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Background: Many studies reported the association between gut microbiota and type 2 diabetes mellitus (T2D), but it is still unclear which bacterial genus plays a key role and how the metabolic function of gut microbiota changes in the occurrence and development of T2D. Besides, there is a high diabetic prevalence in Mongolian population, which may be partly affected by their high calorie diet. This study identified the main bacterial genus influencing T2D in Mongolian population, and analyzed the changes of metabolic function of gut microbiome. The association between dietary factors and the relative abundance of main bacterial genus and its metabolic function was also studied. Methods: Dietary surveys and gut microbiota test were performed on 24 Mongolian volunteers that were divided into T2D (6 cases), PRET2D (6 cases) and Control group (12 cases) according to fasting plasma glucose (FPG) values. The relative abundance and metabolic function of gut microbiome from their fecal samples were measured by metagenomic analysis. Statistic method was used to evaluate the association between dietary factors and the relative abundance of the main bacterial genus or its metabolic function. Results: This study found that the Clostridium genus may be one of the key bacterial genera affecting the process of T2D. First, the relative abundance of Clostridium genus was significantly different among the three groups. Second, there was a higher relative abundance of metabolic enzymes of gut bacteria in PRET2D and T2D group than that in Control group. Third, a strong correlation between Clostridium genus and many metabolic enzymes was uncovered, many of which may be produced by the Clostridium. Last, carotene intake daily was negatively correlated with the Clostridium but positively correlated with tagaturonate reductase catalyzing interconversions of pentose and glucuronate. Conclusions: The gut Clostridium genus may play an important role in the development of T2D and it could be a potential biomarker for T2D in Mongolian population. Meanwhile, the metabolic function of gut bacteria has changed during the early stage of T2D and the changes in carbohydrate, amino acid, lipid or energy metabolism of Clostridium genus may play a critical role. In addition, the carotene intake may affect reproduction and metabolic function of Clostridium genus. [ABSTRACT FROM AUTHOR]

Aims: Reveal the soil organic carbon (SOC) stock change in the Qinghai-Tibetan Plateau (QTP) alpine wetlands in the past fifty years. The Qinghai-Tibetan Plateau (QTP) has a large area of alpine marshland and wet meadows. Artificial drainage, overgrazing and climate change have caused severe degradation of the alpine wetlands. However, little is known about the effects of wetland degradation on SOC stock, and studies only focused on the Zoige marshland, the biggest marshland of China. Direct SOC observations from the extensively distributed wet meadows remain scarce. Methods: SOC in the soil surface layer (0–50 cm) were investigated at four wetland sites where degradation has continued for decades. One site is in marshland, and three are in wet meadows of the QTP. Using datasets from the literature and the field measurements of the present study, we estimated the loss of alpine wetland SOC. Results and conclusions: Initially, marshland degradation to wet meadows prompted the accumulation of SOC; however, grazing in wet meadows reduced SOC accumulation. Wetland degradation to dried meadows led to a much greater SOC loss than that in the initial degradation stage, and grazing exacerbated the loss of SOC. An exponential decay rate of SOC was found in the grazed dried meadows. The wetlands of the QTP, have lost 141 ± 25 Tg in 1966–2016, representing 15% of the SOC stock. [ABSTRACT FROM AUTHOR]

Background: Our study aims to explore the association of rs7025486 single-nucleotide polymorphisms (SNP) in DAB2IP and rs1333049 on chromosome 9p21.3 with the coronary artery disease in Chinese population.Methods: All patients came from the east China area and underwent coronary angiography. Rs7025486 and rs1333049 polymorphism were genotyped in 555 patients with CAD and in 480 healthy controls that underwent coronary angiography.Results: In Chinese population, the rs7025486 genotype in the case group was no significant different than the control group (P = 0.531).Meanwhile, the rs1333049 SNP has statistically significant (P = 0.006), which was the independent risk factors for CAD (OR1.252, P = 0.039), and consistent with the past studies conclusion.Conclusion: Genotype of rs1333049 on chromosome 9p21, but not rs7025486 on chromosome 9q33, is an independent determinant of the incidence of CAD in Chinese population. [ABSTRACT FROM AUTHOR]

• Leaf iWUE increases but ecosystem WUE decreases with aridity level. • iWUE and ecosystem WUE displayed almost opposite trends in response to abiotic factors. • MAT was the strongest factor in predicting iWUE, whereas the most robust factor in predicting ecosystem WUE was LAI. Water use efficiency (WUE) links carbon and water cycling and has been recognized as important in understanding the carbon-water budget of terrestrial ecosystems. However, there are few studies comparing WUE at leaf and ecosystem levels in response to environmental variables on a global scale. Here, we compare global-scale patterns and the drivers of leaf and ecosystem WUEs and quantify the relative influence of biotic and abiotic factors. Using published world-wide δ13C (carbon stable isotope composition) measurements for 6751 C 3 plant populations from 174 publications, as well as our own measurements of δ13C for 418 C 3 plant populations across drylands in China, and satellite-based datasets of gross primary production and evapotranspiration, we determined global patterns and the drivers of leaf and ecosystem WUEs. Leaf intrinsic WUE (iWUE) and ecosystem WUE displayed almost opposite trends, in response to abiotic factors on a global scale. iWUE was highest in arid regions and lowest in humid regions, whereas ecosystem WUE was lowest in arid regions and highest in humid regions. Phylogeny had a significant effect on iWUE. Mean annual temperature (MAT) was the strongest factor in predicting iWUE, whereas the most robust factor in predicting ecosystem WUE was leaf area index (LAI). The data indicate that the two different responses at the leaf and ecosystem levels must be considered when modeling carbon and water balances in response to climate change. [ABSTRACT FROM AUTHOR]

Drylands are expected to be affected by greater global drought variability in the future; consequently, how dryland ecosystems respond to drought events needs urgent attention. In this study, the Normalized Vegetation Index (NDVI) and Standardized Precipitation and Evaporation Index (SPEI) were employed to quantify the resistance of ecosystem productivity to drought events in drylands of northern China between 1982 and 2015. The relationships and temporal trends of resistance and drought characteristics, which included length, severity, and interval, were examined. The temporal trends of resistance responded greatest to those of drought length, and drought length was the most sensitive and had the strongest negative effect with respect to resistance. Resistance decreased with increasing drought length and did not recover with decreasing drought length in hyper-arid regions after 2004, but did recover in arid and semi-arid regions from 2004 and in dry sub-humid regions from 1997. We reason that the regional differences in resistance may result from the seed bank and compensatory effects of plant species under drought events. In particular, this study implies that the ecosystem productivity of hyper-arid regions is the most vulnerable to drought events, and the drought–resistance and drought–recovery interactions are likely to respond abnormally or even shift under ongoing drought change. [ABSTRACT FROM AUTHOR]

• Evaluating the TFWGTE from enterprise perspective based on four-stage SBM-DEA model. • The average TFWGTE of 65 CISEs showed an upward trend from 2005 to 2014. • The improvement of TFWGTE is mainly due to the external environmental factors. • The improvement of environmental awareness has a positive effect in TFWGTE. • Electric furnace steelmaking has significant environmental positive externalities. Taking the four-stage SBM-DEA as the theoretical tool, this paper evaluates the total factor waste gas treatment efficiency (TFWGTE) of 65 Chinese iron and steel enterprises (CISEs) from 2005 to 2014. Then, after the influences of external environmental factors and statistical noise are eliminated, TFWGTE is decomposed into total factor waste gas managerial efficiency (TFWGME) and total factor waste gas environmental efficiency (TFWGEE), and the differences between TEWGTE, TEWGME and TEWGEE are systematically analysed from regional and enterprise perspectives. The results reveal that: (1) TFWGTE and TFWGEE showed an upward trend from 2005 to 2014, whereas TFWGME showed a downward trend from 2005 to 2014. The elimination of external environmental factors had provincial specific effects on TFWGTE; (2) By comparing the dynamic trends of TFWGTE in eastern, central and western regions, it is found that there are differences among different regions, which indicates that the external environmental factors in the region have an impact on TFWGTE; (3) In 4 provinces, TFWGME increased compared with TFWGTE, while in 23 provinces, TEWGME decreased compared with TFWGTE; (4) The Tobit regression results show that the command-and-control environmental regulation, environmental awareness and manufacturing process have significant effects on the input slacks of waste gas treatment, indicating that the strengthening of command-and-control environmental regulation, the improvement of environmental awareness, and the decline of the proportion of the short process can effectively reduce the input slacks of waste gas treatment. [ABSTRACT FROM AUTHOR]

Based on the manufacturing processes panel data for 42 iron and steel enterprises (ISEs) in China from 2005 to 2014, a data envelopment analysis (DEA) model with undesirable output and a Malmquist-Luenberger (ML) index model are used to calculate the pollution control efficiency (PCE) and its variation trend of China's 42 ISEs. The results show that the comprehensive PCE of the 42 ISEs is relatively low, and the PCE of short-process enterprises is better than that of long-process enterprises. The total factor pollution control efficiency (TFPCE) of China's ISEs with a short process presents an increasing trend, which is mainly attributed to the increase of the technical change, while the efficiency change has a slight negative effect. In contrast, the TFPCE of ISEs with a long process is in the trend of decreasing, which is mainly affected by the decline of the technical change, while the efficiency change has a slight positive effect. In addition, the PCE varies significantly across regions and ISEs. Among 42 ISEs, the TFPCE of 18 enterprises shows an increasing trend, while that of 24 enterprises presents a decreasing trend. • We use the SBM-DEA model to measure the pollution control efficiency. • The ML index is used to analyse the change in the pollution control efficiency. • The pollution control efficiency of China's iron and steel industry is relatively low. • The pollution control efficiency shows differences in different manufacturing processes. • The pollution control efficiency varies significantly across regions. [ABSTRACT FROM AUTHOR]

The green development of Chinese iron and steel industry with high pollution and energy consumption has become an urgent issue. Under the economic transition of China, this paper first establishes a theoretical mechanism for the differential effects of governance transformation models on the green process innovation (GPI) of Chinese iron and steel enterprises (CISEs). Based on the environmental protection data of 86 key CISEs from 2005 to 2018, the global Malmquist-Luenberger (GML) index is used to measure the total factor environmental governance efficiency (TFEGE) which represents the green development. Then the compound effects of environmental regulation (ER) and governance transformation on the TFEGE of 86 key CISEs are empirically studied. The results show that: (1) there is a U-shaped relationship between ER and the TFEGE. (2) Governance transformation and GPI can significantly improve TFEGE, and governance transformation will advance the inflection point of the U-shaped curve and accelerate the realization of the Porter hypothesis (PH), producing a preliminary compound effect. (3) The interaction of governance transformation and GPI has a positive and significant effect on improving TFEGE, but the heterogeneity analysis of regional economic and manufacturing process shows that it only promotes the inflection point of ER and accelerates the realization of the PH in middle- and short-process CISEs, producing a profound lagging compound effect. • There is a U-shaped relationship between environmental regulations and the total factor environmental governance efficiency of Chinese iron and steel enterprises (CISEs). • Governance transformation brings the inflection point of the U-shaped curve earlier, and promotes the realization of the Porter hypothesis (PH) in the CISEs. • Green process innovation has a positive impact on the total factor environmental governance efficiency of CISEs, proved the "strong" PH is valid in CISEs. • The intersection of governance transformation and green process innovation further brings the inflection point of the U-shaped curve earlier and accelerates the realization of the PH in the central China and short-process CISEs. [ABSTRACT FROM AUTHOR]

With the deterioration of China's ecological environment, technological innovation (TI) has become an important method of green transformation and upgrading Chinese steel enterprises (CSEs) under the constraint of environmental regulation (ER). Based on environmental protection panel data of 86 CSEs from 2005 to 2014, this paper first analyzes the direct effects of heterogeneous environmental regulation (HER) on TI and then studies the indirect effects of HER on TI through factors such as enterprise size, human capital, enterprise profit margin and executive environmental awareness. Based on a high-dimensional fixed effects model, the results show that (1) command-control environmental regulation (CCER) and voluntary environmental regulation (VER) have direct and positive effects on the TI of CSEs, while market-incentive environmental regulation (MIER) does not; and (2) the indirect effect of human capital is positively regulated by CCER and VER and that of enterprise size is negatively regulated by MIER, while all of the types of HER regulate the negative indirect effect of profit margin and the positive indirect effect of executive environmental awareness. It is necessary that combined and unified policy tools be implemented in the iron and steel industry (ISI) nationwide to coordinate the effects of HER. • This paper analyzed the dual effect of HER on TI of 86 CSEs with a high-dimensional fixed effects model. • Only CCER had the direct and positive effect on TI, whileMIER did not. • CCER had the indirect effect on TI through human capital, enterprise profits, and executive environmental awareness. • MIER had the indirect effect on TI through enterprise size, enterprise profits, and executive environmental awareness. • The robustness test by SYS-GMM verified the above results. [ABSTRACT FROM AUTHOR]

• Drylands store 10.96Pg C and contribute about 12.3% of China's total carbon pool. • MAP explains more spatial variation of vegetation carbon density than MAT. • Soil salinity is mainly driver of SOC density in deserts. • MAT and plant productivity are mainly drivers of SOC density in grasslands. • Surface SOC stock in semi-arid region is the most sensitive to MAT across drylands. Earth's drylands store large amounts of organic carbon and thus play an important role in regulating atmospheric CO 2 concentrations and mitigating climate change. However, little is known about the magnitude and the drivers of organic carbon stocks because of limited data, in particular in desert ecosystems. To fill this gap, we surveyed 763 plots and collected 5091 soil samples from 170 sites covering grassland and desert ecosystems across the drylands of China. The results show that 10.96 Pg organic carbon is stored in these ecosystems (7.07 Pg in grasslands and 3.89 Pg in deserts). The effects of environmental variables on carbon density were found to be contingent on ecosystem type and soil depth. Mean annual precipitation had a strong positive effect on the spatial distributions of vegetation carbon density in both types of ecosystems. The spatial variations of surface (0–40 cm) and subsurface (40–100 cm) soil organic carbon (SOC) density in grasslands were mainly correlated with plant productivity and mean annual temperature (MAT), respectively, while in desert ecosystems, they were mainly correlated with soil salinity (electrical conductivity). The spatial sensitivities (linear regression slopes) of the surface SOC density versus MAT increased from dry subhumid to semi-arid regions and then gradually shifted to decrease from semi-arid to hyper-arid regions, indicating that the surface SOC stock is more sensitive to temperature in semi-arid regions. This study provides a comprehensive survey of ecosystem carbon stocks in China's drylands, fills a gap in our knowledge about carbon stocks in deserts, complements estimates of ecosystem carbon stocks throughout China, and provides insights into our understanding of the carbon cycle in drylands. [ABSTRACT FROM AUTHOR]

• Random forest models were employed to estimate plant species richness in drylands. • Plant richness increased from last interglacial and is projected to increase. • Different plant lifeforms exhibit varying sensitivities to climate change. • Herbaceous species respond more rapidly to climate change than woody species. It is commonly believed that climate plays an important role in shaping the patterns of plant species richness. However, it remains unclear how climate may affect plant richness across large spatial scales and also over long-terms, for example across massive arid regions during the Quaternary and into the future. To fill this knowledge gap, we examined the long-term trends in plant species richness across vast drylands in China based on our newly developed climate-species richness models. We first generated optimal random forest models based on the relationships between the current (CUR, 1970–2000) annual, perennial, woody and total species richness and climatic variables. We subsequently hindcasted and forecasted plant species richness in five other periods: last interglacial (LIG, 120,000–140,000 years BP), last glacial maximum (LGM, about 22,000 years BP), mid-Holocene (MH, about 6000 years BP), 2041–2060 (2050), and 2061–2080 (2070). Our results showed that total and herbaceous species richness exhibited similar patterns that were driven by temperature and precipitation. Both groups of species formed a transition zone between arid and semi-arid regions in all periods except LIG. In contrast, woody species richness did not form any transition zone because it was regulated mainly by temperature. Furthermore, the mean richness of herbaceous, woody and all species exhibited gradually increasing trends from LIG to 2070 across drylands in China. On the one hand, herbaceous species were much more sensitive to climate change than woody species. On the other hand, plant species richness in mountain-basin systems and Taklamakan Desert regions were more sensitive to climate change than in meadows and steppes. These results shed new insights into the past and future changes in plant species richness over vast drylands and provide valuable information for future conservation efforts under global warming. [ABSTRACT FROM AUTHOR]

The safety of underground drinking water has received widespread attention. However, few studies have focused on the occurrence and health risks of pollutants in underground drinking water of coking contaminated sites. In this study, the distribution characteristics, sources, and human health risks of benzene, toluene, xylene (BTX) and polycyclic aromatic hydrocarbons (PAHs) in underground drinking water from a typical coking contaminated site in Shanxi of China were investigated. The average concentrations of BTX and PAHs in coking plant (CP) were 5.1 and 4.8 times higher than those in residential area (RA), respectively. Toluene and Benzene were the main BTX, while Acenaphthene, Fluorene, and Pyrene were the main PAHs. Concentrations of BTX/PAHs were negatively correlated with altitude, revealing altitude might be an important geological factor influencing spatial distribution of BTX/PAHs. PMF model demonstrated that the BTX/PAHs pollution in RA mainly originated from coking industrial activities. Health risk assessments were conducted by a modified US EPA-based model, in which environmental concentrations were replaced by residual concentrations after boiling. Residual ratios of different BTX/PAHs were determined by boiling experiments to be 9.4-93.8 %. The average total carcinogenic risks after boiling were decreased from 2.6 × 10 -6 to 1.4 × 10 -6 for adults, and from 4.3 × 10 -6 to 2.1 × 10 -6 for children, suggesting boiling was an effective strategy to reduce the carcinogenic risks from BTX/PAHs, especially for ingestion pathway. Monte Carlo simulation results matched well with the calculated results, suggesting the uncertainty was acceptable and the risk assessment results were reliable. This study provided useful information for revealing the spatial distribution of BTX/PAHs in underground drinking water of coking contaminated sites, understanding their linkage with altitude, and also helped to more accurately evaluate the health risks by using the newly established boiling-modified models., Competing Interests: Declaration of competing interest Wanjun Wang reports financial support was provided by National Key Research and Development Program of China. Wanjun Wang reports financial support was provided by National Natural Science Foundation of China. Wanjun Wang reports financial support was provided by Guangdong Basic and Applied Basic Research Foundation. Wanjun Wang reports financial support was provided by Key Research and Development Program of Guangdong Province. Taicheng An reports financial support was provided by Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The coking industry can generate large amounts of polycyclic aromatic hydrocarbons (PAHs) and their derivatives, which may negatively impact the environment and human health. In this study, soils nearby a typical coking plant were sampled to assess the impact of coke production on the surrounding residential areas and human health. The mean concentration of PAHs and their derivatives in residential area soils nearby the coke plant was 4270 ng/g dw, which was 1 order of magnitude higher than that observed in areas far from the coke plant and approximately 4 times lower than that revealed the coke plant. In addition, the results showed that coking processing area was the most contaminant area of the coke plant (mean: 74.4 μg/g dw), where was also the main source of pollutants in residential areas. In terms of vertical soils in coking plant, the maximum levels of chemicals (mean: 205 μg/g dw) were presented at the leakage of underground pipelines, where were much higher than those in surface soils, and decreased with the increase of depth. The analysis of variance (ANOVA) results showed obvious differences in the concentrations of 6-nitrochrysene between the plant, residential areas and control areas. Meanwhile, 6-nitrochrysene had potential cancer risk (CR) for human in the coking site. Thus, 6-nitrochrysene was the most noteworthy PAH derivatives. Furthermore, the CR (mean: 5.94 × 10 -5 ) and toxic equivalent quantities (TEQs) (mean: 14.8 μg·TEQ/g) of PAHs and their derivatives was assessed in this study. This finding suggested that PAHs and their derivatives especially those extremely toxic chemicals (Nitro-PAHs (NPAHs) and Br/Cl-PAHs (XPAHs)) might pose a potential health risk to residents nearby the coke plant. The current study provides further insights into the pollution characteristics of PAHs and their derivatives in coke plants and potential risks to the workers and surrounding residents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Taking advantage of a 2005-2018 sample of 86 Chinese steel enterprises (CSEs) and the difference-in-differences method, this paper utilizes the carbon emissions trading scheme (ETS) - as a quasi-natural experiment to investigate the impact of the carbon ETS on the total factor pollution control efficiency (TFPCE) of CSEs to test the green development effect of the carbon ETS. Then, the green development effect of the carbon ETS is empirically tested by a variety of robustness tests, such as DDD and PSM-DID. The results show that the carbon ETS policy significantly improves the TFPCE of CSEs located in the pilot area, generating the green development effect, and that this the annual effect lags by one year. Additionally, the channel analysis from the perspective of enterprise internal management and the external environment shows that strategic innovation, substantive innovation and institutional quality play a positive role in enhancing pollution control performance respectively. The heterogeneity test shows that the green development effect is better for state-owned CSEs and CSEs located in the eastern and central China. The conclusion has significant implications for green and low-carbon development in heavy pollution industries and has implications for further promoting the implementation of market-oriented environmental regulations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

To analyze the change trend of life expectancy, the change trend of premature death due to 4 major chronic diseases, and its impact on the life expectancy of Wuhai residents from 2015 to 2020, and to provide evidence for the prevention and control of chronic diseases in this area. The data on population death comes from the Wuhai City Residents' Causes of Death Network Reporting System and the total population is calculated using statistics from Wuhai City's permanent population management, from 2015 to 2020. Premature mortality from the 4 main chronic illnesses was calculated using the abridged life table approach. The impact of premature death from chronic diseases on life expectancy was analyzed using the Arriaga method. The increasing trend of life expectancy of Wuhai citizens was not statistically significant from 2015 to 2020 (t = 2.570, P = .062). Each year, men had a lower life expectancy than women (P < .05). From 2015 to 2020, the downward trend of premature deaths caused by the 4 major non-communicable diseases in Wuhai City was statistically significant (EAPC = -7.74%, P = .041). Premature death from cancer and chronic respiratory disorders decreased, both of which were statistically significant (EAPC < 0, P < .05). The decline in premature mortality from cancer, cardiovascular and cerebrovascular disorders, and chronic respiratory system diseases has contributed to increased life expectancy. Diabetes's rise in premature mortality made a possible "negative contribution" to life expectancy (-0.036 years, -1.79%). From 2015 to 2020, the decreasing trend of the overall premature mortality caused by the 4 major non-communicable diseases in Wuhai was statistically significant, and the life expectancy of females was higher than that of males. We should concentrate on the prevention and control of major chronic illnesses in males, as well as the influence of changes in diabetes-related early mortality on life expectancy., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: The objective of this study was to evaluate the relationship between short-term fine particulate matter (PM 2.5 )/inhalable particulate matter (PM 10 ) exposure and lung cancer mortality., Method: From 2015 to 2019, data concerning air pollution, meteorology, and deaths were obtained in Wuhai, China. The association between PM 2.5 /PM 10 and lung cancer mortality was investigated using time series analysis., Result: According to the single-pollutant model, a 10 μg/m 3 increase in PM 2.5 /PM 10 was associated with an excess risk of 7.95% (95% CI, 2.22-13.95%), and 2.44% (95% CI, 0.32-4.62%), respectively ( P < 0.05). PM 2.5 /PM 10 had a stronger impact on men and the elderly (>65 years old). Particulate matter had a larger influence on lung cancer mortality during the warm season than the cold season. Furthermore, except for PM 2.5 and PM 10 , the two-pollution model indicated that the other models were statistically significant. The study's single and dual pollutant models were both relatively robust., Conclusion: Short-term exposure to PM 2.5 /PM 10 was correlated with a higher risk of lung cancer death in Wuhai, particularly among men and the elderly (>65 years old). Exposure to PM 2.5 /PM 10 really does have a bigger effect on the population during the warm season. Moreover, it is essential that health administration departments should strengthen their regulatory mechanisms for particulate emissions and take the responsibility for safeguarding the vulnerable populations., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes., Methods: We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment., Results: Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups., Conclusions: In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness., Trial Registration: ISRCTN, ISRCTN12233792 . Registered November 20th, 2017., (© 2022. The Author(s).)

Relationships between biodiversity and multiple ecosystem functions (that is, ecosystem multifunctionality) are context-dependent. Both plant and soil microbial diversity have been reported to regulate ecosystem multifunctionality, but how their relative importance varies along environmental gradients remains poorly understood. Here, we relate plant and microbial diversity to soil multifunctionality across 130 dryland sites along a 4,000 km aridity gradient in northern China. Our results show a strong positive association between plant species richness and soil multifunctionality in less arid regions, whereas microbial diversity, in particular of fungi, is positively associated with multifunctionality in more arid regions. This shift in the relationships between plant or microbial diversity and soil multifunctionality occur at an aridity level of ∼0.8, the boundary between semiarid and arid climates, which is predicted to advance geographically ∼28% by the end of the current century. Our study highlights that biodiversity loss of plants and soil microorganisms may have especially strong consequences under low and high aridity conditions, respectively, which calls for climate-specific biodiversity conservation strategies to mitigate the effects of aridification., (© 2021. The Author(s).)

Objective: The present study compared the effectiveness of asthma control test (ACT)-guided treatment vs. usual care (UC) in patients with asthma from China., Methods: This prospective, phase IV, multicenter, cluster-randomized, open-label 24-week study was conducted in China; patients were randomized to either ACT-guided treatment or UC group. The patients recorded peak expiratory flow, symptoms, and medication in a diary card every day and completed ACT at every clinic visit. For the UC group, patients completed ACT after the physician's treatment decision., Results: In total, 83.6% patients (n = 443/530; ACT: n = 209, UC: n = 234) completed the study. A significantly higher proportion of patients (adjusted OR [95% CI]: 7.87 (1.29, 48.11; p = 0.027) responded to the treatment and had ACT total score ≥20 or demonstrated an improvement of >3 points in ACT total score in ≥1 post-baseline assessment in the ACT-guided treatment vs. UC group. A higher proportion of patients had an ACT total score ≥20 and an improvement of >3 points in ACT total score at Week 24 in the ACT-guided treatment vs. the UC group (adjusted OR (95% CI):2.28 (1.07, 4.85; p = 0.036). A significant difference (p = 0.005) in change from baseline in ACT total score was observed in ACT-guided treatment vs. UC group at Week 24. The mean annual exacerbation rate was similar in both the groups., Conclusions: ACT-guided treatment was more effective in achieving ACT total score ≥20 or showing an improvement of >3 points in the ACT total score and well tolerated compared with UC treatment in the 24-week treatment period., Trial Registration: Clinical trials.gov Identifier: NCT02868281, https://clinicaltrials.gov/; GlaxoSmithKline study ID: 201097, https://www.gsk-studyregister.com/., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate factors associated with EN delivery., Methods: This cross-sectional study was launched in 118 intensive care units (ICUs) of 116 mainland hospitals and conducted on April 26, 2017. At 00:00 on April 26, all patients in these ICUs were included. Demographic and clinical variables of patients on April 25 were obtained. The dates of hospitalization, ICU admission and nutrition initiation were reviewed. The outcome status 28 days after the day of investigation was obtained., Results: A total of 1953 patients were included for analysis, including 1483 survivors and 312 nonsurvivors. The median study day was day 7 (IQR 2-19 days) after ICU entry. The proportions of subjects starting EN within 24, 48 and 72 h after ICU entry was 24.8% (84/352), 32.7% (150/459) and 40.0% (200/541), respectively. The proportion of subjects receiving > 80% estimated energy target within 24, 48, 72 h and 7 days after ICU entry was 10.5% (37/352), 10.9% (50/459), 11.8% (64/541) and 17.8% (162/910), respectively. Using acute gastrointestinal injury (AGI) 1 as the reference in a Cox model, patients with AGI 2-3 were associated with reduced likelihood of EN initiation (HR 0.46, 95% CI 0.353-0.599; p < 0.001). AGI 4 was significantly associated with lower hazard of EN administration (HR 0.056; 95% CI 0.008-0.398; p = 0.004). In a linear regression model, greater Sequential Organ Failure Assessment scores (coefficient - 0.002, 95% CI - 0.008 to - 0.001; p = 0.024) and male gender (coefficient - 0.144, 95% CI - 0.203 to - 0.085; p < 0.001) were found to be associated with lower EN proportion. As compared with AGI 1, AGI 2-3 was associated with lower EN proportion (coefficient - 0.206, 95% CI - 0.273 to - 0.139; p < 0.001)., Conclusions: The study showed that EN delivery was suboptimal in Chinese ICUs. More attention should be paid to EN use in the early days after ICU admission.

Background: Familial hypercholesterolemia (FH), characterized by elevated plasma low-density lipoprotein-cholesterol (LDL-C) levels and premature coronary artery disease (CAD), remains mostly underdiagnosed and undertreated. We investigated the prevalence of clinical FH among Chinese patients with premature ST-segment-elevation myocardial infarction (STEMI) and one-year follow-up on their lipid management and cardiovascular events., Methods: Four hundred and ninety-eight premature STEMI patients (363men) were enrolled. FH patients were identified using the Dutch Lipid Clinic Network Criteria. Lipid management and cardiovascular events in all patients were assessed., Results: Nineteen patients (3.8%) were diagnosed as definite/probable FH, 211 (42.4%) as possible FH and 268 (53.8%) as unlikely FH. All patients were divided into two main groups: unlikely FH (0-2 points) and possible FH (≥3 points). Possible FH patients were younger (50.1 years vs. 53.5 years) with higher NT-proBNP level (3014.15 pg/mL vs. 2326.25 pg/mL), occurrence of multi-vessel CAD (37.4% vs. 18.3%), lower LVEF (47% vs. 49%) and more severe Killip classification (Class 3, 20.0% vs. 9.7%). Follow-up data were available for 203 patients from the possible FH group and 243 patients from the unlikely FH group. High intensity statin intake status (%) of possible FH vs. unlikely FH was as follows: 1) on admission: 4.8% vs. 0.4%; 2) at discharge: 10.4% vs. 1.6% and 3) at one year follow-up: 5.4% vs. 0.8%. A significantly low percentage of possible FH patients (18.7% vs. 51.4%) achieved target LDL-C levels. There were no significant differences in MACE defined as a composite of cardiogenic shock or Class IV heart failure, recurrent MI, cardiovascular-related rehospitalization, TLR and CV death between the two groups. However, the proportion of cardiogenic shock or Class IV heart failure was significantly higher in possible FH patients group (5.9% vs.1.2%)., Conclusion: Clinical diagnosis of possible FH is common in Chinese patients with premature STEMI. A low proportion of FH patients were prescribed high intensity statins. Despite aggressive cholesterol-lowering drugs, a significantly lower proportion of FH patients achieved LDL-C targets compared to unlikely FH patients. Possible FH patients were younger with a significantly higher occurrence of multi-vessel CAD and impaired cardiac function.

Background: Our study aims to explore the association of rs7025486 single-nucleotide polymorphisms (SNP) in DAB2IP and rs1333049 on chromosome 9p21.3 with the coronary artery disease in Chinese population., Methods: All patients came from the east China area and underwent coronary angiography. Rs7025486 and rs1333049 polymorphism were genotyped in 555 patients with CAD and in 480 healthy controls that underwent coronary angiography., Results: In Chinese population, the rs7025486 genotype in the case group was no significant different than the control group (P = 0.531).Meanwhile, the rs1333049 SNP has statistically significant (P = 0.006), which was the independent risk factors for CAD (OR1.252, P = 0.039), and consistent with the past studies conclusion., Conclusion: Genotype of rs1333049 on chromosome 9p21, but not rs7025486 on chromosome 9q33, is an independent determinant of the incidence of CAD in Chinese population.

Objective: To profile the differential expression of plasma miRNAs in gestational diabetes mellitus (GDM)., Methods: In a pilot study conducted at a tertiary hospital in China between 2010 and 2014, peripheral blood samples were collected from women at 16-19weeks of pregnancy. Pooled samples from 10 women who were subsequently diagnosed with GDM and from 10 healthy controls were used to construct two small RNA libraries. High-throughput sequencing was performed, and differentially expressed miRNAs were validated by quantitative real-time polymerase chain reaction (qRT-PCR), followed by target prediction, Gene Ontology analysis, and pathway identification., Results: Sequencing revealed 32 miRNAs that were differentially expressed in GDM, including 12 miRNAs that were upregulated and 20 that were downregulated. Differential expression of five upregulated miRNAs (hsa-miR-16-5p, hsa-miR-17-5p, hsa-miR-19a-3p, hsa-miR-19b-3p, hsa-miR-20a-5p) was confirmed by qRT-PCR. Target prediction showed that the major targets of these miRNAs were associated with insulin resistance and abnormal pregnancies., Conclusion: The five miRNAs that were differentially expressed in GDM could serve as noninvasive biomarkers. The results also provide insights into the molecular mechanisms that underlie GDM, thereby contributing to the diagnosis and treatment of this disease., (Copyright © 2015. Published by Elsevier Ireland Ltd.)

The small non-coding important regulatory molecules, microRNAs (miRNAs), have been widely and deeply studied especially combining high-throughput sequencing technologies. Here, we attempted to track detailed miRNA precursor metabolic products and gain further insight into pre-miRNA processing by completely analyzing high-throughput sequencing data. Highly expressed miRNA precursors could be entirely covered by various short RNAs and small RNA fragments with a hierarchical distribution. miRNAs and some miRNA* regions were detected quite abundant short RNAs as expected, while other regions of precursors were found shorter RNAs or small fragments with fewer sequence counts. Furthermore, we developed a method to analyze relative expression levels of special RNA classes according to divergence of 5' and 3' ends, respectively. Generally, there were several quite abundant RNA classes from a given miRNA locus, which suggested dominant cleavage sites of Drosha and Dicer during pre-miRNA processing. Compared with 3' end, dominant cleavage site in 5' end always focused on a specific position, which ensured conservation of the identity of miRNA (5'-seed sequence, nucleotides 2-8). Overall, a comprehensive analysis of sequencing data can be used to track pre-miRNA metabolic products and mechanism of pre-miRNA processing and metabolism.