall medical care for VTE patients. The substantial myeloma patient population and extensive use of immunomodulatory drugs indicate that MM-associated VTE deserves more attention in China. The results from our cross-sectional study showed that a significant proportion of Chinese hematologists failed to identify the VTE risk factors, most of them cannot select appropriate thromboprophylaxis for different MM therapeutic regimens and lack awareness of stratified thromboprophylaxis for MM-associated VTE. [ABSTRACT FROM AUTHOR]

Background: Oncological care has been disrupted worldwide during the COVID‐19 pandemic. We aimed to quantify the long‐term impact of the pandemic on cancer care utilization and to examine how this impact varied by sociodemographic and clinical factors in southwestern China, where the Dynamic Zero‐COVID Strategy was implemented. This strategy mainly included lockdowns, stringent testing, and travel restrictions to prevent the spread of COVID‐19. Method: We identified 859,497 episodes of the utilization of cancer care from electronic medical records between January 1, 2019, and March 31, 2021, from the cancer center of a tertiary hospital serving an estimated population of 8.4 million in southwestern China. Changes in weekly utilization were evaluated via segmented Poisson regression across service categories, stratified by cancer type and sociodemographic factors. Results: A sharp reduction in utilization of in‐person cancer services occurred during the first week of the pandemic outbreak in January 2020, followed by a quick rebound in February 2020. Although there were few COVID‐19 cases from March 2020 until this analysis, the recovery of most in‐person services was slow and remained incomplete as of March 31, 2021. The exceptions were outpatient radiation and surgery, which increased and exceeded pre‐pandemic levels, particularly among lung cancer patients; meanwhile, telemedicine utilization increased substantially after the onset of the pandemic. Care disruptions were most prominent for women, rural residents, uninsured, and breast cancer patients. Conclusions: As of March 2021, despite few COVID‐19 cases, the COVID‐19 pandemic has had a strong and continuing impact on in‐person oncology care utilization in southwestern China under the Dynamic Zero‐COVID Strategy. Equitable and timely access to cancer care requires adjustment in strict policies for COVID‐19 prevention and control, as well as targeted remedies for the most vulnerable populations during and beyond the pandemic. Future studies should monitor the long‐term effects of the COVID‐19 pandemic and response strategies on cancer care and outcomes. The COVID‐19 pandemic's disruptive impacts on oncology care may persist under the "Dynamic Zero‐COVID Strategy" in Southwestern China, with preserved healthcare capacity but overwhelming testing requirements and travel restrictions. Balanced and coordinated efforts are urgently needed to ensure vulnerable patients' equitable and timely access to affordable oncology care. [ABSTRACT FROM AUTHOR]

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]

Background: This study aimed to investigate lung cancer patients and attitudes of their caregivers toward advance directives (ADs) in China. Methods: A cross sectional study was conducted in the Department of Oncology outpatient clinic in West China Hospital, Sichuan University. A questionnaire was used to survey the attitudes of lung cancer patients and caregivers toward ADs. Results: A total of 148 lung cancer patients and 149 caregivers were enrolled into the study. Of these, 94.6% and 89.9% of patients and caregivers had not heard of AD and none of those in the study had ever signed an AD. A total of 79.7% patients and 75.2% caregivers were willing to sign ADs after they were provided with information. Patients who preferred the end of life period to sign ADs were 5.4 times more likely to have ADs than patients who chose to sign ADs when their disease was diagnosed (P < 0.05, 95%CI [1.27–22.93]). Caregivers who were reluctant to undergo chemotherapy when diagnosed with cancer were 2.16 times more likely to sign ADs than those willing to receive chemotherapy (P < 0.05, 95%CI [1.20–3.90]). Conclusions: In China, lung cancer patients and their caregivers showed lack of knowledge about ADs, and the completion rate of ADs was extremely low. However, participants were positive about ADs and public education on ADs may help to increase the completion rate of ADs in China. [ABSTRACT FROM AUTHOR]

Chlorpyrifos is a type of organophosphate insecticide used extensively in the plantation of tomatoes, a worldwide popular food. However, chlorpyrifos residues on tomatoes bring risks to human health considering the consumption level of tomato is relatively high across many countries. Accurate detection and strict regulation of chlorpyrifos residues are very important in controlling health risks related to chlorpyrifos. Therefore, we developed a rapid, highly sensitive, economical, and nondestructive surface-enhanced Raman spectroscopy (SERS)-based method that can quantitatively determine the content of chlorpyrifos in tomatoes. Silver colloid was optimized and used as the enhance substrate for SERS. Chlorpyrifos residues on tomato surface and in tomato extract were both measured with SERS, and the results acquired under these practical conditions well matched those of chlorpyrifos standard solutions. Linear relationships between chlorpyrifos concentrations and SERS intensities at crucial characteristic peaks under both conditions were established, and the results showed linearity across the entire measured range from 10−3 to 10−9 mol L−1. The detection limit of the proposed method was 10−9 mol L−1, which was much lower than the standards of chlorpyrifos use for China, Japan and EU, and was the lowest reported concentration chlorpyrifos had been measured on any fruit/vegetable surface or in its extract. The proposed method was very promising in the accurate, quantitative detection of pesticide residues, and it may be adapted to a variety of agricultural products and other areas in food science. [ABSTRACT FROM AUTHOR]

Artificial selection is often associated with numerous changes in seemingly unrelated phenotypic traits. The genetic mechanisms of correlated phenotypes probably involve pleiotropy or linkage of genes related to such phenotypes. Dongxiang blue-shelled chicken, an indigenous chicken breed of China, has segregated significantly for the dermal hyperpigmentation phenotype. Two lines of the chicken have been divergently selected with respect to comb color for over 20 generations. The red comb line chicken produces significantly higher number of eggs than the dark comb line chicken. The objective of this study was to explore potential mechanisms involved in the relationship between comb color and egg production among chickens. Based on the genome-wide association study results, we identified a genomic region on chromosome 20 involving EDN3 and BMP7 , which is associated with hyperpigmentation of chicken comb. Further analyses by selection signatures in the two divergent lines revealed that several candidate genes, including EDN3 , BMP7 , BPIFB3 , and PCK1 , closely located on chromosome 20 are involved in the development of neural crest cell and reproductive system. The two genes EDN3 and BMP7 have known roles in regulating both ovarian function and melanogenesis, indicating the pleiotropic effect on hyperpigmentation and egg production in blue-shelled chickens. Association analysis for egg production confirmed the pleiotropic effect of selected loci identified by selection signatures. The study provides insights into phenotypic evolution due to genetic variation across the genome. The information might be useful in the current breeding efforts to develop improved breeds for egg production. [ABSTRACT FROM AUTHOR]

Beijing-you is a Chinese local chicken which is raised for both meat and eggs. In the present study, we detected the effects of different rearing systems on growth, slaughtering performances and meat quality of Beijing-you chickens at 26-40 weeks of age. Six hundred Beijing-you hens were randomly allocated into two groups at 16 weeks of age and raised in free range or battery cage systems. The body weight, slaughtering performance and meat quality were measured for each group at the ages of 26, 30, 35 and 40 weeks. Some of the traits were dramatically influenced by the two systems, although most of them did not show significant changes. For the meat fiber microstructure, we found that the diameter of thigh and breast muscle fiber in the free range group were significantly increased than in the cage group (P < 0.05) at 26 weeks of age. The ratio of fast muscle fiber in thigh muscle samples of the free range group was significantly reduced compared to that of cage group at both 35 (P < 0.01) and 40 (P < 0.01) weeks of age, indicating that the free range system could promote the transforming of fast muscle fiber to slow muscle fiber. [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]