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BackgroundThe past few decades have seen an exponential increase in using mobile phones to support medical care (mobile health [mHealth]) among people living with psychosis worldwide, yet little is known about WeChat use and WeChat-based mHealth among people living with schizophrenia (PLS) in China. ObjectiveThis study aims to assess WeChat use, endorsement of WeChat-based mHealth programs, and health related to WeChat use among PLS. MethodsWe recruited a random sample of 400 PLS from 12 communities in Changsha City of Hunan Province, China. WeChat use was assessed using the adapted WeChat Use Intensity Questionnaire (WUIQ). We also compared psychiatric symptoms, functioning, disability, recovery, quality of life, and general well-being between WeChat users and nonusers using one-to-one propensity-score matching. ResultsThe WeChat use rate was 40.8% in this sample (163/400); 30.7% (50/163) had more than 50 WeChat friends and nearly half (81/163, 49.7%) spent more than half an hour on WeChat, a pattern similar to college students and the elderly. PLS also showed higher emotional connectedness to WeChat use than college students. About 80.4% (131/163) of PLS were willing to participate in a WeChat-based mHealth program, including psychoeducation (91/163, 55.8%), professional support (82/163, 50.3%), and peer support (67/163, 41.1%). Compared with nonusers, WeChat users were younger, better educated, and more likely to be employed. WeChat use was associated with improved health outcomes, including lower psychiatric symptoms, lower depression, higher functioning, better recovery, and higher quality of life. ConclusionsWeChat-based mHealth programs hold promise as an empowering tool to provide cost-effective interventions, to foster global recovery, and to improve both physical and mental well-being among PLS. WeChat and WeChat-based mHealth programs have the potential to offer a new path to recovery and well-being for PLS in China.

BackgroundSchizophrenia is a persistent and debilitating mental illness, and its prognosis depends largely on supportive care and systematic treatment. In developing countries like China, families constitute the major caregiving force for schizophrenia and are faced with many challenges, such as lack of knowledge, skills, and resources. The approach to support family caregiving in an accessible, affordable, feasible, and cost-effective way remains unclear. The wide-spread use of WeChat provides a promising and cost-effective medium for support. ObjectiveWe aim to present a protocol for assessing a WeChat-based integrative family intervention (WIFI) to support family caregiving for schizophrenia. MethodsWe will develop a WIFI program that includes the following three core components: (1) psychoeducation (WeChat official account), (2) peer support (WeChat chat group), and (3) professional support (WeChat video chat). A rigorous stepped-wedge cluster randomized trial will be used to evaluate the implementation, effectiveness, and cost of the WIFI program. The WIFI program will be implemented in 12 communities affiliated with Changsha Psychiatric Hospital through the free medicine delivery process in the 686 Program. The 12 communities will be randomized to one of four fixed sequences every 2 months during an 8-month intervention period in four clusters of three communities each. Outcomes will be assessed for both family caregivers and people with schizophrenia. Family caregivers will be assessed for their knowledge and skills about caregiving, social support, coping, perceived stigma, caregiver burden, family functioning, positive feelings, and psychological distress. People with schizophrenia will be assessed for their symptoms, functioning, quality of life, recovery, and rehospitalization. Cost data, such as intervention costs, health care utilization costs, and costs associated with lost productivity, will be collected. Moreover, we will collect process data, including fidelity and quality of program implementation, as well as user attitude data. Treatment effects will be estimated using generalized linear maximum likelihood mixed modeling with clusters as a random effect and time as a fixed effect. Cost-effectiveness analysis will be performed from the societal perspective using incremental cost-effectiveness ratios. Qualitative analysis will use the grounded theory approach and immersion-crystallization process. ResultsThe study was funded in August 2018 and approved by the institutional review board on January 15, 2019. Preliminary baseline data collection was conducted in May 2019 and completed in September 2019. The WIFI program is expected to start in September 2020. ConclusionsThis is the first study to assess a WeChat-based mHealth intervention to support family caregiving for schizophrenia in China. The innovative study will contribute to the development of a more cost-effective and evidence-based family management model in the community for people with schizophrenia, and the approach could potentially be integrated into national policy and adapted for use in other populations. Trial RegistrationClinicalTrials.gov NCT04393896; https://clinicaltrials.gov/ct2/show/NCT04393896. International Registered Report Identifier (IRRID)PRR1-10.2196/18538

Most of the world's developed countries have negative consequences of unbalanced economic growth and environmental sustainability. The current study contributes to the literature by investigating the impacts of sub‐indices of globalization, renewable energy, and economic growth on CO2 emissions in G‐7 countries of United Kingdom, United States, Japan, Canada, France, Italy, and Germany. The article demonstrates the correlation between numerous variables in the G‐7 countries between 1990 and 2020, including GDP per capita growth, CO2 emissions, globalization, and renewable and non‐renewable energy. The Pooled Mean Group (PMG) technique performs significant tests for cross‐sectional dependence, panel unit root, co‐integration, and descriptive statistics. The study results show that environmental pollution rises with economic growth and falls in the presence of renewable energy sources. Renewable energy use, political globalization, and economic globalization lower environmental harm. From the finding, we indicate that we reduce the environmental pollution in the given countries by lowering or raising the factor affecting the country. A globe map was used in the current study to assign the G‐7 nations. Based on the findings, we addressed several policy initiatives. [ABSTRACT FROM AUTHOR]

Background: The question of whether segmentectomy and lobectomy have similar survival outcomes for patients with early-stage non-small cell lung cancer (NSCLC) is a matter of debate. Methods: A cohort study and randomized controlled trial were included, comparing segmentectomy and lobectomy, by utilizing computerized access to the Pubmed, Web of Science, and Cochrane Library databases up until July 2022. The Cochrane Collaboration tool was used to evaluate the randomized controlled trials, while the Newcastle-Ottawa Scale (NOS) was used to evaluate the cohort studies. Sensitivity analyses were also carried out. Results: The analysis incorporated 17 literature studies, including one randomized controlled trial and 16 cohort studies, and was divided into a segmentectomy group (n = 2081) and a lobectomy group (n = 2395) based on the type of surgery the patient underwent. Each study was followed up from 27 months to 130.8 months after surgery. Over survival (OS): HR = 1.14, 95%CI(0.97,1.32), P = 0.10; disease-free survival (DFS): HR = 1.13, 95%CI(0.91,1.41), P = 0.27; recurrence-free survival (RFS): HR = 0.95, 95%CI(0.81,1.12), P = 0.54. Conclusion: The results of the study suggest that the survival outcomes of the segmentectomy group were not inferior to that of the lobectomy group. Segmentectomy should therefore be considered as a treatment option for early stage NSCLC. [ABSTRACT FROM AUTHOR]

Background: To comprehensively elucidate the genomic and mutational features of lung cancer cases, and lung adenocarcinoma (LUAD), it is imperative to conduct ongoing investigations into the genomic landscape. In this study, we aim to analyze the somatic mutation profile and assessed the significance of these informative genes utilizing a retrospective LUAD cohort. Methods: A total of 247 Chinese samples were analyzed to exhibit the tumor somatic genomic alterations in patients with LUAD. The Cox regression analysis was employed to identify prognosis‐related genes and establish a predictive model for stratifying patients with LUAD. Results: In the Dianjiang People's Hospital (DPH) cohort, the top five frequent mutated genes were (Epidermal growth factor receptor) EGFR (68%), TP53 (30%), RBM10 (13%), LRP1B (9%), and KRAS (9%). Of which, EGFR is a mostly altered driver gene, and most mutation sites are located in tyrosine kinase regions. Oncogene pathway alteration and mutation signature analysis demonstrated the RTK‐RAS pathway alteration, and smoking was the main carcinogenic factor of the DPH cohort. Furthermore, we identified 34 driver genes in the DPH cohort, including EGFR (68%), TP53 (30.4%), RBM10 (12.6%), KRAS (8.5%), LRP1B (8.5%), and so on, and 45 Clinical Characteristic‐Related Genes (CCRGs) were found to closely related to the clinical high‐risk factors. We developed a Multiple Parameter Gene Mutation (MPGM) risk model by integrating critical genes and oncogenic pathway alterations in LUAD patients from the DPH cohort. Based on publicly available LUAD datasets, we identified five genes, including BRCA2, Anaplastic lymphoma kinase (ALK), BRAF, EGFR, and Platelet‐Derived Growth Factor Receptor Alpha (PDGFRA), according to the multivariable Cox regression analysis. The MPGM‐low group showed significantly better overall survival (OS) compared to the MPGM‐high group (p < 0.0001, area under the curve (AUC) = 0.754). The robust performance was validated in 55 LUAD patients from the DPH cohort and another LUAD dataset. Immune characteristics analysis revealed a higher proportion of primarily DCs and mononuclear cells in the MPGM‐low risk group, while the MPGM‐high risk group showed lower immune cells and higher tumor cell infiltration. Conclusion: This study provides a comprehensive genomic landscape of Chinese LUAD patients and develops an MPGM risk model for LUAD prognosis stratification. Further follow‐up will be performed for the patients in the DPH cohort consistently to explore the resistance and prognosis genetic features. [ABSTRACT FROM AUTHOR]

Introduction: A culturally adaptive and easy‐to‐administer 12‐item Caregiving Rewarding Feelings (CRF) scale has been developed in China yet never published in English and validated in another population. Aim: The current study aimed to validate the CRF among a community sample of Chinese caregivers of those diagnosed with schizophrenia. Method: A sample of 449 family caregivers was recruited for scale validation that included factorial validity, construct validity, measurement invariance, item analysis, internal consistency reliability, test–retest reliability, known‐group validity, convergent validity and divergent validity. Results: Confirmatory factor analysis supported the a priori three‐factor structure. Construct validity was supported by high standard regression weight (SRW) and average variance extracted (AVE), measurement invariance across age and gender groups. The CRF showed good internal consistency and test–retest reliability. Known‐group validity was confirmed by the higher CRF scores among caregivers with certain socio‐demographics. The convergent validity of the CRF was supported by its positive correlations with social support, active coping and family functioning. The divergent validity of the CRF was supported by its negative associations with stigma, stress and depressive symptoms. Conclusions: This study confirmed the reliability and validity of the CRF specifically designed for caregivers in Chinese culture. Implications for Practice: The CRF may be further applied and validated in other populations and other countries. [ABSTRACT FROM AUTHOR]

Fruit ripening and the associated softening are major determinants of fruit quality and post-harvest shelf life. Although the mechanisms underlying fruit softening have been intensively studied, there are limited reports on the regulation of fruit softening in apples (Malus domestica). Here, we identified a zinc finger homeodomain transcription factor MdZF-HD11that trans -activates the promoter of Mdβ-GAL18 , which encodes a pectin-degradation enzyme associated with cell wall metabolism. Both MdZF-HD11 and Mdβ-GAL18 genes were up-regulated by exogenous ethylene treatment and repressed by 1-methylcyclopropene treatment. Further experiments revealed that MdZF-HD11 binds directly to the Mdβ-GAL18 promoter and up-regulates its transcription. Moreover, using transgenic apple fruit calli, we found that overexpression of Mdβ-GAL18 or MdZF-HD11 significantly enhanced β-galactosidase activity, and overexpression of MdZF-HD11 induced the expression of Mdβ-GAL18. We also discovered that transient overexpression of Mdβ-GAL18 or MdZF-HD11 in 'Golden Delicious' apple significantly increased the release of ethylene, reduced fruit firmness, promoted the transformation of skin color from green to yellow, and accelerated ripening and softening of the fruit. Finally, the overexpression of MdZF-HD11 in tomato also promoted fruit softening. Collectively, these results indicate that ethylene-induced MdZF-HD11 interacts with Mdβ-GAL18 to promote the post-harvest softening of apple. [ABSTRACT FROM AUTHOR]

This study evaluates historical simulation of solar photovoltaic potential (PVpot) during 1989–2008 over China against the ERA5 reanalysis, using the Weather Research and Forecasting (WRF) model and Regional Climate Model version 4 (RegCM4) within the framework of the Coordinated Regional Downscaling Experiment-East Asia second phase (CORDEX-EA-II). The impacts of spectral nudging technique and land surface model on the simulated PVpot are investigated as well. Results indicate that the observed PVpot is abundant over western China, which can reach up to 26% in summer particularly. The WRF simulations significantly overestimate the PVpot over most areas of China, with the bias about 9% over southeastern China, while the utilization of spectral nudging method and CLM4 land surface model can greatly reduce the deviation. The RegCM4 simulations generate underestimation of PVpot over Northwest China and overestimation over Southeast China. As for the interannual variation, the observed PVpot features an increase of 0.9%/decade over southeastern China. The WRF and RegCM4 simulations can reproduce the rising trend of PVpot, while the magnitude is much lower than ERA5. The WRF simulations can properly portray the characteristics of seasonal cycle of PVpot, with the peaks in May over entire China and most subregions, while RegCM4 exhibits poor skill in reproducing the intra-annual variation. Moreover, the simulated bias in the clear-sky solar radiation (RSDSCS), low-level cloud fraction, and light rain during the daylight may contribute to the deficiency of PVpot. [ABSTRACT FROM AUTHOR]

A wind gust parameterization scheme combined with the Weather Research and Forecasting (WRF) model used as the regional climate model (RCM) is employed to simulate and project the gust wind speed at 10‐m height above ground level for the whole China in the historical and future period 1981–2005 and 2036–2060. The gust wind speed is compared between the historical and future period to investigate its long‐term change under the background of warming climate within the CORDEX‐EA‐II project under the RCP8.5 scenario. First, the gust wind speed simulated by the gust parameterization inputted with the RCM simulations driven by the ERA‐Interim reanalysis data is compared with the ERA5 reanalysis data and their discrepancy is discussed. Then the historical/future gust wind speed is simulated/projected with the RCM simulations driven by four global climate models' results. The comparisons between the historical simulations and future projections show the gust wind speeds overall change slightly with little response to the future warming climate as the whole China is concerned, and the maximal increment and decrement of averaged annual maximal gust wind speed are, respectively, 2.25 and −2.57 m·s−1. The increases greater than 1 m·s−1 are mostly located in the eastern and southeastern coast and northwestern inland while the decreases less than −1 m·s−1 are mostly located in part of the Tibet Plateau and northwestern inland. [ABSTRACT FROM AUTHOR]

Objective: Facial expressions have been served as clinical symptoms to convey mental conditions in psychiatry. This paper proposes to recognize patients with schizophrenia (SCZ) using their facial images based on deep learning algorithm, and to investigate objective differences in facial expressions between SCZ patients and healthy controls using deep learning algorithm and statistical analyses. Methods: The study consists of two parts. The first part recruited 106 SCZ patients and 101 healthy controls, and videotaped their facial expressions through a fixed experimental paradigm. The video data were randomly divided into two sets, one for training a convolutional neural network (CNN) with the classification of "healthy control" or "SCZ patient" as output and the other for evaluating the classification result of the trained CNN. In the second part, all facial images of the recruited participants were put into another CNN separately, which was priorly trained with a facial expression database and will output the most likely facial expressions of the recruited participants. Statistical analyses were performed on the obtained facial expressions to find out the objective differences in facial expressions between the two recruited groups. Results: The trained CNN achieved an overall accuracy of 95.18% for classifying "healthy control" or "SCZ patient." Statistical results on the obtained facial expressions demonstrated that the objective differences between the two recruited groups were statistically significant (p <.05). Conclusions: Facial expressions hold great promise as SCZ clues with the help of deep learning algorithm. The proposed approach would be potentially applied to mobile devices for autorecognizing SCZ in the context of clinical and daily life. [ABSTRACT FROM AUTHOR]

Nitrogen (N) and silicon (Si) are important nutritional elements for rice. However, excessive N fertilizer application and the ignorance of Si fertilizer are common in practice. Straw biochar is rich in Si, which can be used as a potential Si fertilizer. In this study, we conducted a consecutive 3-year field experiment to explore the effects of N fertilizer reduction combined with straw biochar application on rice yield, Si and N nutrition. There were five treatments: conventional N application (180 kg ⋅ hm², N100), 20% N reduction (N80), 20% N reduction with 15 t ⋅ hm² biochar (N80+BC), 40% N reduction (N60), and 40% N reduction with 15 t ⋅ hm² biochar ( N60+BC). The results showed that compared with N100, 20% N reduction did not affect the accumulation of Si and N in rice; 40% N reduction reduced foliar N absorption, but significantly increased foliar Si concentration by 14.0%-18.8%; while combined application of biochar significantly increased foliar Si accumulation, with an increase of Si concentration by 38.0%-63.3% and Si absorption by 32.3%-49.9%, but further reduced foliar N concentration. There was a significant negative correlation between Si and N concentration in mature rice leaves, but no correlation between Si and N absorption. Compared with N100, N reduction or combined application of bio- char did not affect soil ammonium N and nitrate N, but increased soil pH. Nitrogen reduction combined application of biochar significantly increased soil organic matter by 28.8%-41.9% and available Si content by 21.1%-26.9%, with a significant positive correlation between them. Compared with N100, 40% N reduction reduced rice yield and grain setting rate, while 20% N reduction and combined application of biochar did not influence rice yield and yield components. In summary, appropriate N reduction and combined with straw biochar can not only reduce N fertilizer input, but also improve soil fertility and Si supply, which is a promising fertilization method in double-cropping rice fields. [ABSTRACT FROM AUTHOR]

Knowledge graph (KG) embedding for predicting missing relation facts in incomplete knowledge graphs (KGs) has been widely explored. In addition to the benchmark triple structural information such as head entities, tail entities, and the relations between them, there is a large amount of uncertain and temporal information, which is difficult to be exploited in KG embeddings, and there are some embedding models specifically for uncertain KGs and temporal KGs. However, these models either only utilize uncertain information or only temporal information, without integrating both kinds of information into the underlying model that utilizes triple structural information. In this paper, we propose an embedding model for uncertain temporal KGs called the confidence score, time, and ranking information embedded jointly model (CTRIEJ), which aims to preserve the uncertainty, temporal and structural information of relation facts in the embedding space. To further enhance the precision of the CTRIEJ model, we also introduce a self-adversarial negative sampling technique to generate negative samples. We use the embedding vectors obtained from our model to complete the missing relation facts and predict their corresponding confidence scores. Experiments are conducted on an uncertain temporal KG extracted from Wikidata via three tasks, i.e., confidence prediction, link prediction, and relation fact classification. The CTRIEJ model shows effectiveness in capturing uncertain and temporal knowledge by achieving promising results, and it consistently outperforms baselines on the three downstream experimental tasks. [ABSTRACT FROM AUTHOR]

Within the frameworks of the Coordinated Regional Downscaling Experiment‐East Asia first and second phase (CORDEX‐EA‐I and CORDEX‐EA‐II), the impact of spatial resolution, physical parameterization schemes and spectral nudging (SN) on simulating inland and offshore near‐surface wind speed over China is evaluated. By using WRF and RegCM4 models, the CORDEX‐EA simulations driven by the ERA‐Interim reanalysis data are conducted from 1989 to 2008. The regional climate models (RCMs) have the capacity to simulate the spatial patterns of surface wind, although significant overestimations exist over inland China. The WRF CORDEX‐EA‐II experiments with increasing horizontal resolution perform better in reproducing both inland and offshore wind speed than the CORDEX‐EA‐I experiments. Moreover, the experiments with SN can significantly reduce the positive biases of surface wind speed. For the temporal variation of wind speed, almost all the simulations show larger biases in winter than in summer. Particularly, the simulated wind speed in summer in the RegCM4 experiment with CLM3 land surface model (RCC‐II) is close to the observations. The extreme wind speed can be well reproduced by WRF simulations, and the SN experiments perform better than the experiments without SN (NOSN). In addition, the overestimations of surface wind speed can be partly explained by the overestimations of the wind field at 850 hPa level inherited from ERA‐Interim reanalysis and the increase of temperature gradient between the land and ocean in winter. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a chronic neurodegenerative disease, which leads to impairment of cognition and memory. The heat shock protein 70 (HSP70) family plays an important role in the pathogenesis of AD. It is known to regulate protein misfolding in a variety of diseases, including inhibition of Aβ aggregation and NFT formation in AD. As yet, the diagnostic molecular markers of AD remain unclear. Herein, we sought to investigate molecular markers of HSP70 family that can affect diagnosis and treatment in AD through computational analysis. In this study, the intersection between HSP70 family members and immune molecules was taken to screen immune-related HSP70 family genes. Based on the datasets from the NCBI-Gene Expression Omnibus (GEO) database, we found that the expression levels of HSPA1A and HSPA2 were significantly increased in AD samples, while HSPA8 significantly decreased. Surprisingly, the combination of the 3 hub genes had a good diagnosis of AD via receiver operating characteristic curve (ROC). Moreover, the clinical value of the 3 hub genes was further assessed by the Spearman correlation analysis with AD-related genes, β-secretase activity, and γ-secretase activity. In terms of immune cell infiltration, we showed that the distribution of seven immune cell types (macrophages M2, neutrophils, T cells CD4 memory activated, macrophages M0, NK cells activated, plasma cells, and T cells follicular helper) was associated with the occurrence of AD by CIBERSORT. Furthermore, our data suggested that EP300, MYC, TP53, JUN, CREBBP, and ESR1 might be key transcription factors (TFs) for the 3 hub genes. In general, these findings suggest that HSPA1A, HSPA2, and HSPA8 are potential molecular biomarkers for prognosis among HSP70 family in AD, and it provides a new perspective on diagnostic and therapeutic targets for AD. [ABSTRACT FROM AUTHOR]