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The purpose of this study is to evaluate and analyze the quality of guidelines and expert consensus on clinical practice regarding metabolically associated fatty liver disease (MAFLD) over the past five years. Data from the websites were retrieved using computers. We evaluated guidelines and expert consensus on MAFLD that were officially published between January 1, 2018 and March 24, 2023. Two evaluators independently examined the literature and extracted data. The included literature on guidelines and expert consensus was then subjected to quality review and analysis using assessment tools from Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (2016). The intraclass correlation coefficient (ICC) values of all items on the AGREE II scale for the two evaluators were greater than 0.75, indicating a high degree of agreement between their assessments. Scope and purpose (48.90%), participants (49.21%), rigor in the formulation process (56.97%), clarity of expression (90.08%), applicability (66.08%), and independence of file compiling (60.12%) were the AGREE II scoring items with the standardized average scores. Apart from the participants, the average scores of all the scoring items in the guidelines from other countries other than China were higher than those from China (|Z|+>+2.272, p+<+0.05). MAFLD guidelines must be revised to enhance their methodological quality. When creating guidelines, it is recommended that the formulators strictly adhere to the formulation and drafting standards of AGREE II and elevate the quality of the guidelines. [ABSTRACT FROM AUTHOR]

Camellia oleifera oil (CO oil) extracted from C. oleifera seeds has a 2300-year consumption history in China. However, there is relatively little research regarding its non-edible uses. This study determined the physicochemical properties of CO oil extracted via direct pressing, identified its main components using GC-MS, and evaluated its antioxidant, moisturizing, and anti-inflammatory activities. The results revealed that CO oil's acid, peroxide, iodine, and saponification values were 1.06 ± 0.031 mg/g, 0.24 ± 0.01 g/100 g, 65.14 ± 8.22 g/100 g, and 180.41 ± 5.60 mg/g, respectively. CO oil's tocopherol, polyphenol, and squalene contents were 82.21 ± 9.07 mg/kg, 181.37 ± 3.76 mg/kg, and 53.39 ± 6.58 mg/kg, respectively; its unsaturated fatty acid (UFA) content was 87.44%, and its saturated fatty acid (SFA) content was 12.56%. CO oil also demonstrated excellent moisture retention properties, anti-inflammatory effects, and certain free radical scavenging. A highly stable CO oil emulsion with competent microbiological detection was developed using formulation optimization. Using CO oil in the emulsion significantly improved the formulation's antioxidant and moisturizing properties compared with those of the emulsion formulation that did not include CO oil. The prepared emulsion was not cytotoxic to cells and could reduce cells' NO content; therefore, it may have potential nutritional value in medicine and cosmetics. [ABSTRACT FROM AUTHOR]

With the acceleration of the construction of sponge cities in China, porous asphalt pavement (PA) is has been widely used. High-viscosity asphalt (HVA) is the core material in building PA because it has good rheology properties, which can provide good raveling and rutting resistance. However, due to the open-graded structure of PA, HVA was more susceptible to rapid aging, which significantly affects the durability of PA. To investigate the thermal aging effect on the rheological properties of self-modified HVA (SHVA), five types of asphalts were aged using a rolling thin film oven (RTFO) and pressure aging vessel (PAV). Then, rheological tests were adopted, such as temperature sweep test (TS), repeated creep and recovery test (RCR), and bending beam rheometer test (BBR). The results indicate that during the aging process, the oxidation-induced hardening effect of neat asphalt and the degradation-induced softening effect of the modifier changes the rheology properties of HVA significantly. As the aging progresses, the contribution of the modifiers of HVA to anti-aging performance is greatly reduced. At high temperatures, HVA demonstrates better anti-aging performance than conventional styrene–butadiene–styrene (SBS)-modified asphalt (Guo Chuang, GC). The change of the high-temperature rheological indices of the two HVA types (SHVA and TAFPACK-super HVA (TPS)) showed a smaller activation energy index (EAI), a more considerable viscous component of binder creep stiffness (Gv), and more minor accumulated stain (racc), indicating a more significant anti-short-term and long-term aging performance, which is beneficial to the high-temperature performance of asphalts. However, the changes in low-temperature rheological properties do not align with those in high-temperature rheological properties after long-term aging. The BBR test results reveal that TPS exhibits worse low-temperature performance than GC and SHVA. During the thermal aging process, the contribution rate of the modifiers in SHVA against RTFO and PAV aging is higher than that of the modifiers in TPS, which contributes to the superior anti-aging property. Overall, SHVA demonstrates the best anti-aging performance among the five asphalts tested. [ABSTRACT FROM AUTHOR]

Simple Summary: Montane habitats are characterized by mountainous regions with steep environmental gradients within a small geographic area. These habitats play a prominent role in shaping vertical species distributions due to multiple correlations between elevation and a host of environmental factors, such as temperature, humidity, and anthropogenic disturbances. Thus, they make for a fascinating natural laboratory for biodiversity studies. Our study addresses the regional and elevational patterns of taxonomic and phylogenetic species diversity in the amphibians of Fujian Junzifeng National Nature Reserve located in eastern China. By combining various diversity indices, we provide a multi-dimensional framework to study the distribution mechanism of amphibian species diversity along a large elevational gradient, in the hopes of contributing to a greater understanding and effective conservation of mountainous amphibian diversity. Elevational gradients provide an excellent opportunity to assess biodiversity patterns and community structure. Previous studies mainly focus on higher elevations or are limited to small areas in mountainous regions. Little information can be found on amphibian biodiversity in middle- and low-elevational areas, hence our study was devoted to filling up the current gaps in these research areas. To understand the variability of biodiversity of amphibian species in the Fujian Junzifeng National Nature Reserve in eastern China, our study included taxonomic and phylogenetic components to describe the various patterns of regional and elevational distribution. The results showed that (1) most of the taxonomic and phylogenetic diversity metrics were correlated; with regard to the surveyed area, Faith's phylogenetic diversity index (PD) and net relatedness index (NRI) were positively correlated with the Shannon–Wiener index (H'), Margalef index (DMG), and species richness (S), while negatively with the Pielou index; whereas for elevation, only the Pielou index was positively correlated with the nearest taxon index (NTI), but negatively with other indices; (2) taxonomic and phylogenetic diversities did not differ among the three survey locations but differed significantly along the elevational gradient; Simpson index, H', S, and DMG had a hump-shaped relationship with elevations, and PD decreased gradually with the increase in elevation, whereas NRI and NTI sharply increased at the elevation above 900 m; (3) the species range size and the corresponding midpoint of amphibians were affected by a strong phylogenetic signal, which supports the elevational Rapoport's rule upon removal of Pachytriton brevipes and Boulenophrys sanmingensis from the study. [ABSTRACT FROM AUTHOR]

Production strategies and parameters control the efficiency of geothermal energy extraction related to the thermal stability and economic benefits of a geothermal system. The optimization strategies of geothermal energy extraction play a critical role in engineering and are generally determined through a numerical simulation approach. Considering the correlation among production parameters, numerical simulation requires numerous runs and manual adjustments, resulting in lower calculation efficiency and limited or local optimizations. This study proposes a high-efficiency network based on a three-dimensional heterogeneity model in the Gonghe Basin in China to achieve a high-efficiency and high-precision production strategy. The neural network was successfully established as a surrogate of the numerical model for the repetitive forward simulation. Meanwhile, the neural network is integrated with the Harris Hawks algorithm to optimize extraction strategies for sustainable heat extraction. This paper focuses on the effects of human-controlled operational parameters on geothermal systems. Results indicated that the maximum electrical power can be guaranteed 5.2 MW during a 50-year production period at an injection temperature of 60°C, an injection rate of 39 kg/s , and a well spacing of 380 m. The study provides important operational guidance for sustainable utilization in the Gonghe Basin. This simulation-optimization approach can be applied to other geothermal sites for sustainable energy production. [ABSTRACT FROM AUTHOR]

Compound Kushen injection (CKI) is the most widely used traditional Chinese medicine preparation for the comprehensive treatment of colorectal cancer (CRC) in China, but its underlying molecular mechanisms of action are still unclear. The present study employed a network pharmacology approach, in which we constructed a "bioactive compound-target-pathway" network. Experimental RNA sequencing (RNA-Seq) analysis was performed to identify a key "bioactive compound-target-pathway" network for subsequent experimental validation. Cell cycle, proliferation, autophagy, and apoptosis assays and a model of azoxymethane/dextran sodium sulfate-induced colorectal carcinogenesis in mice were employed to detect the biological effect of CKI on CRC. Real-time reverse-transcription polymerase chain reaction, Western blot, and immunohistochemistry were performed to verify the selected targets and pathways. We constructed a predicted network that included 82 bioactive compounds, 34 targets, and 33 pathways and further screened an anti-CRC CKI "biological compound (hesperetin 7-O-rutinoside, genistein 7-O-rutinoside, and trifolirhizin)-target (p53 and checkpoint kinase 1 [CHEK1])" network that targeted the "cell cycle pathway". Validation experiments showed that CKI effectively induced the cell-cycle arrest of CRC cells in vitro and suppressed the development of CRC in vivo by downregulating the expression of p53 and CHEK1. Our findings confirmed that inducing cell-cycle arrest by CKI is an important mechanism of its anti-CRC action, which provides a direct and scientific experimental basis for the clinical application of CKI. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate potential effects and satisfaction of dignity therapy among patients with hematologic neoplasms in the Chinese cultural context. Methods: Sixty-six patients with hematologic neoplasms were randomly assigned into either a dignity therapy group (N = 32) or control group (N = 34). The primary outcomes were level of hope and spiritual well-being, as measured according to the Herth Hope Index and the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, at baseline (T0), 1-week follow-up (T1), and 4-week follow-up (T2). Satisfaction with dignity therapy was assessed using a 5-grade marking system at T1. Results: Among the 66 participants, 61 remained at 1-week follow-up and 57 remained at 4-week follow-up. Group differences were found in the total score and the scores of each dimension of spiritual well-being and level of hope at T1 and T2 (p < 0.05). Interaction effects were statistically significant in terms of spiritual well-being (p < 0.001) and level of hope (p < 0.001). Majority of the patients (93.34%) and family members (96.67%) gave positive evaluations ("very satisfactory" or "relatively satisfactory") for the dignity therapy intervention. Conclusion: Implementing dignity therapy among patients with hematologic neoplasms in China was associated with good efficacy in improving spiritual well-being and the level of hope in the short term. Difficulties and solutions involved in the implementation of dignity therapy in multiple cultures deserve attention. [ABSTRACT FROM AUTHOR]

Long project cycle and uncertainties are important characteristics of public-private partnership (PPP) projects. Since the introduction of PPP projects in China, the timing of capital withdrawal has become important. With the emergence of risk factors during the course of the project, it will face the problem of investment withdrawal by social capital financial investors. Escalation of commitment (EOC) refers to the erroneous behaviour of project decision makers who do not promptly withdraw from a project when they receive negative feedback and continue to invest resources in the project. EOC not only causes more unnecessary losses but also adversely affects decision makers. Therefore, it is crucial to clarify the impact of EOC on the choice of the exit timing of social capital. This article adopts literature survey method and quantitative analysis method: introducing the theory of maximization of income into the real option model, combining the net present value method with the binary tree option pricing model, constructing the decision-making model to analyze the exit timing of PPP social capital in the context of EOC. Then combined numerical simulation and empirical analysis to verify the effectiveness of the decision-making model, discussed the reasons why the social capital party chooses EOC, and proposes measures for controlling EOC. The higher the degree of completion of the project, the easier it is for the person in charge of the project to make inaccurate judgements about the project due to personal psychological factors, and the easier it is for EOC to occur. Therefore, after setting the minimum goal of the project, the decision maker needs to accurately evaluate the existing value of the project to avoid falling into decision-making errors. [ABSTRACT FROM AUTHOR]

Emotional exhaustion in the workplace can cause employees psychological and physical health problems, affect work performance, and create burdens for the organization. Existing studies have demonstrated that psychological empowerment helps reduce emotional exhaustion. This study explores the internal mechanism of this relationship. Drawing on conservation of resources theory, we advance a dual mediation model to explain how high psychological empowerment results in low emotional exhaustion, by increasing psychological safety and organizational embeddedness. Data were collected from 226 on-the-job MBA students at a university in western China. The results demonstrate that psychological safety and organizational embeddedness play mediating roles in the negative relationship between psychological empowerment and emotional exhaustion. The study provides a systematic view of the negative effect that psychological empowerment has on emotional exhaustion. The paper also discusses theoretical contributions, practical implications, and future directions. [ABSTRACT FROM AUTHOR]

Purpose: To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China. Methods: A multicenter cross-sectional study was conducted from April 2017 to January 2018. The sample comprised 207 dyads of adult AL patients and FCs. The participants were required to complete socio-demographic information and the Hospital Anxiety and Depression Scale (HADS). The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu, only for patients) and MOS 36-item Short-Form Health Survey (SF-36, only for FCs) were used to measure QoL. Results: The mean scores of anxiety and depression for AL patients were 7.89 ± 3.85 and 7.18 ± 4.23, respectively. For FCs, the mean scores of anxiety and depression were 9.96 ± 3.73 and 8.64 ± 3.74. In this study, adult AL Patients' sex, patients' depression score, whether patients achieving a CR or not, education, FCs' depression score, patients' social/family well-being and emotional well-being were significantly associated with patients' anxiety or depression (p < 0.05). For FCs, depression was significantly related to the physical component summary (β = 0.127, p = 0.008). There were significant differences in anxiety (t = − 5.92, p < 0.001) and depression (t = − 4.19, p < 0.001) between patients and FCs. Conclusions: AL patients' FCs showed higher score of anxiety and depression than that of patients. The psychological health may have a potential relationship between AL patients and their FCs. Healthcare professionals can conduct family-center interventions to improve mental health and QoL of AL patients and FCs. [ABSTRACT FROM AUTHOR]

Escherichia coli (E. coli) plays an important ecological role, and is a useful bioindicator to recognize the evolution of resistance in human, animal and environment. Recently, extended-spectrum β-lactamases (ESBL) producing E.coli has posed a threat to public health. Generally, captive healthy giant pandas are not exposed to antibiotics; however, they still acquire antimicrobial resistant bacteria. In order to understand whether there is an exchange of resistance genes within the ecosystems of captive giant pandas, this study explored resistance characteristics of 330 commensal E. coli isolates from feces of giant pandas, the surroundings, and breeders. Isolates from different sources showed similar resistance phenotype, and ESBL/AmpC-producing isolates showed more profound resistance to antibiotics than non-ESBL/AmpC-producing isolates (P <0.05). Furthermore, the occurrence of broad-spectrum β-lactamase related resistance genes and colistin resistance genes was detected, and isolates phylogenetic typing and multilocus sequence typing (MLST) were applied in this study. Seven different β-lactamase resistance genes (bla CTX-M-55 , bla CTX-M-15 , bla CTX-M-27 , bla CTX-M-65 , bla TEM-1 , bla OXA-1 and bla CMY) and mcr -1 were found in 68 ESBL/AmpC-producing isolates. bla CTX-M-55 (48.53 %) was found the most predominant resistance genes, followed by bla TEM-1 (19.12 %) and bla CTX-M-27 (16.18 %). Nonetheless, bla CTX-M-55 was commonly detected in the isolates from giant pandas (63.16 %), the surroundings (43.48 %), and breeders (33.33 %). However, there were no carbapenemase genes detected in this study. mcr-1 was harbored in only one isolate from giant panda. Forty-five tansconjugants were successfully obtained in the conjugation experiments. The presence of antimicrobial resistance and related resistance genes tested were observed in the transconjugants. The results indicated that 52.63 % of the isolates from giant panda 73.91 % of the isolates from surroundings, and 100 % of the isolates from breeders were phylogroup A. Total of 27 sequence types (ST) were recognized from the isolate by MLST and found that ST48 (19/68; 27.94 %) was the predominant ST type, especially in the isolates from giant pandas and the surroundings. In conclusion, commensal ESBL/AmpC-producing E. coli becomes a reservoir of ESBL resistance genes, which is a potential threaten to health of giant pandas. The interaction between giant pandas, surroundings and breeders contribute to development of resistant phenotypes and genotypes which might transfer across species or the surroundings easily; hence, strict monitoring based on a "One Health" approach is recommended. • High prevalence of ESBL/AmpC E. coli were detected from giant panda ecosystem. • The bla CTX-M genes play the dominant roles in mediating ESBL resistance. • First detection of mcr-1 in intestinal E. coli of the giant panda. • ST48 is the most frequent observed ST in feces and the surroundings. • Conjugation may be one of the modes of transmission of drug-resistant genes. [ABSTRACT FROM AUTHOR]

Background: Patients with acute leukaemia (AL) usually require prolonged periods of hospitalisation. The treatment and clinical symptoms may lead to patients' supportive care needs (SCNs) not being met and impairs their quality of life (QoL). Studies on QoL and SCNs among AL patients are limited. This study aimed to identify the unmet SCNs and its relation to QoL of adult AL patients in China.Methods: This multicentre cross-sectional study recruited 346 participants to complete a self-developed questionnaire, detailing demographic information and disease-related variables. A 34-item Supportive Care Needs Survey (SCNS-SF34) was used to identify unmet SCNs, and the Functional Assessment of Cancer Therapy-Leukaemia (FACT-Leu) questionnaire measured patients' QoL.Results: Unmet SCN rates for the 34 items ranged from17.6 to 81.7%. Patients' needs were high for health systems and information, but low in the sexual domain. The results reveal nine factors associated with the unmet SCNs of adult AL patients, including marital status, original residence, age, education, occupation, other diseases, chemotherapy course, disease course, and treatment stage (p < 0.05). The total score of the FACT-Leu negatively correlated with the SCNS-SF34 in the physical/daily living (r = - 0.527, p < 0.01), psychological (r = - 0.688, p < 0.01), sexual (r = - 0.170, p < 0.01), patient care and support (r = - 0.352, p < 0.01), and health systems and information (r = - 0.220, p < 0.01) domains.Conclusions: Adult AL patients exhibit a high demand for unmet SCNs, especially in the domain of health systems and information. There was a significant association between patients' unmet SCNs and QoL. Future research should develop tailored interventions to address the unmet SCNs of adult AL patients, to further improve their QoL. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review evidence regarding the benefits of Internet-based psycho-educational interventions among cancer patients.Methods: We performed a systematic review with meta-analysis and qualitative evidence synthesis. Systematic searches for published studies in English or Chinese identified eligible randomized and clinical controlled trials. The following databases were searched: Medline, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Proquest Digital Dissertations, Foreign Medical Retrieval System, China National Knowledge Infrastructure, China Science and Technology Journal Database, China Wanfang Database, and Taiwanese Airiti Library. We also searched the gray literature and reviewed reference lists from relevant articles. Studies were scored for quality using the Cochrane Risk of Bias Tool.Results: Seven eligible studies (1220 participants) were identified that used three intervention tools: website programs (n = 5), e-mail counseling (n = 1), and a single-session psycho-educational intervention (n = 1). The quality of all studies was moderate. The meta-analysis showed that Internet-based psycho-educational interventions had a significant effect on decreasing depression (standardized mean difference (SMD) - 0.58, 95% confidence interval (CI) (- 1.12, - 0.03), p = 0.04) and fatigue (mean difference (MD) - 9.83, 95% CI (- 14.63, - 5.03), p < 0.01). However, there was no evidence for effects on distress (SMD - 1.03, 95% CI (- 2.63, 0.57), p = 0.21) or quality of life (MD 1.10, 95% CI (- 4.42, 6.63), p = 0.70).Conclusion: Internet-based psycho-educational interventions reduce fatigue and depression in cancer patients. More rigorous studies with larger samples and long-term follow-up are warranted to investigate the effects of these interventions on cancer patient quality of life and other psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Direct heat production by double wells is widely used to extract thermal energy from geothermal reservoirs. However, geothermal water is often type of brine with high dissolved salts. Injection and extraction of the geothermal fluid may cause strong chemical reactions, leading to scaling in the wellbore and reservoir. Such process was seldom considered in the heat production optimization. This study numerically investigated the mechanism of chemical damage to the reservoir in the Zhacang geothermal field, China, and optimized the heat production with constraint of weakening chemical damage. It was found that direct injection of the tail geothermal water can lead the porosity to reduce by 0.06%. The degree of precipitation can be controlled by artificial factors, including injection temperature and mixing ratio of the geothermal water with river water. The comparative computation indicated that at an injection temperature of 35 °C, and a mixing ratio of the river to the geothermal water of 6:4, the reservoir porosity was unaffected by chemical reactions in 100 years and geothermal energy production can be maintained above 0.11 MW. The methodology can be applied in other geothermal fields for sustainable geothermal energy production regarding the formation damage in geothermal reservoirs due to fluid-rock interaction. • The mechanism of chemical damage to a granite geothermal reservoir due to heat production was revealed. • Heat production scheme was optimized regarding both the injection chemistry and temperature. • Silica and K-feldspar precipitation, and albite and muscovite dissolution occur near the injection well. • A moderate temperature (35 °C) and lowering ions concentration in the injection water can weaken the chemical damage. [ABSTRACT FROM AUTHOR]

Objective: To develop a communication prompt based on dignity therapy to facilitate effective conversations between patients with haematologic neoplasms and their family caregivers and to improve the programme and preliminarily explore the benefits and challenges of family participatory dignity therapy (FPDT). Methods: A mixed‐methods approach was applied to develop and revise the programme. The FPDT was developed and validated using the Delphi survey, and its further improvement was explored with a simple one‐group pre‐ and post‐trial and semi‐structured in‐depth interviews. Results: Most of the FPDT items were endorsed by experts and patient–family dyads. The Content Validity Index was 93.6% in the first round of the Delphi survey and 100% in the second round. The "hope level," "spiritual well‐being" and "general health" scores of pre‐ and post‐testing increased from 33.60 ± 4.30 to 37.70 ± 5.10 (t = 3.99, p =.003); from 30.30 ± 3.65 to 38.80 ± 7.29(t = 4.13, p =.003); and from 41.67 ± 8.78 to 53.33 ± 8.05 (t = 3.50, p =.007) respectively. The qualitative data also indicated that the project was meaningful and well received. Conclusions: We showed that FPDT was a valuable and feasible means of improving communication between patients with haematologic neoplasms and their family caregivers in China by raising the hope level and spiritual well‐being and promoting general health. [ABSTRACT FROM AUTHOR]

Background: Acute leukemia (AL) not only impairs the quality of life (QOL) of patients, but also affects that of their family caregivers (FCs). Studies on QOL of AL patients and their FCs are limited. This study aimed to evaluate the QOL of AL patients and their FCs, and to explore the factors associated with QOL of patients and of FCs.Methods: A multicenter cross-sectional study was conducted. The QOL of 196 patient-FC dyads was assessed. The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) was used for patients, and the 36-item Short-Form Health Survey (SF-36) was used for FCs. Independent-samples t-tests or one-way analysis of variance were used to compare QOL subscale scores between groups with different sociodemographic/clinical characteristics. Multiple regression analysis was conducted to identify the factors associated with QOL of AL patients and their FCs.Results: The total FACT-Leu score for AL patients was 76.80 ± 16.44, and the physical component summary (PCS) and mental component summary (MCS) scores for FCs were 64.67 ± 15.44 and 52.50 ± 13.49, respectively. All QOL subscales for patients (t = 12.96-34.73, p < 0.001) and FCs (t = 2.55-14.36, p < 0.05), except role emotional (t = - 0.01, p = 0.993), were lower than those reported in previous studies. Sex, employment, and chemotherapy were significantly associated with total FACT-Leu score in AL patients (p < 0.05). Age, sex, marital status, education, employment, and relationship to patients were significantly associated with SF-36 PCS or MCS (p < 0.05).Conclusions: AL patients and their FCs both have lower QOL than the population in previous studies. These findings suggest that not only AL patients' physical and mental health but also overall family QOL should be assessed. Interventions supporting patient-FC dyads should be developed to improve their QOL. [ABSTRACT FROM AUTHOR]

To explore undergraduate nursing students' experiences of psychiatric placements. Placement is an important learning phase for undergraduate nursing students and the placement experiences may affect their career choices. However, nursing students' experiences of psychiatric placements have not been fully explored in China. This study adopted a descriptive, phenomenological design. After psychiatric placement, a semi-structured interview was conducted in June 2022 among 22 final-year undergraduate nursing students using purposive sampling. The data were analysed using Colaizzi's seven-step analysis method. Five themes were identified: i) destigmatising mental illness; ⅱ) beneficial communication; ⅲ) gaining confidence; iv) disappointment and sadness; and v) fear and discomfort. Nursing students experienced various positive experiences and negative emotions during their psychiatric placement. Further research should explore and validate appropriate educational strategies to optimise students' placement experiences to increase their career interest in psychiatric nursing. [ABSTRACT FROM AUTHOR]

To explore nursing students' expectations and career preferences before their clinical placements. Clinical placement is an important adaptation stage through which nursing students become nurses. Nursing students' expectations of clinical placement are not always met. There is a huge demand-supply gap in the nursing labor force and ensuring successful nursing placements could offset this gap. This study adopted a descriptive qualitative design. Each participant was interviewed in the weeks before the start of their clinical placement. Interviews were semi-structured and audio recorded. Data were analyzed using Clarke and Braun's thematic analysis. This study included 25 students (11 males and 14 females; age 20–21 years), which was sufficient to reach data saturation. We identified 138 codes and six themes emerged: a) expectations of role transition; b) expectations of self-enhancement; c) expectations of teaching styles; d) fears and worries; e) preliminary career preferences; and f) motivating and obstacle factors of engaging in a nursing career. Nursing students had various expectations of their upcoming clinical placements alongside certain worries and fears. More predictive and targeted strategies need to be considered to ensure the success of clinical nursing placements. Further research should explore and verify strategies to meet nursing students' expectations and promote their preference for a nursing career. [ABSTRACT FROM AUTHOR]

Background and Objective: China has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions. In order to reduce these disparities, China’s government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Understanding the factors associated with underutilization of CC screening among target populations is important to improve the screening participation rate, and a high participation rate is key to achieving the goals of a screening program. However, data on the knowledge of CC among target populations in program areas is lacking in China. This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the NCCSPRA. Materials and Methods: A cross-sectional survey was conducted and face-to-face interview questionnaires were completed by 308 women who received CC screening services in 6 project counties of NCCSPRA across different socio-economic regions of China. ANOVA and Chi-square tests were used to compare the knowledge rates and scores across the different subgroups. Logistic regression was conducted to examine factors associated with knowledge level. Results: The overall CC knowledge rate of the target population was only 19.5%. Regional socio-economic level, advice from doctors, age, and educational status were strong predictors of knowledge level of CC screening. Significantly lower knowledge rates and scores were identified in older women (55–64 years old), less educated women (with primary school or illiterate), women in less developed regions and women who did not receive any advice about screening results from doctors. Conclusion: The knowledge of CC screening among women in the project counties of NCCSPRA was found to be very poor. Given the importance of knowledge in encouraging women to participate in screening is key to reducing CC burden in rural women in China, it is urgent that a targeted health promotion intervention is developed and implemented in project counties, especially targeting older women, women with less education and women in less developed regions, and focus on improving their CC knowledge and encouraging them to communicate with health care providers. The health promotion intervention targeting health care providers is also important to improve their knowledge of CC and provide best advice to women. [ABSTRACT FROM AUTHOR]

This paper investigates the use of an artificial neural network (ANN) model to predict dissolved organic carbon (DOC) in a river network and evaluates the impacts of watershed characteristics on stream DOC. Samples and relevant environmental variables were obtained from field sampling at 28 hydrological response units (HRUs) and a MODIS/SRTM DEM satellite image. HRUs can provide reliable spatial interpolation for filling data gaps and incorporate potential spatial correlation among observations in each ANN neuron. The process and results of neural network modeling were assessed by deterministic and statistical methods and spatial regression kriging. The spatial prediction results show that ANN, using improved back propagation algorithms of 7-15-1 architecture, was the optimal network, by which predictions maintained most of the original spatial variation and eliminated smoothing effects of RK. The sum of the relative contributions of four sensitive variables, including soil organic carbon density, geographic longitude, surface runoff and Chl a in river water, was >75 %. A minor prediction error of ~6 % was found in HRUs of open shrublands, but HRUs of urban and croplands had an error of 24-30 %. This pattern exemplifies anthropogenic impacts in urban areas on stream DOC and agricultural activities in croplands. The usefulness of ANN modeling-based GIS in this study is demonstrated by depiction of spatial variation of stream DOC and indicates the benefits of understanding sensitive factors for watershed impact assessments. [ABSTRACT FROM AUTHOR]

The association between obesity and sarcopenia remains controversial. The present study was conducted to explore the associations among body mass index (BMI), visceral fat area (VFA), and sarcopenia in older people and analyze their potential mechanisms. This cross-sectional study included 861 community-dwelling older Chinese people from three regions of China. BMI, VFA, muscle mass, muscle strength, physical performance, body composition, and metabolic markers were measured. Muscle mass and muscle strength were positively correlated with BMI, but were negatively correlated with VFA. Simple overweight/obesity was negatively associated with sarcopenia (OR = 0.07, 95% CI = 0.03~0.18), and the OR value was lower than combined obesity (OR = 0.16, 95% CI = 0.09~0.28). Fat free mass and total body protein were positively associated with high BMI but negatively associated with high VFA. Furthermore, high VFA was adversely associated with some metabolic risk factors of sarcopenia. Combination of BMI and VFA increased diagnostic efficiency of low muscle mass and sarcopenia. In conclusion, high BMI was negatively associated with sarcopenia, while high VFA attenuated the negative association between high BMI and sarcopenia. The opposite association may partially be attributed to their different associations with body composition and metabolic risk factors of sarcopenia. Therefore, bedsides BMI, VFA and its interaction with BMI should be considered in sarcopenia prevention. [ABSTRACT FROM AUTHOR]

Cloud droplet size distribution (CDSD) is a critical characteristic for a number of processes related to clouds, considering that cloud droplets are formed in different sizes above the cloud-base. This paper analyzes the in-situ aircraft measurements of CDSDs and aerosol concentration ( N a ) performed in stratiform clouds in Hebei, China, in 2015 to reveal the characteristics of cloud spectral width, commonly known as relative dispersion (ε , ratio of standard deviation (σ) to mean radius (r) of the CDSD). A new algorithm is developed to calculate the contributions of droplets of different sizes to ε. It is found that small droplets with the size range of 1 to 5.5 μm and medium droplets with the size range of 5.5 to 10 μm are the major contributors to ε, and the medium droplets generally dominate the change of ε. The variation of ε with N a can be well explained by comparing the normalized changes of σ and r ( k σ / σ and k r / r ), rather than k σ and k r only ( k σ is Δσ/Δ N a and k r is Δr/Δ N a ). From the perspective of external factors affecting ε change, the effects of N a and condensation are examined. It is found that ε increases initially and decreases afterward as N a increases, and "condensational broadening" occurs up to 1 km above cloud-base, potentially providing observational evidence for recent numerical simulations in the literature. [ABSTRACT FROM AUTHOR]

Background: China is the largest producer of sweet potato in the world, accounting for 57.0% of the global output. Germplasm resources are the basis for promoting innovations in the seed industry and ensuring food security. Individual and accurate identification of sweet potato germplasm is an important part of conservation and efficient utilization., Results: In this study, nine pairs of simple sequence repeat molecular markers and 16 morphological markers were used to construct genetic fingerprints for sweet potato individual identification. Combined with basic information, typical phenotypic photographs, genotype peak graphs, and a two-dimensional code for detection and identification were generated. Finally, a genetic fingerprint database containing 1021 sweet potato germplasm resources in the "National Germplasm Guangzhou Sweet Potato Nursery Genebank in China" was constructed. Genetic diversity analysis of the 1021 sweet potato genotypes using the nine pairs of simple sequence repeat markers revealed a narrow genetic variation range of Chinese native sweet potato germplasm resources, and Chinese germplasm was close to that from Japan and the United States, far from that from the Philippines and Thailand, and the furthest from that from Peru. Sweet potato germplasm resources from Peru had the richest genetic diversity, supporting the view that Peru is the center of origin and domestication of sweet potato varieties., Conclusions: Overall, this study provides scientific guidance for the conservation, identification, and utilization of sweet potato germplasm resources and offers a reference to facilitate the discovery of important genes to boost sweet potato breeding., (© 2023. The Author(s).)

Purpose: The treatment and side effects of chemotherapy for acute leukaemia (AL) may cause both physical and psychological symptoms in patients. This study evaluated the effects of a WeChat-based multimodal psychoeducational intervention (ICARE programme) on fatigue, distress, anxiety, depression, and quality of life (QoL) among adult AL patients., Methods: In total, 72 participants were randomly assigned either to an intervention or control group (n = 36), respectively, from two large tertiary hospitals in Fuzhou, China (from April to December 2019). Data were collected at baseline, post-intervention, and after a 4-week follow-up using the Brief Fatigue Inventory, Distress Thermometer, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-leukaemia. Descriptive statistics was used to summarise the sociodemographic and clinical characteristics of the participants and a linear mixed model was used to analyse the score changes., Results: Between the two groups, there were statistically significant improvements in fatigue, distress, anxiety, depression, physical well-being, social/family well-being, emotional well-being, functional well-being (all p < 0.001), and leukaemia-specific subscale (p = 0.001). The difference over time was significant for leukaemia-specific subscale and fatigue, both (p < 0.001), anxiety (p = 0.001), and social/family well-being (p = 0.005). The interaction effects were significant for fatigue, distress, anxiety, physical well-being, social/family well-being, and emotional well-being, all (p < 0.001), depression (p = 0.019), leukaemia-specific subscale (p = 0.008), and total QoL score (p = 0.004)., Conclusion: WeChat-based multimodal psychoeducational intervention demonstrated a significant effect in reducing fatigue, distress, anxiety, depression, and QoL in AL patients. This ICARE programme contributed to continuing care to support AL patients., Implications for Cancer Survivors: The ICARE programme can improve the mental health and QoL of AL patients. The application of WeChat-based psychoeducational interventions have significant potential to benefit cancer patients due to their reach and can be an added value to routine care., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Severe fever with thrombocytopenia syndrome (SFTS), one kind of tick-borne acute infectious disease, is caused by a novel bunyavirus. The relationship between meteorological factors and infectious diseases is a hot topic of current research. Liaoning Province has reported a high incidence of SFTS in recent years. However, the epidemiological characteristics of SFTS and its relationship with meteorological factors in the province remain largely unexplored., Methods: Data on reported SFTS cases were collected from 2011 to 2019. Epidemiological characteristics of SFTS were analyzed. Spearman's correlation test and generalized linear models (GLM) were used to identify the relationship between meteorological factors and the number of SFTS cases., Results: From 2011 to 2019, the incidence showed an overall upward trend in Liaoning Province, with the highest incidence in 2019 (0.35/100,000). The incidence was slightly higher in males (55.9%, 438/783), and there were more SFTS patients in the 60-69 age group (31.29%, 245/783). Dalian City and Dandong City had the largest number of cases of SFTS (87.99%, 689/783). The median duration from the date of illness onset to the date of diagnosis was 8 days [interquartile range (IQR): 4-13 days]. Spearman correlation analysis and GLM showed that the number of SFTS cases was positively correlated with monthly average rainfall (r s  = 0.750, P < 0.001; β = 0.285, P < 0.001), monthly average relative humidity (r s  = 0.683, P < 0.001; β = 0.096, P < 0.001), monthly average temperature (r s  = 0.822, P < 0.001; β = 0.154, P < 0.001), and monthly average ground temperature (r s  = 0.810, P < 0.001; β = 0.134, P < 0.001), while negatively correlated with monthly average air pressure (r s  = -0.728, P < 0.001; β = -0.145, P < 0.001), and monthly average wind speed (r s  = -0.272, P < 0.05; β = -1.048, P < 0.001). By comparing both correlation coefficients and regression coefficients between the number of SFTS cases (dependent variable) and meteorological factors (independent variables), no significant differences were observed when considering immediate cases and cases with lags of 1 to 5 weeks for dependent variables. Based on the forward and backward stepwise GLM regression, the monthly average air pressure, monthly average temperature, monthly average wind speed, and time sequence were selected as relevant influences on the number of SFTS cases., Conclusion: The annual incidence of SFTS increased year on year in Liaoning Province. Incidence of SFTS was affected by several meteorological factors, including monthly average air pressure, monthly average temperature, and monthly average wind speed., (© 2022. The Author(s).)

Background: Stroke is the leading cause of death in China, and its burdens are rapidly increasing. The prevalence and control of stroke risk factors among stroke patients in China are unknown., Objective: We investigated the stroke risk factors of stroke patients in China., Design: We examined stroke risk factors in 6580 stroke patients aged 18 years or older in the China National Chronic Diseases and Nutrition Surveillance of Adults (2015-2017). With regard to the basic characteristics of the study participants, categorical variables were described as frequency (percent). The chi-square test was used to analyze the difference between men and women. The multivariate logistic regression model was used in the multivariate analysis., Results: Among the 6580 stroke patients, hypertension was the most common stroke risk factor identified in most cases (78.51%), followed by overweight or obesity (61.58%), dyslipidemia (54.38%), smoking (24.04%), diabetes (21.75%), family history of stroke (17.43%), lack of exercise (16.35%), and atrial fibrillation (4.47%). Drinking stroke patients had a lower rate of hypertension, diabetes, and dyslipidemia. Patients with hyperuricemia had a higher rate of hypertension and dyslipidemia than no-hyperuricemia patients. The hypertension awareness, treatment, and control rates among hypertension stroke patients were 73.62%, 70.19%, and 17.79%, respectively. The diabetes awareness, treatment, and control rates among diabetes patients were 69.74%, 65.83%, and 34.59%, respectively. The dyslipidemia awareness, treatment, and control rates among dyslipidemia patients were 42.37%, 29.4%, and 20.07%, respectively. Among treated hypertension patients, the rates of taking medicine as medically advised, controlled diet, increased exercise, and blood pressure monitoring were 91.31%, 58.88%, 45.78%, and 73.99%, respectively. Among treated diabetes patients, the rates of oral antidiabetic medications, insulin injection, diet control, and blood glucose monitoring were 78.24%, 34.71%, 85.77%, and 78.24%, respectively. Among treated dyslipidemic patients, the rate of taking medicine as medical advice, controlled diet, increased exercise, and regular blood lipid monitoring was 80.61%, 77.57%, 56.46%, and 40.3%, respectively., Conclusions: The most common risk factors for community stroke patients in China are hypertension, dyslipidemia, and overweight or obesity. The stroke community patients' suboptimal awareness and treatment of hypertension, and suboptimal awareness, treatment, and control of diabetes, and dyslipidemia are significant problems in China.

Dry rot caused by Diaporthe batatatis leads to the serious decay of sweetpotato storage roots during postharvest storage, which can result in considerable economic loss. Genomic research of the pathogen could provide a basis for study and prevention of sweetpotato dry rot. Herein, we report a high-quality draft genome sequence of D. batatatis CRI 302-4 isolated from infected sweetpotato storage roots in Taizhou City, Zhejiang Province, China. The size of the genome was 54.38 Mb and consisted of 36 scaffolds with a G+C content of 50.56% and an N 50 of 2,950,914 bp. The information provided in this genome sequence will be an invaluable resource for molecular genetic research and disease control in sweetpotato production.

Background: The serine protease inhibitor-1 (SERPINE1) rs1799889 single nucleotide polymorphism (SNP) has been constantly associated with diabetes mellitus (DM) and its vascular complications. The aim of this meta-analysis was to evaluate this association with combined evidences., Methods: The systematic search was performed for studies published up to March 2021 which assess the associations between SERPINE1 rs1799889 SNP and the risks of DM, diabetic retinopathy (DR), diabetic cardiovascular disease (CVD) and diabetic nephropathy (DN). Only case-control studies were identified, and the linkage between SERPINE1 rs1799889 polymorphism and diabetic vascular risks were evaluated using genetic models., Results: 51 comparisons were enrolled. The results revealed a significant association with diabetes risk in overall population (allelic: OR = 1.34, 95 % CI = 1.14-1.57, homozygous: OR = 1.66, 95 % CI = 1.23-2.14, heterozygous: OR = 1.35, 95 % CI = 1.08-1.69, dominant: OR = 1.49, 95 % CI = 1.18-1.88, recessive: OR = 1.30, 95 % CI = 1.06-1.59) as well as in Asian descents (allelic: OR = 1.45, 95 % CI = 1.16-1.82, homozygous: OR = 1.88, 95 % CI = 1.29-2.75, heterozygous: OR = 1.47, 95 % CI = 1.08-2.00, dominant: OR = 1.64, 95 % CI = 1.21-2.24, recessive: OR = 1.46, 95 % CI = 1.09-1.96). A significant association was observed with DR risk (homozygous: OR = 1.25, 95 % CI = 1.01-1.56, recessive: OR = 1.20, 95 % CI = 1.01-1.43) for overall population, as for the European subgroup (homozygous: OR = 1.32, 95 % CI = 1.02-1.72, recessive: OR = 1.38, 95 % CI = 1.11-1.71). A significant association were shown with DN risk for overall population (allelic: OR = 1.48, 95 % CI = 1.15-1.90, homozygous: OR = 1.92, 95 % CI = 1.26-2.95, dominant: OR = 1.41, 95 % CI = 1.01-1.97, recessive: OR = 1.78, 95 % CI = 1.27-2.51) and for Asian subgroup (allelic: OR = 1.70, 95 % CI = 1.17-2.47, homozygous: OR = 2.46, 95 % CI = 1.30-4.66, recessive: OR = 2.24, 95 % CI = 1.40-3.59) after ethnicity stratification. No obvious association was implied with overall diabetic CVD risk in any genetic models, or after ethnicity stratification., Conclusions: SERPINE1 rs1799889 4G polymorphism may outstand for serving as a genetic synergistic factor in overall DM and DN populations, positively for individuals with Asian descent. The association of SERPINE1 rs1799889 SNP and DR or diabetic CVD risks was not revealed., (© 2021. The Author(s).)

Associations between dietary patterns (DPs) and sarcopenia remain controversial, and fewer studies have mentioned the relationship between dietary energy composition and sarcopenia. The present cross-sectional study was conducted in three regions of China, to detect the associations between DPs and sarcopenia, and to identify the influencing nutrients. Exploratory factor analysis was conducted for DP identification. Logistic regressions were performed to explore the associations between DPs and sarcopenia. Dietary nutrients and dietary energy composition were calculated and compared among different DPs. Three DPs were identified from 861 community-dwelling older people. The "mushrooms-fruits-milk" pattern was negatively associated with sarcopenia ( OR = 0.33, 95% CI = 0.14~0.77, p -trend = 0.009). Subjects in the highest quartile of the "mushrooms-fruits-milk" pattern showed more abundant intake (1.7 g/kg/d) of dietary protein, and lower percentage (31%) of energy from fat (PEF) than the other two DPs. Further analyses indicated that lower PEF (<30%) was negatively associated with sarcopenia. In conclusion, the "mushrooms-fruits-milk" pattern was negatively associated with sarcopenia in community-dwelling older Chinese people. This pattern showed abundant protein intake and low PEF, which may partially contribute to its protective effect on sarcopenia. Therefore, besides protein, dietary fat and PEF may also be considered in the prevention and management of sarcopenia.

Background: Over the past few decades, a series of major challenges to global health have successively emerged, which call for China's deeper engagement in global health governance. In this context, the China-UK Global Health Support Programme (GHSP) was launched in 2012 with about 12 million pounds funded by the United Kingdom., Objectives: The GHSP was expected to explore a new type of China-UK partnership to strengthen the cooperation in global health, and enhance China's capacity to engage in global health governance and provide effective development assistance in health (DAH), in order to jointly improve global health outcomes., Programme Design and Implementation: The GHSP was programmed to support capacity building activities in Chinese experience distillation, DAH, global health governance and pilot partnership at national and institutional levels between October 2012 and March 2019. These activities were assigned to different project implementing agencies (PIAs) and their project cooperative agencies (PCAs) or pilot areas, and were then implemented under the guidance and management by the strategic oversight committee and the project management office of GHSP respectively., Main Achievements: At the national level, the GHSP held five rounds of China-UK high-level dialogues, conducted studies on China Global Health Strategies to provide robust evidence for developing and issuing relevant national policies, and supported the establishment of the China Global Health Network. At the institutional level, the GHSP funded a series of activities in research, training, international exchange and pilots etc., produced a large number of high-quality research outputs and policy briefings, cultivated a group of PIAs and individual researchers, facilitated the partnership building between the PIAs and PCAs, enhanced the practical ability of Chinese institutions to conduct overseas DAH, and improved the health service delivery and outcomes in pilot areas of three Asian and African countries., Policy Implications: In the GHSP, China and UK have established a good model for North-South Cooperation and the programme facilitated the 2030 Agenda for Sustainable Development by building a new type of bilateral partnership and carrying out triangular cooperation practices. This model has demonstrated huge potential for cooperation through partnership and can also be referred to by other countries to develop bilateral partnerships., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Background: Breastfeeding rates remain low in China and some mothers stop breastfeeding shortly after returning to work. Our study aimed to investigate the association between breastfeeding practices of working mothers and their employment status (formal versus informal) and occupational fields (agriculture related, industry related, and business and white collar). We also identified key work-related factors that influence breastfeeding practices in Chinese working mothers., Methods: This is a mixed-method research consisted of two components. We conducted a cross-sectional study of 10,408 breastfeeding mothers with children under 12 months old from 12 regions in China from July 2017 to January 2018. Multiple logistic regression was used to calculate adjusted odds ratios (AdjORs) and 95% confidence intervals (CIs) for breastfeeding practices. For the qualitative component, semi-structured interviews were conducted with 84 breastfeeding mothers in the study areas from July to December 2017, Content analysis was used for the qualitative component., Results: Agriculture related occupations were positively associated with early initiation of breastfeeding (AdjOR 1.32, 95% CI 1.15, 1.51), current breastfeeding (AdjOR 1.76, 95% CI 1.41, 2.20), ever breastfed (AdjOR 1.69, 95% CI 1.09, 2.62), exclusive breastfeeding (AdjOR 1.30, 95% CI: 1.04, 1.62), and predominant breastfeeding (AdjOR 1.72, 95% CI 1.44, 2.05). Business and white collar occupations were positively associated with early initiation (AdjOR1.38, 95% CI 1.23, 1.56) and ever breastfed (AdjOR 1.64, 95% CI 1.12, 2.39), and inversely associated with predominant breastfeeding (AdjOR 0.81, 95% CI 0.68, 0.95). For industry related and business and white collar occupations, informal employment was negatively related to current breastfeeding. In qualitative analysis, four main themes were developed to identify key work-related factors that influence breastfeeding practices: 1) employment benefits; 2) commute time; 3) workplace environment; 4) labor intensity. Mothers who experienced difficulties in one or more of the above would choose to lower breastfeeding frequency or stop breastfeeding., Conclusions: Having flexible work schedules and proximity of workplace to home can assist continuance of breastfeeding. Policies promoting supportive breastfeeding environment at work ought to be implemented. Additionally, informally employed mothers require more attention due to limited legal protection., Competing Interests: Competing interestsThe authors declare no competing interests.