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Recent studies of two-phase non-coaxial analogue experiments and natural rifts suggest that the pre-existing faults that form in the first-phase rift could strongly influence the fault development during a subsequent phase of extension. However, related models from natural examples are still lacking. Here we compare the fault geometry and evolution with different pre-existing fault arrays in two adjacent areas (Xijiang and Lufeng sags) from the Pearl River Mouth Basin in the South China Sea. This basin has experienced two-phase rifting including the middle Eocene rift phase 1 (NW–SE extension) and a late Eocene–early Oligocene rift phase 2 (N–S extension). The Xijiang Sag developed an approximately NE-striking listric fault system, while the Lufeng Sag formed complex structure is composed of six major faults with various orientations. We demonstrate that the first-phase fault network in the Xijiang Sag is a colinear listric fault system, while that in the Lufeng Sag comprises two sets of (non-colinear) faults. In the Xijiang Sag, the second-phase fault network consists of the reactivated first-phase faults, newly formed faults abutting against or cross-cutting the pre-existing reactivated faults or occurring between the pre-existing faults. In contrast, in the Lufeng Sag, the second-phase faults include partially reactivated first-phase non-colinear faults and new non-colinear faults. The influence of first-phase faults on second-phase faults is manifested in several distinctive ways. Two sets of major non-colinear faults led to the development of more complicated oblique faults in the Lufeng Sag. The development of the second-phase faults is the result of a combination of geometry and heterogeneity of pre-existing fabrics, variation of extension direction and local perturbations set up by the geometry of pre-existing faults. The Xijiang Sag is controlled by a NE-striking listric fault system, the Lufeng Sag formed complex structure composed of six major faults with various orientations. The heterogeneous intra-basement fabrics led to a faulting viariablity between the Xijiang and Lufeng sags. The influence of first-phase faults on second-phase faults is manifested in several distinctive ways. [ABSTRACT FROM AUTHOR]

Background and purpose: The chemokine monocyte chemoattractant protein‐1 (MCP‐1) is involved in the pathogenesis of Alzheimer's disease (AD). This study aimed to investigate whether urinary MCP‐1 can distinguish patients with AD, patients with amnestic mild cognitive impairment (aMCI) and cognitively normal (CN) subjects. Methods: A total of 754 participants, including 97 patients with AD, 50 patients with aMCI and 84 age‐ and sex‐matched CN controls as well as a cohort of 523 CN subjects of different ages, were enrolled from five hospitals located in different areas of China. Urinary MCP‐1 levels were determined using enzyme‐linked immunosorbent assays. The correlations between urinary MCP‐1 levels and cognition test scores or age were analysed. The optimal diagnostic sensitivity and specificity were determined using receiver operating characteristic curve analysis. Results: In the cohort of CN subjects of different ages, urinary MCP‐1 levels increased with ageing and were correlated with age. The urinary MCP‐1 levels were higher in females than in males. In the cohort composed of patients with AD, aMCI and age‐ and sex‐matched CN controls, urinary MCP‐1 levels were significantly higher in patients with AD and aMCI than in CN controls. There were no differences in urine MCP‐1 levels between the AD group and the aMCI group. The urinary MCP‐1 levels were correlated with the Mini‐Mental State Examination scores and age, and were able to differentiate patients with AD and aMCI from CN subjects. Conclusions: Urinary MCP‐1 is a potential biomarker for the diagnosis of AD and aMCI. [ABSTRACT FROM AUTHOR]

Background: In previous epidemiological study, the prevalence of atopic dermatitis (AD) was 12.94% among children aged 1–7 years by clinical diagnosis, whereas that was 4.76% and 3.51% using U.K., and Hanifin and Rajka diagnostic criteria. Objective: We aimed to propose new diagnostic criteria for children and evaluate its efficiency in different populations. Methods: We screened atopic features and analysed their correlation with AD using data from a previous study. A new set of diagnostic criteria for children in China was proposed and validated in 1031 children in outpatient clinics and 538 children in a birth cohort survey. Clinical diagnosis and atopic feature evaluation were performed face to face by dermatologists specialized in AD. Three criteria were compared for diagnostic efficiency using the clinical diagnosis as the reference. Results: The new diagnostic criteria for children were based on (i) pruritus; (ii) 'typical morphology and distribution' or 'atypical morphology and distribution with xerosis'; and (iii) a chronic or chronically relapsing course. Compared to classical diagnostic criteria, the sensitivity of the new diagnostic criteria was significantly higher in the epidemiological survey and the clinical setting, especially obvious among mild and moderate AD. In the birth cohort, the new criteria showed similar sensitivity and specificity. Conclusion: The new criteria for children yielded higher sensitivity for the diagnosis of AD in the epidemiological survey and clinical setting, particularly for mild and moderate AD. Among the birth cohort with a complete medical history, three criteria showed similar sensitivity and specificity. Linked Commentary: T. Bieber. J Eur Acad Dermatol Venereol 2020; 34: 438–439. https://doi.org/10.1111/jdv.16223. [ABSTRACT FROM AUTHOR]

Curbside bus stops and bus bays are mainstream forms of bus stops in China. There is no specific study available to assess and compare the safety performance of bus stops near intersections. The study provides insights into contributing factors that are positively or negatively related to the variation of the severity of conflicts between vehicles near curbside bus stops or bus bays in the vicinity of signalized intersections. The traffic conflict technique and the ordered probit model are developed to identify the contributing factors on conflict severity outcomes (potential, slight and serious). Results show that conflict-related variables are significantly different under two types of bus stops (location of the bus stop, distance from the intersection, traffic volume, number of dwelling buses, et al). There are more conflicts occurring near curbside bus stops under the same observation period, but the proportion of serious conflicts are higher around bus bays. Bus stops built downstream the intersection can help to decrease the severity level of conflicts from the point of view of vehicle safety. In addition, appropriate distance from the intersection, bus route design and non-motorized vehicle management are conducive to improving the level of road safety. This paper focuses on the conflicts between vehicles without considering the effects of these various options on the safety of pedestrians, the safety performance of bus stops deserves further research. [ABSTRACT FROM AUTHOR]

Background and purpose: Stroke is a heavy economic and health burden for the patients and society. This study aimed to evaluate hospital length of stay (LOS) by admission characteristics and costs correlated with medical insurance status for cerebral infarction in a medium-sized city in China. Methods: A total of 557 consecutive patients with principal diagnosis of cerebral infarction were enrolled. Admission characteristics, LOS, and costs were retrospectively analyzed. Results: The mean LOS was 18.5 days (median, 16 days). Our analysis demonstrated that medical insurance status, stroke severity (National Institutes of Health Stroke Scale score, Functional Independence Measure cognitive and motor score, Glasgow coma scale), Oxfordshire Community Stroke Project (OCSP) classification, some comorbidities (coronary heart disease, chronic obstructive pulmonary disease, and hyperlipemia), and raised leukocytes were the main explanatory factors for LOS by stepwise multiple regression model. The mean per patient costs were US$ 983.0, and mean daily costs US$ 67.0. Drugs were the most expensive cost subtype, all subtypes costs except non-medical care were significantly higher in patients with state medicine than in those with new cooperative medical scheme (NCMS) ( P < 0.001). Conclusion: Stroke severity, OCSP classification, raised leukocytes on admission, some comorbidities, and medical insurance status may help to predict LOS for patients with cerebral infarction. Healthcare expenditures were heavy burdens to inhabitants. State medicine patients could shorten unnecessary LOS to improve the resources allocation and cost-efficiency. [ABSTRACT FROM AUTHOR]

Conventional PCR and two real-time PCR (RTi-PCR) methods were developed and compared using the primer pairs CQULA03F/CQULA03R and CQULA04F/CQULA04R, and TaqMan probe CQULAP1 designed from a species-specific sequence of the rplJ/rplL ribosomal protein gene, for diagnosis of citrus huanglongbing (HLB) disease in southern China. The specificity and sensitivity of the three protocols for detecting ‘ Candidatus Liberibacter asiaticus’ in total DNA extracts of midribs collected from infected citrus leaves with symptoms in Guangxi municipality, Jiangxi Province and Zhejiang Province, were tested. Sensitivities using extracted total DNA (measured as copy number, CN per µL of recombinant plasmid solution) were 439·0 (1·30 × 105 CN µL−1), 4·39 (1·30 × 103 CN µL−1) and 0·44 fg µL−1 (1·30 × 102 CN µL−1) for conventional PCR, TaqMan and SYBR Green I (SGI) RTi-PCR, respectively. SGI RTi-PCR was the most sensitive, but its specificity needed to be confirmed by running a melt-curve assay. The TaqMan RTi-PCR assay was rapid and had the greatest specificity. Concerning the correlation of PCR detection results with the various HLB symptoms, uneven mottling of leaves had the highest positive rate (96·50%), indicating that leaf mottling was the most reliable symptom for field surveys. Dynamic analysis results from the TaqMan assays showed that the titre (CN) g−1 citrus tissue of ‘ Ca. L. asiaticus’ was highest between October and December (threshold cycle ( Ct) average = 29·3, CN = 3·35 × 107) and lowest between March and May ( Ct average = 32·0, CN = 5·10 × 106) in 2004 and 2005. The optimized molecular-based assays should prove useful for presymptom diagnosis of HLB disease, monitoring and identification of ‘ Ca. L. asiaticus’, and field epidemic regulation. [ABSTRACT FROM AUTHOR]

Programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are key components in immune checkpoint studies across various tumors, including those in the urinary tract. The utilization of PD-1/PD-L1 inhibitors in urinary tract tumors is on the rise. This study provides a comprehensive overview of PD-1/PD-L1 research in urinary tract tumors through bibliometric analysis. A search was conducted in the Web of Science Core Collection (WoSCC) database for academic papers on PD-1/PD-L1 in urinary tract tumors published between January 1, 1999, and September 3, 2022. Tools such as VOSviewer, CiteSpace, and an online bibliometric platform, were used for an in-depth analysis covering countries, institutions, authors, journals, references, and keywords. A total of 1,711 articles on PD-1/PD-L1 in urinary tract tumors were analyzed. The United States led in article contributions, followed by China and Japan. Harvard University was the top institution in this research area. With notable conctributions from Choueiri TK, who authored 48 related articles. The Journal for Immunotherapy of Cancer was the top publisher, and Topalian SL's 2012 publication in The New England Journal of Medicine was the most cited article. Key author keywords included "immunotherapy," "PD-L1," "renal cell carcinoma," "bladder cancer," and "immune checkpoint inhibitors." Notably, research on the role of PD-1/PD-L1 in kidney and bladder cancer has garnered significant attention.

Introduction: This study aims to explore the current status of dementia-specific diagnosis and treatment in China., Methods: This national survey was conducted in mainland China from September 2022 to February 2023, with strong support from the Cognitive Disorders Group of the Chinese Society of Neurology, Chinese Medical Association., Results: Among 2721 hospitals surveyed, 244 (8.97%) have dementia-specific clinics (DSCs) and 166 (6.10%) have dementia-specific inpatient departments (DSIDs). Almost all hospitals have brain structural imaging capabilities and basic hematological examinations, but dementia-specific medical staff (DSMS) equipped for DSCs or DSIDs are rare. The proportion of patients with cognitive impairment receiving care through a DSCs or DSIDs is low, and most patients present with advanced (moderate to severe) disease., Conclusion: The survey shows that the proportion of DSCs and DSIDs is low, and the regional distribution varies significantly. Trained DSMS and specialized facilities for the diagnosis and treatment of dementia are inadequate., Highlights: This study was a multi-center national research to comprehensively investigate the distribution and features of dementia-specific clinics and inpatient departments in mainland China, given that the limited literature was available regarding the dementia-specific centers. The study points to significant regional differences in the distribution of cognitive-specific clinics and inpatient departments in mainland China. More centers in Eastern Regions compared to Western Regions, a greater presence in provincial capitals as opposed to other cities, and a predominance of tertiary hospitals over non-tertiary ones. The aim is to provide data support for advancements in medical research within this field. Domestic dementia patients have inadequate access to specialized medical resources and expert assistance, which significantly contrasts with the growing number of dementia cases in China., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Odor emission during livestock manure treatment poses a threat to the environment and human health. However, the odor emission profiles and related factors of commonly employed poultry manure treatments have rarely been studied. Here, we explored the odor emission profiles of 3 common poultry manure treatments in China, namely, ectopic fermentation beds (EFB), annular composting troughs (ACT) and air-drying rooms (ADR). The results revealed that the total odor concentrations in the EFB, ACT and ADR groups were 2407.67 ± 512.94, 13444.00 ± 1269.92 and 621.33 ± 59.27, respectively. The ACT had the greatest number of odorants (31), followed by the ADR (27) and the EFB (24). Methyl mercaptan, acetic acid, acetaldehyde, hydrogen sulfide, ammonia and acrolein were the key odorous compounds detected in all the treatments. ACT contained the greatest number of key odorants (11) and exhibited an extensive co-occurrence relationship with the bacterial community. The 3 poultry manure treatments exhibited significant differences in the beta diversities of the bacterial community. The phylum of most bacteria associated with key odorants was Firmicutes, and Enterococcus and Oceanobacillus were significantly positively correlated with methyl mercaptan. The bacterial functional groups were enriched in carbohydrate metabolism, amino acid metabolism and energy metabolism, and the functional genes shaped the odor emission patterns in the poultry manure treatments. Redundancy analysis demonstrated that odor emission in the 3 treatments was positively correlated with Firmicutes abundance, pH, electrical conductivity and moisture. Thus, our study provides a good understanding of odor emission profiles in poultry manure treatments and data for precise odor emission control during livestock production., Competing Interests: DISCLOSURES The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Scientific assessment of urban ecological security (ES) is an important prerequisite to realize regional sustainable development. Previous studies lack the consideration of quality and poor systematic correlation, which could not reflect the internal dynamic relationship. On the basis of considering the time lag, this study divided the research process into the natural operation stage and the management feedback stage based on the driving forces, pressures, state, impacts, responses, management (DPSIRM) framework model and DEA theory, so as to effectively overcome the above shortcomings. Finally, we analyzed the spatio-temporal characteristics and influencing factors of the ES level of 108 cities in the Yangtze River Economic Belt (YREB) during 2005-2019. The results showed that: (a) both two stages showed a slow and fluctuating upward trend in time series, and the level of urban ES in the management feedback stage was significantly higher than that in the natural operation stage; (b) with the passage of time, the spatial distribution of ES in the natural operation stage gradually developed towards the middle and downstream of the YREB, while the management feedback stage mainly evolved from the midstream to the edge area; (c) the level of urban ES presented a different degree of spatial agglomeration phenomenon, and showed an increasing trend over time; and (d) the key influencing factors gradually changed from pressure to response during 2005-2019. This research aims to provide an innovative perspective for the measurement of urban ES, and provide scientific reference for improving urban ecological sustainable development., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

To investigate the status of dignity impairment symptoms in critically ill patients after ICU treatment and conduct a systematic analysis of its influencing factors, aiming to provide reference for clinical medical decision-making by healthcare professionals. A cross-sectional survey study. From April 15th to 21st, 2024, a cross-sectional survey was conducted in 40 tertiary Grade A comprehensive hospitals in 9 provinces, municipalities, and autonomous regions including Sichuan Province, Zhejiang Province, and Chongqing Municipality. Various critically ill patients who were admitted to ICU treatment were surveyed using a general information questionnaire and the Dignity Inventory. A total of 346 questionnaires were collected in this survey, with 333 valid questionnaires and an effective response rate of 96%. The incidence rate of dignity impairment symptoms in critically ill patients after ICU treatment was 39%. Multifactor logistic regression analysis showed that age [OR = 1.124, 95%CI=(1.067-1.184)], frequency of visits [OR = 1.875, 95%CI=(1.075-3.269)], length of ICU stay [OR = 1.352, 95%CI=(1.108-1.649)], and tracheotomy upon discharge [OR = 2.269, 95%CI=(1.273-4.044)] were risk factors for dignity impairment symptoms in critically ill patients after ICU treatment. Number of children [OR = 0.247, 95%CI=(0.106-0.576)] was a protective factor for dignity impairment symptoms in critically ill patients after ICU treatment. Although the incidence of dignity impairment symptoms in critically ill patients after ICU treatment is relatively low, the psychological trauma it causes cannot be ignored. Healthcare professionals must actively establish and improve its prevention and management system., (© 2024. The Author(s).)

The struggle women face in balancing work and family roles is a significant factor contributing to the decline in their fertility intentions. Therefore, work-family conflict serves as a crucial determinant influencing women's fertility intentions. This study aims to explore the internal mechanism between work-family conflict and the fertility intentions of Chinese women, using data obtained from 334 questionnaires. Data analysis was conducted using Mplus 8.0. The following conclusions were drawn: (1) There is a negative correlation between work-family conflict and women's fertility intentions. (2) Fertility attitudes play a mediating role in the relationship between work-family conflict and women's fertility intentions. (3) The relationship between work-family conflict and women's fertility intentions is moderated by income class. (4) The relationship between work-family conflict and women's fertility intentions is moderated by women's child-rearing burden. The findings of this study provide a foundation for governments at all levels to formulate population policies., (© 2024. The Author(s).)

Lead (Pb) pollution in sediments remains a major concern for ecosystem quality due to the robust interaction at the sediment/water interface, particularly in shallow lakes. However, understanding the mechanism behind seasonal fluctuations in Pb mobility in these sediments is lacking. Here, the seasonal variability of Pb concentration and isotopic ratio were investigated in the uppermost sediments of a shallow eutrophic drinking lake located in southeast China. Results reveal a sharp increase in labile Pb concentration during autumn-winter period, reaching ∼ 3-fold higher levels than during the spring-summer seasons. Despite these fluctuations, there was a notable overlap in the Pb isotopic signatures within the labile fraction across four seasons, suggesting that anthropogenic sources are not responsible for the elevated labile Pb concentration in autumn-winter seasons. Instead, the abnormally elevated labile Pb concentration during autumn-winter was probably related to reduction dissolution of Fe/Mn oxides, while declined labile Pb concentration during spring-summer may be attributed to adsorption/precipitation of Fe/Mn oxides. These large seasonal changes imply the importance of considering seasonal effects when conducting sediment sampling. We further propose a solution that using Pb isotopic signatures within the labile fraction instead of the bulk sediment can better reflect the information of anthropogenic Pb sources., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Coix lacryma-jobi L. is a traditional medicinal plant in east Asia and is an important crop in Guizhou province, southwest China, where there are elevated levels of soil mercury and arsenic (As). Exposure to multiple potentially toxic elements (PTEs) may affect plant accumulation of metal(loid)s and food safety in regions with high geological metal concentrations. Field experiments were conducted to study the effects of PTEs on metal(loid) accumulation and physiological response of C. lacryma in different plant parts at three pollution levels. Total root length, number of root tips, number of branches, and number of root crosses increased with increasing pollution level, with increases in highly polluted areas of 44.2, 57.0, 79.6, and 97.2%, respectively, compared to lightly polluted areas. Under multi-element stress the activity of C. lacryma antioxidant oxidase showed an increase at low and medium PTE concentrations and inhibition at high concentrations. The As contents were all below the maximum limit of cereal food contaminants in China (GB 2762-2022, As < 0.5 mg kg -1 ). The stems had high Tl bioconcentration factors but the translocation factors from stem to grain were very low, indicating that the stems may be a key plant part restricting Tl transport to the grains. C. lacryma increased root retention and reduced the transport effect, thus reducing metal accumulation in the grains. C. lacryma adapted to PTE stress through root remodeling and enhanced antioxidant enzyme activities., (© 2024. The Author(s).)

The developmental trajectory of audiovisual speech perception in Mandarin-speaking children remains understudied. This cross-sectional study in Mandarin-speaking 3- to 4-year-old, 5- to 6-year-old, 7- to 8-year-old children, and adults from Xiamen, China (n = 87, 44 males) investigated this issue using the McGurk paradigm with three levels of auditory noise. For the identification of congruent stimuli, 3- to 4-year-olds underperformed older groups whose performances were comparable. For the perception of the incongruent stimuli, a developmental shift was observed as 3- to 4-year-olds made significantly more audio-dominant but fewer audiovisual-integrated responses to incongruent stimuli than older groups. With increasing auditory noise, the difference between children and adults widened in identifying congruent stimuli but narrowed in perceiving incongruent ones. The findings regarding noise effects agree with the statistically optimal hypothesis., (© 2023 The Authors. Child Development © 2023 Society for Research in Child Development.)

Background: Stroke is a prevalent disease with a significant global impact. Effective assessment of stroke severity is vital for an accurate diagnosis, appropriate treatment, and optimal clinical outcomes. The National Institutes of Health Stroke Scale (NIHSS) is a widely used scale for quantitatively assessing stroke severity. However, the current manual scoring of NIHSS is labor-intensive, time-consuming, and sometimes unreliable. Applying artificial intelligence (AI) techniques to automate the quantitative assessment of stroke on vast amounts of electronic health records (EHRs) has attracted much interest., Objective: This study aims to develop an automatic, quantitative stroke severity assessment framework through automating the entire NIHSS scoring process on Chinese clinical EHRs., Methods: Our approach consists of two major parts: Chinese clinical named entity recognition (CNER) with a domain-adaptive pre-trained large language model (LLM) and automated NIHSS scoring. To build a high-performing CNER model, we first construct a stroke-specific, densely annotated dataset "Chinese Stroke Clinical Records" (CSCR) from EHRs provided by our partner hospital, based on a stroke ontology that defines semantically related entities for stroke assessment. We then pre-train a Chinese clinical LLM coined "CliRoberta" through domain-adaptive transfer learning and construct a deep learning-based CNER model that can accurately extract entities directly from Chinese EHRs. Finally, an automated, end-to-end NIHSS scoring pipeline is proposed by mapping the extracted entities to relevant NIHSS items and values, to quantitatively assess the stroke severity., Results: Results obtained on a benchmark dataset CCKS2019 and our newly created CSCR dataset demonstrate the superior performance of our domain-adaptive pre-trained LLM and the CNER model, compared with the existing benchmark LLMs and CNER models. The high F1 score of 0.990 ensures the reliability of our model in accurately extracting the entities for the subsequent automatic NIHSS scoring. Subsequently, our automated, end-to-end NIHSS scoring approach achieved excellent inter-rater agreement (0.823) and intraclass consistency (0.986) with the ground truth and significantly reduced the processing time from minutes to a few seconds., Conclusion: Our proposed automatic and quantitative framework for assessing stroke severity demonstrates exceptional performance and reliability through directly scoring the NIHSS from diagnostic notes in Chinese clinical EHRs. Moreover, this study also contributes a new clinical dataset, a pre-trained clinical LLM, and an effective deep learning-based CNER model. The deployment of these advanced algorithms can improve the accuracy and efficiency of clinical assessment, and help improve the quality, affordability and productivity of healthcare services., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: The superiority of balloon angioplasty plus aggressive medical management (AMM) to AMM alone for symptomatic intracranial artery stenosis (sICAS) on efficacy and safety profiles still lacks evidence from randomised controlled trials (RCTs)., Aim: To demonstrate the design of an RCT on balloon angioplasty plus AMM for sICAS., Design: Balloon Angioplasty for Symptomatic Intracranial Artery Stenosis (BASIS) trial is a multicentre, prospective, randomised, open-label, blinded end-point trial to investigate whether balloon angioplasty plus AMM could improve clinical outcome compared with AMM alone in patients with sICAS. Patients eligible in BASIS were 35-80 years old, with a recent transient ischaemic attack within the past 90 days or ischaemic stroke between 14 days and 90 days prior to enrolment due to severe atherosclerotic stenosis (70%-99%) of a major intracranial artery. The eligible patients were randomly assigned to receive balloon angioplasty plus AMM or AMM alone at a 1:1 ratio. Both groups will receive identical AMM, including standard dual antiplatelet therapy for 90 days followed by long-term single antiplatelet therapy, intensive risk factor management and life-style modification. All participants will be followed up for 3 years., Study Outcomes: Stroke or death in the next 30 days after enrolment or after balloon angioplasty procedure of the qualifying lesion during follow-up, or any ischaemic stroke or revascularisation from the qualifying artery after 30 days but before 12 months of enrolment, is the primary outcome., Discussion: BASIS trail is the first RCT to compare the efficacy and safety of balloon angioplasty plus AMM to AMM alone in sICAS patients, which may provide an alternative perspective for treating sICAS., Trial Registration Number: NCT03703635; https://www., Clinicaltrials: gov., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study aimed to investigate the antimicrobial resistance (AMR), antibiotic resistance genes (ARGs) and integrons in 157 Escherichia coli (E. coli) strains isolated from feces of captive musk deer from 2 farms (Dujiang Yan and Barkam) in Sichuan province. Result showed that 91.72% (144/157) strains were resistant to at least one antimicrobial and 24.20% (38/157) strains were multi-drug resistant (MDR). The antibiotics that most E. coli strains were resistant to was sulfamethoxazole (85.99%), followed by ampicillin (26.11%) and tetracycline (24.84%). We further detected 13 ARGs in the 157 E. coli strains, of which blaTEM had the highest occurrence (91.72%), followed by aac(3')-Iid (60.51%) and blaCTX-M (16.56%). Doxycycline, chloramphenicol, and ceftriaxone resistance were strongly correlated with the presence of tetB, floR and blaCTX-M, respectively. The strongest positive association among AMR phenotypes was ampicillin/cefuroxime sodium (OR, 828.000). The strongest positive association among 16 pairs of ARGs was sul1/floR (OR, 21.667). Nine pairs positive associations were observed between AMR phenotypes and corresponding resistance genes and the strongest association was observed for CHL/floR (OR, 301.167). Investigation of integrons revealed intl1 and intl2 genes were detected in 10.19% (16/157) and 1.27% (2/157) E. coli strains, respectively. Only one type of gene cassettes (drA17-aadA5) was detected in class 1 integron positive strains. Our data implied musk deer is a reservoir of ARGs and positive associations were common observed among E. coli strains carrying AMRs and ARGs., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Groundwater contamination in China has been greatly concerned due to dramatically increasing fresh water demand accompanied by economic development. However, little is known about aquifer vulnerability to hazardous matters especially in previously contaminated site of rapidly urbanizing cities. Here, we collected 90 groundwater samples from Xiong'an New Area during wet and dry seasons of 2019 and characterized the composition and distribution of emerging organic contaminants (EOCs) in this strategically developing city. A total of 89 EOCs, assigned to organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and volatile organic compounds (VOCs), were detected with the frequencies ranging from 1.11 %-85.6 %. Methyl tert-butyl ether (16.3 μg/L), Epoxid A (6.15 μg/L), and α-Lindane (5.15 μg/L) could be identified as major contributors to groundwater organic pollution. Significant aggregation of groundwater EOCs along Tang River were found due to historical residue and accumulation from wastewater storage there before 2017. Significant seasonal variations (p < 0.05) in the types and concentrations of EOCs could be attributed to discrepant pollution sources between varying seasons. Human health effects from exposure to groundwater EOCs were further evaluated with negligible risk (<10 -4 ) in most samples (97.8 %) and notable risk (10 -6 -10 -4 ) in several monitored wells (2.20 %) located along Tanghe Sewage Reservoir. This study provides new evidences for aquifer vulnerability to hazardous matters in historically contaminated sites and is of significant to groundwater pollution controlling and drinking water safety for rapidly urbanizing cities., Competing Interests: Declaration of competing interest The authors declare that no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: The aim of this study was to explore the mechanism between public services and residents' health, focusing on the role of spatial geographical factors. Methods: Leveraging a comprehensive panel dataset encompassing 30 mainland Chinese provinces from 2007 to 2019, this study engineered a spatial Durbin model furnished with dual fixed effects through the application of the Lagrange multiplier, Hausman, and likelihood ratio tests. The primary objective was to delve into the repercussions of varying public service levels on residents' health outcomes. Results: The empirical findings reveal a palpable spatial autocorrelation between residents' health outcomes and the public services levels dispensed across Chinese provinces. Intriguingly, an elevation in the public service level in a given province not only ameliorates its residents' health outcomes but also triggers a spatial spillover effect, thereby positively influencing residents' health in neighboring provinces. The rigorous endogeneity and robustness checks affirm the reliability of the principal outcomes. Conclusion: Due to the increase in social uncertainty, all regions should break free of the administrative monopoly, enhance regional integration and development, and improve residents' health status by clustering public service supply., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Jia, Liu, Wang and Peng.)

Polycyclic aromatic hydrocarbons (PAHs) and substituted PAHs (SPAHs) are persistent organic pollutants prevalent globally, and SPAHs have received widespread attention in recent years due to their stronger toxicity and carcinogenicity compared to PAHs. There is a lack of systematic examination of PAHs and their derivatives in watersheds. Thus, to clarify the current status, possible sources, and potential risks of PAHs and their derivatives in watersheds, a study was conducted on Yitong River in China. The results showed that the concentrations of ∑PAHs, ∑OPAHs, and ∑NPAHs ranged from 297.9-1158.3 ng/L, 281.1-587.2 ng/L, and 65.7-269.1 ng/L, respectively. Diagnostic ratio analysis showed that the PAHs were mainly derived from petroleum sources, agricultural waste, and coal combustion. Nitrated PAHs (NPAHs) were mainly derived from liquid combustion sources, and oxygenated PAHs (OPAHs) were derived mainly from petroleum source emissions and atmospheric deposition. The exposure risk model of PAHs revealed that 86% of the studied sites would pose carcinogenic risks after dermal contact. The contaminant causing a major carcinogenic risk was DahA, and none of the sites produced non-carcinogenic risks. The lifetime carcinogenic risk of NPAHs was 8.85 × 10 -10 -1.44 × 10 -4 , and some surface waters presented with potential carcinogenic risks., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Swallowing disorder is a common sequela after recovery from COVID-19. Acupuncture is an important traditional therapy for treating swallowing disorder. However, the efficacy of acupuncture for swallowing disorder after recovery from COVID-19 lacks evidence-based medicine., Methods: All randomized controlled trials of acupuncture for swallowing disorder after recovery from COVID-19 will be retrieved and collected from December 2019 to November 2022 with no language restrictions. PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Chinese Biomedical Database, Chinese Science and Technology Journal Database (VIP), and the Wanfang Database will be searched. Two researchers will independently select studies, extract data, and evaluate study quality. The Cochrane risk of bias tool for randomized trials will be used to assess the risk of bias in the included studies. Statistical analyses will be performed using Review Manager version 5.3., Results: This study will provide a high-quality and convincing assessment of the efficacy and safety of acupuncture for swallowing disorder after recovery from COVID-19 and will be published in peer-reviewed journals., Conclusion: Our findings will provide a reference for future clinical decisions and guidance development., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

To direct financial resources for achieving the goal of sustainable development, Chinese government has devoted increasing efforts to developing green finance. However, few studies explored the relationship between green finance and environmental governance. Thus, this paper first theoretically discusses the interactive connection between green finance and environmental governance. And then we construct two comprehensive indicator systems and use entropy method to calculate green finance index (GFI) and environmental governance index (EGI) for 30 provinces of China from 2004 to 2020. The theoretical analysis unveils the complementary and mutual reinforcing relationship of the interaction between green finance and environmental governance through green industry. Using the data of GFI and EGI, the coupling coordination degree of green finance and environmental governance (CCDGE) is measured by coupling coordination model. The trend analysis discovers that GFI is increasing over time while EGI starts decreasing from 2013. Although GFI has grown more rapidly than EGI, but the development of green finance still lags behind environmental governance because of its short history. Just because of the uncoordinated development between green finance and environmental governance, CCDGE has been hovering in the moderate coupling coordination stage for a long time and still has a great distance to the high coupling coordination level. These findings imply that the relationship between green finance and environmental governance is still in a state of disorderly development that restricts each other. Furthermore, the findings of spatial-temporal analysis show there are obvious regional differences in GFI and EGI and the interactive effect between green finance and environmental governance. Specifically, GFI and EGI in eastern China are the highest, while CCDGE presents with a ladder decline status of "eastern region > central region > northeast region > west region." Our findings provide vital references for policymakers to promote the coupling coordination development between green finance and environmental governance., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Although children develop categorical speech perception at a very young age, the maturation process remains unclear. A cross-sectional study in Mandarin-speaking 4-, 6-, and 10-year-old children, 14-year-old adolescents, and adults (n = 104, 56 males, all Asians from mainland China) was conducted to investigate the development of categorical perception of four Mandarin phonemic contrasts: lexical tone contrast Tone 1-2, vowel contrast /u/-/i/, consonant aspiration contrast /p/-/p h /, and consonant formant transition contrast /p/-/t/. The results indicated that different types of phonemic contrasts, and even the identification and discrimination of the same phonemic contrast, matured asynchronously. The observation that tone and vowel perception are achieved earlier than consonant perception supports the phonological saliency hypothesis., (© 2022 The Authors. Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

Ecological compensation has become very common worldwide due to the imbalance in the development of modern society, economy, and the environment and the increased pressure on ecosystem carrying capacity. Nonetheless, the various approaches for quantifying ecological compensation standards differ significantly. Thus, the process for determining a reasonable ecological compensation threshold is important to understand. To ensure the maximization of ecosystem service supply and economic benefit incentives for farmers, this paper constructs a discriminant model of an ecological compensation threshold based on the minimum data approach and the most appropriate land use scenario to define the ecological compensation threshold of the Sloping Land Conversion Program in the upper Yangtze River basin. The results show that with an increase in the compensation price, the proportion of farmers participating in returning farmland to forests and grassland increases, and water conservation increases. However, the discriminant curve first increases to a certain threshold point and then decreases, after which the ecoefficiency rate obtained from the compensation decreases. The ecological compensation thresholds for Chongqing, Sichuan, Yunnan, Guizhou, Hubei, Qinghai, Gansu, Tibet and Shaanxi provinces are 17.74 yuan/m 3 , 13.79 yuan/m 3 , 19.1 yuan/m 3 , 17.79 yuan/m 3 , 15.28 yuan/m 3 , 45.14 yuan/m 3 , 17.23 yuan/m 3 , 25.2 yuan/m 3 and 22.36 yuan/m 3 , respectively. This research examines ecological compensation standards in different watersheds throughout the world and discusses the relationship between ecological compensation and water conservation. The discriminant model of the ecological compensation threshold can provide a new reference for the implementation and management of ecological compensation policies., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Mainland China, the world's most populous region, experienced a large-scale coronavirus disease 2019 (COVID-19) outbreak in 2020 and 2021, respectively. Existing infodemiology studies have primarily concentrated on the prospective surveillance of confirmed cases or symptoms which met the criterion for investigators; nevertheless, the actual impact regarding COVID-19 on the public and subsequent attitudes of different groups towards the COVID-19 epidemic were neglected., Methods: This study aimed to examine the public web-based search trends and behavior patterns related to COVID-19 outbreaks in mainland China by using hot words and Baidu Index (BI). The initial hot words (the high-frequency words on the Internet) and the epidemic data (2019/12/01-2021/11/30) were mined from infodemiology platforms. The final hot words table was established by two-rounds of hot words screening and double-level hot words classification. Temporal distribution and demographic portraits of COVID-19 were queried by search trends service supplied from BI to perform the correlation analysis. Further, we used the parameter estimation to quantitatively forecast the geographical distribution of COVID-19 in the future., Results: The final English-Chinese bilingual table was established including six domains and 32 subordinate hot words. According to the temporal distribution of domains and subordinate hot words in 2020 and 2021, the peaks of searching subordinate hot words and COVID-19 outbreak periods had significant temporal correlation and the subordinate hot words in COVID-19 Related and Territory domains were reliable for COVID-19 surveillance. Gender distribution results showed that Territory domain (the male proportion: 67.69%; standard deviation (SD): 5.88%) and Symptoms/Symptom and Public Health (the female proportion: 57.95%, 56.61%; SD: 0, 9.06%) domains were searched more by male and female groups respectively. The results of age distribution of hot words showed that people aged 20-50 (middle-aged people) had a higher online search intensity, and the group of 20-29, 30-39 years old focused more on Media and Symptoms/Symptom (proportion: 45.43%, 51.66%; SD: 15.37%, 16.59%) domains respectively. Finally, based on frequency rankings of searching hot words and confirmed cases in Mainland China, the epidemic situation of provinces and Chinese administrative divisions were divided into 5 levels of early-warning regions. Central, East and South China regions would be impacted again by the COVID-19 in the future., Competing Interests: The authors declare there are no competing interests., (©2022 Jiang et al.)

Upgrading economic structures and producing less pollution-intensive goods are indispensable for achieving Sustainable Development Goals (SDGs) in BRICS (Brazil, Russia, India, China, and South Africa) that produce 41% of global CO 2 emissions. Economic complexity (ECC), which measures the sophistication of productivity and economic structure, has important environmental repercussions. Theoretically, the environmental impacts of economic complexity at higher levels and lower levels of complexity vary from each other. However, the majority of previous studies have overlooked these theoretical underpinnings while assessing the environmental repercussions of economic complexity. In addition, technological competencies are necessary to boost the economic complexity levels. Accordingly, this study uncovers the non-linear effects of economic complexity on CO 2 emissions including technology, population density, and economic growth in a STIRPAT model. To this end, the panel data from 1992 to 2018 is analyzed using the Continuously Updated Fully Modified method (CuP-FM) in the context of BRICS. The long-run results uncovered that CO 2 emissions intensify at a lower level of economic complexity. On the flip side, a higher level of economic complexity is beneficial in mitigating CO 2 in BRICS. Hence, the economic complexity and CO 2 connections follow an inverted U-shaped curve. The results also disclosed that expanding the level of technology lessens CO 2 and stimulates the quality of the environment. Further, population density and economic growth are evidenced to intensify CO 2 . Moreover, economic complexity and technology Granger cause CO 2 . Lastly, strategies are directed in the context of Sustainable Development Goals 9 and 13 to control CO 2 emissions by upgrading technology and products complexity., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Per-and polyfluoroalkyl substances (PFASs) are manmade chemicals that have wide industrial and commercial application. However, little research has been carried out on PFASs pollution in groundwater from a previously contaminated site. Here, we investigated 43 PFASs in a monitoring campaign from two different aquifers in the North China Plain. Our results revealed that total PFASs concentrations (∑ 43 PFASs) ranged from 0.22 to 3,776.76 ng/L, with no spatial or compositional differences. Moreover, perfluorooctanoic acid (PFOA) and perfluoroheptane sulfonate (PFHpS) were the dominant pollutants with mean concentrations of 177.33 ng/L and 51 ng/L, respectively. ∑ 43 PFAS decreased with well depth due to the adsorption of PFASs to the aquifer materials. Water temperature, total organic carbon, dissolved oxygen, and total phosphorus concentrations were correlated to the PFAS concentrations. Principal component analysis indicated that the main sources of PFASs in groundwater were untreated industrial discharge, untreated domestic wastewater, food packaging, aqueous film forming foams and metal plating, and surface runoff, which overlapped with the industries that previously existed in a nearby city. Human health risks from drinking contaminated groundwater were low to the local residents, with children aged 1-2 years being the most sensitive group. One specific site with a high PFOA concentration was of concern, as it was several orders higher than the 70 ng/L recommended by US Environmental Protection Agency health advisory. This study provided baseline data for PFASs in a previously-contaminated site, which will help in the development of effective strategies for controlling PFASs pollution in the North China Plain., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Microplastic (MP) pollution is ubiquitous in the terrestrial and marine environments, even in the air. However, ecological risk assessment studies of microplastics are scarce. In the present study, an ecological risk assessment model was built to evaluate the risks of microplastics in the Yangtze River Estuary and adjacent marine areas. A basic index database of the impacts of MP pollution on the ecosystem was constructed around three types of indices, namely, the pressure, status, and response indices. While the expert scoring method was used to determine the weights of these indices, in view of the complexity of the ecosystem in the Yangtze River Estuary, the fuzzy comprehensive evaluation method was used to evaluate its ecological risk. According to the model, microplastic pollution in the Yangtze River Estuary and adjacent marine areas was within a lower risk state, indicating that its risks for the marine ecosystem were still within a controllable range., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Blastocystis sp. is a common anaerobic protist with controversial pathogenicity that can infect various animals and humans. However, there are no reports of Blastocystis sp. infections in forest musk deer (Moschus berezovskii). The present study was designed to examine the occurrence, subtype distribution and genetic characterization of Blastocystis sp. in forest musk deer in southwestern China, and to assess the potential for zoonotic transmission. A total of 504 fresh stool samples were collected from captive forest musk deer in four distinct areas of southwestern China. Overall, 14.7% of the forest musk deer (74/504) were found to be infected with Blastocystis sp. The highest occurrence of Blastocystis sp. was observed in Dujiangyan (27.5%), followed by Maerkang (23.3%). The occurrence of Blastocystis sp. was 7.9% and 4.1% in Shimian and Hanyuan, respectively. Significant differences in the occurrence of Blastocystis sp. among different areas were observed (p < 0.05), while we did not observe significant differences among animals of different age and sex (p > 0.05). Two known zoonotic subtypes (ST1 and ST5) and three animal-predominant subtypes (ST10, ST13, and ST14) were identified, of which ST10 was the most common (36/74, 48.6%). Our findings highlight that forest musk deer may be potential reservoirs of zoonotic human Blastocystis sp. infections., (© S. Chen et al., published by EDP Sciences, 2022.)

Microplastic pollution is widespread, affecting even the remotest places on Earth. However, observational data on microplastic deposition in deserts, which comprise 21% of the total land area, are relatively rare. The current study aims to address the knowledge gap in terms of microplastic distribution in Asian deserts. The Badain Jaran Desert in Central Asia is the second largest desert in China. We investigated microplastic distribution and deposition on dunes and lakes of this desert. Microplastics were extracted from surface sediments to determine their characteristics and polymer types by microscopic inspection and μ-FTIR. The abundance of microplastics (detection limit is approximately 40 μm) in the uninhabited area ranged from 0.7 ± 1.5 to 11.7 ± 15.5 items/kg, with an average of 6.0 ± 15.4 items/kg. Fragments and fibers accounted for 77% and 23% of the total microplastics, respectively. Epoxy resin (28%), polyethylene terephthalate (25%), phenoxy resin (25%), and polyamide (9%) were the main polymer components, whose sizes were concentrated at 50-200 μm. Back-trajectory modeling was then performed to explore the possible source direction of the microplastics. The results showed that the microplastics mainly originated from the populated areas southeast of the desert, indicating long-distance atmospheric transport and deposition in deserts. The desert-edge zone with some tourism activity contained more microplastics (8.2 ± 17.9 items/kg) than the non-tourism zone (0.9 ± 1.6 items/kg), indicating a potential contribution from tourism. The abundance in the non-tourism zone (0.9 items/kg) can be used as a reference for microplastic background values in the Central Asian deserts, as this value is critical for simulating and predicting global microplastic yields., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Microplastic (MP) pollution in marine environments and organisms has received substantial international attention. However, long-term field studies of MPs are scarce. Here, we assessed the seasonal variation in MP abundance in the Zhoushan fishing ground (ZFG), one of the most abundant and productive fishing grounds worldwide, and analyzed the long-term MP accumulation in fish gastrointestinal tracts from September 2017 to June 2018. The most common MP particles in the ZFG were polyethylene terephthalate and polypropylene. After four seasons of continuous monitoring, we did not find accumulation of MPs in the fish after 10% KOH digestion. In total, 254 MP particles were removed from the gastrointestinal tracts of all fish. The average number of particles per fish was lower than that reported in previous global marine studies. There were significant differences among species. Moreover, this study provides the calculation of the weight of MPs ingested by fish and an estimate of the load of accumulated MPs in fish. According to the estimation, the load of MPs ingested by fish annually was approximately 3 kg in ZFG. These findings provide the long-term evidence of MP contamination in biota from the ZFG. The amounts of MPs ingested by fish require more detailed and improved investigation and estimation in further studies., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives : The impact of COVID-19 pandemic on endovascular therapy (EVT) for acute ischemic stroke in China is unknown. This study was aimed to verify the volume change of EVT for acute ischemic stroke affected by COVID-19 and its potential factors. Methods: This cross-sectional study was conducted via an online questionnaire survey in China. The questionnaire was mainly composed of descriptive information, volume change of EVT for acute ischemic stroke, and the protection status of medical staff. Results: A total of 103 stroke physicians in 28 provinces across China completed the survey questionnaire. A volume decline in EVT for acute stroke occurred in 93 (90.3%) hospitals after lockdown (23 January 2020). Nearly half of the hospitals (51/103, 49.5%) experienced a volume decline of EVT case more than 50% and 14 (13.6%) hospitals completely ceased offering EVT. Hospitals with decline >50% of EVT case had higher proportion of hospitals with a designated area for COVID-19 screening in the emergency room (44/51, 86.3% vs 34/52, 65.4%, p = 0.01) and medical staff in quarantine (19/51, 37.3% vs 7/52, 13.5%, p < 0.01), with lower proportion of hospitals with personal protective equipment protocol (41/51, 80.4% vs 49/52, 94.2%, p = 0.03) than hospitals with decline ≤50%. Conclusions: The volume of EVT for acute ischemic stroke severely declined after lockdown in China. Designating a specific area for COVID-19 screening, insufficient personal protection and understaffing may exacerbate the volume decline of EVT.

Cryptosporidium spp. have been identified in a wide range of hosts, such as humans and domestic and wild animals, while less information about the prevalence of Cryptosporidium spp. in pet hamsters is documented. A total of 351 dwarf winter white Russian hamsters' fecal specimens were collected from 6 pet markets from the cities of Luzhou and Ziyang in Sichuan province in the southwestern part of China. The prevalence of Cryptosporidium spp. determined with nested-PCR amplification of the partial small-subunit (SSU) rRNA gene was 39.32% (138/351). The highest prevalence of Cryptosporidium spp. was in pet market 5 (79.49%, 62/78), followed by pet market 6 (38.64%, 17/44). The lowest prevalence of Cryptosporidium spp. was observed in pet market 3 (14.89%, 7/47). Statistically significant differences in the prevalence of Cryptosporidium spp. were observed among different pet markets (χ2 = 76.386, df = 5, P < 0.05), and a further post hoc test revealed that only pet market 5 was significantly different from other pet markets. Molecular analysis showed that 4 different Cryptosporidium species or genotypes were identified: Cryptosporidium parvum (n = 127), Cryptosporidium chipmunk genotype III (n = 6), Cryptosporidium andersoni (n = 4), and Cryptosporidium wrairi (n = 1). The identification of Cryptosporidium spp. was further tested with the 60-kDa glycoprotein (GP60) gene, and the positive rate was 29.7% (41/138). This is the first molecular report on Cryptosporidium spp. infection in dwarf winter white Russian hamsters in China. With C. parvum and C. andersoni being identified in both humans and pet hamsters, these findings suggest that pet hamsters may be potential reservoirs of zoonotic Cryptosporidium species and subtypes., (© American Society of Parasitologists 2021.)

Objective: To evaluate the long-term outcome and prognostic factors of patients with nasopharyngeal carcinoma (NPC) from low-endemic regions of China who received definitive intensity-modulated radiation therapy (IMRT)., Methods: The clinical data from 608 patients with newly-diagnosed non-metastatic NPC who have received initial treatment at our cancer center from January, 2008 to December, 2013 were retrospectively reviewed. All patients received definitive IMRT, and 87.7% received platinum-based chemotherapy., Results: The median follow-up duration was 51 months (follow-up rate, 98.5%; range, 10-106 months) for the entire cohort. The 5-year overall survival rate was 79.7%. The 5-year local relapse-free survival rate, regional relapse-free survival rate, distant metastasis-free survival rate and progression-free survival rate were 92.4%, 93.3%, 79.2% and 74.3%, respectively. A total of 153 patients had experienced treatment failure, with distant metastasis as the primary cause in 77.1% (118/153). Patients with T4 or N3 diseases had a significantly poorer prognosis than other subcategories. Stage T4 and N3 were closely associated with distant metastasis, with the metastatic rate of 29.3% and 45.5%, respectively., Conclusion: IMRT provides patients with non-metastatic NPC with satisfactory long-term survival. Both T stage and N stage are important prognostic factors for NPC patients. Patients with T4 or N3 diseases have significantly increased distant metastatic rates and poor survival time., (© 2021. Huazhong University of Science and Technology.)

Giardia duodenalis is a common protozoan parasite that can infect humans and animals. Although previous studies demonstrated that the assemblage E of G. duodenalis is prevalent in cattle, studies on its genetic diversity were mostly based on single loci and very few involved multilocus analysis. To better understand the genetic variability and structure of G. duodenalis assemblage E in Chinese dairy cattle, 651 multilocus sequences derived from nine provinces (Gansu, Guangdong, Henan, Jiangsu, Ningxia, Shaanxi, Shanghai, Sichuan and Xinjiang) of China were analyzed in this study. Results showed that a total of 220 haplotypes were identified in the G. duodenalis assemblage E, with a high haplotype diversity (Hd = 0.97225) and low nucleotide diversity (π = 0.00259). The genetic differentiation index (FST) and gene flow (Nm) results indicated low degree of genetic differentiation, implying frequent genetic communication. Combined with the analysis of molecular variance (AMOVA), genetic variation within populations (81.7%) was higher than that among populations (18.3%), indicating low degree of genetic differentiation between populations. Such low rates of gene differentiation supported no significant correlations with geographical divisions. Moreover, both negative Tajima's D and Fu's FS values of neutrality tests and unimodal curve of mismatch distribution analyses indicated that G. duodenalis assemblage E population in Chinese dairy cattle had experienced demographic expansion. Overall, these findings contribute to an improved understanding of the population genetics and evolutionary biology of G. duodenalis assemblage E and assist in its control in cattle., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Setaria italica is the second-most widely planted species of millets in the world and an important model grain crop for the research of C4 photosynthesis and abiotic stress tolerance. Through three genomes assembly and annotation efforts, all genomes were based on next generation sequencing technology, which limited the genome continuity., Results: Here we report a high-quality whole-genome of new cultivar Huagu11, using single-molecule real-time sequencing and High-throughput chromosome conformation capture (Hi-C) mapping technologies. The total assembly size of the Huagu11 genome was 408.37 Mb with a scaffold N50 size of 45.89 Mb. Compared with the other three reported millet genomes based on the next generation sequencing technology, the Huagu11 genome had the highest genomic continuity. Intraspecies comparison showed about 94.97 and 94.66% of the Yugu1 and Huagu11 genomes, respectively, were able to be aligned as one-to-one blocks with four chromosome inversion. The Huagu11 genome contained approximately 19.43 Mb Presence/absence Variation (PAV) with 627 protein-coding transcripts, while Yugu1 genomes had 20.53 Mb PAV sequences encoding 737 proteins. Overall, 969,596 Single-nucleotide polymorphism (SNPs) and 156,282 insertion-deletion (InDels) were identified between these two genomes. The genome comparison between Huagu11 and Yugu1 should reflect the genetic identity and variation between the cultivars of foxtail millet to a certain extent. The Ser-626-Aln substitution in acetohydroxy acid synthase (AHAS) was found to be relative to the imazethapyr tolerance in Huagu11., Conclusions: A new improved high-quality reference genome sequence of Setaria italica was assembled, and intraspecies genome comparison determined the genetic identity and variation between the cultivars of foxtail millet. Based on the genome sequence, it was inferred that the Ser-626-Aln substitution in AHAS was responsible for the imazethapyr tolerance in Huagu11. The new improved reference genome of Setaria italica will promote the genic and genomic studies of this species and be beneficial for cultivar improvement.

Background: To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources., Methods: 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses., Results: Eight factors, namely, O xygen saturation, blood U rea nitrogen, R espiratory rate, admission before the date the national M aximum number of daily new cases was reached, A ge, P rocalcitonin, C -reactive protein (CRP), and absolute N eutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p  < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts., Conclusions: The OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.

Background and Purpose: The benefit of endovascular treatment (EVT) for large vessel occlusion in clinical practice in developing countries like China needs to be confirmed. The aim of the study was to determine whether the benefit of EVT for acute ischemic stroke in randomized trials could be generalized to clinical practice in Chinese population., Methods: We conducted a prospective registry of EVT at 111 centers in China. Patients with acute ischemic stroke caused by imaging-confirmed intracranial large vessel occlusion and receiving EVT were included. The primary outcome was functional independence at 90 days defined as a modified Rankin Scale score of 0 to 2. Outcomes of specific subgroups in the anterior circulation were reported and logistic regression was performed to predict the primary outcome., Results: Among the 1793 enrolled patients, 1396 (77.9%) had anterior circulation large vessel occlusion (median age, 66 [56-73] years) and 397 (22.1%) had posterior circulation large vessel occlusion (median age, 64 [55-72] years). Functional independence at 90 days was reached in 45% and 44% in anterior and posterior circulation groups, respectively. For anterior circulation population, underlying intracranial atherosclerotic disease was identified in 29% of patients, with higher functional independence at 90 days (52% versus 44%; P =0.0122) than patients without intracranial atherosclerotic disease. In the anterior circulation population, after adjusting for baseline characteristics, procedure details, and early outcomes, the independent predictors for functional independence at 90 days were age <66 years (odds ratio [OR], 1.733 [95% CI, 1.213-2.476]), time from onset to puncture >6 hours (OR, 1.536 [95% CI, 1.065-2.216]), local anesthesia (OR, 2.194 [95% CI, 1.325-3.633]), final modified Thrombolysis in Cerebral Infarction 2b/3 (OR, 2.052 [95% CI, 1.085-3.878]), puncture-to-reperfusion time ≤1.5 hours (OR, 1.628 [95% CI, 1.098-2.413]), and National Institutes of Health Stroke Scale score 24 hours after the procedure <11 (OR, 9.126 [95% CI, 6.222-13.385])., Conclusions: Despite distinct characteristics in the Chinese population, favorable outcome of EVT can be achieved in clinical practice in China. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03370939.

Background: New therapies are urgently needed for Alzheimer's disease (AD). Sodium oligomannate (GV-971) is a marine-derived oligosaccharide with a novel proposed mechanism of action. The first phase 3 clinical trial of GV-971 has been completed in China., Methods: We conducted a phase 3, double-blind, placebo-controlled trial in participants with mild-to-moderate AD to assess GV-971 efficacy and safety. Participants were randomized to placebo or GV-971 (900 mg) for 36 weeks. The primary outcome was the drug-placebo difference in change from baseline on the 12-item cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog12). Secondary endpoints were drug-placebo differences on the Clinician's Interview-Based Impression of Change with caregiver input (CIBIC+), Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale, and Neuropsychiatric Inventory (NPI). Safety and tolerability were monitored., Results: A total of 818 participants were randomized: 408 to GV-971 and 410 to placebo. A significant drug-placebo difference on the ADAS-Cog12 favoring GV-971 was present at each measurement time point, measurable at the week 4 visit and continuing throughout the trial. The difference between the groups in change from baseline was - 2.15 points (95% confidence interval, - 3.07 to - 1.23; p < 0.0001; effect size 0.531) after 36 weeks of treatment. Treatment-emergent adverse event incidence was comparable between active treatment and placebo (73.9%, 75.4%). Two deaths determined to be unrelated to drug effects occurred in the GV-971 group., Conclusions: GV-971 demonstrated significant efficacy in improving cognition with sustained improvement across all observation periods of a 36-week trial. GV-971 was safe and well-tolerated., Trial Registration: ClinicalTrials.gov, NCT0229391 5. Registered on November 19, 2014.

Background: Parkinson's disease (PD) is the second most common neurodegenerative disease worldwide. Genetic factors play important roles in PD risk. rs653765 and rs514049 of ADAM10 were reported to be associated with Alzheimer's disease (AD) in Caucasian population; however, the association of the two variants with PD in Chinese Han population remains unknown. The present investigation aimed to explore the possible association of ADAM10 variants with PD in Chinese Han population., Methods: We enrolled 565 PD patients and 518 healthy controls to conduct a case-control study. DNA samples were extracted from peripheral blood leukocytes, and the genotypes were determined by utilization of MassARRAY platform. Plasma levels were measured by enzyme-linked immunosorbent assay (ELISA)., Results: We found CC genotype of rs514049 was associated with an increased risk of PD (OR (95% CI) = 3.776 (1.127-11.217), p = 0.018). The C allele frequency of rs514049 was significantly higher in PD group (OR (95% CI) = 1.328 (1.031-1.709), p = 0.028), especially in male subgroup (OR (95% CI) = 1.484 (1.053-2.092), p = 0.024). However, there was no significant difference in the genotype or allele frequencies for rs653765 within the groups. Plasma levels were significantly decreased in PD patients compared with controls (p < 0.001)., Conclusions: Our data suggested that C allele of rs514049 in ADAM10 may increase the risk of PD in Chinese Han population, especially in males. The decreased plasma levels are probably involved in PD development., (© 2021 John Wiley & Sons, Ltd.)

Cryptosporidium species are the causative agent of cryptosporidiosis and common intracellular parasites that can infect a wide range of vertebrates, including snakes. In previous studies, Cryptosporidium species infections have been reported in snakes in Asia, Europe, and North America. However, limited information is available about the prevalence and molecular characterization of Cryptosporidium in captive snakes in China. Fecal specimens from 609 captive snakes were collected from Beijing (n = 227), Chengdu (n = 12), Dazhou (n = 359), and Ziyang (n = 11). The partial small-subunit (SSU) rRNA gene was amplified by nested polymerase chain reaction to determine the prevalence of Cryptosporidium, and a phylogenetic tree was constructed to assess evolutionary relationships and genetic characteristics. The overall prevalence of Cryptosporidium was 1.97% (12/609). BLAST and phylogenetic analysis of the small subunit ribosomal RNA (SSU rRNA) gene showed that the parasites belonged to Cryptosporidium serpentis. To the best of our knowledge, this is the first study to report the prevalence of Cryptosporidium in snakes of southwestern and northern China and provides preliminary data for the control and prevention of cryptosporidiosis in the investigated areas., (© American Society of Parasitologists 2021.)

Background: Laterally spreading tumor (LST) is a type of precancerous lesion of colorectal cancer with high malignant potential. The present study aimed to evaluate long-term outcomes of endoscopic treatment for LST in Chinese patients., Methods: This study was a retrospective review of data collected from 653 included patients with LST from six regional representative hospitals in China between January 2007 and January 2017. Demographic characteristics, endoscopic features of LST, operation-related data, and follow-up results were collected and analyzed., Results: LST-granular type (LST-G, 80.3%) was much more common than LST-non-grandular type (LST-NG, 19.7%). The overall submucosal invasion rate of all LSTs was 6.1% and the submucosal invasion rate of LST-NG was significantly higher than that of LST-G (6.79% vs. 3.87%, p = 0.000). The en bloc resection rate of ESD and EMR treatment was 96% and 93.7%, respectively, with pathologic R0 resection rate of 90.1% and 82.8%. After an average duration of follow-up about 34.52 ± 11.76 months, the recurrence rate of ESD was 3.47%, and the recurrence rate of EMR was 8.8% after an average follow-up of about 38.44 ± 4.42 months. However, the recurrence rate of ESD was much lower than piecemeal EMR for LST (3.47% vs. 8.62%, p = 0.017). Retroflexion-assisted technique applied for resection of rectal LST was associated with a significantly shortened operating time (85.40 min vs. 174.18 min, p = 0.002)., Conclusion: Endoscopic resection is a safe and efficient modality for the treatment of colorectal LST with a relatively low recurrence rate and shortened operating time with the use of retroflexion.

Background: Patients with head and neck cancer (HNC) who are receiving radiotherapy commonly face detrimental complications, including oral issues. However, oral symptoms are not well understood given the lack of available specific assessment instruments. The Vanderbilt Head and Neck Symptom Survey version (VHNSS) 2.0 is an instrument specifically developed to identify oral symptoms in HNC patients receiving radiotherapy in the United States., Objective: To perform the translation and cross-cultural adaptation of the original English version of VHNSS 2.0 into a Chinese version (Mainland China)., Methods: The translation and cultural adaptation process involved translation by independent translators, construction of a consensus version, back translation into the original English version, analysis by the expert committee and a pretest. The pretest was administered to 90 patients with HNC to assess the feasibility and practicality of the tool., Results: The final Chinese version approved by the expert committee was well understood by all participants in the study. The instrument had satisfactory content validity, with indexes of 0.83 for semantic and idiomatic equivalence, 0.90 for cultural equivalence, and 0.91 for conceptual equivalence. Furthermore, this version had good internal consistency, with Cronbach's alpha coefficients ranging from 0.74 to 0.95., Conclusion: The Chinese version of VHNSS 2.0 was translated and cross-culturally adapted for use in China. This translation is a feasible instrument to assess oral health-related quality of life in HNC patients undergoing radiotherapy and will be useful for symptom management by clinicians and researchers in China.

Background: Blastocystis sp. is an anaerobic protozoan that parasitizes many animal hosts and the human gastrointestinal tract, and its pathogenicity is controversial. Captive wildlife may be potential reservoirs for human infection with Blastocystis sp. The present study was performed to investigate the prevalence and subtype distribution of Blastocystis sp. in zoo animals in Sichuan Province, southwestern China., Methods: A total of 420 fresh fecal samples were collected from 54 captive wildlife species in four zoos in southwestern China between June 2017 and September 2019. The prevalence and subtype (ST) genetic characteristics of Blastocystis sp. were determined by PCR amplification of the barcode region of the SSU rRNA gene and phylogenetic analysis., Results: Overall, 15.7% (66/420) of the animal samples and 20.7% (14/54) of the species tested were shown to be infected with Blastocystis sp. The highest prevalence of Blastocystis sp. was found in Panzhihua Zoo (24.3%), which was significantly higher than that in Chengdu Zoo (6.9%), and Xichang Zoo (2.9%) (P < 0.05). There are also significant differences in the prevalence of Blastocystis sp. among different species (P < 0.05), and the highest of Blastocystis sp. prevalence was observed in white-cheeked gibbon, black great squirrel, and red giant flying squirrel (100%). Subtype analysis of Blastocystis sp. revealed nine subtypes, including six zoonotic STs (ST1-5, and ST8) and three animal-specific STs (ST10, ST14, and ST17), with ST17 as the predominant subtype (26/66) in Blastocystis sp.-positive isolates., Conclusions: To our knowledge, this is the first report on the prevalence and subtype distribution of Blastocystis sp. among captive wildlife in zoos in southwestern China. This study highlights that these animals may serve as reservoirs for human Blastocystis sp. infections.

Enterocytozoon bieneusi is a common intracellular parasite that infects a wide range of hosts, including humans and companion animals, raising concerns of zoonotic transmission. However, there is limited epidemiological information on the prevalence and genotypes of E. bieneusi in sheltered dogs and cats in Sichuan province, southwestern China. A total of 880 fecal samples were collected from shelters in different cities of Sichuan province, including 724 samples from dogs, and 156 samples from cats. Enterocytozoon bieneusi was determined by sequence analysis of the ribosomal internal transcribed spacer (ITS). Overall, the prevalence of E. bieneusi was 18% (158/880), and the parasite was detected in 18.8% (136/724) and 14.1% (22/156) of the dogs and cats examined, respectively. Sequence analysis revealed the presence of five genotypes in dogs, including three known genotypes CD9 (n = 92), PtEb IX (n = 41), and Type IV (n = 1), and two novel genotypes SCD-1 (n = 1) and SCD-2 (n = 1). Similarly, four genotypes were identified in cats, including CD9 (n = 11), Type IV (n = 6), D (n = 4), and PtEb IX (n = 1). Genotypes D and Type IV have previously been identified in humans and are reported in sheltered dogs and cats in the present study, indicating that these animals could be as potential sources of human microsporidiosis infections., (© Y. Zhong et al., published by EDP Sciences, 2021.)

Blastocystis is a prevalent eukaryotic parasite that has been identified in a wide range of hosts. Several species are considered potential sources of Blastocystis infection in humans, but little is known about the prevalence of Blastocystis in wild animals. In this study, the prevalence and subtypes of Blastocystis were investigated to assess the zoonotic potential of wild animals in Sichuan Wolong National Natural Reserve. A total of 300 fecal samples were collected from 27 wildlife species in three areas of the Reserve. The subtype (ST), genetic characteristics, and prevalence of Blastocystis were determined by PCR amplification of part (~600 bp) of the SSU rRNA gene. Thirty fecal samples (10.0%) were Blastocystis-positive. The highest prevalence of Blastocystis was found in Yinchanggou (18.3%), with significantly less found in Niutoushan (7.5%) and Genda (5.5%) (p < 0.05). No significant differences were associated with different orders of animals in prevalence, which may be because of the small number of positive samples obtained. Sequence analysis showed five subtypes (ST1, ST3, ST5, ST13, and ST14), with ST13 and ST14 being predominant (33% each), followed by ST1 (20%). This is the first molecular investigation of Blastocystis infection in the wild animals of southwestern China. Subtypes ST1, ST3, ST5, and ST14 have previously been identified in humans, suggesting that wild animals may be potential reservoirs of Blastocystis for humans., (© S. Chen et al., published by EDP Sciences, 2021.)

The pathophysiology underlying spiral ganglion cell defect-induced deafness remains elusive. Using the whole exome sequencing approach, in combination with functional assays and a mouse disease model, we identified the potentially novel deafness-causative MAP1B gene encoding a highly conserved microtubule-associated protein. Three novel heterozygous MAP1B mutations (c.4198A>G, p.1400S>G; c.2768T>C, p.923I>T; c.5512T>C, p.1838F>L) were cosegregated with autosomal dominant inheritance of nonsyndromic sensorineural hearing loss in 3 unrelated Chinese families. Here, we show that MAP1B is highly expressed in the spiral ganglion neurons in the mouse cochlea. Using otic sensory neuron-like cells, generated by pluripotent stem cells from patients carrying the MAP1B mutation and control subject, we demonstrated that the p.1400S>G mutation caused the reduced levels and deficient phosphorylation of MAP1B, which are involved in the microtubule stability and dynamics. Strikingly, otic sensory neuron-like cells exhibited disturbed dynamics of microtubules, axonal elongation, and defects in electrophysiological properties. Dysfunctions of these derived otic sensory neuron-like cells were rescued by genetically correcting MAP1B mutation using CRISPR/Cas9 technology. Involvement of MAP1B in hearing was confirmed by audiometric evaluation of Map1b heterozygous KO mice. These mutant mice displayed late-onset progressive sensorineural hearing loss that was more pronounced in the high frequencies. The spiral ganglion neurons isolated from Map1b mutant mice exhibited the deficient phosphorylation and disturbed dynamics of microtubules. Map1b deficiency yielded defects in the morphology and electrophysiology of spiral ganglion neurons, but it did not affect the morphologies of cochlea in mice. Therefore, our data demonstrate that dysfunctions of spiral ganglion neurons induced by MAP1B deficiency caused hearing loss.

Objective: To investigate the prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City., Methods: A cross-sectional questionnaire survey was conducted among AIDS patients in Nanchang City during the period between May and September, 2016. B. hominis infection was detected in patients'stool samples using a PCR assay, and the CD4 + T cell count was measured in subjects'blood samples. In addition, the risk factors of B. hominis infection in AIDS patients were identified using univariate and multivariate logistic regression analyses., Results: A survey was conducted in Nanchang City from May to September 2016. A total of 505 AIDS patients were investigated, and the prevalence of B. hominis infection was 4.16%. Univariate analysis revealed that B. hominis infection correlated with the occupation ( χ 2 = 8.595, P = 0.049), education level ( χ 2 = 14.494, P = 0.001), type of daily drinking water ( χ 2 = 10.750, P = 0.020), root of HIV infections ( χ 2 = 8.755, P = 0.026) and receiving anti-HIV therapy ( χ 2 = 23.083, P = 0.001) among AIDS patients, and multivariate logistic regression analysis identified daily direct drinking of tap water as a risk factor of B. hominis infections [odds ratio ( OR ) = 7.988, 95% confidential interval ( CI ): (1.160, 55.004)] and anti-HIV therapy as a protective factor of B. hominis infection [ OR = 0.183, 95% CI : (0.049, 0.685)]., Conclusions: The prevalence of B. hominis is 4.16% among AIDS patients in Nanchang City. Daily direct drinking of tap water is a risk factor, and anti-HIV therapy is a protective factor of B. hominis infection among AIDS patients living in Nanchang City.