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International students are a significant resource for many host countries because they increase cultural diversity within the community, offer talent and innovation to universities, and make notable economic contributions. Many studies, however, have shown that international students have lower psychological well-being. Thus, this study aimed to evaluate the associations between psychological well-being as a dependent variable and perceived social support as an independent variable, and test the mediating roles of resiliency and spirituality in the link between perceived social support and psychological well-being. This is a cross-sectional study with a random sampling method. A total of 300 Chinese international students in Universiti Putra Malaysia (UPM) participated in this study and completed four questionnaires, namely the Perceived Social Support scale, Psychological Well-being scale, the Spiritual Values scale, and Connor-Davidson Resilience scale. The results from PLS-SEM showed that greater levels of social support are associated with greater levels of psychological well-being. Resiliency and spirituality partially mediated the relationship between social support and psychological well-being. The findings of this study not only revealed an association between perceived social support and psychological well-being among Chinese international students in Malaysia but also expanded our knowledge of the mediating roles of resilience and spirituality in the relationship.

Local language tests are an arena where national language standards can be operationalized to create a hub for integrating assessment results and language support. Few studies, however, have examined the operationalization of national standards in local language assessment contexts. In this study, we proposed a model to present the integration of national standards in local contexts to guide assessment, teaching, and learning. Using this model, we conducted a 5-month longitudinal study involving 689 college students to examine (1) the consistency between their internal and external assessment feedback (i.e., standards-based self-assessment ratings and standards-based individualized English as a Foreign Language [EFL] listening test feedback) and (2) the effectiveness of standards-based teaching intervention in enhancing their perceived and actual language development. The results showed that the test feedback generally aligned well with students' self-assessment and perceptions at the overall listening skill and subskill levels, yet student perceptions outlined needs for feedback refinements. In addition, the use of the standards-based individualized feedback, in conjunction with language support courses and practice materials, facilitated students' perceived and actual listening achievement. This study makes an important contribution to local language testing by demonstrating the potential of a local instrument to provide a bridge between local instructional goals and national standards.

Purpose: This study aimed to examine the mechanisms influencing metacognitive awareness among nursing students, encompassing educational environment, learning motivation, emotional intelligence, and self-directed learning ability. These findings could be a theoretical reference for formulating metacognitive awareness intervention strategies specifically designed for nursing students. Method: Through stratified sampling, 600 nursing students were recruited from two universities in China. Data collection involved five self-report instruments: the Metacognitive Awareness Inventory, Medical Education Environment Evaluation Scale, Learning Motivation Scale, Emotional Intelligence Scale, and Self-Directed Learning Ability Scale. Confirmatory factor analysis was utilized to test the measurement model, while structural equation modeling utilized multiple indices to assess model fit. Bootstrapping was conducted to analyze total, direct, and indirect effects. Results: All study variables differed significantly according to age and year level (p < 0.01). Metacognitive awareness positively correlated with the educational environment, learning motivation, emotional intelligence, and self-directed learning ability (r = 0.493–0.729; all p < 0.01). The test of the measurement model shows good reliability and validity. The model depicting factors influencing metacognitive awareness demonstrated a good fit (χ2/df = 2.42, SRMR = 0.048, RMSEA = 0.049, CFI = 0.947, IFI = 0.935). Path analyses revealed that educational environment (EE), learning motivation (LM), and emotional intelligence (EI) directly impacted self-directed learning ability (SDLA) (βEE = 0.189, βLM = 0.436; βEI = 0.215; all p < 0.05). Moreover, educational environment and self-directed learning ability directly influenced metacognitive awareness (βEE = 0.224, βSDLA = 0.520; all p < 0.05). Lastly, the educational environment, learning motivation, and emotional intelligence influenced metacognitive awareness by self-directed learning ability. Conclusion: Metacognitive awareness in nursing students rises with age and year level. Females exhibit more potent self-directed learning abilities than males. Educational environment, motivation, and emotional intelligence indirectly influence metacognitive awareness via self-directed learning ability. This finding has enriched the ways and perspectives of metacognitive awareness training for nursing students. Highlights: This study profoundly explores the characteristics and interconnections between metacognitive awareness, self-directed learning ability, educational environment, emotional intelligence, and learning motivation in undergraduate nursing students in China. By examining the role of self-directed learning ability as a mediator, the research offers theoretical and practical insights that could guide the design of intervention strategies to enhance metacognitive awareness in nursing education. [ABSTRACT FROM AUTHOR]

Background: There is currently no dedicated measurement for assessing nursing students' study interest in China. Considering the good reliability, validity, and widespread applicability of the Study Interest Questionnaire-Short Form (SIQ-SF), the objective of this study was to validate its usage among Chinese nursing students. Methods: The translation and cross-cultural adaptation rigorously followed the modified Brislin model. A cross-sectional survey was conducted using the Chinese version of the SIQ-SF and convenience sampling was employed to select nursing students. The Psychometric evaluation of the Chinese version of the SIQ-SF was conducted based on Classical Test Theory and Item Response Theory. Results: A total of 1158 participants were included in the analysis. The item-level content validity index (CVI) ranged from 0.9 to 1.0, and the scale-level CVI was 0.98. In the Exploratory factor analysis, three factors with eigenvalues above 1 were identified, accounting for 62.554% of the cumulative variance. In the confirmatory factor analysis, the CMIN\DF was 5.639, the GFI was 0.953, the CFI was 0.902, and the IFI was 0.904. The Cronbach's α coefficient of the Chinese version of the SIQ-SF was 0.70. Thirty-one participants were invited to sign the scale after two weeks. The intraclass correlation coefficient was 0.784, and that of items ranged from 0.70 to 0.819. The infit MnSQ values ranged between 0.76 and 1.51, and the outfit MnSQ values ranged between 0.72 and 1.76. The point-measure correlation value ranged between 0.30 and 0.68. The item difficulty measures ranged from − 0.66 to 1.44 logit and the individual learning interest estimations ranged from − 4.22 to 4.97 logit. DIF contrast ranged from 0.00 to 0.33 logits, with all p values greater than 0.05. Conclusions: The Chinese version of the SIQ-SF demonstrated acceptable reliability and validity among Chinese nursing students and could be used to assess nursing students' study interest in China. With the aid of this scale, teachers can gain a better understanding of nursing students' study interests, thereby maximizing their learning effects through appropriate content and methods. [ABSTRACT FROM AUTHOR]

Objective: To analyze the degree, evolution and causes of socioeconomic inequality in perceived access to health services among the older adults in China. Methods: The data used in this study were drawn from the 4 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2008, 2011, 2014, 2018. Erreygers index (EI) was used to measure socioeconomic inequality in perceived access to health services in each survey wave. A panel logit regression model was used to examine the impact of socioeconomic status on perceived access to health services. The recentered influence function (RIF) regression decomposition method was used to explore the causes of socioeconomic inequality in perceived access to health services. Inverse probability weighting (IPW) was employed to adjust estimates for missing responses and loss to follow-up. Results: "Pro-rich" socioeconomic inequality in perceived access to health services in China was found with inequality falling through time. The older adults with higher incomes, who had adequate financial support, and those who were wealthier compared with other residents reported lower socioeconomic inequality in perceived access to health services. Having basic health insurance and access to care resources when ill can help alleviate such inequalities. Conclusions: Socioeconomic inequality in perceived access to health services was shown to be responsive to policies that enhance health insurance coverage and support the provision of (paid and unpaid) caregiving for the older adults. [ABSTRACT FROM AUTHOR]

Against the backdrop of China's socio-economic transition, there is a growing imperative to examine neighborhood renovation initiatives in addressing the emerging needs of residents. Developing Granovetter's classic work on embeddedness, this paper proposes a conceptual framework of spatial embeddedness to understand changes in the physical space brought about by neighborhood renovation, in order to explore how it affects residents' satisfaction in a dynamic temporal and spatial process. It presents whether and why residents' real feelings produced from their interaction with neighborhood renovation are (un)different, and how their feelings are shaped based on six months of fieldwork in a danwei neighborhood in Xi'an, China. The paper conceptualizes the relationship between the neighborhood space and embeddedness by adopting spatial embeddedness to capture the interplay of temporal, spatial, and social factors in the process of danwei neighborhood renovation. This framework not only integrates multiple perspectives and scales, but also reflects different levels of residents' satisfaction, trying to establish a connection between the abstract space and the renovation space. It suggests that spatial embeddedness should be considered as a response to the negative social impacts resulting from changes in the physical space in neighborhood renovation. [ABSTRACT FROM AUTHOR]

Background: It is imperative to use a validated tool to measure and understand health behavior as it greatly impacts health status. It has been demonstrated that the Health Behavior Inventory - Short Form (HBI-SF) is valid in several countries. The purpose of this study was to translate the HBI-SF into Chinese and test its psychometric properties. Methods: This study employed a two-phase methodology. The phase one entailed the cross-cultural adaptation of the HBI-SF, while the subsequent phase evaluated the psychometric properties of the scale. This evaluation encompassed classical test theory (CTT) and item response theory (IRT) tests to assess reliability and validity. It involved 1058 participants, of whom 1036 completed the questionnaire successfully. Out of these, 518 were analyzed for CTT, along with 518 for IRT. Results: The S-CVI was found to be 0.935, while the I‐CVI ranged from 0.889 to 1.000. The results of the confirmatory factor analysis suggested the goodness-of-fit indices for the four-factor model was acceptable. Regarding the subscales, the average variance extracted (AVE) and Heterotrait-Monotrait Ratio of Correlations (HTMT) matrix also met the cutoff values (AVE > 0.5 and HTMI < 0.85). Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7. Infit and/or outfit values indicated that all items fitted the Rasch model. The Wright map revealed that the average person measures for the participants (mean = − 0.994, SD = 0.430) were comparatively lower than the average item measures (mean = 0.000, SD = 0.257). The person separation reliability values for the four factors ranged from 0.600 to 0.746, indicating an acceptable level of reliability. Two items showed differential item functioning. Conclusions: The findings derived from both CTT and IRT analyses demonstrate favorable levels of reliability and validity for the Chinese version of the HBI-SF. [ABSTRACT FROM AUTHOR]

This study explores aerosol direct, indirect, and feedback effects on meteorology and fine particulate matter during heat waves of August 2022 over eastern China by using an online coupled regional climate–chemistry–aerosol model. In this period, aerosols exerted mean direct (DRE) and indirect (IRE) radiative effects of −3.9 Wm−2 and −2.4 Wm−2 at TOA, which totally caused a decrease in average surface air temperature by 0.3 °C over east China, accompanied by decreases in PBLH (planetary boundary layer height) and precipitation and an increase in PM2.5 concentration. With the anthropogenic emission reduction from 2013 to 2022, DRE apparently decreased while IRE changed little, leading to a decrease in total aerosol radiative effect (TRE) by 27% at TOA. The weakened TRE resulted in increases in surface air temperature and precipitation by 0.14 °C and 2.7 mm, respectively, on average over east China, with the maximum warming exceeding 0.5 °C in BTH (Beijing–Tianjin–Hebei province). This study highlights a warming trend due to weakened TRE, which may exacerbate heat wave, and an increasing importance of aerosol IRE relative to DRE due to weak sensitivity of cloud properties to aerosol change during the emission reduction. [ABSTRACT FROM AUTHOR]

Background: Decision fatigue is a new concept in the field of psychology and refers to a state of fatigue alongside impaired cognitive processing and emotional regulation ability. Previous studies have confirmed that nurses are prone to decision fatigue, and nurses who experience decision fatigue may implement nursing measures that are inconsistent with clinical evidence, thus affecting patients' benefits. COVID-19, as a large-scale global public health emergency, increased the workload and burden of nurses and aggravated decision fatigue. However, the factors leading to decision fatigue among nurses have not yet been identified. Methods: This study is guided by interpretative phenomenology. During the epidemic period of COVID-19: From November 2022 to February 2023, a one-to-one, semi-structured in-depth interview was conducted among nurses with decision fatigue experience who were participating in front-line work in Jilin Province using homogenous sampling. The interview recordings and related data were transcribed into text within 24 h, and data analysis was assisted by NVivo 12.0 software. Results: After a total of 14 front-line nurses were analyzed in this study, The thematic level reaches saturation, the findings present a persuasive and coherent narrative, and the study is terminated, and finally extracted and formed three core themes: "Cognition, influence and attitude of decision fatigue", "Approaching factors of decision fatigue" and "Avoidant factors of decision fatigue". Conclusion: This study confirmed that decision fatigue was widespread in the work of front-line nurses, affecting the physical and psychological health of nurses, the quality of nursing work, the degree of benefit of patients and the clinical outcome. However, nursing staff do not know enough about decision fatigue, so the popularization and research of decision fatigue should be strengthened. Improve the attention of medical institutions, nursing managers and nursing staff.Some suggestions are put forward for the intervention of decision fatigue through personnel, task, tool and technology, organization and environment. [ABSTRACT FROM AUTHOR]

The scientific question of precisely determining the northern boundary of the Qinling Orogenic Belt (QOB) with regard to the southern segment of the North China Craton (S-NCC) has been controversial and unresolved, as it is heavily covered by loess and lacks some geological evidence. In order to identify the concrete northern boundary of the QOB, this paper first reports the metabasalt discovered in the Qianhe River Basin in Northwestern China, on the foundation of petrography, mineralogy, geochronology and geochemistry analyses. Detailed regional geological survey presents that the Qianhe metabasalt (QMB) is in unconformable contact with the Mesoproterozoic Gaoshanhe Group. Moreover, there is the new laser ablation (LA) inductively coupled plasma mass spectrometry (ICP-MS) U-Pb dating for magmatic zircons that yielded a weighted mean age of 450 ± 9 Ma, revealing that the QMB occurred in the Late Ordovician rather than that in the Mesoproterozoic period as previously considered. Both major and trace elements show that the samples are characterized by the back-arc basin (BAB) basalt affinity. In addition, combined with the regional geology analysis, it stands to reason that the QMB is very similar to those of Ordovician Caotangou Group along the northern QOB (N-QOB). Accordingly, it is illuminated that the QMB belonging to the N-QOB, is more likely originated from the back-arc basin setting, and truly defines the QOB's northern boundary in this segment, which has prominent geoscientific significance for determining the tectonic boundary in the heavily loess-covered regions. [ABSTRACT FROM AUTHOR]

The reference evapotranspiration (ETo) is essential for water-consuming in agriculture and land-water cycle research. The synoptic data from meteorological stations can provide reliable ground data for ETo estimation with the FAO-56 Penman-Monteith equation. However, the five primary variables this equation needs, including maximum temperature (Tmax), minimum temperature (Tmin), sunshine duration (SSD), wind speed (Wind), and relative humidity (RH), often experience severe data loss due to force majeure events in synoptic data. The data loss would directly introduce severe data gaps to the complex records for ETo. Machine learning algorithms can fill various data gaps with low error rates, however, to achieve high data quality, the algorithms must be selected properly to deal with the distinct types of data loss and train independently. Here, based on the data characters, we investigated and classified data gaps from the synoptic dataset into 2 major types: the common, minor data loss gaps including Tmax loss/Tmin loss/SSD loss/Wind loss/RH loss/Wind and SSD loss/Wind and RH loss, and the other 19 types of data loss which is more severe in information loss but barely occurred. Our results show that the XGBoost model achieved the best accuracy in all 3 machine learning models with high statistic levels. For the other 19 types of data gaps, the LSTM models were trained separately for each site and achieved average R², RMSE, and nRMSE at 0.9, 0.5 mm d-1, and 38 % for the total 2419 stations. Thus, we propose a high-quality, gap-filled daily ETo dataset during 1951–2021 for China with the proportion of large errors (the data with daily ETo errors more than 1.5 mm d-1) below 0.2 %. Our results also reveal that the entanglement degree between synoptic variables varies a lot from region to region in China. Although most research indicates that wind speed is not very important for ETo estimation with machine learning models, our findings reveal that wind speed played a more significant role in ETo estimation in most areas of China during the years before the 21st century. Still, the impact of wind speed on ETo has also been alleviated in recent years. This ETo dataset for China is available online at https://doi.org/10.5281/zenodo.11496932 (Zhou et al., 2024). [ABSTRACT FROM AUTHOR]

Background: Bismuth-containing quadruple therapy is the first-line treatment for eradicating Helicobacter pylori (H. pylori). The optimal duration for H. pylori eradication using bismuth-containing quadruple therapy remains controversial. Therefore, we aimed to compare the clinical effects of the 10- and 14-day bismuth-containing quadruple treatment regimen to eradicate H. pylori. Methods: Treatment-naïve patients with H. pylori infection (n = 1300) were enrolled in this multicenter randomized controlled study across five hospitals in China. They were randomized into 10- or 14-day treatment groups to receive bismuth-containing quadruple therapy as follows: vonoprazan 20 mg twice daily; bismuth 220 mg twice daily; amoxicillin 1000 mg twice daily; and either clarithromycin 500 mg twice daily or tetracycline 500 mg four times daily. At least 6 weeks after treatment, we performed a 13C-urea breath test to evaluate H. pylori eradication. Results: The per-protocol eradication rates were 93.22% (564/605) and 93.74% (569/607) (p < 0.001) and the intention-to-treat eradication rates were 88.62% (576/650) and 89.38% (581/650) (p = 0.007) for the 10- and 14-day regimens, respectively. Incidence of adverse effects was lower in patients who received 10- vs. 14 days of treatment (22.59% vs. 28.50%, p = 0.016). We observed no significant differences in the compliance to treatment or the discontinuation of therapy because of severe adverse effects between the groups. Conclusion: Compared with the 14-day bismuth-containing quadruple regimens, the 10-day regimen demonstrated a non-inferior efficacy and lower incidence of adverse effects. Therefore, the 10-day regimen is safe and tolerated and could be recommended for H. pylori eradication (NCT05049902). [ABSTRACT FROM AUTHOR]

Background: Haemochromatosis is a genetic disease characterized by the excessive deposition of iron in various tissues and organs, eventually results in organ damage including cirrhosis, diabetes, cardiomyopathy, etc. SLC40A1-related haemochromatosis is associated with gain-of-function mutations in the SLC40A1 gene, which encodes ferroportin. While sporadic reports of this condition exist in mainland China, the understanding of the phenotype and genetic pattern associated with the SLC40A1 p.Y333H mutation remains incomplete. Case presentation: We report a pedigree with heterozygous p.Y333H mutation in Chinese Han population. The proband is a 64-year-old man complaining of persistent abnormality of liver enzyme levels for 1 year, with a history of knee joint pain, diabetes and skin pigmentation. He displayed markedly elevated serum ferritin level and transferrin saturation. Magnetic resonance imaging showed iron deposition in the liver, spleen, and pancreas, along with cirrhosis and splenomegaly. Whole exome sequencing identified a heterozygous allelic variant c.997T > C (p.Y333H). Genetic screening of family members identified four first-degree relatives and three second-degree relatives having the same mutation. Additional cases with this mutation from two published studies were included. Among the probands and screened relatives, all eight males aged over 30 y had ferritin level > 1000 µg/L, transferrin saturation > 90%. Four patients with organ damage in the present study received therapeutic phlebotomy, alleviating clinical symptoms and improving in transferrin saturation and serum ferritin. Conclusions: This study reports the largest pedigree with heterozygous SLC40A1 p.Y333H mutation in the Chinese population to date. In Chinese families, males over 30 years old with hemochromatosis due to SLC40A1 p.Y333H mutation exhibit severe iron overload phenotypes. [ABSTRACT FROM AUTHOR]

The geographical variation and domestication of tree species are an important part of the theory of forest introduction, and the tracing of the germplasm is the theoretical basis for the establishment of high‐quality plantations. Chinese pine (Pinus tabuliformis Carr.) is an important native timber tree species widely distributed in northern China, but it is unclear exactly where germplasm of the main Chinese pine plantation populations originated. Here, using two mtDNA markers, we analyzed 796 individuals representing 35 populations (matR marker), and 873 individuals representing 38 populations (nad5‐1 marker) of the major natural and artificial populations in northern China, respectively (Shanxi, Hebei and Liaoning provinces). The results confirmed that the core position of natural SX* populations ("*" means natural population) in the Chinese pine populations of northern China, the genetic diversity of HB and LN plantations was higher than that of natural SX* populations, and there was a large difference in genetic background within the groups of SX* and LN, HB showed the opposite. More importantly, we completed the "point by point" tracing of the HB and LN plantings. The results indicated that almost all HB populations originated from SX* (GDS*, ZTS*, GCS*, and THS*), which resulted in homogeneity of the genetic background of HB populations. Most of germplasm of the LN plantations originated from LN* (ZJS* and WF*), and the other part originated from GDS* (SX*), resulting in the large differences in the genetic background within the LN group. Our results provided a reliable theoretical basis for the scientific allocation, management, and utilization of Chinese pine populations in northern China, and for promoting the high‐quality establishment of Chinese pine plantations. [ABSTRACT FROM AUTHOR]

Background: The global prevalence of hepatitis B virus (HBV) has presented a persistent challenge for public health prevention and treatment. However, studies that assess the public's access to anti-HBV drugs are absent. Aim: To examine the availability, pricing, and affordability of anti-HBV drugs in Jiangsu province, China and provide recommendations for improvement. Method: An enhanced methodology developed by the World Health Organization (WHO) and Health Action International was applied in a cross-sectional study that included 1026 healthcare facilities distributed in 13 prefectural-level cities in Jiangsu province. Results: Since almost all drugs had an availability of less than 30%, the accessibility of anti-HBV drugs was notably low. Primary healthcare facilities had the lowest availability, reporting 1.4% for Original Brands (OBs) and 1.7% for lowest-priced generics (LPGs). Furthermore, the northern Jiangsu region recorded the lowest availability at 0.7%. LPGs demonstrated higher availability than OBs, with median availability probabilities of 2.6% and 1.4%, respectively. The drugs listed on the WHO Essential Medicines List exhibited higher availability than those on other lists. The median price ratios for OBs, LPGs, and volume-based purchasing drugs were 0.83, 0.50, and 0.27, respectively, less than 1.5 times the international reference price. Despite favorable pricing, affordability rate was 23% for urban residents and 0% for rural residents, which was discouraging. Conclusion: Low availability and affordability of anti-HBV drugs were observed. Policy recommendations should emphasize the improvement of LPG availability by incentivizing priority prescribing. Healthcare subsidies should be provided more effectively and equitably. [ABSTRACT FROM AUTHOR]

Objectives Household consumption significantly affects the quality of life and successful aging of older adults. However, prior research has often overlooked the connection between household consumption and long-term care insurance (LTCI). This study aims to investigate the influence of LTCI on consumption patterns within older Chinese households. Methods We used harmonized data from the China Health and Retirement Longitudinal Study and merged it with data from cities that implemented LTCI in China. We analyzed a total of 6,494 households consisting of individuals who were 60 years of age or older. To ensure accurate and stable research findings, we employed a series of difference-in-differences models. Results We found that LTCI has a significant impact on consumption levels, including total and per capita consumption within older households. Furthermore, our research demonstrates that LTCI significantly enhances enjoyable consumption across the consumption types. Through a heterogeneous analysis, it is shown that LTCI has a unique effect on both the total and enjoyable consumption of urban older households and also promotes comprehensive consumption improvements in older rural and disabled households. Discussion These findings highlight the crucial role of LTCI in improving the financial security and well-being of older households. They also have considerable policy implications for dealing with the challenges of an aging population. [ABSTRACT FROM AUTHOR]

Peer instruction has been used extensively in lecture courses; however, there is little evidence of its use in laboratory courses. The purpose of the present study was to describe the implementation of the peer instruction method in a physiology laboratory course in China. Second-year medical students attended a 6-wk physiology laboratory course in the fall semester of the 2016-2017 school year. In the six new physiology laboratory classes, peer instruction strategies were used to substitute for the traditional short, didactic lectures. The effects of peer instruction were measured by in-class quizzes and confidence levels. The students' evaluations of peer instruction were measured by a Likert scale questionnaire. Peer instruction significantly improved the mean score on quizzes (0.53 [plus or minus] 0.50 vs. 0.68 [plus or minus] 0.47, P [less than] 0.001) and confidence levels (2.36 [plus or minus] 0.66 vs. 2.80 [plus or minus] 0.45, P [less than] 0.001). Furthermore, for individual incorrect answers, 39.07% changed to correct answers after peer instruction, whereas, for correct answers, 6.61% were changed to an incorrect response. Overall, significantly more students changed their answers from incorrect to correct than from correct to incorrect [X[superscript 2] : 333.11; degrees of freedom (df): 1; P [less than] 0.001]. Therefore, the positive effects of peer instruction were higher than the negative effects (X[superscript 2] : 244.55; df: 1; P [less than] 0.001). Moreover, student evaluations of peer instruction were highly positive. In conclusion, the implementation of peer instruction to the physiology laboratory course is an effective strategy to enhance students' performance on in-class quizzes and confidence levels. In addition, the attitude of students toward peer instruction was favorable.

Background: Depression is a common chronic debilitating disease with a heavy social burden. single nucleotide polymorphisms (SNPs) can affect the function of microRNAs (miRNAs), which is in turn associated with neurological diseases. However, the association between SNPs located in the promoter region of miR-17-92 and the risk of depression remains unclear. Therefore, we investigated the association between rs982873, rs9588884 and rs1813389 polymorphisms in the promoter region of miR-17-92 and the incidence of depression in a Chinese population. Methods: we used GWAS (Genome-wide association study) and NCBI (National Center for Biotechnology Information) to screen three SNPs in the miR-17-92 cluster binding sites. A case-control study (including 555 cases and 541 controls) was conducted to investigate the relationship between the SNPs and risk of depression in different regions of China. The gene sequencing ii was used to genotype the collected blood samples. Results: the following genotypes were significantly associated with a reduced risk of depression: rs982873 TC (TC vs. TT: OR = 0.72, 95% CI, 0.54–0.96, P = 0.024; TC/CC vs. TT: OR = 0.74, 95% Cl, 0.56–0.96, P = 0.025); CG genotype of rs9588884 (CG vs. CC: OR = 0.74, 95% CI, 0.55–0.98, P = 0.033; CG/GG vs. CC: OR = 0.75, 95% Cl, 0.57–0.98, P = 0.036); and AG genotype of rs1813389 (AG vs. AA: OR = 0.75, 95% CI, 0.57-1.00, P = 0.049; AG/GG vs. AA: OR = 0.76, 95% Cl, 0.59-1.00, P = 0.047). Stratified analysis showed that there was no significant correlation between the three SNPS and variables such as family history of suicidal tendency (P > 0.05). Conclusions: our findings suggest that rs982873, rs9588884, and rs1813389 polymorphisms may be associated with protective factors for depression. [ABSTRACT FROM AUTHOR]

The clinical benefits of statins have well‐established and recognized worldwide. Although statins are well‐tolerated generally, however, the report of statin‐related adverse event and statin intolerance are common in China, which results in insufficient use of statins and poor adherence. The main reason may be attributed to confusions or misconceptions in the clinical diagnosis and management in China, including the lack of unified definitions and diagnostic standards, broad grasp of diagnosis, and unscientific management strategies. Based on that, this consensus carefully summarized the statin‐related gene polymorphism and statin usage issue among Chinese population, and comprehensively reviewed global research data on statin intolerance, referenced guidelines, and consensus literature on statin intolerance in foreign and different regions, proposes an appropriate and easy to implement statin intolerance definition as well as corresponding diagnostic criteria and management strategies for Chinese clinicians, in order to improve the clinical application of statin drugs and enhance the prevention and treatment level of atherosclerotic cardiovascular disease in China. [ABSTRACT FROM AUTHOR]

Purpose: This investigation aimed to understand the epidemiological characteristics and hospitalization burden and its possible influencing factors of patients with different injury mechanisms. Methods: All trauma patients admitted via the emergency department at a trauma center from November 1, 2020, to April 30, 2022, were identified. The hospitalization burden, including the number of hospitalizations, deaths and in-hospital mortality, length of stay (LOS), and medical costs, was calculated. Univariate and multivariate logistic regression models were used to analyze the factors influencing the hospitalization burden of trauma. The receiver-operating characteristic (ROC) curves were drawn to evaluate the predictive value of the multivariate model. Results: 16 485 trauma patients with 16 552 hospitalizations were included, with an in-hospital mortality rate of 1.269‰, median LOS of 7 days, and median hospitalization costs of 54 725.28 CNY. The median age was 52 years. 62.54% were hospitalized due to falls. The upper and lower extremities were the most common injury regions. There are differences between the demographic, injury, and hospitalization characteristics and factors influencing hospitalization burden across injury mechanisms, but there were also common influencing factors. Injury region, surgery, transfusion, and ICU treatment are influential factors for prolonged LOS. Age, injury region, surgery, and transfusion were influential factors for high hospitalization costs. Conclusions: This study provided primary evidence on the hospitalization burden of trauma. Considering demographics, injury and hospitalization characteristics as additional discriminators could further intervene in LOS and medical costs. Targeted efforts to use more early prevention measures could potentially lower future hospitalization burden. [ABSTRACT FROM AUTHOR]

Carassius auratus gibelio, commonly known as crucian carp, is the main species of freshwater aquaculture in China. Due to high-density aquaculture and environmental pollution, various diseases continue to emerge, especially the diseases caused by pathogenic bacteria have seriously restricted the development of freshwater aquaculture. Among these, Aeromonas hydrophila (AH) is the one of the most serious fish disease causing economic losses among fish farmers. An in-depth understanding of the crucian carp's immune system and its genes involved in the response to bacterial infection is necessary for disease control. In this study, the breeding period was divided into the control group (C group) and the Bacillus licheniformis (B. licheniformis) group (BL group). After 4 weeks of culture, the crucian carp was infected with AH and divided into the control group (Cg group) and the B. licheniformis group (BLg group). After the 72-h challenge, the Illumina-based paired-end sequencing approach to analyze the transcriptome profile of the crucian carp gut following AH infection. A total of 472.05 million valid reads were found from the four intestinal samples and 403.18 million reads were mapped successfully, of which 243.34 million were unique. About GO enrichment analysis, significant differentially expressed genes (DEGs) were more in biological process (406 DEGs), regulation of transcription, DNA-templated (345 DEGs), and signal transduction (304 DEGs). In the cell components, membrane (1913 DEGs) and integral component of membrane (1789 DEGs) had a higher number of significantly different genes. In the molecular function, metal ion binding (780 DEGs), ATP binding (535 DEGs), transferase activity (491 DEGs), and nucleotide binding (482 DEGs) have a large number of significantly different genes. Regarding the KEGG enrich analysis section, this study is arranged in ascending P-value order, andthe most significant signaling paths are lysosome, glucose metabolism, cycline cycline receiver interaction, and phagosome. Among them, the cycline cycline receiver interaction has the highest difference in significant genes. In addition, 5 immune-related genes were selected for real-time fluorescence quantitative PCR analysis to verify the RNA-seq data, and the results showed that the expression of all 5 genes was upregulated, which was consistent with the results of our RNA-seq analysis. After analysis, it was found that B. licheniformis can alleviate the inflammatory response and protect the fish body. Our results provide a reference for further analysis of the antagonism and mitigation mechanism of B. licheniformis against AH. [ABSTRACT FROM AUTHOR]

Background: In the context of the global aging challenge, an increasing number of middle‐aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena. Methods: The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference‐in‐differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting. Results: The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = −0.172, T = 0.65, p = 0.517 in the PSM‐DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, T = 0.26, p = 0.795 in the PSM‐DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves. Conclusions: In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies. Key points: Neither providing grandchildren care nor ceasing such care showed a significant effect on the mental health of caregivers.Inconsistent findings in previous studies regarding the relationship between grandparenting and caregivers' mental health can be attributed, in part, to the difference of research design.The influence of the local cultural context, particularly in regions like China with strong cultural values, has often been overlooked when interpreting the relationship between grandparenting and caregiver's mental health. [ABSTRACT FROM AUTHOR]

Background: With the emergence of numerous scientific outputs, growing attention is paid to research misconduct. This study aimed to investigate knowledge, attitudes and practices about research misconduct among medical residents in southwest China. Methods: A cross-sectional study was conducted in southwest China from November 2022 through March 2023. The links to the questionnaire were sent to the directors of the teaching management department in 17 tertiary hospitals. Answers were collected and analyzed. Logistic regression analysis was performed to explore the factors associated with research misconduct among residents. Results: 6200 residents were enrolled in the study, and 88.5% of participants attended a course on research integrity, but 53.7% of participants admitted to having committed at least one form of research misconduct. Having a postgraduate or above, publishing papers as the first author or corresponding author, attending a course on research integrity, lower self-reported knowledge on research integrity and lower perceived consequences for research misconduct were positively correlated to research misconduct. Serving as a primary investigator for a research project was negatively associated with research misconduct. Most residents (66.3%) agreed that the reason for research misconduct is that researchers lack research ability. Conclusions: The high self-reported rate of research misconduct among residents in southwest China underscores a universal necessity for enhancing research integrity courses in residency programs. The ineffectiveness of current training in China suggests a possible global need for reevaluating and improving educational approaches to foster research integrity. Addressing these challenges is imperative not only for the credibility of medical research and patient care in China but also for maintaining the highest ethical standards in medical education worldwide. Policymakers, educators, and healthcare leaders on a global scale should collaborate to establish comprehensive strategies that ensure the responsible conduct of research, ultimately safeguarding the integrity of medical advancements and promoting trust in scientific endeavors across borders. [ABSTRACT FROM AUTHOR]

The quantile regression technique is introduced into the Lotka–Volterra ecosystem analysis framework. The quantile grey Lotka–Volterra model is established to reveal the dynamic trade relationship between China and the United States. An optimisation model is constructed to solve optimum quantile parameters. The empirical results show that the quantile grey Lotka–Volterra model shows higher fitting accuracy and reveals the trade relationships at different quantiles based on quarterly data on China–US trade from 1999 to 2019. The long-term China–US trade relationship presents a prominent predator–prey relationship because exports from China to the US inhibited China's imports from the United States. Moreover, we divide samples into five stages according to four key events, China's accession to the WTO, the 2008 global financial crisis, the weak global economic recovery in 2015, and the 2018 China–US trade war, recognising various characteristics at different stages. [ABSTRACT FROM AUTHOR]

Various shipping emission restrictions have recently been implemented locally and nationally, which might mitigate their impacts on regional air quality, climate change, and human health. In this study, the daily trace metal elements in PM1 were measured in a coastal megacity in Northern China, from autumn to winter from 2018 to 2022, spanning DECA 1.0 (domestic emission control area), DECA 2.0, IMO 2020, and Pre-OWG Beijing 2022 stages. The trace element changes of V, Ni, Pb, and Zn in PM1 were analyzed. The concentrations of V declined with shipping emission regulations implemented in 2018–2022 at 3.61 ± 3.01, 1.07 ± 1.04, 0.84 ± 0.62, and 0.68 ± 0.61 ng/m3, respectively, with the V/Ni ratio decreasing at 1.14 ± 0.79, 0.93 ± 1.24, 0.35 ± 0.24, and 0.22 ± 0.18. The V/Ni ratio was dominated by the shipping emissions in the DECA 1.0 stage but has been more affected by the inland sources since DECA 2.0. The V/Ni ratio of local transport air mass was higher than that of long-distance transportation, indicating that some ships were still using high-sulfur fuel oil, especially for the ships 12 nautical miles from the coastline. The multiple linear regression model showed a better fit using V as a tracer for ship emission sources of ambient SO2 in the DECA 1.0 stage, while the indication effect reduced since DECA 2.0. The V and V/Ni ratios should be carefully used as indicators of ship sources as more vessels will use clean fuels for energy, and the contribution of inland sources to V and Ni will gradually increase. [ABSTRACT FROM AUTHOR]

The absence of nationwide distribution data regarding heavy metal emissions into the atmosphere poses a significant constraint in environmental research and public health assessment. In response to the critical data deficiency, we have established a dataset covering Cr, Cd, As, and Pb emissions into the atmosphere (HMEAs, unit: ton) across 367 municipalities in China. Initially, we collected HMEAs data and covariates such as industrial emissions, vehicle emissions, meteorological variables, among other ten indicators. Following this, nine machine learning models, including Linear Regression (LR), Ridge, Bayesian Ridge (Bayesian), K-Neighbors Regressor (KNN), MLP Regressor (MLP), Random Forest Regressor (RF), LGBM Regressor (LGBM), Lasso, and ElasticNet, were assessed using coefficient of determination (R2), root-mean-square error (RMSE) and Mean Absolute Error (MAE) on the testing dataset. RF and LGBM models were chosen, due to their favorable predictive performance (R2: 0.58–0.84, lower RMSE/MAE), confirming their robustness in modelling. This dataset serves as a valuable resource for informing environmental policies, monitoring air quality, conducting environmental assessments, and facilitating academic research. [ABSTRACT FROM AUTHOR]

This study is nationwide multicenter epidemiological research, aimed at investigating the distribution changes and seasonal patterns of various airborne allergens among preschool children with allergic rhinitis (AR) in different regions of China, and analyzing the clinical correlation between sensitization to various airborne allergens and AR symptoms in children. Information on children was collected through standard questionnaires, and total IgE (tIgE) and specific IgE (sIgE) for 11 inhalant allergens were tested. The results showed that dust mites are the primary allergens for preschool AR children (39%). Among pollen allergens, Amb a had the highest positivity rate (8.1%), followed by Art v (7.8%). The sensitization rates for two mites peaked in May (46.9% and 40.6%). Art v peaked in August (21.5%), while Amb a had peaks in May (12.7%) and August (17.8%). The sensitization peaks for various tree pollens mainly occurred in August. In the Eastern monsoon region, the sensitization rate to mites was significantly higher than in the Northwest arid and semi-arid regions; whereas, for pollen allergens, the sensitization rates to Amb a, Pla a, Pin a, Pop d, and Bet v were significantly higher in the Northwest arid and semi-arid regions than in the Eastern monsoon region. The correlation among various tree pollens, specifically between Pla a, Pin r, Pop d, and Bet v was strong (0.63 ~ 0.79), with a cross-overlapping percentage of 53.9%. Children with multiple pollen sensitizations had higher cumulative nasal symptom scores than those negative for pollen (P < 0.01). Children with only pollen sensitization had higher cumulative rhinitis symptom scores than the all-negative group (P < 0.0001) and the mite-only sensitization group [P < 0.05], while the mite-only sensitization group also had higher scores than the all-negative group [P < 0.05], and the group sensitized to both pollen and mites had lower scores than the pollen-only group [P < 0.05]. This study indicates that sensitization to mites and grass pollens exhibits significant regional differences, with grass pollen allergies primarily occurring in autumn, sensitization to pollens in general exhibits a pronounced seasonal pattern. Moreover, pollen sensitization aggravates nasal and ocular symptoms in AR children. [ABSTRACT FROM AUTHOR]

Background: Loneliness is a negative emotional state that can lead to physical and mental health problems. This study's objective was to acquire an in-depth understanding of the heterogeneity and the predictors of loneliness among older adults in rural China and provide valuable references for practical interventions. Methods: Older rural adults in China (N = 680) were recruited between January and April 2023. Latent profile analysis (LPA) was employed to identify subgroups of loneliness among participants. Single-factor and multinomial logistic regression analyses were conducted to investigate predictors of loneliness. Results: The loneliness of rural older adults could be divided into three subgroups: low interaction loneliness group (55.0%), moderate emotional loneliness group (31.8%), and high loneliness group (13.2%). The subgroup predictors included age, gender, religious beliefs, marital status, living alone, number of chronic diseases, and smartphone use (P < 0.05). Conclusion: This study identified a classification pattern for loneliness among older adults in rural areas of China, revealed the characteristics of different demographic variables in loneliness categories, and highlighted the heterogeneity of loneliness in this population. It serves as a theoretical reference for formulating intervention plans aimed at addressing various loneliness categories for local rural older adults. Clinical trial registration: ChiCTR2300071591. [ABSTRACT FROM AUTHOR]

The rapid urbanization (UR) and industrialization in the Yellow River Basin (YRB) have resulted in a significant scarcity of water resources (WRs), highlighting the need to investigate the complex and dynamic relationship between UR and WR for sustainable urban development in ecologically fragile areas. This study utilizes the coupling coordination degree model (CCDM), spatial correlation analysis, and Tobit model to examine the coupling coordination relationship, spatial effects, and key factors between UR and WR in sixty prefecture-level cities within the YRB. The empirical findings reveal that the development of the WR subsystem lags behind the UR subsystem and that there is a significant spatial disequilibrium in the CCD between UR and WR. Specifically, the high-high clusters are located in the northwest and east, while the low-low clusters are spread in the southwest. Furthermore, investment in science and technology and economic development have a positive impact on the CCD, while government capacity, urban construction, and industrial structure have a negative impact. These results can provide valuable guidance for decision-making in urban planning for ecologically fragile areas facing water supply constraints. [ABSTRACT FROM AUTHOR]

Delineating management zones (MZs) is considered one of the most important steps towards precision nitrogen (N) management, as MZs are required to optimize N inputs and improve environmental health. However, no reports have fully explored the optimization of regional MZs related to policymaking to achieve long-term Sustainable Development Goals. This study developed a new sustainable environmental index (SEI) by integrating the Euclidean distance after feature normalization, spatial autocorrelation, and expert knowledge. The SEI was then used to delineate MZs in the main wheat-producing provinces of China using the fuzzy C-mean clustering. The results showed that compared to the two data-driven-based methods (Random Forest- and all variables-based methods), the SEI-based method performed the best and identified 9 MZs in terms of practical production and spatial distribution of zones. Further analysis indicated that the dominant drivers of MZ delineation showed strong spatial heterogeneity and high input uncertainty. Climatic factors explained 15.6% of the yield variability, while both soil factors and topographic factors individually accounted for 10.2% of the variability. The similar spatial characteristics of input uncertainty were found to be consistent across various MZs, with a high level of uncertainty ranging from 0.7 on a scale of 0 to 1. Finally, this study provided potentially valuable suggestions for policymakers and farmers, as well as possible directions for further N management. Overall, the proposed methodological framework on regional MZs has important implications for precision N management, providing a new perspective for intensive sustainable development. [ABSTRACT FROM AUTHOR]

In recent years, the diagnosis and treatment of hemophilic children in China has significantly improved. However, oral health conditions, which affect quality of life, haven't received attention in this population. To explore the oral health status and oral hygiene of children and adolescents with hemophilia in the Children's Hemophilia Comprehensive Care Center of China. Dental and oral hygiene examinations were performed in children and adolescents with hemophilia who visited Beijing Children's Hospital. DMFT/dmft (decayed, missing, filled teeth in permanent and primary teeth) was assessed according to World Health Organization (WHO) criteria. The simplified oral hygiene index (OHI-S) was used to evaluate the oral hygiene condition of the subjects. Questionnaires were completed by their parents. SPSS 21.0 was used for statistical analysis. A total of 114 children and adolescents were enrolled. The caries prevalence was 57.4%, 72.2% and 41.2% in primary, mixed and permanent dentitions respectively. The filling rates were 14.4%, 13.9%, and 11.4%, respectively, and the OHI-S scores of the three dentition groups were 1.49 ± 0.46, 1.57 ± 0.43, and 1.76 ± 0.46, respectively. A total of 103 valid questionnaires were collected. Sixty-nine children (67%) didn't brushed their teeth 2 times a day. Nearly half of the parents knew little about fluoride toothpaste. Multiple linear regression analysis revealed that brushing teeth with the help of parents had a significant positive impact on OHI-S. Conclusion: Dental health was unsatisfactory among hemophilic children and adolescents. The caries filling rates were low. Patients and their parents did not give much attention to oral health. What is Known: • Caries and gingivitis are the two main oral diseases that affect children with hemophilia. • However, the oral health conditions of children and adolescents with hemophilia have not received much attention in China. What is New: • This is the first study concentrating on the dental health of children with hemophilia in China. • Dental health was unsatisfactory among children and adolescents with hemophilia in China. [ABSTRACT FROM AUTHOR]

Mining user data and constructing web user profiles of older adults from the perspective of elderly services is conducive to understanding their behavioral habits, needs, and usage preferences on the web, which provides more targeted elderly care services. In this paper, IGA-SOMK + + , which is a novel clustering method for constructing web user profiles of older adults, is proposed based on the China Family Panel Studies (CFPS) survey data, which include 6596 older adults aged greater than 60 years. The selected data aspects include basic information, work situation, health situation, living habits, and web use services. To describe the web user profiles of older adults, a hybrid method based on improved genetic algorithm (IGA) feature selection, self-organizing feature maps (SOM), and K-means + + is proposed. Data on older adults' web use behaviors are first processed, and IGA is used for feature selection based on the adaptive crossover and mutation probabilities. SOM is then used to determine the initial center vectors of K-means + + for further clustering, which is referred to as SOMK + + (SOM-K-means + +). The results of IGA-SOMK + + are compared with those of the state-of-the-art methods, including the K-means, mini batch K-means, Agnes, K-modes, FCM, K-means + + , SOMK + + , and IHPSO-KM. In addition, the significance and robustness of IGA-SOMK + + are analyzed. The experimental results show that the IGA feature selection reduces the influence of the redundant feature factors and improves the performance of the clustering algorithm. SOMK + + overcomes the sensitivity of K-means to initial cluster centers. Moreover, IGA-SOMK + + has the best clustering effect among the compared algorithms in terms of silhouette coefficient (SC), calinski-harabaz (CH) index, and davies-bouldin (DB) metrics. For example, it increases the SC from 0.280 to 0.629. Finally, by analyzing the results, the user group of older adults is segmented to perform the deep mining of CFPS data, which verifies the feasibility of the user profile model. This paper summarizes the basic situation of the current web access of older adults in China in terms of web use services, as well as the importance of the web in their lives and in the information channels. It also provides suggestions for the current problems of older adults in accessing the web. [ABSTRACT FROM AUTHOR]

In order to understand the mechanism of action of oil and fatty acid accumulation and desaturase gene expression in how oilseed flax responds to different fertilization conditions, a three-factor split-plot experiment was conducted to investigate the accumulation trends of oil and fatty acids. The results revealed that soluble sugar (SS) and sucrose (SUC) contents decreased, and the starch (ST) content increased gradually with the grain development and maturity of oilseed flax. The application of sheep manure promoted the accumulation of nonstructural carbohydrates in the grains. Soluble sugar (SS) and sucrose (SUC) contents were negatively correlated with the oil content. Compared with chemical fertilizer, organic manure decreased the total saturated fatty acid but increased the unsaturated fatty acid. Organic manure significantly upregulated the expression of various genes, and fad2a gene expression was higher with the 5.8 t ha−1 chicken manure treatment. The 25 t ha−1 sheep manure treatment was more conducive to the expression of fad3a and fad3b genes and promoted the accumulation of linolenic acid (LIN), and the LIN content increased by 0.64–3.90% compared with other treatments. Consequently, an ongoing anthropogenic sheep manure input may impact the regulation of grain oil quality and yield per unit area. [ABSTRACT FROM AUTHOR]

Various crop rotation patterns can result in differences in nutrient consumption and the accumulation of toxic substances in the soil, indirectly impacting the soil environment and its nutrient supply capacity. Implementing optimized crop planting practices is beneficial for maintaining the favorable physical and chemical properties of farmland soil in the arid area of northwestern China. This study aimed to establish a crop rotation pattern to improve key enzyme activities and soil nitrogen conversion efficiency, as well as understand the underlying mechanism for enhancing nitrogen supply capacity. A field experiment was conducted to study the effect of four flax planting patterns, which included 13 crop rotation patterns with different crop frequencies: 100% Flax (Cont F), 50% Flax (I) (WFPF, FPFW, PFWF, FWFP), 50% Flax (II) (FWPF, WPFF, PFFW, FFWP), 25% Flax (WPWF, PWFW, WFWP, FWPW), on the key enzyme activities and the rate of soil nitrogen conversion, as well as the nitrogen supply capacity. Here, F, P, and W represent oilseed flax, potato, and wheat, respectively. The results indicated that the wheat stubble significantly increased the intensity of soil ammonification and denitrification before planting. Additionally, the activity levels of soil nitrate reductase and nitrite reductase under wheat stubble were significantly increased by 66.67% to 104.55%, while soil urease activity significantly decreased by 27.27–133.33% under wheat stubble compared to other stubbles. After harvest, the activities of soil nitrate reductase and nitrite reductase under the wheat stubble decreased significantly, and the intensity of soil ammonification, nitrification, and denitrification reduced significantly by 7.83–27.72%. The WFWP and FWFP treatments led to a significant increase in soil nitrogen fixation intensity under various crop rotations after harvest and significantly increased the levels of inorganic nitrogen in the soil before the planting of the next crop. This study suggests that the long-term rotation planting patterns WFWP and FWFP can significantly enhance the key enzyme activities of soil nitrogen conversion and significantly improve soil nitrogen conversion before crop sowing. This may increase the rate of soil nitrogen transfer and raise the available nitrogen content of the soil. These findings are crucial for reducing soil nitrogen loss and improving soil nitrogen nutrient supply capacity in dry areas of the Loess Plateau of China. [ABSTRACT FROM AUTHOR]

Self-rated health (SRH) serves as an important indicator for measuring the physical and mental well-being of older adults, holding significance for their health management and disease prevention. In this paper, we introduce a novel classification method based on oversampling and neural network with the objective of enhancing the accuracy of predict the SRH of older adults. Utilizing data from the 2020 China Family Panel Studies (CFPS), we included a total of 6596 participants aged 60 years and above in our analysis. To mitigate the impact of imbalanced data, an improved oversampling was proposed, known as weighted Tomek-links adaptive semi-unsupervised weighted oversampling (WTASUWO). It firstly removes the features that are not relevant to the classification by ReliefF. Consequently, it combines undersampling and oversampling. To improve the prediction accuracy of the classifier, an improved multi-layer perception (IMLP) for predicting the SRH was constructed based on bagging and adjusted learning rate. Referring to the experimental results, WTASUWO can effectively improve the prediction performance of a classifier when being applied on an imbalanced dataset, and the IMLP using WTASUWO achieves a higher accuracy. This method can more objectively and accurately assess the health status and identify factors affecting the SRH of older adults. By mining relevant information related the health status of older adults and constructing the prediction model, we can provide policymakers and healthcare professionals with targeted intervention techniques to focus on the health needs of older adults. Meanwhile, this method provides a practical research basis for improving the health level of older adults in China. [ABSTRACT FROM AUTHOR]

Simple Summary: The authors present a preliminary analysis of caprine remains from 70 burials at Dunping, a burial site associated with Bronze-Age pastoralists in northwestern China and featured by the interment of skulls and hooves of domestic ungulates in burial contexts. The minimal impact of weathering on the skeletal elements and the attachment of atlases in skulls suggest that the caprines chosen for burial may have been slaughtered on-site, and that the inhumation of the caprine skulls and hooves occurred shortly after their death. It is likely that the remaining carcasses of the caprines were consumed by or distributed among funeral participants. The mortality profiles indicate the presence of caprines across various age stages at the site, with individuals aged 6–12 months accounting for the largest proportion. This pattern differed from those observed in contemporaneous pastoral societies in the regions nearby. The late second and first millennium BC witnessed extensive economic, cultural, and political exchanges between pastoralists and sedentary farming states in East Asia. Decades of archaeological fieldwork across northern China have revealed a large number of burial sites associated with pastoralists during the first millennium BC. These sites were characterized by the inhumation of specific animal parts in burials, predominantly the skulls and hooves of sheep, goats, cattle, and horses. However, the selection preference for these animals and how they were integrated into the mortuary contexts of these pastoral societies remain poorly investigated. Here, we report a preliminary analysis of caprine remains from 70 burials at the site of Dunping in the southern Gansu region of northwestern China, dated to approximately the seventh to fourth centuries BC. Based on an examination of species composition, post-depositional effects, traces of human alteration, skeletal element representation, and age at death, we discussed the selection, slaughtering, and inhumation of caprines concerning the mortuary practices at the site. Comparisons between Dunping and several other contemporaneous burial sites in neighboring regions, specifically in terms of the mortality profiles, further highlight distinct patterns in the selection of caprines for mortuary purposes among pastoral societies. These differences suggest varying degrees of emphasis placed on the economic and social significance attributed to caprines. Our findings provide new insights into the roles that caprines played in both ritual performances and subsistence practices among pastoralists in East Asia during the first millennium BC. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that the wet suction technique in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) generates better histological diagnostic accuracy and specimen quality than the dry suction technique. However, conclusions of wet suction on the diagnostic accuracy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) are still controversial. Besides, the optimal number of passes for EUS-FNB has not been determined. We aimed to design a large multicenter randomized trial to compare the diagnostic accuracy of dry suction versus wet suction technique in solid pancreatic lesions (SPLs) using 22G Franseen needles and determine the optimal number of passes required for EUS-FNB. Methods: This is a multi-center open-label, randomized controlled non-inferiority trial with two parallel groups. Two hundred patients with SPLs will undergo EUS-FNB using 22G Franseen needles in 4 tertiary hospitals in China and will be randomly assigned to the dry suction group and wet suction group in a ratio of 1:1. The primary endpoint is diagnostic accuracy. Secondary endpoints include the optimal number of needle passes, sensitivity, specificity, specimen quality, cytological diagnoses, time of the procedure, and incidence of complications. Discussion: This study has been designed to determine (i) whether EUS-FNB using 22G Franseen needle with dry suction is non-inferior to wet suction in terms of diagnostic accuracy and (ii) the optimal number of passes during EUS-FNB of SPLs using 22G Franseen needle. Trial registration: ClinicalTrials.gov NCT05549856. Registered on September 22, 2022. [ABSTRACT FROM AUTHOR]

To explore the transformational leadership competency of graduates from one medical university in China and its influencing variables. From 2020 to 2021, 851 medical graduates from seven hospitals affiliated with the Capital Medical University participated in this survey. The authors conducted a cross-sectional study to assess transformational leadership competency, particularly from three aspects, including values, Emotional Intelligence (EI) abilities, and behaviors using the socially responsible leadership scale (SRLS), emotionally intelligent leadership, and student leadership practices inventory (EILI and SLPI). The SRLS scores were medium except for 'controversy with civility'. The EILI scores were medium. The SLPI scores were high except for 'enable others to act' and 'encourage the heart'. The influencing variables of SRLS, EILI, and SLPI were serving as student cadres, serving longer than two semesters (p = 0.01, 0.02 in EILI and SLPI), joining student organizations, participating in social practice, voluntary service (p = 0.001 in SLPI), in training classes for student cadres (p = 0.02, 0.01, 0.02 in SRLS, EILI, and SLPI), and attending lectures on leadership (except for indicated, p < 0.001). Regression analysis showed that attending lectures on leadership was associated with high SRLS, EILI, and SLPI scores (p = 0.04, SRLS; p < 0.001, others), and SRLS and EILI scores could affect SLPI score (F = 2674.44, p < 0.001, R2 = 0.86). Medical graduates' transformational leadership competency at the Capital Medical University was medium measured from values, EI abilities, and behaviors. Group analysis indicated that knowledge learning, organizational involvement, and social/community involvement were associated with leadership capacity building, meanwhile, leaders' values and EI abilities would affect their behaviors, suggesting medical graduates should undertake leadership training from both knowledge learning and practicing. [ABSTRACT FROM AUTHOR]

Simple Summary: Through a preliminary analysis of animal remains from the large settlement site of Yucun, located east of the Longshan Mountain and associated with the Zhou people during the first half of the first millennium BC, the authors investigated the subsistence practices in relation to the exploitation of animal resources by the site's residents. The examination of animal species representation and the mortality profiles of major domesticates suggest similarities between Yucun and sites associated with the Qin people, located to the west of the Longshan Mountain. However, differences were observed when comparing Yucun to other contemporaneous sites in the middle and lower Yellow River valley. These patterns in animal use strategies appear to have been influenced by local environmental conditions. The first millennium BC saw the expansion of the Western Zhou dynasty in its northwestern frontier, alongside the rise and development of the Qin State in the Longshan Mountain region of northern China. Exploring the subsistence practices of these communities is crucial to gaining a better understanding of the social, cultural, and political landscape in this region at the time. While much of the research to date has focused on the Qin people, the subsistence practices of the Zhou people remain poorly understood. In this study, we analyzed animal remains from Yucun, a large settlement site associated with the Zhou people, located to the east of the Longshan Mountain. These animal remains were recovered in the excavation seasons of 2018–2020. Our results show that pigs, dogs, cattle, caprines, and horses, which were the major domestic animals at Yucun, accounted for over 90.8% of the animal remains examined in terms of the number of identified specimens (NISP) and 72.8% in terms of the minimum number of individuals (MNI), with cattle and caprines playing dominant roles. In terms of the taxonomic composition and the mortality profiles of pigs, caprines, and cattle, Yucun shared similarities with Maojiaping and Xishan, two contemporaneous Qin cultural sites located to the west of the Longshan Mountain, and differ from other farming societies in the middle and lower reaches of the Yellow River valley. Considering the cultural attributes and topographic conditions of these various sites, these findings imply that environmental conditions may have played a more significant role than cultural factors in shaping the animal-related subsistence practices in northern China during the first millennium BC. [ABSTRACT FROM AUTHOR]

This article provides an overview of deubiquitinating enzymes (DUBs) and their role in targeted cancer therapy. It specifically focuses on the DUB OTUB1 and its regulation of CCN6, a tumor suppressor in breast cancer. The article discusses the potential of DUBs as therapeutic targets for cancer treatment, but highlights the need for caution due to the diverse functions of OTUB1 in different cancer types. The article also summarizes different strategies for manipulating the expression and activities of DUBs. The study was conducted by Zhao et al. and acknowledges support from Suzhou Medical College of Soochow University and the Priority Academic Program Development of the Jiangsu Higher Education Institutions of China. [Extracted from the article]

College freshmen are special populations facing great challenges in adapting to the brand new environment, and their lifestyle and emotional states are worthy of attention. Especially during the COVID-19 pandemic, their screen time and prevalence of negative emotions were significantly increased, but few studies have focused on such situation of college freshmen and illustrated relevant mechanisms. Thus, based on a sample of Chinese college freshmen during the COVID-19 pandemic, the current study aimed to investigate the association between their screen time and negative emotions (depression, anxiety and stress), and further explore the mediating effects of sleep quality. Data from 2,014 college freshmen was analyzed. The screen time was self-reported by participants using predesigned questionnaires. The Pittsburgh Sleep Quality Index (PSQI) and Chinese Version of Depression Anxiety and Stress Scale-21 (DASS-21) were used to assess sleep quality and emotional states, respectively. The mediation analysis was conducted to examine the meditation effect. Results indicated that participants with negative emotions tended to have longer daily screen time and worse sleep quality, sleep quality partially mediated the association between screen time and negative emotions.The critical role of sleep quality and related intervention measures should be recognized and implemented. [ABSTRACT FROM AUTHOR]

This article constructs a dual-circulation production network framework on the basis of integrating inter-country and China's multi-regional input-output tables, identifies the propagation and attenuation of sectoral shocks in dual-circulation production networks, and measures the effects of US-China trade frictions on the networks. The research finds that: (1) The asymmetry between domestic- and international-circulation production networks has increased, and with a few sectors becoming key sectors to dual-circulation production networks, sectoral shocks grow increasingly critical for aggregate volatility. (2) Based on the above analytical framework, the global extraction method (GEM) is adopted to simulate the GDP losses in scenarios of China-US i ndustry-wide chain interruptions, certain sectoral frictions, and supply-side and demand-side chain interruptions. The simulation finds that increasing the domestic substitution rate will reduce the value losses caused by China-US chain interruptions, which is applied for both countries. However, even if full substitution can be achieved, the value losses cannot be avoided completely in the China-US decoupling. Whether it is the demand-side chain interruptions plus insufficient market substitution in China, or the supply-side chain interruptions plus insufficient supply substitution in the US, will cause great losses to their economy. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic presents challenges for healthcare systems globally, especially in vulnerable populations such as pediatric hematopoietic stem cell transplant (HSCT) recipients. This study examines the clinical characteristics and outcomes of COVID-19 infection in pediatric HSCT recipients within one year post-HSCT.Methods: Retrospective analysis was conducted on data from 247 pediatric patients. None of them had received SARS-CoV-2 vaccination or had prior infection. SARS-CoV-2 infection was confirmed using RT-PCR testing. COVID-19 disease severity was categorized according to established guidelines. Demographic, clinical, laboratory, imaging and treatment data were collected.Results: The median age of the cohort was 7± 3.7 years, with thalassemia major as the predominant underlying disease. Allogeneic HSCT was performed in the majority of cases, with haploidentical donors being the most common source of grafts. Nearly half of the patients developed COVID-19, with significantly higher infection rates observed in recipients over 100 days compared to recipients within 100 days post-HSCT (40.1% vs 21.7%, p< 0.05, Fisher's Exact test). Fever (n=107, 43.2%) and cough (n=88, 35.6%) were the most common symptoms. While most patients had mild disease and did not require specific anti-viral treatment, a significant proportion required hospitalization (n=34, 13.8%). Various treatments were employed hospitalized patients, including Paxlovid (n=19, 55.9%), methylprednisolone (n=7, 20.6%), IL-6 antibody (n=2, 5.9%), mesenchymal stem cells (n=3, 8.8%), and exosomes nebulization therapy (n=2, 5.9%). Despite multidisciplinary approaches, one patient died from severe respiratory failure. However, overall survival of all patients remained high (99.53%; CI 96.72– 99.93%), indicating favorable outcomes in pediatric HSCT recipients with COVID-19.Conclusion: This study provides insights into clinical features, therapeutic measures, and outcomes of pediatric HSCT recipients following COVID-19 infection in a large HSCT center in China. These findings contribute to our understanding of COVID-19 in this population and inform strategies to mitigate the impact the pandemic's impact on their care. [ABSTRACT FROM AUTHOR]

NADC34-like porcine reproductive and respiratory virus (PRRSV) has had a significant impact on the pig industry, particularly in China. However, the evolutionary characteristics and pathogenicity of NADC34-like PRRSV strains within intensive farming systems are not well understood, particularly regarding the biological characteristic variation of successive outbreaks on a farm. In this study, we conducted continuous surveillance in an intensive farm that experienced a PRRSV outbreak. Two PRRSV strains, GDHZ109/2020 and GDYS162/2022, were isolated and fully sequenced from the same swine farm in Guangdong Province in 2020 and 2022, respectively. Evolutionary analysis based on the ORF5 gene revealed that both strains clustered with NADC34-like strains and shared 96.5% homology. Analysis of the full-length genome and NSP2 gene classified the strains into lineage 1.8, represented by the NADC30 strain. Recombination analysis suggested complex recombination patterns for both strains, involving NADC30-like, NADC34-like, and JXA1-like strains. Although many recombinant regions were nearly identical, there were differences observed in the NSP5–NSP7 region. Pathogenicity experiments conducted on piglets demonstrated that GDHZ109/2020 exhibited higher pathogenicity compared to GDYS162/2022. Piglets in the GDHZ109/2020 infected group had more severe clinical signs and higher mortality. Moreover, analysis of respiratory microbial diversity indicated a significant increase in the abundance of potentially pathogenic microbiota, such as Klebsiella and Erysipelothrix contributing to the respiratory tract of PRRSV-infected piglets, suggesting secondary infections due to differences in immune defense. These findings highlight the importance of NADC34-like recombinant strains' evolution during the farm's epidemic period, which may have contributed to changes in pathogenicity. This study improves our understanding of the current prevalence of PRRSV and provides novel insights into the prevention and control of PRRSV. [ABSTRACT FROM AUTHOR]

Nitrification, a key step in soil nitrogen cycling, is a biologically mediated process crucial to the ecological environment. However, how nitrifiers drive nitrification under different soil properties and climatic factors at large spatial scales is poorly understood. Here, using metagenomic sequencing and network‐based approaches, we identified key nitrifying species of upland agricultural soils in northern China, which spans a wide range of climates and geographic distances. We found that potential nitrification rates (PNRs) varied in different soils and were positively correlated with soil pH (5.42–8.46) and mean annual temperature (MAT) and negatively correlated with the C/N ratio. Network analysis revealed that one module (module 3) was significantly correlated with PNR. In this module, 16 dominant nodes were associated with AOB Nitrosomonas and most nodes were significantly correlated with environmental factors, suggesting that abiotic conditions are important for determining the assembly of these key nitrifiers. Our study advanced the understanding of the key nitrifying populations and their environmental drivers in upland agricultural soil across different soil and climate types. [ABSTRACT FROM AUTHOR]

Background: Hypertension caused by air pollution exposure is a growing concern in China. The association between air pollutant exposure and hypertension has been found to be potentiated by obesity, however, little is known about the processes mediating this association. This study investigated the association between fine particulate matter (aerodynamic equivalent diameter ≤ 2.5 microns, PM2.5) exposure and the prevalence of hypertension in a representative population in southern China and tested whether obesity mediated this association. Methods: A total of 14,308 adults from 48 communities/villages in southern China were selected from January 2015 to December 2015 using a stratified multistage random sampling method. Hourly PM2.5 measurements were collected from the China National Environmental Monitoring Centre. Restricted cubic splines were used to analyze the nonlinear dose-response relationship between PM2.5 exposure and hypertension risk. The mediating effect mechanism of obesity on PM2.5-associated hypertension was tested in a causal inference framework following the approach proposed by Imai and Keele. Results: A total of 20.7% (2966/14,308) of participants in the present study were diagnosed with hypertension. Nonlinear exposure-response analysis revealed that exposure to an annual mean PM2.5 concentration above 41.8 µg/m3 was associated with increased hypertension risk at an incremental gradient. 9.1% of the hypertension burden could be attributed to exposure to elevated annual average concentrations of PM2.5. It is noteworthy that an increased body fat percentage positively mediated 59.3% of the association between PM2.5 exposure and hypertension risk, whereas body mass index mediated 34.3% of this association. Conclusions: This study suggests that a significant portion of the estimated effect of exposure to PM2.5 on the risk of hypertension appears to be attributed to its effect on alterations in body composition and the development of obesity. These findings could inform intersectoral actions in future studies to protect populations with excessive fine particle exposure from developing hypertension. [ABSTRACT FROM AUTHOR]

Highly pathogenic avian influenza H5N6, an acute infectious poultry disease, has appeared in China since 2014. The serious HPAI H5N6 epidemic has caused substantial economic losses to the poultry industry and seriously threatened public health. This study developed two maximum entropy models based on highly pathogenic avian influenza virus H5N6 surveillance data obtained through China's national surveillance program and HPAI H5N6 outbreak data in China, identified risk factors for the disease and developed risk prediction maps. Both models had a good predictive performance with area under the receiver operating characteristic curves of 0.931 and 0.892. Our study considered 26 variables from bioclimate, geographical, and socioeconomic factors. After the screening, 14 variables were retained and incorporated into the construction of the two models. HPAIV H5N6 presence was related to population density, road density, poultry market density, mean diurnal range, and chicken density. HPAI H5N6 poultry outbreaks were associated with population density, road density, mean diurnal range, precipitation of the driest month, and chicken density. Overall, Southern China was the high-risk area for HPAIV H5N6 maintenance and H5N6 outbreak. The risk factors and maps associated with the HPAIV H5N6 presence and HPAI H5N6 outbreak identified in our study will help develop appropriate HPAIV H5N6 control measures to reduce the risk of infection and morbidity in poultry and humans. [ABSTRACT FROM AUTHOR]

This study aimed to examine the representations of nature of science (NOS) in the eight histories of science selected from three series of integrated science textbooks used in junior high school in China. Ten aspects of NOS were adopted in the analytical framework. It was found that NOS had not been well treated in the selected histories of science in the three series of science textbooks. Specifically, it was found that the empirical and inferential aspects were treated better than other aspects, and discrepancies existed among the three series of science textbooks and among the eight histories of science in terms of dealing with the target NOS aspects. Implications for addressing NOS in historical materials in science textbooks were discussed in the final part of this paper. (Contains 5 tables.)

In archaeology, strontium isotope analysis is developing into an efficient scientific technique for tracing the movement of prehistoric humans and animals. Determining the local bioavailable 87Sr/86Sr ratio range is the key to distinguishing whether the human or animal is indigenous to the local area. It has been shown that the 87Sr/86Sr ratio in the enamel of pigs can be an excellent sample to determine the range of local strontium isotope ratio at the site. However, pigs may not be all local at the site, and there is no special study on whether pigs' different ages and tooth types impact the local strontium isotope characteristics. In this paper, the tooth enamel of 19 pigs from the Zaoshugounao site for strontium isotope ratio (87Sr/86Sr) by multicollector–inductively coupled plasma mass spectrometry. There were no significant differences in 87Sr/86Sr ratios of local pigs at different months and different molar types, which did not affect the determination of the local strontium isotope standard. Based on the local strontium isotope ratio range (0.711056–0.711476), we found that five pigs were non‐local. The Jing and Wei river basins (in Guanzhong basin) and northern Shaanxi are likely sources of non‐pigs. [ABSTRACT FROM AUTHOR]