Search

Background: Since 2020, China has implemented an innovative payment method called Diagnosis-Intervention Packet (DIP) in 71 cities nationwide. This study aims to assess the impact of DIP on medical expenditure, efficiency, and quality for inpatients covered by the Urban Employee Basic Medical Insurance (UEBMI) and Urban and Rural Residents Basic Medical Insurance (URRBMI). It seeks to explore whether there are differences in these effects among inpatients of the two insurance types, thereby further understanding its implications for health equity. Materials and methods: We conducted interrupted time series analyses on outcome variables reflecting medical expenditure, efficiency, and quality for both UEBMI and URRBMI inpatients, based on a dataset comprising 621,125 inpatient reimbursement records spanning from June 2019 to June 2023 in City A. This dataset included 110,656 records for UEBMI inpatients and 510,469 records for URRBMI inpatients. Results: After the reform, the average expenditure per hospital admission for UEBMI inpatients did not significantly differ but continued to follow an upward pattern. In contrast, for URRBMI inpatients, the trend shifted from increasing before the reform to decreasing after the reform, with a decline of 0.5%. The average length of stay for UEBMI showed no significant changes after the reform, whereas there was a noticeable downward trend in the average length of stay for URRBMI. The out-of-pocket expenditure (OOP) per hospital admission, 7-day all-cause readmission rate and 30-day all-cause readmission rate for both UEBMI and URRBMI inpatients showed a downward trend after the reform. Conclusion: The DIP reform implemented different upper limits on budgets based on the type of medical insurance, leading to varying post-treatment prices for UEBMI and URRBMI inpatients within the same DIP group. After the DIP reform, the average expenditure per hospital admission and the average length of stay remained unchanged for UEBMI inpatients, whereas URRBMI inpatients experienced a decrease. This trend has sparked concerns about hospitals potentially favoring UEBMI inpatients. Encouragingly, both UEBMI and URRBMI inpatients have seen positive outcomes in terms of alleviating patient financial burdens and enhancing the quality of care. [ABSTRACT FROM AUTHOR]

Tozorakimab is a high‐affinity human immunoglobulin G1 monoclonal antibody that neutralizes interleukin (IL)‐33, an IL‐1 family cytokine. This phase 1, single‐center, randomized, double‐blind, placebo‐controlled, single ascending dose study (NCT05070312) evaluated tozorakimab in a healthy Chinese population. Outcomes included the characterization of the pharmacokinetic (PK) profile and immunogenicity of tozorakimab. Safety outcomes included treatment‐emergent adverse events (TEAEs) and clinical laboratory, electrocardiogram, and vital sign parameters. Healthy, non‐smoking, male, and female Chinese participants aged 18‐45 years with a body mass index 19‐24 kg/m2 were enrolled. In total, 36 participants across 2 cohorts of 18 participants were randomized 2:1 to receive a single subcutaneous dose of tozorakimab (300 mg [2 mL] or 600 mg [4 mL]) or matching placebo (2 or 4 mL). Tozorakimab showed dose‐dependent serum PK concentrations with an approximate monophasic distribution in serum over time and a maximum observed peak concentration of 20.1 and 33.7 μg/mL in the 300‐ and 600‐mg cohorts, respectively. No treatment‐emergent anti‐drug antibodies for tozorakimab were observed in any of the participants. There were no clinically relevant trends in the occurrence of TEAEs across the treatment groups. There were no clinically relevant trends over time in clinical laboratory (hematology, clinical chemistry, and urinalysis), electrocardiogram, or vital sign parameters in any treatment group. Overall, tozorakimab demonstrated dose‐dependent systemic exposure in healthy Chinese participants and was well tolerated, with no safety concerns identified in this study. [ABSTRACT FROM AUTHOR]

Background: On the basis of immunohistochemistry PD-L1 testing results, patients with advanced non-small cell lung cancer (NSCLC) are treated differently. Theoretically, patients with high PD-L1 expression (50% or 1%) should receive PD-1 monotherapy for fewer adverse reactions and cost savings from avoiding chemotherapy; however, there is controversy surrounding the cut-off criteria (1% or 50%) for immunohistochemistry testing and threshold for PD-1 monotherapy. Objective: This study aims to predict the effectiveness and cost-effectiveness of different immunotherapy strategies for patients with NSCLC in China from the healthcare system perspective. Patients and Methods: A microsimulation model was developed to evaluate the effectiveness and cost-effectiveness of three treatment strategies: PD-L1 testing (1%) (PD-1 monotherapy for those with PD-L1 expression at 1% threshold, and combination with chemotherapy for others with immunohistochemistry testing), PD-L1 testing (50%) (PD-1 monotherapy for those with PD-L1 expression at 50% threshold, and combination with chemotherapy for others with immunohistochemistry testing), and No PD-L1 testing (PD-1 combined with chemotherapy without immunohistochemistry testing). The model assumed 1000 patients per strategy, with each patient entering a unique clinical path prior to receiving treatment on the basis of PD-L1 test results. Clinical inputs were derived from clinical trials. Cost and utility parameters were obtained from the database and literature. One-way probabilistic sensitivity analyses (PSA) and six scenario analyses were used to test the model's robustness. Results: The study revealed a hierarchy of survival benefits across three strategies, with No PD-L1 testing demonstrating the most survival advantage, followed by PD-L1 testing (50%), and finally, PD-L1 testing (1%). The comparative analysis demonstrated that No PD-L1 testing significantly enhanced overall survival (OS) (HR 0.85, 95% CI 0.78–0.93), progression-free survival (HR 0.82, 95% CI 0.75–0.90), and progression-free2 survival (PFS2) (HR 0.91, 95% CI 0.83–0.99) when juxtaposed against PD-L1 testing (1%). However, these improvements were not as pronounced when compared with PD-L1 testing (50%), particularly in relation to PFS, PFS2, and OS. The cost-effectiveness analysis further unveiled incremental cost-utility ratios (ICUR), with No PD-L1 testing versus PD-L1 testing (50%) at $34,003 per quality-adjusted life year (QALY) and No PD-L1 testing versus PD-L1 testing (1%) at $34,804 per QALY. In parallel, the ICUR for PD-L1 testing (50%) versus PD-L1 testing (1%) stood at $35,713 per QALY. Remarkably, the PSA result under a willingness-to-pay (WTP) threshold of $10,144 per QALY, with a 100% probability, demonstrated PD-L1 testing (1%) as the most cost-effective option. Conclusions: The survival benefits of PD-1 monotherapy for high expression with PD-L1 immunohistochemistry testing are inferior to those of PD-1 combined with chemotherapy without testing, but it is found to be more cost-effective at the WTP thresholds in China and holds great potential in increasing affordability and reducing the economic burden. [ABSTRACT FROM AUTHOR]

Forest biomass dynamics are important indicators of forest productivity and carbon sinks, which are useful for evaluating forest ecological benefits and management options. Rapid and accurate methods for monitoring forest biomass would serve this purpose well. This study aimed at measuring aboveground biomass (AGB) and stand growth from tree crown parameters derived using unmanned aerial vehicle–light detection and ranging (UAV–LiDAR). We focused on 17-year-old Chinese fir plantations in a subtropical area in China and monitored them using UAV–LiDAR from February 2019 to February 2020. Two effective crown height (ECH) detection methods based on drone discrete point clouds were evaluated using ground survey data. Based on the evaluation results, the voxel method based on point cloud segmentation (root-mean-squared error (RMSE) = 0.62 m, relative RMSE (rRMSE) = 4.26%) was better than the tree crown boundary pixel sum method based on canopy height segmentation (RMSE = 1.26 m, rRMSE = 8.63%). The effective crown area (ECA) of an individual tree extracted using ECH was strongly correlated with the annual biomass growth (coefficient of determination (R2) = 0.47). The estimation of annual growth of individual tree crowns based on annual tree height increase (ΔH) derived from LiDAR was statistically significant (R2 = 0.33, p < 0.01). After adding the crown projection area or ECA, the model accuracy R2 increased to 0.57 or 0.63, respectively. As the scale increased to the plot level, the direct model with ECA (RMSE = 1.59 Mg∙ha−1∙a−1, rRMSE = 15.02%) had a better performance than the indirect model using tree height and crown diameter (RMSE = 1.81 Mg∙ha−1∙a−1, rRMSE = 17.10%). The mean annual growth rate of AGB per middle-aged Chinese fir tree was determined to be 8.45 kg∙a−1 using ECA and ΔH, and the plot-level growth rate was 11.47 Mg∙ha−1∙a−1. We conclude that the rapid and accurate monitoring of the annual growth of Chinese fir can be achieved based on multitemporal UAV–LiDAR and effective crown information. [ABSTRACT FROM AUTHOR]

Soil salinity is a major constraint limiting jujube production in China. Wild jujube (Ziziphus jujuba var. spinosa (Bunge) Hu ex H. F. Chow) is widely used as the rootstock of jujube (Z. jujuba) to overcome the saline conditions. To understand the adaptive mechanism in wild jujube under saline conditions, we combined spatiotemporal and physiological assessments with transcriptomic analysis on wild jujube seedlings undergoing various salt treatments. These salt treatments showed dose and duration effects on biomass, photosynthesis, (K +) and (Na +) accumulation. Salt treatments induced higher levels of salicylic acid in roots and leaves, whereas foliar abscisic acid was also elevated after 8 days. The number of differential expression genes increased with higher doses and also longer exposure of NaCl treatments, with concomitant changes in the enriched Gene Ontology terms that were indicative of altered physiological activities. Gene co-expression network analysis identified the core gene sets associated with salt-induced changes in leaves, stems and roots, respectively. The nitrogen transporters, potassium transporters and a few transcription factors belonging to WRKY/MYB/bHLH families were clustered as the hub genes responding to salt treatments, which were related to elevated nitrogen and K+/Na+. Ectopic overexpression of two WRKY transcription factor genes (ZjWRKY6 and ZjWRKY65) conferred stronger salt-tolerance in Arabidopsis thaliana transformants by enhancing the activities of antioxidant enzymes, decreasing malondialdehyde accumulation and maintaining K+/Na+ homeostasis. This study provided evidence about the spatiotemporal, physiological and transcriptomic dynamics of wild jujube during salt stress and identified potential genes for further research to improve salt tolerance in jujube. [ABSTRACT FROM AUTHOR]

Soil organic carbon (SOC) mineralization impacts the loss and accumulation of carbon (C) in crucial ways. However, it is still unclear how exactly litter quality regulates the SOC mineralization process and SOC stock. We conducted a laboratory incubation experiment under different temperatures, that is 10°C, 20°C, 30°C, and 40°C, and moisture, that is 5%, 10%, and 20% regimes, as well as a control (CK), and different litter qualities, that is, Artemisia ordosica, Caragana korshinskii, and Eragrostis minor. This was conducted in soil from a revegetated area in the Tengger Desert, northern China. We investigated the impacts of litter addition on SOC mineralization by considering the chemical properties of litter, temperature, and soil moisture, as well as the cumulative CO2‐C emissions (CCE), maximum rate (MR), potential mineralizable C (C0), priming effect (PE), temperature sensitivity (Q10), moisture sensitivity (MS), and SOC stock. Litter addition increased the CCE, MR, C0, and MS but decreased the Q10, and the effects of different litter qualities on CCE, MR, C0, MS, and Q10 differed significantly. The SOC mineralization rate increased with increasing temperature and moisture and was also accelerated by the interactions between temperature and moisture. The total C and lignin contents of litter were the key factors that governed SOC mineralization. Litter addition had a positive PE on SOC mineralization, and high‐quality litter with low C:N ratio (A. ordosica and C. korshinskii) increased the PE compared with low‐quality litter with high C:N ratio (E. minor). The PE also decreased with increasing temperature and moisture. Litter addition resulted in an acceleration of the loss of SOC mineralization, and an increase in the SOC mineralization response toward moisture but reduced the SOC mineralization response toward temperature, whereas litter quality was inversely correlated with the SOC stock. Therefore, the input of low‐quality litter will decrease the loss of mineralized SOC caused by PE and diminish the accumulation of SOC in the revegetated regions. These findings may provide a reasonable litter management model to promote the stability of soil C pool in arid revegetated areas. [ABSTRACT FROM AUTHOR]

Operating room nurses play a critical role in patient safety. The evaluation of safety attitudes of operating room nurses reflects their awareness and belief of patient safety. Currently, however, the research on the safety attitudes of operating room nurses is hard to track in the existing literature in China. Therefore, this paper was conducted to explore the factors influencing the safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. A total of 711 operating room nurses from 16 tertiary hospitals in Sichuan Province from March 1, 2018, to 2019 were selected. The general information of operating room nurses, such as age, gender, and years of service in the operating room, was obtained through the basic information questionnaire. The Chinese version of the Safety Attitudes Questionnaire (C-SAQ) was used to evaluate the safety attitude of operating room nurses, and the cognition and attitude of the subjects to adverse event reports were assessed through the questionnaire of cognition and attitude toward adverse event reporting. The average score of safety attitudes of operating room nurses was 4.20 ± 0.49. The two dimensions with a lower positive reaction rate of the safety attitudes of operating room nurses were stress recognition and working conditions. The main factors affecting the safety attitude of operating room nurses were night shifts, as well as cognition and attitudes toward adverse event reporting. There was a positive correlation between the total score of C-SAQ and the total score of cognition and attitudes toward adverse event reporting (P < 0.01 , r = 0.445). The safety attitude of operating room nurses is at the upper-middle level, but the stress recognition and working conditions need to be improved. Through the allocation of nursing human resources, the strengthening of hospital logistics support, and the establishment of nonpunitive nursing adverse event reporting system, the operating room safety can be significantly enhanced. [ABSTRACT FROM AUTHOR]

Cardiovascular disease has become one of the leading causes of death in China, accounting for 45.5% of all deaths in rural areas and 43.16% in urban areas. Hence, its early diagnosis is important. With the development of intravascular imaging technology, the intravascular ultrasound (IVUS) is widely used. The available commercial mechanical rotary side-looking IVUS (SL-IVUS) transducers are driven by external motors that use long flexible shafts to transmit the rotation. However, when the transducer passes through a long-curved blood vessel, it easily causes the nonuniform rotation distortion (NURD) of the image. A catheter which contains a distal motor and sodium chloride (NaCl) solution is presented in this study as an attempt to solve such issues. The NaCl solution is used to connect the transducer and micromotor so that the motor can directly drive the transducer to rotate and acquire the information of the blood vessel. The results showed that the center frequency and −6-dB fraction bandwidth of the single element were 47 MHz and 98%, respectively. The SL-IVUS catheter consists of a distal motor, with speed stability and high resolution, and has the potential to diagnose cardiovascular disease. This novel structure can decrease the dimension at the top of the catheter and reduce the risks of clinical diagnosis. [ABSTRACT FROM AUTHOR]

Background: Few studies have focused on the influencing factors of dietary practices among ethnic minority groups in China, particularly from a social capital perspective. Methods: Between May and September 2019, we conducted a cross-sectional survey among adults (n = 1,813) from three ethnic minority communities (A Chang, De Ang and Jing Po) in Yunnan Province, Southwest China. Dietary intakes during the past 12 months were measured with a 100-item Food Frequency Questionnaire (FFQ), and two forms of social capital (bonding and bridging) were measured using the validated Personal Social Capital Scale 16 (PSCS-16). Principal component factor analysis was used to derive dietary patterns from 20 food groups. Multivariate linear regressions were used to examine the associations between social capital and dietary patterns. Results: Two distinct dietary patterns were identified: the traditional and the modern. The traditional pattern was characterized by high consumptions of tubers, poultry, rice, fruits, vegetables and low consumptions of oil and salt, whereas the modern pattern was highly correlated with egg, nut, beverage, snack and oil consumptions. After adjusted for potential confounders, the modern pattern was positively associated with bonding capital (β = 0.066; 95%CI: 0.058, 0.075) and negatively associated with bridging capital (β = -0.017; 95%CI: -0.024, -0.010). Conclusion: In conclusion, an unhealthy dietary pattern was identified among the ethnic minority groups in Southwest China. The influences of people's social connections on dietary behaviors should be considered in designing and implementing nutrition intervention programs for the population. [ABSTRACT FROM AUTHOR]

In order to encourage innovative medicine to address Chinese unmet medical needs, China has changed its drug regulatory landscape to speed up access to new medicines. In order to understand the fast‐changing landscape and to enable planning of more global drug development programs and study designs in China, we reviewed 15 published clinical pharmacology‐related guidances by the National Medical Products Administration (NMPA), and compared them with reference guidances from the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), or the International Conference on Harmonization (ICH), to understand the similarities and differences, especially any China‐specific requirements, such as ethnic sensitivity analysis. Overall, by reviewing these clinical pharmacology‐related NMPA guidances, it is clear that NMPA guidances are very similar to FDA, EMA, and ICH guidances. There are no relevant differences in the major principles, but some differences in structure, contents, and focus were noted. The NMPA is adapting flexibility statements into newly published guidances. Ethnic sensitivity analysis needs to be implemented early in drug development plans. The NMPA encourages sponsors to conduct early clinical trials in China or include China early in multiregional clinical trials, and to obtain safety, efficacy, and pharmacokinetic data for ethnic sensitivity analysis. Depending on the stage of development, ethnic sensitivity analysis can be conducted using in vitro or literature data, other Asian clinical data, or Chinese clinical data. [ABSTRACT FROM AUTHOR]

Aconitum piepunense belonging to the family Ranunculaceae is an endangered herb species in southwestern China. In this study, the complete chloroplast genome of A. piepunense was sequenced, and the results revealed a typical quadripartite structure with a length of 155,836 bp, including a large single-copy region (LSC, 86,433 bp), a small single-copy region (SSC, 16,945 bp), and a pair of inverted repeat (IR) regions (IRa and IRb, 26,229 bp, respectively). A total of 130 genes were identified in the A. piepunense chloroplast genome, containing 85 protein-coding genes, 37 transfer RNA (tRNA) genes, and 8 ribosomal RNA (rRNA) genes. Phylogenetic analysis based on the maximum likelihood method indicated that A. piepunense formed a monophyletic group, which was sister to A. contortum and A. vilmorinianum. [ABSTRACT FROM AUTHOR]

Ecological restoration is considered an effective strategy for increasing soil carbon storage and mitigating climate change. However, the impact of revegetation in desert areas on the stability of soil organic carbon (SOC) is still unclear. We investigated the content and stability of SOC in restoration sites along a chronosequence in the Tengger Desert, focusing on the mineral-associated organic carbon (MAOC) and particulate organic carbon (POC) fractions. The content of SOC significantly increased with site age from 0.37 g kg−1 at year 0–5.32 g kg−1 at year 66. Revegetation significantly changed the SOC fraction and improved SOC stability as a factor of site age. In the 66-year-old site, the levels of MAOC and POC were increased by 255.67 and 9.24 times, respectively. The percentage of MAOC was increased from 1.50% to 28.92%, whereas that of POC was decreased from 98.50% to 71.08%. Based on our findings, the content and proportion of MAOC and POC are closely related to plant input, soil variables, and the soil microbial community. We estimate that the maximum content and proportion of MAOC are 2.65 g kg−1 and 36.71% with continuous succession, based on the soil clay and silt contents. Overall, revegetation improved the stability of SOC. Our study highlights the importance of the revegetation of temperate desert areas to further mitigate climate change. [Display omitted] • Revegetation significantly changed the SOC fraction and improved SOC stability as a factor of stand age. • Revegetation increased the content and proportion of MAOC, whereas it increased POC content while decreasing its proportion. • The MAOC and POC are closely related to plant input, soil variables, and the soil microbial community. • The maximum content and proportion of MAOC are 2.65 g kg−1 and 36.71% with continuous succession. [ABSTRACT FROM AUTHOR]

• Desert plants had high hydraulic safety and low xylem hydraulic conductivity. • Shrubs and trees diverged in hydraulics but not for native and introduced species. • Hydraulic safety and growth rather than climate of origin driven plant survival. The species-poor woodlands in arid regions are particularly vulnerable to climate change induced plant die-off. Searching for species suitable to replant in these areas is an effective way to prevent further expansion of land desertification. Good knowledge of drought resistance of species is critical for current replanting efforts, however, the related plant survival mechanisms in the process of restoration remain limited. Here, we tested the dominant drivers of plant survival in relation to climate factors, growth characteristics and functional traits including hydraulics and gas exchange across 35 multiple shrub and tree woody species in a common garden at the Tengger Desert, northwest China. We found a wide range of hydraulic thresholds among these desert species, with relatively high hydraulic safety and low xylem hydraulic conductivity. Pant survival was largely determined by hydraulic safety and growth status, but was not affected by the climate of the species' site of origin. Shrubs and trees diverged in hydraulic and growth characteristics, while no difference between native and introduced species was found. Our results highlight the critical roles of hydraulic safety and growth on determining the survival and drought adaptation during desert vegetation development, which provide a new insight into ecological restoration in arid regions under changing climate conditions. [ABSTRACT FROM AUTHOR]

[Display omitted] • Revegetation enhanced SOC mineralization rate in desert region. • Proportion of mineralizable SOC decreased after revegetation. • Temperature sensitivity of SOC mineralization increased with the stand ages. • SOC mineralization was critically related to available phosphorus and C:N ratio and temperature. Revegetation plays a critical role in the soil organic carbon (SOC) cycle, especially in desert regions. However, the effects of this restoration practice on SOC mineralization are poorly understood, which inhibit the accurate estimation of SOC sequestration. In this study, SOC mineralization rates in revegetated sites along a chronosequence in the Tengger Desert were investigated by the incubation method, and the relationships between SOC mineralization rate and the temperature (T) and soil moisture (SM) of incubation, soil properties and vegetation characteristics were analyzed. The results showed that SOC mineralization rates and its temperature sensitivity (Q 10) significantly increased after revegetation. The maximum CO 2 -C emission rates (MR), cumulative CO 2 -C emissions (CCE), potentially mineralizable SOC (C 0) and Q 10 increased by 0.04–5.62, 0.78–4.88, 0.94–4.04 and 0.37–0.47 times in 64 years following revegetation, respectively, while the proportion of C 0 to total SOC (C 0 /SOC) decreased by 2.12–7.22 times. T and SM and their interaction had significant influences on MR, CCE, C 0 and C 0 /SOC, while SM had no significant effect on Q 10. The stepwise multiple linear regression analysis showed that the SOC mineralization rate had greater R2 with stand age and smaller R2 with SM, indicating that the SOC mineralization was mainly regulated by the stand age. The SEMs indicated that the soil properties were the main direct factors affecting SOC mineralization. The RDA indicated that soil AP, C:N ratio and T were the key factors controlling SOC mineralization during the revegetation process. Our findings indicated that long-term revegetation in desert regions enhanced SOC transformation and its temperature sensitivity, but decreased the percentage of CO 2 -C loss from soil, thus leading to SOC accumulation. [ABSTRACT FROM AUTHOR]

• Soil carbon and nitrogen stocks markedly increased after afforestation in desert regions. • Soil organic carbon and nitrogen sequestered faster in topsoil than deep-soil. • Soil carbon stock were positively correlated to soil nitrogen stock and C:N ratio. • An asynchrony in soil nitrogen supply and soil carbon accumulation was found. • It would take about 139 and 177 years for SOC and TSN to recover following afforestation. Afforestation, as a key measure to curb land degradation and to drive the changes in soil C and N stocks and cycles, has been increasingly implemented in drylands worldwide. However, the long-term effects of this restoration practice on C accumulation in soil are still uncertain, especially because C-N interactions are poorly understood, which constrains the accurate assessment of potential soil C sequestration. In this study, we investigated the soil organic C (SOC) and soil total N (STN) storage in artificial shrublands in chronosequences in the Tengger Desert to address the hypothesis that afforestation with xerophytic shrubs significantly enhanced SOC and STN stocks in desert regions and that SOC and STN stocks would be positively correlated during the restoration processes. Our results showed that afforestation significantly enhanced SOC and STN accumulation. The SOC and STN stocks in 17-, 52- and 60-year-old artificial shrublands were 1.22, 2.67, 2.80 and 1.21, 2.33, 2.47 times greater than those in mobile sand dunes, respectively, with increased rates of 5.61 g C m−2 yr−1, 14.25 g C m−2 yr−1 and 13.30 g C m−2 yr−1 and 1.27 g N m−2 yr−1, 2.61 g N m−2 yr−1 and 2.50 g N m−2 yr−1, respectively. The significant enhancement of SOC and STN stocks primarily occurred in the upper 0–20 cm soil layer. SOC stocks were positively correlated with STN stocks and the C:N ratio, and the regression slopes increased with vegetation age, indicating a coupling relationship between SOC and STN stocks. Additionally, this finding suggests that the increase in STN stocks was slower than that of SOC during restoration, leading to an asynchrony in N supply and the demand and subsequent N limitations on SOC accumulation. It would take approximately 139 and 177 years to fully recover SOC and STN stocks in the 100 cm soil profile, respectively, in mobile sand dunes through afforestation with xerophytic shrubs in the Tengger Desert, which implied that afforestation-induced soil quality improvements were a long-term process and that soil conservation was a key issue in water-limited ecosystems; therefore, optimized management strategies are urgently needed. [ABSTRACT FROM AUTHOR]

The occurrence of outbreaks of Cronobacter strains causing necrotizing meningitis in China highlights the need for strain characterization and subtyping of this pathogenic species. A total of 43 Cronobacter isolates and five Enterobacteriaceae strains were used in this study. The strains were characterized using two molecular typing methods, including enterobacterial repetitive intergenic consensus sequence polymerase chain reaction ( ERIC- PCR) and sequence analysis of the gyrB gene. Genetic profiles of cluster analysis from these two molecular typing tests clearly showed that there was no close relationship between Cronobacter spp. and Enterobacteriaceae strains. Discriminatory index of ERIC- PCR typing for the 43 Cronobacter isolates and five Enterobacteriaceae strains was high ( D = 0.984) by Simpson's index of diversity based on the similarity value of more than 80% using Bio Numerics version 5.0. Sequence analysis of the gyrB gene was proven to be suitable for the phylogenetic analysis of the Cronobacter strains. These results demonstrate that ERIC- PCR combined with sequence analysis of the gyrB gene may be a reliable, rapid typing strategy for Cronobacter strains. Practical Applications Molecular typing of foodborne pathogenic bacteria has been shown as a useful tool for tracking the source of infection and detection of virulent strains, as well as for determining the geographical and host distribution of possible variants. ERIC- PCR provides rapid clustered results when a large number of Cronobacter spp. isolates need to be subtyped rapidly. Furthermore, partial sequence analysis of the gyrB gene was utilized to differentiate among the closely related isolates. The results of the current study suggest that ERIC- PCR in conjunction with the gyrB sequence analysis would provide a reliable and accurate typing strategy for Cronobacter spp. strains. This combination of techniques can be used as a rapid means of comparing Cronobacter spp. isolates for epidemiological investigations. [ABSTRACT FROM AUTHOR]

High-density genetic maps play a vital role in dissecting genetic components of biologically or agronomically important traits and molecular marker-assisted selection breeding, especially for a species with limited genomic information. Tree Peony (Paeonia suffruticosa Andr. Moutan DC.) is a traditional flowering plant in China, with important ornamental value, which have been spread around the world. However, less genetic and genomic information is available for the tree peony molecular studies. Here, we performed restriction site-associated DNA sequencing (RADseq) of an F1 population, derived from a traditional variety "Qing Long Wo Mo Chi (QL)" and a variety "Mo Zi Lian (MZL)". High-density genetic maps were developed using RADseq markers for female (1471 markers) and male (793 markers) parents. They covered 965.69 and 870.21 cM, with the average marker intervals of 0.66 and 1.10 cM along the seven and five linkage groups (LGs), respectively. Furthermore, the identified markers were assigned to 1671 bins, representing the unique genetic positions in LGs, and inter-marker distances smaller than 5 cM covered 97.93% of genetic maps. This study suggests that rapid de novo construction of genetic maps in peony could be conducted through RADseq approach, which provides an important tool for further linkage mapping and genomic structure analysis, and enable development of molecular markers for molecular breeding in tree peony. [ABSTRACT FROM AUTHOR]

Lifestyles in children and adolescents are associated with mental health, yet the combined effects of diet-related joint lifestyles on depression are unclear. A cross-sectional study was conducted in January 2020 in primary and secondary schools in Shanghai, China, with 6478 participants in the analysis. Lifestyle behaviors (physical activity, sleep duration, screen time, and diet quality) and depressive symptoms were measured using validated questionnaires. A series of multivariable logistic regressions were performed to examine the associations between lifestyle behaviors and their combinations and depression. The prevalence of depressive symptoms 12.2 % (n = 788). Compared to those considered physically active, physically inactive individuals showed higher odds of depression (adjusted odds ratio [aOR] = 1.206). Similarly, insufficient sleep duration (aOR = 1.449), long screen time (aOR = 1.457) and poor diet quality (aOR = 1.892) were all associated with higher odds of depression. Compared to participants with behaviors meeting all guidelines, the odds of depression increased as the number of behaviors not meeting guidelines increased in a dose-response relationship, with an average increase in depression odds of 49 % on average for each additional unhealthy behavior. Moreover, different combinations of behaviors not meeting guidelines showed varied odds of depression. Our research suggests that lifestyle behaviors not meeting guidelines in children and adolescents are associated with poorer mental health, and the risk varies with the number and specific combination of behaviors not meeting guidelines. Diet-related joint behaviors may be overlooked, and practical measures targeting joint lifestyles are needed to prevent and alleviate mental health problems among children and adolescents. • Multiple key lifestyle behaviors were examined, including dietary behavior that has not been encompassed before. • Multiple lifestyles not meeting the guidelines clustering were observed among children and adolescents. • Joint lifestyles not meeting the guidelines jeopardize children's and adolescents' mental health to a greater extent. [ABSTRACT FROM AUTHOR]

The ion exchange adsorption method is the most promising technique for lithium recovery from low-grade brines, and the main adsorbents are titanium-based and manganese-based ion-sieves. Their expensive cost and poor cycling performance, which have limited their industrial applications, need to be solved fundamentally by finding a new ion-sieve. Hence, in this work, a high-stability and low-priced lithium ion-sieve with aluminosilicate framework was successfully synthesized by solid-phase sintering. The cheap silicon and aluminum raw materials make this ion-sieve have a low synthesis cost. The adsorption behavior of ion-sieves fits the Langmuir model and pseudo-second-order kinetics, indicating that the adsorption of lithium is mainly monolayer adsorption, and the process is chemisorption. After ten cycles, the lithium adsorption capacity is still over 27 mg/g. Moreover, it can recover lithium in the brine of West Taijinar Salt Lake in China even at 160 °C due to the excellent stability of the aluminosilicate framework, which can effectively improve its industrial production efficiency. Therefore, it has great potential to extract lithium from liquid lithium resources with a high Mg/Li ratio. • The ion-sieves with aluminosilicate framework can be easily synthesized by solid phase method. • Silicon and aluminum can effectively reduce the cost of the ion sieves. • The adsorbents exhibit excellent selectivity and stability. [ABSTRACT FROM AUTHOR]

Importance: Misaligned dietary rhythmicity has been associated with metabolic diseases; however, its association with mental health remains largely unexplored., Objective: To examine the association between dietary rhythms and the mental health condition of shift workers, specifically airline crew members., Design, Setting, and Participants: This cross-sectional study analyzed data collected from the Civil Aviation Health Cohort of China, an ongoing large-scale health survey of pilots, flight attendants, and air security officers employed by major airline companies in China. Participants aged 18 to 60 years were invited through text messages to complete a web-based survey. The data collection period was December 2022 to March 2023. Statistical analysis was performed from July 24, 2023, to April 12, 2024., Exposure: Data on timing of breakfast and dinner on workdays and rest days, daily time windows for food intake, and meal and eating jet lags were collected and calculated., Main Outcomes and Measures: Anxiety and depressive symptoms were measured using the 7-item Generalized Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. Multivariate logistic regressions were performed to evaluate the associations of anxiety and depression with meal timing, eating window time, meal jet lag (ie, delayed meals), and eating jet lag (ie, delayed eating). All models were adjusted for individual socioeconomic, demographic, and lifestyle characteristics., Results: Of the 22 617 participants (median [IQR] age, 29.1 [26.3-33.7] years; 13 712 males [60.6%]), 1755 (7.8%) had anxiety and 2768 (12.2%) had depression. After controlling for confounding factors, having dinner after 8 pm on morning-shift days was associated with increased odds of anxiety (adjusted odds ratio [AOR], 1.78; 95% CI, 1.53-2.05) and depression (AOR, 2.01; 95% CI, 1.78-2.27), compared with consuming dinner before 8 pm. Similar results were observed on night-shift days and rest days. An eating window of less than 12 hours was associated with reduced odds of anxiety (AOR, 0.84; 95% CI, 0.75-0.93) and depression (AOR, 0.81; 95% CI, 0.75-0.89) on morning-shift days; the results remained significant on rest days. Delayed dinner on morning-shift days was associated with increased odds of anxiety (AOR, 1.32; 95% CI, 1.13-1.54) and depression (AOR, 1.39; 95% CI, 1.22-1.58). On night-shift days, delayed dinner was associated with higher odds of anxiety (AOR, 1.22; 95% CI, 1.06-1.39) and depression (AOR, 1.21; 95% CI, 1.08-1.36). On morning-shift days, delayed eating rhythms were associated with higher odds of depression (AOR, 1.35; 95% CI, 1.13-1.61), whereas advanced eating rhythms were associated with lower odds of anxiety (AOR, 0.78; 95% CI, 0.70-0.87)., Conclusions and Relevance: This cross-sectional study found that meal timing, long eating window, and meal jet lags were associated with increased odds of depression and anxiety. These findings underscore the need for interventions and supportive policies that help mitigate the adverse implications of shift work and irregular working hours for the mental health of shift workers.

Tenofovir alafenamide fumarate (TAF) is a first-line drug for treating hepatitis B virus infection. This study aimed to establish the prodrug-metabolite population pharmacokinetic (PK) model for TAF and its metabolite tenofovir (TFV) in healthy Chinese volunteers and evaluate the factors affecting the PK. Using 1043 TAF and 1198 TFV plasma sample concentrations collected from 67 healthy volunteers, a population PK model was developed using the nonlinear mixed-effects model. The 1-compartment model containing 4 transit compartments and the 2-compartment model accurately described the PK of TAF and TFV, respectively. Covariates such as meal state and sex were found to be statistically significant and potentially clinically relevant. Both internal and external validations demonstrated good stability and predictive performance of the connected model. This study elucidated the PK process by which TAF was absorbed, converted, and finally metabolized and eliminated as TFV, and explored the sources of interindividual variability between TAF and TFV., (© 2023, The American College of Clinical Pharmacology.)

Urgent natural environmental events, such as floods, power failures, and epidemics, result in disruptions to the traffic system and heavy disturbances in public requirements. In order to strengthen the ability of the transport network to handle urgent natural environmental issues, this paper simulates the disruption situation of traffic stations in the urban agglomeration by attacking nodes, and evaluates the ability of the transport network to resist disruptions (i.e., invulnerability). Firstly, the model of the urban agglomeration integrated passenger transport network is established based on complex network theory. The highway network, railway network, and coupling network are combined into a multi-layer network space structure, and the edge weight is calibrated by travel time and cost. Secondly, the invulnerability simulation process including multiple attack modes under random and deliberate attack strategies is sorted out. By improving the traditional network efficiency indicator, the network impedance efficiency indicator is proposed to measure network performance, and the network relative impedance efficiency indicator is used to evaluate network invulnerability and identify key nodes. Finally, Chengdu-Chongqing urban agglomeration is taken as a case study. The results show that the network does not collapse quickly and it shows certain invulnerability and robustness under continuous random attacks. Network performance and invulnerability are not necessarily positively correlated. The failure of individual nodes that are small in scale but act as transit hubs may significantly degrade the network performance. The identified key nodes have significance for guiding the construction, maintenance, and optimization of the urban agglomeration passenger transport network, which is conducive to promoting public safety.

In order to encourage innovative medicine to address Chinese unmet medical needs, China has changed its drug regulatory landscape to speed up access to new medicines. In order to understand the fast-changing landscape and to enable planning of more global drug development programs and study designs in China, we reviewed 15 published clinical pharmacology-related guidances by the National Medical Products Administration (NMPA), and compared them with reference guidances from the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), or the International Conference on Harmonization (ICH), to understand the similarities and differences, especially any China-specific requirements, such as ethnic sensitivity analysis. Overall, by reviewing these clinical pharmacology-related NMPA guidances, it is clear that NMPA guidances are very similar to FDA, EMA, and ICH guidances. There are no relevant differences in the major principles, but some differences in structure, contents, and focus were noted. The NMPA is adapting flexibility statements into newly published guidances. Ethnic sensitivity analysis needs to be implemented early in drug development plans. The NMPA encourages sponsors to conduct early clinical trials in China or include China early in multiregional clinical trials, and to obtain safety, efficacy, and pharmacokinetic data for ethnic sensitivity analysis. Depending on the stage of development, ethnic sensitivity analysis can be conducted using in vitro or literature data, other Asian clinical data, or Chinese clinical data., (© 2021 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics.)

Objective: Vitamin D-dependent rickets type IA (VDDR-IA) is a rare autosomal recessive disorder characterized by the early onset of severe rickets. The objectives of this study were twofold: (1) to analyze the clinical characteristics and therapy of two patients with VDDR-IA from two separate Chinese families, and (2) investigate the CYP27B1 gene mutations in two large pedigrees., Methods: Medical history, clinical manifestations, physical examination, radiological findings and laboratory data were analyzed from two patients with VDDR-IA. Serum 1, 25-dihydroxyvitamin D [1, 25-(OH) 2 D 3 ] of the two patients and their respective families were measured by ELISA and blood samples from both families was obtained for CYP27B1 gene sequence., Results: Two patients had typical manifestations and radiological evidence of rickets. Laboratory data showed hypocalcaemia and hypophosphataemia, along with high levels of serum alkaline phosphatase, parathyroid hormone and 25-hydroxyvitamin D 3. However, serum 1,25-(OH) 2 D 3 level were low in the patients but normal in their family members. Genetic sequence identified two patients were homozygous for a duplication mutation in exon 8 of CYP27B1 gene (c.1319&#95;1325dupCCCACCC, p.Phe443Profs * 24). After treating with calcitriol and calcium, there was biochemical improvement with normalization of serum calcium and phosphorus, and radiographic evidence of compensatory skeletal mineralization. One patient developed nephrocalcinosis during follow-up., Conclusions: This study identified a recurrent seven-nucleotide insertion of CYP27B1 in two large pedigrees, and compared the clinical characteristics and individual therapy of two affected patients. Additionally, our experience further supports the notion that nephrocalcinosis can occur even on standard doses of calcitriol and oral calcium, and normal level of serum calcium, phosphorus, PTH and 25-(OH)D 3 .

BACKGROUND The association between body mass index (BMI) and recurrence of anorectal abscess remains controversial. This study investigated the exact relationship between BMI and anorectal abscess recurrence or anal fistula formation following initial surgery. MATERIAL AND METHODS This was a retrospective registry-based study conducted at the First Affiliated Hospital of Guizhou University of Chinese Medicine. Patients treated for anorectal abscess from 01/2015 to 03/2016 were included. Clinical data and time to recurrence were recorded. The Cox regression model was used to estimate the association between BMI and recurrence. RESULTS A total of 790 patients were operated on during the study period. The average age of the participants was 38.3±11.6 years, and 83.2% were male. Median follow-up was 27 (range, 1-38) months. Compared with the low BMI (range, 15.7-22.8 kg/m²) patients, the high BMI (range, 26.0-40.6 kg/m²) patients showed higher risk of recurrence (HR=1.75, 95% CI: 1.15-2.67). In the non-adjusted model, high BMI was found to be positively correlated with recurrence (HR=1.62, 95% CI: 1.10-2.40, P=0.02), and a stronger association was found in the fully adjusted model (HR=1.75, 95% CI: 1.15-2.67, P=0.01). BMI was also used as a continuous variable for sensitivity analysis, and a similar trend was observed (P=0.01 for trend). CONCLUSIONS Elevated BMI is an independent risk factor of anorectal abscess recurrence and for increased risk of abscess recurrence or anal fistula formation.

A field experiment was conducted using a 3 × 3 orthogonal regression design to explore the growth promotion of one-year-old Yunnan pine seedlings (Pinus yunnanensis Franch.) in response to foliar application of IAA (indole-3-acetic acid) at rates of 0, 200 and 400 mg·L(-1) and IBA (indole-3-butyric acid) at rates of 0, 200 and 400 mg·L(-1) in order to promote the growth during the seedlings' early stage. The experiment was conducted at the Lufeng Village Forest Farm of Yiliang County in Kunming, Yunnan, China. The results showed that IAA and IBA were effective in growth promotion of Yunnan pine seedlings. The response of both growth increment and biomass accumulation to the concentration of IAA and IBA can be modeled using a bivariate surface response, and each growth index had a peak value. Growth indexes increased with the increase of the dosage of photohormones before reaching a peak value, and then decreased. The different growth indexes had various responses to the concentrations and ratio of IAA and IBA. The foliar application of IAA in combination with IBA showed the largest improvement on the biomass of the needles, followed by stems and roots. The higher ratio of IAA promoted stem diameter growth, root system development and biomass accumulation in the needles, while a higher ratio of IBA contributed to height growth and biomass accumulation in the stem. Based on the auxin effect equations on the different growth indexes and surface response, the optimum concentrations and the (IAA:IBA) ratios can be obtained. The optimum concentrations of IAA and IBA were 167 and 186, 310 and 217, 193 and 159, 191 and 221, and 206 and 186 mg·L(-1), with corresponding ratios of 1:1.11, 1:0.70, 1:0.82, 1:1.15 and 1:0.90, respectively, at the maximum seedling height and collar diameter growth as well as biomass accumulation at the root, stem and needle. The above growth indexes were 22.00%, 79.80%, 48.65%, 82.20% and 107.00% higher than the control treatment.