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Farmland mortgages are expected to drive county agricultural economic growth (CAEG) as a crucial component of furthering the reform of the rural land system and the reform of the rural financial system against the new backdrop of the new era. This study gathers panel data from 2045 Chinese counties from 2011 to 2020 and uses the difference-in-differences method and the synthetic control method to systematically examine the effects of China's farmland management right mortgage loan (FMRML) pilot program on CAEG. The FMRML pilot program was implemented in 2016, and this research is presented as a quasi-natural experiment. The findings indicate that there is a "policy trap" and that CAEG has not been successfully promoted by the FMRML pilot program. The reason for this is because the pilot program has made county resource mismatch worse, making it unable to fully realize the promotional effect on CAEG, rather than significantly activating the three key drivers of agricultural economic growth: people, land, and money. The impact of the FMRML pilot policy on CAEG is not uniform, according to the results of the heterogeneity study, with a substantial "blocking" effect only in the central region and no significant influence in the western, northeastern, or eastern regions. The findings propose that in order to optimize agricultural mortgage policy and advance CAEG, China and other emerging nations can benefit greatly from the insights this study offers. [ABSTRACT FROM AUTHOR]

Background: The introduction of multiparameter MRI and novel biomarkers has greatly improved the prediction of clinically significant prostate cancer (csPCa). However, decision-making regarding prostate biopsy and prebiopsy examinations is still difficult. We aimed to establish a quick and economic tool to improve the detection of csPCa based on routinely performed clinical examinations through an automated machine learning platform (AutoML). Methods: This study included a multicenter retrospective cohort and two prospective cohorts with 4747 cases from 9 hospitals across China. The multimodal data, including demographics, clinical characteristics, laboratory tests, and ultrasound reports, of consecutive participants were retrieved using extract-transform-load tools. AutoML was applied to explore potential data processing patterns and the most suitable algorithm to build the Prostate Cancer Artificial Intelligence Diagnostic System (PCAIDS). The diagnostic performance was determined by the receiver operating characteristic curve (ROC) for discriminating csPCa from insignificant prostate cancer (PCa) and benign disease. The clinical utility was evaluated by decision curve analysis (DCA) and waterfall plots. Results: The random forest algorithm was applied in the feature selection, and the AutoML algorithm was applied for model establishment. The area under the curve (AUC) value in identifying csPCa was 0.853 in the training cohort, 0.820 in the validation cohort, 0.807 in the Changhai prospective cohort, and 0.850 in the Zhongda prospective cohort. DCA showed that the PCAIDS was superior to PSA or fPSA/tPSA for diagnosing csPCa with a higher net benefit for all threshold probabilities in all cohorts. Setting a fixed sensitivity of 95%, a total of 32.2%, 17.6%, and 26.3% of unnecessary biopsies could be avoided with less than 5% of csPCa missed in the validation cohort, Changhai and Zhongda prospective cohorts, respectively. Conclusions: The PCAIDS was an effective tool to inform decision-making regarding the need for prostate biopsy and prebiopsy examinations such as mpMRI. Further prospective and international studies are warranted to validate the findings of this study. Trial registration: Chinese Clinical Trial Registry ChiCTR2100048428. Registered on 06 July 2021. [ABSTRACT FROM AUTHOR]

Species diversity has been shown to be influenced by environmental factors, but the mechanism underlying their relationship remains unclear across spatial scales. Based on field investigation data collected from 3077 sample plots in temperate forest ecosystems, we compared tree species richness, evenness and dominance at 10 km × 10 km, 30 km × 30 km and 90 km × 90 km spatial scales. Then, we detected the scale dependence of changes in tree species composition on climate, topography and forest structure using variation partitioning and quantified their contribution to tree diversity with gradient–boosted models (GBMs) and fitted their relationships. The magnitude of tree richness, evenness and dominance significantly increased with spatial scale. Ecological factors jointly accounted for 24.3%, 26.5% and 38.5% of the variation in tree species composition at the three spatial scales, respectively. The annual mean temperature had a strong impact on tree richness, evenness and dominance and peaked at an intermediate scale. Tree evenness and dominance increased with the variation of temperature but had upper and lower limits. Tree richness obviously increased with annual precipitation on multiple scales and decreased with annual sunshine duration at large spatial scales. Tree richness, evenness and dominance obviously increased with the variation in elevation and diameter at breast height at large scales and small scales, respectively. Tree dominance decreased with tree height at a small scale. The dependence of tree diversity on ecological factors increased with spatial scales. Furthermore, different factors exert various controls on tree diversity at different spatial scales, representing a comprehensive mechanism regulating tree diversity. [ABSTRACT FROM AUTHOR]

Simple Summary: We performed transcriptome sequencing of the ovaries and testis of T. blochii to acquire sex-biased miRNAs. RNA-seq analysis yielded 1366 known and 69 novel miRNAs with 289 significant DEMs (p < 0.05). KEGG analysis indicated that the target genes of the DEMs were mainly enriched in pathways connected to sex differentiation and gonadal development signals, consisting of the MAPK signaling pathway, Wnt signaling pathways, and steroid biosynthetic pathways. Co-expression network analysis of miRNA-mRNA indicated that some miRNAs (oar-let-7b, bta-miR-2898, pma-miR-138b, and novel-176) may play crucial roles in gonadal development in T. blochii. Our research identified a set of sex-biased miRNAs that might be regulatory factors affecting gonadal development in T. blochii. This provides new insight and may further our understanding the role of miRNAs in gonadal development of this economically valuable species. The golden pompano (Trachinotus blochii) is a marine fish of considerable commercial importance in China. It shows notable sexual size dimorphism; the growth rate of females is faster than that of males. Therefore, sex-biased research is of great importance in T. blochii breeding. However, there have been few studies on sex differentiation and mechanisms underlying sex determination in T. blochii. MicroRNAs (miRNAs) play crucial roles in sex differentiation and determination in animals. However, limited miRNA data are available on fish. In this study, two small RNA libraries prepared from the gonads of T. blochii were constructed and sequenced. The RNA-seq analysis yielded 1366 known and 69 novel miRNAs with 289 significantly differentially expressed miRNAs (p < 0.05). Gene ontology (GO) analysis confirmed that the TFIIA transcription factor complex (GO: 0005672) was the most significantly enriched GO term. The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the differentially expressed miRNAs and target genes were mainly related to sex determination and gonadal developmental signaling pathways, specifically the Wnt signaling pathway, MAPK signaling pathway, and steroid biosynthetic pathway. MiRNA-mRNA co-expression network analysis strongly suggested a role for sex-biased miRNAs in sex determination/differentiation and gonadal development. For example, gata4, foxo3, wt1, and sf1 genes were found to be regulated by bta-miR-2898; esr2 and foxo3 by novel_176, and ar by oar-let-7b. Quantitative real-time polymerase chain reaction analysis of selected mRNAs and miRNAs validated the integrated analysis. This study established a set of sex-biased miRNAs that are potential regulatory factors in gonadal development in T. blochii. These results provide new insight into the function of miRNAs in sex differentiation and determination in T. blochii and highlight some key miRNAs for future studies. [ABSTRACT FROM AUTHOR]

Globally, microplastics (MPs) are highly prevalent, especially in coastal areas. Unfortunately, golden pompano as a major marine fish in China is typically raised in floating marine cages near coasts, facing these MPs sources. However, toxicological studies on Golden Pompano which farm in coastal areas and face actual microplastic exposure are rare. Therefore, golden pompano were exposed to 10.0 μg/L, 100.0 μg/L, and 1000.0 μg/L polystyrene MPs (PS-MPs) for 14 days to study the potential impact of the microplastics on the Golden Pompano. Fish show slowed growth after 14 days of exposure. Histopathology shows irregular shaped nuclei and nuclear and cytoplasmic vacuolation traits in liver. Oxidative stress-related enzyme activity and gene expression data show that oxidative damage occurs in the high-concentrations (100.0 μg/L and 1000.0 μg/L) of PS-MPs exposures. Up-regulation of Grp78 , Xbp-1 , Eif-2α and chop gene expression indicates the occurrence of endoplasmic reticulum stress, and the western blot results also confirmed this. Severe oxidative stress also caused ERS, which ultimately increased BAX/Bcl-2 ratios and induces apoptosis. Furthermore, up-regulated anaerobic respiration, altered lipid metabolism, and immune disturbance were exhibited during PS-MPs stress. Therefore, oxidative stress appeared to be the main toxicity issue caused by MPs, while ERS-mediated apoptosis, metabolic alterations, and immune responses were induced by this stress. Notably, endoplasmic reticulum stress and apoptosis are a self-protective mechanism, which may be an intermediate link in the toxicity of microplastics. This study highlights the role of endoplasmic reticulum stress in MPs toxicology and assesses the adverse effects of microplastics on Golden Pompano. • Microplastics will affect the physiological status of large cultured fishes. • Microplastics alter liver structure and function in golden pompano. • Oxidative stress induced by microplastics mediates endoplasmic reticulum stress leading to apoptosis of liver. [ABSTRACT FROM AUTHOR]

Climate, topography, and tree structure have different effects on plant diversity that vary with spatial scale. In this study, we assessed the contribution of these drivers and how they affect the vascular plant richness of different functional groups in a temperate forest ecosystem in Northeast China. We investigated about 0.986 million plants from 3160 sites to quantify the impact of annual mean temperature, sunshine duration, annual precipitation, standard deviation of diameter at breast height, and forest type on richness of vascular plants (total species, tree, treelet, shrub, and herb, separately) using the gradient boosting model. The results show that annual mean temperature had the strongest impact on plant richness. The tree richness peaked at intermediate annual mean temperature and sunshine duration and increased with annual precipitation. The Shannon diversity index and Simpson dominance index increased with annual precipitation and standard deviation of diameter at breast height, decreased with sunshine duration, and peaked at intermediate annual mean temperature and forest type. The total richness and understory richness increased with annual mean temperature and standard deviation of diameter at breast height and peaked at intermediate sunshine duration and annual precipitation. A comprehensive mechanism was found to regulate the plant diversity in forest ecosystems. The relationship between tree richness and annual mean temperature with latitudinal effect could be affected by the differences in number and size of tree individuals, indicating that plant diversity varies with the utilization of energy. The force driving plant richness varied with the functional group due to the different environmental resource requirements and the life history strategies of plants layers. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to assess the clinical outcome of percutaneous kyphoplasty (PKP) assisted with mixed reality (MR) technology in treatment of osteoporotic vertebral compression fracture (OVCF) with intravertebral vacuum cleft (IVC). Method: Forty cases of OVCF with IVC undergoing PKP were randomized into a MR technology-assisted group (group A) and a traditional C-arm fluoroscopy group (group B). Both groups were performed PKP and evaluated by VAS scores, ODI scores, radiological evidence of vertebral body height, and kyphotic angle (KA) at pre-operation and post-operation. The volume of injected cement, fluoroscopy times, and operation time were recorded. And cases of non-PMMA-endplates-contact(NPEC) in radiological evidence was also recorded postoperatively. The clinical outcomes and complications were evaluated afterwards. All patients received 10 to 14 months follow-up, with an average of 12 months. Result: This MR-assisted group (group A) acquired more about the amount of the polymethyl methacrylate (PMMA) injection and postoperative vertebral height and less about postoperative KA, fluoroscopy times, and operation time compared with the control group (group B) (P < 0.05). The VAS scores and ODI scores in both groups have improved, but more significantly in group A (P < 0.05). Also, more cases achieve both-endplates-touching of cement in group A (P < 0.05). And there are less of the loss of vertebral height, KA, and occurrence of re-collapse of the vertebra in group A during the follow-up (P < 0.05). Conclusion: PKP assisted with MR technology can accurately orientate the position of IVC area, which can be augmented by the balloon leading to more satisfied vertebral height improvement, cement diffusion, and pain relief. Trial registration: ClinicalTrials.gov Identifier: NCT03959059. Registered 25 September 2016. [ABSTRACT FROM AUTHOR]

• Lignin stabilization was achieved by aggregate protection in broadleaf-pine forest. • Lignin accumulation was enhanced by plant residues input in broadleaf forest. • High macroaggregate proportion did not support great SOC sequestration in broadleaf forest. The variation of soil organic carbon (SOC) stability is independent of the amount of SOC in the soil. For predicting the conservation of soil carbon in different forest ecosystems, it is crucial to investigate the mechanisms of plant derived residues allocation and stabilization in soil aggregates in different forest ecosystems. The role of aggregate protection in SOC sequestration (using lignin as a biochemical indicator) requires understanding of the interaction of many factors. We studied aggregate proportion, SOC amount and lignin phenol contents in the soil fractions from 0–5, 5–10 and 10–20 cm layers in a virgin mixed broadleaf-Korean pine (BK) and secondary broadleaf Betula-Populus (BP) stands at Changbai Mountain Nature Reserve, Northeastern China. Macroaggregates had higher lignin contents compared to the bulk soil in both BK and BP. The SOC and lignin contents in bulk soil and aggregates obviously declined with soil deepening in the two stands. BK exhibited more protected lignin in aggregates compared to the same particles from BP. The results suggested that the aggregates have limited capability to sequestrate more carbon, which causes carbon loss in the soil particles with soil depth increment in the secondary broadleaf forest. Stable lignin sequestration was achieved via effective aggregate protection in BK, while lignin occlusion was mainly regulated by the importation of plant residues into the topsoil of BP. [ABSTRACT FROM AUTHOR]

Introduction: Perinatal anxiety (PNA) is a major public health concern., Methods: A hybrid effectiveness-implementation trial was conducted in two antenatal clinics in Hefei, China, to assess the effectiveness and cost-effectiveness of application-based tiered care (Mom's Good Mood, MGM) in treating PNA and to understand how well it fits into routine practices. Pregnant women who scored at least 5 points on the 7-Item Generalised Anxiety Disorder Scale (GAD-7) scale were successively assigned to the control group or the intervention group, which were given the usual care and MGM on usual care, respectively. At 6 months post partum, anxiety, depression and life satisfaction were assessed. Intention-to-treat analysis and the Reach, Effectiveness, Adoption, Implementation and Maintenance framework were adopted., Results: A total of 214 women were assigned to the control group and 341 to the intervention group. The mean changes in GAD-7 scores (Least-squares means, LSM, -1.42, 95% CI -2.18 to -0.66) and the risk of anxiety (adjusted odds ratio, aOR 0.30, 95% CI 0.18 to 0.51) were decreased, and the anxiety remission rate (aOR 2.72, 95% CI 1.69 to 4.40) were improved in the intervention group. Similar findings were observed regarding the change in Edinburgh Postnatal Depression Scale scores (LS -1.92, 95% CI -2.85 to -0.99), depression remission rate (aOR 2.24, 95% CI 1.39 to 3.63) and the risk of depression (aOR 0.57, 95% CI 0.33 to 0.98). MGM only costs ¥1.88 (US$0.27) per pregnant woman to boost the postpartum anxiety remission rate by 1% and was revealed to have a high reach rate of 78.3%, an adoption rate of 51.3%-80.8%., Conclusion: MGM is a cost-effective and accessible tool in coping with PNA., Trial Registration Number: ChiCTR2100053419., 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.)

Introduction: Whether the coronavirus disease-2019 (COVID-19) pandemic is associated with a long-term negative impact on acute stroke care remains uncertain. This study aims to compare the timing of key aspects of stroke codes between patients before and after the COVID-19 pandemic., Methods: This retrospective cohort study was conducted at an academic hospital in Shanghai, China and included all adult patients with acute ischemic stroke hospitalized via the emergency department (ED) stroke pathway during the 24 months since the COVID-19 outbreak (COVID-19: January 1, 2020-December 31, 2021). The comparison cohort included patients with ED stroke pathway visits and hospitalizations during the same period (pre-COVID-19: January 1, 2018-December 31, 2019). We compared critical time points of prehospital and intrahospital acute stroke care between patients during the COVID-19 era and patients during the pre-COVID-19 era using t test, χ 2 , and Mann-Whitney U test where appropriate., Results: A total of 1194 acute ischemic stroke cases were enrolled, including 606 patients in COVID-19 and 588 patients in pre-COVID-19. During the COVID-19 pandemic, the median onset-to-hospital time was about 108 min longer compared with the same period of pre-COVID-19 (300 vs 192 min, p = 0.01). Accordingly, the median onset-to-needle time was 169 min in COVID-19 and 113 min in pre-COVID-19 (p = 0.0001), and the proportion of patients with onset-to-hospital time within 4.5 h was lower (292/606 [48.2%] vs 328/558 [58.8%], p = 0.0003) during the pandemic period. Furthermore, the median door-to-inpatient admission and door-to-inpatient rehabilitation times increased from 28 to 37 h and from 3 to 4 days (p = 0.014 and 0.0001)., Conclusions: During the 24 months of COVID-19, a prolongation of stroke onset to hospital arrival and to intravenous rt-PA administration times were noted. Meanwhile, acute stroke patients needed to stay in the ED for a longer time before hospitalization. Educational system support and process optimization should be pursued in order to acquire timely delivery of stroke care during the pandemic., (© 2023 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)

Background: Increased rates of methicillin-resistant Staphylococcus aureus (MRSA) antibiotic resistance and the associated morbidity have increased dermatologists' attention to skin and soft tissue MRSA infections. However, the clinical characterization of MRSA skin and soft tissue infections (SSTIs) in Southwest China is lacking, which precludes optimal prevention and treatment of these infections., Objectives: This study was conducted to characterize the prevalence, clinical comorbidities and antibiotic susceptibility of MRSA isolates from SSTIs, including community-associated (CA) and healthcare-associated (HA) isolates., Methods: In the Dermatology Inpatient Department of the First Affiliated Hospital of Guangxi Medical University, a retrospective study was conducted on data, including patient demographics and clinical information, from culture-confirmed S. aureus isolated from skin and soft tissue between January 1, 2015, and December 31, 2021. Isolate susceptibility to 13 antibiotics was determined using the Vitek 2 system., Results: From among 864 S. aureus strains, we identified 283 MRSA (32.75%) isolates comprising 203 CA-MRSA and 80 HA-MRSA isolates. The average rate of CA-MRSA isolation for MRSA SSTIs was 71.73%. The HA-MRSA isolation rate for MRSA SSTIs increased significantly. HA-MRSA-infected patients were older. The most common dermatological presentation of CA-MRSA infection was staphylococcal scalded skin syndrome, while the comorbidity severe drug eruption was significantly associated with HA-MRSA infection. One CA-MRSA strain was resistant to linezolid, and one HA-MRSA strain had an intermediate phenotype for vancomycin; both strains had low sensitivity to clindamycin and erythromycin (3.70%~19.40%). However, HA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole., Conclusions: CA-MRSA is a predominant pathogen causing SSTIs, and HA-MRSA infection incidence is increasing gradually. Both strains showed increasing antibiotic resistance. Our data on MRSA susceptibility may guide dermatologist antibiotic treatment decisions. Dermatologists should consider these identified comorbidities of MRSA SSTIs when patients are admitted and initiate early prevention and treatment of MRSA., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yao, Wu, Xu, Lei, Long, Li, Gu, Jiang and Cao.)

The unsaturated permeability coefficients are often used to solve geotechnical problems associated with unsaturated soils. But it is very difficult to measure. However, the unsaturated permeability coefficients can be predicted by the Soil-water Characteristic Curves (SWCCs). The Van Genuchten Model (VG model) is very rife as it's smooth and good fitting, thus, it has the most research data. Therefore, the research data on VG model parameters (α, n, θs and θr) of Malan loess in Chinese Loess Plateau are collected in the past two decades to obtain the spatial distribution characteristics of parameters. The trend surface analysis method is employed to clarify the regional scale distribution and the variation regular pattern on ArcGIS. Then the linear regression method is utilized to fit the relationship between suction and water content in three different regions of Chinese Loess Plateau, which is divided according to the properties and particle gradation. By using this relationship and the trend surface analysis contour map, the unsaturated permeability coefficient of the sample can be predicted after measuring the saturated permeability coefficient. The example verification shows that the difference between the prediction results and the experimental results is very small when the sample has the lower saturation, and the deviation is slightly larger if it has the higher saturation, but they are all within the acceptable range. This method not only saves the test cost, but also considers the physical properties of the loess in the three different regions of the Loess Plateau. With the improvement of data and the gradual improvement of sampling density, the prediction accuracy will gradually improve. It can provide convenience for solving the engineering problems of loess and water and other engineering applications., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Fang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Importance: It remains unknown whether children born at different degrees of prematurity, early term, and post term might have a higher risk of developmental coordination disorder (DCD) compared with completely full-term children (39-40 gestational weeks)., Objective: To differentiate between suspected DCD in children with different gestational ages based on a national representative sample in China., Design, Setting, and Participants: A retrospective cohort study was conducted in China from April 1, 2018, to December 31, 2019. A total of 152 433 children aged 3 to 5 years from 2403 public kindergartens in 551 cities of China were included in the final analysis. A multilevel regression model was developed to determine the strength of association for different gestational ages associated with suspected DCD when considering kindergartens as clusters., Main Outcomes and Measures: Children's motor performance was assessed using the Little Developmental Coordination Disorder Questionnaire, completed by their parents. Gestational age was determined according to the mother's medical records and divided into 7 categories: completely full term (39 to 40 weeks' gestation), very preterm (<32 weeks), moderately preterm (32-33 weeks), late preterm (34-36 weeks), early term (37-38 weeks), late term (41 weeks), and post term (>41 weeks)., Results: A total of 152 433 children aged 3 to 5 years (mean [SD] age, 4.5 [0.8] years), including 80 370 boys (52.7%) and 72 063 girls (47.3%), were included in the study. There were 45 052 children (29.6%) aged 3 years, 59 796 (39.2%) aged 4 years, and 47 585 (31.2%) aged 5 years. Children who were born very preterm (odds ratio [OR], 1.35; 95% CI, 1.23-1.48), moderately preterm (OR, 1.18; 95% CI, 1.02-1.36), late preterm (OR, 1.24; 95% CI, 1.16-1.32), early term (OR, 1.11; 95% CI, 1.06-1.16), and post term (OR, 1.17; 95% CI, 1.07-1.27) were more likely to be classified in the suspected DCD category on the Little Developmental Coordination Disorder Questionnaire than completely full-term children after adjusting for the same characteristics. Additionally, there was no association with suspected DCD in younger (aged 3 years) early-term and postterm children by stratified analyses., Conclusions and Relevance: In this cohort study, every degree of prematurity at birth, early-term birth, and postterm birth were associated with suspected DCD when compared with full-term birth. These findings have important implications for understanding motor development in children born at different gestational ages. Long-term follow-up and rehabilitation interventions should be considered for children born early and post term.

Background: Neck pain is common and can have a significant impact on patients' physical functionality, mobility, and quality of life (QOL). In clinical practice, traditional Chinese mind and body exercise (TCMBE) is a combination of different types of exercise based on traditional Chinese medicine, including qigong, tai chi, the 12-words-for-life-nurturing exercise, and so on, and many studies have found that it is safe and effective at helping patients with neck pain., Objective: The aim of this study was to investigate the effectiveness of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain., Methods: The PubMed, MEDLINE, PEDro, and Embase databases were systematically searched for relevant studies. Randomized controlled trials reporting the effects of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain were included. Screening, data extraction, and literature quality assessments were performed independently by two reviewers. RevMan5.4 software was used for data analysis., Results: Six studies with 716 participants met the inclusion criteria. Compared with the control groups, TCMBE had no therapeutic advantage in improving pain intensity (visual analogue scale: mean difference (MD) = 1.8, 95% confidence interval (CI): -7.70 to 11.46, and P  = 0.70); functional mobility (neck disability index: MD = 0.15, 95% CI: -6.37 to 6.66, and P  = 0.96; neck pain and disability scale: MD = 1.31, 95% CI: -4.10 to 6.71, and P  = 0.64); or 36-item short-form health survey (SF-36) scores for physical function (MD = 5.58, 95% CI: -8.03 to 19.18, and P  = 0.42), general health (MD = 1.87, 95% CI: -4.99 to 8.72, and P  = 0.59), body pain (MD = 2.26, 95% CI: -3.80 to 8.32, and P  = 0.46), vitality (MD = 6.24, 95% CI: -1.49 to 13.98, and P  = 0.11), social function (MD = 8.06, 95% CI: -4.85 to 20.98, and P  = 0.22), role physical (MD = -1.46, 95% CI: -8.54 to 5.62, and P  = 0.69), or role emotional (MD = 6.5, 95% CI: -3.45 to 16.45, and P  = 0.2). However, TCMBE was less effective at improving mental health results based on the SF-36 survey (MD = 3.37, 95% CI: 0.5 to 6.24, and P  = 0.02)., Conclusions: Based on the meta-analysis, there is insufficient evidence to support the clinical use of TCMBE in improving pain intensity and enhancing functional mobility and QOL in individuals with neck pain., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Yu-Hua Xie et al.)

Objectives: The authors sought to assess the benefits of pulmonary artery denervation (PADN) among combined pre- and post-capillary pulmonary hypertension (CpcPH) patients in a prospective, randomized, sham-controlled trial., Background: PADN has been shown to improve hemodynamics of pulmonary arterial hypertension in a series of patients. Additionally, benefits of targeted medical therapy for patients with CpcPH secondary to left-sided heart failure are unknown., Methods: Ninety-eight CpcPH patients, defined as mean pulmonary arterial pressure ≥25 mm Hg, pulmonary capillary wedge pressure >15 mm Hg, and pulmonary vascular resistance (PVR) >3.0 Wood units (WU), were randomly assigned to PADN or sildenafil plus sham PADN. Standard medical therapy for heart failure was administered to all patients in both groups. The primary endpoint was the increase in the 6-min walk distance at the 6-month follow-up. The secondary endpoint was change in PVR. Clinical worsening was assessed in a post hoc analysis. The main safety endpoint was occurrence of pulmonary embolism., Results: At 6 months, the mean increases in the 6-min walk distance were 83 m in the PADN group and 15 m in the sildenafil group (least square mean difference 66 m, 95% confidence interval: 38.2 to 98.8 m; p < 0.001). PADN treatment was associated with a significantly lower PVR than in the sildenafil group (4.2 ± 1.5 WU vs. 6.1 ± 2.9 WU; p = 0.001). Clinical worsening was less frequent in the PADN group compared with the sildenafil group (16.7% vs. 40%; p = 0.014). At the end of the study, there were 7 all-cause deaths and 2 cases of pulmonary embolism., Conclusions: PADN is associated with significant improvements in hemodynamic and clinical outcomes in patients with CpcPH. Further studies are warranted to define its precise role in the treatment of this patient population. (Pulmonary Arterial Denervation in Patients With Pulmonary Hypertension Associated With the Left Heart Failure [PADN-5]; NCT02220335)., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Preterm birth, the birth of an infant prior to 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Preterm infants are at greater risk of respiratory, gastrointestinal and neurological diseases. Despite significant research in developed countries, little is known about the causes of preterm birth in many developing countries, especially China. This study investigates the association between sciodemographic data, obstetric risk factor, and preterm birth in five Maternal and Child Health hospitals in Beijing, China., Methods and Findings: A case-control study was conducted on 1391 women with preterm birth (case group) and 1391 women with term delivery (control group), who were interviewed within 48 hours of delivery. Sixteen potential factors were investigated and statistical analysis was performed by univariate analysis and logistic regression analysis. Univariate analysis showed that 14 of the 16 factors were associated with preterm birth. Inter-pregnancy interval and inherited diseases were not risk factors. Logistic regression analysis showed that obesity (odds ratio (OR) = 3.030, 95% confidence interval (CI) 1.166-7.869), stressful life events (OR = 5.535, 95%CI 2.315-13.231), sexual activity (OR = 1.674, 95%CI 1.279-2.191), placenta previa (OR 13.577, 95%CI 2.563-71.912), gestational diabetes mellitus (OR = 3.441, 95%CI1.694-6.991), hypertensive disorder complicating pregnancy (OR = 6.034, 95%CI = 3.401-10.704), history of preterm birth (OR = 20.888, 95%CI 2.519-173.218) and reproductive abnormalities (OR = 3.049, 95%CI 1.010-9.206) were independent risk factors. Women who lived in towns and cities (OR = 0.603, 95%CI 0.430-0.846), had a balanced diet (OR = 0.533, 95%CI 0.421-0.675) and had a record of prenatal care (OR = 0.261, 95%CI 0.134-0.510) were less likely to have preterm birth., Conclusions: Obesity, stressful life events, sexual activity, placenta previa, gestational diabetes mellitus, hypertensive disorder complicating pregnancy, history of preterm birth and reproductive abnormalities are independent risk factors to preterm birth. Identification of remedial factors may inform local health and education policy.